United Healthcare 2013 Annual Report Download - page 13

OptumInsight’s products and services are sold primarily through a direct sales force. OptumInsight’s products
are also supported and distributed through an array of alliance and business partnerships with other technology
vendors, who integrate and interface OptumInsight’s products with their applications.
OptumInsight provides capabilities targeted to the needs of four primary market segments: care providers (e.g.,
physician practices and hospitals), commercial payers, governments and life sciences.
Care Providers. Serving four out of five U.S. hospitals and tens of thousands of physician practices,
OptumInsight provides capabilities that help drive financial performance, meet compliance requirements, and
deliver health intelligence. OptumInsight’s offerings in clinical workflow, revenue management, health IT and
analytics helps hospitals and physician practices improve patient outcomes, strengthen financial performance and
meet quality measurement and compliance requirements, as well as transition to new collaborative and
accountable care business models.
Commercial Payers. OptumInsight serves approximately 300 health plans with employer, individual, Medicare,
and Medicaid membership. OptumInsight applies its solutions across the payer’s operations, helping clients to
improve operational and administrative efficiency, meet clinical performance and compliance goals, develop
strong provider networks, manage risk and drive growth. OptumInsight is also helping payer clients adapt to new
market models, including health insurance exchanges, consumer driven health care and engagement, pay-for-
value contracting, and population health management.
Governments. OptumInsight provides services to state, federal and municipal agencies and departments, across
35 states and the District of Columbia. Services include financial management and program integrity services,
policy and compliance consulting, data and analytics technology, systems integration and expertise to improve
medical quality, access and costs.
Life Sciences. OptumInsight’s Life Sciences business provides services to more than 400 global life sciences
organizations. OptumInsight’s services use real-world evidence to support market access and positioning of their
products, to deliver strategic regulatory services, to provide insights into patient reported outcomes and to
optimize and manage risk.
OptumRx
OptumRx provides a range of pharmacy benefit management (PBM) services to nearly 28 million people
nationwide, managing approximately $33 billion in pharmaceutical spending annually and processing an annual
run rate of more than one-half billion adjusted retail, mail and specialty drug prescriptions. OptumRx’s PBM
services include retail pharmacy network management services, mail order and specialty pharmacy services,
manufacturer rebate contracting and administration, benefit plan design and consultation, claims processing,
Medicare Part D services, and a variety of clinical programs such as formulary management and compliance,
drug utilization review and disease and drug therapy management services. OptumRx has a network of more than
67,000 retail pharmacies and two mail services facilities in California and Kansas.
The mail order and specialty pharmacy fulfillment capabilities of OptumRx are an important strategic component
of its business, providing patients with convenient access to maintenance medications, offering a broad range of
complex drug therapies and patient management services for individuals with chronic health conditions, and
enabling OptumRx to manage its clients’ drug costs through operating efficiencies and economies of scale.
OptumRx provides PBM services to UnitedHealthcare members enrolled in benefit plans that offer pharmacy
benefits. Throughout the course of 2013, OptumRx transitioned 12 million new or migrating UnitedHealthcare
commercial members. Additionally, OptumRx managed specialty pharmacy benefits across nearly all of
UnitedHealthcare’s businesses with services including patient support and clinical programs that ensure quality
and value for consumers. Specialty drug management is important in managing overall drug spend, as biologicals
and other specialty medications are fast growing pharmacy expenditures. OptumRx also provides PBM services
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