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Article
Learn how health plans can fill care gaps by offering greater support and personalized solutions for women experiencing menopause.
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.
On-demand webinar
Learn how to help transform hospital revenue cycle operations with healthcare automation.
All healthcare industry insights
How senior care facilities can elevate dementia care
Learn how multi-layered, proactive interventions can help reduce hospitalizations.
Navigating the future of healthcare financial growth
Explore expert-led strategies to boost financial resilience and long-term growth in today’s evolving healthcare landscape.
Enhance system security with cloud-native imaging solutions
Learn about the in-depth security capabilities of cloud-native imaging.
The state of value-based care in 2025: Growth and challenges
Unpack the state of VBC in early 2025 and see where it’s going next. Learn how specialty care will fit into the future VBC landscape.
Market for patient engagement webinar
View the public launch of Optum Patient Access and Engagement on demand.
Digital MSK tools: 5 important features
Digital MSK can improve outcomes while reducing costs. Learn how payers and employers can choose a program that delivers on health benefits and savings.
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.
Streamline clinical value analysis processes in a growing surgical market
Access resources on how to reduce surgical costs for your health system.
Using the cloud for medical imaging
Learn how to unlock the power of cloud migration in your medical imaging.
Optum Recognized as RCM Leader Report
Optum is honored to be recognized as a Leader in the Everest Group RCM Platforms PEAK Matrix Assessment for 2025, highlighting our comprehensive RCM solutions.
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.
Adventist West’s success through redesigning and automating UM
Discover how to leverage automation for centralized, exception-based utilization management.
3 new drugs are coming for rare and chronic conditions
This edition of Notable New Drugs includes new treatments for high cholesterol, excessive daytime sleepiness and autoimmune disease that offer promising results and improved competition.
Improving CDI efficiency
See how Lima Memorial improved efficiency with advanced technology.
Delivering a deeper connection to infusion care
Our infusion care ecosystem is based on a commitment to clinical innovation and providing consistent, convenient and compassionate care.
Imaging, data reporting and the cardiology user experience
How can cardiovascular imaging departments leverage user experience design to address the challenges of fragmented data?
Improve savings and accuracy with payment integrity software
A step-by-step guide for health plans to optimize payment integrity software, maximize cost savings and increase payment accuracy.
How do pharmacy benefit managers work?
Hear how PBMs negotiate to deliver the lowest possible cost, benefiting plan sponsors and members alike.
Generative AI’s role in modern healthcare delivery
Discover how generative artificial intelligence (AI) is reshaping healthcare by boosting speed, precision and care.
Access to mental health care within 48 hours
Optum expands care options while reducing crisis events and costs.
How technology supports staff and empowers patients
We surveyed front office staff to learn how patient engagement technology streamlines their jobs and improves access to care.
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.
Strengthening program integrity in a new federal fraud enforcement era
A policy-oriented perspective on practical pre-payment controls, claims editing and infrastructure-aware modernization.
Focus on patients, not paperwork
Watch the webinar to learn actionable strategies on tackling decreased hospital margins, increased labor costs and staffing shortages.
Support for substance use disorders
Expand access to evidence-based support to help individuals achieve stabilization and sustain recovery.
4 myths: Carving out specialty pharmacy
We examine the impact of carve-out approaches, how these carve-outs work against patient experience and clinical value, and how the integrated Optum Rx approach works better for all stakeholders.
Succeeding under CMS TEAM: an AI‑enabled performance playbook
Hear from Optum experts on how hospitals can successfully manage cost and quality across 5 episodes of care under the new CMS model, TEAM.
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.
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.
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.
How AI is delivering efficiencies for radiologists
Learn how AI solutions can boost your organization’s return on investment (ROI).
Helping people navigate care in a connected, AI‑driven ecosystem
In an increasingly complex system with many providers and platforms, health plans have an opportunity to simplify experiences and reduce friction.
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.
A day in the life of an Optum specialty pharmacist
How a specialty pharmacist ensures patient health and safety through education, screening for drug contraindications and check-ins with prescribing clinicians.
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.
Real-time transparency will transform healthcare
Learn how provider organizations can evaluate and implement new AI-powered claim technologies that lower costs and administrative burden.
Assessing your Annual Enrollment Period performance: A checklist
You made it through the Annual Enrollment Period (AEP). Assess how things went so you can strategically plan for the 2027 AEP.
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.
Optimize and modernize your EHR ecosystem
Turn EHR complexity into measurable performance gains.
Exploring the evolving landscape of autonomous coding
This panel will address autonomous coding trends, challenges and innovations within the middle revenue cycle.
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.
Asia pacific culture of health
By engaging region-specific expertise, your company can strategically improve the well-being of its employees.
Smart revenue cycle investments
These two targeted investments will strengthen your revenue performance more than deep cost cutting.
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.
7 key trends in risk adjustment
Examine the trends reshaping risk adjustment and learn how your organization can stay ahead in 2026.
Create a expert-level front-end revenue cycle
Learn six ways to take your operations from good to great.
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.
Empowering providers to focus on patient care
Our provider performance team partners with your providers to reduce administrative burden and drive positive patient outcomes.
Aligning with CMS: Medicare Content Navigator and InterQual Transparency
Discover how to meet the latest regulatory requirements for Medicare Advantage plans.
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.
Supporting members through life’s challenges
See how mental health support from Optum helped a member navigate grief.
Beyond payment integrity: An AI-driven approach to affordability
Medical costs are rising, and health plans need solutions. See how an AI-driven, enterprise-wide approach may be the key to affordability.
Why site of care matters now more than ever
Smart clinical strategy: meet patient needs with expanding sites of care
Critical steps to navigating change management
See how an effective change management strategy can help people adapt to change more quickly and nimbly.
The fight for techquity
Get ideas for how to fundamentally change your approach to building technology and incorporate techquity into your organization.
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.
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.
Robotic process automation (RPA)
We utilize RPA to advance federal government programs.
Risk adjustment coding 101 for providers
Learn actionable strategies and best practices for effective implementation of coding programs for provider organizations.
Develop your growth strategy
Optum Market Advantage helps you choose your own path forward.
Opportunities in the DSNP market: Essential insights for MA leaders
Join speakers Cori Leech and Jared Landis as they discuss how to meet the challenges facing health plans in the D-SNP market right now.
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.
A simpler GLP-1, plus big-market launches
This edition of Notable New Drugs includes another oral GLP-1, the first preventative treatment for COVID-19 and the most effective oral drug for plaque psoriasis.
Innovation Without Compromise: Navigating Faster Turnaround Times with Responsible AI
Discover what to ask AI vendors and how to build a strategy that supports accelerated decision-making, reduces administrative burden and maintains clinical integrity.
Revenue cycle ripple effect
Streamline your patient experience, enhance satisfaction, reduce costs and improve your financial performance with our digital tools.
One doctor’s journey as an Optum provider
Dr. Benito Calderon, a provider in Nevada, explains how working within the Optum Network transformed his practice.
Why behavioral health plays a critical role in the cancer journey
Understand how depression, anxiety, care access and treatment adherence drive higher utilization and costs for employers and payers when left unaddressed.
Building trust in AI: A responsible approach
At Optum Rx, we’re using AI responsibly — fairly, safely, ethically — to make health care easier and better for the people we serve.
Patient access starts before the appointment
New research reveals how access, transparency and digital tools shape patient satisfaction long before care begins.
Health plans system modernization
Learn how technology and infrastructure investments enable growth and help with evolving regulatory requirements and increasing competition.
Addressing staffing challenges in senior care
Ongoing staffing shortages are straining senior care facilities. Strategic partnerships and clinician-led support can help bridge the gaps.
Debunking revenue cycle myths: The path to financial health
Discover how partnering with a managed services partner can help improve financial operations.
Anesthesiology group improves rcm physician practices
How one anesthesiology medical group increased profitability, efficiency and stability with physician group management services from Optum.
States achieve health equity with actionable analytics
By applying analytics solutions, states can create a comprehensive roadmap to better health equity.
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.
The provider review playbook
Access a comprehensive guide on how to build a consistent, defensible review cycle for OPPEs, FPPEs and peer reviews.
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.
Closing the clinical handoff gap in post‑acute care
Incomplete, backward-looking information during care transitions drives avoidable utilization. Learn why MA plans must focus on the handoff, not just readmissions.
Call centers and AI technology
Transform state contact centers into 24/7 problem solvers.
Optimize employee benefits with healthcare analytics
With the right tools, employers can transform employee benefits data into actionable insights that drive better experiences and add value.
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.
Trends shaping the future of clearinghouses
Discover 5 key trends that can help healthcare organizations streamline processes, minimize errors and deliver faster, more reliable services.
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.
How Medicare Advantage leaders can thrive in the D-SNP market
We discuss the growth potential and the imperative for integrated care coordination and enhanced benefits for the dual-eligible population.
