O4 Hubs

All solutions

Design for Fitness and Well-being

With over 30 years' experience and 500 design projects, we know how to bring your fitness and well-being vision to life.

Global corporate health solutions

How do you engage employees around the world?

Claims and payment accuracy

Optum® Payment Integrity strengthens accuracy at every touch point in the billing lifecycle.

Population health services

HouseCalls

Help manage member care and close Star gaps with in-home member assessments.

Rally

Overcome barriers to engage employees in their health.

Emergent Care Transformation

Emergent Care Transformation

Support for oncology providers

CES Professional

CES Facility

CES Application Managed Services

Provider Network Management and Performance

Fraud, Waste and Abuse Services

Quit For Life

Submission Services

We provide end-to-end management of submissions, direct errors and remediation. Insights promote continual improvement to maximize accuracy.

Maternity Support Programs

Help deliver healthier babies and better outcomes.

Focused Claims Review

Ensure billing accuracy of professional and facility claims.

Musculoskeletal (MSK) Solutions

Manage escalating spend and utilization.

ePrescribe and ePA

Advanced Communication Engine

Comprehensive kidney solution for employers

Optum uses a proactive approach to managing different stages of renal disease. Find information on comprehensive kidney solutions for your employees here.

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.

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 services for health plans

We help health plans navigate their toughest challenges.

Health care data and analytics

Health care operations

We help federal health agencies improve system performance.

Pharmacy care services for TPAs

We provide dedicated support to help you grow your business.

Medicaid management

Take an efficient, services-based approach to your Medicaid enterprise.

Health IT solutions

Learn more about our IT solutions.

Analytics for state government

Get insights to improve decision-making and program outcomes.

EHR Data

Gain visibility across therapeutic areas and the continuum of care.

Medicaid Risk Adjustment

Optum has the expertise, breadth and scale to help optimize and support your Medicaid risk and quality programs.

Subrogation

Maximize recoveries with member sensitivity.

Symmetry

The Optum® Symmetry® suite produces standard units of analysis to help health plans manage costs, mitigate risk and measure quality.

Itemized Bill Review

Save on high-dollar inpatient cases.

Advisory Services

Take the proactive path to payment integrity.

Payment Recovery

Focus on claims resolution.

Credit Balance

Maximize overpayment recovery.

Data Mining

Identify and recover payment errors.

Impact Pro

Optum® Impact Pro® helps you identify individuals who will benefit most from population health management programs.

Oncology Management Programs

Manage cancer costs, improve outcomes and quality of care.

Managed Transplant Program

Manage the risks of complex medical conditions.

Specialty Pharma Solutions

Manage specialty medical drug expenses.

Transplant Solutions

Get significant savings and statistically superior outcomes.

Kidney Disease Management

Attain comprehensive, cost-effective disease management.

IT Performance

We enable partners with the technology, expertise, secure operations and economics to digitally transform health care for improved outcomes.

Engage Physicians in Care Transformation

Network Planning

Develop, refine and enhance network planning.

Patient Profiles

Create a customized picture of patients and their health.

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.

Leaders

Pharmacy solutions and services

Drive better engagement, adherence and outcomes for your patients.

Substance Use Disorders

We offer resources and support to help individuals achieve stabilization, build resiliency and sustain recovery.

Transplant Services

Get significant savings and statistically superior outcomes.

Partner with Our Epidemiology Consultants

Advance public health and safety with our trusted experts and data.

Clinicogenomics

Better understand diseases and drug development opportunities.

Musculoskeletal (MSK) Condition Services

Manage escalating spend and utilization.

Oncology Services

Align the right care, the right time and the right provider.

Quit Services

Learn how Optum is providing fresh insights for states to modernize tobacco cessation programs.

Pharmacy care services for public sector

We help you provide affordable pharmacy benefits.

Digital Research Network for Providers

Data and technology combine to help providers enroll patients in clinical trials for better outcomes.

Specialty Pharmacy

At Optum Specialty Pharmacy we make patient referrals, enrollment processes and online prescriptions easy for providers.

Enhance Clinical Trial Design and Performance

Modernize your approach to protocol design and patient finding.

"Design, Pilot and Scale Engagement Programs"

Take advantage of our connections to all parts of the health system.

Patient Care Management

Manage patient care across the health care ecosystem.

Physician Practice Performance

Solve challenges in ambulatory operations related to population health management (PHM), value-based care (VBC), patient engagement and revenue cycle.

Service-Line Profitability

Increase surgical volume and improve patient care.

Analytics Managed Services

Market Advantage

Develop your future growth strategy.

Optum Provider Management Services

Streamline your partnerships with Medicaid providers.

Ergonomics in the Workplace

Improve comfort and decrease risk of injury with ergonomics.

