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Emergent Care Transformation

ED use is on the rise and so is spend. Our solution identifies trends, patterns and opportunities to reduce use and spend.

Proactive prediction helps manage ED spend

Health plans may have limited success deploying point solutions focused on retrospective lookback of ED use to drive member interventions. Optum® Emergent Care Transformation is a comprehensive program designed to enable health plans to proactively manage the rising costs of ED use and spend.

 

Optum deploys an industry-leading predictive model that monitors data from a wide variety of sources. The model looks for trends and patterns to actively identify appropriate opportunities to reduce use and spend. It accurately predicts at-risk members and pairs them with intervention partners to redirect care paths that prevent avoidable ED.

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>90%

Future frequent user ED spend flagged by predictive model.1

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20% to 30%+

Predictive model spend savings opportunity2

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$47B

Per year for unecessary ED visits3

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Improving member experience

Through proactive identification accompanied by a robust intervention program, Optum Emergent Care Transformation can help health plans guide members toward more appropriate and convenient care. Member experience can be improved by shorter wait times and decreased cost of care.

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Is your ED spend management strategy effective?

Let Optum perform a business case for your health plan at no cost to you. In 60 days, Optum delivers recommended program optimization and estimated ED savings opportunities.

    • Provides a gap analysis.
    • Offers industry insights on how your competitors manage ED spend.
    • Creates a transformational roadmap to show the financial opportunity and how long it may take to achieve.
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Emergent Care Transformation program

Download product sheet (PDF 351.3kb)

See how Optum can drive better outcomes for members, health plans and providers.

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  1. Observed by Optum during model testing
  2. Average potential savings. Your results may vary.
  3. Unnecessary ER visits cost $47B a year, report finds (beckershospitalreview.com)

Disclaimer: Optum Insight, Inc. (“Optum”) provides its AI predictive model for informational purposes only. Any reliance upon, interpretation of, or use the AI predictive model is solely and exclusively at the discretion of the user. In creating the AI predictive model, Optum uses a range of data sources and advanced analytics techniques, including machine learning. These techniques have the potential to result in statistical or other unintentional biases (e.g., age, gender, and socioeconomic data) against a given cohort. While Optum performs bias testing, testing is limited by available data. Optum may perform additional testing, if required member level data is provided.