Reform Update: UnitedHealth's Optum Labs adds universities, insurer and Merck

The research and development laboratory launched by UnitedHealth Group and the Mayo Clinic to capitalize on healthcare's data profusion and healthcare reform expanded again this week, adding two prominent universities, a Minnesota health plan and pharmaceutical giant Merck.

Optum Labs, the Cambridge-based research arm of UnitedHealth's analytics and consulting subsidiary Optum, added the Harvard Medical School, University of Maryland Baltimore and insurer Medica to a growing roster of organizations that includes the AARP, drugmakers and health systems, the organizations said this week.

The expansion—and the ambitions of researchers who have joined the lab—underscores a frenzy underway in public policy and the marketplace to exploit the emergence of data that has long been missing, incomplete or inaccessible in healthcare. That rush has been fueled by new policies in the Patient Protection and Affordable Care Act that introduce financial incentives for efficiency among hospitals and doctors and a retail shift in healthcare that has sparked demand for consumer-friendly and low-cost products and services.

The Optum Labs database was significantly bolstered by Optum's 2013 acquisition of electronic medical record analytics firm Humedica, which included records for 30 million individuals. Combined with claims data from private health insurers, the database includes information for 150 million patients.

The new entrants to the laboratory's research community said Optum Labs' uniquely expansive data was the primary draw.

The Medica Research Institute, the research arm of Minnesota health plan Medica, will focus its research on how consumers make choices about health plans and the degree to which they understand and use health benefits, said Kristina Bloomquist, the institute's executive director.

Other research may inform the company's accountable-care efforts, she said, by helping it understand the choices patients make about where to seek medical care. Accountable-care contracts are built on financial incentives that encourage providers to meet cost and quality targets for a group of patients.

Optum Labs data may also help researchers learn more about the newly insured Americans who bought health plans this year in the commercial exchanges created under the health reform law, he said.

“We're very concerned with the healthcare market and healthcare spending, and the system is in the middle of a transformation,” said Michael Chernew, an economist with Harvard Medical School. Harvard researchers see the potential to broadly study how physicians practice medicine, which may help identify ways to improve the quality and cost of medical care. “It's going to be very important to track what's going on in different systems and in the system overall,” he said.

Eleanor Perfetto, who left Pfizer last year to become a professor of pharmaceutical health services research at the University of Maryland Baltimore, said the commercial population included in Optum Labs' data will complement data already available for some Medicare enrollees. Researchers armed with Optum Labs' data may study older adults on the cusp of Medicare, she said. Results could help project Medicare spending based on the needs of incoming seniors. It may also help identify targets for prevention among aging adults.

Dr. Nilay Shah, scientific director for the Mayo Clinic's work with Optum Labs, said the laboratory has sought to attract researchers with diverse expertise from across healthcare's sectors to cultivate an incubator for health policy and products, such as mobile applications or new AARP consumer education.

Many researchers are asking similar questions but tackle those questions with varied approaches, Shah said. Bringing them together could yield new insights with new data, which is the laboratory's goal, he said. “Can we leverage data to understand what works, what doesn't, for whom and in what context?”

Economists have long blamed fee-for-service (do a service, earn a fee) for giving hospitals and doctors a clear incentive to deliver as much care as they can. A study says the complexity of U.S. medical bills is also adding to the nation's $2.9 trillion medical tab. Compared with seven other nations, the U.S. spends the most on hospital administration (25.3% of hospital expenses), researchers wrote in the journal Health Affairs. Why? “Hospital administrative costs appear to be driven by the complexity of the reimbursement system and the mode of capital funding,” they said. So what's less expensive? “Scotland and Canada, whose single-payer systems pay hospitals global operating budgets, with separate grants for capital, had the lowest administrative costs,” they said.

The Affordable Care Act ushered more price-sensitive consumers into the healthcare marketplace, joining the growing number of those with high-deductible health benefits from an employer. This may be good news for retailers with ambitions to expand their healthcare operations, such as CVS, Walgreen, Wal-Mart and Target. “These companies' substantial store footprint places them in tantalizingly convenient proximity to the consumer and their good cash flow generation gives them the wherewithal to continue making acquisitions in the health care services space,” reports Standard & Poor's.

Follow Melanie Evans on Twitter: @MHmevans