Optum
- Company typePrivate
- Founded1988
- HeadquartersSan Antonio, United States
- Headcount5,001–10,000
- GTM typeB2B and B2C
- OfferingServices
Optum firmographics
Firmographics- Name
- Optum
- Legal name
- Optum Inc.
- Website
- https://optumrx.com
- Company type
- Private
- Founded year
- 1988
- Operating status
- Operating
- Headcount range
- 5,001–10,000 employees
- Ownership category
- akta.pro rank
Optum industry classification
Industry- Product category
- Pharmacy Benefit Management
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health and Welfare Funds (525120)
- SIC
- Insurance Agents, Brokers & Service (6411), Wholesale-Drugs, Proprietaries & Druggists' Sundries (5122)
- akta.pro primary industry
- PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL)
- akta.pro secondary industries
- Formulary Management & Clinical Pharmacy Programs (HLAEAKAA), Pharmacy Benefit Analytics, Reporting & Employer Consulting (HLAEAKAK), Pharmacy Benefit Management (PBM) & Formulary Management IT (HLACAKAD), Pharmacy Benefit Management (PBM) & Pharmacy Network Administration (HLAFALAI)
Keywords
Where Optum is headquartered
LocationHeadquarters
- HQ city
- San Antonio
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Optum business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Personnel, Supply Chain, Operations, Technology or R&D, Infrastructure, Marketing or Sales
Revenue model
- Pharmacy Benefit Management (PBM): Optum Rx operates as one of the Big Three PBMs, managing prescription drug benefits for health plans, employers, and government programs. Revenue comes from formulary management, rebate administration, and pharmacy network management.
- Specialty Pharmacy Services: Specialty pharmacy services for complex therapies including cancer, autoimmune diseases, and inflammatory conditions with personalized patient care and clinical support.
- Weight Engage Program: GLP-1 care program providing clinically supervised prescribing and wraparound support services for weight management, partnering with employers and health plans.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Monthly | Low-cost insulin program |
| Subscription | Monthly | Home Delivery Pharmacy |
Go-to-market motion2 records
Distribution channels5 records
Marketing channels2 records
Optum product offering
Product offeringCore offering
Optum provides pharmacy benefit management (PBM) services through Optum Rx, administering prescription drug benefits, home delivery, specialty pharmacy, and infusion pharmacy for health plans, employers, and government programs. It complements these services with the HealthSafe ID authentication platform, the Optum Rx Mobile App, and the Optum.ai healthcare AI platform for clinical analytics and AI-enabled workflows. The company serves members across all 50 U.S. states and integrates pharmacy services with broader Optum health services capabilities.
Product overview
Optum is a health services company offering a comprehensive pharmacy ecosystem centered on Optum Rx, its pharmacy benefit management (PBM) platform. The core Optum Rx product provides prescription drug coverage, pharmacy network management, and medication pricing tools for members and employer clients. This core platform is augmented by complementary pharmacy services: Optum Specialty Pharmacy handles complex conditions (cancer, autoimmune diseases, multiple sclerosis), Optum Home Delivery Pharmacy offers mail-order prescription delivery, and Optum Infusion Pharmacy manages IV therapies. Supporting brands include divvyDOSE (pre-sorted medication packaging) and Genoa Healthcare (mental health pharmacy). The portfolio also includes the Weight Engage Program for GLP-1 weight management, Optum Payments Network for health benefits payments, and HealthSafe ID for secure member authentication across platforms.
Differentiator
Problem solved
Functional benefit
Brands
- Genoa Healthcare: Mental health and complex condition medication management services
- divvyDOSE
- Optum Labs
Products and services
- Optum Rx Pharmacy Benefit Management Pharmacy benefit management platform providing prescription drug coverage, home delivery pharmacy, pharmacy network management, drug pricing tools, and prior authorization support for health plans, employers, and individual members.
- Optum Specialty Pharmacy Specialty pharmacy service for complex conditions including cancer, Crohn's disease, ulcerative colitis, inflammatory arthritis, multiple sclerosis, and viral hepatitis, offering one-on-one clinical support, temperature-sensitive shipping, and virtual visits.
- Optum Home Delivery Pharmacy Mail-order prescription delivery service offering free standard shipping, 24/7 pharmacist access, automatic refill options, and temperature-controlled packaging for chronic condition medications.
- Optum Infusion Pharmacy Specialized pharmacy service for infusion therapies, enabling patients to manage IV treatments at home or through provider settings.
- divvyDOSE Medication management service that pre-sorts prescriptions by day and time and delivers them to patients' homes for improved adherence.
- Genoa Healthcare Pharmacy services for mental health and complex conditions, providing medication management and coordination for behavioral health patients.
- Frontier Therapies Rare disease medication management services helping patients access and manage treatments for uncommon medical conditions.
