Kidney Resource Services: Earnestine’s story

Chronic kidney disease (CKD) is a complex and costly condition. One in seven adults has CKD. Earnestine was one of them. Fortunately, through Optum® Kidney Resource Services, she was able to work with Carolyn, a nurse case manager, to help her follow the strict diet recommended by her doctor, take her medications and understand her […]
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2018 Bid submission: Best practices for aligning bid strategy and operational execution

The Centers for Medicare & Medicaid Services (CMS) released its 2018 Advance Notice and Draft Call Letter in February, proposing numerous changes for Medicare Advantage (MA) and Part D plan sponsors. The combination of benchmark, risk adjustment, quality Star rating, cost sharing and benefit design requirements, coupled with uncertainty of several 2018 payment variables and […]
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“Do I need to cleanse my gut?” and other thoughts about bacteria

If you’ve seen commercials on TV or scanned the dairy aisle at your local grocery store, you may have noticed the recent trend encouraging people to try supplements, yogurts and other products intended to help people improve their health by cleansing their gastrointestinal (GI) tract. As a dietitian, I get many questions from my clients […]
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Consumer-centric wellness solutions for health plans

When individuals are able to proactively manage their health and wellness — whether they have multiple chronic conditions or are relatively healthy — they’re able to live their best lives. And as health risks are reduced, so are costs. Optum offers NCQA-accredited wellness solutions tailored to the needs of each population’s needs. These services are […]
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Do bundled payments encourage more procedures? New study offers answer

New research aims to determine whether a claim that bundled payments may actually increase costs rather than control them holds any weight. Becker’s Hospital Review and McKnight’s reported on the study from the Centers for Medicare and Medicaid Services and the Altarum Institute. At issue was whether bundled payments — also known as episode-based payments […]
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MACRA requires knowledge of qualities of “good” data

Medicare is allowing physicians and group practices to set their own course toward compliance with the Medicare Access and CHIP Reauthorization Act, or MACRA. But regardless of the path chosen, accurate measurement is key. That’s because the most basic level of participation requires physicians to submit data on one quality measure and one improvement activity […]
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Sit-Stand Adjustable Desks: Should you invest now?

By now it’s common knowledge that prolonged sitting is harmful to our health. Headlines such as “Is Sitting is the New Smoking” and “Is Sitting Killing Me” have alerted the general public to the negative effects of sitting all day – from to weight gain and fatigue to muscle tension and low back pain.   […]
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Ease a transition to new tech by communicating with your whole staff

Digital technology is revolutionizing health care — but everybody who adopts it knows that it presents challenges in a clinical setting. There are learning curves with hardware and software, new habits to develop, glitches to deal with, and a whole lot more — while you’re taking care of patients under time constraints. According to Judy […]
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Health plans: Consider new metrics for assessing organ transplant programs

Organ transplants save lives, and the number of transplants is rising. That’s why it’s important for health plans to reassess the metrics they use to measure the value of organ transplant programs. Our white paper,“Reassessing how payers determine the value of organ transplant programs,” explores the Transplant Value Initiative. This Optum initiative looks at how […]
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A way to save real dollars on each business transaction

As providers work to meet the demands of value-based care and population health management, they are discovering the importance of data and the ability to share that data. Often the focus is on the shareability of clinical data. But data sharing can also provide opportunities for efficiencies and cost savings in claims submissions and patient payments — […]
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