AI-driven, Proactive Benefits
Optimization and Management
Platform for Health Payers

Transforms D-SNP member engagement by building trust and emotional connection with members at scale

Transforms D-SNP member engagement by building trust and emotional connection with members at scale

The Challenge

Effective consumer engagement aimed specifically at dually eligible individuals (especially those with complex health needs) and their caregivers has been limited(1).

The Solution

A digitally integrated platform that fosters
continuous member engagement, reduces
abrasion, enhances Star Ratings and health
equity, closes care gaps, increases benefit
adoption, and optimizes cost efficiency by
enabling payer teams to operate at top of license.

Higher Annual
Churn Rate

23% of members switch every year to competing D-SNPs(2) due to low engagement and intense competition

Downward Average
Star Rating (2022-24)

An average of 8% decline in star ratings due to regulatory changes and a renewed focus on member experience(2)

Increased healthcare
expenses YoY

7% increase in the health plan’s Total Cost of Care(3) as 68% of dual eligible members have multiple chronic conditions(4)
D-SNP members face barriers like low health literacy, limited digital access, and challenges related to social determinants of health (SDOH), including transportation and housing instability(5). Dual-eligible members have average star ratings 4% lower than non-dual members. Addressing these factors and enhancing member engagement through touchpoints like Health Risk Assessments (HRAs) and house calls is essential for reducing disenrollment and improving star ratings(2).

Whats Needed?

Establishing emotional connections
with members

Proactively preventing care gaps

Continuous member engagement
and touchpoints

Personalizing member benefits to
boost member satisfaction

Encouraging preventive care and
medication adherence

Ultimately improving
health outcomes

Our AI-driven ActiveAgent continuously engages, educates, and
guides members on a personal level to the benefits that best
match their needs. Improve D-SNP member outreach, adoption,
satisfaction with optimal supplemental benefits – all at scale and
at a reduced cost. Unlock your path to reduced member churn
and higher CMS Star Ratings through AI-powered engagement
leveraging our ActiveAgent technology.

Discover how our D-SNP solution works

Schedule a Demo

(1) https://www.healthaffairs.org/content/forefront/d-snp-enrollee-advisory-committees-step-toward-meaningful-consumer-engagement-dually
(2) https://www.oliverwyman.com/our-expertise/insights/2023/feb/managing-member-retention.html
(3) https://www.milliman.com/-/media/milliman/pdfs/2024-articles/3-5-24_key-insights-into-2024-medicare-advantage-d-snp.ashx
(4) https://www.pgpf.org/blog/2024/03/7-key-facts-about-us-healthcare-spending
(5) https://www.mathematica.org/news/why-dually-eligible-beneficiaries-stay-or-leave-integrated-care-plans