95% 88% 90% 68% 50%€¦ · CIOs accelerate the digital transformation that responds to evolving...
1
EFFICIENCY OPTIMIZATION TRANSFORMATION INNOVATION Enable interoperability and data access to deliver intelligence across the broader ecosystem. Seamlessly integrate business partners to deliver outcome based care and a 360° view of an individual. You have created a modern, secure health plan by uniting technology and stakeholders in a connected, continually refreshed ecosystem. CIO Leadership Deliver scalable, IoT-adaptable digital applications and business models to improve customer experience. Deliver reliable, efficient and secure core IT services at a lower cost by shifting plan technology to the cloud. Efficiency Efficiency Efficiency CIO’s ROLE CIO’s ROLE CIO’s ROLE DATA SECURITY DATA AND ANALYTICS OF CIOS 95% 88% OF PROVIDERS AND PAYERS use or plan to use predictive analytics in the next 5 years. 4 90% OF HEALTH CARE ORGANIZATIONS had a data breach in the past two years. 2 OF CMS PAYMENTS 50% will be moved to value-based care in 2018. 5 expect digitalization to change their jobs. 1 CIOs accelerate the digital transformation that responds to evolving business demands. CIOS ARE THE ARCHITECTS OF THE CONNECTED HEALTH CARE ECOSYSTEM MODERNIZED OPERATIONS MEMBER EXPERIENCE AND ENGAGEMENT PROCESS ACCURACY OF CONSUMERS prefer electronic payment methods to pay their medical bills. 3 68% Efficiency Innovation Optimization Transformation CIO’s ROLE CIO’s ROLE CIO’s ROLE CIO’s ROLE Get your assessment at www.optum.com/CIO 1 Gartner, The 2018 CIO Agenda, Mastering the New Job of the CIO 2 https://www.ponemon.org/local/upload/file/Sixth%20Annual%20Patient%20Privacy%20%26%20Data%20Security%20Report%20FINAL%206.pdf 3 https://instamedcorpprd.cachefly.net/wp-content/uploads/Trends-in-Healthcare-Payments-2016-Infographic.png 4 https://www.soa.org/healthcare-analytics/ 5 https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html CHIEF VP INFORMATICS CHIEF CHIEF CHIEF CHIEF Secure ecosystem Proactive protection of digital data, systems and networks. Process accuracy Across claims, enrollment, billing, reconciliation, and encounters to reduce waste and increase quality. Consumer engagement Expert guidance, education and resources to find the best care at the right price. Member growth and retention Sustained engagement through exceptional experiences to drive growth. Outcome based partnerships Robust data and analytics paired with top medical, behavioral and Rx care programs. Connected Aligned member, payer and delivery system for a healthier community. REALIZE YOUR VISION Modernized operations Manage administration processes to lower PMPM costs, adapt quickly and thrive. EFFICIENCY OPTIMIZATION TRANSFORMATION INNOVATION Optum Health Care Technology as a Service A P P L I C A T I O N S E R V I C E S S Y S T E M S I N T E G R A T I O N E N T E R P R I S E D A T A P L A T F O R M I N F R A S T R U C T U R E S E R V I C E S S E C U R I T Y A N D C O M P L I A N C E A D V I S O R Y S E R V I C E S Data Driven Decisions Financial Management Benefit Plan Management Claims and Member Administration Medical Management Customer Service Risk and Quality Management Provider and Network Management Comprehensive Payment Integrity CHIEF EXECUTIVE OFFICER CHIEF MEDICAL OFFICER CHIEF OPERATIONS OFFICER CHIEF COMPLIANCE OFFICER VP CLAIMS CONSUMER CHIEF INFORMATION SECURITY OFFICER CHIEF FINANCIAL OFFICER CHIEF MARKETING OFFICER CHIEF STRATEGY OFFICER VP INFORMATICS VP CLAIMS CLINICAL CARE OPERATIONS MEMBERSHIP Reduce administrative expenses Provide rapid response to security