Perspectives on health plan trends
Resources to help navigate the challenging world of health care
Together, we are driving toward the same things for our health care system — better quality, lower cost and higher consumer and provider satisfaction.
Latest health plan trends
Outcomes-based contracts for payers
Enable outcomes-based contracts and ease challenges.
Move the affordability lever
Learn how to activate savings through comprehensive payment integrity.
Prepare for market expansion
Develop a strategy roadmap for a government programs entry.
Insights
5 questions: Optum Rx chief pharmacy officer
Michael Einodshofer addresses the risks, challenges and opportunities facing the industry.
4 more psoriasis drugs on the way
Psoriasis costs up 40% in 5 years. Will these drugs help?
Moving toward preemptive kidney transplants
Avoiding dialysis in favor of organ transplant can yield better patient outcomes and lower health care costs. So why is it still uncommon?
Case study 1: High-dollar claim savings
DRG outlier identified, resulting in $200,578 savings.
Hemophilia: Extremely rare, extremely expensive
Better management strategies and new treatments emerge
Case study: 5/5 satisfaction on implementation
OptumRx earns 100% implementation score from City of Toledo
Four myths: Carving out specialty pharmacy
Integrating specialty pharmacy means better care, lower costs.
How the pandemic has changed pharmacy care
Learn how COVID-19 has accelerated the rise of home and virtual care.
Taking the Pain Out of Prior Authorization
How we are revamping the prescribing process
The New Model Of Personalized Care
Predictive analytics improves user experience and outcomes.
Newest regulations impacting pharmacy
View the recent activity at both the state and federal level.
A new approach to rising specialty costs
See how contracting with medical providers can reduce drug costs
Case study: Strategic formulary changes
How a third-party administrator helped clients save $6.49 PMPM.
How to control drug costs without compromising care
Explore three principles driving better pharmacy benefit decisions.
Don't Pay 5000% More for Commonly Available Generic Drugs
This widespread practice costs plans millions.
Drug pricing spotlight: Wound care
Combat against brand name products costing 125 times more.
Reducing disparities in care and outcomes
Achieving health equity is a community-wide effort.
Gene therapy: Big potential, big prices
New strategies needed as revolutionary but costly therapies emerge.
3 ways CRISPR will change the drug world
Pharmaceutical industry finding novel uses for gene editing tools
Will Diabetes Drugs Help Us Tackle Obesity?
Discover four things to know about new uses of GLP-1 drugs.
How a client avoided $109M in pharmacy costs
View the Optum Rx Drug Pipeline Insights Report for 2022.
Managing diabetes gains an 8:1 return on investment
Learn how a third-party administrator’s client improved health outcomes and lowered costs.
Case Study: Advanced Pharmacy Audit Services
How a health plan saved more than $1 million
Personalized care: Focusing on the member
Hear from OptumRx chief of operations, Jon Mahrt
Redirecting Specialty Infusion Costs by Redirecting Site of Care
See how you can lower your plan costs by up to 52%.
4 steps to limit infusion drug costs
Specialty drugs account for over half of all drug spending
Will these 4 new drugs re-shape the market?
Get the latest in this quarter’s Drug Pipeline Insights Report.
How to eliminate prescription waste
Achieve savings by targeting expensive, low-value drugs.
The big picture on cancer
How high cost oncology drugs are changing specialty pharmacy.
Optum Rx Customer Obsession Video
How one Optum Rx employee made the system work better for everyone
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.
Creating connections through partnerships
Hear from an Optum Rx client on how we're partnering together for everyone we serve.
Kidney Disease Care: A Comprehensive Approach
Find out how an integrated approach produces better outcomes for renal disease — a common, complex and costly condition.
Population health management best practices
Learn about industry players in the population health management (PHM) market and what to look for in a best-in-class solution.
Smart formulary management
Developing and managing formularies that bring clinical and financial value
Specialty Drugs & Prior Authorizations
Having a prior authorization process in place is not enough to ensure specialty drug utilization meets your policy criteria.
How our medication packaging helps the planet
New packaging saves CO2, water, energy, and plastic waste.
Controlling the unprecedented costs of gene therapies
See how you can leverage cost benefits from gene therapy.
