The work used to take all week. Now it takes minutes.
HealthCare Partners is the largest IPA in the country: roughly 1,000 providers and 200,000 lives across New York City and Long Island. Its quality, pharmacy, nursing, and risk teams ran on spreadsheets stitched together by hand. Then they put all of it on one system, and went live in two weeks.
8 hours of weekly assignment work, down to 15 minutes. Live in two weeks.
The quality, pharmacy, nursing, and risk leaders at HealthCare Partners, in their own words.
- Lives managed
- 200,000+
- Providers
- ~1,000
- Region
- NYC & Long Island
- Teams on Pelica
- Quality, Pharmacy, Nursing, Risk
The data came from everywhere. Putting it together ate the week.
Every health plan sent its own member opportunity reports, on its own cadence, in its own format. Before anyone could pick up the phone, someone had to stitch them together by hand.
At HealthCare Partners, that someone was often a director. Spreadsheets were combined column by column, copied and pasted between portals and databases, filtered, then reassigned across the team one member at a time. It worked at low volume. It did not scale, and every hour spent wrangling data was an hour not spent with a member or a provider.
“You get Excels coming from left, right, and center on different cadences, some regular, some irregular, different columns, different values. Taking all of that and turning it into something actionable and usable is really difficult.”
One record. The AI does the work. The team does the care.
Pelica took the same messy files HealthCare Partners already had and turned them into one live record, then put an AI workforce next to every team that depends on it.
- About 8 hours of weekly assignment, stitched together by hand
- Notes written up after every call
- One long, flat spreadsheet of members
- Each team working from its own copy of the data
- 15 minutes, prioritized automatically
- Notes filed in about 10 seconds
- A ranked work list, member by member
- Quality, pharmacy, nursing, and risk on one record
Every source, one member.
The weekly payer reports load straight in. Medical, lab, and pharmacy claims, the full outreach history, and call notes come together into one cohesive picture of each member and provider, available to every team at once.
The AI decides who to reach.
Pelica scores the work and assigns it member by member: who to call today, who can wait. When new reports arrive, they rebalance into the existing assignments automatically. No more hand-built call lists.
More than a dashboard.
The team works a prioritized list with each member’s whole history in front of them before the call connects, and the AI writes and files the note in seconds. Questions that used to span several calls now close in one.
Hours given back. Every number here is one they said on camera.
“We’ve seen real lift on adherence and quality: half a percent to one and a half percent across our contracts, year over year. And we’re only halfway through the year.”Alex Wiggall · SVP, Quality & Clinical Revenue Integrity
The team behind the numbers.
I’m no longer behind a computer running power queries for hours every week. With Pelica, the sky has been the limit. It’s reinvigorated my passion for value-based care and quality.
My favorite feature is the AI call recording. My team used to take notes during every call. Now they can be fully present with the member, and the AI writes the perfect note for them.
Now we can see the whole picture for the patient. We’re catching illness early, so we can be preventative instead of reactive.
The biggest opportunity is to put the data that matters most directly in the provider’s hands, and to capture conditions concurrently, at the point of care, not months later.
A few questions, answered.
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Pelica felt like an extension of our team. You don't just get software, you get partners.
Alex Wiggall
SVP, Quality & Clinical Revenue Integrity · HealthCare Partners
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