Strengthening risk adjustment with payer and provider collaboration
Learn how Optum utilizes scale, innovation and strong partnerships to optimize risk adjustment services for both providers and payers.
Preparing for a rise in ambulatory surgical care
Explore market conditions driving the outpatient shift, considerations for patient selection and current opportunities in the ambulatory space.
Biosimilars to save billions in this decade
Prices for popular brand-name biologics drop up to 60% with generic-equivalent biosimilars.
Five things your denial rate isn't telling you
Learn 5 ways to make changes that will prevent and remediate denied claims.
Improve your radiology performance
Learn how Change Healthcare Radiology Solutions™ 14.2.1 can help your department improve diagnostic confidence.
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.
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.
Wellbeing shifts with meaningful impact
Results from the 8th annual Wellbeing in the Workplace study from Optum highlight how over 400 global employers are winning at wellness.
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.
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.
Decrease denials strategy
Understanding the reasons for your claim denials is the first step to preventing them from happening in the future.
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.
Driving the future of liver care
Why the Optum approach to liver fibrosis is a game changer.
A/R recovery services provide continuity
Provider maintains A/R revenue continuity during HIS conversion.
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.
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.
Doubling down on the cloud
Learn how technology is advancing imaging workforce challenges and revenue.
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.
Remove roadblocks to 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).
Optum wins 2023 enabling technology leadership award
Optum won the 2023 North American Enabling Technology Leadership Award.
Combating the opioid epidemic
Medication interventions save lives — more people need access to them.
From transformation to triumph
Read this executive summary about Optum Serve's need to stay competitive amid dynamic trends and customer demands.
Structured cardiovascular reporting
Learn how structured cardiovascular reporting can reduce late charges.
How Optum supported one practice in its transition to value-based care
Dr. James Corcoran shares his experience as a member of the Optum Network in Arizona, focusing on how the organization supported his practice’s transition to value-based care.
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.
Navigating the next era of Medicaid
Major Medicaid policy changes are coming fast. Learn how smarter tools, better data and strong partnerships can reduce risk and support patients.
The impact of AI on today's pharmacy benefits
In our latest podcast, two AI experts discuss how Optum Rx is leveraging artificial intelligence while prioritizing privacy and security.
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.
Reimagine your employee assistance program
Help employees feel mentally, physically and financially well with Emotional Wellbeing Solutions.
Revolutionizing cardiology
Discover how Boulder Community Health and Optum Advisory worked together to achieve smart growth and sustainable change.
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.
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.
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.
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.
Improving transparency in payer-provider connections
Explore how real-time connections can enable more accurate claim submission to create a more efficient healthcare payment system.
Identifying suspicious billing patterns
Learn how a fraud detection algorithm flagged a suspicious vendor, saving States millions for improved program integrity.
Payment integrity strategies that help generate savings quickly
This guide can help you optimize your payment integrity program and achieve savings goals within 12 months.
Increasing behavioral health patient access with self-scheduling
Learn how Alma partnered with Optum to offer frictionless patient access to care through digital-first channels.
Digital scheduling at a rural health system
Learn how a rural health system achieved an ideal patient experience and increased bookings with digital scheduling.
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.
Modernize your revenue cycle workforce
New staffing challenges require new approaches. Learn how to optimize your workforce to increase productivity and retention.
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%.
Designing cardiac training programs through innovation
Learn how we’re training the next generation of cardiac clinicians with advanced technology.
Strengthen your surgical capacity
Learn how to optimize surgical capacity by implementing and sustaining a highly-effective block management process.
Celebrating the unique role of Optum Infusion Pharmacy nurses
On average, Optum Infusion nurses spend approximately 1,300 hours per year providing care to patients. Hilary, an Optum Infusion nurse, knows this firsthand.
Optum recognized as 2026 RCM market-defining leader
Optum named a leader in Everest Group’s Revenue Cycle Management (RCM) Platforms PEAK Matrix® Assessment for 2026.
5 questions executives are asking about AI in pharmacy benefits
Discover the unique challenges and responsibilities of introducing AI into pharmacy benefit solutions.
The benefits of cardiovascular structured reporting
Discover the key features of cardiovascular structured reporting that drive adoption, EHR integration and customization.
Maximizing CareSelect Imaging for value-based care
Discover how to transform your approach to clinical decision-making and advance your organization’s value-based care goals.
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.
Denial prevention: From admission to post-discharge and beyond
Discover how to prevent denials — from pre-claim to appeals and automation — with expert insights across the care continuum.
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.
US military entrance processing command
Optum Serve conducts physical and mental examinations for military applicants.
Making care easier for people navigating rare diseases
Optum Frontier Therapies delivers personalized, patient-centered care.
Payer-provider collaboration: Improving patient outcomes
Tech and value-based care can improve payer-provider collaboration, reduce admin burden and enhance patient outcomes through data sharing.
Taking the paper out of member communications
Discover how digital communications can increase member engagement and lower the cost of care.
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.
Boost engagement with personalized benefits communication
Learn how personalized employee communications can help meet benefit strategy objectives
Pharmacy Insights Podcast
Listen to our resident experts discuss critical industry challenges and the solutions you need to control rising drug costs.
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.
Why advance care planning matters in senior care
Advance care planning helps care teams understand patient goals, guide treatment decisions and support families before a crisis occurs.
Provider report cards help emergency medicine groups
Learn more about how provider report cards can help emergency medicine groups thrive.
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.
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.
VBC 5.0: Mastering the 5 pillars of value-based care success
Explore the 5 pillars of value-based care every health system, health plan and provider needs to succeed.
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.
Shifting to the left: Innovating prospective risk adjustment
Arati Swadi, VP of Risk Adjustment at Optum, shares how Prospective Solutions are paving the way for value-based care.
Improving the provider experience
Learn about a modern and proactive approach to payment integrity for health plans.
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.
Transforming maternal health: A roadmap for states
We offer analytics, consulting insights and real-world application for states to improve maternal health care for women enrolled in Medicaid.
Innovating care for vulnerable populations
Join speakers Saad Ahmad and Jared Landis to see how in-home technology helps payers give better care, solve social problems and improve health for people who need it most.
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.
Smart formulary management
Develop and manage formularies that bring clinical and financial value.
Transform your risk adjustment strategy
A strategic risk adjustment analytics framework guide for health plans.
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.
Maximize digital mammography reading efficiency
Learn how an all-in-one workstation for mammography and radiology increased study volume and accelerated turnaround.
Help enhance coding accuracy with the HCC Tearsheet 2025
Accurate HCC codes are essential for effective care management and compliance.
The role of imaging decision support in VBC
See how tools like CareSelect® Imaging can help providers enhance clinical decision-making, improve patient outcomes and reduce administrative burden.
How payers can improve maternal care in the 4th trimester
Learn how payers can drive meaningful impact through preconception care, postpartum coaching and managing chronic conditions early.
Scaling AI without sacrificing safety, quality or trust
Gain access to a discussion where health leaders across the U.S. share how AI can help transform care delivery and financial sustainability.
Drive wellbeing programme utilisation
Strengthen your international wellbeing programme with an integrated health promotion specialist.
Transforming the pharmacy member experience with AI
Our AI technology proactively identifies and solves issues – before members even realize there’s a problem.
CMS quality measure rules 2024
Upcoming changes in federal quality measures for Medicaid and CHIP will impact state governments.
The cost of inaccurate data: An overview of risk adjustment audits
As CMS moves to increase RADV audits, payers must understand the implications of RADV and find the right support for a smooth audit process
What to know about managing rising transplant costs
What payers need to know about transplants and other high-cost care.
Empowering providers with AI innovation
Generative AI is reshaping healthcare — boosting efficiency, easing documentation and empowering providers across the system.
AI in action: Practical use cases for state health programs
AI transforms state health programs by automating detection, strengthening oversight and driving impact. Get key insights from experts.
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.
How CAPs directly impact your Stars performance
Stars performance is in your control. Learn how you can take action now.
Leveraging data-driven heat maps
The Optum network gives transparency to customized potential connections, helping boost revenue.
Outlook on oncology 2024
See how emerging trends, including a global pandemic, are reshaping the landscape of oncology care and medication.
Visualizing fraud, waste and abuse
Graph analytics and machine learning drive the future of program integrity.
Trends shaping the future of payment integrity
Explore the market trends that are shaping the future of payment integrity and learn what they will mean for health plans.
A new generation of in-home senior care
Explore how evolving care models bring proactive, personalized support to seniors where they live, helping them age in place longer.
Level up your surgical savings
Discover game-style strategies and real-world case studies for reducing surgical costs and standardizing supply use with Crimson AI.
How the Optum support system reduced one doctor’s workload
In this video, Dr. Peter DeSilva shares a detailed account of his experience working with the Optum Network in California.
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.
Guide to achieving seamless digital integration
Optum offers digital solutions in 3 key areas: data acquisition, insight sharing and enhanced functionality.
