All solutions
All solutions
Medical Record Review
Discover more about our comprehensive Medical Record Review solution that includes retrieval, abstraction, program management and audit support.
AI-Enabled risk adjustment solution
How smart is your retrospective risk adjustment solution?
Retrospective Risk Adjustment Solutions
We offer comprehensive strategies for health plans.
Submission Services
We provide end-to-end management of submissions, direct errors and remediation. Insights promote continual improvement to maximize accuracy.
Risk management and quality performance
We go beyond risk adjustment to drive better outcomes.
Medicaid Risk Adjustment
Optum has the expertise, breadth and scale to help optimize and support your Medicaid risk and quality programs.
Behavioral health solutions for health plans
Building a better future for behavioral health care with capabilities to support health plans, members and providers across the entire health continuum.
Laboratory affordability products
Reduce your lab spend and improve patient outcomes with a comprehensive approach.
Pharmacy care services for health plans
We help health plans navigate their toughest challenges.
Specialty Pharmacy Management
We take an integrated approach to controlling specialty costs by managing across both benefits and creating a seamless patient experience.
Pharmacy care support
We prioritize patient care through proactive insights that empower informed decisions and control costs — without compromising excellence.
Health care operations
We offer a full range of technology services, including applications and infrastructure design, development and operations.
Provider Data and Network Management
Improve provider data quality; enhance network strategies.
Claims Editing Services
We use data and powerful editing technology to maximize auditing for government, commercial, Medicaid and Medicare claims.
Claims and Billing Solutions
Expansive claims and billing solutions help preempt denials, send cleaner claims, automate workflows, and improve efficiencies and payments.
Program Integrity Services
Our solution enhances and modernizes program integrity to combat fraud, waste and abuse by working to support the federal government.
Capabilities
Our expertise in health care spans policy design to program research and beyond.
Optum Serve consulting solutions
Our health policy and consulting expertise can help you make informed policy choices.
Infusion Pharmacy
Specialty Pharmacy
At Optum Specialty Pharmacy we make patient referrals, enrollment processes and online prescriptions easy for providers.
Support for oncology providers
Pharmacy solutions and services
Drive better engagement, adherence and outcomes for your patients.
Electronic Prescribing (eRx) to Optum Home Delivery
Enable accurate and efficient electronic prescribing to send prescriptions directly to the pharmacy.
Optum Home Delivery Pharmacy
Increase medication adherence and satisfaction while providing patients a cost-effective and easy way to receive prescriptions at home.
Utilize real-time benefit check
Get patient-specific prescription costs, lower-cost options and coverage details right at the point of care through your ERM platform.
Optum Pay
Accelerate progress toward a healthier future with a platform that helps expedite payments and streamlines access to historical claims data.
Payments and lending
Optum Financial® is setting a new standard for how care is financed and paid for.
Analytics Managed Services
Neonatal Support
Help improve outcomes for infants in the NICU, and assist families in caregiving.
Women’s Health Solutions for Health Plans
Support women and families with integrated solutions.
Oncology Care Management Programs
Manage cancer costs, improve outcomes and quality of care.
Stars/HEDIS Strategy and Operations
Strengthen quality initiatives to boost Stars ratings and improve performance.
Specialty Fusion
Experience a specialty drug management solution that does more by bringing medical and pharmacy benefits together at the point of care.
Member health and care management
We strive to shape a health system that works best for the member's whole health and provide care as needed.
Health and Wellness Portal Solutions
Reduce health risks and help prevent chronic disease.
Disease and Condition Management Programs
Identify at-risk individuals and help resolve health care gaps.
Care Coordination for Chronic Conditions
Provide support and advice a member needs to restore their health.
Biometric Screening Solutions
Offer biometric screening options for your whole population.
PCPs and the Optum ISNP Care Model in SNFs
Close gaps in care and reduce fragmentation by participating in a cross-functional, team-based care experience.
The Optum Care Model
Improve quality and maintain census stability by bridging care for senior living residents.
