Becker's Spine Review

35 OUTPATIENT SURGERY Optum has 50,000 employed, affiliated physicians and a vision for the future By Laura Dyrda O ptum has grown considerably in the past two years through acquisitions and has plans for continued growth in the future. During the Wells Fargo Securities Health- care Conference in Boston, Optum CEO Andrew Witty said the company expects to report $110 billion in revenue for 2019 after acquiring both Advisory Board in 2017 and DaVita Medical Group in June. He also touched on the company's strate- gy and where it sees big opportunities in the coming years. He noted that there are 30 million Americans with three or more diagnosed chronic diseases, and that num- ber is expected to hit 80 million by 2030. Patients in that category are associated with 10 times higher costs than patients with one chronic disease. "What we are going to see is a growth of the aging population, so severity of illness and cost of illness is going to go up," he said. "at's why we are so focused on resolving fundamental changes in the model moving forward." Mr. Witty then outlined the infrastructure Optum has in place to approach chronic care issues. On the data side, Optum is home to UnitedHealth Group's technolo- gy, and the company invests substantially in data and analytics capabilities to better predict outcomes and assist physicians and patients in the decision-making pro- cess. OptumHealth and OptumCare cur- rently have 50,000 employed or affiliated physicians and multiple ambulatory care capabilities, including primary care, ur- gent care and surgery centers as well as behavioral pharmacy. "In a typical city where we are well-estab- lished, we may have seven different types of capabilities," he said. "We may have 30 to 40 different locations. In the most advanced cities, 30 percent of all patients may be cared for by Optum. ose are very interesting plat- forms from which we can envision a different type of care environment." He described a situation where patients with- in the Optum network could use services at several locations without re-enrolling with the provider, and where physicians could maintain the human connection with their patients. At the same time, the network would optimize cost reduction based on gathered information. "We want to empower that network with in- formation and insights that we have as an or- ganization," said Mr. Witty. "Imagine the dis- tributed care in the ambulatory environment, which essentially influences about 95 percent of the spend in healthcare by making good or bad decisions." Optum is close to making this vision a real- ity in 12 major cities across the U.S. Going forward, Mr. Witty anticipates the company could partner with more hospitals in the future, mirroring its alignment with John Muir. Optum partnered with John Muir earlier this year and took over management of some non-clinical functions, including health IT, revenue cycle management, pur- chasing and claims processing. e information will help primary care phy- sicians direct patients to the right place for additional care, which affects downstream costs. e company can move toward capita- tion and take on risk. Finally, Mr. Witty touched on the compa- ny's desire to coordinate care for patients with significant disease, beginning with cancer. "What we are aiming to do here is look at every step of the journey for pa- tients from diagnosis to a cure, or end of life care," he said. "We want to straighten out the incentive system and make sure pa- tients and physicians have the right infor- mation." n Ambulatory healthcare top of mind for C-level executives By Rachel Popa H ealthcare executives are increasingly focusing on revenue growth in outpatient services, according to Advisory Board's 2019 Health Care CEO survey. Advisory Board, a research and consulting company, surveyed 90 C-suite lead- ers between January and March. Fifty-seven percent of respondents said their No. 1 priority was increasing ambulatory access. Increasing ambulatory access includes changing hours of operation, the num- ber of staff available and the movement of patients through a facility. "Executives are more interested in moving upstream to capture revenue growth through ambulatory access and primary care, rather than traditional strategies of boosting hospital market share," said Yulan Egan, Advisory Board's practice manager of research. The other four top priorities for healthcare executives include: 1. Minimizing unwarranted clinical variation: 53 percent 2. Strengthening primary care alignment: 53 percent 3. Redesigning health system services for population health: 52 percent 4. Innovative approaches to expense reduction: 51 percent n

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