I’m Ravi Ika, Founder, President & CEO of nirvanaHealth. I have been in the healthcare industry for 20 years now and have always aimed to disrupt and simplify.
In 2000, I founded a company called ikaSystems. The goal of ikaSystems was to reduce administrative and medical costs within payer (health insurance) organizations through enterprise-wide platforms. Influencing meaningful change within the payer technology industry was a challenging endeavor. Despite adversity and systemic adherence to the status quo, our team at ikaSystems demonstrated the art of the possible. The platform we built enabled clients like health insurer BCBS Michigan and thirty others to significantly reduce medical costs and reduce administrative costs by as much as 50%.
Through my experience at ikaSystems, the team and I frequently engaged with pharmacy benefit managers (PBMs) and were struck by the antiquated technology and systems employed in this space. These shortcomings signified substantial opportunity to redefine the PBM ecosystem and how PBMs interact with payers. This is why I stepped down from ikaSystems in 2013, to found RxAdvance.
At the time and even still largely to this day, the PBM market lacked the systems that would allow them to operate efficiently, transparently, and with real value for clients. At RxAdvance, we built such systems in the form of a PBM enterprise platform that is capable of managing all the functions that make up PBM operations and is capable of meaningfully reducing overall pharmacy costs, specialty drug costs, and avoidable drug-impacted medical costs. This is made possible by incorporating technology such as robotic process automation (RPA), machine learning (ML), and artificial intelligence (AI) into the platform.
With this differentiating platform at the heart of our service model, we are proud that RxAdvance has gained significant traction in the market from national payers and large employer groups and has demonstrated the value our platform delivers by reducing costs for payers and improving quality of care for members.
With the demonstrated success of our PBM platform under our belts, in 2018, my healthcare journey began to come full circle. When I entered the PBM industry, I knew that PBMs and payers together managed the majority of the $4 trillion annual healthcare spend. I knew there was, and still is, about $900+ billion of waste in the system, most of which is a result of the lack of infrastructure to effectively manage the multitude of necessary functions – infrastructure such as enterprise platforms built on RPA, ML, AI. Having left ikaSystems, an organization founded to reduce costs on the payer side and subsequently founding an organization focused on reducing costs on the PBM side, I recognized there is an immense need to overhaul existing platforms in both the payer and PBM industries. It is my dream to have one single integrated platform for payers & PBMs to manage their pharmacy, behavioral health, and medical business. An enterprise platform capable of significantly reducing waste and improving care in the healthcare system is only possible together: through a truly integrated PBM and payer enterprise platform.
With this vision, we built Aria, the robotic process automation cloud for healthcare and expanded our scope to target both the PBM industry as well as the payer industry. As a result, we felt that the RxAdvance name no longer accurately represented us and our new mission. Thus, we decided to retire the RxAdvance name and became nirvanaHealth.
Our Aria platform was built from the ground-up to employ RPA across the payer and PBM enterprises. To build this platform, our team needed to thoroughly understand each of the functions it would need to facilitate. To do this, our team spent a great deal of time examining each of the 15-20 departments within a payer organization, the 2,000 – 3,000 functions fulfilled by these departments, and examining the 10-15 departments within a PBM and the 500+ functions carried out across these departments. Aria automates these functions with a bot and logically deploys these bots into modules to achieve enterprise automation. This platform-driven strategy allows for innovative risk models, which means the 90% of premium dollars currently allocated for actual care can be administered at only 75% to 80%, and administrative costs which currently range from 10% to 15% of the premium can be cut by a third to half.
nirvanaHealth and Aria continue to grow and evolve. The majority of our Aria platform has already been built and deployed. At nirvanaHealth, our goal is for our platforms to deliver value that transcends beyond just the administrative side but that also meaningfully reduce medical costs. We are working towards this every day.
As we continue to innovate, build, deploy, and scale our platform, it is our commitment to bring the art of possible to payer and PBM industries to help significantly reduce costs, improve member care, and empower consumers to manage their health in collaboration with care providers.
President & CEO
Since 2013, the RxAdvance team has been dedicated to disrupting the healthcare industry, specifically in pharmacy benefit management. After 3 years of development, we went live with our first client in 2016 and delivered groundbreaking pharmacy benefit management services. Now that we have proven success year-after-year, we have decided to expand our impact beyond just the PBM industry—onto the payer industry. These two industries alone control the majority of the healthcare spend in the United States, including the $900+ billion of waste generated annually. With our expansion into a new portion of the industry, we have outgrown the RxAdvance name, since it does not accurately capture the scope of our healthcare reach and mission. We are excited to announce our new name and brand—nirvanaHealth. The RxAdvance name has served us well for many years and will continue to do so under nirvanaHealth.