Author Archives: Optum

Top outpatient surgery center trends in health care

Health plans are focusing on ambulatory surgery centers (ASCs) as a source of cost savings. The same procedure performed in an ASC may be less than it is in other outpatient ambulatory settings. Acute care facility inpatient admissions will gradually decrease as most health plans are moving services to the outpatient service facilities such as […]
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How the right HSA provider can support your employees’ health and security

Medical bills: trying to understand them may be nearly as painful as the injury or illness that generated them. This is an exaggeration, of course. But for many consumers, those bills can represent big problems, such as how to pay for their health care, how to plan for future care and how to achieve financial […]
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Next AI ‘wave’ will be a sea change for health care

The artificial intelligence (AI) journey from theory to mainstream has evolved in waves. While health care may see AI as an abstract concept, I believe that technology capabilities have already entered their second wave of evolution. The roots of artificial intelligence (AI) technologies go back to 1950, when Alan Turing suggested that machines could be […]
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Are your employees getting enough sleep?

The occasional night without sleep can leave anyone irritated and grouchy. But it might not cause much harm to long-term health and business productivity. Chronic poor sleep is defined as several consecutive nights of insufficient sleep. That may have mental health effects that can become much more serious, affecting concentration and decision-making. These issues can […]
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Pathways to Success: Five key areas participants should evaluate based off of the CMS Final Rule

The Centers for Medicare and Medicaid Services (CMS) delivered sweeping changes on December 21, 2018. Yet they should come as no surprise given the clear indications of the new direction throughout 2018. CMS has set the foundation for “Pathways to Success.” The most apparent change in the Final Rule is to reduce participants’ time in […]
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What will you do differently this HEDIS® season?

Speaking from experience With limited resources during the short HEDIS season, health plans must make quick decisions to prioritize the number of medical records to retrieve, abstract and over read to meet their goals. One year when I was at a health plan, we were at the end of the HEDIS season. We were two […]
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The people side of “analytics”

For HHS agencies, the focus is on improving lives To slightly misquote Benjamin Disraeli, there are lies, damn lies, and analytics. Okay, let me say it another way.  It’s not that “analytics” are actually lies, but – like “statistics” in Disraeli’s time – they can be misleading and, if not used and interpreted properly, can […]
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After nearly 50 years, it’s time to retire traditional MMIS procurements

There are only 51 of them in the entire country, but their reach affects millions and their impact is profound. Cumulatively through the years, these systems have cost states billions of dollars and consumed thousands of hours of productivity. They’ve caused headaches, heartburn and sleepless nights for agency IT experts, financial executives and policy analysts […]
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A SMART approach to your employees’ New Year’s resolutions — or any time

It’s that time of year again. With the holidays close by, it’s natural for your employees to start thinking about New Year’s resolutions. Keeping a promise to oneself is more easily said than done, though. Year after year, people enter January with ambitious goals: losing weight, exercising more, signing up for a race. Sound familiar? […]
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Population health management requires care coordination and patient engagement

Healthcare is experiencing unprecedented change at the moment; some would say this is long overdue. Between regulatory and reimbursement reforms, emerging technologies, and the pursuit of the Triple Aim, managing population health has become a fundamental requirement for most health systems. While the benefits of value-based care are many, the transformation to a more patient-centric […]
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