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Pelica Health›
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Pelica Health

Pelica Health

Pelica Health provides an AI operating system for value-based care organizations.

Operating headquarters
San Francisco, CA, US🇺🇸
Founded
2025
Accelerator
Y Combinator logoY CombinatorS25
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Contents

  1. 01Products & Services
  2. 02Market Outlook
  3. 03Competitive Strengths
  4. 04Pricing Strategy
  1. 01Products & Services
  2. 02Market Outlook
  3. 03Competitive Strengths
  4. 04Pricing Strategy

Product Overview

Pelica's AI Operating System for Value-Based Care integrates six specialized copilots: risk adjustment, quality and Stars ratings, pharmacy and Part D adherence, provider network management, care management, and plain-language data analysis.

Each copilot is designed to automate specific workflows within value-based care organizations, from real-time HCC capture to ADT-driven transitions-of-care worklists.

Source: pelica.com

Market Outlook

The value-based care software market is projected to grow significantly as Medicare Advantage enrollment expands and regulatory requirements for quality and risk adjustment tighten.

Pelica sits at the intersection of AI adoption and healthcare operational transformation, competing with point solutions in HEDIS, coding, and adherence while differentiating through unified data and AI copilots.

Source: pelica.com

Competitive Advantages

Pelica unifies claims, EHR, pharmacy, lab, and ADT data into one live record, eliminating the fragmentation that plagues point solutions.

Six AI copilots automate workflows across risk adjustment, quality ratings, pharmacy adherence, provider networks, and care management, reducing manual effort while improving outcomes.

Source: pelica.com

Pricing Strategy

Pelica operates a SaaS pricing model targeting Medicare Advantage plans, IPAs, MSOs, and ACOs with risk-bearing contracts. Pricing scales based on member volume and the number of AI copilots deployed.

The company offers business-associate agreements and tiered access to its platform, with HIPAA and SOC 2 Type II compliance included in all contracts.

Source: pelica.com