Youth mental health research findings
In our new report, you'll learn key findings about the mental health needs of young people and their caregivers, and discover opportunities for intervention.
SNFs Improve Care & Business Outcomes for Facilities
The Optum Care Model Helps SNFs Meet Strategic Goals
Beyond barbells: What seniors need in fitness
Medicare Advantage plans need to offer an array of choices to meet the overall health needs of members.
Leveraging Virtual Care Management During Coronavirus (COVID-19)
Learn strategies to manage the rapid influx of patients.
Opioids: Managing Costs By Managing Risk
Costs associated with abuse have increased dramatically.
Avasant Healthcare Payor Digital Services
Avasant's annual RadarView report helps healthcare payors craft a robust strategy for digital transformation based on industry outlook and best practices.
Maximize Recoveries with Subrogation
Identify, investigate and recover medical and disability payments related to accidents.
5 questions: Premium Value formulary
Hear from OptumRx SVP of clinical & formulary services
Flexing seniors’ brains and social muscles
Medicare Advantage plans can differentiate supplementary programs by addressing cognitive health and social interaction.
Optum HouseCalls: In-home Multi-Dimensional Clinical Evaluation
In-home clinical evaluation of health and ongoing care needs
Alternative funding: Real savings or problems?
See how much "free" drugs will actually cost you.
How holistic programs improve senior health
Medicare Advantage plans need to rise above the competition by going beyond traditional fitness offerings.
Clinicians in 2030
Optum CNO Kristy Duffey talks with NEJM Catalyst about health care workforce trends and the changes coming to care delivery.
Case study 2: High-dollar claim savings
DRG outlier identified, resulting in $600,000 savings.
Enhance R&Q data acquisition with AI and NLP
Learn how digital clinical data, AI and NLP can help health plans get the data they need, when they need it.
Medicare Advantage Regulatory Update: CMS 2022 Final Notice
In this Optum executive summary, learn about the potential impact the CMS 2022 Final Notice may have on your health plan.
Increasing at-home dialysis for ESRD patients | Optum
See why home-dialysis patients tend to fare better than in-clinic patients, and how patient-centric kidney care management helps them make informed choices.
Transforming the six zones of consumer experience
Discover innovations and success factors to drive engagement, loyalty and growth.
Regulatory developments in pharmacy 2022, 2023
We discuss the Inflation Reduction Act, the drug pricing executive order and other federal and state regulations passed in 2022. We also look ahead to 2023.
Intelligent Automation Benefits for Health Plans | Optum
See how IA increases the throughput of the retro case developer process, reducing processing time and freeing resources for other high-value tasks.
Health Care's Guide to Machine Learning
What you need to know about AI's latest buzzword.
Delivering Value-Based Care for Veterans Affairs & DOD | Optum
Best practices to help transition to value-based care.
Targeted care and lower cost: How one state achieved both
One state achieved both in delivering home health services.
Center for Health Equity - The Lewin Group, Part of Optum Serve
See how we help public and private health care leaders, policy makers and researchers support equitable individual and community health.
Accelerate your digital transformation
Capitalize on the momentum around digital health solutions.
Clinical and claims data: A powerful combination
Get a snapshot of the pros/cons of clinical and claims data.
Health Equity & Women's Health
Create meaningful change for the women in your workforce.
Star ratings are important to Medicare Plans
Learn how health plans can improve Star ratings through high-touch strategies.
Impact member care with in-home assessments
Download the infographic to learn more about how in-home assessments can uniquely impact SDOH.
Health plan solutions designed to lower the cost of care
Tour our ecosystem of capabilities designed to tackle broad-based health plan challenges.
Third Annual Optum Survey - AI in Health Care
AI on the rise: Health leaders turn to tech in the pandemic.
Optum Care Model & UnitedHealthcare Assisted Living Plan
Support residents living in a senior living community.
Why equity in women’s health demands an integrated approach
Why equity in women’s health demands an integrated approach
Assisted living plan comparison scenario
Keep your SNF-qualified residents with you longer.
SDOH and Medicare Advantage
This paper examines the critical impact of social determinants of health (SDOH) on patient care and how in-home assessments can help.
Reimagining Quit Services for the Future webinar
Create a focused approach to tobacco cessation.
