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Case Study: ProHealth Physicians ACO, LLC achieves rapid D-SNP insourcing and full operational readiness with Optum
A Optum Case Study
How ProHealth Physicians used self-guided online scheduling to ease administrative burden and rebound patient volume after COVID-19
ProHealth Physicians ACO, LLC engaged Optum to insource its dual-eligible special needs plan (D-SNP) model of care after the incumbent vendor dissolved. The organization faced a six-week mandatory go-live, no internal D-SNP knowledge, and an outdated software platform that required significant modification.
Optum’s consulting team customized the legacy system, led exhaustive testing, developed policies and procedures, created CMS-compliant reporting, and onboarded and trained staff. Optum met the six-week deadline and delivered a smooth go-live: ProHealth Physicians ACO, LLC is now fully operational on all D-SNP processes, with trained staff, a robust policy set, and stabilization efforts underway.
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