The Optum ISNP Care Model for SNFs
Break the high-cost cycle by increasing care and benefits to Institutional Special Needs Plan (ISNP) members.
Behavioral health services for state government
Helps improve outcomes for high-risk populations.
Integrated Solutions for I/DD Populations
Ensure predictable costs while supporting positive outcomes.
Behavioral Programs for the Justice-Involved
Optum helps direct people with behavioral health disorders in the criminal justice system to appropriate clinical and support services.
Peer Support Services for Behavioral Health
Our peer services help people move from treatment to daily life and reduces re-admission.
Optum Integrated Eligibility Services
Simplify eligibility and enrollment for your HHS programs.
Optum State Insurance Exchanges
Simplify access to care with a state-based exchange that meets all your marketplace needs.
Health care access
Simplify access to care for your health and human services (HHS) programs.
Optum COVID-19 Vaccine Billing Services
Quit Services
Learn how Optum is providing fresh insights for states to modernize tobacco cessation programs.
Optum Center for Wellbeing Research
A Trusted Partner in a Time of Crisis
We're taking action to support state governments. Find the resources you need to predict, respond and recover from the pandemic.
Data and analytics
Improve decision-making and outcomes with a suite of advanced enterprise analytics products.
Policy Research, Analytics and Consulting
Understand program results to deliver more value.
Automated Health Care Claims Triggers & Notifications
We help state agencies maximize auditing capabilities.
Provider management services
Designed to alleviate the administrative burden on both Medicaid agencies and providers, Optum Provider Management Services improves the way agencies manage provider relationships and administrative tasks.
Optum Maintenance and Operations Services
Help reduce costs and system instability by outsourcing M&O.
Program operations
Transform your operations with modern technology complemented by services.
Optum Interoperability and Patient Access Services
Specialty Pharmacy Management for state government
We take an integrated approach to controlling specialty costs by managing across both benefits and creating a seamless patient experience.
Pharmacy care services for public sector
We help you provide affordable pharmacy benefits.
Symmetry
The Optum® Symmetry® suite produces standard units of analysis to help health plans manage costs, mitigate risk and measure quality.
Impact Pro
Optum® Impact Pro® helps you identify individuals who will benefit most from population health management programs.
Patient Help Line
Optum experts address patients’ immediate symptom concerns and clinical questions, day or night, 365 days a year.
Physician Practice Performance
Solve challenges in ambulatory operations related to population health management (PHM), value-based care (VBC), patient engagement and revenue cycle.
IT Performance
We enable partners with the technology, expertise, secure operations and economics to digitally transform health care for improved outcomes.
Market Advantage
Develop your future growth strategy. Our planning solution provides analytics, business development guidance and implementation support.
Engage Physicians in Care Transformation
Precision Marketing - Health Care Providers
Learn how our precision marketing services can help you more effectively reach and engage patients who need your services and increase your marketing ROI.
Performance Analytics
Military and Veteran health services
We provide high-quality and reliable health services.
Creating a Safe Return-to-Worksite Strategy
What types of COVID-19 resources suit your worksite needs?
Support a Return to Routine Care
Find accessible care to reduce risks and close critical gaps in care.
Address Mental Health Challenges from COVID-19
Attend to the explosion of need due to COVID-19.
Pharmacy care services for TPAs
We provide dedicated support to help you grow your business.
Specialty Medication Management for Employers
We take an integrated approach to controlling specialty costs by managing across both benefits and creating a seamless patient experience.
Pharmacy benefit management (PBM)
As a pharmacy benefit manager, our goal is to improve the cost of health care and prescription drugs for both plan sponsors and members.
Stop Loss Insurance
Protect your self-funded employer benefit plan from excessive expenses related to increased health care utilization.
Health Reimbursement Arrangements
Use a health reimbursement arrangement (HRA) to help offset employees’ health care costs while providing tax savings to the organization.
Health Savings Accounts
Accelerate progress toward a healthier future with an HSA that helps employees take control of their care, payments and overall health.
Financial solutions
Empower your employees to take control of their health and lead them toward greater financial wellness.
