In a fragmented healthcare system, it can be hard to exchange information efficiently

As a health plan, you’ve built up tremendous expertise in healthcare management. Your data gives you a unique opportunity to improve members’ health. But when providers and care managers don’t have up-to-date patient insights, expenses balloon—and the member experience suffers. 

Communication gaps hinder care management.

It can be hard to connect with providers promptly and securely with medication updates or member care concerns. And the data your own care management teams need is often delayed. 

Only 17% of physicians can easily find medication adherence data electronically.1
62% of patients say privacy protections are more important than easier access to their health data.2

Clinicians prescribe without seeing the full picture.

When your members’ prescription benefit plan details aren’t easy to find, prescribers make medication decisions without a clear view of patient costs and coverage. 

Cost has deterred 53% of patients from taking a medication.3
Moving to electronic prior authorization could save health plans $99 million a year in labor costs.4

Enable fully informed, cost-effective care decisions

  • Intelligent Prescribing
  • Clinical Interoperability
  • Benefits & Authorizations
  • Care Team Evolution
  • Value-Based Care
  • Specialty Medications

Intelligent Prescribing

Lay the groundwork for safe prescriptions that align with your members’ benefit plans by sharing coverage information with clinicians. 

Clinical Interoperability

Inform treatment and transitions of care by giving clinicians and your own care managers more patient insights and better communication channels.

Benefits & Authorizations

Share prescription benefit intelligence throughout the care journey, making it easy to choose the best medication option and swiftly handle (or avoid unnecessary) prior authorizations.

Care Team Evolution

As care delivery evolves, help your members receive exceptional care wherever they seek it with more clinical and cost information in practitioner workflows.

Value-Based Care

Help pinpoint opportunities to improve adherence, avoid unnecessary costs and close gaps in care with a sharper view of your members’ medication history, care activity and benefits.

Specialty Medications

Help ensure healthcare professionals have the trusted intelligence they need to get specialty medications to your members quickly, with less paperwork and lower costs.

Success Stories

Real-world results

“The availability of member-specific drug cost information in the EHR points to a truly advanced prescribing experience that is helping to make medicines more accessible and affordable for consumers.”

Dr. Troyen Brennan Former Chief Medical Officer, CVS Caremark/Aetna

“Payers need to be able to look at populations taken care of by providers to see what we are getting for our money.”

Don Rucker, MD Former National Coordinator for Health Information Technology, U.S. Department of Health & Human Services
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Power care management & more with a QHIN™ connection

Enhance your care management, risk adjustment, utilization control and population health programs. As a QHIN candidate, Surescripts Health Information Network is preparing to help you access more data through TEFCASM with Interconnect.

Why Surescripts

One powerful connection to the point of care

trusted health nationwide reach

A trusted network with nationwide reach

Surescripts processes 23.8 billion health data transactions per year.5

one channel

One channel to reach nearly every prescriber

Surescripts connects 2.14 million healthcare professionals and organizations.5

collaborating change through healthcare

Collaborating to drive change through healthcare

Surescripts works closely with organizations such as AHIP and NCPDP to advance innovation. 


Keep pace with healthcare innovation

  1. Surescripts, “Data Brief: Physician Perspectives on Access to Patient Data,” April 2018, p. 1.
  2. Morning Consult and America’s Health Insurance Plans, “Price Transparency Polling Presentation,” January 2020, p. 3.
  3. Surescripts, “Prescription Price Transparency and the Patient Experience,” February 2020, p. 2.
  4. CAQH, “2019 CAQH INDEX: Conducting Electronic Business Transactions: Why Greater Harmonization Across the Industry Is Needed,” 2020, p. 17.
  5. Surescripts, “2023 National Progress Report,” March 2024.
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