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Looking at health from all angles helps create solutions that work for each individual.

When we put a person at the center of his or her own care and look at all dimensions of health — not just traditional medical factors — we see a more complete picture.

To bring that picture into focus for all people, Optum is working collaboratively to provide the services and care they need, even beyond medical care; guide them along their personalized care journey; and work to achieve health equality.

 

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  • Graphic of overlaping circles with a person in the center.

    The outer ring lists medical care, genetics and biology, social circumstances, physical environment and individual behavior.

    The next ring lists government, hospitals, primary care, specialties, insurance companies and pharmacies.

    The ring closest to the person lists community, financial health, behavioral health, support groups, family and education.

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More than medical care

Keeping people healthy takes more than medical care

About 80% of a person’s health happens outside the clinic or hospital — healthy behaviors, socioeconomic and environmental factors play a larger role in determining an individual’s health. To improve health outcomes, reduce inequities and lower costs, it is critical to invest more heavily into resources, programs and pursuits that positively impact non-medical determinants of health.

 

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  • Health determinants 

    Correlations between chronic disease incidence and determinants of health (DOH) found in inaugural Optum survey.

    • The number of health determinant factors increases the prevalence of behavioral health conditions (no DOH = 6%; one DOH = 14%; two DOH = 26%).
    • People without access to enough food or safe water are 5.2x more likely to have chronic kidney disease.

    *Results of an online Optum survey of 10,270 U.S. adults in Q3 2019, conducted by Forrester Research

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Community health workers address all dimensions of health, one person at a time

They may not be seen as typical health staff, but Optum community health workers who provide outreach, health education and social supports can bring profound change to the well-being of a community and individuals. 

With their in-depth knowledge of a community’s culture, communication styles and resources, it is a community health worker’s priority to connect people with a wide range of non-medical services and address issues that can undermine clinical care.

These workers help people better manage their own health, leading to fewer emergency room visits and hospitalizations, better medication adherence and reduced health disparities.

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Stable housing is a first step to wellness

When people do not have safe, affordable housing, their health often suffers grave consequences.

Those who are homeless or housing insecure are at a higher risk of substance abuse, violence and even death. With stable housing, hospitalizations and visits to the emergency room can be reduced, and people find it easier to manage ongoing medical conditions.

Optum, along with its sister and parent companies, has spent about $400 million to date on affordable housing projects nationwide, which may also help lower health care costs.

A study found that providing housing and supportive services to chronically homeless people in New York saved $8,260 per person annually as a result of decreased psychiatric hospitalizations. 

 

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Personalized Care

Personalization is at the heart of people-centered care

Treating people as people — not just patients — enables a more holistic perspective into the factors impacting their health and their care. Using that lens gives a clearer picture of the pathways needed to improve individuals’ experience with their health care.

 

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Case managers wholly support personal health journeys

Learn how an Optum case manager helped Madeleine navigate the complexities, benefits and challenges of her gender confirmation journey.

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Madeleine, Optum Member: From the outset of my transition there were a lot of things that I worried about. So, so one of them was, I never had surgery, I've never even had a stay in a hospital until this journey.  

Text on screen: Two years ago, Madeleine made the decision to have gender confirming surgery. 

Melinda Raines, RN: I am an advocate for the member to help them to figure out how to navigate the health care system.  

Melinda on the phone: Hello, this is Melinda.  

Melinda: With Madeleine's case, there's many different moving parts, there's different surgeons, there's a plastic surgeon, a urologist, there’s a regular doctor, maybe an endocrinologist dealing with hormones and making sure that all those doctors are collaborating together.  

Madeleine: I had already looked at the benefits, so I thought I had a pretty good idea of what was offered being an employee of a larger company. But talking to Melinda, like, there were more there. And I wouldn't have been able to do that without Melinda's help.  

Melinda: When I first spoke with Madeleine there was an instant connection. Trust is the most important thing to have with the members that I work with so they feel comfortable sharing with me their personal health history.  

Madeleine: Melinda is really compassionate, she accompanied me on this journey. I couldn’t have made it in the same way without her.  

