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White paper
Discover how your health plan can strengthen its risk adjustment programs with Optum.
Article
Learn how Optum takes an innovative approach to smarter, more accurate healthcare coding.
Article
Medical costs are rising, and health plans need solutions. See how an AI-driven, enterprise-wide approach may be the key to affordability.
Article
Zeel Sheth explains how connected data, analytics and coordinated execution help organizations activate earlier and support better risk adjustment outcomes.
All technology and automation insights
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.
Market for patient engagement webinar
View the public launch of Optum Patient Access and Engagement on demand.
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.
Adventist West’s success through redesigning and automating UM
Discover how to leverage automation for centralized, exception-based utilization management.
Improving CDI efficiency
See how Lima Memorial improved efficiency with advanced technology.
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.
Generative AI’s role in modern healthcare delivery
Discover how generative artificial intelligence (AI) is reshaping healthcare by boosting speed, precision and 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.
Breast density: Research for Radiologists
New research on breast density is changing the way radiologists approach mammography.
Focus on patients, not paperwork
Watch the webinar to learn actionable strategies on tackling decreased hospital margins, increased labor costs and staffing shortages.
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.
Addressing burnout with cloud PACS solutions
Health care leaders share how cloud-native solutions can help ease risks and improve efficiency for radiologists.
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.
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.
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.
Smart revenue cycle investments
These two targeted investments will strengthen your revenue performance more than deep cost cutting.
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.
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.
The fight for techquity
Get ideas for how to fundamentally change your approach to building technology and incorporate techquity into your organization.
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.
Risk adjustment coding 101 for providers
Learn actionable strategies and best practices for effective implementation of coding programs for provider organizations.
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.
Patient access starts before the appointment
New research reveals how access, transparency and digital tools shape patient satisfaction long before care begins.
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.
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.
Strong financial future through partnership
See how Boulder Community Health partnered with Optum to continue to successfully fund its mission.
Call centers and AI technology
Transform state contact centers into 24/7 problem solvers.
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.
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.
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.
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.
A/R recovery services provide continuity
Provider maintains A/R revenue continuity during HIS conversion.
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.
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.
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.
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.
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.
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.
MIPS program recommendations physicians
Traditional MIPS plans concluded in 2023. Understand MIPS reporting types and get help navigating the changes.
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.
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.
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.
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.
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.
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.
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.
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.
Provider report cards help emergency medicine groups
Learn more about how provider report cards can help emergency medicine groups 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.
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.
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.
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.
Transform your risk adjustment strategy
A strategic risk adjustment analytics framework guide for health plans.
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.
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.
Leveraging data-driven heat maps
The Optum network gives transparency to customized potential connections, helping boost revenue.
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.
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.
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.
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.
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.
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.
Optimizing physician reimbursement
Learn how physician groups can leverage automation and incorporate advanced analytics to help ensure they’re collecting every dollar.
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.
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.
Consumer-centric health care research report
Examine the acceleration toward consumer-centric care with insights and perspective from healthcare leaders.
Change Healthcare Workflow Intelligence
Learn about our vendor neutral, flexible medical imaging workflow rules engine.
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.
Benefits of artificial intelligence reach the revenue cycle
The use of NLP makes the revenue cycle work smarter, not harder.
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.
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.
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.
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.
Intelligent workflow case study
Learn how intelligent workflow can help improve efficiency and patient care.
Emerging trends impacting payment integrity
We take a look at how market shifts, AI innovation and cost pressures are redefining health plan strategies.
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.
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.
Engaging and transforming patient experiences
Healthcare leaders share strategies to improve patient outcomes by addressing friction points, emphasizing empathy and valuing staff.
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.
Navigating AI in Healthcare
Watch this on-demand webinar for expert insights on AI capabilities, business challenges and robust governance in healthcare.
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.
Advancing dme benefits management
Learn how DME Navigator can help streamline durable medical equipment (DME) benefits management.
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.
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.
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.
How cloud-native PACS transformed a rural hospital
In this case study, learn how cloud-native technology can unlock efficiency.
The missing link to risk adjustment success
Discover how program orchestration helps health plans align systems, vendors and strategies amid regulatory and financial pressures.
Reduce length of stay and enhance resource efficiency
Learn more about how Crimson AI enables best practices for achieving operational excellence.
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.
Modernize prior authorization with intelligent automation
Intelligent automation quickens determinations, improves submissions and gives real-time status visibility, helping reduce burden, delays and denials.
