Impacting provider engagement through strategic collaboration

Richard joined Optum in 2018, and his role as an HCA is a perfect fit that allows him constant opportunities to learn, grow and contribute in the clinical setting. He enjoys collaborating with people who share his commitment to the mission of Optum: to help people live healthier lives and make the health system work better for everyone.

Richard’s job involves extensive planning, local travel and meetings focused on improving the quality of care for Medicare Advantage, commercial and Medicaid patients. Richard visits most of his practices every 1–2 months, and although no two days are ever the same, they are always full of activity focused on improving patient care and engaging in as much provider interaction as possible.

Morning

Richard spends most of his mornings in internal virtual meetings with other HCAs, clinical consultants and coders. Richard feels that connecting with teammates is essential for sharing learnings and best practices to develop strategic partnerships with providers and adding value to provider relationships.

Afternoon

In the afternoon, Richard travels to the first provider practice stop of the day. Once at his destination, he’ll meet with the quality director and chief medical officer of a provider group to go over their In-Office Assessment Program participation. Together, they review submitted assessments and go over the findings of a medical record review. Richard takes time to review each patient individually, note whether they have followed the doctor’s care recommendations, identify any quality gaps and ensure accurate documentation of chronic conditions.

Following this visit, Richard often travels to another borough for a meeting with a practice provider and office manager. Richard covers many topics in these meetings, like introducing an Optum tool for chronic kidney disease, demonstrating how to complete assessments at the point of care and tips for using Practice Assist. In addition, Richard often speaks with groups about focusing more on chronic care management services, as well as resources for annual wellness visits and social determinants of health assessments.

After scheduling next month’s visit with the office manager, Richard travels to another practice. There he meets with the office manager and a provider to review program expectations, goals and submissions. They review a list of open care gaps and patients who have not had their annual wellness exam, and they discuss patient outreach. Richard also conducts staff trainings for Practice Assist, demonstrating how to navigate the portal and use its features. 

For Richard, one of the most fulfilling aspects of his job is the positive impact his work has on provider groups and the opportunity to enhance patient care. For example, Richard worked with one provider group that joined the In-Office Assessment Program in 2019. Although this group was already involved in other quality and risk-sharing initiatives, their patient records were often inconsistent and inaccurate due to the use of disparate systems and their reliance on paper forms. This inconsistency made it challenging to fully understand their patients' health and to identify all potential health conditions, necessary screenings and quality gaps.

However, the practice soon began to see the advantages of the In-Office Assessment Program, particularly in how it transformed their operations. Two years into the program, they adopted digital tools for point-of-care use, which significantly enhanced their efficiency through Practice Assist. This platform allowed them to consolidate patient care opportunities into a single portal, streamlining their processes.

These improvements led to a 20% increase in patient-facing time and a notable rise in patient satisfaction. Additionally, the group saw a 10% improvement in closing care gaps.

Richard's passion for his role as a Health Care Advocate is evident in every interaction he has with providers, office managers and staff. They all know they can rely on him for support, advice and resources at any time.

His deep knowledge, expertise and unwavering dedication make him a valued partner in the healthcare community. Like his peers among the more than 1,000 Health Care Advocates across the country, Richard is committed to helping provider practices succeed at every stage of their transition to value-based care.