Relentless preparation leads to a strong 2026 implementation

First, a quick definition: 1/1 readiness is our name for how Optum Rx prepares to ensure a smooth, accurate and reliable benefits transition for clients and members. These efforts begin early in the year, extend across the company and focus on getting benefits, systems, digital tools, pharmacy operations and service teams ready, so clients and members have outstanding experiences when their new benefits begin. 

A successful 1/1 also positions our clients and members for a great experience all year. Strong readiness means people get the care they need when they need it, which:

• Reduces call and issue volume
• Builds trust
• Protects long term relationships

January 1st is a high-risk moment because pharmacy benefit plans can be complex. And the stakes are even higher because we’re dealing with the timely supply of medicines that people rely on for their health and well-being. 

So we spend the time leading up to every transition working on improving every aspect of our service. Whether that means faster answers, new self-service opportunities, more accurate benefits or faster prescription delivery, it’s all centered on removing friction for your people.

Service built right, delivered right 

Our systems processed over 140 million claims in January, demonstrating strong stability and scale readiness for high volume periods. 

Easy, intuitive digital tools

Members are choosing digital more often, with a 12% increase in digital channel use. This represents 72% of all service interactions, providing improved self-service experiences and access to real-time support, as needed.

Premier member support

Call volume reduced 25%. This was driven by improved benefit accuracy and stronger digital experiences, meaning fewer members needed to reach out for help. When members called, service remained strong with a call center net promoter score of 77, call satisfaction at 94% and first call resolution at 88%.

Proactive, rapid resolution

There were 27% fewer member issues year over year and 85% fewer over the last two years, demonstrating a continual focus on quality and prevention. 

This kind of performance provides a member-first experience and demonstrates the scale, discipline and consistency our clients can rely on all year long. 

1/1 is also an important time for clients to change or update their programs. Voice of the Client results for both new and existing clients across all market segments highlighted consistently positive feedback. 

Clients expressed appreciation for the smooth go-live processes and proactive support, reinforcing strong satisfaction and confidence in the teams’ responsiveness and collaboration. 

Employers have been switching to Optum Rx pharmacy benefit management for decades because they get value well beyond a medication’s price. Contact your Optum Rx representative to learn more about how we can deliver a seamless, stress-free transition that helps keep your employees and business moving without disruption.