Acquisition and retention
Gain powerful insights that enable innovation in a rapidly changing landscape.
Increasing demand for individual health coverage, the introduction of health benefit exchanges, and Affordable Care Act (ACA) regulations have created new challenges in health care. It’s more important than ever to align business practices with the needs of consumers.
Optum® makes sure health plans are ready. With proven methodologies, customizable tools and experienced professionals who have a deep understanding of the health care market, we provide insights in the following areas:
- Analysis and evaluation of new business opportunities
- Modeling and impact of expected population shifts
- Implications of new regulations and deadlines
Optum assists in effectively targeting, acquiring, retaining and maximizing the right customer relationships through integrated technology platforms, services and consulting solutions.
Health plans of all sizes will need to adjust to remain competitive in this changing landscape. The ACA law included program expansions, rating reforms, new subsidies and penalties that have created unprecedented shifts in coverage sources. Payers will seek the lowest prices in their targeted growth markets, bringing about fierce competition. Traditional product development and distribution channel strategies are no longer enough. To ensure profitable growth and retention, businesses must align all internal capabilities to engage targeted consumers, manage their health and drive efficiencies.
Direct-to-consumer marketing strategy requires rapid positioning and realignment for payers to succeed both on and off state exchanges and in the private market. New competitors are entering the market (ACOs, CO-OPs, Traditional Medicaid plans) and some have competitive advantages; new alliances and joint ventures are forming to excel in direct-to-consumer capabilities.
Over 50 versions of exchange requirements will challenge health plans to develop scalable solutions. Optum can help plans deliver profitable ROI. We help ensure that off-exchange business models still maintain growth, deliver optimal service and maintain a close eye on the medical loss ratio (MLR) and administrative costs.
Optum drives health plan growth through innovative strategies and analytics. This means stronger consumer engagement, improved processes for designing products, and better methodologies for rating and pricing — all to help your health plan stand out in a competitive market.
Financial and risk management services
Optum financial and risk management solutions help plans automate standard, manual processes, manage forecasting, analyze trends, and reduce costs while driving profitable growth. With the right rating and underwriting tools, data analytics and consulting, health plans can improve risk management and accelerate speed to market.
Product and distribution services
Enhanced distribution and product management capabilities are needed for health plans to effectively navigate new membership growth opportunities. Optum product and distribution solutions help plans to assess and execute on exchange strategies, manage distribution channels to drive acquisition efficiency, and manage product portfolios to support expanded product strategies.