Optum executives spoke with Becker’s throughout 2025 about how the company is applying AI and data analytics to address inefficiencies across the healthcare system, from claims processing delays and operating room bottlenecks to pharmacy operations and value-based care delivery.
What five Optum execs told us this year:
1. Puneet Maheshwari, senior vice president and general manager for Optum Real, outlined the need for real-time claims infrastructure in healthcare in an op-ed, comparing the industry’s current state to contract signing before DocuSign. He argued that advances in generative AI and large language models now make it possible to analyze thousands of payer contracts and deliver instant decisions on coverage, prior authorization and patient responsibility, a shift he said could reduce the 12% of claims currently rejected due to administrative errors and move the industry “from denial management to denial elimination.”
2. John Kontor, MD, senior vice president of clinical technologies at Optum, discussed hospital operating room inefficiencies and how predictive analytics can help address them. Dr. Kontor described Optum’s Crimson AI platform as a tool that integrates EHR, scheduling and supply chain data to forecast demand and reduce bottlenecks, sharing that early adopters are seeing surgeries scheduled about seven days faster and a 7% improvement in OR case volume, while one New York health system reduced operative supply spending by 16% after identifying frequently wasted materials.
3. Jennifer McGonigle, senior vice president of enterprise capabilities at Optum Rx, discussed how the company is using AI to improve pharmacy operations and patient care. She described several initiatives, including an AI pill validation model that uses image recognition to maintain a 99.998% accuracy rate in home-delivery pharmacies and a demand planning system that has reduced out-of-stock incidents by 85% year over year by predicting drug shortages before they occur. McGonigle said predictive models have also prevented or streamlined more than 4 million customer service calls in 2025.
4. Ken Cohen, MD, Executive Director of Translational Research at Optum Health, discussed the impact of value-based care models on patient outcomes on the Becker’s Healthcare podcast. He shared key findings from his recent research, including how Medicare Advantage patients in value-based arrangements can receive better care and how those benefits can extend to traditional Medicare patients.
5. “Providers are wasting massive amounts of time and resources trying to get paid for care they’ve already delivered. Average payment cycles stretch to 51 days — that’s nearly two months of resources tied up in administrative tasks instead of patient care. Providers should be caring for patients, not navigating thousands of policies and contracts. Facilitating real-time interoperability between payers and providers will make this possible and help the health system work better for everyone,” Erin Satterwhite, CEO of Provider Market for Optum Insight, told Becker’s.
