Providing care while reducing spend
Physical Health helps improve outcomes and reduces your organization’s musculoskeletal spend on conditions such as back pain through our Physical Health Networks and Clinical Support Program.
Optum™ has the largest credentialed networks of quality providers in the industry. These networks include chiropractors; physical, occupational and speech therapists; and complementary and alternative medicine providers who work directly with our providers toward:
- Significantly reducing variability of clinical decision-making
- Reducing variability of clinical decision-making by aligning care with evidence-informed medicine
- Improving the individual’s experience by providing convenient access to quality providers, lowering out-of-pocket costs and improving clinical outcomes
Physical Health Networks
Optum™ works directly with providers to manage the cost of health care, making it affordable for employer clients and their employees to seek quality care.
Through our national networks of chiropractors; physical, occupational and speech therapists; and complementary and alternative medicine providers, we help people improve their health and relieve symptoms through non-invasive techniques. We deliver access to providers who follow evidence-based treatment practices, reducing unnecessary visits and services, resulting in medical cost savings.
Access to high-quality providers
Optum has the largest national network of tiered and credentialed physical health care providers in the industry. Highlights include:
- A chiropractic network with more than 26,000 providers
- A physical, occupational and speech therapist network made up of more than 60,000 providers
- A complementary and alternative medicine discount network of more than 8,900 including acupuncturists, massage therapists, naturopathic doctors and dietitians
- A tiered network of quality providers that adhere to evidence-informed medicine guidelines
- NCQA Certification for chiropractic provider credentialing
- URAC accredited for credentialing and network management for physical, occupational and speech therapist network
- A provider website that allows provider access to evidence-informed treatment resources and guidelines
Network recruitment flexibility
Our national network team is dedicated to the recruitment of quality providers to meet and exceed your organization’s needs for provider access. Our network development department works with employers to identify network needs, fill provider accessibility gaps, and reduce out-of-network spend.
Clinical Support Program
Unexplained variation in clinical decision-making among providers is a well-documented issue, and an important factor associated with lower quality and increasing cost of health care services.
By working with providers on the delivery of evidence-informed health care, our Clinical Support Program consistently drives a reduction in the variability of practice patterns to positively impact individual outcomes and decrease costs for musculoskeletal spending.
Through the efforts of our program, which seeks to increase providers’ adoption of current best clinical evidence, Optum can:
- Save organizations 15 to 20 percent when compared to an unmanaged network
- Ensure that individuals obtain consistency in the quality, outcome and cost of their care experience
The cornerstone of our program is outreach and communication with participating providers. Our approach focuses on provider accountability and the adoption of evidence-informed approaches at the individual level. In addition, we have a unique approach of collaborating with cross-functional industry experts in the development of program policies and guidelines. Highlights include:
- A peer-to-peer approach to utilization management
- A standardized health care record for each individual
- Peer review of treatment requests, with outreach on an individualized patient basis, as well as aggregate provider data sharing
- Peer-to-peer educational efforts to assist in the adoption of evidence-informed treatment approaches to increase the quality of patient care and reduce unexplained variance
- 24/7 access to a comprehensive provider website, giving providers the opportunity to obtain information on evidence-based health care, complete administrative functions and compare their aggregate treatment data with those of their peers