Support for long-term recovery
Find substance use disorder treatment that includes evidence-based resources and compassionate care for members and their communities.
Strengthening nursing home partnerships during COVID-19
Optum and Saber worked together to ease the COVID-19 burden.
Case Study: UMass utilizes analytics to improve adult immunizations
Population health analytics drive UMass participation in the AMGA AI Collaborative
The Doctor Will See You…Anywhere
A profound shift toward coordinated, responsive care is underway in American medicine.
Executive Perspectives: Tech Innovation in Health Care
How AI and other technologies can help heal the health care system
Technology Helps Reduce Barriers to Tobacco Cessation
Learn about the growing change in tobacco cessation.
Veterans Benefits Administration
They honored their commitment. It's time to honor ours.
Solutions to the maternal care crisis are coming into focus
Solutions to the maternal care crisis are coming into focus
Improve Women's Health with Community-Based Solutions
Improve Women's Health with Community-Based Solutions | Optum
Optum Advanced Practice Clinician (APC) video
Advanced practice clinicians give personal care
Taking the Blinders Off Cancer Through Immunotherapy
Webinar: Taking the Blinders Off Cancer Through Immunotherapy
Evidence-based Clinical Practice Guidelines for DoD and VA
Improve continuity of care by reducing variation in practice for service members transitioning to Veteran status.
Insights on improved care through technology and scale
John Muir Health shares how the organization uses technology to reach those in need of health care services.
Improved Arkansas Medicaid Outcomes
Helping Arkansas improve Medicaid outcomes, reduce costs.
2021 PEAK Matrix Report : HealthCare Top 20
2021 PEAK Matrix Report : HealthCare Top 20 | Optum
Accelerating growth in the health economy
Learn how to secure market relevance in a shifting landscape.
Gaining maximum benefit from your revenue cycle strategy
Learn how innovation can help you achieve financial resiliency and stay competitive in today’s market.
Value Transformation at Keck Medicine of USC
Value Transformation at Keck Medicine of USC
Increasing Value Through Higher Volume
Improve revenue integrity by expanding admission reviews.
Viewpoints on the 2023 CMS Advance Notice
Leaders from Optum will discuss the proposed Medicare Advantage regulatory changes and the potential impact of the CMS 2023 Advance Notice.
Navigating Forward: C-suite check-in — Research findings state of health care
Find out what 161 C-suite health care leaders think about how COVID-19 has changed the industry — and where we still must make progress.
How value-based care became vital for survival
Article for C-suite leaders to learn how value-based care became vital for survival and whether accelerating their move to value will help their organization thrive in today’s environment.
Biosimilars explained: 5 questions you’ve been asking
Get prepared for more biosimilars to come to market.
Reality check: New drugs will cost more
The trend toward complex biologic drugs continues.
Tackling the youth mental health crisis
A board-certified adult, child and adolescent, and addiction psychiatrist discusses how to connect children and families to needed behavioral health solutions.
Pharmacy Insights Podcast
Listen to our resident experts discuss critical industry challenges and the solutions you need to control rising drug costs.
Read a report about claims payments opportunities.
Thinking about going paperless for claims payments? We commissioned a study of senior health plan executives to hear what’s on their minds.
Moving to lower-cost electronic payments
Partner with Optum Financial to increase ACH payments
Behavioral Health Provider Digital Access Survey | Optum
Improve access to care with HouseCalls
White Paper: Improve Access to Care With HouseCalls | Optum
4 key forces shaping the future of pharmacy
These emerging trends will help define the road ahead.
4 new drugs to watch this year
Breakthrough treatments for menopause, Alzheimer's and hemophilia are coming.
Enabling Success for the Health Plan Ecosystem
Optum has a complete portfolio of assets designed to enable health plans to make meaningful strides toward achieving their goals.
Inflammatory conditions: Trends, pipeline, management strategies
Hear leaders discuss trends for inflammatory conditions and gain insights on how the market is changing with a deep dive on pipeline, biosimilars, and care management strategies.
Hearts Behind the Work: Meet Our People
Meet the people of Optum who are putting you at the center of everything we do.
New rules to watch: Summer 2022
How the work of national and local lawmakers will impact you.
3 ways to deal with escalating drug costs
Innovations custom built for today’s specialty challenges.