Rising expectations among health care consumers
Learn about the growing expectations people have for their healthcare experience and how to improve the consumer journey.
Managed Transplant Program: Clinical outcomes and cost impact
New research examines how structured, nurse‑led case management influences cost, utilization and outcomes for members undergoing complex organ transplants.
Reimagining fraud prevention
Find out how modernization of emergency relief programs can detect and prevent fraud.
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.
SDOH solutions: Improving population health outcomes
See how to use technology to understand and implement effective health interventions.
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.
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.
Pre‑Care: What Consumers Expect Today and in the Future
Find out what we learned when we asked more than 1,000 people how they feel about the pre-service journey, from provider search to AI use.
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.
Everest Group guide to selecting RCM services
Buyer’s guide helps hospital leaders evaluate and select RCM services partners with the future in mind.
Risk adjustment Star ratings success
Discover 5 strategies that will help your health plan be prepared to factor risk adjustment data into Star Ratings.
Cloud-based upgrades
Learn how cloud-based imaging solutions can speed upgrades and reduce maintenance.
Beyond the pitch: How to evaluate AI vendors with clinical confidence
Learn what to look for in an AI healthcare partner — from clinical rigor to transparency — to support safe, effective implementation.
Change Healthcare Stratus Imaging Share
Learn how much you could save by eliminating CD burning.
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.
How one infusion nurse's attention to detail saved a patient's life
How an Optum Infusion Pharmacy nurse stops an emergency as a parent keeps fighting for care.
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.
Top 5 ways Optum Rx is putting AI into action
See how we’re using AI to make pharmacy care faster, more personalized and proactive.
How small and emerging biopharma can generate real-world evidence
Here are questions small and emerging biopharma need to ask to generate meaningful evidence and be competitive.
Optimizing physician reimbursement
Learn how physician groups can leverage automation and incorporate advanced analytics to help ensure they’re collecting every dollar.
Using biosimilars to treat chronic inflammatory conditions
In today’s healthcare landscape, the introduction and increasing use of biosimilars offers a promising solution to rising medication costs.
Join us in supporting those who serve
Service members, military families and Veterans may find it difficult to access services they’re eligible for. Optum Serve research highlights 7 opportunities.
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.
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.
Viewpoints on the 2027 CMS Advance Notice
The proposed changes contain a mix of both opportunities and challenges. Read the report to learn how these changes could impact your organization.
A new approach to managing genetic testing
Explore ways to better manage genetic testing to ensure the right test is used at the right time to determine the right care.
Reduce risk and capture lost revenue
Learn how Change Healthcare Imaging Actionable Findings can help, solve complex care needs.
Site-of-care: A longitudinal review
Gain insights into the site-of-care landscape, what market data reveals and how outmigration could affect your hospital.
Transform your pharmacy benefits with end-to-end transparency
Learn 8 ways that plan sponsors can benefit from a comprehensive approach to transparency and accountability.
Consumer-centric health care research report
Examine the acceleration toward consumer-centric care with insights and perspective from healthcare leaders.
Are employees checked out mentally present
Keys to investing in wellbeing programs that meet employees where they are and offering solutions for everyday life.
Advancing clinical access to whole genome sequencing
Learn how Optum and Illumina are working together to help patients with genetic testing for rare diseases.
Change Healthcare Workflow Intelligence
Learn about our vendor neutral, flexible medical imaging workflow rules engine.
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.
Payer-provider interoperability to enhance prospective risk management
Payers and providers are using advanced technology in healthcare to create efficient processes that capture chronic conditions and deliver better health outcomes .
How AI is transforming hospital utilization management
In the landscape of hospital utilization management, effectively applying AI and automation is essential to achieving meaningful results.
Unpacking recent federal actions on GLP-1s
Evolving federal policy on popular weight loss medications introduces additional cost and coverage uncertainties.
Benefits of artificial intelligence reach the revenue cycle
The use of NLP makes the revenue cycle work smarter, not harder.
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.
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.
Upstream partnerships that maximize payment integrity strategies
Find out how aligning payment integrity with other complementary functions at health plans reduces unnecessary spend and provider abrasion.
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.
Getting back to the joy of clinical practice through value-based care
Daniel Frank, MD, experienced firsthand the frustrations of not being able to dedicate enough time to patients.
Achieving equitable care: The shift to race-neutral equations
Discover how the InterQual team facilitated the timely adoption of new industry guidance for improving health outcomes in clinical practice.
Can a holistic approach help with UM challenges?
Learn how acute care organizations can address UM challenges with a holistic, comprehensive approach.
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.
Simplifying provider engagement for health plans
See how Optum can help your providers deliver coordinated, high-quality care for patients.
Streamlining real-time eligibility and claims
Discover how real-time eligibility, benefits and claim status inquiries can improve accuracy and efficiencies for payers and providers.
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.
GLP-1s: Real-life wonder drugs?
Hundreds of clinical trials are vetting GLP-1s to treat everything from Alzheimer’s to arthritis. The question is: How will we afford it?
Advancing payment integrity with real-time solutions
John Hoffman, VP of Product at Optum, discusses how the future of payment integrity is built on preventing errors before payments are made.
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.
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.
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.
Which growth strategy path is right for you?
Discover which growth strategy path is right for your health system.
Emerging trends impacting payment integrity
We take a look at how market shifts, AI innovation and cost pressures are redefining health plan strategies.
Health loyalty rewards programs
Learn how employers can tap best practices to ensure their health rewards and loyalty programs make a meaningful difference.
Case study: Investing in employees' success
Tailored financial wellbeing support eases employee stress and boosts productivity for global telecommunications company.
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.
Rethinking the healthcare payment process
Explore ways to create a more seamless and transparent payment experience for healthcare consumers.
How we’re advancing the future of healthcare payments with AI
ptum Financial is exploring ways to leverage AI and other advanced technologies to connect healthcare payments and information for a simpler experience.
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.
Discover 8 capabilities to power your EHR
Learn how Optum solutions can enhance your EHR for better patient engagement and financial data integrity.
MD Perspective: Reducing the burden of costly secondary reviews
Explore how objective criteria, strong clinical documentation and medical review automation can help improve workflow efficiency, generate time savings, and enhance secondary review.
Staying current in your core admin platform
Get current, stay current and leverage the newest platform capabilities with ongoing release management.
Beyond OBBBA: 3 strategic capabilities every health system needs
How healthcare leaders should adapt their priorities in the era of OBBBA to achieve sustainable transformation.
Engaging and transforming patient experiences
Healthcare leaders share strategies to improve patient outcomes by addressing friction points, emphasizing empathy and valuing staff.
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.
Reduce claim errors with front-end RCM solutions
Cut down on claim mistakes by collecting accurate data and refining your workflows.
AI and API integration for reduced denials
Transform claims with AI and API integration to reduce denials, strengthen transparency and drive more efficient, intelligent operations.
Visionary approaches to the OR
Watch experts reveal how leading health systems are using AI-enabled analytics to reduce surgical costs and improve operating room (OR) capacity.
A systemic transformation is needed to fix clinician burnout
One Optum expert explains how value-based care offers a way to address the clinician burnout crises.
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.
Navigating AI in Healthcare
Watch this on-demand webinar for expert insights on AI capabilities, business challenges and robust governance in healthcare.
Leveraging GLP-1s for a whole-person approach
A holistic, strategic approach to GLP-1s combines medication, surgery and behavioral health to support weight management and reduce costs.
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.
Stop chasing fraud: Move prevention upstream with AI strategies
How AI, data and investigative expertise are helping health plans detect fraud earlier and stop losses before they occur.
Financial case connected care
Get thought starters for assessing how a connected care model can strengthen your financial position.
Advancing dme benefits management
Learn how DME Navigator can help streamline durable medical equipment (DME) benefits management.
Beyond the hype: Real AI use cases to drive payment accuracy
Explore real use cases for using AI to drive payment accuracy and the effective ways health plans are leveraging these emerging technologies.
Trusted specialty pharmacy support
Optum Specialty Pharmacy simplifies prior authorizations, offers patient support and helps you save time with digital tools.
Navigating the two-midnight rule in the Medicare Advantage world
Watch this on-demand webinar to hear top insights and an analysis of the latest trends impacting the utilization management function since the latest changes became effective.
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.
Is your PBM delivering the best value? 4 key questions to ask
See if your PBM is giving you the tools and guidance you need to balance savings with improved outcomes.
Optum recognized as RCM market-defining leader
We're proud to be recognized as the Frost Radar™ Revenue Cycle Management Operations 2025 growth and innovation leader.
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.
Supporting employee wellbeing after a loss
Learn how Optum helped a member find support after a loss.
Quick and safe digital specialty pharmacy service
Optum Specialty Pharmacy leverages specialized expertise and resources with flexibility, delivering personalized care that drives better outcomes.
First oral GLP-1 drug for weight loss
Explore 3 new drugs for chronic conditions including obesity, severe asthma and hives (also known as urticaria).
