Health Plan Solutions
Real-Time Intelligence for Health Plans
Connect plan teams to real-time intelligence at the moments that matter most, so care management, quality, and risk performance move together.
How We Support Health Plan Teams
Health plans are accountable for outcomes that happen in care settings they don’t own. Members move between hospitals, SNFs, and home. Risk concentrates in the handoffs. Claims data arrives weeks behind. PointClickCare connects plans to real-time intelligence across 2,800+ hospitals, 27,000+ post-acute providers, and 3,600+ clinics covering 100M+ lives, so teams can act in the moments that matter.
Top Health Plan Challenges
Members move between hospitals, SNFs, and home faster than claims data can keep up with them.
Readmissions compound in the days after discharge—the window when intervention has the greatest impact.
HEDIS and Star measures triggered at discharge require action in days, not weeks.
Care management touches a fraction of members. Quality and revenue are measured across the full population.
40%
Operating income at risk by a drop from 4.5 to 3.5 Stars
$1M+
Savings a year by preventing 1 readmission per week
Clinical Intelligence Built for Health Plans
Discharge Intel turns 20+ pages of ED and inpatient discharge documentation into AI-powered clinical summaries care teams can act on—with medications, diagnoses, follow-up needs, and barriers to care, delivered within 24 hours.
Expand Care Management Capabilities
Solutions Designed for Health Plans
Additional Solutions
Proven Impact for Health Plans
See more customer storiesCareOregon reduced readmissions by 50% in Year 1 and saved care managers 3+ hours daily on member identification.
L.A. Care achieved 70% time savings on case management outreach and 50% improved outcomes for transitions of care.
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CareOregon reduced readmissions by 50% in Year 1 and saved care managers 3+ hours daily on member identification.
View customer story
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L.A. Care achieved 70% time savings on case management outreach and 50% improved outcomes for transitions of care.
View customer story
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