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Case study

Targeted care, lower cost

One state achieved both in delivering home health services.

The right level of care for the right person

At-home care allows people to stay in their homes rather than enter inpatient settings. But precision is critical. Providing and reimbursing the most appropriate level of care helps allocate finite resources to those who will benefit from them the most.

Partnering to assess opportunities

One state partnered with Optum to assess the home-based nursing care they cover, revealing opportunities:

  • $80 million in annual savings
  • Reduced nursing visits by 37%
  • Increased medication administration visits by 15%

All with minimal to no disruption for constituents and less cost to taxpayers.

Key takeaways

  • At-home nursing care is an invaluable service, but determining the appropriate level of care is complex
  • Working with Optum to enhance prior authorization portal and provider education led to $80 million in annual savings for the state
  • Integrating long-term care operations with Optum provided a single point of accountability, improving efficiency and collaboration
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