threats Reduce cost of paying claims Automate business processes Reduce medical expenses Reduce cost per acquisition gains better understanding of services e o o C F l D I G I T A L A C C E S S C O N S U M E R 1.9 BILLION Claims processed annually with 99% accuracy. CLINICAL CARE OPERATIONS MEMBERSHIP 1,000+ Optum business advisory consultants with unmatched health care expertise. gains better understanding of cost and risk e o o C F l D I G I T A L A C C E S S C O N S U M E R Balance CAPEX/OPEX Maintain compliance with regulations Improve claim accuracy Provide quick, flexible delivery capability Simplify data to understand membership Ensure data security and privacy CLINICAL CARE OPERATIONS MEMBERSHIP experiences convenient, integrated, personalized services e o o C F l D I G I T A L A C C E S S C O N S U M E R Pilot new provider payment models Create transformative pilot programs Use analytics to lower costs, improve care Evolve goals based on analytics Offer value-based payment models Provide flexibility to enter/exit models Proprietary health care data on more than 240 MILLION LIVES CLINICAL CARE OPERATIONS MEMBERSHIP achieves ability to proactively manage health concerns e o o C F l D I G I T A L A C C E S S C O N S U M E R Spot industry points of growth Offer concurrent, real-time payment options Create high-performing networks and variated CoEs Operationalize successful transformative programs Provide a 360º view of members Improve contracting through shared data Create a differentiated market network $2.9 BILLION Invested annually in technology and innovation
Transcript of 95% 88% 90% 68% 50%€¦ · CIOs accelerate the digital transformation that responds to evolving...
EFFICIENCY OPTIMIZATION TRANSFORMATION INNOVATION
Enable interoperability and data access to deliver intelligence across the broader ecosystem.
Seamlessly integrate business partners to deliver outcome based care and a 360° view of an individual.
You have created a modern, secure health plan by uniting technology and stakeholders in a connected, continually refreshed ecosystem.
CIO Leadership
Deliver scalable, IoT-adaptable digital applications and business models to improve customer experience.
Deliver reliable, efficient and secure core IT services at a lower cost by shifting plan technology to the cloud.Efficiency
Efficiency
Efficiency
CIO’s ROLE
CIO’s ROLE
CIO’s ROLE
DATA SECURITY DATA AND ANALYTICS
OF CIOS 95% 88%
OF PROVIDERS AND PAYERSuse or plan to use predictive analytics in the next 5 years.4
90%OF HEALTH CARE ORGANIZATIONShad a data breach in the past two years.2
OF CMS PAYMENTS
50%will be moved to value-based care in 2018.5
expect digitalization to change their jobs.1
CIOs accelerate the digital transformation that responds to evolving business demands.
CIOs ARE THE ARCHITECTS OF THE CONNECTED HEALTH CARE ECOSYSTEM
MODERNIZED OPERATIONS
MEMBER EXPERIENCE AND ENGAGEMENT
PROCESS ACCURACY
OF CONSUMERSprefer electronic payment methods to pay their medical bills.3
68%
Efficiency
Innovation
Optimization
Transformation
CIO’s ROLE
CIO’s ROLE
CIO’s ROLE
CIO’s ROLE
Get your assessment at www.optum.com/CIO
1 Gartner, The 2018 CIO Agenda, Mastering the New Job of the CIO2 https://www.ponemon.org/local/upload/file/Sixth%20Annual%20Patient%20Privacy%20%26%20Data%20Security%20Report%20FINAL%206.pdf3 https://instamedcorpprd.cachefly.net/wp-content/uploads/Trends-in-Healthcare-Payments-2016-Infographic.png4 https://www.soa.org/healthcare-analytics/5 https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
Secure ecosystemProactive protection of digital data, systems and networks.
