Over 160 million Americans are served by Optum, yet many still don’t fully understand what it actually does—or why it matters.
Dr. Patrick Conway, newly appointed CEO of Optum and former head of CMS Innovation Center and Blue Cross NC, joins Steve for a wide-ranging discussion on the state of healthcare delivery, affordability, and the potential of value-based care at a national scale. With experience spanning the frontlines of medicine to top government and corporate leadership, Conway breaks down how Optum aims to improve care while controlling costs—and why he continues to practice as a pediatric hospitalist on weekends.
We cover:
💡 What Optum actually does—and how it operates across care delivery, pharmacy, and data
📉 How value-based care is being scaled, and why two-sided risk models matter
🧠 Using AI to reduce cycle times, drive affordability, and improve clinical decision-making
💊 What’s broken—and what’s working—in the U.S. pharmacy system
🧑⚕️ What leaders, policymakers, and physicians need to know to truly fix healthcare
🧵 How personal tragedy, frontline stories, and government service continue to shape Conway’s leadership today
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About our guests:
Patrick Conway, MD, MSc, was named chief executive officer of Optum Rx in August 2023. In this role he leads an integrated pharmacy care services organization that is making drugs more affordable and creating a better experience for consumers, filling more than 1.5 billion adjusted retail, mail and specialty drug prescriptions annually. He joined Optum in February 2020 and
previously served as the chief executive officer of Care Solutions, where he led a portfolio of care continuum businesses serving over 70 million people across acute and post-acute care, care in the home in-person and virtually, mental and behavioral care benefits and delivery, broad population and complex disease health management, specialty care and government health services.
Dr. Conway was president and chief executive officer of Blue Cross and Blue Shield of North Carolina from 2017-19. From 2011 to 2017, he served as Deputy Administrator for Innovation and Quality at the Centers for Medicare and Medicaid Services and as director of the Center for Medicare and Medicaid Innovation and the agency’s Chief Medical Officer. Before joining CMS, he oversaw clinical operations and quality improvement at Cincinnati Children’s Hospital Medical Center.
Dr. Conway is a practicing pediatric hospitalist. He was elected to the National Academy of Medicine in 2014, received the President’s Senior Executive Distinguished Service Award, and was a White House Fellow from 2007 to 2008. He earned his MD with high honors from Baylor College of Medicine, residency training at Boston Children’s Hospital, and Master of Science in clinical epidemiology from the University of Pennsylvania.
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🙏 Thanks to Flexpa for sponsoring this episode. Flexpa is refactoring healthcare. Connect to 300+ health plans through a single, secure integration to access patient-consented, identified claims data instantly.
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