Changing health care from the inside out
Shifting to a value-based system is disruptive to traditional health care business models. While the promise of value-based care is clear, the path to achieving it is uncertain. Optum™ helps the full breadth of provider organizations navigate the journey with powerful insight, expertise and solutions that convert health data to health intelligence, enable compliance, empower collaborative care and improve revenue cycle management. In other words, we help make the health care system work better for everyone.
Revenue Cycle Management
Hospitals and physicians are tasked with achieving healthy financial performance while determining how to most effectively fund new care models in the future. The added complexity and urgency of the ICD-10 code migration in October 2014 requires an unprecedented level of vigilance on reimbursement and denials management, both before and after the transition. Optum offers you a level of industry knowledge and experience that few technology partners can match. We can help you shape a comprehensive approach to revenue cycle management, one that factors in your organization’s ICD-10 coding and compliance requirements, reimbursement and cash performance, staffing demands and your roadmap to value-based care. Get control of coding, compliance and reimbursement data and processes and make essential financial information accessible where it's needed.
We provide insights from predictive modeling and clinical and financial analytics to drive population health improvement. In addition, we synchronize data points to develop a holistic profile of every individual in a population and proactively identify and prioritize care opportunities. As a result, our solutions help consumers obtain consistency in the quality, outcome and cost of their care experience.
Population Health Management
Build a culture of health and well being with physician engagement. Analytics built on evidence-based medicine (EBM) and disease trends help identify opportunities for intervention before major health issues occur. When you cascade that information to physicians, they become empowered to make informed decisions.
Prepare your system for the shift. Focus on health care’s most mission-critical challenges with interoperable technology that supports collaboration, maximizes clinical outcomes and compliance and reduces errors, redundancy and cost.
New financial incentives, payment models and compliance mandates, coupled with a shifting national focus on reduction of waste and fraud, present hospitals with increasing compliance challenges. Successful compliance programs are built on rigorous processes, access to clinical information and proactive strategies. Optum can help simplify the complexity.
Propel your data to the next level with predictive analytics.Predictive models depend on the size, source and quality of your data. Without all three, you’re not seeing the whole picture.
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Harness the power of a fully integrated coding solutionTransition to ICD-10 with one complete solution.
Educate for ICD-10 successOptum360™ offers comprehensive ICD-10 training and education based on specialized learning needs across your organization. Take courses online, schedule onsite sessions, or ask our consultants to assess your needs and recommend a tailor-made plan.
Optum™ Claims Manager plays pivotal role in OrthoCarolina’s highly profitable revenue management systemUsing Optum Claims Manager, OrthoCarolina was able to reduce claim denials by over 60 percent within two years of implementation.
Predictive analytics: poised to drive population healthWhy today is the tipping point for predictive analytics in health care.
Health care plays Moneyball for game-winning insightThe Oakland A’s won games by crunching numbers. Now, analytics has the potential to become health care’s ‘Moneyball’.
CDI Physician Training VideoTaking it to the next level: Optum360 Clinical Documentation Improvement Physician Training
RAC Up Your Revenue Cycle: How Medicare’s Recovery Audit Contractor Program Is Changing and How It Affects YouHelp save your organization time and resources spent managing RAC reviews.
Connecting with Optum360 prepares Truman Medical Centers for ICD-10Truman Medical Centers saves $7 million over the course of vendor agreement with an outsourced coding solution.
Intelligent solutions for a variety of areas, including EDI, Claim Management, EMR, and HIE
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