Provider Network Optimization
Optum’s Provider Network Optimization solution helps managed care organizations maximize the effectiveness of their provider networks, leading to higher quality, lower costs and improved outcomes. Our network management consultants team with expert clinical consultants, market-leading health care analytics and in-market provider engagement specialists to design, develop, measure and improve optimal network strategies. Our network optimization approaches include support for tiering, pay-for-performance, pay-for-quality, gain-sharing, risk-sharing, medical home and ACO formation and support.
OptumInsight helps organizations:
- Analyze the effectiveness of current networks
- Design and develop network improvement programs for current networks as well as new network expansion programs
- Improve quality of delivered care
- Reduce medical costs
Health Care Analytics
Managed care organizations, including health plans, provider organizations and ACOs can better manage clinical resources, assess risk, measure quality, and conduct predictive modeling with Optum health care analytics, including the Symmetry® and Impact suites of solutions.
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Consulting
OptumInsight medical management design, evaluation, and improvement consulting empowers you to evaluate population management programs, develop and implement pay-for-performance plans, and review disease and utilization management – all with an eye toward reducing costs and improving the health of your members.
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Staff Augmentation
OptumInsight Provider Network Management staff augmentation supports and extends your in-place network management team with in-market provider engagement specialists. These professionals meet with local providers and groups to review cost and quality ratings, suggest improvement programs and emphasize individual treatment to close evidence-based medicine gaps in care.