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Optum: Modular Solutions for Compliance Management

 Larry Renfro, CEO
With the introduction of the Affordable Care Act (ACA), Chief Compliance Officers (CCOs) have to meet increasing compliance requirements and combat dwindling resources simultaneously. To meet these objectives, COOs in healthcare organizations adopt numerous solutions to adhere to the pressing compliance requirements and avoid litigation. However, while choosing a compliance management solution, they are unable to find a well-rounded offering that meets their organization-specific needs. Optum, a healthcare services provider, offers a modular platform to integrate and centralize all compliance auditing processes, making it easier for CCOs. “We help healthcare organizations tackle challenges like managing a variety of decentralized compliance initiatives in clinical, regulatory, and financial areas,” says Larry Renfro, CEO of Optum.

The Compliancy Suite from Optum provides a centralized view of compliance management across a healthcare organization. Being built on adaptable architecture, this solution reduces the risk incurred by providing a consolidated view of risk and compliance. With an automated and unified approach to streamline compliance operations, the Optum Compliance Suite assesses, manages, and monitors compliance throughout an enterprise. The solution is highly adaptable and can be configured to meet compliance needs like Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security assessments, Patient Health Information (PHI) access monitoring, and hospital compliance program effectiveness and risk management. Furthermore, it is thoughtfully designed to support claims, internal and external audits, and vendor compliance audits. The suite’s individual modules for managing various compliance tasks are delivered over the cloud giving clients the freedom to select only the features they need.

With the federal and state governments enforcing laws on data security, the Optum Compliance Suite, used during HIPAA compliance audits also meets the complex privacy and security regulations.
The Health Information Technology for Economic and Clinical Health Act (HITECH) requires the department of Health and Human Services (HHS)to conduct periodic audits on healthcare organizations to ensure that HIPAA privacy, security and breach notification rules are followed. “Our comprehensive suite of compliance management tools enables providers to protect against risks and system weaknesses, reducing the likelihood of privacy and security breaches,” says Renfro. With a centralized repository for policies, procedures, documents, and contracts, the solution keeps track of documents and makes compliance management an effortless yet, precise operation.

In addition, Optum is a certified assessor for the Health Information Trust Alliance’s (HITRUST) Common Security Framework (CSF). Being affiliated to this body, Optum contributes immensely by helping various healthcare organizations assess risk and create clear plans for corrective actions to prevent data breaches and privacy gaps.
Over the years, Optum has emerged as a leader through innovations in their healthcare specific compliance platform. Unlike its competitors who attempt to manage different compliance initiatives on independent platforms, Optum’s strategy to streamline the operations on a singular solution has helped it garner clients.

Our comprehensive suite of compliance management tools enables providers to protect against risks and system weaknesses, reducing the likelihood of privacy and security breaches


With the need to simplify and speed up compliance audits, the adoption of enterprise-wide compliance programs by health organizations is on the rise. “Optum will continue to serve our clients with the best healthcare solutions to ensure complete compliance management,” concludes Renfro. The ability to integrate data from multiple sources into a single platform has ensured that patient records are secure and easily manageable, solidifying the position of Optum in the market.