- Weight Engage Program GLP-1 weight loss drug program providing clinically supervised prescribing and wraparound support services for obesity treatment, delivered through partner organizations for employer and health plan populations.
- HealthSafe ID Identity verification and single sign-on system providing secure access to Optum health benefits information across multiple Optum platforms, with multi-step verification including member ID, social security number, and mobile phone verification.
- Optum Connections Virtual care platform offering scheduled virtual visits with care teams and video series featuring patients with similar conditions for education and support.
Quantifiable outcome
- $6,081 total cost of care savings per patient demonstrated through Oshi Health partnership with Optum Advisory
- +2 more outcomes
Companies that use Optum
Customer profileNamed customers1 record
Segments4 records
Ideal customer profiles5 records
Optum technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability3 records
Feature4 records
Optum partnerships and signals
Strategic signalPartnerships
Seven partnerships are on record, tiered core and minor.
- Omada HealthcoreOmada Health partnered with Optum Rx to participate in its Weight Engage program for GLP-1 care offerings. This partnership addresses growing demand for GLP-1 weight loss drugs amid spotty coverage and adherence challenges. The expansion gives Omada relationships with all three largest PBMs and supports the company's growth trajectory while addressing employer demand for comprehensive cardiometabolic care solutions.
- Eli Lilly (Employer Connect Program)coreOmada Health announced partnerships with Eli Lilly's Employer Connect program and Optum Rx's Weight Engage program for GLP-1 care offerings, expanding access to weight management treatments.
- CalibrateminorExisting partner in the Weight Engage program alongside Omada Health, providing clinically supervised prescribing and wraparound support services for GLP-1 weight management.
- Virta HealthminorExisting partner in the Weight Engage program alongside Omada Health, providing clinically supervised prescribing and wraparound support services for GLP-1 weight management.
- CDE SolutionscoreStrategic alliance with Optum Payments Network to expand S3 Health Benefits payment acceptance across a broader network of retail merchants nationwide. The collaboration combines CDE's merchant onboarding and payment processing capabilities with Optum's healthcare and benefits infrastructure to enable more retailers to accept S3 Health Benefits payments for eligible food and approved over-the-counter health products, helping Medicare Advantage members use their monthly S3 Health Benefits allowances.
- ANSRcoreANSR partnered with Optum to launch the Healthcare GCC Accelerator Platform powered by advanced AI capabilities. The platform combines ANSR's end-to-end GCC execution model with Optum's healthcare AI technology through Optum.ai, designed to help healthcare enterprises build and scale AI-enabled capability centers. ANSR claims purpose-built AI platforms can drive 20-25% efficiency gains initially and up to 50-60% as capabilities mature, including 35+ automated workflows and a pipeline of 50-75 new AI use cases annually.
- Oshi HealthcoreOshi Health, a virtual multidisciplinary GI clinic, partnered with Optum Advisory to conduct intervention vs. control analysis demonstrating $6,081 in total cost of care savings per patient and 5.9x return on investment. This partnership enabled Oshi Health to secure and outperform value-based contracts with commercial health plans.
Scale indicators5 records
Recent moves5 records
Expansion highlights5 records
Optum competitors and assessment
Company assessmentMarket position
Competitive moat6 records
Key risks4 records
Key highlights7 records
Customer concentration
Optum social profiles
Digital presenceOptum compliance and trust
Trust signalCompliance7 records
Optum financial estimates
Financial estimateRevenue estimate
Valuation estimate
Optum leadership team
Management profileNumber of profiles
Profiles3 records
Optum subsidiaries and ownership
Company hierarchySubsidiaries5 records
Optum funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Optum M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Optum
What does Optum do?
Optum provides pharmacy benefit management (PBM) services through Optum Rx, administering prescription drug benefits, home delivery, specialty pharmacy, and infusion pharmacy for health plans, employers, and government programs. It complements these services with the HealthSafe ID authentication platform, the Optum Rx Mobile App, and the Optum.ai healthcare AI platform for clinical analytics and AI-enabled workflows. The company serves members across all 50 U.S. states and integrates pharmacy services with broader Optum health services capabilities.
Is Optum a public or private company?
Optum is a private company. It is classified as corporate owned and is currently operating.
When was Optum founded?
Optum was founded in 1988. It employs 5,001 to 10,000 people.
Where is Optum based?
Optum is headquartered in San Antonio, United States, in the North America region.
How does Optum make money?
Three revenue lines are on record. Pharmacy Benefit Management (PBM) is the primary driver. The others are specialty Pharmacy Services and weight Engage Program.
Does Optum have an API?
No public API is recorded for Optum.
What industry is Optum in?
Optum's product category is Pharmacy Benefit Management. Its primary akta.pro industry code is HLAEAKAL, PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools), with a secondary code of HLAEAKAA, Formulary Management & Clinical Pharmacy Programs. Its NAICS code is 524292 and its SIC code is 6411.