The COVID-19 pandemic has had a significant impact on how Americans seek medical care. It has also impacted the delivery of care and operations of health care providers. During the ongoing pandemic, the Centers for Medicare & Medicaid Services (CMS) released several waivers and flexibilities. This is to support health care providers and health plans […]
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Employers face constant pressure to strike a balance between building human capital and driving financial performance. This health care dilemma pulls organizations in two directions when it comes to reporting. They’re looking for ways to support employee health and wellness while remaining competitive in the market. Add to that the increasing challenges of an evolving […]
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HouseCalls advanced practice clinicians, like Cassandara in this example, are known for their astute assessment skills. Their systematic approach can uncover serious issues that members may have been ignoring or minimizing. As Cassandara demonstrated so well, it also takes thoughtful determination to identify how to best connect a member to the appropriate care team and […]
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Millions of Medicare Advantage medical charts are retrieved and reviewed manually each year to improve accuracy and completeness of member health status. Traditional retrospective risk adjustment processes lack the technology and tools to predict and prioritize charts likely to support unreported diagnosis codes. The result has been a less efficient process, which can disrupt providers […]
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Across the health care system, COVID-19 has demanded fast, thoughtful transformation to deliver care. Recognizing that members still needed support even when in-person visits weren’t possible, Optum® HouseCalls created a highly flexible, responsive solution. Learn how Optum HouseCalls was able to use telehealth to continue “visiting” members and support other front-line teams. Continuing member care […]
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Innovation is abundant in health care today. From new technology to virtual visits to clinical trials, people across the medical spectrum are finding new and better ways to deliver care. The payer space is also seeing tremendous change. And innovations from Optum are helping drive more efficiencies and growth. “We’re taking a holistic approach to […]
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The home environment often helps members open up in ways they may not in a clinician’s office. Perhaps that’s because the advanced practice clinician and the member don’t feel rushed. The advanced practice clinician has the time to encourage one-to-one conversations with members. They take the time to listen to a member’s health concerns and […]
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Whether members live alone or even when they have others in the home with them, they can ignore worsening health conditions. It takes an expert perspective — like that of a HouseCalls advanced practice clinician — to identify symptoms that have become normalized. In this case, HouseCalls advanced practice clinician Carrie’s thoughtful physical assessment helped […]
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The Medicare Advantage (MA) bid process is a function of the overall product strategy that a health plan organization wants to put in place over a multi-year time frame in the marketplace. When preparing bids, several entities of each health plan in an organization are needed such as: executive, finance, marketing, sales and operations. During […]
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In 2019, more than 20 million members enrolled in Medicare Advantage (MA) plans. That number is expected to grow to more than 30 million members before 2030.1 For the 2020 plan year, the Optum Advisory Services actuarial practice is highlighting 2020 premium and supplemental benefit changes. We believe that MA growth can help private health […]
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