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Insights for state government agencies

Explore our latest insights on emerging topics in government health programs.

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Bots are a game changer for Medicaid

How robotic process automation (RPA) is improving health care

RPA is helping state Medicaid programs improve workflow and accuracy. The result is lower costs and faster delivery of benefits.

Featured insights

Speed up the claims process with AI

Read about our Claims Automated Rules Engine (CARE).

Call centers and AI technology

Transform state contact centers into 24/7 problem solvers.

Targeted care. Lower costs.

One state achieved both aims in delivering home health services.

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Insights

Shipping sensitive medications

See how medications are protected in transit.

Specialty and Weight Loss Webinar

Hear how weight loss drugs are shaping traditional and specialty spend.

4 key forces shaping the future of pharmacy

These emerging trends will help define the road ahead.

Creating better behavioral health care

We help people find care and support that’s easy to understand and access.

Weighty issue: How to contain GLP-1 costs

Get strategies for handling the new anti-obesity medications.

How to manage blockbuster anti-obesity drugs

The pricey weight management drugs work well, but users need coaching and support to maintain the benefits.

How our medication packaging helps the planet

New packaging saves CO2, water, energy, and plastic waste.

GLP-1 agonists: A new class of weight loss medications

In this conversation, discover how new weight loss drugs like Wegovy are changing obesity management and their connection to diabetes.

Regulations to watch: Spring 2024

Get the latest on legislation impacting PBM operations.

How to control drug costs without compromising care

Explore three principles driving better pharmacy benefit decisions.

Modernizing the Medicaid experience

Read our 9 key takeaways for states to modernize the provider management experience.

Making sense of copay cards

How copay cards can disrupt your benefit strategy

NASPO ValuePoint Helps States Streamline MMIS Procurements

Streamline MMIS procurements through cooperative purchasing.

Optum Health Care Interoperability & Patient Access Services

Our solution is fully developed and ready right now to help your state meet compliance.

Helping members achieve their goals

See how the right mental health care makes a difference.

Healthier Outcomes for Moms and Babies Through Data

By reaching out to women earlier in pregnancy, one state is supporting moms and babies and creating healthier outcomes for both with help from Optum.

Empowering clients with more choice and transparency

Helping make prescription drugs more affordable for plan sponsors and the members we serve is a universal focus.

Health Equity Vision Into Action Report

Learn how identifying and addressing disparities in health care allows everyone to live their healthiest life.

Rare diseases, large costs

The rise in orphan drugs is offering hope

Regulatory update: Winter 2023

Get the latest on legislation impacting PBMs.

Addressing pharmacy issues that matter to you

From specialty pharmacy to drug affordability, our experts tackle your biggest pharmacy challenges.

Regulatory updates with Optum Rx

Stay up-to-date on what’s happening in pharmacy legislation.

Alternative funding: Real savings or problems?

See how much "free" drugs will actually cost you.

Drugs to Watch in summer 2023: New therapies

New drugs for postpartum depression, dermatitis and blindness are coming.

Increasing Value Through Higher Volume

Improve revenue integrity by expanding admission reviews.

Exciting advances for sickle cell, chronic obesity, Alzheimer’s

See potential cures for sickle cell and new help for chronic obesity and Alzheimer’s, along with how they work and how much they cost.

Transforming the pharmacy industry with transparency

Hear how the industry’s most transparent and independent Pharmacy & Therapeutics Committee evaluates drugs for the Optum Rx formulary.

A seamless pharmacy benefit change?

We guarantee it. And it's easier than you think.

Orphan drugs market: Can we afford them?

We examine key questions around orphan drugs such as why they're so expensive, how they're being used and what plan sponsors should do next.

A young patient’s hemophilia story

See how OptumRx helped change a patient’s life.

Technology Helps Reduce Barriers to Tobacco Cessation

Learn about the growing change in tobacco cessation.

Key learnings for modernizing your state’s legacy system

As you embark on maintenance and operations (M&O) modernization, consider how these 8 best practices can drive your success.

Understanding the health care needs of Veterans

Ethnographic research conducted to help address Veterans' needs across the health care system.

Advancing health equity: How Optum Rx Is overcoming challenges

Thought leaders discuss the intentional vigilance needed to overcome obstacles impeding better access to health care for all.

Think differently: Strategies for incremental modernization

States can build on a step-by-step approach to modernization, incrementally transforming the user experience without disruption.

Make your pharmacy benefit plan work better

4 key questions you should be asking.

3 new first-in-class therapies coming

See how innovation is driving the latest product development.

What to consider about weight loss drugs

Get the most from these pricey new obesity drugs by choosing the right coverage strategy and helping your members build lifelong habits.

Four myths: Carving out specialty pharmacy

Integrating specialty pharmacy means better care, lower costs.

3 steps to slash medication costs

This is your guide to reducing your health care spending.

Supporting Youth Mental Health: On-Demand Webinar

Dr. Yusra Benhalim shares insights on the challenges we must overcome to reach youth.

Modernizing the Medicaid Experience | Optum

How can states and providers use modularity to modernize? Dustin Haisler at GovTech.com interviews Optum product leaders for insights.

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

Get ahead of 3 pharmacy trends that will affect your plan

Find out what’s changing the pharmacy market and how it could impact you.

Decreasing avoidable claim denials with transparency

In this white paper, see how near real-time visibility prevents improper claim denials.

Key considerations when updating provider management modules

Explore 6 key factors when updating, streamlining and coordinating provider management modules with other Medicaid functions.

Drug pricing spotlight: Wound care

Combat against brand name products costing 125 times more.

Managing diabetes gains an 8:1 return on investment

Learn how a third-party administrator’s client improved health outcomes and lowered costs.

