From raw data to retained members — in four steps.
Carelytics connects to your existing systems, identifies members at risk, triggers targeted interventions, and tracks every outcome — automatically.
Connect your plan's data
Carelytics ingests claims, pharmacy, enrollment, and SDOH data from your existing systems. No rip-and-replace. Standard HL7 and flat-file feeds have you live in weeks, not months.
Carelytics scores every member for risk
Our custom-built model, trained on 150+ clinical, behavioral, and social features, flags members at risk of medication non-adherence, or HEDIS gap creation 60–90 days before they become a problem.
Automated, personalized outreach
The Intervention Engine routes the right action to the right channel - electronic refill requests via direct pharmacy connections, SMS reminders, care manager alerts, automated scheduling with providers through EHR connections, or live agent escalation — based on each member's risk profile.
Track outcomes & HEDIS performance
Real-time dashboards show open HEDIS gaps by measure, member, and provider. Track medication adherence rates, intervention ROI, and projected Star Rating impact — all in one place, updated continuously.
See Carelytics in action
Get a personalized demo tailored to your plan's quality, member engagement, and retention challenges.