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Data and analytics | Finances and payments | Mental health | Patient and member engagement | Pharmacy care and management | Technology and automation | Value-based care | View all
Latest featured insights
E-book
Create meaningful change for the women in your workforce. Learn steps to help close the gap in health equity, improve health and lower costs.
![A Quarter-Century of Pharmacy Benefit Changes [E-Book]](/content/dam/optum-dam/images/business/pharmacy/hand-with-vial-1080x720.jpg)
E-book
Explore the dramatic changes in the years since 2000 — in drug performance and design, and especially affordability.
Article
Explore how evidence-based tools like The ASAM Criteria® Navigator and InterQual® Substance Use Disorders Criteria are helping payers and providers efficiently and effectively navigate the complex substance use disorder landscape today.
![Automation Strategies for Empowering Staff and Patients [Webinar]](/content/dam/o4-dam/images/professionals/company-meeting-1080x720.jpg)
On-demand webinar
Learn how to help transform hospital revenue cycle operations with healthcare automation.
Data and analytics
On-demand webinar
Optum experts give a snapshot of commonly encountered pitfalls when using RWD and recommendations to help avoid them in this PMSA webinar.
Article
This interview with Jason Spangler, MD, MPH, FACPM, is part of the "Let's Talk" conversation series.
Article
Understand how routine clinical practice impacts information captured in real-world data (RWD).
Article
Read the interview for insights into how state leaders can reduce administrative cost and support collaboration with providers.
Finances and payments
Article
Discover 4 ways health plans can save money today — and in the future — by engaging with a digital claim payment partner.
Article
Health savings pathways, part 2: Optum delivers insight on how employers can develop more balanced employee benefits strategies. Read the full series here.
Article
Learn how payment delivery optimization can improve the healthcare financial cycle and bridge the gap between payers and providers.
Article
Identify, investigate and recover medical and disability payments related to accidents.
Mental health
Video
When the Minnesota Fire Service needed emotional well-being support for their firefighters, Optum stepped in to help.
Article
Learn more about the current research on mobile crisis teams (MCTs), how to build an MCT as well as envision a future for them.
![Support for Substance Use Disorders [White Paper]](/content/dam/optum4/images/ohb-sud-wp-adaptive-image-1080x720.jpg)
White paper
Expand access to evidence-based support to help individuals achieve stabilization and sustain recovery.
Patient and member engagement
Article
Optum Nevada’s mobile medical clinic helps promote health and break down transportation barriers for patients in Nevada.
Article
Robotics process automation can improve maintenance and operations of state Medicaid systems.
Pharmacy care and management
Article
Learn how a holistic model enhances multiple sclerosis care.
Article
Optum tackles the many issues infusion pharmacy care faces as it serves vulnerable patients with acute needs and complex conditions.
Video
Our infusion care ecosystem is based on a commitment to clinical innovation and providing consistent, convenient and compassionate care.
Video
Our infusion care ecosystem is based on a commitment to clinical innovation and providing consistent, convenient and compassionate care.
Technology and automations
Case study
Provider maintains A/R revenue continuity during HIS conversion.
On-demand webinar
Clinical documentation integrity programs are expanding to support risk adjustment initiatives. Integrated CDI technologies are needed to support revenue and integrity.
Article
Optum won the 2023 North American Enabling Technology Leadership Award.
Article
Discover an interactive EPCS mandate map providers can use to track where and when mandates are happening in each U.S. state.
Value-based care
Article
Navigating a complex healthcare environment is challenging. Using hub and advocacy solutions together helps employers and employees alike.
Article
There’s a lot at stake with organ transplant claims. Learn the importance of selecting an effective payment integrity approach.
E-book
Discover specialty medication management strategies to help you slow carve-out and stop member attrition.
![Revolutionizing Specialty Medication Management [E-book]](/content/dam/internal-resources/images/specialty-fusion-ebook-thumbnail-1080x720.jpg%20)
E-book
Get an in-depth assessment of the ways Specialty Fusion™ is revolutionizing specialty drug management.
All healthcare industry insights
Outlook on oncology 2024
See how emerging trends, including a global pandemic, are reshaping the landscape of oncology care and medication.
Reimagine your employee assistance program
Help employees feel mentally, physically and financially well with Emotional Wellbeing Solutions.
Success stories in connected care
See how health organizations are creating new ways to deliver care.
Develop your growth strategy
Optum Market Advantage helps you choose your own path forward.
A/R recovery services provide continuity
Provider maintains A/R revenue continuity during HIS conversion.
Support risk adjustment with CDI technology
Clinical documentation integrity programs are expanding to support risk adjustment initiatives. Integrated CDI technologies are needed to support revenue and integrity.
Optum wins 2023 enabling technology leadership award
Optum won the 2023 North American Enabling Technology Leadership Award.
EPCS mandates state interactive map
Discover an interactive EPCS mandate map providers can use to track where and when mandates are happening in each U.S. state.
Global Nurse Advice Line
We support mission-critical programs for federal health agencies.
Driven to bring care to those in need
Optum Nevada’s mobile medical clinic helps promote health and break down transportation barriers for patients in Nevada.
State M&O innovations: Robotics process automation
Robotics process automation can improve maintenance and operations of state Medicaid systems.
Costs for unrecognized kidney disease
A new study published by The American Journal of Managed Care highlights health care costs associated with unrecognized progression to late-stage kidney disease.
How to maximize ROI real world data
Optum experts give a snapshot of commonly encountered pitfalls when using RWD and recommendations to help avoid them in this PMSA webinar.
How Cardiology IT solutions can solve workflow issues
Learn how new reporting features within cardiology IT solutions helped one medical center build an innovative user experience and workflow.
Online scheduling covid 19 vaccinations
Learn how Southwest Medical Associates (SMA) used the Optum platform to automate vaccine scheduling and reminders for both shots at once.
Breast density: Research for Radiologists
New research on breast density is changing the way radiologists approach mammography.
Closing the diagnosis gap in CKD
Most people with chronic kidney disease (CKD) don’t know they have the condition. These payer strategies can help turn the tide.
Value assessment frameworks
This interview with Jason Spangler, MD, MPH, FACPM, is part of the "Let's Talk" conversation series.
Achieving health equity: Strategies for payers
Learn more about a comprehensive solution for health payers to address health disparities and achieve health equity.
Webinar: Trends and challenges in telehealth
Explore new ways of doing business that allow you to meet shifting customer expectations, workforce challenges and emerging business goals.
Address the complexity of the claims process
Read the interview for insights into how state leaders can reduce administrative cost and support collaboration with providers.
Using behavioral science to inform hemodynamics product design
Learn how behavioral science can improve the hemodynamics solution in vital ways for physicians and technicians.
Why quality fitness benefits are crucial for employers
Whether you offer exercise classes, fitness equipment or nutritious snacks, investing in your employees’ movement and health will always be smart.
How health data can improve msk care
Here’s how payers can harness the power of data to bring more effective — and timely — musculoskeletal (MSK) care to their members.
Filling revenue cycle resource shortfalls
Learn how to identify and overcome common revenue cycle challenges despite current labor market issues.
Orphan drug market: Rare diseases, large costs
Orphan drugs offer hope to people with rare diseases. They also add large costs. Our Orphan Drug Program is a targeted strategy to help control costs.
Guidance along fertility journey
Discover how health plans can set aside ad hoc solutions and adopt a comprehensive approach to improve health outcomes and accessibility of fertility care.
Smart revenue cycle investments
These two targeted investments will strengthen your revenue performance more than deep cost cutting.
Solve contract challenges for gene therapies
Gene therapies have the potential to be transformative, but there are hurdles to overcome for value-based contracts to become widespread.
Addressing the Root Causes of Mental Health Disparities
Discover steps and strategies to reduce disparities among vulnerable populations and remove barriers for more equitable mental health care.
Using data to monitor behavioral health services
See how Optum helped one state visualize utilization and demographic data around behavioral health programs.
The fight for techquity
Get ideas for how to fundamentally change your approach to building technology and incorporate techquity into your organization.
How states can serve members more holistically
Lori Halpern and Dennis Vaughan discuss interoperability, helping communities address the growing mental health crisis and new ways of delivering care.
Preserving talent and enabling career growth insights
The Optum Market Performance Partnership is designed to help health systems achieve strategic, operational outcomes while preserving talent.
States achieve health equity with actionable analytics
By applying analytics solutions, states can create a comprehensive roadmap to better health equity.
Call centers and AI technology
Transform state contact centers into 24/7 problem solvers.
Five things your denial rate isn't telling you
Learn 5 ways to make changes that will prevent and remediate denied claims.
Top employer wellbeing challenges
The Optum 2023 Wellbeing in the Workplace benchmark study reveals current health and wellbeing trends across 405 global companies.
