VA Community Care Network
Optum is a proud partner with the VA through its Community Care Network (CCN). We are the third-party administrator for the VA CCN for Regions 1, 2 and 3, encompassing 36 states, Puerto Rico, the U.S. Virgin Islands and the District of Columbia.
Through the CCN, Veterans have access to regional networks of high-performing, licensed health care providers who work together with the VA to ensure Veterans receive timely, high-quality care in the right setting. Through this network, VA medical staff can authorize and schedule care from a community care provider with the Veteran’s approval.
To support this contract, Optum leverages its extensive network and relationships across UnitedHealth Group and beyond to provide a robust provider network for the VA in these regions. This includes medical, behavioral, chiropractic, skilled nursing, vision, pharmacy, dental and other complementary and integrative health services like hypnotherapy and Tai Chi. In addition, Optum processes claims from providers who see Veterans as part of CCN.
Medical Disability Examinations
Under the Veterans Benefits Administration Medical Disability Examinations program, OptumServe assists the VA in providing quality compensation and pension examinations to Veterans seeking benefits for service-connected health issues. Clinical findings from the examinations are delivered to the government to facilitate timely disability award determinations.
In 2019, OptumServe performed more than 263,000 compensation and pension examinations for Veterans. This includes medical, audio, mental health, vision, traumatic brain injury and dental exams for Veterans in 39 states and the District of Columbia.
Telephone Lifestyle Coaching
OptumServe is proud to support the VA’s Telephone Lifestyle Coaching (TLC) Program, which is a custom lifestyle coaching program designed for Veterans in partnership with the VHA National Center for Health Promotion and Disease Prevention and the VHA Office of Rural Health. The program focuses on empowering and equipping Veterans to take charge of their health and engage in health behaviors that promote well-being, prevent illness and reduce the burden of chronic conditions.
The TLC Program is an evidence-based lifestyle behavior change coaching model. The coaching is done over the phone, which eliminates the need to visit a medical center or community-based outpatient clinic. This gives Veterans the freedom to participate when and where they desire. TLC helps Veterans address a number of behaviors, including: striving for a healthy weight, eating wisely, being physically active, managing stress and limiting alcohol.
Clinical Practice Guidelines (DoD and VA)
Clinical Practice Guidelines (CPGs) are designed to inform shared decision-making by clinicians and patients regarding diagnosis, treatment and other care management. In particular, evidence-based CPGs are informed by a rigorous methodology, including systematic reviews of evidence and assessment of the benefits and harms of alternative care options.
For a joint program between the VA and DoD, OptumServe leverages an interdisciplinary team of clinicians, health services researchers and health informaticians to facilitate and provide technical and managerial support on more than 20 CPGs, including guidelines on asthma, chronic kidney disease, concussion/mild traumatic brain injury, diabetes, hypertension, low back pain, post-traumatic stress disorder and acute stress reaction, and opioid therapy for chronic pain.
Properly implemented, evidence-based CPGs support high-quality care, reduce errors, improve patient outcomes and promote health care system accountability.