Case Study: Large Midwest Medical Center secures $934M in Medicaid coverage and streamlines eligibility with Optum Eligibility and Enrollment Services

Streamline Medicaid eligibility and enrollment for increased patient satisfaction

Large Medical Center, a 664‑bed Midwest hospital serving underserved patients, faced rising uninsured volumes, long A/R days and limited internal capacity to manage recurring eligibility and compliance changes. To streamline Medicaid eligibility and enrollment and refocus staff on patient care, the organization engaged Optum and implemented Optum Eligibility and Enrollment Services®.

Optum deployed onsite eligibility and enrollment teams working alongside hospital staff to proactively identify and enroll patients in Medicaid, educate patients on financial responsibility, and optimize complex claims. Over a 10‑year partnership Optum helped secure acceptance of more than 25,000 accounts (representing 15,000+ patients), approved over $934 million in gross charges and delivered a 96% approval rate—reducing uncompensated care and bad debt while improving patient satisfaction and staff capacity.