Solutions
Electronic Health Records Practice Management Revenue Cycle Management Population Health Payer Solutions Life Sciences Enterprise ERP
Our Clients
Independent Practices Medical Specialties Hospitals & Health Systems Payers Life Sciences
Insights
Market Themes Resources Thought Leadership
Company
Who We Are Newsroom Join Us Contact Us
Request a Demo
For Health Plans & Payers

Connect Your Plan to
the Care Members Receive

Veradigm bridges the data gap between health plans and the 700K+ clinicians in our network — giving you the clinical insight you need to improve member outcomes.

Solutions for Payers

Clinical data that makes
your plan perform

Stop relying on lagging claims data. Veradigm gives you real-time clinical data from the EHR — where care actually happens.

Provider Network Data Exchange
Real-time clinical data from 700K+ clinicians via direct EHR integration. Know what's happening with your members before the claims come in.
HEDIS Measure Analytics
Automate HEDIS data collection across your provider network. Identify numerator-ready members and close gaps before year-end.
Stars Ratings Optimization
Identify your highest-leverage opportunities to improve Medicare Advantage Stars ratings. Prioritize interventions for maximum impact.
Prior Authorization Automation
Reduce PA friction between your plan and providers. Faster approvals, fewer disputes, happier members and providers.
Care Gap Closure
Work with providers to close care gaps for your highest-risk members. Our tools make it easy for practices to surface and act on your gap closure requests.
Value-Based Care Analytics
Track total cost of care, quality performance, and utilization trends across your VBC contracts. Make better decisions on contract design.
300M+
Patient records accessible
60+
Health plans served
85%
Clients improved Stars ratings
40B+
Clinical data points accessible
Get Started

Ready to see what
Veradigm can do?

Join thousands using Veradigm to deliver smarter care.