Melinda: It's common for me to see people not utilizing all of the benefits that they have available to them.  

Madeleine: What I loved about working with Melinda is that even when she didn't know what the next step was, she'd go away and come back with ok, here's what you need to do next. Throughout this journey the emotional part of it, right, kind of runs on its own path. But it's nice knowing that like I wasn't doing it alone.  

Melinda on the phone: Any concerns with your emotional health?  

Melinda: I always do make sure people know what's available to them.  

Text on screen: Through Optum, some employer health plans offer behavioral health support. 

Melinda: We're able to offer emotional support, if they're having trouble with anxiety, depression, or stress.  

Madeleine: I've never felt better cared for than I have throughout this whole process. Because these benefits are quite expansive, without coordination it would be the same as having no benefits at all. You really need that, that guide.  

Melinda: I feel a sense of purpose in what I do and working for Optum. I feel like I'm able to serve the members that I work with much more holistically.  

Melinda on the phone: I’m really looking forward to seeing you tomorrow. Ok, take care, bye.  

Text on screen: Melinda wanted to meet Madeleine in person. 

Melinda: Hi Madeleine!  

Madeleine: Hi come in.  

Melinda: I just want to thank you for being so open and sharing your personal health history and your journey. 

Madeleine: All the journeys may look a little bit different, but hopefully more and more of those journeys will have you involved with them. It meant so much to me to have you. Yeah, that we had this instant sisterhood. 

 

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Proactive preventive care comes to seniors’ homes

With the additional health challenges age brings, many older adults can benefit from an at-home health visit. HouseCalls is a yearly evaluation that can proactively address a range of health issues.

In addition to conducting a physical, mental and behavioral exam, providers also get insight into the person’s environment. What is their living space like? Are there notable hazards or needs? Do they have the social support necessary for overall well-being?

With this comprehensive review, Optum clinicians can offer educational materials and resources tailored to individual health care needs, provide referrals to further resources and communicate with primary care providers for continuing care.

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Personalized, integrated pharmacy services help underserved communities

People living with serious and persistent mental illness, substance use disorder or other complex conditions need extra support to cope with their illnesses and stay on treatment plans.

When pharmacy services are provided within a community mental health clinic, pharmacy and clinic staff can work together to offer individualized care. Genoa Healthcare, an OptumRx subsidiary, offers this kind of integrated care through services such as medication therapy management, comprehensive medication reviews, personalized health care handbooks and refill reminder calls.  

This specialized attention drives measurable results, increasing medication adherence and lowering behavioral health-related hospitalizations and emergency room visits.

 

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Health Equity

Achieving equitable care begins by seeing disparities 

An individual’s gender and ethnicity, place of birth, education, employment status and income can all contribute not only to his or her health but also to the kind of care he or she receives. Creating equality in health status among different populations can have a significant impact on individuals, on society and on the total cost of care.

 

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Women are underserved in health care

Women have disproportionately high rates of chronic disease, misdiagnosis, complications and negative experiences for many conditions. And yearly per capita health care spending is 1.3 times more for women than men.

These inequities are driven by biological, socioeconomic and systemic drivers:

  • Biological — Health care treatment is often not tailored to account for gender and sex differences in disease manifestation, treatment and response. For example, abnormal lab results might go undetected as most tests are not calibrated for women.
  • Socioeconomic — Women are more likely to delay routine care, possibly because of lower access to care, more time spent caring for others or poor past experiences.
  • Systemic — Providers often lack training in women’s health and in gender-based differences. Women are also underrepresented in clinical studies, consumer research, product design and health care leadership.

Changes in areas like cardiovascular disease, depression, maternal health and caregiver burden could have high impact in gender health equality.

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  • Health inequities

    • White patients are 1.5x more likely to receive pain medication than black patients with the same condition.
    • Maternal death rates vary significantly by race (White = .013%; Native American = .030%; Black = .041%).
    • Women are 30% more likely than men to be sent home from the ER with misdiagnosed stroke symptoms.

    Sources:

    1. National Academy of Sciences
    2. CDC
    3. Diagnosis
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