Optum has introduced its Accountable Care Solutions business to enable hospitals, physicians and health plans to better coordinate patient care, enhance care quality and financial performance and, ultimately, increase consumers’ satisfaction with the health system.
Since its formation earlier this year, the Accountable Care Solutions team now includes more than 700 experienced professionals across Optum’s businesses, including the recent addition of Carol Corporation, a consulting firm with specialized expertise in care redesign and clinical performance management services. This team leverages Optum’s broad portfolio of health information technology, consulting and population health management capabilities to help health systems across the country design, build and operate new models for collaborative care, balancing risk and reward for all constituents in their markets.
"Community by community, care teams around the country will now be focused on integrating into new clinical models and collaborating with others in the community to become accountable for delivering high-quality care to a population. Optum is dedicating the people, the tools, the technology and much of the know-how to support this effort,” said Andy Slavitt, CEO of OptumInsight and executive vice president of Optum.
Optum has assembled and integrated the critical elements necessary for health systems to transform to a population-centric, integrated pay-for-value model represented by Accountable Care Organizations (ACOs). Optum’s Accountable Care Solutions team is led by Todd C. Cozzens, co-founder and CEO of Picis, which was acquired by OptumInsight in 2010. Cozzens has more than 25 years of experience in health services and technology.
This team addresses the full range of needs for successful ACO development and implementation, including:
- patient and population health management, with the industry-leading services of OptumHealth;
- informatics, analytics and technology, including predictive modeling and care-pattern analysis tools, as well as leading Health Information Exchange (HIE) and EMR technologies;
- clinical integration, network development and physician change management, including a team of 30 clinical consultants and condition protocol experts from Carol Corporation;
- payment model, contracting and actuarial expertise, including a specialized actuarial team, and contractors to ensure financial stability; and
- operating expertise, including end-to-end revenue cycle management; bundled payment capabilities; governance, Managed Service Organization (MSO) services; and technology implementation.
A dedicated group also works with commercial health plans and government payers on their alignment strategies, under the leadership of Benton Davis, senior vice president of clinical community and network services for OptumInsight.
"Sustainable Health Communities will emphasize wellness and preventive care – not only the treatment of patients who are already sick – making it essential to balance community engagement with ongoing financial viability by aligning the interests of care providers, payers and patients,” said Cozzens. “Optum’s unmatched and integrated portfolio of capabilities is ideally equipped to be a trusted partner in this new era of health care, and we are excited to continue our work with communities across the country to help create healthier populations.”
Connected, Intelligent, Aligned: New Research from IDC Health Insights
To help clients and the industry navigate the complexities of collaborative care models, Optum partnered with leading health care research firm IDC Health Insights to research opportunities for ACOs. In a newly published report, “Foundations for the Future: Building a Better ACO,” Lynne Dunbrack, program director for IDC Health Insights' Connected Health IT Strategies program, examines the critical role technology will play in informing and educating patients in a model where they are more engaged in their own health.
The report affirms Optum’s perspective that Sustainable Health Communities must be connected, intelligent and aligned. That is, information must flow freely among all participants; data must be turned into actionable information through the use of analytics and informatics; and the interests of all participants must be considered equitably. For care providers to be successful, a critical key is payer alignment, which includes performance monitoring. The report is available via this link: www.OptumInsight.com/ACOFoundations.
Earlier this year, Optum announced its innovative partnership with Tucson Medical Center in which the two businesses are collaborating to create the nation’s first Sustainable Health Community based on an ACO model.