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Optum Enlists Former ProMedica Leader To Expand Supplier-Led I-SNP Services

Former ProMedica Senior Care President David Parker took on a new role at Optum this summer, leveraging his 30+ years of skilled nursing leadership as Vice President of Strategy for its management division. complex care.

Optum is the care delivery arm of UnitedHealth Group and has been providing value-based care plans for more than 20 years, Parker told Skilled Nursing News. Now Optum aims to develop its relationship with the Supplier-Led Institutional Special Needs Plans (I-SNPs), as well as the Chronic Disease, Double Eligible SNPs and Institutional Equivalents managed by the supplier.

SNPs are types of Medicare Advantage (MA) plans that restrict enrollment based on eligibility. Most SNP recipients are expected to require the services of a skilled nursing facility or other facility.

Originally planning to take time off after leaving ProMedica, Parker was recruited by Optum for its close ties with aging services advocacy groups like the American Health Care Association and the National Center for Assisted Living (AHCA / NCAL) and post-acute care operations. perspective gained from 26 years of experience with ProMedica, based in Toledo, Ohio.

Parker is known for fostering relationships that led to expansion during his time at ProMedica, overseeing the acquisition of nursing home giant HCR ManorCare announced in 2018, and partnering with the Real Estate Investment Trust. (REIT) Welltower Inc. (NYSE: WELL) to purchase Real Estate from ManorCare in a joint venture.

He began his career in the skilled nursing industry as an administrator of a Louisiana facility at the age of 21, then headed nursing homes “from the Atlantic to the Pacific and across Canada. in the Gulf, ”Parker told SNN.

Skilled Nursing News’ conversation with Parker has been edited for length and clarity.

How did you find yourself in this new role at Optum, after more than 30 years in skilled nursing and leadership at ProMedica?

When I left I was really going to take the time and try to work on my sanity and get some rest and relax. But, I have had a great and strong relationship with the Optum leadership team for a very long time. They contacted me and asked if I would be potentially interested in joining Optum.

So what are you doing in your new role?

I spent a lot of time in my, you know, 25-30 years, working around advocacy, government relations, looking to help change policies, improve outcomes and models of payment. Optum wants to take a stand in this regard. We want to be with the industry and advocate for improved support and services, a shift both in capital investment as well as reimbursement and regulatory relief for skilled nursing and assisted living.

The pandemic taught me and many others who worked in skilled nursing and assisted living that it was time for a change. We need to be able to support capital investments in skilled nursing.

It sounds like a lot of advocacy work on behalf of the skilled nursing industry.

I will continue to work with Mark Parkinson and Cliff Porter, state leaders like Pete Van Runkle in Ohio, to be a voice and a strategic partner in trying to change and evolve with what is going to be needed in the world. industry in the very near future.

Does your role at Optum also require you to work closely with qualified nursing operators and their supplier-led I-SNP plans?

I think with the pandemic, declining occupancy rates and increasing hospitalizations have complicated provider-led I-SNPs and IE-SNPSs. They are not performing at the level that many predicted and I think many of these plans have now seen that they need to partner with a proven leader in this space.

So this partner would be Optum?

We partnered with a vendor-led plan – West Virginia Senior Advantage – owned and operated by Stonerise, about two years ago. This plan has grown over the past two years thanks to our involvement. [We] have found this to be a very rewarding way to help vendors who have implemented their own I-SNP plan.

Obviously we still want and have a priority around our I-SNP plan owned and operated by Optum for UnitedHealth Group, but those who have decided that they want to run their own plan… if you’re going to do that, I think it’s It is better for both the patient and the bottom line, and for the provider, that they do so with a proven and committed organization that delivers value, that brings innovation, integrity and compliance.

Where is your department with I-SNP vendor-led partnerships?

I currently have several conversations with vendor-led plans, with the ability for Optum to step in and be their lead on both the clinical side and the sales and membership side, as well as a third-party administrator. This side of our business will continue to develop.

How exactly will Optum help supplier-led plans?

We’re not going to be what I would call a financial partner, you know, a JV type model in the plan, but we think for plans that are owned by vendors, we can come up with our experience and manage their plans. , provide quality results to their limbs and create a return to lower care costs to treat in place than anyone else based on our years of experience.

Are there any other interesting aspects of your role and the clinical care management division of Optum?

Really just working with our leadership team within the management of complex care, helping them educate them on the operational side and the caregiving side in skilled nursing homes – understand the pressures they are under, keep going. during this pandemic and in this very difficult job market and try to make sure that I can help them understand what is really going on in the post-acute world and how we can best, not just as organization, but as a leadership team and as caregivers, how we can best support them.

So you are their window into the post-acute space?

I have a role to play in working with each of the executives on our team and making sure they have an overview of what operations look like inside a qualified nursing facility and a assisted living – I think it’s an eye-opening experience.

What other trends do you see in the skilled nursing space, in terms of operators at this stage of the pandemic?

I think the pandemic has really highlighted the challenges and difficulties in the operating space, and obviously I have had experience in this area for over 30 years. The challenges of properly funding skilled nursing facilities have really been highlighted during the pandemic and the attempts to exit the pandemic with challenges related to paying our caregivers.

In your opinion, are there other trends that should be taken into account by industry players?

There have been a lot of changes in ownership structures and business structures across the industry over the past 10 years. This intensified considerably due to the challenges and the operating environment during the pandemic. And so, you know, it’ll be interesting to see how things develop over the next couple of years.

After the pandemic, the industry is still recovering from the challenges and the declining occupancy rate and, again, from the challenges related to employment. We’re going to have to work collaboratively from a Medicare Advantage perspective as well as across states to make sure there is appropriate funding for expected outcomes and expected care. Otherwise, it will always be a tough operating environment.

What about the evolving relationship between acute and post-acute care, given your time at ProMedica?

My company that I worked for for 25 years – HCR ManorCare was taken over by an acute care company, a non-profit organization that owns 13 hospitals. They own medical practices and have their own managed care plan. Obviously, I have had the opportunity over the past three years to learn a lot from the ProMedica leadership team and all the clinical leaders and executives in the acute care field, as well as their medical component with ProMedica.

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