Reduce costs, manage risk, improve outcomes
Optum® Complex Care Management offers an integrated suite of benefit management services.
These services help health plans and self-insured employers reduce total cost of care, manage organizational risk and improve outcomes for members facing complex disease states.
By combining condition-centric capabilities with flexible funding models, including full risk transfer, Optum delivers the greatest impact to the patients and payers who need it most.
Providing personalized support for complex member needs
- Care management
- Utilization management
- COE/Network
- Focused claims review
Complex care management solutions
Solution suite
Bariatric Resource Services
We help reduce medical expenses associated with bariatric surgery and provide support for your members, their family members and caregivers.
Solution suite
Focused Claims Review
Save on total claims dollars reviewed with this innovative approach targeting procedure, surgery and facility claims.
Solution suite
Oncology Solutions
Our solutions address complex challenges and help manage cancer costs while improving outcomes and quality of care.
Solution suite
Transplant Solutions
Get significant savings and statistically better clinical outcomes.
Industry insights
Article
Musculoskeletal surgeries are driving up costs. Payers can bend the curve with digital care, expert second opinions and high-performing surgical centers.
White paper
New research examines how structured, nurse‑led case management influences cost, utilization and outcomes for members undergoing complex organ transplants.
On-demand webinar
As transplant, cell and gene therapies grow in complexity, payers need new approaches to manage cost, risk and support long-term sustainability.
Article
Understand how depression, anxiety, care access and treatment adherence drive higher utilization and costs for employers and payers when left unaddressed.