Payers (Health Plans, Medicare Advantage, Commercial Insurers)

Clinical Enablement for Payers & Health Plans

PharmD Live® supports payers with clinical operations—CCM, RPM, TCM, medication programs, risk capture—to manage membership, reduce cost, and improve quality.

Care Management Built for Payers and Health Plans

Health Plans · Medicare Advantage · Commercial Insurers · Managed Medicaid

PharmD Live® supports payers with clinical operations—CCM, RPM, TCM, medication programs, risk capture—to manage membership, reduce cost, and improve quality.

Clinical Enablement for Payers & Health Plans

Payers need to manage risk, control cost, and deliver quality to stakeholders. We become your clinical care management arm, delivering member-centric programs across their network. We support risk stratification, clinical oversight, care coordination, and medication expertise so you meet your value-based goals.

Challenges with Data / Stat

Payers lose revenue and face high medical loss ratio due to avoidable hospitalizations.

Medication nonadherence alone accounts for $100–300B in avoidable costs annually.

Solutions Offered

VBC Complete™™ (payers coupling with provider networks)

Chronic Care Management (CCM) + RPM

Transitions of Care Management (TCM)

HCC Risk Capture & Documentation

Medication Optimization / MTM

Quality Measures We Improve

Why Payers Partner with Us

We provide a turnkey clinical operations engine across provider networks. With our pharmacist-led care, analytics, and coordinated execution, payers can reduce MLR, improve member outcomes, and elevate plan competitiveness.