Risk optimization & business performance
Manage and grow the business
Today’s environment of continual change and pressure tests health plans’ ability to achieve business growth and profitability.
No longer will competitive risk selection be sufficient. With an estimated 30 million newly insured people likely to enter the risk pool through expansions in Medicaid and/or participation in health benefit exchanges, insurers need to understand likely population shifts and the corresponding financial impact to mitigate risk, invest intelligently, and expand or contract as needed.
OptumInsight provides the expertise, tools, and methodologies to assess the landscape, plan new initiatives, and evaluate programs on an ongoing basis. With effective rating and underwriting processes and the right product, channel, sales, and retention strategies, our clients are able to capitalize on opportunities, navigate risks, and increase business performance.
Articles
Navigating MLR Rules Requires Preparation and Planning Read more.
Plans Need to Start Gauging Member Movement Impact Read more.
White Papers
Facility Editing Enhance payment integrity while building strong provider relationships Read more.
A Comprehensive Literature Review of Studies on Care Coordination and Other Health Management Programs Read more.