Fire department boost collections forty percent
Our case study shows how the Cincinnati Fire Department recovered missing revenue with Optum billing and collection systems.
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.
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.
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.
4 steps to optimizing value-based care
Learn how combining these steps can help power a holistic workflow between payers and care delivery.
Optimizing UM with InterQual AutoReview
An Optum expert explains how hospital systems can transform their UM programs and drive efficiency with InterQual AutoReview.
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.
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.
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.
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.
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.
How AI accelerates workflows and patient cancer care
Discover the potential of AI and how it helps save thousands of lives each year.
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.
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.
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.
The benefits of microservice imaging architecture
Our cloud-native solutions use dynamic load balancing to optimize resource use across all applications.
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.
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.
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.
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.
Find immediate ROI with cloud-native enterprise imaging
Learn how artificial intelligence (AI) can support patient care, improve workflows and more.
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.
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.
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.
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.
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.
From data collection to intervention
Learn how you can leverage analytics to address social determinants of health.
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.
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.
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.
Build a more sustainable provider system
Address access, capacity and workforce challenges head-on.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Improve medicaid risk adjustment accuracy
Explore Medicaid best practices for health plans and learn three actions to take and when to take them.
Making cardiovascular data work for the future
What can technology leaders do today to facilitate future advancements in cardiovascular data and analytics?
A single database cardiology platform that drives efficient workflow
Read our case study.
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.
Health leaders share IT transformation stories
Hear John Muir Health and Bassett Health’s observations on digital transformation, modernizing infrastructure and strategic automation.
Innovating risk adjustment strategies
Read this blog to learn how Renown Medical Group empowers clinicians and improves patient outcomes.
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.
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 innovation with new revenue cycle services
One organization decreased uncompensated care, increased loyalty and patient satisfaction, and connected patients with more funding sources.
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.
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.
Key data insights for your hospital services strategy
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.
Solutions to simplify Medicare compliance
Discover solutions that help you efficiently and consistently comply with CMS-4201 and CMS-0057 requirements.
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.
Streamline Medicaid eligibility and enrollment processes
The rise of healthcare consumerism has prompted many hospitals and health systems to rethink their patient satisfaction strategies.
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.
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.
Improve physician practice revenue
Learn key strategies to strengthen the financial performance of your physician practice.
Making risk adjustment programs work
Learn how three care delivery organizations reduced administrative burden to spend more time with patients and improve outcomes.
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.
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 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.
Bassett Healthcare partnering insights
Tommy Ibrahim, MD, CEO of Bassett Healthcare Network, shares insights on reinventing a health system for success.
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.
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.
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.
Five priorities improve financial performance
This E-book will help you master five fundamentals for a sound financial future.
Migrate your enterprise imaging to the cloud
Watch our webinar on migrating your enterprise imaging to the cloud.
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.
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.
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.
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.
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.
Explore our AI-enabled radiology portfolio
Learn how our Radiology Solutions use AI to rapidly identify relevant radiology images.
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.
Hospital employed anesthesiologists and RCM
Dive deeper into the market shift transforming the modern anesthesia employment market.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Diagnose the health of your health plan
Learn 8 advantages of an end-to-end risk adjustment platform.
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.
Improve price transparency
Deliver a better patient experience through price transparency.
Automate your front office to address the staff pinch
Learn how automating appointment scheduling, eligibility verification and communications, and more eases pressure on staff.
Transforming care through payer-provider collaboration
Discover the key elements to creating a positive, mutually beneficial relationship.
Improving performance at Excel Medical Center
Empower provider success and improve member care through digital integration.
Innovations in contact center efficiency
Hear from our experts as they discuss the role of AI and other trends in a well-connected system.
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.
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.
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.
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.
How AI is delivering efficiencies for radiologists
Learn how AI solutions can boost your organization’s return on investment (ROI).
The AI technology transforming imaging
Learn how artificial intelligence (AI) can support patient care, improve workflows and more.
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.
Four steps to smarter provider education
Discover how health plans can reduce billing errors and strengthen provider relationships through AI-enabled proactive education.
Coding modernization: Leveraging the power of AI
Learn how Optum takes an innovative approach to smarter, more accurate healthcare coding.
Reframing growth in an AI-mediated health plan
Predictive analytics has evolved from an analytical advantage into a board-level growth capability.
Building a framework to support value-based care
Discover how your health plan can strengthen its risk adjustment programs with Optum.