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​​UPMC Focused Care: A Team Approach Toward Better Health

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Coordinated Care That’s Always There

Welcome to UPMC Focused Care, a new Medicare program. Are you a Medicare recipient with two or more chronic conditions? The UPMC Focused Care program can help your primary care team take better care of you. This program was designed for Medicare recipients who have two or more chronic conditions. We are here to help coordinate and manage your appointments, specialists, medicines, and more. We want you to know that you can reach out to your care team when you have a question or a concern.

Benefits of the Program

Coordinated Care Services Can Improve Your Health

Medicare patients with 2 or more chronic medical conditions are at greater risk of having their health become worse over time. The UPMC Focused Care program, a Medicare program, reflects our commitment to give you the best care experience possible. This program offers a comprehensive plan, with you at the center. After enrolling in the program, your care team (i.e. primary care doctor, nurse, diabetes educator, wellness guide, social worker, etc.) will spend at least 20 minutes each month coordinating your care over the phone. We’ll coordinate your providers, check on your health, help you manage all your medicines, and refer you to specialists as needed — and you’ll have access to care management services.

Low Cost

If you have visited your primary care doctor (PCP) in the last 12 months, you are able to sign up for UPMC Focused Care over the phone. Call your PCP’s office to request to join the program. If you have not been seen by your PCP in the last 12 months, you will need to schedule an appointment with your PCP in order to be enrolled into the program. Although Medicare covers the program, you may have a small monthly copay if you do not have a supplemental, Medigap, or secondary insurance plan. Please talk to your insurance company about coverage before enrolling in the program.

If your supplemental insurance company does not cover the copay associated with this service, you will be responsible for the balance. Please note, you will only be charged for this service during months when your care team spends at least 20 minutes coordinating your care.

Care Without Leaving Home

Your care team, including a dedicated nurse, will be in regular contact with you by phone or messaging via our patient portal, MyUPMC. Your individualized health plan will be monitored and revised once a year, or sooner if needed. Your care team will provide ongoing care coordination to help you meet your personal health goals.

We combine the power of the best caregivers, most advanced research, and state-of-the-art technologies, and make sure our patients know they are heard, understood, and valued.

Some of the chronic conditions that are eligible for UPMC Focused Care are listed below. If you believe you have two or more chronic conditions (even if they are not listed below), please ask your PCP.

  • Alzheimer’s Disease and Related Disorders
  • Asthma
  • Atrial Fibrillation
  • Benign Prostatic Hyperplasia
  • Chronic Kidney Disease
  • Chronic Obstructive Pulmonary Disease
  • Coronary Artery Disease
  • Depression
  • Diabetes
  • Heart Attack
  • Heart Failure
  • Hip/Pelvic Fracture
  • Hypertension
  • Osteoporosis
  • Rheumatoid Arthritis/Osteoarthritis
  • Stroke/Mini Stroke

Your care team will help create a tailored health plan for your needs and will provide ongoing care coordination throughout your health journey.

To learn more about UPMC Focused Care or to schedule an appointment, please call your PCP.