Defining the future of alternate-site infusion pharmacy care
Optum tackles the many issues infusion pharmacy care faces as it serves vulnerable patients with acute needs and complex conditions.
Digital front door strategy improves patient experience
Discover how a digital patient engagement strategy can provide easier access, reduce cancellations, and enhance front-end collections.
Understanding the benefits of single-database cardiology
Learn about our single-database cardiology solution that integrates with your EHR and VNA to help create a complete, unified cardiovascular record.
Revolutionizing cardiology
Discover how Boulder Community Health and Optum Advisory worked together to achieve smart growth and sustainable change.
A case study on Excel Medical Center
Using digital integration to ease administrative burdens can help you spend more time with patients and deliver positive patient outcomes.
Digital claim payments can save you money
Discover 4 ways health plans can save money today — and in the future — by engaging with a digital claim payment partner.
Addressing challenges with CDI and coding
Read the success story to hear how Optum technology helped increase John Muir Health's monthly CDI case review average by 22%.
The benefits of cardiovascular structured reporting
Discover the key features of cardiovascular structured reporting that drive adoption, EHR integration and customization.
Four ways to strengthen your practice
Strategies to help provider groups maintain independence, support long-term stability and drive success.
Improve members' health with Optum HouseCalls
Medicare Advantage members receiving in-home assessments saw fewer emergency department visits and inpatient hospital stays across 4 conditions.
Provider report cards help emergency medicine groups
Learn more about how provider report cards can help emergency medicine groups thrive.
Human-centered design in healthcare
This Optum white paper shows how human-centered design builds technology and programs that are easy and intuitive for consumers to use.
Leveraging data-driven heat maps
The Optum network gives transparency to customized potential connections, helping boost revenue.
Visualizing fraud, waste and abuse
Graph analytics and machine learning drive the future of program integrity.
Extending an independent lifestyle for seniors
The Optum differentiator helps communities attract and retain residents.
Strengthen ED visit-level determinations with these key elements
Learn how to strengthen your ED visit-level determinations, and identify areas for improvement.
The benefits of outsourcing medical billing
Discover a step-by-step strategy for gaining administrative buy-in.
Break down silos in clinical trial design
Clinical trial protocol design and feasibility often occur in silos. Learn how to make the overall trial design process more effective with RWD and other tools.
Cloud-based upgrades
Learn how cloud-based imaging solutions can speed upgrades and reduce maintenance.
Change Healthcare Stratus Imaging Share
Learn how much you could save by eliminating CD burning.
Address health equity barriers in cancer care
Discover the 5 pillars of equity-driven member navigation.
Health equity and women's health
Create meaningful change for the women in your workforce. Learn steps to help close the gap in health equity, improve health and lower costs.
Using the right tools to approach RWD
RWD pitfalls part 1: When working with real-world data, learn from the lessons of others to help maximize your own business return.
Determining treatment safety for pregnancy and infants
Studying the impact of treatments on pregnancy and infants can help patients, providers and pharmaceutical companies make key decisions.
Case study: Investing in employees' success
Tailored financial wellbeing support eases employee stress and boosts productivity for global telecommunications company.
Preemptive kidney transplants
Avoiding dialysis in favor of organ transplant can yield better patient outcomes and lower healthcare costs. So why is it still uncommon?
6 workforce strategies for healthcare leaders
Strengthen and inspire your healthcare workforce. Our actionable toolkit offers new strategies to reconnect with talent, simplify workflows and more.
More inclusive MSK care: How can employers help?
Discover what employers can do to support all employees who may be coping with costly and common musculoskeletal conditions.
Using clinical intelligence for revenue cycle
Our white paper shows how investing in smart technologies, such as clinical intelligence, supports the revenue cycle from patient registration through full reimbursement.
HouseCalls: Fewer ED visits, hospital stays
A Yale Medicine study shows how in-home health assessments can help Medicare Advantage members get the care they need.
2024 Annual Healthcare Trends Report
Get expert analysis for C-suite healthcare leaders on the forces driving change. Explore challenges, what to watch and how to move forward.
Is poor market visibility compromising your growth?
Optum offers an infographic to help hospitals better understand true growth potential and the potential impact of physician outreach.
Using clinicogenomics to advance research
Rich, longitudinal clinicogenomics data can fuel all stages of drug development.
Cost breakthroughs in complex care management
Not every complex care management program is built equally. Here's how to optimize them for maximum benefits.
Value dex z codes
Optum and Palmetto experts partner in discussing how to solve genetic lab challenges in legacy solutions.
Enterprise imaging cloud strategy webinar
Learn about the differences between “cloud-based” and “cloud-native” image hosting.
Hospital employed anesthesiologists and RCM
Dive deeper into the market shift transforming the modern anesthesia employment market.
Specialty Pharmacy 101
Specialty pharmacies deliver high-touch services to help patients stay adherent to treatment plans and live healthier lives.
Five step InterQual evidence-based development process
The InterQual Criteria is developed through a rigorous, five-step process by our clinical development team.
An employee benefits strategy that balances cost and care
Health savings pathways, part 2: Optum delivers insight on how employers can develop more balanced employee benefits strategies. Read the full series here.
Improving underwriting results with automation
Machine learning coupled with software features and cost-tuning delivered significantly improved predictive value and underwriting results.
Health Equity Vision into Action Report
Learn how identifying and addressing disparities in healthcare allows everyone to live their healthiest life.
Improve efficiency with Optum CAC and CDI 3D
See how one health system partnered with Optum to transform their coding and CDI program.
"No regret" IT investments
Learn which tech investments can benefit providers most today.
Self scheduling boosts access
Learn how ProHealth Physicians used self-guided online scheduling to ease administrative burden and rebound patient volume after COVID-19.
Real-world data fills rare disease data gaps
Read how you can fill the data divide to develop effective treatment options.
Assess drug performance with integrated data
Explore real-world use cases to see how integrated data empowers research and commercial teams to compete in today’s crowded market.
Care Pathways study
Mental health specialists serve a critical role in reducing total cost of care for plan sponsors.
Ways digital movement reshaping member experiences
As digital fitness, physical therapy and virtual musculoskeletal care surge in popularity, they’re yielding benefits for health plans and members alike.
Help your bottom line through UM optimization
An efficient utilization management (UM) program is a must to deliver high-quality patient care while managing costs.
Improve price transparency
Deliver a better patient experience through price transparency.
Boost efficiency with payment optimization
Learn how payment delivery optimization can improve the healthcare financial cycle and bridge the gap between payers and providers.
Youth-centered mental health
Find new ways to address youth mental health and how health care leaders and communities can come together to achieve long-lasting impact.
Fighting breast cancer with early detection
Early detection is critical to fighting breast cancer; advances in technology are helping.
What is subrogation?
Identify, investigate and recover medical and disability payments related to accidents.
How the revenue cycle and leaders are evolving
Find out how to shift your revenue cycle left, focusing on front-end revenue cycle management (RCM) capabilities.
Solving clinical trial recruitment challenges
Watch clinical trial leaders from Optum and Biogen discuss how to address trial recruitment struggles by unlocking real-world data (RWD).
Pharmacy benefit managers add value lower costs
PBMs don’t cause high drug costs — they’re part of the solution. Our drug prices beat the “low cost” vendors.
Is your real world data research ready
Real-world data can help evaluate the effectiveness of medications and therapies, which is why evaluation should be part of the investment.
6 thoughts: Shipping refrigerated medications
See how temperature-sensitive medications are protected in transit with Optum Rx.
Maintain operational and financial viability
Read this white paper to learn strategies that can help critical access and independent hospitals remain viable in their communities.
The keys to revenue cycle transformation
Gain expert insights into strategies to decrease costs, unlock new sources of growth and improve patient experiences.
Maternal and infant health insights
Optum Advisory uncovers disparities in maternal and infant outcomes — commercial vs. Medicaid — identifying key factors.
Outsourcing medicaid eligibility enrollment
Discover how one client outsourced Medicaid eligibility and enrollment to drive patient satisfaction and higher reimbursement levels.
10 hurdles to reimbursement
Focus on the specific hurdles that hinder your claims and cause most of your denials. We'll walk you through how to clear each obstacle.
Choosing an accounts receivable partner
Selecting a strategic accounts receivable partner requires careful evaluation.
Regulations to watch: Spring 2024
Get the latest on legislation impacting PBM operations.
Buck denial trends
Learn about the latest national denial trends to help you avoid rework and future denials.
2024 Stars preview: A path forward
Perform key actions to manage your Stars performance with a focus on member engagement. Learn how to take control of your Star ratings now.
NLP methods for RWD insights
Natural language processing (NLP) systems allow us to draw insights from billions of unstructured medical notes. Learn more about our methodology.
