SOUTHBOROUGH, Mass.–(BUSINESS WIRE)–nirvanaHealth, the first to deploy an integrated Payer and PBM platform across all departments, announces the launch of its digital Transaction-as-a-Service (TaaS) solution on AWS designed for health plans and PBMs to substantially reduce operating costs with a digital workforce. Powered by nirvanaHealth’s cloud-native Aria platform, the TaaS model enables Payers and PBMs to offload all transactional functions across the fully-insured, ASO, and PBM administrative and care continuums to a fully automated digital workforce, significantly reducing operating costs while allowing human capital to focus on transaction exception handling. With Aria, Payers and PBMs can not only reduce current operating costs by over one-third, but also rapidly expand value-based care networks, new markets, and product innovation for all lines of business.
This digital workforce, operating in real-time on clean data and clear logic, continuously trains Aria’s agentic and transactional AI within the Aria closed ecosystem. Aria AI continuously learns and improves, delivering not just probabilistic outcomes but rather precise, deterministic outcomes.
Additionally, the Aria digital TaaS solution is designed for seamless adoption through a modular approach. If desired, Payers and PBMs can avoid multiple massive platform migrations and integrations, allowing them to build incremental confidence in the solution with rolling deployments tied to new business and renewal business. This minimizes disruption to existing operations while maintaining current business renewal cycles: every 1-2 years for the fully-insured business and every 3 years for both the ASO and PBM businesses. As a result, net total migration can be achieved incrementally within 1-3 years.
“Transaction-as-a-Service is exactly what the industry has been asking for. By shifting these transactional functions to a digital workforce, Aria empowers Payers and PBMs to drive product innovation, expand rapidly into new markets, expand value-based care networks, reduce friction between Payers, providers, and patients, and improve net income through modernization,” says Ravi Ika, President and CEO of nirvanaHealth.
nirvanaHealth’s TaaS solution arrives at a pivotal time in United States healthcare. In the Payer space, regulatory momentum, operating profit pressures, and rising stakeholder expectations are propelling Payers toward broader adoption of value-based care (VBC) across every line of business, from Commercial and ASO to Medicaid, Medicare, and ACA. However, implementing and scaling VBC remains challenging due to legacy infrastructure, disjoint point solutions, and lack of collaborative Payer and provider workflows.
In parallel, the PBM sector is experiencing its own transformation, where Payers and large ASOs are shifting away from traditional PBMs with rebates and spread pricing and towards the transparent, fixed-fee, and value-focused Pharmacy Benefit Administrator (PBA) model. In fact, nirvanaHealth has already proven the success of the PBA model at a national scale with one of top 5 employers, seeing year-over-year expansion and success. This deployment demonstrates not only Aria’s scalability but also validates the PBA model as a transparent, modern, and profitable alternative to traditional PBMs.
These new models demand platforms with low overall operating costs that minimize the dependency on human capital and are also capable of real-time actionable intelligence across the care continuum, deployment of a digital workforce-trained transactional and agentic AI for automated transaction processing, and strict regulatory compliance at scale. This Aria-powered TaaS solution addresses these needs directly, transforming operations while enabling organizations to adapt to the rapidly changing healthcare landscape.
For ASOs and Payers supporting ASOs, nirvanaHealth’s TaaS solution can help accelerate their path to value-based care and creative level-funding models. By leveraging Aria as a one-stop shop for both pharmacy and medical segments, ASOs can overcome the challenges of fragmented platforms and disjoint processes that have since hindered VBC adoption. By providing the infrastructure needed to launch, manage, and scale all types of risk arrangements (e.g. episodes of care, bundled payments, upside/downside risk, full-risk, and MSO models), Aria empowers ASOs and Payers supporting ASOs to not only operate at one-third of current operating costs but also helps future-proof for value-based care and other innovative level-funding models.
“Aria makes it possible for our clients to operate at a portion of today’s costs while positioning their organizations for long-term success in value-based care and beyond,” says John Sculley, Chairman of nirvanaHealth and Former CEO of Apple. “We believe this represents a fundamental shift in healthcare administration, benefiting Payers, PBMs, providers, employers, and most importantly, members.”
By offering a Transaction-as-a-Service solution through its Aria platform, nirvanaHealth is redefining how Payers and PBMs can operate, helping pave the way for a more transparent, efficient, and member-centric future with reduced friction between Payers, providers, and patients.
About nirvanaHealth
nirvanaHealth is an innovative Payer and pharmacy benefit manager (PBM) platform provider that leverages their robotic process automation (RPA) cloud platforms to manage integrated medical, pharmacy and behavioral services that reduce overall administrative, medical, and pharmacy costs and improve overall quality. nirvanaHealth offers the first one-stop shop, cloud-native Payer and PBM integrated platform in the industry. nirvanaHealth pioneers healthcare automation by uniquely combining deep healthcare domain expertise with proven platform-building experience to deploy RPA and agentic/transactional AI using cloud-native architecture across the Payer and PBM industries. Learn more at nirvanaHealth.com
Contacts
Chelsea Jang
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