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Keep a finger on the pulse of future CVD care
The years ahead will see greater challenges in cardiovascular disease (CVD) care. To prepare for what’s coming, providers and payers will benefit from working together to optimize quality of care and...
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Leading a team approach to value
Collaboration around the business of health care is critical In a recent marketplace survey by NEJM Catalyst on the transition from fee-for-service to value-based care, we gained interesting insight...
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Specialty Rx: An exponential challenge for health plans
Health plans are seeing exponential growth in both the use and medical cost expense of specialty medications. In the past decade, the Food and Drug Administration (FDA) has approved more than 250...
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Spotlight on Caring: Angela H.
As a clinician myself, I have seen the power of the in-home assessment to help members live healthier lives—a key aspect of our mission. The work our Optum HouseCalls clinicians do often results in...
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Spotlight on Caring: Richard H.
Often we hear specific feedback from our valued members about our clinicians. These notes of gratitude underscore the impact that each Optum HouseCalls employee has in achieving our mission to help...
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Special topic: An Optum Forum 2019 preview
More than 1,500 clients, partners, industry analysts and health care leaders will attend Optum Forum 2019 in Las Vegas next week. The annual health care event will feature thought-provoking content...
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Emerging trends and complexities of genetic testing reimbursement
Complexities of genetic testing reimbursement Genetic testing has become an increasingly important and effective tool in identifying and treating disease. Genetic testing can confirm or rule out...
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Spotlight on Caring: Lisa T.
Member education is a vital part of each HouseCalls visit. We are deeply committed to enabling members to be more engaged with their health care providers and health care choices. That is why our...
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Spotlight on Caring: Kelly Z.
It’s humbling to think how a HouseCalls visit can make a big difference in a member’s health. It requires significant training and a practiced eye to evaluate a situation so that you can understand...
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Spotlight on Caring: David R.
In addition to rigorous training to prepare our HouseCalls advanced practice clinicians, we also equip them with powerful screening tools. These tools, like the QuantaFlo system noted in this example,...
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Spotlight on caring: Christy T.
The connection between our HouseCalls advanced practice clinicians and a member’s care team cannot be overemphasized. As our clinician Christy so aptly demonstrated in this example, we are an extension...
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Health plans recognize need to improve encounter data quality
Health care organizations are under increasing pressure to reduce costs. An important consideration is whether revenue for risk adjusted populations, including Medicare Advantage plans, is based on...
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Health plan drivers of innovative risk and quality provider reimbursement...
Over the course of the past few decades, provider reimbursement has taken on different forms with varying degrees of acceptance and success. Many have had their share of challenges and opportunities,...
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HEDIS measures, ECDS and telehealth: Are health plans ready?
According to the National Committee for Quality Assurance (NCQA), the Electronic Clinical Data Systems (ECDS) reporting standard represents a step forward in adapting the Healthcare Effectiveness Data...
View ArticleSocial determinants of health data challenges and their impact on risk and...
The impact of social determinants of health (SDOH) on patient care is becoming more and more critical. Over the past few years, the Centers for Medicare & Medicaid (CMS) has focused on addressing...
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Spotlight on caring: Marcia K.
The home visit is a vital way to connect with members in a way that enables them to more fully communicate their concerns and needs. But first you have to earn their trust — from the call to set up the...
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Spotlight on Caring: Ed V.
HouseCalls enables its advanced practice clinicians to be as flexible as possible to adjust to each member’s needs. Just as importantly, our clinicians are trained to be persistent in reaching out to...
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2020 MA plans: More benefits at little or no cost to members
In 2019, more than 20 million members enrolled in Medicare Advantage (MA) plans. That number is expected to grow to more than 30 million members before 2030.1 For the 2020 plan year, the Optum Advisory...
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Leveraging market landscape data for 2021 bid preparation
The Medicare Advantage (MA) bid process is a function of the overall product strategy that a health plan organization wants to put in place over a multi-year time frame in the marketplace. When...
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Spotlight on Caring: Carrie B.
Whether members live alone or even when they have others in the home with them, they can ignore worsening health conditions. It takes an expert perspective — like that of a HouseCalls advanced practice...
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