Payers & Health Plans
Care Management Built for Payers and Health Plans
Clinical Enablement for Health Plans, Medicare Advantage, Commercial, and Managed Medicaid
PharmD Live® delivers clinical operations, risk stratification, care coordination, medication expertise, and risk capture across provider networks—helping plans reduce cost and improve quality.
Network Performance
$100–300Bin avoidable annual costs are associated with medication nonadherence.
High MLRis driven by avoidable hospitalization and inconsistent clinical execution.
Turn Population Data Into Coordinated Clinical Action
Payers need to manage risk, control cost, and deliver quality at scale. We become the clinical care management arm across the network—supporting member engagement, provider execution, medication optimization, and value-based program alignment.
Activate the right intervention at the right point in the member journey.
Why PharmD Live®
Why Payers Partner With Us
Our turnkey clinical operations engine combines pharmacist-led care, analytics, and coordinated execution to reduce medical loss ratio, improve member outcomes, and strengthen plan competitiveness.
Build a Payer Strategy With Us
Quality Dashboard
Measures We Help Improve Across the Network
UtilizationStar Ratings — adherence and readmissions
Quality PerformanceHEDIS chronic-condition and preventive-care measures
UtilizationInpatient, emergency, and readmission utilization
Experience & AccessCAHPS and member satisfaction
Risk PerformanceRisk adjustment and RAF accuracy
From Strategy to Execution
Build a Payer Strategy With Us Build a clinical operating model that performs across your organization.
Align care management, medication expertise, quality improvement, and documentation around measurable outcomes.