Data Warehousing and Business Intelligence Solutions

Achieve superior outcomes with advanced health information technology

Sophisticated data warehousing has little impact without deep domain knowledge and a track record in the government sector. At Optum™, our experts understand the nuances. We have the experience needed to create actionable insights from Business Intelligence solutions. Our insights get results. We can help contain costs and improve outcomes for Health and Human Service agencies, program beneficiaries and taxpayers.

Optum™ helps you improve program management and drive better health care outcomes with a more holistic view of your program beneficiaries. From individual recipients to an aggregated programmatic view, we’ve built an integrated environment that provides an across-the-board perspective. So you can get a better read on the data and make more informed decisions.

We help our clients:
  • Improve health and human services outcomes
  • Realize significant financial gains through improved decision-making capabilities
  • Reduce risk and lower costs
  • Enhance program management and deliver services more efficiently
  • Leverage existing investments
  • Shape and influence policy


Optum Business Intelligence (BI) Solutions include:

Data Warehousing Services

Optum offers agencies a better analytical environment than the Medicaid Management Information System (MMIS). You'll quickly gain the benefits of a flexible, scalable and open solution that allows you to aggregate the data and get the information you need most.

Business Intelligence

We built our comprehensive BI tools and data sets specifically for solving government agencies’ biggest challenges in health care. Our analytics services include leading-edge predictive analytics, sophisticated algorithm methodologies, unsupervised learning, social network analysis and advanced data mining and query capabilities to help provide insight and identify opportunities to solve agency and state challenges. Agencies can apply this insight to improve program integrity, decision support, programs for beneficiaries, policy decision-making and more.

Health Management and Population Analytics

Our multidimensional, episode-based predictive modeling and program management analytics solutions are designed to help states utilize health risk analytics to monitor quality, reward improvements in care, and control spending. Based on evidence based-methodologies, our analytics provide program managers the information necessary to initiate actionable changes to program policies, improve care management programs and reduce future program expenditures.

Program Integrity Analytics

Our end-to-end services help governments detect, investigate, stop, or recover inappropriate, erroneous and fraudulent payments. We offer a comprehensive program integrity solutions suite that provides advanced detection analytics designed exclusively for Medicaid as well as robust prospective and retrospective solutions that provide proven and measurable savings.

Management and Reporting Services

Think of our solutions as a centralized and comprehensive information hub and management portal for Medicaid programs. You'll have ready access to a CMS-certified financial reporting and analytics component, as well as insight into Medicare program rules and regulations.

Data Visualization Services

Uncover the “needles in the haystack” by capturing actionable information in a clear and comprehensive picture of program performance. Drawing from the data warehouse environment, visualization permits direct exploration and analysis of variables to reveal opportunities to improve quality of and access to care as well as overall health care cost drivers.

Consulting Services

Our consultants and business analysts can help bring clarity to vast amounts of data. Years of sector experience gives them the unique insights needed to help government organizations make significant improvements in program effectiveness and efficiencies.

Data Warehousing and Business Intelligence Solutions

Optum™ leads the way in Business Intelligence (BI) Solutions serving government Health and Human Services (HHS) agencies. Our solutions help effectively manage programs and services that cover one of every four Medicaid recipients — approximately 20 million people.

States that use Optum Business Intelligence Solutions account for more than one of every three dollars spent on Medicaid ― approximately $140 billion annually. Our HHS clients have documented more than $3 billion in Medicaid/HHS benefits using our solutions.

We help HHS agencies get the insight they need to deliver tangible benefits to program beneficiaries, state legislatures, and taxpayers while addressing today’s pressures, problems, and emerging trends, including:

  • Health care reform compliance
  • Population health programs, payment modernization, and delivery system improvement programs
  • Performance-based demonstrations and programs
  • Provider and network quality measurement and programs
  • Budgetary deficits and improved program effectiveness
  • Foster care management
  • Program integrity improvement and mandates
  • Long-term care management
  • Improved primary care management