For health plan operators

Built for your Stars, quality, and pharmacy teams

HealthAgent deploys as a workflow layer against your existing PDC targets — not a clinical protocol replacement, just resolved administrative friction, reported against the MLR and PDC outcomes you already track.

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Cross the 80% PDC line

Targeted outreach for the members closest to falling out of the adherence band that determines your Stars bonus.

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Lead with MLR, not just Stars

Adherence gaps cost money independent of bonus payments — the case holds even before Stars enters the conversation.

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No call audio retained

Structured outcome data only, by design — a simpler compliance review than most vendor calls in this category.

Where each workflow hits your scorecard

Four workflows, mapped to the measures you're already tracking

Medication management

Refill gaps are flagged before supply runs out. A navigator calls the pharmacy, resolves the delay, and confirms pickup.

PDC / triple-weighted Stars measure

Scheduling & care access

Referrals get booked, confirmed, and followed up on — reducing no-shows and closing the loop on completed visits.

HEDIS / CAHPS access to care

Benefit navigation

Unused OTC and supplemental benefits are identified, ordered, and delivered — turning entitled benefits into activated ones.

CAHPS / MLR

Post-discharge management

The 30 days after discharge are covered end to end — medication reconciliation, day-7 follow-up, and readmission-risk outreach.

Readmission reduction / HRRP

These four workflows share one navigator and AI infrastructure — a plan can start with one and expand without a new contract or a new integration.