Devices & Diagnostics

Mayo Clinic, UnitedHealth give collaborative twist to payer-provider integration with Optum Labs

  SCROLL DOWN FOR UPDATE Mayo Clinic and Optum, insurance giant UnitedHealth Group’s claims, health IT and health services division, announced that they are creating Optum Labs, a collaborative research and development organization with the overarching goal of improving patient care. The initiative is intended to be an open environment centered in Cambridge, Massachusetts, where […]

 

SCROLL DOWN FOR UPDATE

Mayo Clinic and Optum, insurance giant UnitedHealth Group’s claims, health IT and health services division, announced that they are creating Optum Labs, a collaborative research and development organization with the overarching goal of improving patient care.

The initiative is intended to be an open environment centered in Cambridge, Massachusetts, where the life sciences industry can come together and harness the clinical and claims expertise of the two institutions to come up with new ways to deliver patient care. Mayo and Optum expects that other participants in Optum Labs will be academic institutions, life sciences companies, commercial and government payers and care providers.

Collaboration will be supported in many different areas including finding the best treatments for diseases in a given setting, understanding variations in care and evaluating the efficacy of patient programs and approaches, according to a news release.

“By combining the Mayo Clinic’s robust clinical insight with Optum’s extensive claims information, we will be able to better understand healthcare delivery over time, compare the effectiveness of care we provide today and analyze the total cost of care for specific procedures or diseases,” said Dr. Veronique Roger, director of the Mayo Clinic Center for the Science of Health Care Delivery, in the news release. ‘This will help provide better care to patients and help the healthcare industry better define value through outcomes instead of volumes.”

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

Some examples of the work that Optum Labs scientists are doing include developing ways to measure the relative cost effectiveness of medical devices, using outcomes data to understand which are the best treatments for serious blood cancer chronic myelogenous leukemia and analyzing means of improving the diagnosis of hepatitis C.

“Bringing together in one location health information and insights from many contributors can provide a deeper understanding of important trends and patient care issues that no single organization could achieve on its own,” said Andy Slavitt, group executive vice president of Optum, in a news release. “At Optum Labs, we have the opportunity to generate insights and develop practical innovations that care providers, life sciences companies and government agencies can begin using today to improve patient care.”

Mayo Clinic and Optum are hosting a conference call with reporters to talk in more detail about this new incarnation of a growing trend — payer-provider integration.

 UPDATE

In a conference call, executives from the Mayo Clinic and Optum hailed the Optum Labs partnership as a means to derive the “big answers” in healthcare and underscored that this combination of clinical and claims data is the “largest effort of its kind in the country.”

But there were few specifics on the financial nature of the initiative. Mayo’s President and CEO John Noseworthy explained that Mayo had no ownership interest in Optum Labs and that it is more a strategic research alliance than an intention to make money.

Optum’s Slavitt explained that Optum Labs is a business unit of for-profit Optum and the “purpose of the partnership is to pursue research.”

OK, but surely Optum Labs is not giving away claims and clinical data that providers and other healthcare players like pharmaceutical and medical devices firms would love to get a piece of?

Well, of course not.

“There will be financial agreements and relationships with the companies that we choose to partner with and who choose to partner with us,” Slavitt later said. “Research needs will be looked at on a project-by-project basis and will require some funding from interested parties …”

So what kind of big questions is Optum Labs trying to answer? Dr. Roger of Mayo Clinic said Optum Labs may try to, for instance, answer what triggers frequent hospital admissions for heart failure.

“Right now, we are at a little bit of a loss for what causes heart failure admissions,” she said.

But with reams of patient data and claims data — all de-identified to protect patient privacy — patterns will emerge based on not only  how patients were treated at the hospital but what happened once they were discharged. That end-to-end visibility multiplied millions of times can help to provide a powerful model that can predict what triggers frequent hospital admissions for heart failure.

And with that knowledge, action can be taken to reduce hospital admissions for this condition and therefore bend the overall cost curve of healthcare.  As Noseworthy put it, the partnership is directed to “accelerate the essential shift in healthcare from volume to value …”