A collaborative approach to advancing maternal health

Learn how leaders, communities, and institutions can work with Optum to promote safe pregnancies and childbirth.

How to eliminate prescription waste

Achieve savings by targeting expensive, low-value drugs.

Supporting care for at-risk minors

Learn about a lightweight, scalable foster-family placement system developed for one Northeastern state.

Optum Rx customer obsession video

How one Optum Rx employee made the system work better for everyone

Creating connections through partnerships

Hear from an Optum Rx client on how we're partnering together for everyone we serve.

The American Rescue Plan and public health

ARP is an opportunity for state governments to improve public health through investment, infrastructure and innovation.

Biosimilars to save billions in this decade

Prices for popular brand-name biologics drop up to 60% with generic-equivalent biosimilars.

How to manage medication overload

Hear from a leader's perspective on how to manage polypharmacy.

The secret to lowering the total cost of care

Rising pharmacy costs concern everyone. Managing the underlying health conditions behind each prescription is key to addressing these high costs.

Personalized care: Focusing on the member

Hear from Optum Rx chief of operations, Jon Mahrt

Which rules will impact pharmacy in 2023?

2023 is already a busy year for pharmacy regulation. Read about the latest regulations that could impact you and your pharmacy benefit plan.

Rules impacting pharmacy: Summer 2023 legislative sessions

Learn what's at stake as the Senate considers PBM legislation.

What’s changing the PBM industry?

In this conversation, learn from Optum Rx thought leaders on how access, affordability and transparency have become imperatives for pharmacy benefit management.

First big drugs for 2024

New treatments for NASH, schizophrenia and more are on the way.

Pharmacy Insights Podcast

Listen to our resident experts discuss critical industry challenges and the solutions you need to control rising drug costs.

Smart formulary management

Developing and managing formularies that bring clinical and financial value

Case Study: Advanced Pharmacy Audit Services

How a health plan saved more than $1 million

Keeping your data secure is mission critical

See how we help prevent costly, disruptive cyberattacks.

Gene therapies: Can we afford the future of medicine?

Learn how to manage financial risk as gene therapies become more commonplace.

3 new drugs to watch this fall

As the year begins to close, we highlight three essential pipeline drugs with an expected U.S. Food and Drug Administration (FDA) decision this fall.

Improving access to behavioral health services

See how Optum helped one state visualize utilization and demographic data around ‌behavioral health programs.

5 questions: Premium Value formulary

Hear from OptumRx SVP of clinical & formulary services

MMIS Game-Changer: Collaborative Contracting

NASPO ValuePoint helps states streamline procurement.

OPA for HHS: See how it works

Accelerate your state's efforts to address health inequity.

8 ways to make drugs more affordable

Discover what plan sponsors need to know.

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.

The next biosimilar wave has arrived. Now what?

In this conversation, learn about a new class of biosimilars and what this means for competition, cost and volume in the PBM market.

Using data to improve health equity

Together, we can identify disparities and take steps toward health equity for all Americans.

Lowest net cost and your bottom line

Learn about strategies to achieve the lowest net cost of prescription drugs through formularies, biosimilars and our Vigilant Drug Program.

Is your pharmacy benefit manager delivering value?

4 key questions you should be asking.

Experts agree: PBMs add value, lower costs

PBMs don’t cause high drug costs — they’re part of the solution. Our drug prices beat the “low cost” vendors.

5 trends that defined pharmacy in 2023

See which trends are shaping the present and future of pharmacy care services.

Achieving health equity: Actionable analytics unlock improved outcomes

By applying analytics solutions, states can create a comprehensive roadmap to better health equity.

Optum Quit Services

Discover the difference of an evidence-based program that offers a truly personalized approach and blends technology with a human touch.

Fighting fraud

How one plan sponsor recovered $315,000 in six months.

3 ways to deal with escalating drug costs

Innovations custom built for today’s specialty challenges.

3 ways to address vaccine fatigue

Learn about researched vaccine messaging themes and important steps you can take to promote critical vaccinations for members.

Optum Rx Drug Pipeline Insights Reports

Read the most recent quarterly reports on new drugs coming down the pipeline.

Support state Medicaid agency goals for members

Find out how a person-centered approach can help.

Health Care Interoperability Solutions

Optum Interoperability and Patient Access Services can help your state comply with CMS' final rule. View our overview video to find out how.

Unlocking the promise of personal medicine

See how a peek at your genes enables more precise prescribing.

Getting ahead of the mental health crisis

See how leaders are advancing data strategies, screenings and exploring ways to connect consumers to mental health support.

Redefining the prior authorization process

How we are revamping the prescribing process

Innovations in Health Monitoring, Care Management & Support

Linking health care and public health data improves care management, clinical care, and public health reporting and monitoring.

4 new drugs to watch this year

Breakthrough treatments for menopause, Alzheimer's and hemophilia are coming.

2024: A new year promises a host of new drugs

See which trends to consider when assessing the pharmacy benefit, which new drugs may be flying under the radar and what’s coming this year.

Specialty drug prices giving you sticker shock?

See how Specialty Compass defuses exploding drug costs.

Regulations to watch: Fall 2023

Learn what's at stake as the PBM legislation advances on Capitol Hill.

5 questions: Optum Rx chief pharmacy officer

Michael Einodshofer addresses the risks, challenges and opportunities facing the industry.

The dangers of polypharmacy

Millions of workers at risk due to overprescribed drugs

New mandatory CMS reporting rules will impact states

To meet the requirements, states should consider focusing on five key areas.

Alzheimer's treatment: Time for a level-set?

See success rates, risks and costs of the new Alzheimer’s treatments.