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Helping health plans support quality care

Simpler operations lead to higher quality care for members. Reduce administrative work, strengthen provider relationships and support connected care.

Explore payer solutions

Simpler systems lead to better outcomes

Deliver better experiences

Give real-time visibility into coverage, cost and care decisions to streamline experiences. This helps people stay engaged in their care.

Learn how with Optum Real

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Lower total costs & manage risk

Bring clarity to payments and plan operations so you can see where dollars are going and reduce waste. Plus improve accuracy and manage your financial performance.

Learn about Payment Solutions

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Help members live healthier

Connect clinical teams, benefits and support services together to better support members with chronic and complex conditions with more coordinated care.

Explore complex care

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Analyst recognition

Optum continues to be a proven leader across a wide range of services and solutions.

Frost & Sullivan

Optum has been recognized as a best practices leader in Gen AI bringing greater efficiency to payers.

Everest Group

Optum was recently recognized by Everest Group as Leader in Utilization Management Operations PEAK Matrix® Assessment.

Everest Group

Everest Group positions Optum in the highest Leader position for Care Management Platforms for Payer in PEAK Matrix® Assessment.

Everest Group

Optum is the highest-designated Leader in Payment Integrity Solutions in PEAK Matrix® Assessment.

Explore payer solutions

Find solutions to help manage costs and improve your plan operations.

Service

Consulting services

Best for:
  • Federal government
  • Manufacturers
  • Payers
  • Providers
  • State governments

We help healthcare leaders and organizations create change and drive growth.

Solution suite

Analytics performance

Best for:
  • Health systems and hospitals

Drive growth, financial performance and clinical excellence with actionable data and analytics through technology and managed services.

Solution suite

Financial solutions

Best for:
  • Employers
  • Health systems and hospitals
  • Payers
  • Providers

Explore our tailored healthcare solutions to help you strengthen financial health, reduce complexity and achieve operational excellence.

Service

Home & Community

Best for:
  • Payers

We deliver personalized, whole-person care to older adults in the comfort of their home or community, supporting aging in place through various coordinated care options.

Solution suite

Health benefits

Best for:
  • Employers
  • Federal government
  • Payers
  • State governments

We empower employees and members to take control of their health and well-being.

Solution suite

Ancillary Benefits Management

Best for:
  • Payers

Reduce the burden of managing ancillary benefits programs separately across the care continuum. Our solutions leverage an affordability framework to close gaps for better care with lower costs.

Service

Epic Payer Platform Managed Services

Best for:
  • Payers
  • Providers

Payer and provider collaboration supporting member care and quality outcomes.

Software

Pharmacy technology solutions

Best for:
  • Health systems and hospitals
  • Manufacturers
  • State governments

We support the entire pharmacy claims life cycle, with unparalleled data and insights to optimize pharmacy operations.

Solution suite

Risk adjustment, quality and engagement

Best for:
  • Payers

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

Service

Home Delivery Pharmacy for Payers

Best for:
  • Payers

Our digital pharmacy is designed to meet your needs, simplify the medication delivery experience for patients, and grow alongside your business.

Solution suite

Pharmacy benefits

Best for:
  • Brokers and consultants
  • Employers
  • Payers
  • State governments

We offer clear drug pricing and aligned scale and insights that guide decision-making, helping you navigate change with confidence.

Solution suite

Payment integrity

Best for:
  • Payers

Improve payment accuracy across the claim lifecycle.

Software

Network connectivity

Best for:
  • Executives
  • Health systems and hospitals
  • Providers
  • State governments

Enhance connectivity and streamline EDI transactions for health care providers, health plans and pharmacies through our nationwide network.

Service

Optum Frontier Therapies for Payers

Best for:
  • Payers

We partner with payers to support advanced therapies through a clinical framework focused on quality, transparency and lasting outcomes.

What's next for health plans

Explore ideas, guidance and “worth-your-time” reads for people making real decisions.

Transform Your Risk Adjustment Strategy

White paper

Transform your risk adjustment strategy

A strategic risk adjustment analytics framework guide for health plans.

Celebrating the Unique Role of Optum Infusion Pharmacy Nurses

Article

Celebrating the unique role of Optum Infusion Pharmacy nurses

On average, Optum Infusion nurses spend approximately 1,300 hours per year providing care to patients. Hilary, an Optum Infusion nurse, knows this firsthand.

Improve Savings & Accuracy with Payment Integrity Software

E-book

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.

The AI-Driven Health Plan [White Paper]

White paper

The AI-driven health plan

This white paper offers expert perspectives on leveraging AI to optimize health plan operations efficiency, growth and member experiences.

Let’s talk about what’s next