Andrew Witty: So let me ask John to start and then maybe ask Heather to make a couple of comments on the claim dynamic. Go ahead, John.
John Rex: Yes, Lisa. So definitely kind of seeing seniors obtaining RSV vaccinations and some of the respiratory activity that was going on in the quarter. So broadly similar features. For Optum Health, one of the comments that we’ve made throughout the year, though, also has to do with the progression here of taking on a large block of new membership. So we took on about 900,000 new members as we started the year. And one of the comments we’ve made throughout the year is engaging with these members, because the most important thing we need to do is have the clinical engagement with these members in terms of start improving their health outcomes, getting them and to see physicians, having our clinicians interacting — having — interacting with them.
And it’s a comment we’ve made throughout the years, we’ve seen the Optum Health margin progression, so one of the great things. We probably started the year at kind of roughly at 20% engagement level with that 900,000-member block. We exit the year having engaged with about 80% of these members. Super important factor as we think about Optum Health, as we think about 2024 and how — and that progression. And that’s been a big focus of the team at Optum Health all year long of getting that engagement in. So we can have impact on their health. But far and away, especially given what this population is like, they typically have complex needs, that’s important. Another really important market as it relates to the new membership patients that we’re bringing into Optum Health for 2024 again.
So I talked about that 20% engagement level we started ’23 with. For 2024, we’re going to start at a 50% engagement level with that new membership. So we’re making advances in that and that’s exactly what you should expect from the team. Their efforts have been really strong.
Andrew Witty: Great. Thanks, John. Maybe, Heather, you could comment on Lisa’s question around claims, and then I’d like to ask Amar also to follow up on your perspective on engagement and what’s driving that. Please go ahead, Heather.
Heather Cianfrocco: Sure. So the only thing — the thing I would add to, so I appreciate, on top of John’s point, when you think about engaging the patient early, then it’s really in the clinician’s hands. And I think about the way we think about our clinicians is that importance to your point about visibility than to kind of action. And the way we think about our clinicians is, once we get that engagement, and as John said, early engagement is so important, then our clinicians having the tools, and I think we’ve been — what’s really essential for us is those 130,000 clinicians having visibility early, what to do next. And the first thing is that they’ve got the technology, they’ve got solutions around them, they’ve got referral management practices that they can engage with high-quality specialists when they need to for outpatient procedures.
And then that they’ve got the supports in behavioral health and the home and community-based — home and community services that we’ve been investing heavily in over the last year. And then the last thing I would point to is the contract protections that we’ve been focused on with our payers, to be sure that the structures are in place so that our clinicians can practice in a responsible way. They have got visibility into the dynamics that are happening with the patients, and then they’ve got the support in place with the payers.
Andrew Witty: Amar?
Amar Desai: Yes, thanks for that question. Look, I think I’d reiterate the point around our highest risk complex members, where we’re engaging at a 2 times higher rate than the same time last year. And within engagement and our clinical programs, I’d focus around referral management and high-value evidence-based medicine programs, including our optimal care program, where a majority of our clinicians are engaged with these evidence-based programs are able to get patients the care that they need. And importantly, get the support with the provision of wraparound services, including specifically home-based services, so that the highest risk groups have their care connected from the primary care setting into the home. Thanks for the question.
Andrew Witty: Amar, thanks. And John, maybe just to tie up the whole question.
John Rex: Yes, and Lisa, tying up just on the last part of your question here regarding visibility into care activity claims like, no — we don’t — that’s not a factor. Just given the model of Amar’s business and how those groups run, we — frankly, it’s one of the areas where we get probably early sensing mechanisms in terms of the care activity that’s going on, is one of the early sensing mechanisms from much earlier in the year when we were able to talk about what we were seeing in these senior populations and the care activity within these orthopedic and other procedures. So that’s not a factor. In fact, if anything, it’s probably a strength of the organization.
Andrew Witty: Yes. Thanks, John. And Lisa, thanks so much for the question. And we obviously just spent a couple of minutes there talking about engagement, and I hope that gave you a strong sense of some of the progress we’ve made over the last 12 months in this area. I would say we’re night and day in a different position today than we were a year ago in terms of our ability to be engaged with these complex patients making sure our physicians are ready to go, that’s a really important aspect of what’s building our confidence for 2024. And make no apology for just spending a couple more minutes, making sure you hear some of the great work that’s gone on over the last year to ensure that we’ve got these very high levels of engagement and real substance behind that engagement.
