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
Improving care, outcomes and costs
Achieve better care through understanding the customer, not just the patient.
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?
Kidney Disease Care: A Comprehensive Approach
Find out how an integrated approach produces better outcomes for renal disease — a common, complex and costly condition.
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.
Case study 1: High-dollar claim savings
DRG outlier identified, resulting in $200,578 savings.
Star ratings are important to Medicare plans
Improving the quality of care and general health status for members.
Case study 2: High-dollar claim savings
DRG outlier identified, resulting in $600,000 savings.
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.
Supporting Youth Mental Health: On-Demand Webinar
Dr. Yusra Benhalim shares insights on the challenges we must overcome to reach youth.
E-book: How payers can evaluate Centers of Excellence
Not all Centers of Excellence are created equal. Here are five questions that payers should keep in mind.
Cost breakthroughs in complex care management
Not every complex care management program is built equally. Here's how to optimize them for maximum benefits.
Rules impacting pharmacy: Summer 2023 legislative sessions
Learn what's at stake as the Senate considers PBM legislation.
Cancer costs are rising — are you ready?
Digital Claim Payments Can Save You Money
Discover 4 ways health plans can save money today, and into the future, by engaging with a digital claim payment partner.
Care Pathways study
Mental health specialists serve a critical role in reducing total cost of care for plan sponsors.
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.
Intelligent automation is improving member outcomes
Optum Advisory's Loren Koerber and Matt Matousek break down intelligent automation and reducing the administrative burden in health care.
Making Risk Adjustment Programs Work for You
Learn how three care delivery organizations reduced administrative burden to spend more time with patients and improve outcomes.
Achieving growth through technology
How are you identifying overpayments?
Identifying overpayments after a claim has been paid is a core component of payment integrity.
Supporting providers with a custom approach
Health plan assessment programs for value-based care help both physicians and patients.
Struggling to balance paperwork and patients?
You may be missing out on health plan services that can help.
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.
HouseCalls: Fewer Emergency Visits, Hospital Stays
HouseCalls: Fewer Emergency Visits, Hospital Stays
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.
Flexing seniors’ brains and social muscles
Medicare Advantage plans can differentiate supplementary programs by addressing cognitive health and social interaction.
How Health Plans Can Improve Encounter Data Quality
How holistic programs improve senior health
Medicare Advantage plans need to rise above the competition by going beyond traditional fitness offerings.
Alternative funding: Real savings or problems?
See how much "free" drugs will actually cost you.
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.
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.
Is your pharmacy benefit manager delivering value?
4 key questions you should be asking.
3 ways to deal with escalating drug costs
Innovations custom built for today’s specialty challenges.
Moving to lower-cost electronic payments
Partner with Optum Financial to increase ACH payments
A case study on Excel Medical Center
Using digital integration to ease administrative burdens can help you spend more time with patients and deliver positive patient outcomes.
HouseCalls: Helping to care for members where they are
As demand for home and community care grows, Optum® HouseCalls can reach your Medicare Advantage members and assess members’ health needs.
Managing risk in value-based care delivery
Watch as Erik Johnson explores models for risk in delivering value-based care (VBC).
Changes to risk adjustment are coming. Are you prepared?
Learn how your practice may need to evolve to proactively anticipate the upcoming changes announced in April related to MA and Part D.
Optum Rx Drug Pipeline Insights Reports
Read the most recent quarterly reports on new drugs coming down the pipeline.
Optimize member engagement through collaboration with Optum
A health plan increased in-home assessment rates for their Medicare Advantage members by working with Optum to increase member engagement.
Achieving Growth Through Technology: Part 2
Pharmacy Insights Podcast
Listen to our resident experts discuss critical industry challenges and the solutions you need to control rising drug costs.
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.
The Impact of In-home Health Assessments
Learn about the benefits of HouseCalls assessments with these 5 fast facts.
Maximize Recoveries with Subrogation
Identify, investigate and recover medical and disability payments related to accidents.
