Your health plan, your outcomes, your success, our solution
For us, it’s personal. Every resident is someone’s person and deserves to benefit from an institutional special needs plan (ISNP).
Optum offers a range of capabilities that help deliver strong outcomes through rigorous operating discipline, resulting in health plan profitability. This helps reduce the administrative burden for the ISNP while providing metrics visibility for success.
We support your ISNP so that you can continue to focus on what you do best and give you peace of mind.
Want to learn more? Contact snpsolutions@optum.com or fill out the form to get in touch.
Frequently asked questions
Optum® Special Needs Plan (SNP) Solutions delivers a total end-to-end package for institutional special needs plans (ISNPs). The industry has seen a trend of skilled nursing operators expanding their business portfolio to include the launch of ISNPs.
Health plans can choose a package which includes services from the pillars of expertise listed below.
Knowledge and execution
- Medical expense management
- Comprehensive network management
- Stars/HEDIS management
- Complete and accurate documentation
- CMS required materials including marketing
- Model of care
- Quality care management
- Health plan operational activities (UM, grievance and appeals, customer service)
Data and analytics
- CMS audit preparedness and Part C reporting
- Bid and benefit submission management
- Performance reporting
- Incentive and capitation payment reporting
Technology-based capabilities
- Claims payment and adjudication
- Enrollment and disenrollment processing
- HEDIS engine
- Website management
We are a team that not only understands the skilled nursing environment, but has managed various aspects of ISNP health plans for over 30 years.
Our solution gives you full transparency because you own the health plan. It also provides:
- Peace of mind by decreasing the administrative burden
- Exceptional quality of care for your residents
- Control of the health plan’s benefits available to your residents
Our proof is in the results:
- 100% of plans eligible for a star rating achieved 4+ stars
- 45% reduction in hospital re-admissions
- 38% reduction in overall hospitalizations
- 92% of residents and their family members are satisfied with the services and care provided by Optum model of care*
*2018 Member Satisfaction Survey, Optum Consumer Experience Research Program
- Delivery of proactive and preemptive care
- Early intervention and prevention
- Treat in place
- Benefits beyond traditional Medicare
The Optum care model is a patient-centric model led by clinicians (nurse practitioner or physician assistant). It provides the structure for care management processes and systems designed to deliver results. It also enables the health plan to manage the whole person through coordinated care.
- Medical management
- Care coordination and transitions of care management
- Ability to treat in place
- 24/7 telephonic support for SNP members
SNP Solutions is here to support your special needs plan.
Contact us to learn how we can support your needs.
SNP Solutions can support many components of a health plan’s operations. However, the health plan must retain ownership of health plan compliance and management of Part D.
Disclaimer: SNP Solutions is a separate Optum solution and is not affiliated with the UnitedHealthcare nursing home plan.