ViVE 2024: Optum Health CEO talks cyberattack, what's next for value-based care

LOS ANGELES—Optum Health CEO Amar Desai, M.D., took the stage at ViVE on Monday morning to discuss the company's value-based care ambitions and strategy, but there was a clear elephant in the room: the cyberattack on Change Healthcare that's still causing disruption nationwide.

Desai said the Optum team has been in regular communication with its clients' technology and cybersecurity leaders as it navigates a response to the lingering challenge. He emphasized that the issue is confined to Change's systems, and that Optum broadly, UnitedHealthcare and UnitedHealth Group were spared.

"We don't have much more to share than what has been shared publicly, but we continue to work the problem," he said. "We have external partners also engaged with us in every aspect of it."

Desai was also asked about lessons learned over the past week, and he said that "first and foremost, vigilance is important at all times." He said it's also critical to make sure both the internal team and external partners understand "that there is a proud level of interconnectedness" at play.

In addition, Desai said the team has put a focus on engaging actively and collectively with partners and clients as the situation continues, and having that alignment in communication is key to moving forward.

"That's been the biggest and most important thing, particularly in a situation where you're working with a lot of different parts of the healthcare sector," he said.

As of the latest update from Optum on Tuesday evening, there is no end in sight for the ongoing disruption, and that's caused major logjams in reimbursement and claims processing for providers and pharmacies.

Desai was joined at the keynote session at the ViVE conference Monday by Lori Morgan, M.D., president and CEO of Huntington Health, an affiliate of Cedars-Sinai. Morgan said that a situation like the one at Change should make key stakeholders step back and take a closer look at who they're sharing data with.

Cybersecurity has become a key point in contracting conversations with vendors of all kinds, and she said that there is a risk for smaller firms to be left behind because they're not able to meet the rigorous security demands working with healthcare data require.

While a cyberattack wasn't the planned agenda for the session, data more broadly were on the table as they're critical to making value-based care work. Optum Health has put a focus on driving its physicians toward value-based arrangements, and, at UnitedHealth Group's investor day last fall, executives said that 4 million Optum patients are currently treated in fully accountable, value-based models.

The shift to value is a strategy priority across UHG, as well.

Desai said that while the transition has historically been, and continues to be, quite slow industrywide, the Centers for Medicare & Medicaid Services' (CMS') focus on new models and paradigms of care has been an effective catalyst to drive notable change.

"I think that's been a significant area where I think that the government broadly and CMS in particular has really helped to push value-based care," he said.

However, there's still plenty to be done to make these models work effectively and continue to rethink how healthcare operates, Morgan said. While there have been some very successful demonstrations, "a long history of misaligned investments versus incentives" makes it hard to drive reform on a large scale.

"I guess I'd sort of say it's kind of a D+, if I had to give it a grade," she said. "Maybe a C-."

In addition, value-based care models require significant investment upfront in an outcome that may be years or decades away. Payers and providers may be investing in a patient who is no longer in their cohort when the true value of their care experience manifests, she said.

"My assessment is if you look at all of it, we have not been super successful," she added. "And I think a lot of that reason is value-based care, to my mind, is really a long-term play. We really are making investments today for better health five, 10, 20, 40 years from now, and Americans don't have a lot of patience for that."