Our revolutionary and scientifically validated approaches to inpatient and outpatient care advocacy reach beyond traditional care management to support those who have the highest clinical risk and require the most intensive behavioral health services. Our Full Care Management ensures your employees receive the right care, at the right time, in the right place, from the best practitioners.
Unconventional Methods. Unprecedented Results.
OptumHealth Behavioral Solutions focus resources where they make the greatest impact for each employee. We orchestrate risk identification, early intervention, targeted condition-specific programs, integrated therapies and monitored practitioner performance to enhance clinical results and boost employee productivity.
Our industry-leading approach to care optimization manages over- and under-utilization of both inpatient and outpatient services. We ensure that your employees receive the right care, at the right time, in the most efficient way; and that your organization receives the best value for its health care dollar.
Our innovative clinical solutions and advanced analytical resources are engineered to meet and exceed your requirements. We quantify the efficacy of our revolutionary clinical programs, boost your employees' total health and productivity, and lower your overall health care costs.
Full Care Management Services and Resources Include:
- ALERT®: Revolutionary Data-Driven Outpatient Care – Our proprietary algorithm-driven system processes patient-reported and claims data to measure treatment effectiveness and detect high-risk conditions and treatment problems early.
- Intensive, High-Touch Care Advocacy – We reach beyond traditional care management to support employees who have the highest clinical risk and require the most intensive and costly behavioral health services.
- The Nation’s Largest, Performance-Tiered Care Network – More than 80,000 licensed and certified professionals and 3,600 facility locations are tiered by specialty and clinical outcomes, allowing us to identify the most appropriate practitioners and facilities.
Most importantly, our behavioral health programs can be clinically integrated across the entire continuum of care, providing a seamless extension of your medical, disease management, disability and other specialty health programs.
Features
Outcomes-Driven Care
By leveraging groundbreaking technology and sophisticated data analysis with our industry-leading care advocacy approach, we champion the health and well-being of your members.
ALERT®: Revolutionary Data-Driven Outpatient Care
ALERT measures the severity of a patient’s condition, monitors their ongoing clinical progress during treatment, and gauges clinical outcomes four months after the start of treatment. ALERT processes patient-reported data, claims and other administrative data throughout a treatment episode, using our proprietary, algorithm-driven system to flag risk factors. It allows Care Advocates and treating practitioners to identify and address high-risk conditions and treatment problems early, and significantly enhances our ability to impact care.
ALERT allows us to:
- Dramatically reduce costly clinical errors
- Identify the over- and under-utilization of outpatient and inpatient care
- Identify undetected clinical risks such as depression and substance abuse
- Quantify the effectiveness of therapy
- Refer employees to practitioners who achieve the best clinical outcomes
- Evaluate the clinical and financial impact of medical co-morbidities
- Measure improvement in employee well-being and workplace productivity
Intensive, High-Touch Care Advocacy
Another industry innovation, our Intensive Care Advocacy approach reaches beyond traditional care management to support employees who have the highest clinical risk and require the most intensive and costly behavioral health services. Our clinical models are uniquely tiered to help ensure people with acute, chronic or severe mental illness, as well as those with serious medical co-morbidities, receive evidence-based treatments and targeted interventions.
Our clinically licensed Care Advocates, who are individually assigned to each patient, collaborate with the patients and clinicians to help high-risk patients remain stable. They also work with families, social service agencies and community resources to establish access to a full range of support services. This approach helps decrease inpatient/residential care admissions and number of days.
The Nation’s Largest, Performance-Tiered Care Network
We offer the largest specialized care network in the country — more than 80,000 licensed and certified professionals and 3,600 facility locations, tiered by specialty and clinical outcomes for the most appropriate practitioners and facilities. We use a sophisticated nine-point profiling system to connect your employees to practitioners who consistently demonstrate effective care. In addition, we give practitioners direct feedback on their performance to promote best practices and continuous quality improvement.
Benefits
Our Full Care Management program offers clear advantages:
- Increased employee productivity
- Improved clinical and financial outcomes for co-morbid conditions
- Increased treatment compliance
- Decreased inpatient/residential care admissions and number of days
Put Our Experience to Work for You
We can help you control the rising cost of health care. Our product flexibility, value-based pricing options and proven approach to coordinated care add up to a measurable return on your investment.