Thread regarding Optum layoffs

@1w0 agreed

Also wondering if the goals are the goals or if we’re always being compared to the “enterprise average”. That’s a moving target. I really can’t stand this for much longer.

Was told next year they are moving away from completion efficiency to visits per day instead.
Seems like it will be borderline impossible to get QVC next year if they do that. Another cost savings for them!
And more micro managing and metric pushing to tell us all how bad we are doing.

The VPD are based on 8 hour day work week. Those of us that work 10 hours are already being disadvantaged because if you work 8hr 5 days x 6 patients per day = 30. 10 hr 4 days with 7 patients per day = 28. Another thing not being accounted for.

@18t the fact that the cases per day average doesn't account for holidays or PTO means the metrics are almost always under reporting the correct average.

Counting the TAT from fax UPLOAD versus AVAILABILITY to the CC can add a lot of time to that metric.

Getting a Friday notice of Admission on Monday means earliest contact is day 4, even though you're reaching out first day you know they're HIB.

We need to be working above targets to hit the metrics and be side tracking our work to make sure we "get credit" when taking PTO - and also to CYA when so much engagement isn't done while we're away (can just be due to license restrictions).

@18t yes!

@18t yes same. Always miss the higher bonus by like 0.5-1% when I track it myself also and when I do the math it’s higher. And always told there’s nothing they can do about it

Has anyone else noticed their metrics being reported are inaccurate? I bring this up but there always seems to be an explanation or reason from leadership as to why. I track some of my own because I’ve wanted to genuinely improve but now I’m ready to throw my hands up because month over month it’s just not adding up. It makes me question everything.

@OP so very true. Every word. In the end after being around nearly a decade, first with nH, then the monster--the layoff came as a relief.

Agreed. No matter what area you’re working in, it’s evident everyone is doing what needs to be done to get a metrics number, even when it doesn’t make sense.
Started here a few years ago and metrics were barely mentioned at that point, out of no where about 1.5 years in metrics became everything and it only continues to get worse.

There is so much false documentation in H&C. People are terrified of losing their jobs. I know for a FACT that multiple people work off the clock to get their work done. Back in the navi days it was 4-6 cases per day. Now its a minimum of 6, weekly total of 30. Riddle me that. All with more work demands. Not to mention false engagement. People will be calling the ethics line after this layoff.

@dc Couldn’t have said it better myself. The healthcare industry is nothing more than a ponzi scheme to enrich the elite and decrease the surplus population on the planet.

The business of health care runs on people staying sick . And prices going up . That's it.

@OP ever since optum took nh, it's been all about los and metrics. I guess optum saw the opportunity to make more money. Once upon a time a long time ago, patients mattered and doing the right thing was the right thing to do. Now, you risk your job if you don't meet your metrics, and although LOS isn't "a thing " anymore, I can promise you sr leadership holds the managers to it.

I’m gonna help everyone out here and MAYBE someone will believe. After 16 years of direct patient care, I can tell you without a doubt, that patient care is not even TALKED ABOUT at an administrative level. It’s all checking a box, preparing for surveys, and educating staff how to “score well” when any level of oversight comes around. This can be from a government entity or even in house “quality control”. If you want to help someone change their health, you’re gonna have leave the industry and go into something involving diet/exercise. Since the average American is offended with the truth, the medical model will keep winning. And by “winning”, I mean poisoning the public with dr-gs with limited efficacy and very high financial costs.

You can keep believing the lie that an insurance company wants to help their customer base or you can see the light and leave the industry completely. The choice is yours

It’s very likely H&C is slowly moving away from on-site CC and high touch approach. I know people from different payers who do in-house CSR with no member/provider engagement and minimal provider interaction. Only provider outreach is for clinical requests, NOMNCs etc. Technically, will only speak with providers for admin work.

@a7 I feel like that can go two ways. It's impossible to engage with everyone, so when you see that I feel like its candy coated metrics, not real. Just a CC doing what they can to meet and get a bonus. Which I can understand. The flip is this: when those CCs do that it is technically sc--wing the overall team and enterprise metrics into unrealistic expectations. I sure wish everyone could document honestly. It would show senior leaders the real crunch!

@OP what you are describing sounds more like when H&C was naviHealth. I remember the good Ole days lol

100%. Metrics rule. Actual patient care is the last thing on anyone’s mind.

Home and Community will not be a thing in a year or two. Most managed care companies do not engage like they do and it takes up a lot of labor to do that. Most managed cares get along just fine without all the bells and whistles. Let’s face it- AI and money will drive there to be a very limited amont of CCs per state.

Metrics are not even captured accurately in terms of personal performance. Work cases for a colleague timely sure you get the point for reviews per day but the TAT on time goes to the CC who is assigned the building. So when your on PTO for a week your eating the cr-p Metrics fellow CC accomplished for you. You are punished for their lack of engaging with patient or facility.

There is no checks and balances. No proof that on-site CC even speak with the members and no proof calls are made because apparently they cant track that in Teams for those who are remote. Quite odd that there are such phenomenal CC that ALWAYS have successful outreach with ALL patients and ALL SNF by day 3 while so many others will hage multiple unsuccessful outreach attempts documented.

Its a dumpster and the end of H&C will occur for all at some point if they don't clean up their focus and purpose.