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Complex Care Management for Payers

Discover simple solutions for complex conditions.


Reduce costs, manage risk, improve outcomes

Optum® Complex Disease Prevention and Management offers an integrated suite of benefit management services.

These services help health plans and self-insured employers reduce total cost of care, manage organizational risk and improve outcomes for members facing complex disease states.

Woman surrounded by the Complex Disease Prevention and Management solutions

Providing personalized support for complex member needs

  • Care management
  • Utilization management
  • COE/Network
  • Focused claims review

By combining these condition-centric capabilities with flexible funding models, including full risk transfer, Optum delivers the greatest impact to the patients and payers who need it most.

How we help

Bariatric Resource Services

Offer cost effective, quality proven, weight-loss surgery.

Focused Claims Review

Ensure billing accuracy of professional and facility claims.

Musculoskeletal (MSK) Solutions

Manage escalating spend and utilization.

Oncology Care Management Programs

Manage cancer costs, improve outcomes and quality of care.

Transplant Solutions

Get significant savings and statistically superior outcomes.

Kidney Solutions

Attain comprehensive, cost-effective disease management.

Specialty Pharma Solutions

Manage specialty medical drug expenses.

Learn more about Complex Disease Prevention and Management