Understanding IESNPs in senior living
IESNPs support seniors with complex needs while helping them live independently in senior communities.
Survey: How Healthcare Costs Can Influence the Patient Journey
Diagnosis and care recommendations for rare congenital anomaly
Rigorous work-up leads to conservative CHD (congenital heart disease) treatment approach.
Going Beyond Risk Adjustment in Provider Engagement
Learn innovative techniques for risk adjustment workflows that help emphasize pre-visit chart prep and clinical suspect identification.
Cost breakthroughs in complex care management
Not every complex care management program is built equally. Here's how to optimize them for maximum benefits.
Menopause in the workplace: Promoting awareness and support
How employers and payers can step up with tailored benefits, workplace accommodations, and integrated care.
Three tips to help providers transition to value-based care
Some quick insights on how to make a VBC model work for your organization.
How Optum Care Transitions helps improve post-acute performance for health plans
See how a leading health plan reduced costs, improved outcomes and strengthened provider relationships with a modern post-acute care model.
A beginner’s guide to implementing risk adjustment coding
This guide for provider groups outlines a 3-step process to build a robust coding program that supports improved value-based care outcomes.
Value dex z codes
Optum and Palmetto experts partner in discussing how to solve genetic lab challenges in legacy solutions.
Re-examining radiology with Optum
Explore the transformative changes happening in the field of radiology and their impact on advancing healthcare.
HouseCalls: Reach members where they are
Help manage members’ health through in-home or virtual assessments.
Reduce the risks of polypharmacy in nursing homes
Learn 5 tips for effective deprescribing to improve resident quality of life.
How cloud-native PACS transformed a rural hospital
In this case study, learn how cloud-native technology can unlock efficiency.
Transform underwriting technology
Automation, technology and scalable staffing drive growth.
The missing link to risk adjustment success
Discover how program orchestration helps health plans align systems, vendors and strategies amid regulatory and financial pressures.
The Physician Liaison Outreach Playbook
Learn how proactive planning is the key to successful physician-to-physician marketing.
New mandatory CMS reporting rules will impact states
To meet the requirements, states should consider focusing on five key areas.
Reduce length of stay and enhance resource efficiency
Learn more about how Crimson AI enables best practices for achieving operational excellence.
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.
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
Discover payment integrity best practices to help you achieve your in-year cost savings goals.
Reprioritizing growth: Differentiate and deliver
Learn about nuanced growth strategies focusing on service differentiation, targeted patient acquisition and integrated care delivery.
Denials index
Learn about the latest trends in medical claim denials and find out how to decrease them.
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.
Modernize prior authorization with intelligent automation
Intelligent automation quickens determinations, improves submissions and gives real-time status visibility, helping reduce burden, delays and denials.
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.
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.
Protecting refrigerated medications
Optum Rx ships temperature-sensitive medications in carefully designed packaging to ensure protection from both the heat and the cold.
The GLP-1 revolution continues
New pills and expanded indications are poised to alter the dynamics of GLP-1 costs and treatments.
Help members access behavioral health care
Guide members to quality, affordable behavioral health care.
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.
Delivering actionable data insights for better care
See how our actionable data insights empower providers to deliver better, more efficient care.
Data-driven AI for RCM transformation
AI and clean data are helping change healthcare for the better. Discover how teamwork and smart tech can help payers and providers work together.
Navigating the complexities of healthcare automation
Learn how to assess your organization’s readiness for automation. Get strategies to unlock the full potential of your automation investments.
Digital equity across the healthcare system
Remove gaps and improve digital access for everyone.
The keys to revenue cycle transformation
Gain expert insights into strategies to decrease costs, unlock new sources of growth and improve patient experiences.
Developing an industry-leading middle revenue cycle for hospitals
Explore the six focus areas for improving performance to create an industry-leading 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.
4 steps to optimizing value-based care
Learn how combining these steps can help power a holistic workflow between payers and care delivery.
When healthcare works better for everyone
See how building an outcomes-based model for behavioral healthcare can benefit both clinicians and patients.
Guide to 5 types of vendors and partners
Advisory Board experts describe types of nonclinical partners and vendors, their benefits and their use cases.
Optimizing UM with InterQual AutoReview
An Optum expert explains how hospital systems can transform their UM programs and drive efficiency with InterQual AutoReview.
How payers can prepare for the next wave of cellular therapy patients
CAR T-cell therapies have been remarkably successful and may become more widely available. Here’s how to get ready for a rise in these expensive treatments.
Women's health: Susan's story
Learn how OB Homecare and advanced analytics can help manage at-risk pregnancies.
Transforming data into health system growth
Learn how Medical Center Health System partnered with Optum to win in its market.
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.
RCM essentials for 2025 and beyond
Learn how digital and self-service strategies can help improve patient experience and financial outcomes.
Maternal and infant health insights
Optum Advisory uncovers disparities in maternal and infant outcomes — commercial vs. Medicaid — identifying key factors.
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.
A forward approach to medical coding accuracy
Our coding software can systemize aspects of your middle revenue cycle, resulting in a seamless and cost-effective workflow.
What healthcare leaders really think about AI
For our 2-part series on the future of AI, we surveyed more than 100 healthcare leaders. Part 1 reveals how leaders are approaching AI investments. Part 2 looks at the leadership challenge that executives face.
Alzheimer's treatment: Time for a level-set?
See success rates, risks and costs of the new Alzheimer’s treatments.
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.
Partnering with state Medicaid and HHS agencies for over 30 years
See how state teams can turn data, responsible AI, and deep Medicaid expertise into insights that support decision-making and human-centered care.
Adapting to the changes in Medicaid policies
The upcoming changes to Medicaid policies are set to significantly impact organizational operations.
Star ratings are important to Medicare plans
Learn how health plans can improve Star ratings through high-touch strategies.
The challenge of managing rising neonatal costs
NICU-related claims are becoming more costly. For payers, a comprehensive benefit management strategy, including focused claims review, is crucial.
Outsourcing medicaid eligibility enrollment
Discover how one client outsourced Medicaid eligibility and enrollment to drive patient satisfaction and higher reimbursement levels.
Navigating growth in the healthcare industry
Learn how to overcome challenges and achieve scalability with your medical practice.
The high price we pay when seniors lack access to health care
Challenges around affordability and access to quality health care are far more prevalent than one might think. In fact, about half of Medicare Advantage members live on an annual income of less than $25,000.
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.
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.
The Next Chapter in RCM
Discover expert insights to transform revenue cycle management with the latest in AI and healthcare technology.
Physician outreach toolkit
Get tools for applying data-driven outreach to develop a successful growth strategy.
Beyond change management: Real digital transformation
Digital transformation fails when change management is an afterthought. Learn how to address the problem, people and culture for success. c
How AI accelerates workflows and patient cancer care
Discover the potential of AI and how it helps save thousands of lives each year.
Patient engagement platform checkboxes
Learn how a platform that covers the full patient journey, from scheduling care to payment and follow-up, can streamline operations and costs.
Transforming payer operations with Steve Yurjevich
Optum payer market CEO Steve Yurjevich discusses opportunities to streamline operations and deliver more value across the health system.
How Optum HouseCalls helps close gaps in care at home
Learn how Optum HouseCalls delivers in-home and virtual health assessments that help health plans identify gaps in care and support better coordination.
Supporting the unique needs of firefighters
When the Minnesota Fire Service needed emotional well-being support for their firefighters, Optum stepped in to help.
The importance of workforce mental health maintenance
See how employee mental health benefits are evolving to support workforce wellbeing.
Macro trends shaping military and Veteran care
See how Optum Serve and Fusion Hill explored the lived healthcare experiences of Veterans, military service members, and their families.
Choosing an accounts receivable partner
Selecting a strategic accounts receivable partner requires careful evaluation.
The AI-driven health plan
This white paper offers expert perspectives on leveraging AI to optimize health plan operations efficiency, growth and member experiences.
What plan sponsors need to know about WAC pricing shifts
The move to Maximum Fair Prices for popular drugs will trigger new economic considerations for plan sponsors.
Q&A: How Optum Financial is modernizing healthcare payment delivery
Explore how Optum Financial payment solutions streamline operations for healthcare organizations in this Q&A with Senior VP Brian Andrews.
Business intelligence delivers financial insights lab
Learn how BI can improve operational performance, provide access to key financial indicators and support compliance.
The new AI approach to eliminating contract-based errors
Learn how we're leveraging AI to help minimize payment errors associated with manual contract reviews.
Buck denial trends
Learn about the latest national denial trends to help you avoid rework and future denials.
Viewpoints on the 2026 CMS Final Rate Announcement
Learn how the 6 key final changes may impact your organization in 2026.
Success stories in connected care
See how health organizations are creating new ways to deliver care.
The benefits of microservice imaging architecture
Our cloud-native solutions use dynamic load balancing to optimize resource use across all applications.
