Provider-sponsored health plan analytics
Optimize networks, lower costs and align incentives.
To accommodate new care models and the shift in how health care providers are reimbursed for their services, providers need a better understanding of the shared-risk models that are emerging in the industry. They also need the right tools.
Both payers and providers share goals of improved care and reduced medical and administrative costs. With 300+ health plans, who rely on our data and analytics to run their business, OptumTM is well-suited to help provider organizations gain the payer perspective. Our robust analytics can help form the basis of new business and risk models that optimize networks, reduce costs and align incentives.
Provider health plan enablement analytics
Many of the payment reforms that are taking place focus new approaches that emphasize the quality of care and reduced costs. To achieve this, providers find themselves examining new models of risk and building new partnerships with payers. Those payers and providers who share goals of improved care and reduced costs require a collaborative relationship and an optimized network.
To give providers the insight they need to support these risk-sharing arrangements, Optum offers sophisticated databases, data-mining capabilities, and statistical analysis tools. These give managed care organizations access and visibility into information and insights to help them make better informed care decisions. These data-mining techniques build predictive models that identify which members are most likely to need certain services as well as those members likely to experience specific disease conditions. They can also detect and measure evidence-based medicine gaps in care, which form the foundation for provider quality measurements.
Our techniques and tools can compare normalized costs for services to give relative clinical performance. Health organizations can then use these measures to examine retrospective provider quality and cost performance, which form the basis for engagement and improvement programs, as well as reimbursement models that align incentives.
These tools strengthen you as a care provider while helping you view and manage costs with the rigor of a payer.
Optum Impact Suite
Identify opportunities for growth.
OptumTM Impact Suite offers you the flexibility to analyze and dissect data by whatever dimension or measure you choose. Customized report views allow individual users to focus on the data they need most. Designed with the highest concern for security, it can be easily integrated into your company’s existing HIPAA compliance program.
Delivering high-quality, cost-effective care requires a detailed understanding of utilization trends, patient outcomes and past performance. Impact Suite incorporates leading clinical analysis tools to help providers identify opportunities for improvement.
Measure quality and maintain evidence-based standards with the Optum™ Symmetry® suite of solutions.
Learn how the Symmetry suite of solutions can allow you to better manage clinical resources, assess risk, measure quality and conduct predictive modeling through an integrated platform and consistent methodology.