AI operating system for quality, risk, and care operations at health plans, ACOs, IPAs, and risk-bearing medical groups with a shared canonical member record.
Pelica provides an AI workforce platform for value-based care organizations that unifies claims, EHR, pharmacy, labs, ADT, and telephony data into one canonical member record serving all teams simultaneously. Specialized AI copilots handle risk adjustment (HCC capture, RADV-defensible), quality and Stars gap closure, pharmacy and Part D adherence, provider network coordination, and care management, all reading from and writing to the same shared record so captured HCCs inform network agendas and pharmacy gaps update Stars projections. The platform currently serves over 350,000 members and is HIPAA-compliant with tenant isolation, end-to-end encryption, and an annual independent audit cadence. Pelica is a product of Pelica.