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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.

Insights

Supporting Youth Mental Health: On-Demand Webinar

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

A collaborative approach to advancing maternal health

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

Rules impacting pharmacy: Summer 2023 legislative sessions

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

Regulations to watch: Spring 2024

Get the latest on legislation impacting PBM operations.

Summer: Fast action for postpartum and depression

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

Supporting care for at-risk minors

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

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.

Regulations to watch: Fall 2023

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

Alternative funding: Real savings or problems?

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

Make your pharmacy benefit plan work better

4 key questions you should be asking.

Keeping your data secure is mission critical

See how we help prevent costly, disruptive cyberattacks.

Is your pharmacy benefit manager delivering value?

4 key questions you should be asking.

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.

A seamless pharmacy benefit change?

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

3 steps to slash medication costs

This is your guide to reducing your health care spending.

Optum Rx Drug Pipeline Insights Reports

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

Pharmacy Insights Podcast

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

8 ways to make drugs more affordable

Discover what plan sponsors need to know.

4 key forces shaping the future of pharmacy

These emerging trends will help define the road ahead.

Four myths: Carving out specialty pharmacy

Integrating specialty pharmacy means better care, lower costs.

Drug pricing spotlight: Wound care

Combat against brand name products costing 125 times more.

Smart formulary management

Developing and managing formularies that bring clinical and financial value

The dangers of polypharmacy

Millions of workers at risk due to overprescribed drugs

Managing diabetes gains an 8:1 return on investment

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

How to eliminate prescription waste

Achieve savings by targeting expensive, low-value drugs.

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.

How to manage medication overload

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

Specialty drug prices giving you sticker shock?

See how Specialty Compass defuses exploding drug costs.

5 questions: Optum Rx chief pharmacy officer

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

How our medication packaging helps the planet

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

Making sense of copay cards

How copay cards can disrupt your benefit strategy

A young patient’s hemophilia story

See how OptumRx helped change a patient’s life.

Case Study: Advanced Pharmacy Audit Services

How a health plan saved more than $1 million

Understanding the health care needs of Veterans

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

OPA for HHS: See how it works

Accelerate your state's efforts to address health inequity.

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.

NASPO ValuePoint Helps States Streamline MMIS Procurements

Streamline MMIS procurements through cooperative purchasing.

Technology Helps Reduce Barriers to Tobacco Cessation

Learn about the growing change in tobacco cessation.

The American Rescue Plan and public health

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

Redefining the prior authorization process

How we are revamping the prescribing process

Shipping sensitive medications

See how medications are protected in transit.

Rare diseases, large costs

The rise in orphan drugs is offering hope

Specialty and Weight Loss Webinar

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

Modernizing the Medicaid experience

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

MMIS Game-Changer: Collaborative Contracting

NASPO ValuePoint helps states streamline procurement.

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.

Optum Health Care Interoperability & Patient Access Services

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

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.

Unlocking the promise of personal medicine

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

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.

Addressing pharmacy issues that matter to you

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

Support state Medicaid agency goals for members

Find out how a person-centered approach can help.

Creating better behavioral health care

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

Helping members achieve their goals

See how the right mental health care makes a difference.

Personalized care: Focusing on the member

Hear from Optum Rx chief of operations, Jon Mahrt

Optum Quit For Life

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

5 questions: Premium Value formulary

Hear from OptumRx SVP of clinical & formulary services

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.

Optum Quit Services

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

How to control drug costs without compromising care

Explore three principles driving better pharmacy benefit decisions.

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.

Winter: First big drugs for 2024

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

Using data to improve health equity

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

The new drugs plan sponsors need to watch for

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

Weighty issue: How to contain GLP-1 costs

Get strategies for handling the new anti-obesity medications.

Regulatory updates with Optum Rx

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

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.

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

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.

3 ways to address vaccine fatigue

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

How to manage blockbuster anti-obesity drugs

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

Decreasing avoidable claim denials with transparency

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

Gene therapies: Can we afford the future of medicine?

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

5 trends that defined pharmacy in 2023

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

Health Equity Vision Into Action Report

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

Regulatory update: Winter 2023

Get the latest on legislation impacting PBMs.

Fall 2023: 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.

Think differently: Strategies for incremental modernization

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

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.

Key considerations when updating provider management modules

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

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.

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

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

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.

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.

Improving access to behavioral health services

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

Achieving health equity: Actionable analytics unlock improved outcomes

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

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.

Biosimilars to save billions in this decade

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

New mandatory CMS reporting rules will impact states

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

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.

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.

Autoimmune, oncology, diabetes and obesity rule drug spending

Many patients combined with expensive drugs leads to top spending classes.

New innovative treatments for hemophilia B, RSV, COPD

Cutting-edge research in gene therapy, mRNA editing and blood enzymes pays off with powerful new advances for these drug classes.

Eliminating surprises in pharmacy spend

Old strategies and new drugs don’t mix. Future-proof your plan and get better predictability with new specialty pricing models.

Connections that count: Redefining the PBM experience

Hear from experts on better ways to simplify the complex health care experience through impactful innovation.

Get immediate savings on specialty drugs

Specialty drug spend is a "top threat" to employer-provided benefits. Discover sustainable savings with your existing Optum Rx plan.

Building the PBM of the future

Creating solutions plan sponsors need today to tackle tomorrow’s pharmacy challenges.

The latest PBM regulations: Summer 2024

Get your guide to the evolving health care regulatory landscape and see what’s coming as lawmakers debate 600+ new bills impacting PBMs.

Specialty drugs: Not just set and forget?

For optimizing specialty drug therapy, monitoring patients throughout their care is key to cost-effective use of high-cost drugs.

Taking the paper out of member communications

Discover how digital communications can increase member engagement and lower the cost of care.