UHealthSolutions celebrates 15 years of serving Medicare and Medicaid populations, health plans

May 03, 2016

In the 15 years since its inception, UHealthSolutions, the nonprofit business affiliate of UMass Medical School, has grown from managing the Massachusetts pharmaceutical assistance program to delivering high-performance, customized health care solutions to a variety of clients nationwide.

UHealthSolutions, known as Public Sector Partners until 2011, was launched in 2001 when it assumed responsibility for all of the operational components of the Massachusetts state pharmaceutical assistance program, Prescription Advantage. Today it provides business process outsourcing, contact center resources, consulting services and Star Rating Enhancement to health plans – customized solutions for health care organizations and the populations they serve.

“It’s exciting to reach this milestone,” said Jeff Auger, director at UHealthSolutions. “I expect UHealthSolutions to continue to grow incrementally, year by year.”

In recent years, UHealthSolutions has developed expertise in helping people access benefits and services, focusing on its extensive call center resources.

“We’re pretty well-positioned to grow our call center business,” Auger said. “It’s been good for us to be able to concentrate our focus over the last couple of years.”

UHealthSolutions works closely with Clinical Pharmacy Services, a unit within UMass Medical School’s Commonwealth Medicine division. The two teams developed a Star Rating Enhancement services package to help health plans increase their Medicare Star Rating and save money through medication adherence, member and prescriber outreach, and data management and analytics.

In November, UHealthSolutions launched a referral service through its call center for MassOptions, a new, free state service aimed at connecting the elderly, individuals with disabilities and their caregivers with long-term services and supports (LTSS).

UHealthSolutions’ member outreach initiatives have been successful because the organization uses data to show the days and times when it has the most success reaching people.

In fiscal 2015, UHealthSolutions handled more than 630,000 inbound and outbound calls, and more than 100,000 pieces of mail correspondence.

UHealthSolutions does work with Prescription Advantage, the Massachusetts State Supplement Program, a Rhode Island-based health plan, MassOptions, US-Rx Care, UDiscovering, the Federal Bureau of Prisons in Butner, North Carolina, Medicare Appeals BSA, and New England Consortium Systems Organization (NESCO).

Auger began with the organization 14 years ago as a billing analyst and worked his way up to director of UHealthSolutions.

The organization has 140 employees. At its 15th anniversary celebration in April, employees were honored for five, 10 and 15 years of service:

  • 15 years: Natty Algarin, Marilyn Carrion, Sybil Mielnicki, Lila Ortiz and Chana Thibodo.
  • 10 years: Linda Aggas, Theresa Burke, Karla Busky, Sarah Harbeh, Paula Lehner, Larissa Proctor and Eva Tollkuci.
  • 5 years: John “Jay” Shea and Morsen Steele.

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