4 ways small biopharma can harness RWD
Small and emerging biopharma companies are already having an impact on the industry. Learn how RWD can enhance the ability to innovate.
5 provider strategies to improve margins
Discover how healthcare organizations are prioritizing a path to improved financial sustainability and margins.
Integrated RWD: The key to accelerating innovation
To maximize the value of clinical innovations, you need dimensional, robust data. Learn about leveraging integrated cost and clinical data.
3 ways to beat vaccine fatigue
Learn about researched vaccine messaging themes and important steps you can take to promote critical vaccinations for members.
Validating short-stay hospital bills
Prevent inpatient billing errors for outpatient encounters.
Insights in claims payment processing
Thinking about going paperless for claims payments? We commissioned a study of senior health plan executives to hear what’s on their minds.
Insomnia treatment research study
Optum combined real-world data and primary research to create better understanding of insomnia and help create new treatments.
Healthier outcomes for moms and babies
By using enterprise data to reach out to women earlier in pregnancy, one state is supporting moms and babies and creating healthier outcomes for both with help from Optum.
Monitoring COVID-19 vaccine safety
Discover insights from Dr. John Seeger’s recent participation at the Duke-Margolis Thirteenth Annual Sentinel Initiative Public Workshop.
Path to techquity
New research explores how to use technology to advance health equity.
Enhancing fraud investigations with AI
Learn how AI is changing the fraud case review process.
Volume 1: Better financial health and improved operations
Read the white paper for strategies on controlling fixed costs, efficiency and organizational flexibility.
Gratitude for heroism
Optum Serve is proud to recognize female Service Members and Veterans.
Creating a health equity strategy
Watch this 15-minute Q&A on building a health equity strategy. Explore the role of partnerships and how to make a sustainable impact.
Addressing pharmacy issues that matter to you
From specialty pharmacy to drug affordability, our experts tackle your biggest pharmacy challenges.
Making cardiovascular data work for the future
What can technology leaders do today to facilitate future advancements in cardiovascular data and analytics?
Improving UR effectiveness with Case Advisor
Learn how Optum helped Regional One Health alleviate staffing pressure, multiply the value to the organization and raise its credibility among physicians.
Kidney care breakthroughs: What payers should know
Explore the most promising innovations in renal care for people with chronic kidney disease.
Electronic Health Records (EHR): Implement and Operate
Maximize your EHR investment through partnership.
Using epidemiological data build public confidence
See how the FDA and Optum use real-world evidence to monitor the safety and effectiveness of COVID-19 vaccines in our youngest populations.
The impact of CAPs on Stars ratings
Learn more about the impact and implications of a Corrective Action Plan and how Stars and these corrective actions are interconnected.
Supporting care for at-risk minors
Learn about a lightweight, scalable foster-family placement system developed for one Northeastern state.
Virtual urgent care scheduling for telehealth
Optum Patient Access and Engagement connects consumers to virtual urgent care through a national telehealth platform.
Supporting Veteran truckers
Learn how Optum Serve supports Veterans through a whole-health approach to work and life.
Clinical exchange eprescribe enhances care delivery
Streamline workflow and increase accuracy with Clinical Exchange ePrescribe and Surescripts Real-Time Prescription Benefits.
Reducing avoidable Medicaid claims denials
In this GovTech.com interview with John Campbell of Optum State Government Solutions, see how the right technology can modernize the claims process.
Enhance system security with cloud-native imaging solutions
Learn about the in-depth security capabilities of cloud-native imaging.
Improving CDI efficiency
See how Lima Memorial improved efficiency with advanced technology.
Imaging, data reporting and the cardiology user experience
How can cardiovascular imaging departments leverage user experience design to address the challenges of fragmented data?
Focus on patients, not paperwork
Watch the webinar to learn actionable strategies on tackling decreased hospital margins, increased labor costs and staffing shortages.
How Optum supports value-based goals with powerful products
See how Optum’s products help hospitals succeed with value-based contracts, earning appropriate incentives and avoiding penalties.
Tackle the workforce crisis with human innovation
Explore human-focused innovations for solving healthcare workforce challenges while reaping benefits for all.
Addressing burnout with cloud PACS solutions
Health care leaders share how cloud-native solutions can help ease risks and improve efficiency for radiologists.
Improve physician practice revenue
Learn key strategies to strengthen the financial performance of your physician practice.
Making risk adjustment programs work
Learn how three care delivery organizations reduced administrative burden to spend more time with patients and improve outcomes.
Shift-of-site care is a win for women
With unique needs, women benefit greatly from a wider array of care options. Payers and employers can reap big rewards by providing them.
Consumer care preferences survey
Optum surveyed more than 1,200 consumers to understand their experiences when accessing care. Download this e-book to read our findings.
Increasing potential of genomic data
Hear from experts in this Endpoints News webinar on the increasing importance of clinicogenomic data, including diverse phenotypic and genotypic profiles.
Provider telehealth use experience survey
Learn the telehealth features and frustrations providers say impact their virtual care experiences.
The unifying power of integrated data
Read how the integration of EHR and claims data can change what we can collectively learn about outcomes.
Bassett Healthcare network blazes bold path forward
Optum helped Bassett achieve independence and financial resilience while maintaining outstanding care delivery. See how the partnership came together.
Modernizing the Medicaid experience
How can states and providers use modularity to modernize? Dustin Haisler at GovTech.com interviews Optum product leaders for insights.
Maximize Your Real-World Data Strategy
Optum Life Sciences leaders break down common missteps when using RWD and how to create practical strategies to overcome them. Watch the video from STAT Summit.
Supporting providers in the transition to VBC
Learn how value-based care (VBC) partnerships between payers and providers are more important than ever.
How health equity can be a catalyst for growth
Providing better care for the underserved is vital for healthier communities. It can also be a wise strategy to unlock organizational growth.
The connection between money and health
The connection between money and health runs deeper than just costs — your employees rely on your benefits strategy for overall wellness.
Bassett Healthcare partnering insights
Tommy Ibrahim, MD, CEO of Bassett Healthcare Network, shares insights on reinventing a health system for success.
Automate fraud waste abuse improve program integrity
Learn how artificial intelligence (AI) and natural language processing (NLP) can help federal agencies improve program integrity, cut costs and deter fraud.
Cancer costs are rising — are you ready?
As experts forecast a steep climb in already-expensive oncology costs, payers must prepare for the big changes ahead.
What if providers’ clinical data were research-ready?
Providers collect data about patients every day. But what should they be considering — and doing — to put their clinical data to good use?
Optum, FDA collaborate on vaccine and biologic research
FDA reaches agreement with life sciences segment of Optum to provide data and expertise to evaluate and research biologics and vaccines.
Five priorities improve financial performance
This E-book will help you master five fundamentals for a sound financial future.
Teaming up with task force movement
Learn how Optum Serve is helping to advance the health and well-being of Veterans and spouses in the trucking and cybersecurity workforce.
Migrate your enterprise imaging to the cloud
Watch our webinar on migrating your enterprise imaging to the cloud.
HouseCalls: Helping to care for members where they are
As demand for home and community care grows, Optum® HouseCalls can reach your Medicare Advantage members and assess members’ health needs.
Helping emergency services practice streamline accounting
A busy emergency services practice gets help to ensure its financial health and allow physicians more time and confidence to do their jobs.
Promises and pitfalls: AI and clinical decision-making
Learn more about why evidence-based criteria and clinician insight are needed for informed and trustworthy decisions while leveraging AI.
Senior brain health and social interaction
Medicare Advantage plans can differentiate supplementary programs by addressing cognitive health and social interaction.
Innovative approaches to collaborate with PCPs
Understanding the challenges confronting Medicare Advantage plans and their Medical Loss Ratio.
Defragment care with in-home assessments
In-home assessments can help to improve mental health and other social determinants for seniors. Read about the HouseCalls approach.
Boulder Community Health and Optum
Optum partnership insights and strategies enable near- and long-term success for provider organizations.
Key considerations when updating provider management modules
Explore 6 key factors when updating, streamlining and coordinating provider management modules with other Medicaid functions.
Strategies for incremental modernization
States can build on a step-by-step approach to modernization, incrementally transforming the user experience without disruption.
Health equity in kidney disease management
Learn 5 strategies for health plans to address inequities in the kidney care landscape and create more equitable access, treatment and outcomes for all.
Symmetry EBM Connect
Increasing compliance with evidence-based standards to enhance care.
Opening digital doors for all consumers
Digital gateways are the new social determinant of health. Read this strategy guide on expanding access and health equity.
Partnering to reduce fraud, waste and abuse
We partner with federal agencies to address challenges and support their unique needs through technologies, solutions and best practices.
Create a best-in-class front-end revenue cycle
Learn six ways to take your operations from good to great.
