Perspectives on health plan trends
Together, we are driving toward the same things for our health care system — better quality, lower cost, and higher consumer and provider satisfaction.
What’s top of mind for health plan leaders?
Increasing affordability
Reducing the total cost of care is a challenging but key affordability lever. Health plans are investing in analytics to better understand cost drivers in complex care, care gaps, medical cost management, specialty Rx, digital technology and SDOH.
Toolkit
Achieve success in claims editing
Explore best practices around delivery models, content and rule definition to manage claim edits with optimal outcomes.
Article
Improving genetic test reimbursement
It’s an exciting time for genomics. But to control costs, plans must get a handle on the clinical side of this market.
Article
Specialty drugs and prior authorizations
A prior authorization process may not be enough for health plans to ensure that specialty drug utilization meets their policy criteria.
Podcast
Until It's Fixed
Listen to this can’t-miss podcast for professionals across health care.
Cultivating provider relations
Improving provider/payer communication by removing points of friction in clinical and administration processes is a key driver of success in the health system. Strategies to reduce provider burden while increasing transparency enable more time to focus on patients.
Webinar
How advanced data science can predict disease
See how combining advanced data science with risk adjustment is leading to earlier disease detection and prediction.
Article
Navigating forward: Holistic risk
Learn how CEOs can protect their organizations from growing uncertainty.
Driving growth at scale
Payers are focused on growth and entry into new lines of business including Medicare Advantage, ACA and Medicaid. They’re also looking at developing new plan and network designs. Successful growth requires effective risk management and strong performance on quality outcomes.
Article
The customer experience trap
Why is consumer loyalty decreasing when innovation in customer experience has become an even bigger focus?
Article
The path to 4+ Star performance
Read how adopting our three-point strategy can impact 2023 Stars performance.
White paper
Mastering growth with government contracts
Optum Advisory Services provides a look into how government program expansion is creating opportunities.
Thought leadership
Advisory Board best practices for health plans
Discover insights, actionable strategies and tools to support sustainable growth and practical innovation.
White paper
Identify and address low-value care
Learn how Symmetry® EBM Connect® enables health plans to better understand the appropriateness of care.
E-book
Transforming the six zones of consumer experience
Discover innovations to drive engagement, loyalty and growth.
White paper
Social determinants of health
Discover a nonclinical approach to health and well-being.
Webinar
Improving care management and population health
Find out how Optum® RxComplex technology identifies members who may need an increased level of support and guides members into appropriate care management programs.