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Healthcare access

Healthcare access for state HHS agencies

Simplify access to care for all your health and human services programs, improving benefits enrollment and user experience.

Modernizing eligibility and enrollment processes

Navigating the complexities of healthcare eligibility and enrollment can be daunting for state governments and their beneficiaries.

States can face significant hurdles with managing outdated systems and ensuring compliance with complex and rapidly evolving policies. And users may be eligible for multiple programs with different requirements and access points.

It’s vital that states choose an approach that helps maintain and modernize their operations. It should include safeguards for critical information systems and ensure timely access to quality care and programs.

We offer a no-wrong-door approach to system management. Automated, user-friendly solutions make it easier for beneficiaries to determine their eligibility and enroll in the right programs — including Medicaid, SNAP, TANF, QHP, child welfare and more.

Our goal is to provide your agency practical and accessible solutions that are compliant and centered on the user experience.

Healthcare access and maintenance operations

Optum Integrated Eligibility Services

Our benefit determination system for Medicaid and human services programs simplifies eligibility for cost-effectiveness and efficiency.

Optum State-Based Exchanges

Optum State-Based Exchanges provide a robust and user-friendly SaaS approach for states looking to establish an ACA-compliant marketplace.

Optum Maintenance and Operations Services

Optum Maintenance and Operations offers a structured approach to eligibility and enrollment systems takeover and management.

Related healthcare insights

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Speed up the claims process with AI

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State M&O innovations: Robotics process automation

Robotics process automation can improve maintenance and operations of state Medicaid systems.

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Strategies for incremental modernization

States can build on a step-by-step approach to modernization, incrementally transforming the user experience without disruption.

Let’s connect to see how we can partner with your state