Changing health care from the inside out

Shifting to a value-based system is disruptive to traditional health care business models. While the promise of value-based care is clear, the path to achieving it is uncertain. Optum™ helps the full breadth of provider organizations navigate the journey with powerful insight, expertise and solutions that convert health data to health intelligence, enable compliance, empower collaborative care and improve revenue cycle management. In other words, we help make the health care system work better for everyone.

Revenue Cycle Management
Hospitals and physicians are tasked with achieving healthy financial performance while determining how to most effectively fund new care models in the future. The added complexity and urgency of the ICD-10 code migration in October 2014 requires an unprecedented level of vigilance on reimbursement and denials management, both before and after the transition. Optum offers you a level of industry knowledge and experience that few technology partners can match. We can help you shape a comprehensive approach to revenue cycle management, one that factors in your organization’s ICD-10 coding and compliance requirements, reimbursement and cash performance, staffing demands and your roadmap to value-based care. Get control of coding, compliance and reimbursement data and processes and make essential financial information accessible where it's needed.

Healthcare Analytics
We provide insights from predictive modeling and clinical and financial analytics to drive population health improvement. In addition, we synchronize data points to develop a holistic profile of every individual in a population and proactively identify and prioritize care opportunities. As a result, our solutions help consumers obtain consistency in the quality, outcome and cost of their care experience.

Population Health Management
Build a culture of health and well being with physician engagement. Analytics built on evidence-based medicine (EBM) and disease trends help identify opportunities for intervention before major health issues occur. When you cascade that information to physicians, they become empowered to make informed decisions.

Clinical Performance
Prepare your system for the shift. Focus on health care’s most mission-critical challenges with interoperable technology that supports collaboration, maximizes clinical outcomes and compliance and reduces errors, redundancy and cost.

Medical Necessity
New financial incentives, payment models and compliance mandates, coupled with a shifting national focus on reduction of waste and fraud, present hospitals with increasing compliance challenges. Successful compliance programs are built on rigorous processes, access to clinical information and proactive strategies. Optum can help simplify the complexity.

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Resource center

Find insights and perspectives on the latest health care topics. Also, find additional information about our products and services and the successes our clients have seen.

Propel your data to the next level with predictive analytics
Predictive models depend on the size, source and quality of your data. Without all three, you’re not seeing the whole picture.
Optum featured topic: The importance of clinical and claims data

An examination of the importance of using comprehensive clinical and claims data to manage patient risk.

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Radical Transformations

How did data help Beverly, Liz and Dewayne radically transform their emergency departments?

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Video: Game Changing Analytics
See data differently and better understand how to leverage analytics to make game-changing plays for your organization.
Educate for ICD-10 success
Optum360™ offers comprehensive ICD-10 training and education based on specialized learning needs across your organization. Take courses online, schedule onsite sessions, or ask our consultants to assess your needs and recommend a tailor-made plan.
Harness the power of a fully integrated coding solution
Transition to ICD-10 with one complete solution.
CDI Physician Training Video
Taking it to the next level: Optum360 Clinical Documentation Improvement Physician Training
Health care plays Moneyball for game-winning insight
The Oakland A’s won games by crunching numbers. Now, analytics has the potential to become health care’s ‘Moneyball’.
Optum™ Claims Manager plays pivotal role in OrthoCarolina’s highly profitable revenue management system
Using Optum Claims Manager, OrthoCarolina was able to reduce claim denials by over 60 percent within two years of implementation.
RAC Up Your Revenue Cycle: How Medicare’s Recovery Audit Contractor Program Is Changing and How It Affects You
Help save your organization time and resources spent managing RAC reviews.
White Paper: The four steps of population health management
Big stat, small state. What did one Connecticut health insurer see after restructuring its referral network?
Connecting with Optum360 prepares Truman Medical Centers for ICD-10
Truman Medical Centers saves $7 million over the course of vendor agreement with an outsourced coding solution.

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