Less pain, more recovery: Reframing the DME experience

For starters, we are expanding and strengthening our DME network. This direction isn’t just about adding more options — it’s about improving consistency, so the right equipment reaches injured workers more quickly.

According to Dean Myers, chief operating officer, “In this phase we’re focusing on layering the network. With wider network access, we can deliver better turnaround times and service to injured workers faster.”

For claims professionals and case managers, the difference means fewer escalations, clearer status visibility, and faster delivery. For injured workers, it means earlier access to the equipment that supports their recovery — without avoidable delays or rework. With an expanded network of quality DME providers, we can reduce friction and increase speed where it matters most.

Our next step will be to enable more digital paths from order to fulfillment — particularly by introducing a digital-first experience that health care providers can use to order equipment directly through their electronic medical record (EMR) system with integration and authorization pathways built into our VitalPoint portal.

As Myers explains, “These efforts are aimed at shortening the time it takes for orders to go through the intake and provisioning processes. The more we reduce manual touches and handoffs, the more consistently we can compress order-delivery cycle times and improve accuracy.”

Our client relationships will help guide this development. Alan Phillips, SVP, innovation and capability strategy, works closely with clients when designing new features and updating the innovation road map. In partnership with the Optum Client Experience team, his team listens carefully to find out where clients feel “pain” most acutely. These conversations help Optum develop applications and tools with the most positive impact.

As Phillips points out, “With the DME program, we’re working to develop integrated tools that will allow speedier transactions, and more transparency and visibility into order status. We’re continually working on providing better communication back to our clients and better experiences for injured workers.”

For Wolfe, the direction is clear: We need to provide the same type of ordering ease in the DME selection process that consumers have become accustomed to in other areas. “As we continue to enhance our DME program, we’re quickly moving towards not only integrating into the EMR workflow for provider-generated orders but also putting a digital ordering solution directly in front of claims professionals. Imagine a soon-to-be future where a claims professional can point, click, and fulfill DME in the same way we use online shopping tools today.”

Optum is also working to extend the same digital pathways to our internal teams and client stakeholders, so that each touchpoint can benefit from cleaner data and fewer emails, faxes, and phone calls.

Wolfe puts it this way, “We’re exploring how to leverage the technology end-to‑end … eliminating the need for emails and faxes and phone calls between parties and greatly accelerating the fulfillment process so that injured workers receive their equipment faster and claims professionals and our internal staff can benefit from increased efficiency.”

Tron Emptage, chief clinical officer, is quick to point out the reason behind this work: “We need to make it simpler, faster, and less cumbersome to get injured workers exactly what they need.” Optum is committed to this.

In a recent case, we worked with Lydia, who faced severe medical and functional challenges driven primarily by morbid obesity and advanced edema. These conditions caused chronic, debilitating swelling in her legs and placed her at high risk for worsening organ function, skin breakdown, recurrent infections, and even potential limb loss.

As a result, Lydia’s mobility was extremely limited; she relied mainly on short transfers and could not walk meaningful distances. Her mobility struggles had also contributed to anxiety, both for Lydia and her husband, her primary family caregiver.

Lydia’s DME challenges were complex. She needed a wheelchair that was well fitted, comfortable, durable, and could be loaded into her van. Understanding how essential the right wheelchair was to her physical and mental wellbeing, the Optum care team moved quickly to support her.  

Her primary care physician authorized a rare, comprehensive in-home care conference involving Lydia, her husband, her nurse case manager, a wheelchair vendor, and a senior physician on the Optum team. In this setting, the team listened closely as Lydia described her quality-of-life goals, mobility needs, and barriers. They also noted her responsiveness to receiving guidance in her home environment, which allowed the senior physician to offer weight loss strategies.

Together, the group found a new type of wheelchair and customized it to address safety, weight distribution, home access, transportation challenges, and Lydia’s emotional comfort. With this tailored solution, Lydia became more mobile and regained confidence. Feeling heard and included, she also agreed to try a medication that helped her lose almost 40 pounds.

As Robert Hall, medical director, explains “For Lydia, receiving the right DME in a timely manner not only improved her health and independence, it also boosted her dignity, sense of control, and hope for the future.”

At Optum Workers’ Comp and Auto No-Fault, we are making the DME order process faster, easier, and more effective for everyone involved. By expanding our network, building intuitive digital tools, and focusing relentlessly on the real people behind every order — people like Lydia — we’re reducing friction and restoring confidence in the recovery journey.

And as we continue to innovate, our commitment stays the same: less process pain, more healing, and more moments where injured workers feel supported, empowered, and able to move forward.