OptumHealth Interviews

Both Rob Webb (CEO of OptumHealth Care Solutions) and Chad Wilkins (CEO of OptumHealth Financial Services) were presenting at the WHCC in DC and were able to sit down with me for an hour to talk about their business.

Let’s start with some of the basics:

  • OptumHealth is part of United Health Group.
  • OptumHealth Care Solutions provides consumer advocacy, wellness, health care decision support, disease management, case management, health information portals, and specialized networks.
  • OptumHealth Financial Solutions is a health care financial services provider which provides consumer health accounts (HSAs, FSAs, HRAs), benefits administration, and debit cards (among other things).

In preparing to write up my notes from the interview, I retrospectively read the press packet. My one takeaway is that most of the programs here (e.g., dental or incentives) are not what you typically think of when you think of UHG. They second caveat I will add is that we jumped around a bit as I was interested in learning about lots of little things versus creating one big story.

I began by asking them what they thought about using flat dollar copays on drugs versus percentage dollar copays. [Dr. Gupta from CNN had done a report that morning around how patients should look for health plans with flat dollar copays. And, the WSJ had earlier in the week had a story about how percentage copays on specialty drugs disadvantage the sick.] I think their response (rather than no comment) was appropriate in saying that:

  • In general, simpler plan design eases adoption which I take to mean drives the intended behaviors. (and I know it reduces calls)
  • Using a percentage copayment brings the condition into play. (I completely agree)

We moved on to my favorite topic – communicating with patients. We talked about how socio-economic conditions play into prevalence of conditions and phases of change in terms of messaging. Rather than being big believers in the Pro-Change model, they talked about focusing on “how compelling is the case for change”. They focus on delivering a message that says something like “we have something for you to consider” and including some data to reinforce that suggestion. I will have to follow-up with them to get the data, but we then spent some time talking about using inductive call logic versus deductive call logic.

I can’t talk about communications without talking about messaging channels so we addressed that next. I specifically asked them what if anything they had done on the SMS / text messaging front. Although I am generally a skeptic about text messaging in healthcare for things that require lots of PHI (protected healthcare information), I do think there is a role for some wellness type activities like smoking cessation and weight loss. There has also been a study done over in Scandinavia that had positive results (although the cell phone culture there is more like Japan than the US). They mentioned two things:

  • They added a second phone option for cell phones several years ago.
  • They recently added an “opt-in” type of field for patients to say they were willing to accept text messages. (Since some people still get charged per message, this is important.)

After that, we spent a few minutes talking specifically about each of their businesses. First, Chad talked about the Financial Services business giving me some of the history. We then talked about their scope of services. A couple of interesting takeaways were:

  • They are able to take the card data and integrate it into their PHR. (Which I think every PHR should do.)
  • 27% of the people with HSA plans used to be uninsured. This is a very interesting fact.
  • Since it was Earth Day, their PR person pointed out the amount of paper they save per year by moving all these things to electronic.
  • He talked about linking accounts, cards, and incentives.
  • We also spoke about the impact that the economy would have on the business. He pointed out that at $1 to print a check, $30 to talk with a provider, and $5 to re-process a check that the current downward trend in the economy would likely drive cost-focused programs.

Next, I talked with Rob specifically around Care Solutions. A few of my takeaways here were:

  • They focus on trying to identify why a patient has (or could have) a gap in care and solve the problem systemically (what I would call quality at the source) versus how he positions their competitors as focusing on the gap in care.
  • Since United Health Group is the biggest buyer of their services, he believes they bring a healthy skepticism to the table in terms of evaluating program outcomes and ROI.
  • I asked him about their predictive engine which I know companies like ActiveHealth have. He talked about the fact that they have a similar model, but that ActiveHealth has done a great job of bringing back the appeal of the predictive engine. And, he talked about their interest in pursuing a low-cost model for intervention using letters at $1.50 per intervention. [It was hard for me not to point out here that for similar or less cost we could probably get them a much higher response rate and ROI using our personalization engine and automated outbound call technology at Silverlink.]

Overall, I found it a very interesting conversation about two areas of United Health Group that aren’t always the first thing consumers think of. I am sure our interactions with them are more that each of us think given their market prevalence.

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