Powerful capabilities.
Proven expertise.
Exponential possibilities.



We help you find success in a complex healthcare system.


When we join forces, the opportunities are limitless

Better outcomes. Cost of care. The pace of innovation. What keeps you up at night keeps us up too — but for different reasons. With perspective gained from serving more than one in three people in the U.S., we know that this is challenging work. It’s what we do.


Through our flexible approach and industry-leading data, capabilities, and digital tools, we help health plans, employers, providers, government agencies, and pharmacies make their critically important work easier and more successful.

Behavioral health

Bringing parity to behavioral and physical health once and for all


We are ready to meet heightened demand for behavioral health support through a full range of clinical, administrative, and financial capabilities that manage risk in specialty populations. With a wide network of behavioral health providers, we deliver patient-centered care that integrates behavioral and physical health to address crises in mental wellness, recovery, and addiction.


Our behavioral health business Beacon Health Options


in-network utilization




individuals served

Many communities aren’t built to handle behavioral health crises. A new infrastructure with scalable services is changing that.

Value-based care delivery

Providing specialized care for high-risk individuals with complex, chronic conditions or advanced-stage illnesses


We drive integrated, patient-centered whole health solutions for complex care journeys. Through a high-tech and high-touch multidisciplinary model that proactively manages risk and addresses social and behavioral health factors, we reduce hospital and inpatient admissions and bed days — while improving health outcomes and decreasing cost of care.


Our value-based care delivery businesses Aspire Health, CareMore Health


fewer inpatient admissions


fewer inpatient bed days


minutes for primary
care appointments

Related resources

Meeting the individual where they are, physically and clinically, with tireless compassion. That’s healthcare the way it should be.


Innovative pharmacy solutions


CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member’s health.


Our pharmacy business CarelonRx


overall drug trend (medical + pharmacy)


overall specialty drug
trend (medical + pharmacy)


more adherent with medications


care gaps closed

We are CarelonRx, a pharmacy benefit manager that believes there’s a better way to deliver healthcare.


Our vision is focused on serving the individual with clinical insights and innovative solutions to meet members wherever they are in their healthcare journey. By collaborating with key stakeholders, we solve existing challenges and deliver value through cost savings and better health outcomes.

Related resources

Digital platforms

Transforming the health ecosystem by connecting stakeholders through data-enabled digital tools


We make whole health possible by connecting the healthcare system with dynamic digital tools united under one platform and powered by our platform intelligence. With insights gained from an organization serving millions of people, we generate significant cost savings through automation of health operations, and insights that personalize care and improve health outcomes.


Our digital platforms business Carelon Digital Platforms


insights based on 115 million people

Care pathways

Ensuring appropriate, safe, and affordable healthcare


Carelon works hard to make care effective, affordable, and accessible. Our specialty and post-acute medical benefits management solutions help providers to align care with proven best practices and helps members access that care in their community. From musculoskeletal care and cancer care to cardiology and home health, our evidence-based care pathways routinely improve outcomes while strengthening partnerships with key stakeholders, like providers and community-based organizations.


Our care pathways businesses AIM Specialty Health, myNEXUS


of total health plan cost of care managed


provider satisfaction



reduction in hospital admissions

Better healthcare starts with best practices. Explore the five practices that leading health plans are adopting to make exceptional care the norm.

Related resources


Delivering powerful insights to drive better health outcomes


Our unique combination of expertise, data, and relationships enables us to ask meaningful questions and arrive at more-informative and more-actionable answers. From prospective, observational, interventional, or retrospective research, our experience spans the healthcare spectrum. With decades of experience designing and carrying out a broad range of complex and meaningful studies, we generate evidence in healthcare to deliver better value and outcomes.


Our research business HealthCore


lives of robust data within its ecosystem


years of experience


abstracts, posters, and manuscripts
published over the last three years

Operations and technology services

Improving health plans’ efficiency through digital and operational transformation


We provide value to health plans and reduce their costs through streamlined operations and automated, scalable services. From end-to-end operations management to individual services, like claims processing, cloud adoption, provider system management, analytics, and contact center operations, we help health plans operate more efficiently and raise customer satisfaction.


Our operations and technology services business Carelon Global Solutions


IT professionals, data scientists, and engineers


contact center
customer satisfaction


reduced cost of
claims operations


batch job 

Payment integrity

Accelerating accuracy to improve costs


We address fraud, waste, and abuse so that health plans can focus their resources more on achieving better whole health outcomes. For all lines of business, including Federal Employee Plans, we apply our unrivaled experience, rigorous data science, and advanced analytics to optimize each step of the payment value chain, with an emphasis on prevention rather than reaction. And we do all of this while delivering providers an exceptional experience and helpful education.


Our payment integrity business Meridian Resource Company


years of experience

<1 year

average recovery cycle


recovered in 2019


Net Promoter Score

Ready to learn more?

We’re here to answer any questions you have about our capabilities.