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Around the nation: Optum Insight is going deep on AI


UnitedHealth Group's* (UHG) Optum Insight has made AI a central part of its growth and revenue strategy, offering several tools focused on prior authorization and revenue cycle management, in today's bite-sized hospital and health industry news from Maryland and Minnesota. 

  • Maryland: FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) unanimously voted to recommend Moderna's new mRNA flu vaccine mFlusiva for people ages 50 to 64, as well as those ages 65 and older. Committee members voted 9-0 that the benefits of the vaccine outweigh its risks. FDA will consider VRBPAC's recommendations as part of an ongoing review of Moderna's application for its new flu vaccine. Currently, Moderna is seeking accelerated approval of the vaccine for older patients and standard approval for younger patients. "We appreciate the thoughtful review by the members of VRBPAC and their recognition of the clinical evidence supporting mRNA-1010 [mFlusiva]," said Moderna CEO Stéphane Bancel. "We believe mRNA-1010 has the potential to provide an important new option for seasonal flu prevention and further demonstrate the versatility of our mRNA platform. We look forward to continuing to work with the FDA as it completes its review." (Cloonan, Wall Street Journal, 6/18; Weixel, The Hill, 6/18)
  • Maryland: CMS has created a new Office of Health Technology and Products to lead the agency's health tech strategy. The office, which will include eight groups, will oversee the design and development of digital health tools, manage AI implementation, and promote healthcare data exchange. Amy Gleason, who has worked as a strategic advisor to CMS and currently runs the agency's Health Tech Ecosystem initiative, will lead the office, serving as deputy administrator and chief product officer. According to Healthcare Dive, the office was established as part of CMS' broader efforts to centralize and streamline its technology functions and better support the Health Tech Ecosystem, which aims to increase data sharing and digital health adoption. (Olsen, Healthcare Dive, 6/12)
  • Minnesota: As insurers and providers aim to reduce costs and increase margins, organizations are turning to AI to streamline internal processes like claims adjudication, call center automation, and workforce training. Optum Insight, the data analytics and consulting division of UHG's subsidiary Optum, has capitalized on this growing desire for AI technology with several new tools. For example, one of its latest offerings is Optum Real, a tool designed to speed up the prior authorization process. Since Optum Real launched last year, it has processed over 1 billion transactions. Another tool is the revenue cycle management platform Optum Integrity One, which eliminates the need for organizations to work with multiple vendors. Organizations can also access Optum Value Connect, which includes over 1,600 predictive models. So far, 20 of the largest 25 health plans use Optum Value Connect. "We would love everything inside that's successful to be available commercially outside to all of healthcare," said Optum Insight CEO Sandeep Dadlani. According to AJ Rice, managing director of equity research at UBS, Optum Insight's focus on AI could give UHG an advantage in the market. "They're investing in and upgrading the product cycle there to reposition their offerings to be more consistent with an AI-first strategy," Rice said. (Tong, Modern Healthcare, 6/26)

*Advisory Board is a subsidiary of Optum, a division of UnitedHealth Group. All Advisory Board research, expert perspectives, and recommendations remain independent.  


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