Today, health systems and communities are confronted with a host of complex problems: costs are escalating, for one, and a significant number of people lack access to health services. For organizations looking for new and innovative thinking, Optum Market Performance Partnerships offer a framework to bridge gaps, improve care delivery and achieve results that are measurable.
So What Are Optum Market Performance Partnerships?
Optum Market Performance Partnerships are models of collaboration designed to reshape healthcare delivery and outcomes. Partnerships bring together the main actors in healthcare—providers, payers, and employers—to concentrate their efforts on such quantifiable performance metrics as patient care improvement as well as cost reductions and operational efficiencies.
This is not the traditional model where each organization operates in its own silo. By this approach to care delivery, the partnerships emphasize a data-driven and value-based approach to achieving progressively better results. At the center of it all is Optum’s considerable technology and data capabilities, which make prompt actionable strategies possible.
So Here’s Why Optum Market Performance Partnerships Make a Difference
Better Results through Better Ties
No one healthcare business is like another. In the past, fragmentation among those who have a stake in the health delivery or outcome has often stood as an obstacle to improvements. Optum Market Performance Partnerships attempt to break down these obstacles by aligning remuneration incentives and promoting collaboration between payers, providers, and employers.
These choices result in a win-win situation for both sides. Costs of medical treatment are effectively managed, with patients getting quality care suited to their needs.
Decision Making Based on Data
Something that epitomizes Optum is their leadership in using industry data for analysis. By means of the insights yielded in their partnership activity from claims, clinical, and social determinants of health input, they provide organizations with information required to formulate policies that are sound and cost-effective.
For example:
- Predictive analytics can spot groups at high risk sooner.
- Studies of cost present open chances for both administrative and prescription drug expenses.
- Information allows for pinpointed interventions that produce definite results.
How Optum Market Performance Partnerships Could Help
Step 1: Evaluating and Objectives Setting
Optum Management Performance Partnerships is the first step in adjusting to value-based healthcare models. It is a framework for promoting high-quality care and cost reduction, with incentives to back up the effort.
Consider, for instance, that tailor-made care management programs can cut hospital readmissions by a substantial percentage while at the same time increasing patient satisfaction overall.
How Optum Market Performance Partnerships Work
Step 1: Assessment and Goal Setting
The first step is to understand what specific needs and goals the organization has. Optum will work closely with partners to find out where key challenges lie and where improvements can be made.
Common goals include:
- Reducing total cost of care
- Raising patient outcomes
- Improving the efficiency that operations is run with
Step 2: Data Integration and Insights
Once goals are set, Optum adds in multi-sourced data like HIPPAs, Rx and IMDSA to the mix. The company then uses advanced analytical tools to provide actionable insights which meet the objectives of its partnership experiences.
Example:
A payer may discover, for instance, that a certain demographic profile in their insured population has a higher risk than average of chronic conditions such as diabetes. The partnership will then be able to put in place care management programs targeted specifically at this risk.
Step 3: Strategic Execution
With these insights, Optum works with partners who can implement their tailored solutions. Such might involve:
- Sending care coordinators in to manage patient populations
- Changing the benefit structures of insurers to encourage prevention
- Streamline workflows within hospitals one step more efficient
Step 4: Measuring Outcomes
Optum Management Performance Partnerships drives itself forward with this commitment to measure and report outcomes. With real-time tracking through dashboards and reports, stakeholders will easily see how they are progressing against objectives.
For instance:
A provider and payer working in unison would be able to track metrics such as decreased emergency department visits or whether patients are better off remaining on their medical regimen.
Real-World Applications of Optum Market Performance Partnerships
Improving Population Health Management to Strategies for Reducing Health Care Expenses
A major employer has pursued to reverse rising health care costs among its workforce. It specified whom high-risk workers were and implemented specific wellness programs offering:
- a 20% reduction in hospital stays
- a 15% increase in employee involvement with Preventing Care
Improving Coordination of Care
The end result of a multi-specialty clinic’s participation in Market Performance Partnership was this:
- A 25% decrease in unnecessary tests and procedures
- More than just winnowing out bad apples
Partnering with Optum on the Plan Design
One health plan worked with Optum to assess and shape its pharmacy benefit plan. Through optimizing formulary design and encouraging generic drug use, the health plan realized:
- a 12% cut in pharmacy spend
- The members also took their medications more regularly
How to Know If Market Performance Partnership is Right for You — Ask
- Are rising healthcare costs hurting your business bottom line?
- Is it hard to get care seamlessly among different parts of your organization?
- Do you demand the use of data for decision-making?
- Is raising patient satisfaction scores and patient outcomes a primary concern for you?
If your response to any of these questions is “yes”, consider Optum Market Performance Partnerships for your own organization. They may well be just the answer.
Takeaways: There are Two Important Points
Transformation through Optum Market Performance Partnerships is a new starting point for tackling some
Take the Next Step
If you would like to know more about how Optum Market Performance Partnerships will change your company’s healthcare strategy, phone us for a consultation today.
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