For Payers
Decrease Utilization and Lower PMPM Costs
With verified adherence data, plans gain visibility into member behavior — enabling earlier, more efficient interventions that support STAR performance and reduce total cost of care.
Cost savings
Cost savings
Aspire Health Plan Results with Congestive Heart Failure 80% Hospitalization Reductions and 67% Payer Cost Savings
Data from real-world pilots show consistent improvements: up to 25% increase in verified adherence, reduced hospitalizations in polypharmacy patients, and documented cost savings for payers.
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Value for Payers
Measurable Impact on Your Bottom Line
HiDO delivers verified medication adherence data that directly impacts quality metrics, reduces medical costs, and improves member outcomes. Our platform integrates seamlessly with your existing systems to provide real-time insights into high-risk populations.
STAR Rating Improvement
PMPM Cost Reduction
MLR Optimization
Risk Adjustment Support
HEDIS Measure Support
Part D Adherence (PDC)
Readmission Reduction
Claims Data Integration
Payer Solutions
Comprehensive Solutions for Health Plans of All Sizes
Quality Metrics & STAR Performance
Real-time adherence data impacts CMS STAR measures for diabetes, hypertension, and cholesterol medications. Verified PDC tracking and automated reporting demonstrate true member compliance, not just prescription fills.
High-Risk Population Management
Real-time alerts flag non-adherence for CHF, COPD, and diabetes patients, enabling early intervention. Prevent costly hospitalizations and reduce top 5% member costs by 30-50%.
Seamless Data Integration & Compliance
HIPAA-compliant platform integrates with claims systems, care platforms, and EHRs via secure APIs or HL7/FHIR. Receive standardized reports and real-time alerts with verifiable outcomes data meeting CMS audit standards.
Scalable Solutions
From Regional Plans to National Payers
Medicare Advantage Plans:Optimize STAR ratings with verified adherence data for Part D medications. Target high-risk seniors with chronic conditions to reduce hospitalizations and improve member satisfaction scores.
Commercial & Medicaid Plans:Reduce medical loss ratios through early intervention programs. Scale from pilot programs with 100 members to enterprise deployments across entire networks. Flexible pricing models accommodate plans of all sizes.
Value-Based Care Programs:Support ACO, bundled payment, and shared savings models with objective adherence outcomes. Demonstrate ROI with documented cost savings averaging $3,000-$8,000 PMPM for high-risk members.
Proven ROI
67%
Average payer cost savings in CHF population
80%
Reduction in hospitalizations for monitored members
25%
Increase in verified medication adherence rates
$5,400
Average PMPM savings for high-risk chronic disease patients
Schedule a Meeting
Partner with HiDO to Transform Member Outcomes
Schedule a consultation to discuss how verified adherence data can improve your quality metrics, reduce costs, and support value-based care initiatives.