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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

Analytics Consulting

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

Medicaid Risk Adjustment and Quality

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

Member Engagement Solutions

We help health plans precisely target the right members and efficiently deliver programs based on member needs.

Prospective Solutions

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

Quality Solutions

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

Retrospective Solutions

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

Risk View

Learn about our risk adjustment software platform that helps insurers better understand risk score trends and opportunities

Related healthcare insights

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Risk adjustment star ratings success

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

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Improve medicaid risk adjustment accuracy

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

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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.

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Community Connector helps member assessment

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