Best practices for identifying overpayments
Learn how a multi-tiered approach to data mining helps maximize savings and achieve payment accuracy earlier in the claim lifecycle.
Generating new data voice to claim research
Using our Voice-to-Claim® methodology to better understand the attitudes and behaviors of patients and physicians and their effects on cost and utilization.
NEJM Catalyst Q&A: Value-based care
Dr. Wyatt Decker discusses the path forward for value-based care, including implementation challenges, benefits and keys to success.
Collaborating to advance maternal health
Learn how leaders, communities and institutions can work with Optum to promote safe pregnancies and childbirth.
Clinical Exchange Orders and Results tool
Streamline the implementation process of healthcare lab operations and enhance enrollment control with our self-service tool.
Aligning with CMS: Medicare Content Navigator and InterQual Transparency
Discover how to meet the latest regulatory requirements for Medicare Advantage plans.
Critical steps to navigating change management
See how an effective change management strategy can help people adapt to change more quickly and nimbly.
Robotic process automation (RPA)
We utilize RPA to advance federal government programs.
Why you should prioritize digital payments
Digital payment processing doesn’t have to be a daunting task. Here's why it should be at the top of your priority list.
Payer-provider collaboration in ESRD care
Kidney disease is complex and disproportionately impacts people with limited financial resources. Here’s how payers can help transform care.
Toward outcomes-based payments
Learn from industry leaders about the push to generate evidence and demonstrate healthcare provider value.
Anesthesiology group improves rcm physician practices
How one anesthesiology medical group increased profitability, efficiency and stability with physician group management services from Optum.
Understanding artificial intelligence for radiologists
Learn why implementing artificial intelligence in the radiology department shouldn't lead to panic.
Trends and perspectives for health plans
Together, we are driving toward the same things for our healthcare system — better quality, lower cost and higher consumer and provider satisfaction.
Achieve claim pricing accuracy and efficiency
Learn how to create a framework that drives payment accuracy on the first pass.
Strong financial future through partnership
See how Boulder Community Health partnered with Optum to continue to successfully fund its mission.
Emergency department performance metrics
Learn about the key metrics that should be monitored within your emergency department to improve financial performance and optimize efficiency.
New billing system improves financial performance
Radiology Associates of Nevada made a smooth transition to Optum as its new billing vendor. This significantly improved its financial performance.
Precision medicine trends: A conversation with Chris Boone, PhD
AbbVie Vice President Chris Boone discusses what the life sciences industry can do to realize precision medicine’s full potential.
Innovation help healthcare workforce crisis
Harvard Business Review Analytic Services and Optum leaders examine human-focused innovations for the health care workforce.
Decrease denials strategy
Understanding the reasons for your claim denials is the first step to preventing them from happening in the future.
Doubling down on the cloud
Learn how technology is advancing imaging workforce challenges and revenue.
Lowering cardiovascular disease risk
An innovative program involving patient awareness and provider outreach improves patient use of lipid-lowering therapies.
Remove roadblocks behavioral health
Enhance patient access to mental health services online.
Speed up the claims process with AI
Read about our Claims Automated Rules Engine (CARE).
Structured cardiovascular reporting
Learn how structured cardiovascular reporting can reduce late charges.
Mental health: Optum addresses the great information divide
Explore the challenges and opportunities in using mental health data to understand prevalence, risk, impact and treatment in patients, members and communities.
Symmetry Oncology Analytics
Learn about powerful tools to measure the cost and quality of cancer care.
MIPS program recommendations physicians
Traditional MIPS plans concluded in 2023. Understand MIPS reporting types and get help navigating the changes.
Digital scheduling at a rural health system
Learn how a rural health system achieved an ideal patient experience and increased bookings with digital scheduling.
Modernize your revenue cycle workforce
New staffing challenges require new approaches. Learn how to optimize your workforce to increase productivity and retention.
Designing cardiac training programs through innovation
Learn how we’re training the next generation of cardiac clinicians with advanced technology.
Get competitive with CDI and coding analytics
Watch the demo to learn how our analytics platform provides custom, value-added reports with the data insights you want.
US military entrance processing command
Optum Serve conducts physical and mental examinations for military applicants.
How VBC can work for manufacturers
Value-based contracts can present challenges that must be overcome to bring gene therapies to market.
Exploring possibilities cdi metrics
Watch the panel-style webinar with Banner Health CDI and analytics leaders to discuss business intelligence analytics and health information management.
Taking aim at the U.S. maternal mental health crisis
New and expectant mothers are facing an epidemic. Here’s what they need, not only to withstand pregnancy and early parenthood but to thrive.
Future ready claims review automation not enough
As claims grow more complex, many automation methods aren't sophisticated enough for the job. See how payers can take claims review to the next level.
Top stakeholder questions to consider
Ask your life sciences stakeholders what they need early on. Consider these top questions that patients, providers, payers and regulators are looking to answer.
Antiracism and inclusion
Optum saw the value in a project for a community cohort, Leadership for Racial Equity, and quickly worked to create a national strategy.
What to know about managing rising transplant costs
What payers need to know about transplants and other high-cost care.
7 strategies for meeting more mental health needs
Discover how to create an interconnected network of services that help people get properly diagnosed, access support and sustain progress.
How to achieve more inclusive MSK care
Musculoskeletal conditions are costly, common and fraught with health inequities. Here’s how a more holistic approach can help.
Identifying patients' bone fracture risk
Optum Life Sciences experts used real-world data to assist in the testing of an algorithm designed to assess for osteoporosis risk.
Expanding health equity in clinical trials
Jamie Freedman, MD, PhD, and Shalini Mohan, MD, discuss challenging assumptions about expanding diversity and representation in clinical trials.
Building a connected care model
People feel the disconnect of a siloed healthcare system. Get insights on how to build more holistic care through connected care models.
Claim review: How to adopt best practices
Learn how a comprehensive claim review strategy can help you stop repeat errors and increase payment accuracy across the claim lifecycle.
Inventory management solutions made simple
Discover inventory management solutions that guide the decision-making process for efficiency gains, better practices, cost savings and safer care delivery.
Optimizing physician reimbursement
Learn how physician groups can leverage automation and incorporate advanced analytics to help ensure they’re collecting every dollar.
Behavioral health provider digital access survey
Get insights on how patients access and schedule mental health services online in this e-book, based on original research by Optum.
Arkansas' new approach to Medicaid management
See how data and analytics help Arkansas manage one of the state's most vital and widely used government programs.
Are employees checked out mentally present
Keys to investing in wellbeing programs that meet employees where they are and offering solutions for everyday life.
The 6 trends shaping pharma strategies in 2024
Life sciences market experts from Optum and Advisory Board share perspectives on trends that will influence the future drug value chain.
C-suite Insights
Explore actionable resources for healthcare executives including peer-to-peer insights, dialogue, perspectives and analysis.
We follow the science and defend against bias
See how Optum follows the science where it leads, validating the research we find to uphold the clinical integrity of InterQual content.
Payers address family building inequities
Read how payers can turn the tide on 5 worrisome statistics.
Benefits of artificial intelligence reach the revenue cycle
The use of NLP makes the revenue cycle work smarter, not harder.
The HouseCalls difference: Kim's story
Kim, a HouseCalls advanced clinician practitioner, believes a good day is when she’s helped someone. Watch the video to see her story.
Payer channel scheduling St. Luke's case study
St. Luke’s Health dramatically increased volumes and decreased costly no shows with Optum digital scheduling. Learn how your health system can, too.
How employers can make better benefits decisions
Assessing vendors is daunting enough. But for many employers, limited data, contract variations and employee confusion add complexity.
Staying current in your core admin platform
Get current, stay current and leverage the newest platform capabilities with ongoing release management.
The impact of in-home health assessments
Learn about the benefits of HouseCalls assessments with these 5 fast facts.
Closing gaps in pain management
More than half of nursing home residents suffer from chronic pain. Read the white paper to learn how we can make a difference in their lives.
Financial case connected care
Get thought starters for assessing how a connected care model can strengthen your financial position.
Redefining the prior authorization process
Learn how we are revamping the prescribing process.
Supporting employee wellbeing after a loss
Learn how Optum helped a member find support after a loss.
HouseCalls: Reach members where they are
Help manage members’ health through in-home or virtual assessments.
The Physician Liaison Outreach Playbook
Learn how proactive planning is the key to successful physician-to-physician marketing.
Mitigating maternal care deserts
For some mothers-to-be, healthcare options are disturbingly limited — or even nonexistent.
The ASAM Criteria® Navigator, 4th edition
Learn how to streamline efficiency and consistency of the utilization review process.
Delivering on promise of fertility care
As a highly specialized area of care, fertility treatment is a significant cost driver for health plans and employers.
New dimensions in life sciences research
Proving the impact on clinical outcomes as well as costs.