Behavioral health support for millennials at work
Millennials are leading the charge for mental wellness—and employers are stepping up.
Engaging specialists in value-based care
Alternate payment methods (APMs) can boost quality and cut costs by aligning payment and delivery for specialist providers.
Future of prior authorizations: Automation, integration and results
Discover how the right technology partner paired with deep EHR integration and workflow alignment can transform your prior authorization process.
Executive insights on accelerating rural health transformation
States face urgent timelines to launch rural health initiatives and show progress. The right analytics and consulting partner can help.
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.
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.
Patient education: The secret to success in risk adjustment and VBC
Effective patient education fosters adherence to medical treatments and promotes healthy patient behaviors, in turn facilitating successful risk adjustment and value-based care.
Attracting Gen Z employees with smart benefits strategies
Gen Z is changing workplace expectations — employers must evolve benefits to keep up..
The AI technology transforming imaging
Learn how artificial intelligence (AI) can support patient care, improve workflows and more.
5 steps to reduce surgical cost variance
Is your surgical center under cost constraints? Leverage this process that has saved Optum clients millions of dollars in surgical costs.
Your guide to digital quality measurement in 2026
The $20 billion opportunity in healthcare automation
Discover how the final shift to electronic transactions can save billions and transform healthcare operations.
Rethinking quality in the digital frontier
Learn about NCQA’s shift to digital quality reporting and how Optum can help your organization stay ahead.
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.
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?
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.
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.
Seamless image sharing for better care coordination
See how a large health system improved care coordination and patient experience with Change Healthcare Stratus Imaging Share.
The big 4: Which drug classes are driving spending?
Rising pharmacy costs extend far beyond GLP-1s — inflammatory conditions and oncology therapies continue to drive significant spend.
How AI in pharmacy is powering new innovations
From predicting drug trend to earlier fraud protection, see how we’re leveraging AI to improve operations for clients and members.
9 ways to modernize the Medicaid experience
Read our 9 key takeaways for states to modernize the provider management experience.
Supporting family mental health
See how the Child and Family Behavioral Coaching program helped a family find support for their child’s ADHD.
Is your pharmacy benefit manager delivering value?
The 5 key questions you should ask to make sure your pharmacy benefit manager (PBM) is able to promote value, drive innovation and improve health outcomes.
Maximize OR efficiency with predictive analytics
Learn how to use AI-enabled recommendations to optimize surgical capacity and predictive analytics to forecast future block utilization.
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.
How Optum works alongside you
Go inside the collaborative partnership Optum offers to providers who are transitioning to value-based care.
Easing transition strain: Supporting service members moving into civilian
A white paper examining opportunities to improve outcomes for Veterans through more personalized, coordinated and ongoing support across the care continuum.
Creating shared success with Optum
See how Optum is committed to being your value-based care partner.
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.
5 provider strategies to improve margins
Discover how healthcare organizations are prioritizing a path to improved financial sustainability and margins.
How plan sponsors can stay ahead of the latest drug cost trends
A transparent fee-based model, real-time tools, and integrated pharmacy care help plan sponsors achieve affordability, predictability and better member outcomes.
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 pillars of physician revenue cycle management
How cultivating a combination of people, processes and technology is a critical driver of RCM success.
5 AI use cases in payment integrity
A strategic blueprint to modernize your payment integrity program through intelligent, AI-driven health plan operations.
Dashboard streamlines Medicaid SUD program
Virginia’s new Medicaid analytics dashboard centralizes SUD data, improving treatment strategies and reporting for vulnerable communities.
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.
Innovating care for vulnerable populations
See how in-home technology helps payers give better care, solve social problems and improve health for people who need it most.
3 ways to beat vaccine fatigue
Learn about researched vaccine messaging themes and important steps you can take to promote critical vaccinations for members.
Streamlining DME with accuracy and efficiency
Explore how health plans can streamline their DME process to deliver a seamless, connected experience that enhances the payer experience.
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.
Packaging your employee benefits experience
Use best practices to build a gift-wrapped benefits experience that engages your people and optimizes your employees’ well-being.
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.
Behavioral health support helps improve ROI
With work-life balance becoming a priority, offering no-cost outpatient therapy is more than a benefit — it’s a commitment to wellbeing.
From data collection to intervention
Learn how you can leverage analytics to address social determinants of health.
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.
Reducing administrative variation with artificial intelligence
Infuse technology into your medical necessity process.
Unlock the full potential of your payment integrity office
Discover the 5 key components of a high-performing payment integrity program. Build a structure that helps optimize savings.
Managing risk in value-based care delivery
Watch as Erik Johnson explores models for risk in delivering value-based care (VBC).
The facts about pharmacy benefit managers
There are many misconceptions of pharmacy benefit managers (PBMs) and their services. Here are the facts.
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.
Improve well-being engagement and usage
Learn 5 critical factors that can help you successfully engage employees in your wellness strategy.
The value of working with an ISNP
Learn how institutional special needs plans have proven results in driving better health, financial and quality outcomes for nursing home care.
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.
Understanding the transition to cloud-native imaging
Imaging center uses cloud-native technology to future-proof operations.
The No Surprises Act
Get an overview of the Act with recommendations for physician practices.
5 lessons from a year in flux
From tariffs to GLP-1s and AI, see which pharmacy topics led the conversation — and why they still matter going into 2026.
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.
Bridge the payment gap between payers and providers
Our innovative healthcare payment delivery platform simplifies processes, saves time and lowers costs for all involved.
The future of payment integrity in healthcare
iscover how Optum is contributing to the transformation of the healthcare industry with innovative solutions in payment integrity.
A quarter-century of pharmacy benefit changes
Explore the dramatic changes in the years since 2000 — in drug performance and design, and especially affordability.
Prioritizing social determinants of health is a must in value-based care
How one practicing physician learned that addressing the social and economic challenges of patients was crucial.
Emotional wellbeing support
Help your workforce take charge of their health, so they can be more resilient and present every day.
Build a more sustainable provider system
Address access, capacity and workforce challenges head-on.
Optum revenue cycle solutions
Improve financial outcomes, decrease operational costs, improve efficiency and elevate the patient experience with our revenue cycle solutions.
The criticality of evidence-based medicine
Evidence-based medicine improves quality of care while reducing the cost of care.
Data collection for risk adjustment compliance
Learn the 4 core pillars of a strong data collection process — a strategic imperative for improving healthcare outcomes.
Fix readmission vulnerabilities before they become overpayments
As health plans address billing, coding and inpatient utilization issues, readmissions have drawn renewed focus as a payment integrity risk.
Revolutionizing prior authorization solutions
Improving hospital quality and utilization
Learn how data insights helped 4 organizations transform their operations.
Injecting humanity back into patient care
Hear firsthand how the help of extended team clinicians can offer patients better care.
3 key forces shaping the future of pharmacy
These emerging trends will help define the road ahead.
Path to techquity
New research explores how to use technology to advance health equity.
Extracting value-based care insights from claims data
We provide actionable insights for health plans and providers to adopt a data-driven approach and achieve value-based care goals.
A new standard for objective frailty criteria
Learn how the InterQual® team developed objective frailty criteria through a process that ensured clinically applicable content.
Best practices utilization review
Learn best practices of utilization review to help your health system maintain clinical, compliance and revenue integrity.
Volume 1: Better financial health and improved operations
Read the white paper for strategies on controlling fixed costs, efficiency and organizational flexibility.
Managing the high cost of cancer drugs
Breakthrough cancer drugs offer better outcomes – but soaring costs pose challenges for affordability.
How transplant care can guide cell and gene therapy management
Payers facing rising CGT costs and complexity can draw on decades of transplant care experience to improve systems for coordination, risk management and patient support.
Pharmacogenomics in medication selection
Enable more effective and targeted treatments that address unique needs for patients with pharmacogenomics.
5 building blocks for an effective member engagement strategy
Learn how to build a holistic engagement strategy to help improve member satisfaction and better achieve your goals.
Unblocking the digital access journey
View this infographic to learn how to create a friction-free patient access journey.
Middle RCM tech
Artificial intelligence (AI) and automation are having a major impact on improving the middle RCM for healthcare providers.
A lower-risk approach to Community Engagement Verification (CEV)
In a recent demo of the Optum CEV solution, experts covered how states can address requirements under HR1.
Military and Veteran health care journey
Delivering and managing health care at key phases of life for Military Service Members and Veterans.
Advancing whole health access for Veterans
Uncover essential insights from Veterans aimed at enhancing access to VA and comprehensive health care.
Second Opinion plus COEs can help address avoidable MSK surgeries
Musculoskeletal surgeries are driving up costs. Payers can bend the curve with digital care, expert second opinions and high-performing surgical centers.
RCM essentials for 2025
From process re-design to automation with advanced technology, learn how healthcare finance leaders optimize their RCM operations for the future.
4 ways behavioral support helps make GLP-1s cost effective
As GLP-1 use surges, payers and employers need to include behavioral support, deprescription planning and long-term care to sustain outcomes.
