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Seizing the opportunity to reshape care delivery

Care delivery should be more patient-centered, informed by clinical expertise, driven by data and enabled by technology.

Dr. Dan Frank | March 26, 2021

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Imagine, for a moment, that you could wave a magic wand and build a new health care system from scratch. How would you describe it? We’d each have our own list of priorities, but I bet we’d all agree on some common traits this system would have. Health care would be:

  • Simple We would have access to care where and when we need it, the oftentimes complex health care journey would be simplified, and our time respected.
  • Informed Wherever we went to get care, our care team would take the time to “know me,” by learning our stories, our values, and knowing what we care about — without us needing to provide it again each time we speak to someone new.
  • Complete Everyone’s whole-person health needs would be met, inclusive of physical, mental and social needs. Our health care needs would be anticipated using data about our health and conditions to intercept disease earlier and keep us healthier. 
  • Compassionate Care delivered with compassion as our care teams would listen and act on what they know about us with empathy. 
  • Trusted We would trust in our providers and in the system and feel confident in the reliability and ability of our health care professionals. 
  • Warm and welcoming The experience would uplift the human spirit and feel as if we were guests in a friend’s home, with a clinic experience that serves us as patients while building a sense of community. 

Notice one thing that’s not mentioned on my list? Cost. That’s because excess cost is a symptom of not addressing these needs well enough — it’s not a problem in and of itself. 

The money we spend on health care is astronomical — it was about $4 trillion in 2020* — but its scale is a byproduct of inefficient processes, the unbalanced allocation of resources, legacy payment approaches that favored quantity over quality, and outdated regulations that don’t reflect today’s reality. We all know we can do better.

So, without our magic wand, what are some steps we can take that get us closer to the patient-centric, physician-led health care delivery system that does begin to earn those descriptions? Offering one glimpse at beginning to make this vision a reality is a network of nearly 74,000 clinicians in communities across the country.  

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Serving millions of individuals across the U.S.

For the nearly 74,000 Optum Care clinicians on the front lines, it’s not just a job. It’s a calling. A promise to help keep patients healthy, help heal the sick, cherish life and answer questions for everyone who comes to them.

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Personalized insights at the physician’s fingertips

Low-value, inefficient care adds unnecessary and financially unsustainable costs to the system — not to mention an increased risk of adverse events. Despite this criticality, it’s impossible for individual clinicians to keep up with all relevant information at the pace it’s available with new medical articles appearing at a rate of at least one every 26 seconds.

With Optimal Care, our proprietary evidence-based clinical decision support process built by providers, for providers gives doctors across Optum Care® up-to-date clinical information from the latest medical and scientific literature on a patient’s condition — right at their fingertips. 

We do this through teams of expert physicians who stay on top of research and create evidence-based approaches that can be embedded seamlessly into a physician’s workflow, and increasingly, embedded directly in their EMRs. 

Embedded in this body of knowledge are insights that can help guide individual patients to better outcomes, and when you’re serving patients covered under risk arrangements, those outcomes translate into financial viability for your organization. 

This is especially true in Texas and Florida, in our largest care delivery organization that consists of 22,000 physicians serving over 1 million patients. It’s a physician-led practice that built its entire model around preventive care and has delivered value-based care for decades. 

We’re applying what we’ve learned here to improve care across the country for the patients we serve. When we talk about analytics and technology augmenting professional skills, this is exactly what we mean: new advances that help physicians work at the top of their license and deliver care at the optimal intersection of cost and quality.

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Enabling technologies turn data into care actions

Across the Optum Care integrated ecosystem, we depend on our own powerful interoperability engine: Optum® Data Exchange, or ODX. ODX gathers and standardizes clinical data to develop deeper insights on disease and patient health trends. It helps our clinicians — nearly 74,000 of them — make more informed decisions and close gaps in care. And for the past year, it has been the hub of our COVID-19 case tracking, analytics and reporting. 

Approximately 85% of Optum Care patient clinical data is available in ODX, and we are on track to reach 100% this year.

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Continuing to expand, one neighborhood at a time

Our network is perhaps the most comprehensive in the U.S., encompassing primary care, ambulatory surgery centers, urgent care, specialty benefit and complex care management, post-acute care, behavioral health and in-home care.

All Optum Care practices are moving toward value-based care — truly delivering value at scale with better experiences, costs and outcomes. 

We continue to strengthen our value-based care continuum in many areas, such as post-acute care. We offer evidence-based protocols and dedicated clinical staff to track patient recoveries, manage hospital discharges, reduce readmissions and, with tools like Optimal Care, support efficient clinical decision-making. 

Over the last 12 years, Optum Care has grown from a single geography to serving 44 states and 3.6 million value-based lives through risk-based contracts. Our more than 74,000 employed or aligned clinicians care for the nearly 20 million domestic U.S. patients of Optum Care, serving over 80 health plan partners. 

We’re still early in this journey of developing high-performing local care delivery organizations. Learn more about who we are, where we are and what we do here. And if we don’t already, we look forward to serving you soon.

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Eric Rock

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Dr. Daniel Frank

Chief Medical Officer, Optum Care

Dr. Daniel Frank is responsible for partnering with local care delivery systems across the nation to advance clinical initiatives, foster an exceptional provider experience, improve patient outcomes and transform the way care is delivered.

Dr. Frank also oversees the Office of Provider Advancement, chairs the Clinical Leadership Congress, and serves on the Physician Executive Council of Optum Care. In addition, he is an executive board member of the Center for Clinician Advancement at UnitedHealth Group. Through these governance bodies and partnerships, he upholds our commitment to ensure our care delivery capabilities are developed in a highly collaborative, physician-led environment.

Dr. Frank received his bachelor’s degree in microbiology at the University of Florida, and his medical degree from the University of Miami, Miller School of Medicine. He completed his residency in family practice at Jackson Memorial Hospital in Miami where he became board certified in Family Medicine.

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* Centers for Medicare & Medicaid Services. NHE Fact Sheet.

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