UnitedHealth to link Optum’s analytics, provider subsidiaries

By | September 6, 2019

Dive Brief:

  • UnitedHealth Group plans to link its network of tens of thousands of physicians in its population health management and care delivery business, OptumHealth, with insights it gleans from its data analytics business, OptumInsights.
  • Patients and providers will be able to access health data in real time as part of this new “digital ecosystem,” Optum CEO Andrew Witty, former chief at GlaxoSmithKline, said Thursday at the Wells Fargo Securities Healthcare Conference. It will link all Optum care locations in a particular geography and rely on a risk-based, capitated fee structure to align all participating players together, Witty said.
  • Currently, UnitedHealth has bandwidth in about a dozen U.S. cities to implement the program. It plans to partner with health systems where it doesn’t have a strong enough provider presence to advance value-based care and tackle chronic diseases.

Dive Insight:

Healthcare companies across the sector are looking to capitalize on the promise of big data, with potential uses for claims forecasting, AI training, research and development and more.

Optum’s success is indicative of this trend. The health services branch of UnitedHealth Group has grown dramatically since the launch of the health services division in 2011. It’s forecast to reach $ 110 billion in annual revenue this year, Witty said Thursday.

The division contracts with four out of every five U.S. hospitals, four out of five employers in the Fortune 500 and roughly three out of every four health plans, according to the company. Currently, OptumHealth employs or is affiliated with roughly 50,000 physicians across different sites of care.

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“What we want to do is empower that network with the information and insights created from the information we have as an organization,” Witty said. “If you can make that [provider] environment more competent, more insightful, more predictive, then you can make significant impacts on downstream costs.”

UnitedHealth executives hinted at the strategy in their second quarter earnings call in July, noting they were focusing on consumer engagement, actionable health info and analysis and the shift to value-based care to drive business growth.

In regions where UnitedHealth has a smaller footprint, the healthcare giant plans on partnering with hospital systems on ways to jointly advance value-based care in that area. The strategy is already in play. In July, Optum linked with John Muir Health in the Bay Area to manage all nonclinical and back office functions for the chain and says its received interest from multiple other regional systems.

“Without us having to buy ambulatory care practices, we can start deploying the same mentality, the same approach — we hope with the same outcome,” Witty said. “That opens up the whole country.”

One focus area is investing more resources into patients with chronic conditions. By 2030, about 18 million Americans will have three or more chronic diseases, Witty said, and each one costs on average 10 times more than a patient with only one condition.

UnitedHealth Group, which owns the country’s largest payer, UnitedHealthcare also plans to funnel more resources into several specific high-cost diseases such as cancer.

UnitedHealth Group topped Wall Street earnings expectations for the past quarter, driven in part by double digit growth in OptumRx and OptumHealth. Optum overall reported revenues of $ 28 billion for the quarter — a more than 13% spike year over year — hastened by a series of acquisitions and organic growth.​

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