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Perspectives on health plan trends

Together, we are driving toward the same things for our health care system — better quality, lower cost, and higher consumer and provider satisfaction.

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[Text On Screen –John Hoffman, Vice President, Optum Payer]


Hi. I’m John Hoffman, VP in the Optum Payer market business. I’m here to talk to you about our approach to building new and innovative capabilities through integrated Optum solutions and external partnerships that ultimately reduce the total cost of care and improve provider and member experience for our health plan customers. 


[Text On Screen – Speed -> Value]


With a laser focus on speed to value, we are working to both harness the power of assets


[Text On Screen – Power of Optum]


across once disparate business units, 


[Text On Screen – External Partnerships]


coupled with external partnerships with world-class companies to combine solutions at scale in joint market offerings, to drive meaningful impact for health plans. All of our health plan partners are facing similar challenges around improving the provider and member experience,


[Text On Screen – Improving the provider and member experience]


affordability and emerging spend trends, 


[Text On Screen – Affordability and emerging spend trends]


constant regulatory changes, 


[Text On Screen – Constant regulatory changes]


continually evolving digital technologies, 


[Text On Screen – Continually evolving digital technologies]


and many more challenges that require nimble, innovative partners that can deliver solutions rapidly. In response, Optum has evolved beyond individual point solutions into holistic, comprehensive offerings. As we continue to evolve 


[Text On Screen – Innovation identification]


[Text On Screen –Optum capability integration]


[Text On Screen – External partnerships]


[Text On Screen – Outcomes or risk based health plan partnerships]


[Text On Screen – Optum Insight payer innovation]


and stand up new capabilities, we are taking a very deliverable approach to investing in new internal offerings that are built from scratch and/or executing external partnerships with well-established market leaders. These integrated solutions that come from our wide and broad portfolio of Optum businesses, coupled with capabilities from leading external companies, has allowed us to deliver market offerings


[Text On Screen – New market offerings, Laboratory benefit management, Outcomes-based contract enablement, Emergency department spend management]


that can tackle some of the most complex problems in healthcare today, with the scale and resources to achieve significant impact quickly. Some recent examples that are currently resonating across the market include integrated solutions in areas such as labs and genomics, specialty pharmacy, durable medical equipment, behavioral health, and emergency department diversion. In time, you will see others across additional medical spend trends and disease specific categories, payer provider collaboration and transparency, and provider enablement. These broad offerings will also pivot away from traditional license fee


[Text On Screen – Traditional license fee]


and shared savings type models


[Text On Screen – Shared savings]


to full outcomes-based


[Text On Screen – Outcomes-based or risk-based partnerships]


or risk-based partnerships where in some cases, our customers offload risk 


[Text On Screen – Offload -> Optum]


for certain membership or spend categories to Optum. These comprehensive solutions 


[Text On Screen – Reduce cost of care, improve member and provider experience]


combined with risk-based partnerships, 


[Text On Screen – Partnerships solutions, Outcomes-based partnerships, Integrated solutions]


will allow Optum to completely take on our customers’ broad challenges that simply cannot be solved for by typical point solution vendor offerings. Our health plan thought leadership page is designed to give you information about 


[Text On Screen – Example resources, Achieve success in claims editing, Improving genetic test reimbursement, Specialty drugs and prior authorizations, How advanced data science can predict disease, The rising cost of care, Navigating forward: holistic risk, The customer experience trap]


what is top of mind for healthcare leaders across the market and what Optum is doing to address these challenges head on. If you are interested in any specific topic, 


[Text On Screen – Thank you.]


please don’t hesitate to contact us. Thank you for your time today. 


[Text On Screen – Optum, ©2022 Optum, Inc. All rights reserved.]

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