Commuter Benefits
Support your employees with a pre-tax account that saves them money on qualified expenses for their individual commute to work.
Flexible Spending Accounts
Help your employees budget and save for qualified expenses during the benefit plan year through pre-tax contributions to FSAs.
Healthy food benefits
Make fresh produce and healthier food a realistic option for all of your employees with instant rewards for purchasing nutritious products.
Lifestyle Spending Accounts
Attract and retain talent in a competitive market, connect your benefits to your culture and show you care for your employees.
Coordination of Benefits
Identify critical administrative coordination of benefits issues.
Claims pricing solutions
Drive prospective payment system pricing accuracy and efficiency with Optum® EASYGroup™.
Emergency Department Claim (EDC) analyzer
Control rising emergency outpatient facility cost.
Payment integrity
Optum® Payment Integrity strengthens accuracy at every touch point in the billing lifecycle.
Biometric screenings and vaccinations
Engage employees with biometric screenings and vaccinations.
Coronary Artery Disease Management
Improve health and lower costs for those living with the most common form of heart disease: CAD.
Diabetes Management
Help your employees living with diabetes by providing one-to-one support.
Asthma Management
Help your employees living with asthma make positive changes to improve their health.
Heart Failure Management
Our dedicated nurses help empower healthier choices to manage heart failure.
Neonatal and NICU Support Programs
We help improve clinical outcomes for infants admitted to the NICU, and assist families in preparing for their new caregiver roles.
Population health services
Women's Health Solutions for Employers
We offer help from preconception through baby's first year.
Solutions for Health Care Providers
Increase employee engagement and control medical plan costs.
Oncology Care Management Programs
Ensure the right care at the right time with the right provider.
Substance Use Disorders
We offer resources and support to help individuals achieve stabilization, build resiliency and sustain recovery.
Return Better
Find comprehensive solutions for employers and employees throughout the COVID-19 pandemic and beyond.
Oncology and Immunology Research
Voice-to-Claim Research
The Optum® HEOR Primary Data Collection (PDC) team focuses on real-world evidence generation through primary and secondary data.
Central Nervous System and Behavioral Health Research
We offer insightful, real-world research in CNS and BH.
Diabetes and other endocrine diseases research
Strengthen your value story with HEOR
Tap into our expertise in health economics and outcomes research.
Respiratory disease research
Infectious Disease Research
Leaders
Engage payers with value-based contracts
Assess the fit, develop metrics and track care outcomes over time.
Digital Research Network for Providers
Data and technology combine to help providers enroll patients in clinical trials for better outcomes.
Enhance Clinical Trial Design and Performance
Modernize your approach to protocol design and patient finding.
Design and Pilot Engagement Programs
Work with the Cross Optum team and take advantage of our connections to all parts of the health system.
Generate evidence with real-world data
Derive evidence from the unmatched depth and scale of our data assets.
Health Care Claims Data and Analysis
Integrating and linking deep patient data from multiple real-world sources helps clarify market dynamics.
Market Clarity: Linked EHR and Claims Data
Unlock insights using the industry’s largest and most trusted repository of longitudinal clinical and claims data.
Dynamic Assessment of Pregnancies & Infants (DAPI)
Drive informed decisions about maternal and infant health.
Partner with Our Epidemiology Consultants
Advance public health and safety with our trusted experts and data.
Empower Commercial, Brand and Access Teams
Reveal market opportunities using our data assets and expertise.
Specialty and Infusion Support for Hospitals
Medication therapy management
The Medication Therapy Management Program (MTMP) improves outcomes for Medicare Part D/Optum Rx members who meet specific medical criteria.
Optimize your pharmacy network strategy
Our full-spectrum pharmacy services are designed to provide affordable access to prescription medications and therapies.
Rare disease
Optum state and federal reporting
Stay compliant and reduce costs with a proven CMS-certified solution.
Gain a Truer Picture of Disease Prevalence
Optum Enlighten is a groundbreaking pharma intelligence platform that identifies disease prevalence in populations at a hyper-local level.