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Solutions for health plans

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Connecting care across the health system

Optum delivers personalized support to health plans of every size, across all lines of business.

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Health care. Connected.

Better health and a better experience at a lower cost. See how data and analytics, payment integrity and risk and quality programs can enhance outcomes and efficiency. Simplify administration and empower members with personalized care.

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Let's take a look at how Optum is working with health plans of every size, including government programs like Medicaid, Medicare, and the VA to build strategic partnerships that bring connected care to the individual.

[Narrator] When we talk about populations, we're talking about people. Individuals who wanna be well, and want the health system to work for them. By bring Optum services together to make healthcare more intelligent and consumer-centric, we help payers drive performance to improve health while lowering costs. Our data and analytics offer insight into unique populations, so payers can engage members meaningfully as individuals. And our advisors work hand-in-hand with payers to architect and implement programs with consumers in mind. We help people navigate the health system with personalized and coordinated support, empowering them to take charge of their own health, while our specialized teams support chronic and complex conditions. Our payment integrity tools improve claims accuracy, so payers can manage expenses while building loyalty among providers and members. And Optum's risk and quality programs simplify administration for providers. Because when physicians focus on care instead of paperwork, outcomes and the bottom line both improve. Optum is partnering with payers to create a system built on performance and intelligence with consumers at the center, so everyone can lead a healthier, happier life.

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  • Driving growth at scale​

    Payers are focused on growth in terms of geographic or market expansion; entry into new lines of business including Medicare Advantage, ACA and Medicaid; and developing new plan and network designs. Successful growth requires effective risk management and strong performance on quality outcomes.​

    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 for patient focus — all while driving growth and priorities.​

    Advancing member health experience​

    To drive systemic change, SDOH initiatives have taken on greater importance. Increased financial pressure, food insecurity and housing challenges have been worsened by COVID-19. Virtual care strategies focus on meeting members where they are.

    Increasing affordability​

    Reducing the total cost of care is a key affordability lever. Yet tackling it continues to be a challenge. 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.​

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Perspectives on health plan trends 

Get insights on driving growth at scale, advancing member health experience, cultivating provider relationships and increasing affordability.

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Explore our solutions

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Analyst recognition 

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

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Gartner

Gartner Hype Cycle

Optum appears in nine different categories within the Healthcare Payer and Provider market reports.

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Frost & Sullivan

Best Practices Awards

Optum receives awards for Global AI for Healthcare IT Innovation Excellence and Growth and more.

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Aite

Impact report

Optum recognized for our end-to-end Provider Management solution.

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IDC

IDC MarketScape

Optum named Major Player in U.S. Health Plan Bundled Payment Management Solutions MarketScape and more.

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Logo for Everest Group PEAK Matrix Leader 2020

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Everest Group

Everest PEAK Matrix

Optum is recognized as a Leader in 11 categories measured by Everest Group’s PEAK Matrix® Assessment.

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HFS Research

Healthcare Sector Service Providers Winner’s Circle

Optum ranked #1 for Execution, Business Process Services, Provider Experience, and size, scale and growth.

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Ready to create a healthier tomorrow? See how Optum can help you improve outcomes and lower costs.

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