5 approaches to address prescription affordability
Watch our On-Demand webinar to learn about 5 key solutions designed to attack the affordability challenges your members face head on.
Building new possibilities for infusion care
How we are exceeding the evolving needs of the home parenteral nutrition market
A better path to managing specialty
Learn the actions you can take today to better manage spend and trend while finding the right care for those who need it most
Achieving growth through technology
How are you identifying overpayments?
Identifying overpayments after a claim has been paid is a core component of payment integrity.
Value-based insurance and network design
Optum has access to one of the industry’s largest health care data assets and many of the industry’s top professionals.
Breaking through vaccine fatigue: Top 4 reasons to get yours
New flu and Covid bugs are coming. Time to boost your immunity.
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.
Fighting the tide of opioid overdose
The rate of drug overdose death involving opioids has spiked. See how Optum is the first in the industry to demonstrate expertise in opioid management.
Celebrating American Pharmacists Month
Hear from 5 pharmacists on how they’re advancing patient care.
Support for substance use disorders
Expand access to evidence-based support to help individuals achieve stabilization and sustain recovery.
The HouseCalls difference: Kim's story
Kim, a HouseCalls advanced clinician practitioner, believes a good day is when she’s helped someone. Watch the video to see her story.
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.
The Impact of In-home Health Assessments
Learn about the benefits of HouseCalls assessments with these 5 fast facts.
How Health Plans Can Improve Encounter Data Quality
Addressing pharmacy issues that matter to you
From specialty pharmacy to drug affordability, our experts tackle your biggest pharmacy challenges.
Mitigating maternal care deserts
For some mothers-to-be, health care options are disturbingly limited — or even nonexistent.
Health equity in kidney disease management
Learn 5 strategies for health plans to address inequities in the kidney care landscape and create more equitable access, treatment and outcomes for all.
Unlocking the promise of personal medicine
See how a peek at your genes enables more precise prescribing.
White paper: Defragment care with in-home assessments
In-home assessments can help to improve mental health and other social determinants for seniors. Read about the HouseCalls approach.
Social Determinants of Type 2 Diabetes
This study analyzes how social determinants of health (SDOH) variables impact the incidence and progression of Type 2 diabetes.
Achieving Growth Through Technology: Part 2
Viewpoints on the 2024 CMS Advance Notice
In this webinar, health plans will hear Optum viewpoints on the proposed CMS changes and how they may affect your MA plan. Be prepared now.
Preparing a strategy roadmap for government programs entry
Amy Jensen, VP of Optum Advisory Services, outlines requirements for a new market expansion.
Delivering the Personal Touch
Family-building inequities
Read how payers can turn the tide on 5 worrisome statistics.
Spend more time with members and less time on paperwork
See how prospective assessment programs can reduce administrative burden and allow physicians to focus on what matters most: member care
Webinar: Trends and challenges in telehealth
Explore new ways of doing business that allow you to meet shifting customer expectations, workforce challenges and emerging business goals.
Health Plan Leaders on StepWise Migration to the Cloud
Mental health support for youth and caregivers
Youth are struggling more than ever before with their mental health and well-being. We can help.
Digital scheduling at a rural health system
Learn how a rural health system achieved an ideal patient experience and increased bookings with digital scheduling.
Study reveals costs for unrecognized kidney disease
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.
DocASAP Digital Scheduling for Health Plans
Request a demo of DocASAP to learn how we help payers drive more appointments and improve member satisfaction.
3 new first-in-class therapies coming
See how innovation is driving the latest product development.
How to achieve more inclusive MSK care
Musculoskeletal conditions are costly, common and fraught with health inequities. Here’s how a more holistic approach can help payers better serve all members.
Creating better behavioral health care
We help people find care and support that’s easy to understand and access.
Slowing the specialty pharmacy carve-out stampede
Improve outcomes with EHR implementation and optimization
Learn how to define a new way forward by optimizing workflow, automation, and key metrics with your EHR.
Personalized support for members with autism
Optum is breaking barriers in supporting members and families who are diagnosed with autism spectrum disorder (ASD).
Platform strategy for digital transformation
Read more about the digital transformation journey and how to approach these challenges by working toward a product driven model.
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