Working together to help end the opioid epidemic
Opioids are powerful drugs with a high risk of misuse and dependence. A comprehensive solution can help address this complex problem.
Workplace fitness benefits: What to know
Employers must adjust their fitness programs to meet employees' evolving fitness needs. Here’s how to bring your offerings into the new era.
Reimagining senior care to meet changing demands
Learn about the holistic care that Medicare Advantage Plans can offer your residents. Plans with the Optum Care Model are available.
Targeted care, lower costs
One state achieved both aims in delivering home health services.
Elevating employee engagement
Data-driven, targeted strategies help successfully increase employee use of mental health, financial and legal services.
Cyberthreat webinar
Learn practical steps you can take to safeguard your enterprise imaging data.
Establish renewed priority on revenue loss
In volume 2 of this white paper, discover 3 strategies to improve revenue performance from proper levels of reimbursement to writing off bad debt and expanding into new service areas.
Forging a new frontier in mental and behavioral health
Overcome today's barriers with leadership, collaboration and investment strategies that proactively address mental and behavioral health.
Applying robotic process automation compliance
See how robotic process automation (RPA) helped saved 9,465 hours and $950,000 over five years in our client use case example.
Deliver program integrity efficiencies
We help federal agencies with an effective data strategy and analytic roadmap to predict and prevent fraud, waste and abuse.
Race ethnicity data bridge gap in health equity
The life sciences industry needs robust real-world data. For that data to reflect real-world populations, you need race and ethnicity data.
Optimize member engagement through collaboration
A health plan increased in-home assessment rates for their Medicare Advantage members by working with Optum to increase member engagement.
Best practices for reducing provider abrasion
Find out what is driving the recent increase in abrasion and learn what health plans can do to alleviate provider pain points.
Impacting SDOH for patients and communities
CNO Kristy Duffey discusses the benefits of home-based care, opportunities in value-based care and how digital tools can overcome barriers.
Slowing specialty pharmacy carve out stampede
Discover specialty medication management strategies to help you slow carve-out and stop member attrition.
Addressing high cost musculoskeletal care deferral
With musculoskeletal (MSK) incidence rates and costs rising, connecting members with the care they need is more urgent than ever.
Boulder community health partners employee success
Explore how Boulder Community Health partnered with Optum to continue elevating its most critical component of success — its workforce.
The costs and benefits of cloud-based imaging
Understand the seen and unseen costs of migrating your enterprise imaging to the cloud.
New mandatory CMS reporting rules will impact states
To meet the requirements, states should consider focusing on five key areas.
NEJM Catalyst Q&A: Care delivery innovation
Optum Health CEO discusses care delivery innovation within value-based care and the role of alignment, partnership and analytics.
Optimizing your payment integrity program
Learn best practices to help health plans achieve in-year cost savings goals.
Latest takes in-life sciences industry
Discover what’s on the minds of innovative life science leaders with thought -provoking insights and discussions.
Denials index
Learn about the latest trends in medical claim denials and find out how to decrease them.
Fire department boost collections forty percent
Our case study shows how the Cincinnati Fire Department recovered missing revenue with Optum billing and collection systems.
Connected communities
A panel discussion examines how to use data-driven, virtual and automated technologies to advance and refine population health strategies.
Patient access to gene therapies for rare disorders
Optum Life Sciences experts discuss value-based contracts at the 5th Annual Gene Therapy for Rare Disorders Conference.
Digital equity across the healthcare system
Remove gaps and improve digital access for everyone.
Developing a best-in-class middle revenue cycle for hospitals
Explore the six focus areas for improving performance to create a best-in-class middle revenue cycle for your hospital.
The heart behind the business
People are at the heart of all we do at Optum. Meet the people behind the business at Optum and learn why they put you at the center of everything we do.
Optimizing UM with InterQual AutoReview
An Optum expert explains how hospital systems can transform their UM programs and drive efficiency with InterQual AutoReview.
Women's health: Susan's story
Learn how OB Homecare and advanced analytics can help manage at-risk pregnancies.
Improving SGLT2i therapy guideline adherence
A manufacturer worked with Optum Life Sciences to help increase guideline adherence for patients with diabetes and cardiovascular disease.
Navigating growth in the healthcare industry
Learn how to overcome challenges and achieve scalability with your medical practice.
Real-world data centralized teams
Expanding the use of RWD requires expertise and leadership. Learn how to maximize the success of a centralized RWD team.
Moving to lower cost electronic payments
Partner with Optum Financial to increase ACH payments.
Navigating the pandemic
Learn how Optum revenue cycle management services helped Santa Fe Pathology Services maintain financial stability throughout the COVID-19 crisis and position the practice for growth.
Physician outreach toolkit
Get tools for applying data-driven outreach to develop a successful growth strategy.
How AI accelerates workflows and patient cancer care
Discover the potential of AI and how it helps save thousands of lives each year.
8 ways to make drugs more affordable
Discover what plan sponsors need to know to help remove or limit cost as a barrier to medication access.
Business intelligence delivers financial insights lab
Learn how BI can improve operational performance, provide access to key financial indicators and support compliance.
The benefits of microservice imaging architecture
Our cloud-native solutions use dynamic load balancing to optimize resource use across all applications.
RCM services allow laboratory navigate difficult waters
Learn how Optum implemented comprehensive revenue cycle management procedures to help Meridian Laboratory Physicians bill for clinical pathology, increase reimbursement and support practice growth.
Fitness needs across generations
Fitness needs vary across generations. Here’s how to make sure your offerings are serving each age bracket.
Find immediate ROI with cloud-native enterprise imaging
Learn how artificial intelligence (AI) can support patient care, improve workflows and more.
9 ways to modernize the Medicaid experience
Read our 9 key takeaways for states to modernize the provider management experience.
Improve fertility treatment efficiencies and outcomes
Whether for personal or professional reasons, many couples today are delaying starting a family. However, waiting to conceive can lead to fertility issues — for one partner or both.
NASPO ValuePoint streamlines procurement
Streamline enrollment and admin activities with the Optum Provider Services Module, a self-service gateway for Medicaid providers and agency staff.
3 pillars of physician revenue cycle management
How cultivating a combination of people, processes and technology is a critical driver of RCM success.
Increasing at-home dialysis for ESRD patients
See why home-dialysis patients tend to fare better than in-clinic patients, and how patient-centric kidney care management helps them make informed choices.
Strategies to reduce administrative costs
Strategies to fix payer-provider collaboration, streamline patient financial experience and apply AI technologies for better cost savings.
Optum Serve: Protecting taxpayer dollars
Eliminate fraud, waste and abuse in healthcare spending.
2023 3rd Annual C-suite Research Report
How are market dynamics impacting decision-making across healthcare? Research report examines progress, challenges and priorities in 2023.
Emotional wellbeing solutions for health care workers
Support healthcare workers, who put others first every day.
Things to know about new landscape fertility benefits
More and more, benefits leaders see the value of reproductive health — and it’s changing how they approach offerings. Here are 5 things to know.
Easier access to mental health services
Learn how Refresh Mental Health used online scheduling to simplify consumer access to mental health care.
Reducing administrative variation with artificial intelligence
Infuse technology into your medical necessity process.
Managing risk in value-based care delivery
Watch as Erik Johnson explores models for risk in delivering value-based care (VBC).
How to make most of your fitness benefits
Get a step-by-step guide for employers to maximize ROI, design the best offering and keep their workforce engaged in essential offerings.
Take action maximize impact real world data
We design programs between life sciences companies, payers, providers and patients to improve care and patient and provider satisfaction.
The No Surprises Act
Get an overview of the Act with recommendations for physician practices.
Emotional wellbeing support
Help your workforce take charge of their health, so they can be more resilient and present every day.
Improve women's health with community-based solutions
Research shows that community-based care is an effective way to lessen the negative effects of social factors that can heavily influence health outcomes.
Analytics answer compliant coverage identification
Using advanced analytics and rich data resources can help boost providers’ ability to screen the self-pay patient.
Community Connector helps member assessment
Optum helps health plans address member needs through screening and community-based organization (CBO) referral services.
Improved Arkansas Medicaid Outcomes
Optum has completed more than 200K+ assessments in Arkansas, helping coordinate care for people with chronic, high-cost and long-term care needs.
Tips for selecting a fit for purpose data set
Using real-world data (RWD) that are not fit for purpose can waste time and money. Review 6 simple steps to guide your research towards the right data.
Clinical exchange eprescribe self service tool speeds enrollment
Healthcare systems need new systems to better facilitate enrollment despite staffing shortfalls.
Causes of medical necessity denials
Learn two critical indicators causing these denials, and how to account for them effectively.
Fitness for a generation that never gets old
With baby boomers rapidly aging into Medicare, health plans must take an informed approach when marketing fitness benefits. Here’s how.
