Market Segments - Certilytics Market Segments - Certilytics
Health Plans and PBMs

Certilytics has years of experience working with health plans and PBMs to cleanse and standardize data, optimize population health management programs, bolster risk forecasting, and support new pricing strategies.

Examples of specific deployments include:

  • Clinical engagement: A national insurer uses Certilytics’ Aspects Suite toolkit to power its in-house clinical engagement solution, prioritizing day-to-day nurse outreach and care management. Actuaries and underwriters leverage the included BrainstormTM AI to create precise upside/downside pricing strategies. Analysts and managers use Aspects Forecasts, Aspects Reports, and Aspects Dashboards to track opportunity, performance, and utilization at a strategic level—guiding spend decisions and measuring against performance guarantees.
  • Clinical episode grouping: A major PBM replaced its legacy clinical episode grouper with Certilytics’ CORE next-gen grouping technology. This deployment demonstrated CORE’s unique capabilities and lowered costs by seamlessly integrating with the PBM’s in-house reporting tools. This customer is also using Aspects Forecasts behind-the-scenes for a number of its internal risk stratification products.
Provider Health Systems

Certilytics empowers provider health systems with tools that optimize their clinical engagement and pharmacy services and provide greater precision in forecasting risk and negotiating contracts.

Our Healthcare Predictive Data Analytics Platform unifies provider data into a single platform, providing critical intelligence for hospital executives, IT and finance departments, physicians, pharmacists, and nurses.

Self-Funded Employers

The Aspects Suite toolkit is uniquely positioned to serve ASO plans by providing views for both insurers and employers to mutually track progress on shared targets for cost savings.

With simple visualizations and support for SSO and embedded application views, it’s easy to integrate Aspects Suite into existing offerings instead of another standalone dashboard.

Government Programs

Certilytics equips state Medicaid programs with innovative population health management predictive analytics — in a fiscally sustainable manner.

The Certilytics “as a service” deployment model reduces deployment hurdles and lowers CapEx. In addition, our products come at a lower price point than homegrown or legacy solutions.