Steve Clark Senior Vice President

Transcription

1 Steve Clark Senior Vice President 1

2 Collaborations Opportunity for life sciences companies Partner with Optum & United leadership to design and pilot high-impact programs Close key gaps in care to improve patient outcomes, costs and satisfaction in priority therapeutic areas Generate real-world evidence to support clinical pathways, interventions Drive improvements in quality measures (e.g., STARs, HEDIS) Develop and test new capabilities, ahead of scaling 2

3 Scope Optum partners across the health system to drive changes in clinical practice or implement new payment models by assembling new programs. What? With whom? Drive changes in clinical practice or patient behavior through: Education Patient monitoring/data collection Coaching Disease management Clinical interventions Care coordination Design, pilot, execute and manage risk-based contracting Patients and physicians Payers (UHC+) IDNs (Optum One, RQS, local care delivery) PBM (OptumRx ) Employers Clinics In-home Retail pharmacies 3

4 Process Optum pursues a staged approach to design, piloting and scaling that defines and assesses program value for all health care stakeholders, including outside UHG. Research Design Pilot Scale Target patient? What gaps in care exist? What works best for whom under what circumstances? (clinical, economic, humanistic) What opportunities should we target? How is success measured? What channel(s)? What intervention? By whom? With what frequency? How is data collected and how frequently? What could go wrong and how is it avoided? How well does it work? Opportunities to improve? Considerations for scale? Best channels? Roll out plan? Investment requirements? Oversight by and alignment with UHG and sponsor leadership at each stage 4

5 Assembling the Building Blocks Claims Optum Care/ CPM Behavioral Rx web mobile/ tablet pharma contact centers EHR Prevention Intervention Network Solutions social media home mail clinic Consumer Financial Distribution Consumer on-site doc office Data + Optum products + Channels = Integrated experience Right Care Right Time Right Place Right Cost 5

6 Groups Involved in Cross-Optum Efforts to Date Optum Life Sciences (AVS, HEOR) Optum Consumer Solutions Group Optum Behavioral Health Optum One Optum Care Optum Risk & Quality Solutions Optum Complex Medical Conditions UnitedHealth Group Clinical Innovation UnitedHealthcare Medicare & Retirement 6

7 Case Studies & Capabilities: Provider Engagement Model Web/ /Mobile Medicare Account Profile Large scale, non-profit hospital provider with 2,000+ physicians representing most clinical specialties Medicaid Consumer/Member Contact Center Individual Engaged Consumer Quality Care Support Provided: Appointment Scheduling, Specialty Clinic Referrals, Class Registration and Seminars, Engagement/Outreach Providers Community Education Proactive Engagement Team Family Technology Solution: bconnected Markets Served: Medicare, Medicaid, Individual & Family Site Locations: Orlando Total Agents: ~50 Our provider engagement model ensures consumers receive the most current and accurate information to drive high quality care and engagement Deep integration with provider specialty clinics provides a cohesive patient experience This partnership has enabled high retention rates for this provider in response to network drops 7

8 Applying big data for superior service Optum Innovation award-winning patent pending program & NICE award recipient for voice analytics supporting customer excellence Personalization Strategy: Proactively engage consumers through tailored experience Enhance the consumer experience Drive employee engagement Improve business results Analytics and modeling leveraging company, customer and external data to determine how to engage the consumer CRM and system tools with a personalized user interface to prioritize, present and track results Agent participation in strategy and change management across all business processes to promote adoption Voice Analysis with NICE Interactive Analytics: Provides data-driven insights LISTEN to voice data at scale across the organization through call recording. Provides an unbiased, quantitative view of the call recorded data UNDERSTAND hidden consumer needs through voice analytics technology. Identifies opportunities we do not know and quantifies the areas of opportunity we are aware EVOLVE to proactively satisfy consumer needs through projects driven by data insights, Allows to discover words and phrases on calls that have already taken place, while also monitoring words and phrases on live interactions 8