Cloud PACS helps ensure continuity
Cloud-native Stratus Imaging PACS by Optum helped CIRA restore patient care, reading 7,000 exams in days during a cyber incident.
Analytics answer compliant coverage identification
Using advanced analytics and rich data resources can help boost providers’ ability to screen the self-pay patient.
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.
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.
The state of risk adjustment, quality programs and value-based care
Learn what insights we discovered by partnering with Frost & Sullivan on a benchmarking survey of payers and providers.
How in-home support reopened access to essential infusion therapy
When a breakdown in care left a patient without essential IV nutrition, learn how Optum Infusion Pharmacy stepped in with a new approach.
Future-ready infrastructure: The path to modernization
Practical steps to strengthen platforms, operations and readiness for what’s next.
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.
A proven path to stable, reliable, scalable modernization
Learn how a more than 10-year collaboration led to a seamless enrollment experience in 2025 for millions of consumers in Medicaid and QHP plans.
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.
Reframing growth in an AI-mediated health plan
Predictive analytics has evolved from an analytical advantage into a board-level growth capability.
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.
Making cardiovascular data work for the future
What can technology leaders do today to facilitate future advancements in cardiovascular data and analytics?
Alternative funding: Real savings or problems?
See how much "free" drugs will actually cost you.
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.
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.
A single database cardiology platform that drives efficient workflow
Read our case study.
Building the PBM of the future
The solutions plan sponsors need today to tackle the pharmacy challenges of tomorrow.
StepWise Application Migration to the Cloud
Learn from health plan leaders on how to accelerate and optimize your cloud-adoption journey.
Kidney care breakthroughs: What payers should know
Explore the most promising innovations in renal care for people with chronic kidney disease.
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.
Wellbeing in the Workplace Study
Explore the latest insights and trends shaping workplace wellbeing from our global employer survey.
How holistic programs improve senior health
Medicare Advantage plans need to rise above the competition by going beyond traditional fitness offerings.
Electronic Health Records (EHR): Implement and Operate
Maximize your EHR investment through partnership.
5 symptoms of a non-optimized EHR
A practical framework to assess EHR performance and opportunity.
Tailoring Medicare plans for specific populations
Learn some of the best practices and strategies for serving your members effectively through special needs planning and beyond.
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.
Risk adjustment solutions: The impact of medical innovations
Explore the influence of key innovations on risk adjustment solutions. Learn how these technologies are shaping the future of healthcare.
Five ways to improve your cardiovascular workflow
Learn how to improve productivity with a workflow solution that innovates in five key areas.
What’s next for AI in pharmacy?
Two AI experts share insights on how we’re using AI and advanced technology to improve everything from trend prediction to member services.
Health leaders share IT transformation stories
Hear John Muir Health and Bassett Health’s observations on digital transformation, modernizing infrastructure and strategic automation.
Revolutionizing specialty medication management
Get an in-depth assessment of the ways Specialty Fusion™ is revolutionizing specialty drug management.
Innovating risk adjustment strategies
Read this blog to learn how Renown Medical Group empowers clinicians and improves patient outcomes.
Telephone Lifestyle Coaching for Veterans
Learn how Optum Serve helped Veterans achieve health and wellness goals, promoted well-being, prevented illness and reduced the burden of chronic conditions.
Analytics in action: Building a strategic framework for risk adjustment
Explore how to harness the power of analytics to shape your 2026 risk adjustment strategy.
Creating connections through partnership
Hear from an Optum Rx client on how we're partnering together for everyone we serve.
Automating the prior authorization process
Discover our latest innovation to the PA process — PreCheck Prior Authorization — which reduces approval times, appeals and denials.
A beginner’s guide to risk adjustment analytics for providers
Learn how you can implement advanced analytics at your provider organization with our 7-step guide.
Driving healthcare innovation
Matthew Kinney, growth and innovation leader at Optum, describes how to create holistic strategies for meaningful impact.
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.
Building a framework to support value-based care
Discover how your health plan can strengthen its risk adjustment programs with Optum.
Driving innovation with new revenue cycle services
One organization decreased uncompensated care, increased loyalty and patient satisfaction, and connected patients with more funding sources.
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.
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.
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.
How to transform imaging with behavioral science
Behavioral science is being applied to unique methods of enterprise imaging product design.
Achieving healthcare supply chain excellence
Get actionable insights to navigate today’s most pressing challenges.
The perfect blend: AI and human validation in condition capture
In the ever-evolving landscape of healthcare, the need for complete and accurate risk adjustment has never been more critical.
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.
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.
The new digital landscape
Explore the 5 key components of a good digital health care experience to meet rising consumer expectations.
Challenges when financing your EHR
Key themes and insights that can guide your organization toward a successful electronic health record (EHR) transformation.
Why earlier insight is becoming central to risk, quality and value
Explore why earlier insight is becoming a growing focus across today's health care landscape.
Optum a leader in GenAI payer workflow platforms
Optum has been recognized with a Product Leadership Recognition in the North America GenAI payer workflow platform industry by Frost & Sullivan.
Move your enterprise imaging to the cloud
Learn how to highlight the immediate cost and efficiency gains of cloud adoption.
5 ways to help your employees reach their wellness goals
Learn how employers can bridge the wellness gap through workplace wellness programs that offer personalized, practical and human support.
Four steps to smarter provider education
Discover how health plans can reduce billing errors and strengthen provider relationships through AI-enabled proactive education.
Key data insights for your hospital services strategy
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.
5 ways to help improve access to personalized behavioral health care
Leading payers are implementing strategies that expand access, simplify navigation and connect members to the right behavioral health support at the right time.
Virtual urgent care scheduling for telehealth
Optum Patient Access and Engagement connects consumers to virtual urgent care through a national telehealth platform.
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.
How to eliminate prescription waste
Achieve savings by targeting expensive, low-value drugs.
Improving financial performance through education
See how educational programs at Optum are designed to improve a providers’ financial performance while maintaining top-tier patient care.
Unlock the power of pharmacogenomics with Optum® Precision Script
Integrate PGx data into pharmacy claims to support safer prescribing, smarter medication management and better patient outcomes.
Q&A: Designing a connected member journey for risk adjustment programs
Zeel Sheth explains how connected data, analytics and coordinated execution help organizations activate earlier and support better risk adjustment outcomes.
A young patient’s hemophilia story
See how Optum Rx helped change a patient’s life with access to life-altering medicines.
Solutions to simplify Medicare compliance
Discover solutions that help you efficiently and consistently comply with CMS-4201 and CMS-0057 requirements.
Managing the high costs of complex conditions with Centers of Excellence
How to build a resilient benefits strategy that drives access and improves outcomes sustainably.
Coordinated care, every step of the way
Follow Ben's story from the day of his surgery to his recovery at home and see how Optum Home & Community is helping improve the lives of patients.
Supporting Veteran truckers
Learn how Optum Serve supports Veterans through a whole-health approach to work and life.
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.
Clinical exchange eprescribe enhances care delivery
Streamline workflow and increase accuracy with Clinical Exchange ePrescribe and Surescripts Real-Time Prescription Benefits.
Automating success revenue cycle transformation
Set the foundation for synchronized and connected revenue cycle management.
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.
Streamline Medicaid eligibility and enrollment processes
The rise of healthcare consumerism has prompted many hospitals and health systems to rethink their patient satisfaction strategies.
Addressing staffing challenges in senior care
Ongoing staffing shortages are straining senior care facilities. Strategic partnerships and clinician-led support can help bridge the gaps.
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.
Social Care Assistance helps member assessment
Optum helps health plans address member needs through screening and community-based organization (CBO) referral services.
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.
Achieving better patient outcomes through medication adherence
Learn about 5 strategies for consistent medication use and how Optum Specialty Pharmacy can help.
How patient-first care helps women with cancer
A growing number of women are navigating cancer care. Targeted supports can make a difference in patient experience, outcomes and costs.
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.
AI is helping build a better, more human health care experience
As rising costs, administrative friction and uneven access continue, the need for smarter and simpler solutions remains urgent.
Safeguard the mental health of content moderators
Learn how we support the unique workplace needs of content moderators with a tailored wellbeing strategy.
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.
3 ways holistic MSK care improves all avenues of care
Our holistic approach can help payers better fight against rising musculoskeletal care costs while better serving members.
Improve physician practice revenue
Learn key strategies to strengthen the financial performance of your physician practice.
Achieving health equity: Strategies for payers
Learn more about a comprehensive solution for health payers to address health disparities and achieve health equity.
Personalized support for members with autism
Optum is breaking barriers in supporting members and families who are diagnosed with autism spectrum disorder (ASD).
Making risk adjustment programs work
Learn how three care delivery organizations reduced administrative burden to spend more time with patients and improve outcomes.
3 strategies to control pharmacy spend
See the critical products our clients use to manage drug spend and improve outcomes.
