Tag Archives: Optum

Weintraub foresees future data usage exploding

The amount and depth of health care information on individual patients and entire populations is huge and growing larger by the day, Michael Weintraub, President and CEO, Optum Analytics, said in an interview conducted at the Forbes HealthCare Summit, and this data represents a tremendous opportunity to influence the decision making process. “The capabilities are […]
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Trusting predictive analytics

Most likely, the last time you purchased something online you were offered “recommendations” or saw what “others also liked.” The technology behind these common prompts uses predictive analytics. Your online merchant is leveraging data about your shopping and online searching behavior to predict their desired outcome — that you might buy something else! As we […]
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Making the most of health care claims data in value-based care

In my last blog post, I wrote about the need for using clinical data to create a comprehensive data set for analytics. The other side of that equation, however, is using claims data effectively. Providers already can more easily leverage claims data than clinical because of stronger reporting tools and standards, but there are some […]
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10 tips for working with MCOs to advance Medicaid program integrity

Have you turned to managed care organizations (MCOs) to reduce Medicaid costs and improve patient care? If so, you probably know how difficult it is to know for sure whether your MCOs are doing all they can to reduce fraud, waste and abuse. In May 2015, CMS proposed a new rule that MCOs strengthen their […]
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A healthy partnership: Medicaid managed care organizations and federally qualified health centers

“Triple Aim” has become recognized as the methods designed to put our health care system on the path to long-term sustainability. Stakeholders recognize the triple aim as simultaneously lowering population health costs, increasing quality and improving the health care experience for patients. Critical to improving the patient experience is measuring the performance of health providers, […]
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Analytics are key to engaging providers in the process of change

As health care groups continue to grow larger, it becomes increasingly difficult for information to flow from the health care providers to the central office and vice versa. I have seen this happen to a number of health care organizations that were rapidly adding new practices and personnel. How does a growing organization keep the […]
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Adapting epidemiologic principles to “big data”

Optum’s epidemiology experts apply the rigor of advanced epidemiologic methods to the challenges inherent in “big data” The term “big data” is ubiquitous these days. Within healthcare, electronic data from administrative systems and electronic health records (EHRs) are increasingly voluminous, varied and accessible. Within health care and public health, our capacity to use data has […]
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Florida Medical Clinic scores new contracts after using analytics

In the move from fee-for-service to value-based health care a number of organizations are missing the target. I have seen several very good health care groups miss out on substantial value-based contracts because they could not take on the risks. The solution is to manage the risks through the utilization of analytics. Florida Medical Clinic, […]
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Pay-for-value can improve behavioral health care

Paying for value not only helps drive improvements in behavioral health care and lower costs. It also inspires innovation in treatment and empowers consumers. Today at Optum, nearly 20 percent of our total spending on inpatient network-based behavioral health is tied to performance-based contracts. These contracts reward providers for collaboration, better patient outcomes and improved […]
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HIPAA audits and investigations — they’re baaaack…

If you didn’t receive a HIPAA pre-audit questionnaire from the U.S. Department of Health and Human Services Office of Civil Rights (OCR) last summer, you likely breathed a heavy sigh of relief. But don’t rest easy just yet, as your audit reprieve could be short-lived. Approximately 400 audits are coming, and organizations selected to be […]
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