4 key forces shaping the future of pharmacy
These emerging trends will help define the road ahead.
ACDIS CDI Survey and Report
Internal collaboration and clinically intelligent AI are key.
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.
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.
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.
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
Health plan solutions designed to lower the cost of care
Tour our ecosystem of capabilities designed to tackle broad-based health plan challenges.
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.
Trends and perspectives for health plans
Driving toward the same things for our health care system — better quality, lower cost, and higher consumer and provider satisfaction.
How our medication packaging helps the planet
New packaging saves CO2, water, energy, and plastic waste.
Transforming the six zones of consumer experience
Discover innovations and success factors to drive engagement, loyalty and growth.
Why equity in women’s health demands an integrated approach
Why equity in women’s health demands an integrated approach
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.
Value Transformation at Keck Medicine of USC
Value Transformation at Keck Medicine of USC
Case Study: Advanced Pharmacy Audit Services
How a health plan saved more than $1 million
Case Study: UMass utilizes analytics to improve adult immunizations
Population health analytics drive UMass participation in the AMGA AI Collaborative
Delivering Value-Based Care for Veterans Affairs & DOD | Optum
Best practices to help transition to value-based care.
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.
SNFs Improve Care & Business Outcomes for Facilities
The Optum Care Model Helps SNFs Meet Strategic Goals
Improve access to care with HouseCalls
White Paper: Improve Access to Care With HouseCalls | Optum
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.
Executive Perspectives: Tech Innovation in Health Care
How AI and other technologies can help heal the health care system
The Doctor Will See You…Anywhere
A profound shift toward coordinated, responsive care is underway in American medicine.
Technology Helps Reduce Barriers to Tobacco Cessation
Learn about the growing change in tobacco cessation.
Accelerate your digital transformation
Capitalize on the momentum around digital health solutions.
Optum Advanced Practice Clinician (APC) video
Advanced practice clinicians give personal care
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.
Taking the Blinders Off Cancer Through Immunotherapy
Webinar: Taking the Blinders Off Cancer Through Immunotherapy
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.
Impact member care with in-home assessments
Download the infographic to learn more about how in-home assessments can uniquely impact SDOH.
Support for long-term recovery
Find substance use disorder treatment that includes evidence-based resources and compassionate care for members and their communities.
Star ratings are important to Medicare Plans
Learn how health plans can improve Star ratings through high-touch strategies.
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.
Preparing a strategy roadmap for government programs entry
Amy Jensen, VP of Optum Advisory Services, outlines requirements for a new market expansion.
Optum Care Model & UnitedHealthcare Assisted Living Plan
Support residents living in a senior living community.
Improved Arkansas Medicaid Outcomes
Helping Arkansas improve Medicaid outcomes, reduce costs.
Navigating government programs
Learn how small and community-based plans can enter Medicaid programs in our navigating government programs video.
Redefining the prior authorization process
How we are revamping the prescribing process
Supporting providers in the transition to VBC
Learn how value-based care (VBC) partnerships between payers and providers are more important than ever.
Emerging technologies in underwriting
Listen to the on-demand webinar from Becker Healthcare in partnership with Bill Dimmock, VP of Advisory Services at Optum.
2021 PEAK Matrix Report : HealthCare Top 20
2021 PEAK Matrix Report : HealthCare Top 20 | Optum
Veterans Benefits Administration
They honored their commitment. It's time to honor ours.
Accelerating growth in the health economy
Learn how to secure market relevance in a shifting landscape.
Health Equity & Women's Health
Create meaningful change for the women in your workforce.
Solutions to the maternal care crisis are coming into focus
Solutions to the maternal care crisis are coming into focus
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.
Behavioral Health Provider Digital Access Survey | Optum
Family-building inequities
Read how payers can turn the tide on 5 worrisome statistics.
Unlocking the promise of personal medicine
See how a peek at your genes enables more precise prescribing.
