Risk and Quality
Explore innovation driving health care risk and quality forward.
Learn how Optum is revolutionizing the health care landscape through groundbreaking strategies in risk adjustment, enhanced quality and patient involvement.
Payment integrity
Innovation in payment integrity: What’s next for health plans
Stay informed of industry challenges with forward‑looking insights and real‑world strategies from Optum experts.
Payment integrity
5 AI use cases in payment integrity
Explore how forward-looking AI insights support smarter planning, helping anticipate shifts in utilization, provider behavior and medical spend
Explore AI‑driven insights
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In an increasingly complex system with many providers and platforms, health plans have an opportunity to simplify experiences and reduce friction.
Article
Predictive analytics has evolved from an analytical advantage into a board-level growth capability.
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Learn how we're leveraging AI to help minimize payment errors associated with manual contract reviews.
Article
Learn how Optum takes an innovative approach to smarter, more accurate healthcare coding.
Explore strategies for using AI to modernize payer operations and drive measurable business value
See how Optum is always innovating to help payers modernize operations and improve member experience.
Discover solutions for payment integrity, risk and quality, and plans.
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Optum Advisory
AI‑enhanced consulting to modernize payer strategy and performance
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Risk adjustment and quality engagement
AI-powered insights to help improve coding accuracy and close care gaps
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Payment integrity
AI‑powered detection improves accuracy and reduces improper payments
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Learn how Optum utilizes scale, innovation and strong partnerships to optimize risk adjustment services for both providers and payers.
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Learn how Optum uses a member-first digital approach, advanced analytics and AI to enhance quality for clients and health plan members.
Article
In the ever-evolving landscape of healthcare, the need for complete and accurate risk adjustment has never been more critical.
Article
Optum offers digital solutions in 3 key areas: data acquisition, insight sharing and enhanced functionality.
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By collaborating with health plans and their members, Optum helps build a more cohesive, supportive system that prioritizes member needs.
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Discover how health plans can reduce billing errors and strengthen provider relationships through AI-enabled proactive education.
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Explore the market trends that are shaping the future of payment integrity and learn what they will mean for health plans.
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Explore real use cases for using AI to drive payment accuracy and the effective ways health plans are leveraging these emerging technologies.
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Discover how a digital-first DME strategy can enhance efficiency and transparency for health plans, clinicians and members.
Podcast
Optum payer market CEO Steve Yurjevich discusses opportunities to streamline operations and deliver more value across the health system.