Process accuracyAcross claims, enrollment, billing, reconciliation, and encounters to reduce waste and increase quality.
Consumer engagementExpert guidance, education and resources to find the best care at the right price.
Member growth and retentionSustained engagement through exceptional experiences to drive growth.
Outcome based partnershipsRobust data and analytics paired with top medical, behavioral and Rx care programs.
ConnectedAligned member, payer and delivery system for a healthier community.
REALIZE YOUR VISION
Modernized operations Manage administration processes to lower PMPM costs, adapt quickly and thrive.
EFFICIENCY OPTIMIZATION TRANSFORMATION INNOVATION
Optum Health Care Technology as a Service
APP
LICA
TION SERVICES
SYSTEMS INTEGRATION
ENTERPRISE DATA PLATFOR
M
INFRASTRUCTURE SERVICES
SECURITY AND COMPLIANCE ADVISORY SE
RVIC
ES
Data DrivenDecisions
FinancialManagement
Benefit PlanManagement
Claims and Member
Administration
MedicalManagement
CustomerService
Risk and QualityManagement
Provider and Network Management
ComprehensivePaymentIntegrity
CHIEF EXECUTIVE OFFICER
CHIEF MEDICAL OFFICER
CHIEF OPERATIONS OFFICER
CHIEF COMPLIANCE OFFICER
VP CLAIMS
CONSUMER
CHIEF INFORMATION SECURITY OFFICER
CHIEF FINANCIAL OFFICER
CHIEF MARKETING OFFICER
CHIEF STRATEGY OFFICER
VP INFORMATICS
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CHIEF MARKETING
OFFICER
CHIEF STRATEGYOFFICER
CHIEF OPERATIONS
OFFICER
VP CLAIMS
CHIEF INFORMATION
SECURITYOFFICER
CHIEF COMPLIANCE
OFFICER
VP INFORMATICS
CHIEF MEDICALOFFICER
CHIEF FINANCIAL
OFFICER
CHIEF EXECUTIVE
OFFICER
CONSUMER
CLINICAL CARE
OPERATIONS MEMBERSHIP
Reduce administrative expenses
Provide rapid response to security threats
Reduce cost of paying claims
Automate business processes
Reduce medical expenses
Reduce cost per acquisition
gains better understanding of services
Choice of CoverageA
cces
s to
Care
Financial Control
DIG
ITAL ACCESS
C
O N S U ME R
1.9 BILLIONClaims processed annually
with 99% accuracy.
CLINICAL CARE
OPERATIONS MEMBERSHIP
1,000+Optum business advisory
consultants with unmatched health care expertise.
gains better understanding of cost and risk
Choice of CoverageA
cces
s to
Care
Financial Control
DIG
ITAL ACCESS
C
O N S U ME R
Balance CAPEX/OPEX
Maintain compliance with regulations
Improve claim accuracy
Provide quick, flexible delivery capability
Simplify data to understand membership
Ensure data security and privacy
CLINICAL CARE
OPERATIONS MEMBERSHIP
experiences convenient, integrated, personalized services
Choice of CoverageA
cces
s to
Care
Financial Control
DIG
ITAL ACCESS
C
O N S U ME R
Pilot new provider payment models
Create transformative pilot programs
Use analytics to lower costs, improve care
Evolve goals based on analytics
Offer value-based payment models
Provide flexibility to enter/exit models
Proprietary health care data on more than
240 MILLION LIVES
CLINICAL CARE
OPERATIONS MEMBERSHIP
achieves ability to proactively manage health concerns
Choice of CoverageA
cces
s to
Care
Financial Control
DIG
ITAL ACCESS
C
O N S U ME R
Spot industry points of growth
Offer concurrent, real-time payment options
Create high-performing networks and variated CoEs
Operationalize successful transformative programs
Provide a 360º view of members
Improve contracting through shared data
Create a differentiated market network
$2.9 BILLIONInvested annually in
technology and innovation