AI advancements bridge the gap to dual eligibility enrollment
See how AI-powered technology and personalized member engagement are helping to identify and enroll more members into Medicaid programs.
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.
New hope for neurological conditions
Learn how a holistic model enhances multiple sclerosis care.
How experiences shape military and Veteran health care
In this Let’s Talk Healthcare Perceptions video seminar, explore how lived experiences shape the care that military families and Veterans receive and how the healthcare system can evolve to meet those needs.
See how an Optum care coordinator works
Supporting care, reducing stress, and serving as a point-of-contact are just a few of the benefits care coordinators offer.
The cancer data divide: Why integration is the next frontier
These billion-dollar drugs are set to lose their exclusivity. But good things happen when generics and biosimilars are allowed to compete with costly brand-name drugs.
Reimagining behavioral health
Join speakers Lou Dierking and Miranda Anderson as they share insights into how technology can drive much-needed improvements in behavioral health care.
Global Nurse Advice Line
We support mission-critical programs for federal health agencies.
Reconcile your RWD expectations to maximize your investment
Understand how routine clinical practice impacts information captured in real-world data (RWD).
Insights on GLP-1s: Costs and coverage
Balancing the risks and the benefits of GLP-1 drugs.
How are you capitalizing on the power of real-world data?
Maximize your investments with a more coordinated and connected real-world data strategy.
Provider telehealth use experience survey
Learn the telehealth features and frustrations providers say impact their virtual care experiences.
Social determinants of health in urban America
Learn more about addressing social determinants of health in Brooklyn, NY.
Whole-person cancer care: 4 strategies for employers and payers
Life after cancer is complex, and survivorship — living with and beyond diagnosis — demands long-term support for mental, physical and financial health.
Succeeding at Optum with value-based care
Learn how Optum provides value-based care resources which enable providers to succeed.
Pivotal momentum in women’s health benefits
From fertility to menopause, smarter women's health benefits drive retention, reduce costs and support evolving workforce needs.
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.
Coding modernization: Leveraging the power of AI
Learn how Optum takes an innovative approach to smarter, more accurate healthcare coding.
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.
Modernizing the Medicaid experience
How can states and providers use modularity to modernize? Dustin Haisler at GovTech.com interviews Optum product leaders for insights.
Trends shaping pharma strategy in 2026
How should pharma manufacturers strategically evolve as the industry shifts? Get expert insights from Advisory Board and Optum® Life Sciences.
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.
How organizations can support neurodiversity in the workplace
Recognizing the unique perspectives of neurodivergent individuals and creating an inclusive workplace can enrich and empower your teams.
Subscribe to Optum Pharmacy Provider Pulse Quarterly Newsletter
Stay up to date on our Specialty and Infusion Pharmacy offerings and get important industry developments delivered directly to your inbox.
Supporting providers in the transition to VBC
Learn how value-based care (VBC) partnerships between payers and providers are more important than ever.
3 key steps to building an effective annual wellness visit program
Drive improved outcomes and lower costs for blood cancers with CAR T therapy
This white paper analyzes CAR T utilization, outcomes and economic impact across commercial and Medicare populations in the Optum Cell and Gene Therapy (CGT) program from 2022–2024.
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.
How mature is your health plan's payment integrity program?
Discover the five levels of maturity and practical tips to strengthen your plan's performance.
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.
Better outcomes with value-based care versus fee-for-service Medicare
A first-of-its-kind evidence-based study indicates the positive impacts of value-driven reimbursement and care delivery on patient outcomes.
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.
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.
Bassett Healthcare partnering insights
Tommy Ibrahim, MD, CEO of Bassett Healthcare Network, shares insights on reinventing a health system for success.
How to manage medication overload
Hear from a leader's perspective on how to manage polypharmacy.
Quality innovation: A member-first approach
Learn how Optum uses a member-first digital approach, advanced analytics and AI to enhance quality for clients and health plan members.
Creating a seamless durable medical equipment experience
Discover how a digital-first DME strategy can enhance efficiency and transparency for health plans, clinicians and members.
Best practices for efficient medical record retrieval
Medical record retrieval is an essential task for healthcare providers and insurers, but it can often be a complex and time-consuming process.
Site-of-care decisions: Navigating safety, access and value
Learn about benefits and challenges of the site-of-care shift and how InterQual Site of Service helps organizations navigate the transition.
Using behavioral science to inform hemodynamics product design
Learn how behavioral science can improve the hemodynamics solution in vital ways for physicians and technicians.
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.
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?
Steps to smarter prior authorization
Healthcare organizations face challenges with prior authorization. Learn how automation can help save resources and improve patient care.
Small price hikes make for big drug prices
We know about the high prices for new drugs, but drug companies make most of their money from repeated small price increases on older drugs.
Modernizing pharmacy management for accuracy and efficiency
Discover how pharmacies can modernize management systems to reduce operational friction, improve workflow efficiency and support more connected care delivery.
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.
Optum is the leader in payer-provider collaboration
Optum has been named the market leader in the Frost Radar™: Healthcare Payer-Provider Collaboration Solutions in North America report by Frost & Sullivan.
Digital integration and the path to interoperability
Creating a connected system to improve risk and quality outcomes.
Optum Rx customer obsession
Watch how one Optum Rx employee made the system work better for everyone.
Advancing infection prevention in senior communities
Discover proactive practices for protecting residents from both the common and the unexpected.
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?
How millennials and Gen Z are transforming workplace wellbeing
Millennials and Gen Z are reshaping workplace wellbeing into whole‑person, tech‑enabled support that boosts engagement, retention and value.
Creating a better pharmacy experience
We’re committed to a expertly designed member experience built on affordability, accessibility and compassionate support from knowledgeable benefit experts.
Helping a member find support
See how one mother found in-the-moment support during a family crisis.
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.
What real-world data can reveal about weight loss medications
Optum Life Sciences expert provides insights on how manufacturers can build value stories for their stakeholders.
Automation's next chapter in the healthcare revenue cycle
Leaders from Banner Health and Optum lay out a bold, multiyear vision for automation and AI in health care revenue cycle management.
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.
Our care doesn’t stop, no matter where your patients are
Optum helps providers keep patients on therapy during travel, relocation or disruption through coordinated, nationwide infusion and specialty pharmacy support.
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.
Innovate or fade: Payers at the crossroads of senior care
Join Dr. Jamira Duffy and Heather Jarrett from Optum Health as they discuss the urgent need for innovation in senior care and the considerations payers should focus on.
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.
Senior brain health and social interaction
Medicare Advantage plans can differentiate supplementary programs by addressing cognitive health and social interaction.
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.
Meet an Optum senior care nurse practitioner: A day in the life
See how nurse practitioners help identify health changes early, treat residents and strengthen collaboration in senior living communities.
Innovative approaches to collaborate with PCPs
Understanding the challenges confronting Medicare Advantage plans and their Medical Loss Ratio.
Transparency helps medicaid providers
See how technology can be used to reduce complexity, administrative rework and improper claims denials.
How proactive clinical management halved therapy discontinuations
Learn how Optum Frontier Therapies proactively partnered with the drug manufacturer to address the issue and implement targeted strategies.
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.
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.
Filling revenue cycle resource shortfalls
Learn how to identify and overcome common revenue cycle challenges despite current labor market issues.
Strategies for incremental modernization
States can build on a step-by-step approach to modernization, incrementally transforming the user experience without disruption.
How Optum Rx goes further to promote transparency
We’re redefining pharmacy benefit management with full transparency. Explore how our platform delivers unmatched access to detailed data and insights.
Navigating 3 new pharmacy regulations in 2026
From GLP-1s to vaccines to tariffs, government policies will touch every area of pharmacy services this year.
Strategies for navigating growth in transplant, cell and gene therapies
As transplant, cell and gene therapies grow in complexity, payers need new approaches to manage cost, risk and support long-term sustainability.
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.
The impact of AI on value-based care
Learn 7 ways artificial intelligence is changing the game in healthcare.
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.
Driving ACO success through integrated value enablement
Discover the key performance levers for ACO success and how Optum can help you turn strategy into measurable results in this on-demand webinar.
Behavioral healthcare made better
We help people find care and support that’s easy to understand and access.
Making inroads with maternal health
Learn how Indiana and Washington, D.C., are tackling critical maternal health equity disparities.
Symmetry EBM Connect
Increasing compliance with evidence-based standards to enhance care.
How improving charge capture can reduce your CMS risk
How Optum helped a health system consolidate over 40,000 charges.
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.
Explore our AI-enabled radiology portfolio
Learn how our Radiology Solutions use AI to rapidly identify relevant radiology images.
Mitigating maternal care deserts
For some mothers-to-be, healthcare options are disturbingly limited — or even nonexistent.
Delivering better value for our plan sponsors
We partner with you to determine which solutions – designed to ease rising drug costs and support better health outcomes – best match your pharmacy needs.