Improve medicaid risk adjustment accuracy
Explore Medicaid best practices for health plans and learn three actions to take and when to take them.
Patient engagement leader
Everest Group recognizes Optum in its 2023 Patient Engagement Platforms PEAK Matrix® Assessment.
How to implement patient-centered oncology care
Patient-focused care is becoming the highest aspiration in cancer care. Here’s what payers should know to embrace this beneficial approach.
A single database cardiology platform that drives efficient workflow
Read our case study.
StepWise Application Migration to the Cloud
Learn from health plan leaders on how to accelerate and optimize your cloud-adoption journey.
Catalyze the use of RWE in life sciences
Discover how using real-world evidence (RWE) in the life sciences industry can help catapult learning and drive impact for your company.
How holistic programs improve senior health
Medicare Advantage plans need to rise above the competition by going beyond traditional fitness offerings.
Five ways to improve your cardiovascular workflow
Learn how to improve productivity with a workflow solution that innovates in five key areas.
Health leaders share IT transformation stories
Hear John Muir Health and Bassett Health’s observations on digital transformation, modernizing infrastructure and strategic automation.
Telephone lifestyle coaching for veterans
Optum Serve can help Veterans achieve health and wellness goals. Promote well-being, prevent illness and reduce the burden of chronic conditions.
Informing FDA best initiative
As a key FDA collaborator, Optum Epidemiology generates reproducible results that inform regulatory decisions for COVID-19 vaccines.
Challenges when financing your EHR
Key themes and insights that can guide your organization toward a successful electronic health record (EHR) transformation.
Move your enterprise imaging to the cloud
Learn how to highlight the immediate cost and efficiency gains of cloud adoption.
What employers should know about a hub benefits strategy
A fresh approach to benefits is easing leaders’ administrative burden and connecting employees to better care.
Can automation cure workforce challenges
Rethink how to support workers, while simplifying and improving care.
What if pragmatic clinical trials were more practical
Pragmatic trials look increasingly attractive to researchers, but they’re tough to execute. Learn how to simplify the process.
Evidence-based clinical practice guidelines for DoD and VA
Improve continuity of care by reducing variation in practice for service members transitioning to Veteran status.
Key learnings for modernizing your state’s legacy system
Dr. Garry Choy, CMO, discusses the pros and cons of using automation and clinical decision support to meet today’s workforce challenges.
Youth mental health research findings
In our new report, you'll learn key findings about the mental health needs of young people and their caregivers, and discover opportunities for intervention.
Stay current on core claims systems releases
Stay current on core claims systems releases See how upgrade as a service from Optum helps health plans stay up-to-date on admin and core claims platform releases.
Women’s health is more than reproductive care
Discover 5 areas of focus for payers and employers looking to improve women’s health outcomes, costs and member satisfaction.
The secret to lowering the total cost of care
Rising pharmacy costs concern everyone. Managing the underlying health conditions behind each prescription is key to addressing these high costs.
Time to outsource workers compensation payments
Learn how outsourcing payments could help you stay competitive and compliant.
The role of navigation to simplify health care
An active approach to advocacy can help improve member experiences while driving down costs. Read our e-book to learn how.
4 key forces shaping the future of pharmacy
These emerging trends will help define the road ahead.
How to manage blockbuster anti-obesity drugs
The pricey weight management drugs work well, but users need coaching and support to maintain the benefits.
Driving healthcare innovation
Matthew Kinney, growth and innovation leader at Optum, describes how to create holistic strategies for meaningful impact.
How to eliminate prescription waste
Achieve savings by targeting expensive, low-value drugs.
New innovative treatments for hemophilia B, RSV and COPD
Cutting-edge research in gene therapy, mRNA editing and blood enzymes pays off with powerful new advances for these drug classes.
Asia pacific culture of health
By engaging region-specific expertise, your company can strategically improve the well-being of its employees.
Get immediate savings on specialty drugs
Specialty drug spend is a “top threat” to employer-provided benefits. Discover sustainable savings with your existing Optum Rx plan.
Debunking revenue cycle myths: The path to financial health
Discover how partnering with a managed services partner can help improve financial operations.
Specialty drugs: Not just set and forget?
For optimizing specialty drug therapy, monitoring patients throughout their care is key to cost-effective use of high-cost drugs.
Taking the paper out of member communications
Discover how digital communications can increase member engagement and lower the cost of care.
Utilizing patient access contact center
See how a hospital streamlined scheduling for about 700 providers and strengthened customer service for over 65,000 patient calls monthly.
Drive wellbeing programme utilisation
Strengthen your international wellbeing programme with an integrated health promotion specialist.
SDOH solutions: Transforming health care for all
Learn from experts how to transform health care by addressing the social and economic factors that impact health outcomes.
Avoid surprises in pharmacy spend
Old strategies and new challenges don’t mix. Future-proof your plan and get better predictability with new pricing models and risk management tools.
Unlock clinical insights with NLP technology
Learn about natural language processing (NLP) challenges and opportunities in the real-world data (RWD) space from Optum® NLP experts.
Diagnosis and care recommendations for rare congenital anomaly
Rigorous work-up leads to conservative CHD (congenital heart disease) treatment approach.
Automation and workforce strategies in healthcare
Get 6 key takeaways from a C-suite panel discussion.
Automate your front office to address the staff pinch
Learn how automating appointment scheduling, eligibility verification and communications, and more eases pressure on staff.
Preparing your plan for the GLP-1 era
After revolutionizing care for diabetes and weight loss, GLP-1 drugs are being eyed for more. Can we afford it?
Help members access behavioral health care
Guide members to quality, affordable behavioral health care.
Top 4 drug spend categories
Many patients combined with expensive drugs leads to top spending classes.
The latest PBM regulations: Summer 2024
Get your guide to the evolving health care regulatory landscape and see what’s coming as lawmakers debate 600+ new bills impacting PBMs.
Building the PBM of the future
The solutions plan sponsors need today to tackle the pharmacy challenges of tomorrow.
Bring wellness strategy to life
Discover how partnering with a health promotion specialist can help you unlock creative ways to engage your employees with wellness programs and initiatives.
Social Care Assistance helps member assessment
Optum helps health plans address member needs through screening and community-based organization (CBO) referral services.
Partnering to close gaps in maternal health
Learn how we can collaborate with your state to use analytics and consulting to address your most important maternal health challenges.
Impacting provider engagement
Step into the shoes of Richard Solomon, a Health Care Advocate, who goes above and beyond to support providers in risk adjustment programs.
Challenges and opportunities with clinicogenomic data
Genomic data linked to the longitudinal health record hold great insight. How should researchers think about and use these powerful data?
How to ease the emotional toll of caregiving for members
Learn how plan sponsors can support caregivers and their loved ones' mental health with resources and tools.
What’s informing HEOR strategies in 2025?
Discover how Ami Buikema and Rifky Tkatch are helping prepare their clients for next year.
4 myths: Carving out specialty pharmacy
Integrating specialty pharmacy means better care, lower costs.
Risk adjustment Star ratings success
Discover 5 strategies that will help your health plan be prepared to factor risk adjustment data into Star Ratings.
Engage providers impact member outcomes
Download our infographic to learn how Optum can take the burden off payers to impact provider performance.
Improving performance at Excel Medical Center
Empower provider success and improve member care through digital integration.
4 steps to optimizing value-based care
Learn how combining these steps can help power a holistic workflow between payers and care delivery.
Supporting the unique needs of firefighters
When the Minnesota Fire Service needed emotional well-being support for their firefighters, Optum stepped in to help.
Market for patient engagement webinar
View the public launch of Optum Patient Access and Engagement on demand.
Why workforce wellness programs must reward more than health tasks
To ensure that well-being benefits drive results, employers must let go of strategies built around one-and-done health tasks. Here’s how.
Holistic msk improves care
Our holistic approach can help payers better fight against rising musculoskeletal care costs while better serving members.
Pharmacy legislative rules fall 2024
An assessment of the latest rules impacting PBMs from state and federal legislation.
Enterprise transformation services
Health systems continue to face many challenges. Do you have the flexibility and focus to deliver on strategic goals or transform your business?
Developing evidence-based tools for accessible and quality care
Explore how evidence-based tools like The ASAM Criteria® Navigator and InterQual® Substance Use Disorders Criteria are helping payers and providers efficiently and effectively navigate the complex substance use disorder landscape today.
Health plans system modernization
Learn how technology and infrastructure investments enable growth and help with evolving regulatory requirements and increasing competition.
Design an exceptional physician review strategy
Optimize your physician review process to help save time, reduce costs and improve care quality.
