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Surescripts
reduction in nonadherence false positives with Medication History for Populations1
reduction in 90-day follow-up calls with Medication History for Populations2
healthcare professionals and organizations using Clinical Direct Messaging to coordinate care in 20253
Inform and accelerate decisions to keep member care on track
As value‑based care raises the stakes on quality, cost and outcomes, health plans need to identify risk earlier and act with confidence. When insight into medication access and care activity arrives too late, teams struggle to prioritize and intervene effectively—driving higher costs and poorer member experiences. Timely, workflow‑embedded intelligence enables earlier risk identification, smarter prioritization and faster action to keep member care on track.
Limited visibility at the point of decisions
Manual work & communication gaps slowing care management
Affordability & authorization friction driving abandonment & poorer outcomes
Earlier identification and intervention for at-risk members
Actionable insights embedded in existing workflows
Streamlined prior authorization & benefit coordination
Stronger medication adherence & improved Stars & HEDIS performance
Better care decisions, improved access to medication & lower costs
More time for care managers to act & less time spent chasing data
Enable fully informed, cost-effective care decisions
Turn data into action. Deliver timely, workflow‑activated member intelligence directly into the tools prescribers and care managers already use—so they can improve adherence, manage costs and close gaps in care across every stage of the member journey.
Boost quality ratings
Improve care management and risk stratification with a near-real-time view of your members’ care.
Coordinate with providers
Engage providers with timely insights about your members’ medications and gaps in care.
Improve payment integrity
Quickly determine payment responsibility and substantiate claims with clinical information.
Connect with our team to explore how we can partner to increase patient safety, reduce costs and ensure quality care.
Real-world results
One powerful connection to the point of care
Surescripts processes 30.5 billion health data transactions per year.5
Surescripts connects 2.32 million healthcare professionals and organizations.6
Surescripts works closely with organizations such as AHIP and NCPDP to advance innovation.
Keep pace with healthcare innovation
Find out more about how we help health plans
How does Surescripts help health plans reduce prescription abandonment?
By enabling real-time benefit information and more efficient prior authorization workflows, Surescripts solutions help prevent cost surprises and long delays, which can lead to prescription abandonment. Health plans can also receive prescription notifications for potential issues such as running out of refills or an abandoned prescription, enabling timely interventions.
What interoperability capabilities are available for health plans?
Surescripts connects 2.32 million healthcare professionals and provider organizations, bringing a comprehensive and connected view of care when and where it’s needed most. Health plans can use Surescripts solutions to give clinicians and their own care managers more patient insights and better communication channels.
How does Surescripts support value-based care initiatives for health plans?
Surescripts helps health plans advance value-based care by improving visibility into medications, coverage and care activity. Products such as Clinical Direct Messaging, Medication History for Populations and Real-Time Prescription Benefit help deliver timely insights that support adherence, reduce avoidable costs and close gaps in care across provider networks.
How does Surescripts approach security and compliance for health plans?
The Surescripts network adheres to standards set by leading privacy and security organizations, including the gold standard of cybersecurity: the NIST Cybersecurity Framework. We hold a HITRUST r2 Certification as well as certifications from the Electronic Healthcare Network Accreditation Commission (EHNAC) and DirectTrust.
- Surescripts, “Case study: How Aledade improved quality scores and star ratings,” 2025.
- Surescripts, “Case Study: How Medication History Helps Parkland Health & Hospital System Avoid Readmissions and Pinpoint Nonadherence,” January 2021.
- Surescripts, “2025 Annual Impact Report,” p. 22.
- Surescripts, “2025 Annual Impact Report,” p.6.
- Surescripts, “2025 Annual Impact Report,” p.6.