A chronic care program built to survive clinical and financial review.
Ciba works with national and regional health plans to lower medical and pharmacy spend for members with cardiometabolic, autoimmune, and GI conditions, with outcomes documentation built for your clinical validation process from day one.
Chronic condition spend is concentrated and hard to move.
ConcentrationA small share of members with chronic and autoimmune conditions drive an outsized share of total spend.
Specialty RxGLP-1 and specialty pharmacy costs are outpacing most plans’ ability to manage utilization responsibly.
Network gapsMembers with autoimmune and GI conditions often wait months for a specialist appointment.
EvidenceClinical and financial validation teams need documented, third party reviewed outcomes, not vendor claims.
Built for clinical and financial validation review.
Members in the autoimmune program cohort
Symptom improvement
Medication burden reduction
Pharmacy return on investment
Pharmacy cost savings, cardiometabolic population
Overall program return on investment
Documentation ready for your process: we provide the underlying methodology, cohort definitions, and outcomes detail your clinical validation and medical policy teams need, not a summary slide.
From vendor evaluation to a signed member population.
A defined path, with legal, clinical, and technical review happening in parallel rather than in sequence.
Vendor and clinical evaluation
We submit outcomes documentation, methodology, and credentialing detail for your clinical validation process.
Contracting
MSA and any required addenda move through legal review with a dedicated point of contact on our side.
Technical and data integration
Eligibility files, reporting cadence, and data exchange are configured to your existing systems.
Launch and ongoing reporting
Population launches with a defined outcomes reporting cadence built for your medical and pharmacy trend review.