Payer Solutions

Bridge the Gap Between
Plans and Providers

Connect your health plan's data to the clinical reality of what's happening at the point of care. Improve HEDIS scores, Stars ratings, and member outcomes.

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Core Capabilities

Turn provider data into
plan performance

Veradigm connects health plans with one of the largest ambulatory EHR networks in the country — giving you the clinical data you need.

Member Data Interoperability

Real-time bidirectional data exchange between your plan and the provider practices treating your members — via HL7 FHIR and direct EHR integration.

HEDIS Analytics

Automate HEDIS measure data collection across your provider network. Identify numerator-ready members and close gaps before year-end.

Stars Ratings Optimization

Identify the highest-leverage opportunities to move your Medicare Advantage Stars rating. Prioritize interventions that move the needle fastest.

Prior Authorization Automation

Streamline PA workflows between your plan and network providers. Reduce friction, speed approvals, and improve member and provider satisfaction.

Network Gap Analysis

Identify care gap patterns across your provider network. Understand which practices are closing gaps — and which ones need support.

Value-Based Care Reporting

Generate comprehensive reports on total cost of care, quality performance, and utilization trends to support VBC contract negotiations.

Bridge the Gap BetweenPlans and Providers

Turn provider data intoplan performance

Ready to see whatVeradigm can do?

Bridge the Gap Between
Plans and Providers

Turn provider data into
plan performance

Ready to see what
Veradigm can do?