Transplant Resource Services

See significant savings and statistically superior outcomes.

Dynamic Assessment of Pregnancies & Infants (DAPI)

Drive informed decisions about maternal and infant health.

Clinical Programs

Strengthen patient care through a dedicated clinical team.

Analytics Tools

Drive insights with actionable information and knowledge.

Pharmacy Network

Grant access to local pharmacies, home delivery and infusion

Educational Resources

Access a wide range of resources for staff and patients.

Hospice Pharmacy Solutions

Provide care-focused and cost-effective solutions.

Technology Solutions

Improve efficiencies with innovative and flexible solutions.

Risk management and quality performance

We go beyond risk adjustment to drive better outcomes.

Workplace Wellness and Fitness

With well-being solutions customized for your population’s needs, we’ll help increase employee participation in all your wellness programs and services.

Claims and Billing Solutions

Expansive claims and billing solutions help preempt denials, send cleaner claims, automate workflows, and improve efficiencies and payments.

Employee Assistance Program (EAP) Solutions

Build a resilient, productive workforce, and mitigate risk.

How to Enroll

Streamline your payment experience with Optum Pay.

Diabetes and Other Endocrine Diseases Research

Infectious Disease Research

Oncology and Immunology Research

Respiratory Disease Research

Claims Edit System

Edit claims for all business lines and claim types.

Emergency Department Claim Analyzers

Control rising emergency outpatient facility cost.

Coordination of Benefits

Identify critical administrative coordination of benefits issues.

Provider Education

Enhance billing accuracy and provider relations.

Comprehensive Payment Integrity

Centralize payment integrity for increased results.

Network Solutions

Our solutions focus on out-of-network claims.

Claims Pricing Solutions

Drive prospective payment system pricing accuracy and efficiency with Optum® EASYGroup™.

Claims Validation

Validate all claims while minimizing provider abrasion.

Market Clarity: Linked EHR and Claims Data

Unlock insights using the industry’s largest and most trusted repository of longitudinal clinical and claims data.

Laboratory Benefit Management

Manage all routine and genetic lab testing spend.

Engage Payers with Value-Based Contracts

Assess the fit, develop metrics and track outcomes over time.

Targeted cost of care management

Better manage high-spend areas like lab testing or emergency department with solutions that integrate analytics, technology and services.

Cardiovascular Disease Research

We develop research to advance treatment of CVD.

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.

Central Nervous System and Behavioral Health Research

We offer insightful, real-world research in CNS and BH.

Pharmacy care services for employers

As a pharmacy benefit manager, our goal is to improve the cost of health care and prescription drugs for both plan sponsors and members.

HEOR

Tap into our expertise in health economics and outcomes research.

Optum Enriched Oncology EHR Data for Life Sciences

Behavioral health services for state government

Helps improve outcomes for high-risk populations.

Risk Management

Reduce worries with sustained financial risk management.

Focused Claims Review

Ensure billing accuracy of professional and facility claims.

Bariatric Services

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

Complex Medical Management

Our specialty network offers focused clinical interventions.

Solutions for Health Care Providers

Increase employee engagement and control medical plan costs.

Prioritizing Employee Mental Health

Evidence-based solutions for employees and their dependents.

Digital Engagement

Motivate more employees to take charge of their health.

Support a Return to Routine Care

Find accessible care to reduce risks and close critical gaps in care.

Creating a Safe Return-to-Worksite Strategy

What types of COVID-19 resources suit your worksite needs?

Optum Utilization Management

Deliver appropriate care quickly and efficiently.

Optum COVID-19 Vaccine Billing Services

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.

Disease and Condition Management Programs

Identify at-risk individuals and help resolve health care gaps.

Asthma Management Programs

Help people make positive changes to improve their health.

Biometric Screening Solutions

Offer biometric screening options for your whole population.

Care Management Solutions

Drive value with improved health outcomes and reduced costs.

Health and Wellness Portal Solutions

Reduce health risks and help prevent chronic disease.

Stars/HEDIS Strategy and Operations

Strengthen quality initiatives to boost Stars ratings and improve performance.

Prospective Solutions

How do we drive more value from outcomes-based programs?

The Optum Care Model

Improve quality and maintain census stability by bridging care for senior living residents.

Performance Analytics

Consumer Acquisition Services

Convert valuable consumers into engaged patients

Optum Integrated Eligibility Services

Simplify eligibility and enrollment for your HHS programs.

Health payment delivery solutions

We're creating a better payment experience for health plans and their members and health care providers.

Public health solutions

Transform public health in your state.

Empower Commercial, Brand and Access Teams

Reveal market opportunities using our data assets and expertise.

Prevention and well-being

Help employees be healthier.

