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Healthcare delivery insights

 

 

Making health care more affordable

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Optimizing your payment integrity program

Learn best practices to help health plans achieve in-year cost savings goals.

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Best practices for reducing provider abrasion

Find out what is driving the recent increase in abrasion and learn what health plans can do to alleviate provider pain points.

E-book

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.

 

 

Better payer/provider relations within health plan markets

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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.

Guide

Engage providers impact member outcomes

Download our infographic to learn how Optum can take the burden off payers to impact provider performance.

Guide

Improve medicaid risk adjustment accuracy

Explore Medicaid best practices for health plans and learn three actions to take and when to take them.

White paper

Steps optimizing value based care

Learn how combining these steps can help power a holistic workflow between payers and care delivery.

 

 

Driving plan growth and diversification at scale

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White paper

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.

 

 

Advancing member health and experience

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White paper

Maternal and infant health insights

Optum Advisory uncovers disparities in maternal and infant outcomes — commercial vs. Medicaid — identifying key factors.

 

 

Latest guides

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White paper

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.

Guide

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.

Guide

HouseCalls: Reach members where they are

Help manage members’ health through in-home or virtual assessments.

 

 

Latest on-demand webinars

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On-demand webinar

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.

On-demand webinar

Connected communities

A panel discussion examines how to use data-driven, virtual and automated technologies to advance and refine population health strategies.

 

 

Latest white papers

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White paper

Patient engagement leader

Everest Group recognizes Optum in its 2023 Patient Engagement Platforms PEAK Matrix® Assessment.

Article

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.

White paper

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.

 

 

Latest videos

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Video

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.

Video

Reimagine your employee assistance program

Help employees feel mentally, physically and financially well with Emotional Wellbeing Solutions.

 All healthcare delivery insights

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.

Financial case connected care

Get thought starters for assessing how a connected care model can strengthen your financial position.

Five step InterQual evidence-based development process

The InterQual Criteria is developed through a rigorous, five-step process by our clinical development team.

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.

Developing a best-in-class middle revenue cycle for hospitals

Explore the six focus areas for improving performance to create a best-in-class middle revenue cycle for your hospital.

Enhancing fraud investigations ai

Learn how AI is changing the fraud case review process.

Patient engagement leader

Everest Group recognizes Optum in its 2023 Patient Engagement Platforms PEAK Matrix® Assessment.

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.

Filling revenue cycle resource shortfalls

Learn how to identify and overcome common revenue cycle challenges despite current labor market issues.

Develop your growth strategy

Optum Market Advantage helps you choose your own path 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.

Choosing an accounts receivable partner

Selecting a strategic accounts receivable partner requires careful evaluation.

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.

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.

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.

Disruption and risk in healthcare

Dr. Wyatt Decker discusses how innovation can be the upside of disruption and the importance of value-based care in changing the status quo.

Connected communities

A panel discussion examines how to use data-driven, virtual and automated technologies to advance and refine population health strategies.

Managing risk in value-based care delivery

Watch as Erik Johnson explores models for risk in delivering value-based care (VBC).

Connected care

See the whole picture for whole-person health.

Achieving health equity: Strategies for payers

Learn more about a comprehensive solution for health payers to address health disparities and achieve health equity.

Best practices for identifying overpayments

Learn how a multi-tiered approach to data mining helps maximize savings and achieve payment accuracy earlier in the claim lifecycle.

Achieve claim pricing accuracy and efficiency

Learn how to create a framework that drives payment accuracy on the first pass.

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.

Improving care coordination with analytics: Part 1

Optum Advisory actuarial expert Jeremiah Reuter advises providers to use data to adapt to the constant changes in healthcare.

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.

Comprehensive payment integrity savings

Learn how to reduce costs and improve relationships throughout the claim lifecycle with a comprehensive approach to payment integrity. 

Improving care coordination with analytics: Part 2

Optum Advisory expert Aaron Jurgaitis shares his perspective on how providers can more creatively leverage data to help advance care.

Staying current in your core admin platform

Get current, stay current and leverage the newest platform capabilities with ongoing release management.

Achieving success in claim editing

Learn how a flexible editing program can help your plan solve editing challenges, enforce policies, improve accuracy and increase savings.

Best practices for reducing provider abrasion

Find out what is driving the recent increase in abrasion and learn what health plans can do to alleviate provider pain points.

What is subrogation?

Identify, investigate and recover medical and disability payments related to accidents.

Optimizing your payment integrity program

Learn best practices to help health plans achieve in-year cost savings goals.

Validating short-stay hospital bills

Prevent inpatient billing errors for outpatient encounters.

Community Connector helps member assessment

Optum helps health plans address member needs through screening and community-based organization (CBO) referral services.

StepWise Application Migration to the Cloud

Learn from health plan leaders on how to accelerate and optimize your cloud-adoption journey.

Automation and workforce strategies in healthcare

Get 6 key takeaways from a C-suite panel discussion.

Revolutionizing cardiology

Discover how Boulder Community Health and Optum Advisory worked together to achieve smart growth and sustainable change.

Improving underwriting results with automation

Machine learning coupled with software features and cost-tuning delivered significantly improved predictive value and underwriting results.

Challenges when financing your EHR

Key themes and insights that can guide your organization toward a successful electronic health record (EHR) transformation.

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.

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.

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.

Risk adjustment star ratings success

Discover 5 strategies that will help your health plan be prepared to factor risk adjustment data into Star Ratings.

Steps optimizing value based care

Learn how combining these steps can help power a holistic workflow between payers and care delivery.

5 provider strategies to improve margins

Discover how healthcare organizations are prioritizing a path to improved financial sustainability and margins.

Strategies to reduce administrative costs

Strategies to fix payer-provider collaboration, streamline patient financial experience and apply AI technologies for better cost savings.

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.

Symmetry EBM Connect

Increasing compliance with evidence-based standards to enhance care.

Medicare content navigator

Discover how to meet the latest regulatory requirements for Medicare Advantage plans.

Symmetry Oncology Analytics

Learn about powerful tools to measure the cost and quality of cancer care.

Follow science 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.

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.

Leading through disruption

Get insights and data from 150+ leaders and experts from across healthcare on how to succeed amid transformation.

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.

Innovation help healthcare workforce crisis

Harvard Business Review Analytic Services and Optum leaders examine human-focused innovations for the health care workforce.

Healthcare workforce crisis report

We surveyed 150 healthcare leaders on the impact of staffing disruptions, obstacles to progress and how to build for a sustainable future.

Path to techquity

New research explores how to use technology to advance health equity.

Tech's role in the healthcare workforce

Dr. Garry Choy, CMO, discusses the pros and cons of using automation and clinical decision support to meet today’s workforce challenges.

See how Optum can help you improve outcomes and lower costs for your members

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