Improve medical and financial performance.
As providers transform into fee-for-value models, they are being forced to think more like traditional health plans, looking for ways to reduce the cost of care while they endeavor to improve patients’ health. To effectively manage medical cost and risk, providers need clear benchmarks that help identify opportunities to improve medical and financial performance. OptumTM offers actuarial services that deliver clinical informatics to help providers negotiate payer contracts and improve health outcomes. Our actuarial and analytic solutions are used by nearly 300 health plans covering more than 200 million lives.
Optum actuarial services can help providers:
- Optimize medical risk, underwriting and pricing.
- Analyze reimbursement, network contracting, and payments.
- Illustrate cost drivers and key performance indicators.
Health care data analysis can assist with creation of disease and condition registries and identification of evidence-based medicine gaps in care and information.