Benefit communication strategy use case: Engage employees with personalization
Learn how personalized employee communications can help meet benefit strategy objectives
New options to treat schizophrenia, COPD
A clever combination drug offers new help for schizophrenia with reduced side effects, while Dupixent expands its footprint to COPD.
How to manage organ transplant costs
There’s a lot at stake with organ transplant claims. Learn the importance of selecting an effective payment integrity approach.
CMS quality measure rules 2024
Upcoming changes in federal quality measures for Medicaid and CHIP will impact state governments.
Rising expectations among health care consumers
Learn about the growing expectations people have for their healthcare experience and how to improve the consumer journey.
Reimagining fraud prevention
Find out how modernization of emergency relief programs can detect and prevent fraud.
Everest Group guide to selecting RCM services
Buyer’s guide helps hospital leaders evaluate and select RCM services partners with the future in mind.
Key new drugs help close out 2024
New biologics for breast cancer, hemophilia, and a rare form of heart disease are poised to add competition and choice in these classes.
Specialty vs. retail pharmacy
Specialty medications require high-touch support. Learn more about what sets specialty pharmacy apart from retail.
Hub and advocacy solutions work together
Navigating a complex healthcare environment is challenging. Using hub and advocacy solutions together helps employers and employees alike.
Improving hospital quality and utilization
Learn how data insights helped 4 organizations transform their operations.
Middle RCM tech
Artificial intelligence (AI) and automation are having a major impact on improving the middle RCM for healthcare providers.
How the Defensive Health Agency community is digitally transforming
In this webinar, learn about the ongoing modernization of the care experience for Service Members.
Revolutionizing specialty medication management
Get an in-depth assessment of the ways Specialty Fusion™ is revolutionizing specialty drug management.
Automating success revenue cycle transformation
Set the foundation for synchronized and connected revenue cycle management.
Building a better oncology managed care program
New cancer treatments can transform patients’ lives — but they also create costs that demand a new kind of cancer guidance program.
Digital integration and the path to interoperability
Creating a connected system to improve risk and quality outcomes.
When chronic conditions and behavioral health collide
The collision of chronic conditions and behavioral health challenges can’t always be stopped, but healthcare leaders can work to mitigate its impact.
The future of quality reporting
Learn how AI, interoperability and ECDS are transforming healthcare quality reporting and the solutions that can help you stay ahead.
New treatments for rare and common conditions
Our report emphasizes new, next-gen and first-in-class treatments for cystic fibrosis, non-opioid treatment and GLP-1 drugs.
Making inroads with maternal health
Learn how Indiana and Washington, D.C., are tackling critical maternal health equity disparities.
Revenue cycle ripple effect
Streamline your patient experience, enhance satisfaction, reduce costs and improve your financial performance with our digital tools.
Improve provider engagement mobile query
Respond to query opportunities in real time and get access to clinical and coding decision-making information with our secure mobile app.
Alma simplifies access to in-network mental health providers with digital self-scheduling
Learn how Alma partnered with Optum to offer frictionless patient access to care through digital-first channels.
How payers can improve maternal care in the 4th trimester
Learn how payers can drive meaningful impact through pre-conception care, postpartum coaching and managing chronic conditions early.
Which growth strategy path is right for you?
Discover which growth strategy path is right for your health system.
Discover 8 capabilities to power your EHR
Learn how Optum solutions can enhance your EHR for better patient engagement and financial data integrity.
Advancing dme benefits management
Learn how DME Navigator can help streamline durable medical equipment (DME) benefits management.
Transform underwriting technology
Automation, technology and scalable staffing drive growth.
Supporting women beyond the reproductive years
Learn how health plans can fill care gaps by offering greater support and personalized solutions for women experiencing menopause.
Continuous insurance coverage discovery
Learn how our two-stage approach to eligibility coverage links pre- and post-service analysis in near real time.
The importance of workforce mental health maintenance
See how employee mental health benefits are evolving to support workforce wellbeing.
A quarter-century of pharmacy benefit changes
Explore the dramatic changes in the years since 2000 — in drug performance and design, and especially affordability.
Making informed care decisions with accessible health plan data
Learn about a health plan STAR ratings tool that provides residents with clear, interactive comparisons of health plans.
How to build a mobile crisis team
Learn more about the current research on mobile crisis teams (MCTs), how to build an MCT as well as envision a future for them.
Safeguard the mental health of content moderators
Learn how we support the unique workplace needs of content moderators with a tailored wellbeing strategy.
Optum Recognized as RCM Leader Report
Supporting members through life’s challenges
See how mental health support from Optum helped a member navigate grief.
Smart, sustainable growth in the era of Medicare Advantage
Health systems face financial challenges and increasing competition as more seniors transition to Medicare Advantage, requiring smart strategies for sustainability and growth.
Viewpoints on the 2026 CMS Advance Notice
Go inside the latest changes to the 2026 program.
Reduce the risks of polypharmacy in nursing homes
Learn 5 tips for effective deprescribing to improve resident quality of life.
Integrated risk and quality programs: A strategic approach
Unlock new efficiencies with a digital-first, AI-powered approach to empower value-based care and enhance health plan performance.
New pharmacy benefit solutions to help bend the cost curve
In this conversation, get a peek into upcoming solutions and technologies designed to address high-cost medications.
Transform your pharmacy benefits with end-to-end transparency
Pharmacy benefits should be clear and simple. Are they? In this latest e-book, see how true transparency drives better outcomes.
Are your pharmacy benefits working hard enough?
Pharmacy benefits should be transparent, affordable and easy to use. Get clear on your pharmacy benefit manager’s value with these 3 questions.
Analytics in payer-oncologist partnerships
See 4 ways that payers can help healthcare providers unlock the power of real-world data to drive quality and innovation in cancer care.
3 steps to slash medication costs
This is your employer guide to reducing your healthcare spending.
New hope for neurological conditions
Learn how a holistic model enhances multiple sclerosis care.
How to manage medication overload
Hear from a leader's perspective on how to manage polypharmacy.
2023 trends shaping life sciences strategies
Life sciences market experts from Optum and Advisory Board offer their bold predictions and insights in 2023 for the industry.
What Gen Z wants in employer fitness benefits
The pricey weight management drugs work well, but users need coaching and support to maintain the benefits.
Pharmacy Insights Podcast
Listen to our resident experts discuss critical industry challenges and the solutions you need to control rising drug costs.
Make your pharmacy benefit plan work better
Learn 4 key questions you should be asking.
Gene therapies: Can we afford the future of medicine?
Learn how to manage financial risk as gene therapies become more commonplace.
Reassessing the Inflation Reduction Act with real-world evidence
Cut through the noise of the Inflation Reduction Act of 2022 with key points aimed to help life sciences leaders leverage impactful data.
Alzheimer's treatment: Time for a level-set?
See success rates, risks and costs of the new Alzheimer’s treatments.
Alternative funding: Real savings or problems?
See how much "free" drugs will actually cost you.
Orphan drugs market: Can we afford them?
We examine key questions around orphan drugs such as why they're so expensive, how they're being used and what plan sponsors should do next.
Spend more time with members
See how prospective assessment programs can reduce administrative burden. Physicians spend less time on paperwork, so they can focus on what matters most: member care.
Optum Rx customer obsession
Watch how one Optum Rx employee made the system work better for everyone.
Biosimilars to save billions in this decade
Prices for popular brand-name biologics drop up to 60% with generic-equivalent biosimilars.
Proactively renew dual eligibles for Medicaid
Learn how Optum uses AI, state-specific logic and robust workflows to help with proactive dual eligible Medicaid renewals.
Advanced Pharmacy Audit Services
See how a health plan used advanced audit services to prevent and detect pharmacy fraud, saving over $1 million.
How to contain GLP-1 costs
Get strategies for handling the new anti-obesity medications.
Fighting fraud how plan sponsor recovered funds
How one plan sponsor recovered $315,000 in six months.
Managing diabetes gains an 8:1 ROI
Learn how a third-party administrator’s client improved health outcomes and lowered costs.
Creating connections through partnership
Hear from an Optum Rx client on how we're partnering together for everyone we serve.
Empowering clients with choice and transparency
Helping make prescription drugs more affordable for plan sponsors and the members we serve is a universal focus.
Adventist West’s success through redesigning and automating UM
Discover how to leverage automation for centralized, exception-based utilization management.
3 ways to deal with escalating drug costs
Explore innovations custom built for today’s specialty challenges.
How our medication packaging helps the planet
Our eco-friendly, fully sustainable prescription packaging eliminates polystyrene and reduces CO2, water and plastic waste.
Winter: First big drugs of 2024
New treatments for NASH, schizophrenia and more are on the way.
Smart formulary management
Develop and manage formularies that bring clinical and financial value.
Drug pricing spotlight: Wound care
Combat against brand name products costing 125 times more.
