Risk bearing capabilities

Bringing over 20 years of experience with 300 health plans and 5,000 hospitals to every meeting, Optum processes claims for more than 60 percent of Medicare Advantage members and understand longitudinal health status as well as lifetime health costs. Our professional guidance and insights can help ensure your next step forward is the right one.

Optum offers leading processes, analytics and supporting services to help health care providers operate using this risk-based business model. Whether your organization is only beginning to plan for a value-based business model or actively managing risk-based contracts, our risk enablement solutions and services can help ensure accurate payment and funding for patient care, close gaps in care and improve patient outcomes — while optimizing your financial performance.

 

Performance acceleration team

On-site team with expertise in risk-enablement operations.

Optum brings an on-site team with risk-operations expertise to accelerate performance and results for risk contracts in provider organizations.

Network and referral management

Holistic solution including technology, scheduling, 24/7 triage and network management

Optum has developed a comprehensive network and referral management solution to help providers improve the consistency and quality of care, patient satisfaction and care retention.

Integrated clinical model

Clinical solutions address contract (STAR ratings, HEDIS, Risk-Adj.) and patient (TCM, CCPM) needs

Optum has developed an integrated data, analytic, service and field-based enablement model to deliver against the core payer risk contract value levers.

Optum analytics

Optum has developed a comprehensive analytics platform that drives knowledge and action by utilizing clinical (EMR) and claims data, and driving population and patient-level insights, while integrating with registry and care coordination modules to drive action.

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We're ready to put our solutions to work for you. Let's start the conversation.
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Thank You for Contacting Us

An Optum professional will contact you within one business day. If you have additional questions, please contact us at 1-800-765-6619 or discover@optum.com.

In the meantime, please enjoy reading our infographic, Health Care Risk Challenge.