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Operations and technology

Risk adjustment, quality and engagement

We go beyond risk adjustment to drive better health outcomes for your members.

Explore our full suite of solutions

Service

Analytics Consulting

Best for:
  • Providers
  • Payers

We can improve your business performance through our industry-leading health care analytic advisors, the largest care databases and tools.

Solution suite

Medicaid Risk Adjustment and Quality

Best for:
  • Payers

Optum has the expertise, breadth and scale to help optimize and support your Medicaid risk and quality programs.

Solution suite

Member Engagement Solutions

Best for:
  • Payers

Precisely target the right members, understand how to support them and efficiently deliver programs based on the member’s need.

Solution suite

Prospective Solutions

Best for:
  • Payers
  • Health systems and hospitals

We support providers by standardizing processes on behalf of multiple payers to allow more time caring for patients.

Solution suite

Quality Solutions

Best for:
  • Payers

Improve quality with a comprehensive, innovative approach to manage HEDIS® performance.

Solution suite

Retrospective Solutions

Best for:
  • Payers

Our diverse and deep experience paired with the largest MA database in the industry powers analytics to improve accuracy and completeness.

Service

Risk Analytics

Best for:
  • Payers
  • Health systems and hospitals

Learn about our comprehensive risk adjustment analytics platform that helps organizations evaluate data to help provide actionable insights.

Risk Adjustment Program Assessment

Best for:
  • Payers
  • Health systems and hospitals

Leverage our advanced risk adjustment analytics technology and deep subject matter expertise to get a 360-degree view of your program.

Industry insights

The Future of Quality Reporting

Article

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.

Digital Integration and the Path to Interoperability

E-book

Digital integration and the path to interoperability

Creating a connected system to improve risk and quality outcomes.

Innovating Risk Adjustment Strategies

Article

Innovating risk adjustment strategies

Read this blog to learn how Renown Medical Group empowers clinicians and improves patient outcomes.

Establishing Trust to Improve Value-Based Care Outcomes

Article

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.

Impacting Provider Engagement

Article

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.

Risk Adjustment and Star Ratings Success

White paper

Risk adjustment Star ratings success

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

Proactive Dual Eligible Medicaid Renewal

Article

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.