Mitigating maternal care deserts
For some mothers-to-be, health care options are disturbingly limited — or even nonexistent.
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
Slowing the specialty pharmacy carve-out stampede
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.
Addressing pharmacy issues that matter to you
From specialty pharmacy to drug affordability, our experts tackle your biggest pharmacy challenges.
Digital scheduling at a rural health system
Learn how a rural health system achieved an ideal patient experience and increased bookings with digital scheduling.
Making a better future for mental health care
Guide members to the right behavioral health care when they need it.
Addressing health equity barriers in cancer care
Discover the 5 pillars of equity-driven member navigation.
Personalized support for members with autism
Optum is breaking barriers in supporting members and families who are diagnosed with autism spectrum disorder (ASD).
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.
Study reveals costs for unrecognized kidney disease
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.
Mental health support for youth and caregivers
Youth are struggling more than ever before with their mental health and well-being. We can help.
Helping members achieve their goals
See how the right mental health care makes a difference.
Payer-provider collaboration in ESRD care
Kidney disease is complex and expensive, and disproportionately impacts people with limited financial resources. Here’s how payers can help transform care.
Personalized care: Focusing on the member
Hear from Optum Rx chief of operations, Jon Mahrt
Comprehensive payment integrity savings
Inform and improve your entire claims management lifecycle.
Clinical and claims data: A powerful combination
Get a snapshot of the pros/cons of clinical and claims data.
Improve Women's Health with Community-Based Solutions
Improve Women's Health with Community-Based Solutions | Optum
Optum HouseCalls: In-home Multi-Dimensional Clinical Evaluation
In-home clinical evaluation of health and ongoing care needs
5 questions: Premium Value formulary
Hear from OptumRx SVP of clinical & formulary services
Third Annual Optum Survey - AI in Health Care
AI on the rise: Health leaders turn to tech in the pandemic.
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.
Closing the diagnosis gap in chronic kidney disease
Most people with chronic kidney disease don’t know they have the condition. These payer strategies can help turn the tide.
Insights to improve outcomes and lower costs
Enabling providers and clinical teams with actionable patient data can create effective value-based care behavioral health programs.
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.
A new approach to managing genetic testing
Better manage genetic test management solutions, ensuring the right test is used at the right time to determine the right care.
Achieving health equity: Strategies for payers
Learn more about a comprehensive solution for health payers to address health disparities and achieve health equity.
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.
Improving performance at Excel Medical Center
Empower provider success and improve member care through digital integration.
Weighty issue: How to contain GLP-1 costs
Get strategies for handling the new anti-obesity medications.
Addressing the high cost of musculoskeletal care deferral
With musculoskeletal (MSK) incidence rates and costs rising, connecting members with the care they need is more urgent than ever.
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.
Integrated in‑home and in‑office assessments program
Help manage care and improve quality by providing members in-home and in-office care assessment options through one streamlined approach.
Viewpoints on the 2025 CMS Advance Notice
Don't miss this exclusive webinar and the chance to learn how your Medicare Advantage plan can better prepare for the 2025 changes.
Combating the opioid epidemic
Medication interventions save lives — more people need access to them.
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.
Meet the rising demand from seniors to age in place
In-home assessments can improve outcomes, reduce health care costs and align with member preference.
How to manage blockbuster anti-obesity drugs
The pricey weight management drugs work well, but users need coaching and support to maintain the benefits.
The impact of corrective actions on Stars ratings
Learn more about the impact and implications of a Corrective Action Plan and how Stars and these corrective actions are interconnected.
A New Approach: guidance along the fertility journey
Discover how health plans can set aside ad hoc solutions and adopt a comprehensive approach to improve health outcomes and accessibility to fertility care.
Why you should prioritize digital payments
Digital payment processing doesn’t have to be a daunting task. Here's why it should be at the top of your priority list.
