Analyze and learn
Transform health information into health intelligence.
Inside the data are the keys to understanding the population for which health organizations are now accountable. Optum™ can help you answer questions such as: Who are these new patients? What are their morbidity profiles? How and where do they consume medical resources? Who needs intervention now? Who are the top performers in improving outcomes? Today, most health organizations do not have the information, the platform or the ability to perform these analyses.
With the right analytics engine, you can start to measure performance and the health of your patient populations. By synthesizing your health information into health intelligence, you can refine your capacity to measure, manage and report quality, cost and performance.
Making the shift to a secure, electronic, interoperable health information system holds the potential to boost efficiency and quality across the entire care continuum. Organizations at this phase can identify both preventive and chronic care interventions that improve the health of all while making good use of physician and system resources.
With an end-to-end system of actionable health information technology and intelligence that supports both measurement and management of care, organizations can gain insights at the right points of care to improve quality and facilitate fair, efficient financial transactions. Alignment of tools and processes for evaluating performance and informing corrective actions decrease the complexity and cost to the system.
The intelligent health platform.
Optum™ One streamlines health organization management by converting health information to health intelligence.
The Optum One intelligent health management platform enables providers and delivery systems to improve health and manage cost. The platform is powered by the industry’s most advanced integrated data and a flexible suite of applications that leverage health insights and pivot this knowledge into targeted action at the point of care.
Optum One uses an unmatched foundation of health care data that is cleaned, normalized and validated. This includes:
- Clinical data of 30 million patient records
- Claims data covering more than 109 million lives
- 19 years of longitudinal health records
- Socio-demographic and care management data
By integrating claims, clinical, socio-demographic and care management data, you receive both a retrospective and prospective view of your patients and your patient populations. This type of view enables you to identify at-risk patients earlier, preserve patient health, reduce costs and prevent complications.
Population and risk reporting services
The right information at the right time.
Despite increasingly rigorous expectations, many providers have limited or delayed access to the information they need to optimize care delivery. OptumTM offers population and risk reporting services that uses claims data to provide a comprehensive picture of a system’s population, cost and risk. This timely, flexible, easy-to-access view gives providers the swift ability to:
- Clarify cost and utilization trends.
- Identify high-risk individuals.
- Find opportunities to improve quality and cost.
- Understand patient utilization “leakage.”
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. Optum™ 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.
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.