Transform Specialty Drug Management with Specialty Fusion

Chapter 1: Introduction/Overview (00:00–00:25)

Bring medical and pharmacy benefits together with Optum® Specialty Fusion™, the one-stop, cross-benefit solution for total specialty medication management. 

It’s a smart, new tool that integrates medical and pharmacy benefits into a single platform to streamline your process, provide full visibility to specialty trends, and connect patients with the right treatment at the optimal cost—faster than ever. 

Chapter 2: The Challenge (00:25–01:15)

Eighty percent of new medications are considered specialty drugs—and the cost of these drugs is on the rise.

With more and more specialty treatments being covered under both the medical benefit and the pharmacy benefit, it can be difficult for plan sponsors to see the full picture of their specialty spend and make the right coverage decisions.

The division between medical and pharmacy benefits also has a significant impact on care providers and patients.

Providers are challenged to keep up with the highest-quality treatment options, but they must access multiple portals to understand drug costs across populations and to complete prior authorizations, contributing to increasing rates of burnout.

Meanwhile, patients may experience disjointed care across providers, delays in treatment and higher-than-necessary costs.

That’s where Optum® Specialty Fusion™ comes in.

Chapter 3: The Solution (01:15–02:05)

Optum® Specialty Fusion™ is a simplified, patient-centric approach to specialty medication management.

Using this one-stop, benefit-agnostic platform, providers no longer need to choose between requesting treatment authorization through the medical benefit or the pharmacy benefit, because Optum Specialty Fusion considers both in real-time.

Optum Specialty Fusion combines our robust data, analytics and administrative expertise to simulate every possible regimen scenario—across benefits—and recommend the most clinically appropriate and financially optimized specialty treatment options for each patient.

Through this flexible, market-leading prior authorization tool, it all happens in seconds at the provider point of care.

Chapter 4: The Results (02:06–02:45)

Optum® Specialty Fusion™ works across all populations and harmonizes your specialty workflow, reducing administrative stress and working quickly to provide secure treatment approval in under ten minutes — which is how we maintain a provider Net Promotor Score in the mid-sixties.

The platform’s comprehensive view can drive up to fifteen dollars per-member-per-month savings and reduce future specialty spend by as much as fifty percent. It also gives payers access to a wealth of real-time specialty trend data that can be leveraged to improve specialty strategy over time.

And Optum Specialty Fusion is better for patient care. Where appropriate, medical and pharmacy prior authorizations can be approved together, helping patients start treatment up to fifty percent faster.

Chapter 5: Closing (02:46–03:00)

From patient experience to provider preference to your own daily workflow, discover how a unified approach to specialty benefits management delivers value across the board.

Simplify specialty with Optum® Specialty Fusion™.

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