SDOH solutions: Transforming health care for all
Learn from experts how to transform health care by addressing the social and economic factors that impact health outcomes.
Taking aim at the U.S. maternal mental health crisis
New and expectant mothers are facing an epidemic — and a lack of support in addressing it. Read how health plans and employers can help.
How CAPs directly impact your Stars performance
Stars Final Rule and the importance of taking a member-centric approach to improve health equity.
Gene therapies: Can we afford the future of medicine?
Learn how to manage financial risk as gene therapies become more commonplace.
SDOH solutions: Improving population health outcomes
Learn how we are utilizing technology to understand and impliment effective population health interventions.
5 trends that defined pharmacy in 2023
See which trends are shaping the present and future of pharmacy care services.
The value of DEX Z-Codes in the commercial space
Optum and Palmetto experts partner in discussing how to solve genetic lab challenges in legacy solutions.
2024 Stars Preview: A Return to Normal and a Path Forward
Perform key actions to manage your Stars performance with a focus on member engagement. Learn how to take control of your Star ratings now.
Health Equity Vision Into Action Report
Learn how identifying and addressing disparities in health care allows everyone to live their healthiest life.
Fitness for a generation that never gets old
With baby boomers rapidly aging into Medicare, health plans must take an informed approach when marketing fitness benefits. Here’s how.
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.
How Health Data Can Improve MSK Care for Members | Optum
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.
Help Improve Your Members' Health with Optum HouseCalls
Medicare Advantage members receiving in-home assessments saw reductions in emergency department visits and inpatient hospital stays across 4 conditions.
HouseCalls travels far and wide to support members’ health
The HouseCalls program provides health plans with annual in-home clinical assessments for Medicare Advantage members available in 50 states.
Innovative approaches to collaborate with PCP's
Understanding the challenges confronting Medicare Advantage plans and their Medical Loss Ratio.
3 Ways Digital Movement Is Reshaping Member Experiences | Optum
Best practices for reducing provider abrasion
Find out what is driving the recent increase in abrasion and learn what health plans can do to alleviate provider pain points.
Staying current in your core admin platform
Get current, stay current and leverage the newest platform capabilities with ongoing release management.
Alzheimer's treatment: Time for a level-set?
See success rates, risks and costs of the new Alzheimer’s treatments.
Spotlight: Fitness needs across generations
How to engage hard-to-reach kidney disease patients
Chronic kidney disease impacts millions of Americans. Payers must partner more closely with providers to better target the members most at risk.
How to implement patient-centered oncology care
Future-ready claims review: automation isn’t enough
As claims grow more complex, many automation methods aren't sophisticated enough for the job. See how payers can take claims review to the next level.
Working together to help end the opioid epidemic
Opioids are powerful drugs with a high risk of misuse and dependence. A comprehensive solution can help address this complex problem.
5 ways shift-of-site care is a win for all women
With unique needs, women benefit greatly from a wider array of care options. Payers and employers can reap big rewards by providing them.
Supporting our kids
Mental health needs are increasing in youth. Experts share their insights on how to best support them so they can grow into healthy adults.
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.
Ensuring responsible use of AI in health care
See how we use artificial intelligence (AI) and machine learning (ML) to help people live healthier lives and make the health system work better for everyone.
Breakthroughs in kidney care
Explore the most promising innovations in renal care for people with chronic kidney disease.
Intelligent automation improves underwriting results
Machine learning coupled with software features and cost-tuning delivered significantly improved predictive value and underwriting results.
Four steps to optimizing value-based care
Learn how combining these steps can help power a holistic workflow between payers and care delivery.
Collaborative strategies to optimize complex care management
As caring for complex patients gets more complicated, payers and providers must partner to provide better, more accessible, lower-cost care.
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.
Fertility solution overview
Whether for personal or professional reasons, many couples today are delaying starting a family. However, waiting to conceive can lead to fertility issues — for one partner or both.
