Category Archives: Health Plans

Spotlight on Caring: Kelly Z.

It’s humbling to think how a HouseCalls visit can make a big difference in a member’s health. It requires significant training and a practiced eye to evaluate a situation so that you can understand what may be really happening. In this example, our clinician Kelly’s thoughtful, highly responsive action helped mitigate what could have been […]
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Spotlight on Caring: Lisa T.

Member education is a vital part of each HouseCalls visit. We are deeply committed to enabling members to be more engaged with their health care providers and health care choices. That is why our clinicians are well equipped with educational resources, and encouraged to take the time needed to answer member questions. This is exactly […]
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Emerging trends and complexities of genetic testing reimbursement

Complexities of genetic testing reimbursement Genetic testing has become an increasingly important and effective tool in identifying and treating disease. Genetic testing can confirm or rule out suspected genetic conditions as well as determine whether a person can pass those conditions onto their offspring. This can help clinicians focus on the correct treatment as quickly […]
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Special topic: An Optum Forum 2019 preview

More than 1,500 clients, partners, industry analysts and health care leaders will attend Optum Forum 2019 in Las Vegas next week. The annual health care event will feature thought-provoking content delivered by industry-leading speakers, interactive experiences, and extensive opportunities for our guests to connect and share. Moving health FORWARD The Optum Forum theme – FORWARD […]
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Spotlight on Caring: Richard H.

Often we hear specific feedback from our valued members about our clinicians. These notes of gratitude underscore the impact that each Optum HouseCalls employee has in achieving our mission to help members live healthier lives and make the system work better for them. One important way our clinicians do that every day is by recognizing […]
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Spotlight on Caring: Angela H.

As a clinician myself, I have seen the power of the in-home assessment to help members live healthier lives—a key aspect of our mission. The work our Optum HouseCalls clinicians do often results in members reaching out to tell us how a visit made all the difference in their lives. In this example, proactive care […]
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Specialty Rx: An exponential challenge for health plans

Health plans are seeing exponential growth in both the use and medical cost expense of specialty medications. In the past decade, the Food and Drug Administration (FDA) has approved more than 250 specialty medications. By 2020, specialty medications are estimated to cost $400 billion. Forty percent of that cost is expected to be paid under […]
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Leading a team approach to value

Collaboration around the business of health care is critical In a recent marketplace survey by NEJM Catalyst on the transition from fee-for-service to value-based care, we gained interesting insight into the state of value in health care. These included snapshots of revenue distribution, models in use, barriers, important measures and more. All are important points […]
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Keep a finger on the pulse of future CVD care

The years ahead will see greater challenges in cardiovascular disease (CVD) care. To prepare for what’s coming, providers and payers will benefit from working together to optimize quality of care and patient outcomes and lower the total cost of patient care. The relentless rise of cardiovascular disease CVD is the costliest chronic disease in the […]
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BPCI Advanced: March’s get-out-of-jail-free card

Has it been four months already? That’s when the first performance period began for CMS’ latest bundled payment model, BPCI Advanced. Now participants are less than a month away from the March 1st deadline. By March 1st, they can drop participation in any (or all) of the 32 clinical episodes without penalty or financial risk. […]
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