Prior authorizations

Electronic Prescribing (eRx) to Optum Rx

Enable accurate and efficient electronic prescribing to send prescriptions directly to the pharmacy.

Data and analytics enablement

Better understand and predict cost, risk and quality.

Generate Evidence with Real-World Data

Derive evidence from the unmatched depth and scale of our data assets.

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.

Care Coordination for Chronic Conditions

Provide support and advice a member needs to restore their health.

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.

Optum Pay

Accelerate progress toward a healthier future with a platform that helps expedite payments and streamlines access to historical claims data.

Return Better

Find comprehensive solutions for employers and employees throughout the COVID-19 pandemic and beyond.

Wellness Coaching Programs

Offer your employees coaching, online learning and support.

Stop Loss Insurance

Protect your self-funded employer benefit plan from excessive expenses related to increased health care utilization.

Address Mental Health Challenges from COVID-19

Attend to the explosion of need due to COVID-19.

Optum Pay Advance

A digital-first cash flow solution provides easy and fast access to funds for health care practices

Performance Analytics for HHS

Improve program performance and member outcomes with Optum® Performance Analytics for Health and Human Services (OPA for HHS).

Optum Center for Wellbeing Research

Peer Support Services for Behavioral Health

Our peer services help people move from treatment to daily life and reduces re-admission.

Optum State Insurance Exchanges

Simplify access to care with a state-based exchange that meets all your marketplace needs.

Policy Research, Analytics and Consulting

Understand program results to deliver more value.

Eligibility and determination

Simplify access to care and services.

Fertility Solutions

Improve fertility outcomes and reduce costs.

Neonatal Support

Help improve outcomes for infants in the NICU, and assist families in caregiving.

Bariatric Resource Services

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

HEDIS Medical Record Review

Streamline HEDIS data collection and medical review process.

Women’s Health Solutions for Health Plans

Support women and families with integrated solutions.

Chronic Care Management for Medicare

It's more than revenue — it's value.

Patient Help Line

Offer patients clinical and non-clinical support 24/7.

Program Integrity Services

Our solution enhances and modernizes program integrity to combat fraud, waste and abuse by working to support the federal government.

Chronic Kidney Disease Stage 4–5

Provide comprehensive, cost-effective disease management.

Heart Failure Management

Our dedicated nurses help empower healthier choices to manage heart failure.

COPD Management

Provide personalized support for managing COPD.

Optum Interoperability and Patient Access Services

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.

Employee Nutrition Services

Provide employees safe, realistic and maintainable nutrition solutions for improved health, regardless of where they are working.

Medical benefit management

Discover simple solutions for complex conditions.

Bariatric Resource Services

Support your employees before and after weight-loss surgery to improve their potential for success.

Retrospective Risk Adjustment Solutions

We offer comprehensive strategies for health plans.

Quit For Life

Empower employees to overcome nicotine dependence.

Rally Rewards

Rewarding members for repeat engagement in healthy actions.

Rally

Overcome barriers to engage employees in their health.

Consumer Engagement Portal

Help employees make sustainable changes to reduce risks.

Coronary Artery Disease Management

Improve health and lower costs for those living with the most common form of heart disease: CAD.

EDI Messaging

Achieve higher first-pass billing accuracy.

Quality measurement and reporting

How are your quality metrics?

Health care operations

We offer a full range of technology services, including applications and infrastructure design, development and operations.

Provider Data Solutions

Maintain and improve your provider data.

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.

Optum Performance Analytics

Unify clinical and financial analytics to improve outcomes.

Integrated Data

Add another dimension to your data-driven strategies.

Health policy research, analytics, consulting

Our consulting helps to create and manage the best strategy to maximize federal agency services and make informed policy choices.

Optum Maintenance and Operations Services

Help reduce costs and system instability by outsourcing M&O.

Optum Claims Administration

Modernize your claims administration process.

Automated Health Care Claims Triggers & Notifications

We help state agencies maximize auditing capabilities.

CES Facility

Manage commercial and Medicare facility claims editing.

Advanced Communication Engine

Prevent claim inefficiency and lower administrative costs.

CES Application Managed Services

Automate claims edit services for better accuracy.

CES Professional

Eliminate needless administrative, financial, time burdens.

Optum Program Integrity Solutions for Medicaid

Protect taxpayer money by decreasing improper payments.

Infusion Pharmacy

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.

Pharmacy eServices

Managed Transplant Program

Manage the risks of complex medical conditions.

Health Care Advisor

Decrease ER visits with patient education and support.

Clinical Case Management

Empower your employees with chronic or complex conditions.

NurseLine Services

We provide 24/7 support to help people understand their symptoms.

End-Stage Renal Disease Management

Providing comprehensive, cost-effective disease management.