Unraveling complexity in specialty care
Learn how Optum is streamlining care delivery with insights from patients and providers to improve outcomes and drive down costs.
Biosimilars to save billions in this decade
Prices for popular brand-name biologics drop up to 60% with generic-equivalent biosimilars.
Analytics in payer-oncologist partnerships
See 4 ways that payers can help health care providers unlock the power of real-world data to drive quality and innovation in cancer care.
5 things to know about the new landscape of fertility benefits
More and more, benefits leaders see the value of reproductive health — and it’s changing how they approach offerings.
Delivering on the promise of fertility care
As a highly specialized area of care, fertility treatment is a significant cost driver for health plans and employers.
Health system boosts reach with payer channel scheduling
St. Luke’s Health dramatically increased volumes and decreased costly no shows with Optum digital scheduling. Learn how your system can, too.
Understanding college students' mental health needs
Read about the realities of campus behavioral health care and how we can make it better.
Guided help for mental health support
We’re making it easier for people to access care.
Engage providers to impact member outcomes
Download our infographic to learn how Optum can take the burden off of payers to impact provider performance.
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.
Navigate the intersection of risk adjustment and Stars
Discover 5 strategies that will help your health plan be prepared to factor risk adjustment data into Star Ratings.
How to push back on 3 key pharmacy headwinds
Innovative formulary structures and clinical programs can help plan sponsors meet the challenge of expensive orphan, biologic and GLP-1 drugs.
Establishing trust to improve value-based care outcomes
Read this blog to get tips on how payers can support providers to increase engagement and reduce administration burden for better patient care.
Connections that count: Redefining the PBM experience
Hear from experts on better ways to simplify the complex health care experience through impactful innovation.
3 ways holistic MSK care improves all avenues of care
An integrated approach can help employers and health plans fight back against skyrocketing musculoskeletal (MSK) costs.
Best practices for optimizing your payment integrity program
When health care works better for everyone
See how building an outcomes-based model for behavioral health care can benefit both clinicians and patients.
How to ease the emotional toll of caregiving for members
Discover how to support caregivers and their loved ones’ mental health by providing resources and tools.
How to effectively manage organ transplant costs
Access to mental health care within 48 hours
Optum expands care options while reducing crisis events and costs.
Regulations to watch: Fall 2024
An assessment of the latest rules impacting PBMs from state and federal legislation.
Driving healthcare innovation
Analysis on forces driving change, what to watch and how to move forward for C-suite health care leaders.
Trends for health plan quality performance
An outlook report on how health plans can stay ahead of the curve and prepare for key trends likely to impact their quality programs in 2025 and beyond.
Advancing DME benefits management
Hearts Behind the Work: Meet Our People
Meet the people of Optum who are putting you at the center of everything we do.
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.
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.
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.
New options to treat schizophrenia, COPD
A clever combination drug offers new help for schizophrenia with reduced side effects, while Dupixent expands its footprint to COPD.
Viewpoints on the 2025 CMS Final Notice
Download this executive summary to learn how these changes may affect your Medicare Advantage plan.
Targeted care and lower cost: How one state achieved both
One state achieved both in delivering home health services.
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.
Preparing your plan for the GLP-1 era
After revolutionizing care for diabetes and weight loss, GLP-1 drugs are being eyed more. Can we afford it?
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.
Autoimmune, oncology, diabetes and obesity rule drug spending
Many patients combined with expensive drugs leads to top spending classes.
Delivering the Personal Touch
Building the PBM of the future
Creating solutions plan sponsors need today to tackle tomorrow’s pharmacy challenges.
Revolutionizing specialty medication management
Get an in-depth assessment of the ways Specialty Fusion is revolutionizing specialty drug management.
Assisted living plan comparison scenario
Keep your SNF-qualified residents with you longer.
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.
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.
Health Plan Leaders on StepWise Migration to the Cloud
2024 Denials index data-driven strategy infographic
Data-backed strategies to combat increasing medical claim denial trends.