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Synchronizing clinical care for a total health care approach

With pharmacy, the most frequent consumer touch point, we use every member interaction as an opportunity to direct members to their next best health and savings action. 

We pinpoint these opportunities with OptumIQ™ — a unique combination of data, analytics, and health care expertise that allow us to synchronize medical and pharmacy information and see a complete view of each member’s current health.

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health opportunities

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savings opportunities 

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$11-16 PMPM in medical cost savings

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OptumRx goes beyond pharmacy, delivering total health outcomes at lower overall cost.
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How data drives improvements in clinical care and costs

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ANDREA MARKS: We're not sitting back

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and watching the healthcare

system fall apart,

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we're actually shaping

what the healthcare system

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is going to be in the

future, and that's exciting.

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Data in and of itself is

not going to be useful,

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you need to be able to take

data and turn it into action.

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And we at OptumRx, are really focused

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around mining the data and

putting it into action.

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We have predictive models

that are put in place

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to be able to identify

who needs the right type

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of intervention at the right time.

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All of our algorithms are built not only

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within pharmacy data,

we incorporate a number

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of different types of data sources

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to be able to get to the right outcome.

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The data we have access

to at OptumRx comprises

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over 250 million lives and 20

years of longitudinal data.

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But also a deep set of clinical

data, information from EMRs,

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information from lab results,

behavioral health information

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to really provide us with

a very comprehensive set

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of information that we can mine.

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Synchronization is critically

important to our clients

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as well as to our members.

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It provides them a single

touchpoint to be able

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to engage members at the time

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that they are also engaging with us.

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When a member calls in and

we have the opportunity

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to be able to talk to them

at that point in time,

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we wanna make sure that

we've presented all

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of the the opportunities that

we have for that individual

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so that we can coach them through things,

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connect them to the right pieces,

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connect them to the

right parts of healthcare

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so that we can affect the

overall outcome of that patient.

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Success for our clients

is really no surprises.

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They wanna make sure that they understand

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what happened in the past,

what's happening now,

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but then also what's gonna

happen in the future.

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We can partner with them to

be able to identify new ways

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so that we can actually change

the course of the future.

[00:01:54.04]

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How data drives improvements in clinical care and costs

The use of data and analytics is helping to define the future of pharmacy care services. Drawing on vast and deep data sets, OptumRx is using cutting-edge analytics to better understand the most challenging problems in health care.

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Simplifying the member experience 

We all know the health system is complex, fragmented and confusing to navigate. Here’s how we’re providing better care and support to our members:

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Connecting touch points

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Providing transparency

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Prioritizing opportunities

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Personalizing communications

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Helping members online and on the go

Both optumrx.com and the OptumRx App offer a one-stop-shop for members to make their pharmacy experience as simple as possible. Members can easily:

  • Refill and renew prescriptions.
  • Transfer a retail prescription to home delivery.
  • View prescription order status and claim history.
  • Locate a pharmacy.
  • Find drug prices and lower-cost options.

Visit optumrx.com or download the OptumRx App now from the Apple® App Store or Google PlayTM.

Video Component

Opt Rx Movie App

A young girl named Jessica and her dad, John sit down for a movie in a theater

Jessica receives a text message from her mom, Jane, saying, “Hi Honey :)”

Jessica turns to her dad and mouths ‘mom’

Mom sends Jessica another text saying ‘did you take ur medication?”

Jessica begins to type and replies “Yesss!”

Jessica sends another text to mom- “But… I only have a few pills left :(“

Jessica looks over at her dad smirking while texting as the lights dim in the movie theater

John’s phone beeps and he takes it out of his pocket

John gets a text message from Jane, the young girl’s mother, saying “Did you refill her Rx?”

John cringes looking at the text worried

John smiles at Jessica then pulls up his OptumRxÒ app with his family members name’s listed

John clicks on Jessica’s name and goes into her “My Medicine Cabinet’ to refill her prescription that she is currently taking

John then orders refill, checkouts and processes payment on the OptumRxÒ app

John receives an order confirmation

John replies to Jane’s text message of “Did you refill her Rx?” with, “Yes.. will be on our doorstep in no time ;)”

Jane replies back to John, “Ur the best. Have fun!”

Jessica and John both look over at each other and smile

(OptumRxÒ logo)

The OptumRx App- Empowering Members to Manage Their Prescriptions

(Graphic of iPhone with the OptumRxÒ app homepage up)

(Find the OptumRx App on iTunes or Google Play)

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