Employee Assistance Program

Build a resilient, productive workforce, and mitigate risk.

Condition Management

Case Management

Address care opportunities and decrease future spend.

Telehealth Services

Behavioral Health Solutions for Federal Programs

Connect members to effective services to improve outcomes.

Complex Medical Conditions Solutions for Federal Agencies

Improve outcomes, reduce costs and enhance experiences.

Prevention and Well-Being

Improve health and productivity, reduce risks and costs.

Biometric Solutions

Biometric screening options for your entire population.

Wellness Coaching

Wellness Coaching

Data management

Maximize the quality of your data to increase performance.

Claims Data

Meet your potential with more complete data.

Clinical/EHR Data

Change your perspective on care with more useable data.

Corporate Fitness Center Management

Attract and retain talent with fitness center programming.

Primary Data Collection

Clinformatics for Managed Markets

Achieve greater marketplace power.

Health Care Claims Data and Analysis

Integrating and linking deep patient data from multiple real-world sources helps clarify market dynamics.

In-Home Health Assessments

Watch how HouseCalls is providing compassionate care.

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?

Audit Services

How much support do you get during an audit?

Optum Virtual Care

Rally Rewards

Rewarding members for repeat engagement in healthy actions.

The Optum ISNP Care Model for SNFs

Break the high-cost cycle by increasing care and benefits to Institutional Special Needs Plan (ISNP) members.

Military and Veteran health services

We provide high-quality and reliable health services.

Employee Assistance

Improve well-being and productivity.

Workplace Well-Being

See how you can bring your organization's wellness strategy to life with health promotion specialists, wellness coaches, digital fitness apps and more.

Biometrics

Inspire positive behavior through confidential screenings.

COVID-19 Vaccine Support

Discover what employers need to know about COVID-19 vaccines.

Workplace Health Promotion

Help employees make healthier habits part of their work life.

Employee Wellness Coaches

Support employees in reaching their health goals.

Payments and banking

Optum Virtual Care

Optum Pay Resources

Utilization Management (UM) Changes

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 Rx Home Delivery

Increase medication adherence and satisfaction while providing patients a cost-effective and easy way to receive prescriptions at home.

Capacity Planning

Optum Virtual Care

Pharmacy care support

We prioritize patient care through proactive insights that empower informed decisions and control costs — without compromising excellence.

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.

Optum Maintenance and Operations Services

Help reduce costs and system instability by outsourcing M&O.

Analytics Consulting

Analytics Consulting

Health Reimbursement Arrangements

Use a health reimbursement arrangement (HRA) to help offset employees’ health care costs while providing tax savings to the organization.

Healthy food benefits

Make fresh produce and healthier food a realistic option for all of your employees with instant rewards for purchasing nutritious products.

Flexible Spending Accounts

Help your employees budget and save for qualified expenses during the benefit plan year through pre-tax contributions to FSAs.

Financial solutions

Empower your employees to take control of their health and lead them toward greater financial wellness.

Health Savings Accounts

Accelerate progress toward a healthier future with an HSA that helps employees take control of their care, payments and overall health.

Integrated Solutions for I/DD Populations

Ensure predictable costs while supporting positive outcomes.

Commuter Benefits

Support your employees with a pre-tax account that saves them money on qualified expenses for their individual commute to work.

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.

Peggy O’Reilly, RN

Case Manager, Women’s Health Solutions, Optum

Fertility Benefit Programs

Reduce infertility treatment costs, decrease NICU costs.

Shelly Roy

Social Worker, Optum Women’s Health Solutions

Obstetric (OB) Homecare Programs

Help improve high risk pregnancy outcomes and patient experience.

Women's Health Solutions for Employers

We offer help from preconception through baby's first year.

Maternity Support Program

Help deliver healthier babies and better outcomes.

Benefits Analytic Manager

Manage benefit performance with valued insights.

Advocacy Solutions

Simplify benefits to guide and empower employees.

Biometric Screenings and Vaccinations

Engage employees with biometric screenings and vaccinations.

Managed Business Services

IT Consulting and System Integration

Security and Privacy Services

Software and Cloud Application Engineering

Software Quality Assurance

Population health

Lifestyle Spending Accounts

Attract and retain talent in a competitive market, connect your benefits to your culture and show you care for your employees.

Employee Benefits Brokers

Condition Management

Provide the right resources at the right time to meet needs.

Medical Benefit Management

Discover simple solutions for complex conditions.

Analytics Performance

Health care can do better — and no one can do it alone.

Revenue Cycle

Innovate the revenue cycle for peak performance.

Transform Specialty Medication Management

Eliminate the burden of managing specialty medications separately across the medical and pharmacy benefit.