The ASAM Criteria® Navigator, 4th edition
Learn how to streamline efficiency and consistency of the utilization review process.
Enterprise imaging cloud strategy webinar
Learn about the differences between “cloud-based” and “cloud-native” image hosting.
Exploring the health savings pathways series
A 3-part series to help guide your employee benefits strategy, balance care costs and enhance employee well-being.
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.
Automating success: A smarter path to revenue cycle transformation
Learn how health systems are using revenue cycle automation to provide better patient experience, financial outcomes and operational resilience.
Pharmacy benefit management solutions, built for you
Clear pricing. Aligned scale. Actionable insights — helping you make smarter decisions, faster.
Understanding college and graduate student mental health needs
Explore the realities of mental health among college students and graduates and how we can make it better.
Expanding patient support for holistic care
Our value-based care model can expand patient support by enabling providers to deliver holistic care.
Driving efficiency and accuracy across the middle revenue cycle
Learn how to address staffing shortages, reduce administrative costs and improve outcomes with a single, unified platform.
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.
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.
How Optum pharmacy experts bring passion to quality care
Hear what drives three Optum® Home Delivery pharmacists to go above and beyond in advancing treatment.
What health plans need to know about provider usage of AI
Uncover the 4 major ways providers are leveraging AI and how this trend is changing payment integrity for health plans.
Why risk adjustment is critical for the success of ACOs
Learn how ACOs can leverage risk adjustment to enhance provider engagement, compliance and patient equity in care delivery
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.
Enhancing health care access for military families
Explore insights to advance comprehensive health care for military families and elevate VA support systems.
Transforming coding compliance and efficiency with automation
Our computer-assisted coding (CAC) solution provides the essential tools for professional coding operations and appropriate revenue capture.
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.
Automation and workforce strategies in healthcare
Get 6 key takeaways from a C-suite panel discussion.
Developing Medicaid Core Set measures for States
Discover how Michigan and Virginia took different approaches to meet the federal mandate of tracking care quality for Medicaid and CHIP.
Targeted care, lower costs
One state achieved both aims in delivering home health services.
How proactive fall prevention improves senior care
Explore how evidence-based screening, education and collaboration help reduce falls, injuries and hospitalizations among older adults.
Member engagement: Advancing whole-person care
By collaborating with health plans and their members, Optum helps build a more cohesive, supportive system that prioritizes member needs.
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.
Elevating employee engagement
Data-driven, targeted strategies help successfully increase employee use of mental health, financial and legal services.
Can larger systems change how they provide care?
One expert explains that even larger organizations can make a successful leap to value-based care.
Marrying clinical results and financial stability in value-based care
In this Q&A with an Optum expert, get some key insights about the clinical and financial impacts of value-based care.
Engage providers impact member outcomes
Download our infographic to learn how Optum can take the burden off payers to impact provider performance.
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.
Five step InterQual evidence-based development process
The InterQual Criteria is developed through a rigorous, five-step process by our clinical development team.
Redefine success in value-based care (VBC)
Our recent survey shares why 83% of executives feel optimistic about value-based care and offers strategies to expand your VBC relationships.
First once-weekly insulin for type 2 diabetes
This edition of Notable New Drugs includes first once-weekly insulin, new psoriatic arthritis treatment and first oral treatment for allergic reactions
Unlock the future of risk and quality in healthcare
Discover how Optum is helping revolutionize the healthcare industry with innovative solutions in risk adjustment, quality improvement and member engagement.
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.
An Employee Benefits Strategy that Balances Cost and Care
Learn how to develop an efficient benefits strategy that helps your people be well — while balancing your budget and achieving value.
Unlocking new possibilities in risk adjustment
Learn how Optum helps health plans improve performance by using data, AI and smart technology to enhance accuracy, efficiency and integration.
How value-based care helps physicians work at the top of their license
Learn about the value-based care strategies changing the definition of productivity.
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.
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.
Specialty vs. retail pharmacy
Specialty medications require high-touch support. Learn more about what sets specialty pharmacy apart from retail.
Time to outsource workers compensation payments
Learn how outsourcing payments could help you stay competitive and compliant.
The future of payment integrity
Unpack key trends shaping the future of payment integrity and discover steps you can take to get started on your path to payment precision.
5 things a claims review program does that you might not realize
Learn more about how an all-in, centralized claims review can contain costs while boosting consumer and provider experiences.
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.
Improving underwriting results with automation
Machine learning coupled with software features and cost-tuning delivered significantly improved predictive value and underwriting results.
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.
Rethinking clinical trial recruitment: Adapting to real-world data
Clinical trial recruitment shortfalls are often the result of protocol designs that don’t reflect how care is delivered. Real-world data can make a transformative difference.
How real-world evidence can inform pharma strategies in 2025
Health economics and outcomes research (HEOR) can play a key role in helping the life sciences industry improve patient outcomes.
Improve efficiency with Optum CAC and CDI 3D
See how one health system partnered with Optum to transform their coding and CDI program.
Strategies for centering patients and staff
Learn how to help transform hospital revenue cycle operations with healthcare automation.
"No regret" IT investments
Learn which tech investments can benefit providers most today.
Why stronger clinical handoffs matter in post-acute care
In this webinar, Optum Home and Community and Advisory Board examine how improving the clinical handoff can improve post-acute care outcomes.
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.
Deliver program integrity efficiencies
We help federal agencies with an effective data strategy and analytic roadmap to predict and prevent fraud, waste and abuse.
Navigating the future of addiction treatment with The ASAM Criteria® Fourth Edition
Explore the development of The ASAM Criteria® Fourth Edition and discover tools and programs available to support your transition.
Blockbuster drug patent expirations in 2026 and what they mean
These billion-dollar drugs are set to lose their exclusivity. But good things happen when generics and biosimilars are allowed to compete with costly brand-name drugs.
Clinician Real Talk Podcast
Join host Adia Morris for inspiring chats with clinicians on care, culture and how Optum supports their journey every step of the way.
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.
Bronson's cloud imaging archive journey
Bronson Healthcare transitioned to a cloud-native imaging archive, reducing administrative burden, improving system speed and enhancing provider and patient experience.
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.
Predictions from the 9th annual Optum Wellbeing in the Workplace Survey
New Optum survey of more than 450 employers signals a reset: Wellbeing strategies must close gaps in mental health, engagement and accessibility to drive impact.
Race ethnicity data bridge gap in improving health outcomes
The life sciences industry needs robust real-world data. For that data to reflect real-world populations, you need race and ethnicity data.
Diagnose the health of your health plan
Learn 8 advantages of an end-to-end risk adjustment platform.
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.
Break down silos in claims processing
Fragmented payer-provider communication fuels denials, delays and rework. Learn how real-time insight can help address root causes earlier in the claims process.
Best practices for reducing provider abrasion
Find out what is driving abrasion and what health plans can do to alleviate pain points.
Improve price transparency
Deliver a better patient experience through price transparency.
State M&O innovations: Robotics process automation
Robotics process automation can improve maintenance and operations of state Medicaid systems.
Relentless preparation leads to a strong 2026 implementation
We delivered a seamless 1/1 transition for over 800 new clients with strong service, stable operations and improved member experiences.
Automate your front office to address the staff pinch
Learn how automating appointment scheduling, eligibility verification and communications, and more eases pressure on staff.
Care coordinator stories
The story of Kayla Perno, an Optum Care Coordinator, demonstrates how dedication to compassionate care leads to better outcomes.
Hub and advocacy solutions work together
Navigating a complex healthcare environment is challenging. Using hub and advocacy solutions together helps employers and employees alike.
Transforming care through payer-provider collaboration
Discover the key elements to creating a positive, mutually beneficial relationship.
Boost efficiency with payment optimization
Learn how payment delivery optimization can improve the healthcare financial cycle and bridge the gap between payers and providers.
Meet consumer expectations while addressing provider frustrations
Learn how Patient Access and Engagement streamlines the end-to-end care journey.
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.
Improving performance at Excel Medical Center
Empower provider success and improve member care through digital integration.
Empower your D-SNP strategy
How Optum Home & Community Care helps health plans align and advance.
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.
Innovations in contact center efficiency
Hear from our experts as they discuss the role of AI and other trends in a well-connected system.
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.
Fighting breast cancer with early detection
Early detection is critical to fighting breast cancer; advances in technology are helping.
Addressing high-cost of 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.
Frequently asked questions about risk adjustment audits
Preparing for and undergoing an audit can be a massive task. Optum provides support every step of the way.
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.
The costs and benefits of cloud-based imaging
Understand the seen and unseen costs of migrating your enterprise imaging to the cloud.
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?
Fighting fraud, waste and abuse in pharmacy
How one plan sponsor realized more than $128,000 in savings and recoveries in one year.
Infusion nurse kayaks through hurricane damage to administer care
An Optum Infusion Pharmacy nurse’s commitment to ensure her patients received their medication after a hurricane is just one example of the care team’s compassion and commitment.