Health plan performance
We help payers in all market segments examine and enhance their strategies to meet and exceed evolving member needs and expectations.
Enabling transformative change
Health plans are juggling seemingly competing priorities. They need to reduce total cost of care, improve and document quality, and keep pace with changing regulations. At the same time, they strive to enhance the member experience.
Our ambition is to help them succeed in today's and tomorrow's environment. We do this by developing and implementing strategies that both align and address these priorities.
We serve payers across all market segments who are:
- Focused on securing and improving market position, achieving and maintaining financial sustainability
- Looking to identify and implement (new) and profitable growth strategies
- Seeking analytical and operational rigor to improve performance, and may be time, resource, or talent constrained
Emerging from a highly disruptive year
This study summarizes insights and strategies garnered from over 20 conversations with our community, regional, national, provider-sponsored and Blue plans partners.
Themes that came out of the study include:
- rising customer expectations
- government influence
- labor shortages
Explore our solutions
Actuarial Services
We help clients create financial transparency and understand the "why" behind finances through superior reporting, forecasting and modeling.
Government Programs Advisory Services
We help health plans compete in a changing regulatory environment, stay agile and build for the future.
StepWise and Underwriting
Our underwriting software, capabilities and expertise help health plans simplify the design, deployment and distribution of products.
Payer Technology Services
Technology solutions to help health plans achieve their growth goals.
Articles and blogs
Transform underwriting with cutting-edge technology
Learn how to leverage automation, technology and scalable staffing to drive growth.
Video
Navigating government programs
Learn about the application and RFP process for state-sponsored Medicaid programs and about steps health plans can take when entering into government programs.
Video
Preparing for new market expansion
Amy Jensen is VP of RFP Services and Business Development at Optum Advisory Services. In this video, she outlines a new market strategy roadmap and how vendor partners can help health plans to prepare for expansion.
White Paper
Member experience is a winning strategy
For 2023 Star Ratings, performance on the CAHPS measures will be the key differentiator between high-performing and low-performing plans. Read about why focusing on the member experience is a winning strategy for high-performing plans.
White paper
The path to 4+ Star performance
Focus on member centricity to impact 2023 Star Ratings.
Articles and blogs
The customer experience trap
Learn why customer loyalty is decreasing while innovation in member experience is increasing.