Using recognized standards for care.

National guidelines for quality health care.

UnitedHealth Premium designations are awarded to physicians who meet specific standards for quality care. The quality criteria come from evidence-based medicine standards and national guidelines published by clinical societies, and input from leading physicians practicing in specialty areas.

We start by evaluating claims data to understand doctors’ treatment histories, then compare them to national guidelines. Those who meet these guidelines receive one star.

Local benchmarks for cost-efficiency.

Physicians that meet the quality criteria are then analyzed for cost-efficiency. Cost-efficiency criteria are based on patient care provided over an entire procedural episode of care, including use of diagnostic testing, the procedure itself and follow-up care. Total treatment costs are compared to market standards.

Click here for a complete description of how we evaluate and measure quality.