Protecting taxpayer dollars

The Government spends more than $1 trillion on healthcare every year through large programs such as Medicare, Medicaid, TRICARE, and through the Department of Veterans Affairs.

Ensuring those dollars aren’t wasted — or misused due to fraud or abuse — is an ongoing challenge.

For more than 20 years, Optum Serve has partnered with the Centers for Medicare and Medicaid Services (CMS) and other federal agencies to establish and maintain program integrity initiatives. Building on successes achieved working with commercial and state government clients, we deliver a deep knowledge of the health care industry and extensive IT capabilities to government agencies. We invest in innovation and development resources to ensure our commercial best practices align with the federal program integrity objectives while allowing for flexibility and scalability in program design based on clients’ needs. The following three case study briefs explain how Optum Serve makes a difference in mitigating and recovering money by detecting fraud, waste and abuse (FWA).