To meet the growing demand for greater transparency, simplicity, and value in health care billing, Dignity Health and Optum have formed Optum360, a major new venture that combines the companies' industry-leading revenue cycle management capabilities. Optum360 is dedicated to transforming the registration, documentation, billing, and payment system so it works better for hospitals, health systems and other care providers, and delivers a better patient experience.
With a workforce of more than 3,000 employees from Dignity Health and Optum, Optum360's revenue cycle management services can meet the large-scale needs of major hospitals and health systems, and enable new care delivery and risk-sharing models, such as Accountable Care Organizations. The venture joins Dignity Health's proven revenue cycle operations expertise and scale with Optum's market-leading technology, expertise in ICD-10 readiness, and a client base of thousands of hospitals and physician groups. Optum serves more than 300 commercial and public health plans, and its deep payer operations expertise will be applied to making administrative processes between payers and providers more direct, faster, and simpler.
Optum360's patient-centric approach to revenue cycle management has the potential to fundamentally transform both administrative processes and revenue yield and accuracy – from patient registration to financial resolution of payments – in ways no other solution can. It is designed to reduce costs and make medical costs more transparent while helping hospitals, health systems, clinics, and physicians modernize administrative processes and ensure appropriate revenue yield. Importantly, the Optum360 solution provides a complete view of the care experience from the patient's perspective, helping providers deliver a simpler, more satisfying experience to their patients.
"The health care billing process is too often a source of stress during a time when healing should be the primary focus, and together through Optum360 we are committed to being part of the solution," said Lloyd Dean, president and chief executive officer of Dignity Health. "Our goal is nothing less than to modernize the revenue cycle so that it is intuitive and easy to manage, and allows patients and providers alike to focus their attention on healing."
Approximately 1,700 employees from Dignity Health and 1,300 employees from Optum make up the initial workforce of Optum360, which will be the exclusive revenue cycle services provider to Dignity Health's hospitals, clinics, and physicians. Optum360 is also working with additional major health care provider partners nationwide and plans to announce these relationships in the months ahead.
"Optum360 is singularly focused on helping care providers nationwide transform the registration, billing and payment system so it works better for them and their patients," said Larry Renfro, chief executive officer of Optum. "The unique combination of Optum's leading technology and Dignity Health's proven expertise in revenue cycle management will allow us to partner with hospitals, health systems, clinics and physicians across the health care system to significantly improve performance and the patient experience."
Bringing Simplicity to Patients and Providers
Optum360 is focused on improving the patient experience through a unique combination of technology and superior customer service. For example, patients can expect a more streamlined admission process and access to secure online and mobile applications for benefits information, health management tools and financial statements. Optum360 service representatives will educate patients about their insurance benefits, provide financial counseling, and help them understand what they can expect from the payment process.
"Dignity Health has always been committed to simplifying the billing process and helping our patients understand their health benefits," said Michael Blaszyk, senior executive vice president and chief financial officer for Dignity Health. "With Optum360, we are taking these efforts to the next level by implementing Optum's proven technology. We are excited to bring these resources to the patients we serve as well as to the broader health care marketplace."
Optum360 can help ensure providers receive accurate, timely reimbursements for the patient services they have rendered. The suite of technology and services available to providers includes clinically integrated electronic financial records, ICD-10 resources, computer-assisted coding applications, utilization management capabilities, clinical documentation improvement solutions, and claims management tools. Optum360 is well positioned to help providers adapt to the requirements of ICD-10, and will fully support new forms of payment methods such as bundled payments and Accountable Care Organizations.
Transparency and Improved Relationships with Payers
To support the relationship between care providers and health care payers, Optum360 is focused on streamlining approvals and claims adjudications, and on breaking down barriers to information for patients and payers. Payers can more quickly and clearly understand their members' treatment plans, including intervention outcomes and associated medical costs. Ultimately, greater communication and understanding can help ensure that medical services are cleared for payment in a more efficient time frame.
Optum (www.optum.com) is a leading information and technology-enabled health services business dedicated to helping make the health system work better for everyone. Optum is comprised of more than 40,000 people worldwide who collaborate to deliver integrated, intelligent solutions that work to modernize the health system and improve overall population health.
About Dignity Health
Dignity Health, one of the nation's five largest health care systems, is a 21-state network of nearly 10,000 physicians and 56,000 employees who provide patient-centered care at more than 300 care centers, including hospitals, urgent and occupational care, imaging centers, home health, and primary care clinics. Headquartered in San Francisco, Dignity Health is dedicated to providing compassionate, high-quality and affordable patient-centered care with special attention to the poor and underserved. In 2012, Dignity Health provided $1.6 billion in charitable care and services. For more information, please visit our website at www.dignityhealth.org. You can also follow us on Twitter and Facebook.