Optum California CEO on delivering quality, accessible care on a budget

For Amar A. Desai, MD, family and a love of science during high school provided a starting point for his interest in medicine.

He saw how a person's health can affect the trajectory of their life and the difference great physicians and care systems can make for people.

He received his bachelor's and medical degrees from Brown University in Providence, R.I., and his master's degree in public health at Harvard T.H. Chan School of Public Health in Boston and began practicing as a physician.

He noted how organizational structure, public policy and incentives within care systems affected the physician-patient relationship and decided "to direct my career into roles which would allow the ability to influence, and hopefully improve, areas of care."  

Dr. Desai has now spent nearly 20 years as a practicing nephrologist, public health leader and healthcare executive.

He first worked as an engagement manager at McKinsey & Co., a global management consulting firm, gaining exposure to the business side of integrated health systems, hospitals, medical technology companies and governments.

He then took on his first role in an operating environment as a senior executive at DaVita, a Denver-based kidney dialysis services provider.

"That was a natural place to go for a nephrologist because I spent time as a clinician and health services researcher really looking at outcomes research and quality improvement, [and] there was this platform of DaVita to take that work and scale it across an organization and platform of [at that time] over 1,600 clinics," said Dr. Desai.

He went on to serve as CEO of USC Care Medical Group, a medical faculty practice of Los Angeles-based Keck Medicine of USC, and later president of El Segundo, Calif.-based HealthCare Partners, a medical group and integrated delivery network that serves 700,000 patients in Southern California. 

Now, he is taking on his newest role as president and CEO of Optum in California. Optum, the health services arm of UnitedHealth Group, is a large player in U.S. healthcare, serving 120 million individual consumers and 80 percent of health plans nationwide. 

In his new role, Dr. Desai will be responsible for Optum care delivery organizations and physician networks in California, including HealthCare Partners, Monarch HealthCare, North American Medical Management California and AppleCare Medical Group. Collectively, these groups provide care for more than 1.3 million people in Southern California.

Dr. Desai recently spoke with Becker's Hospital Review about the new role and what he sees on the horizon for Optum.

Question: What gets you most excited about the new role?

Dr. Amar Desai: I think the future for both Optum California and Optum overall is exciting. Within California, we have four of the leading medical groups and physician networks that led around clinical quality, affordability for years as individual groups. What we're looking to do going forward is to bring those pieces together into one integrated network that is experienced and operates as one network that consumers can look to for consistent and high-quality care. We also have the benefit in California of working with many payers. Being a preferred and high-performing network is what has made us attractive to our payer partners and why, regardless of the payer, we are able to do unique things in terms of delivering care across geographies, bringing high levels of coordination across settings and from an outcomes standpoint, meeting and exceeding quality goals and affordability goals that are important to make the overall healthcare benefit to consumers.

This notion of, "How do you deliver affordability so this high-quality network can be accessible to as many people as possible?" is top of mind for us.

Q: How do you see Optum in California fitting in with Optum's plans to make healthcare more seamless for patients?

AD: We're going to be the tip of the spear in a lot of those efforts, largely because we have the geographic coverage and scale to be able to impact many patients and communities, but also because we are working with many different payers across different lines of business, [including Medicare, Medicaid and commercial]. I think one area which we're evolving in is having our overall network be much more coordinated as far as patients being able to move across the different parts of Optum in a more seamless way. We're looking at working with different parts of Optum to be able to create more convenient and higher quality offerings for our patients. For example, we're working with Surgical Care Affiliates to develop surgery centers across our geography [in California] that can allow the best site of service for patients who have surgical care done in an ambulatory care center.

We're going to be rebranding HealthCare Partners, a process which we expect to extend across the rest of Optum California.  How we represent ourselves and how our patients see us in the market is going to be under more of a unified brand. We're knitting together these pieces into what can be a much more scaled and integrated network. When the end consumer sees these different pieces, we want them to begin to recognize a high-quality affordable network for themselves as well as their family members.

Q: Optum spent 2019 making key acquisitions and investments, including its $4.3 billion DaVita Medical Group acquisition and its partnership with John Muir Health to manage nonclinical functions. What do you see on the horizon for 2020?

AD: I think we will continue to look for opportunities to strengthen our care delivery capabilities, including the possibility of welcoming additional groups and independent physician associations to the organization so we can get deeper in the communities we serve. I think there's real value in having both market-leading breadth and depth of our network. The other place we're looking to make investments is in capabilities to have the pieces work more cohesively together. In addition, we're looking at specific opportunities where we can bring other capabilities of Optum to our patients and the physicians in our network. For example, OptumInsight, [which provides business solutions and consults to healthcare organizations]and OptumRx [pharmacy benefit manager], have significant data analytics and pharmacy service capabilities, respectively. These partners can be brought to bear within OptumCare, [which offers primary, pediatric, specialty, surgical, urgent, senior and advanced care], where our patients benefit from those clinical capabilities and services.

Doing any of that work — whether it's IT and analytics, or building clinical capabilities such as pharmacy services, requires investment. I think those are areas where we're putting in investment in terms of dollars but also in terms of our overall leadership team's time and energy. There’s so much potential given all of the work that's occurred over the years building Optum’s various capabilities. To begin leveraging those capabilities in local ecosystems like Southern California and bring the best of Optum to the patients we serve is exciting. That's our intent this year and moving forward.


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