Latest featured insights
Case study
Explore real-world examples of how hospitals are streamlining provider review workflows and supporting quality oversight with Crimson AI.
Article
A policy-oriented perspective on practical pre-payment controls, claims editing and infrastructure-aware modernization.
Report
Address access, capacity and workforce challenges head-on.
On-demand webinar
Hear from Optum experts on how hospitals can successfully manage cost and quality across 5 episodes of care under the new CMS model, TEAM.
All data and analytics insights
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.
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.
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.
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.
Collaborating to advance maternal health
Learn how leaders, communities and institutions can work with Optum to promote safe pregnancies and childbirth.
Using data to monitor behavioral health services
See how Optum helped one state visualize utilization and demographic data around behavioral health programs.
The fight for techquity
Get ideas for how to fundamentally change your approach to building technology and incorporate techquity into your organization.
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.
Robotic process automation (RPA)
We utilize RPA to advance federal government programs.
States achieve health equity with actionable analytics
By applying analytics solutions, states can create a comprehensive roadmap to better health equity.
The provider review playbook
Access a comprehensive guide on how to build a consistent, defensible review cycle for OPPEs, FPPEs and peer reviews.
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.
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.
Symmetry Oncology Analytics
Learn about powerful tools to measure the cost and quality of cancer care.
Identifying suspicious billing patterns
Learn how a fraud detection algorithm flagged a suspicious vendor, saving States millions for improved program integrity.
Strengthen your surgical capacity
Learn how to optimize surgical capacity by implementing and sustaining a highly-effective block management process.
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.
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.
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.
CMS quality measure rules 2024
Upcoming changes in federal quality measures for Medicaid and CHIP will impact state governments.
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.
Visualizing fraud, waste and abuse
Graph analytics and machine learning drive the future of program integrity.
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.
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.
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.
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.
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.
Which growth strategy path is right for you?
Discover which growth strategy path is right for your health system.
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.
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.
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.
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.
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.
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.
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.
Engaging specialists in value-based care
Alternate payment methods (APMs) can boost quality and cut costs by aligning payment and delivery for specialist providers.
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.
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.
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.
9 ways to modernize the Medicaid experience
Read our 9 key takeaways for states to modernize the provider management experience.
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.
Dashboard streamlines Medicaid SUD program
Virginia’s new Medicaid analytics dashboard centralizes SUD data, improving treatment strategies and reporting for vulnerable communities.
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.
Build a more sustainable provider system
Address access, capacity and workforce challenges head-on.
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.
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.
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.
Supporting care for at-risk minors
Learn about a lightweight, scalable foster-family placement system developed for one Northeastern state.
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.
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.
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.
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.
Reconcile your RWD expectations to maximize your investment
Understand how routine clinical practice impacts information captured in real-world data (RWD).
How are you capitalizing on the power of real-world data?
Maximize your investments with a more coordinated and connected real-world data strategy.
Social determinants of health in urban America
Learn more about addressing social determinants of health in Brooklyn, NY.
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.
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.
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.
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?
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.
Strategies for incremental modernization
States can build on a step-by-step approach to modernization, incrementally transforming the user experience without disruption.
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.
New dimensions in life sciences research
Proving the impact on clinical outcomes as well as costs.
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.
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.
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.
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.
Real-world data fills rare disease data gaps
Read how you can fill the data divide to develop effective treatment options.
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.
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.
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.
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.
Modernizing provider review for consistency and compliance
Explore real-world examples of how hospitals are streamlining provider review workflows and supporting quality oversight with Crimson AI.
Deliver program integrity efficiencies
We help federal agencies with an effective data strategy and analytic roadmap to predict and prevent fraud, waste and abuse.
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.
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.
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.
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.
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.