Extend current provider networks to effectively meet the needs of members who require specialty areas of care
The price tag to treat certain conditions can be staggering. A relatively small number of medical conditions account for a disproportionate share of treatment spend. Health plans’ traditional networks are not equipped to provide care to people with this type of specialized need. At Optum, we build integrated systems of care focused on specialty areas that complement existing networks and medical programs.
Our networks are comprised of high-quality, clinically superior centers of excellence. Optum invests more resources than any organization in the country to identify and qualify the programs that deliver superior outcomes. As a result, Optum can help:
- Drive consistent quality outcomes
- Achieve reductions in overall spend
- Ensure regulatory compliance
5min on Specialized Care Management
A new compact for behavioral health care: improving outcomes with advanced provider performance ratings
A new compact for care: improving behavioral health outcomes with advanced provider performance ratings
Controlling Cost and Quality Through Specialized Care
Health Reform WP 1920 HCR Overview
Solutions for Medicare Advantage Transplant Challenges
Kidney Resource Solutions
Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are common and costly conditions affecting millions of Americans. Available to both commercial and Medicare Advantage populations, the comprehensive kidney solution from Optum™ helps health plans address this health concern with proven clinical and economic outcomes.
Musculoskeletal conditions, including neck and back pain, make up the largest portion of medical expenses for health plans.1 Spine care for neck and back pain accounts for 40 percent of estimated annual total orthopedic costs in the United States,1 adding up to $849 billion.2 Our analysis shows that more than 75 percent of spine care expense is associated with surgery, imaging, prescriptions, injections, evaluations and emergency room visits.1
Complementary and Alternative Medicine Network
An increasingly popular treatment option in the United States, complementary and alternative medicine (CAM) seeks to relieve symptoms or treat illnesses through noninvasive and non-pharmaceutical techniques. These treatments and therapies focus on stimulating the body’s ability to heal itself through nutrition, mind-body practices, exercise and lifestyle counseling. Access to these services can be an important—and valued—part of your benefits package.
Transplant costs can be unpredictable for health plans. With more than 123,000 Americans on waiting lists for lifesaving organ transplants as of 2015, the need is high.1 So is the cost. The average billed cost for a transplant episode in 2014 was almost $600,000, but depending on the circumstances, it can rise to $1 million or more.2
Infertility Maternity and Neonatal Programs
Physical Occupational and Speech Therapy Network
We know it’s important to identify quality physical, occupational and speech therapy providers who deliver consistent results at reasonable costs. Optum™ helps your members make the most of their therapeutic experience through a credentialed network of therapists providing high-quality, cost-effective treatment informed by current clinical evidence.