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Community Care for Seniors

We bring an extra layer of ongoing clinical care to members who reside in an assisted living or skilled nursing facility.

Collaborative care for better outcomes

We partner with health plans to bring specialized healthcare benefits, clinical support and over 25 years of experience to residents in skilled nursing facilities (SNFs), assisted living communities (ALCs) and memory care units.

1,800 SNFs and ALCs with active care model1

Our patient-centric care model is led by nurse practitioners or physician assistants, and often supported by registered nurses.

26 states served

We have served 26 states plus the District of Columbia1.

More than 70,000 members nationwide1

We coordinate and enhance the quality of care for Medicare Advantage Special Needs Plan (SNP) members.

Helping to find family satisfaction and peace of mind

Financial benefits

Our care model helps prevent unnecessary ER visits and hospitalizations.

  • Census stability 
  • Reduces hospital readmissions
  • Supports HEDIS and Star metric improvement
  • Ensures appropriate CMS payment
  • Provides education and in-service for staff

Clinical benefits

Our clinical team collaborates with the PCP, staff and other providers.

  • Principal point of contact 
  • No 3-day qualifying hospitalization 
  • Reduces hospital and ER visits
  • Support available 24/7
  • Advance care planning focus

Support benefits

Our team provides personal, one-on-one support to each member, resulting in family satisfaction and peace of mind.

  • Serves as the primary contact for family and care team
  • Develops relationships through face-to-face visits
  • Provides ongoing family education and engagement
  • Creates a personalized care plan and performs assessment
  • Attends to unique needs and concerns

Financial benefits

Our care model helps prevent unnecessary ER visits and hospitalizations.

  • Census stability 
  • Reduces hospital readmissions
  • Supports HEDIS and Star metric improvement
  • Ensures appropriate CMS payment
  • Provides education and in-service for staff
The biggest benefit for having Optum in a nursing facility is that they bridge the gap between the nursing staff and your medical director and the staff.

Director

Gretchen Black

Explore community care solutions for seniors

PCPs and the Optum ISNP Care Model in SNFs

Close gaps in care and reduce fragmentation by participating in a cross-functional, team-based care experience.

Skilled Nursing Facility Programs

Break the high-cost cycle by increasing care and benefits to Institutional Special Needs Plan (ISNP) members.

Related healthcare insights

White paper

Closing gaps in pain management

More than half of nursing home residents suffer from chronic pain. Read the white paper to learn how we can make a difference in their lives.

Case study

Optimize member engagement through collaboration

A health plan increased in-home assessment rates for their Medicare Advantage members by working with Optum to increase member engagement.

Guide

Improve members' health with Optum HouseCalls

Medicare Advantage members receiving in-home assessments saw fewer emergency department visits and inpatient hospital stays across 4 conditions.

Let’s talk about a partnership in care

  1. 2019 Plan Year, reporting as of December 2019