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HealthTeam Advantage Partners with nirvanaHealth to Implement the First Integrated Payer & PBM Platform Ever Built to Automate Entire Payer and PBM Operations

nirvanaHealth (formerly RxAdvance) and HealthTeam Advantage (“HTA”) announce their partnership, with HTA embracing both nirvanaHealth’s Medicare Advantage and PBM complete enterprise solution. These solutions run on Aria, nirvanaHealth’s integrated Payer & PBM robotic process automation (RPA) cloud-native platform. Based in Greensboro, NC, HTA is a Medicare plan with a five-star rating offers Medicare Advantage plans to eligible Medicare beneficiaries and is expected to go live with nirvanaHealth for this Fall’s annual enrollment period (AEP). HTA will be migrating onto the Aria platform and will also use nirvanaHealth for both PBM and Payer business services.

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“HTA will be the first Payer in the country to have integrated Payer and PBM”

Both nirvanaHealth’s Medicare Advantage and PBM complete enterprise solutions include its Aria platform, which runs on AWS and leverages RPA, machine learning (ML), and artificial intelligence (AI). Aria is the first integrated Payer & PBM platform. nirvanaHealth’s Aria platform will be the backbone of all Payer and PBM operations for HTA, helping to recognize significant savings and enhance plan improvements for their members. Aria delivers a Patient 360° view to every care provider in the care continuum, including point-of-sale and point-of-care. “We have never seen anything like Aria. With this revolutionary platform, we can recognize significant SG&A cost savings that will then enable more premium dollars to be used for the overall healthcare needs of our members,” says Brendan Hodges, President & CEO of HTA. “We’re excited to bring quality care improvements and a delightful experience to our members.”

Aria deploys a digital workforce to automate and manage all health plan and PBM operations—including sales, marketing, claims adjudication, administrative, financial, clinical, medical, utilization, care management, quality rating, and risk contracting & management functions—with built-in compliance. Plans can then allocate their human capital to more high-touch value activities, such as member healthcare experience, social determinants of health, wellness regimens, and care management functions. “Even these needed high-touch operations are made more intelligent through artificial intelligence (AI) and machine learning (ML),” says Ravi Ika, CEO and Founder of nirvanaHealth.

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nirvanaHealth’s Medicare Advantage solution includes Payer business services, which leverages Aria to simplify Medicare Advantage operations end-to-end for any health plan in a compliant way. “MA plans like HTA can manage at low SG&A costs when fully implemented. Aria eliminates the need to utilize multiple vendors and platforms, increasing operational efficiency,” adds Ika. “By using the Aria platform, Medicare Advantage plans can creatively distribute and manage risk with partners, such as IPAs and MSOs. Additionally, Aria can help improve quality ratings by sharing actionable intelligence directly into care provider workflows. This includes gaps in care, continuity of care, and accurate risk-adjustment,” says John Sculley, Chairman of nirvanaHealth and former CEO of Apple.

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Similarly, nirvanaHealth’s PBM complete enterprise solution includes full-service PBM services on top of the Aria PBM platform capabilities. HTA will go live on the Aria platform with nirvanaHealth as its full-service PBM with competitive 100% pass-through network and rebate contracts. This solution reimagines the pharmacy benefit management ecosystem to reduce overall pharmacy costs, converts specialty drug management from buy and bill to value-based & outcome-driven, and integrates pharmacy care management to eliminate avoidable medical costs. “HTA will be the first Payer in the country to have integrated Payer and PBM,” concludes Ika. “We are excited to partner with HTA and demonstrate how one platform is all you need to manage Payer and PBM.”

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