The new drugs plan sponsors need to watch for
See which trends to consider when assessing the pharmacy benefit, which new drugs may be flying under the radar and what's coming.
Making sense of copay cards
Discover how copay cards can disrupt your benefit strategy.
A young patient’s hemophilia story
See how Optum Rx helped change a patient’s life with access to life-altering medicines.
Support for substance use disorders
Expand access to evidence-based support to help individuals achieve stabilization and sustain recovery.
Understanding students' mental health needs
Read about the realities of campus behavioral healthcare and how we can make things better for college students.
Wellbeing in the Workplace study
Global employers share insights on their efforts to adapt wellbeing strategies to meet their greatest workplace challenges.
How AI is delivering efficiencies for radiologists
Learn how AI solutions can boost your organization’s return on investment (ROI).
Behavioral healthcare made better
We help people find care and support that’s easy to understand and access.
The role of AI in enterprise imaging
Learn how AI is being used to improve imaging workflow management and help care providers collaborate more efficiently.
Access point-of-care ultrasound imaging data
Discover how centrally stored point-of-care ultrasound images can help your organization increase efficiency and improve revenue.
Change Healthcare Workflow Intelligence
Learn about our vendor neutral, flexible medical imaging workflow rules engine.
When healthcare works better for everyone
See how building an outcomes-based model for behavioral healthcare can benefit both clinicians and patients.
The AI technology transforming imaging
Learn how artificial intelligence (AI) can support patient care, improve workflows and more.
How to transform imaging with behavioral science
Behavioral science is being applied to unique methods of enterprise imaging product design.
Using the cloud for medical imaging
Learn how to unlock the power of cloud migration in your medical imaging.
Personalized support for members with autism
Optum is breaking barriers in supporting members and families who are diagnosed with autism spectrum disorder (ASD).
Strategic planning for imaging in the cloud
Learn what health IT and imaging leaders need to do before moving their enterprise medical imaging to the cloud.
Evidence in Action newsletter
Our quarterly e-newsletter helps you stay up to date with current issues facing life sciences leaders and the role of real-world evidence.
Improve your radiology performance
Learn how Change Healthcare Radiology Solutions™ 14.2.1 can help your department improve diagnostic confidence.
Combating the opioid epidemic
Medication interventions save lives — more people need access to them.
Maximize digital mammography reading efficiency
Learn how an all-in-one workstation for mammography and radiology increased study volume and accelerated turnaround.
Viewpoints on the 2025 CMS Advance Notice
Don't miss this exclusive webinar and the chance to learn how your Medicare Advantage plan can better prepare for the 2025 changes.
Reduce risk and capture lost revenue
Learn how Change Healthcare Imaging Actionable Findings can help, solve complex care needs.
Addressing social determinants of health
Create solutions to eliminate barriers to care and support members.
Intelligent workflow case study
Learn how intelligent workflow can help improve efficiency and patient care.
Re-examining radiology with Optum
Explore the transformative changes happening in the field of radiology and their impact on advancing healthcare.
Explore our AI-enabled radiology portfolio
Learn how our Radiology Solutions use AI to rapidly identify relevant radiology images.
Access to mental health care within 48 hours
Optum expands care options while reducing crisis events and costs.
Insights on GLP-1s: Costs and coverage
Balancing the risks and the benefits of GLP-1 drugs.
Biosimilars: Hard to make but lower costs
Biosimilars compete with expensive biologic drugs by offering the same safety and effectiveness, but at a lower cost.
From transformation to triumph
Read this executive summary about Optum Serve's need to stay competitive amid dynamic trends and customer demands.
The Health Equity Alignment Solution (HEALS)
HEALS is a data analytics solution that highlights where and how inequities occur within a community, state or a health plan’s member population.
Achieving equitable care: The shift to race-neutral equations
Discover how the InterQual team facilitated the timely adoption of new industry guidance for promoting health equity in clinical practice.
4 shifts shaping the future of oncology
An evolution in cancer prevention and treatment promises to forge a new path for patients, physicians and health plans alike.
Viewpoints on the 2025 CMS Final Notice
Download this executive summary to learn how these changes may affect your Medicare Advantage plan.
Navigating the challenges of outpatient evaluation for patients with acute coronary syndrome
Learn how the InterQual level of care team tackled a content development challenge following updated societal guidelines for acute coronary syndrome.
Strategies for centering patients and staff
Learn how to help transform hospital revenue cycle operations with healthcare automation.
Addressing the loneliness epidemic and cognitive decline in seniors
To tackle this problem, payers need to take a holistic approach to delivering connection while addressing seniors’ mental and physical needs.
Reexamine the effect of the Inflation Reduction Act
Learn how real-world data and evidence can help prepare you for healthcare-related Inflation Reduction Act policies.
Star ratings are important to Medicare plans
Learn how health plans can improve Star ratings through high-touch strategies.
The state of pharmacy regulations
In this conversation, learn the implications of new pharmacy legislation and rulemaking, and how you can manage your benefits effectively.
Patient engagement platform check boxes
Learn how a platform that covers the full patient journey, from scheduling care to payment and follow-up, can streamline operations and costs.
Aging workforce and the impact on drug spend
An estimated 23% of the workforce will be over age 65 by 2050 – but what does that mean for my drug plan?
Interqual autoreview efficient proactive
A cloud-based solution designed to increase utilization management efficiency and review accuracy.
Packaging your employee benefits experience
Part 3 of our health savings pathways series explores best practices to help employees understand and use their benefits.
Military and Veteran health care journey
Delivering and managing health care at key phases of life for Military Service Members and Veterans.
Automating the prior authorization process
Discover our latest innovation to the PA process — PreCheck Prior Authorization — which reduces approval times, appeals and denials.
How to push back on 3 key pharmacy headwinds
Innovative formulary structures and clinical programs can help plan sponsors meet the challenge of expensive orphan, biologic and GLP-1 drugs.
The value of clinical notes
What more is there to the patient story? Get deeper data insight into patient-clinician interactions with de-identified clinical notes.
Transparency helps medicaid providers
See how technology can be used to reduce complexity, administrative rework and improper claims denials.
Transforming CDI and coding with advanced analytics
Banner Health partnered with Optum to pair AI-powered technology with advanced analytics, enabling an expanded focus on quality and risk-adjustment initiatives.
Trends for health plan quality performance
Learn how health plans can stay ahead of the curve and prepare for key trends likely to impact their quality programs in 2025 and beyond.
How CAPs directly impact your Stars performance
Stars performance is in your control. Learn how you can take action now.
SDOH solutions: Improving population health outcomes
See how to use technology to understand and implement effective health interventions.
The road to modernization: What’s next for your contact center?
Today’s constituents and stakeholders expect to interact with state agencies quickly, effortlessly and through their preferred communication channel.
Consumer centric health care research report
Examine the acceleration toward consumer-centric care with insights and perspective from healthcare leaders.
Fecal transplant to treat recurrent urinary tract infection
Learn how leveraging a microbiome approach helped one patient with von Willebrand disease and multiple antibiotic allergies.
Coding audits: Why and how to do them
Discover how regular coding audits can streamline audit and compliance efforts, boost hospital reimbursements, and improve patient financial experiences.
Rethinking the healthcare payment process
Explore ways to create a more seamless and transparent payment experience for healthcare consumers.
Reduce claim errors with front-end RCM solutions
Cut down on claim mistakes by collecting accurate data and refining your workflows.
DC maternal health homelessness
Learn about our collaborative approach to promoting maternal health in Washington, D.C., with a focus on homelessness and perinatal care.
Transforming care through payer-provider collaboration
Discover the key elements to creating a positive, mutually beneficial relationship.
What makes a meaningful health advocacy program?
A great health advocacy program helps employees get the most out of their benefits while fostering strong health outcomes and savings.
Guide to 5 types of vendors and partners
Advisory Board experts describe types of nonclinical partners and vendors, their benefits and their use cases.
Establishing trust to improve value-based care outcomes
Gain insights into how supporting providers can help increase engagement and reduce administration burden for better patient care.
Improve well-being engagement and usage
Learn 5 critical factors that can help you successfully engage employees in your wellness strategy.
Best practices utilization review
Learn best practices of utilization review to help your health system maintain clinical, compliance and revenue integrity.
Driving innovation with new revenue cycle services
One organization decreased uncompensated care, increased loyalty and patient satisfaction, and connected patients with more funding sources.
The new digital landscape
Explore the 5 key components of a good digital health care experience to meet rising consumer expectations.
2024 in review
Another busy year in pharmacy is coming. Read about top stories in GLP-1s, biosimilars, top spend classes, key regulations and innovations.
Streamline Medicaid eligibility and enrollment processes
The rise of healthcare consumerism has prompted many hospitals and health systems to rethink their patient satisfaction strategies.