A health plan member engagement platform is the layer that sits between a plan's core systems and its members, turning passive data into outreach that actually gets a response. Most plans have the systems. What they're missing is the AI layer that decides who to reach, on which channel, and when.
A health plan member engagement platform is the system that decides how and when to reach a member, across every channel, and carries the interaction through to a completed action, not just a sent message.
It sits on top of what a plan already has: claims data, a care management system, an eligibility file, a member portal. None of those systems were built to proactively reach a member and get a response. That decision layer is the part most health plans don't have.
Care Management Platform
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Engagement Layer
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Calls, texts, adjusts, escalates
Underneath the different teams and budgets, most health plan engagement work comes down to two jobs, run today on one platform and one member record.
Maximize incentive dollars, boost Star Ratings
Optimize care delivery, extend your care team's reach
Underneath the different teams and budgets, most health plan engagement work comes down to two jobs, run today on one platform and one member record.
One Northeast health plan runs this model across its full membership base today, supporting HEDIS gap closure, Star Ratings goals, and HRA outreach.
Underneath the different teams and budgets, most health plan engagement work comes down to two jobs, run today on one platform and one member record.
A care management platform tracks case status, risk stratification, and clinical workflows. A health plan member engagement platform is the outreach and self-service layer that acts on that data, reaching members proactively and resolving inbound calls.
No. Zappix sits on top of the systems a plan already runs, pulling from existing data to decide who to reach and how, rather than replacing the systems of record underneath.
CAHPS and patient experience measures now make up roughly 57% of a Medicare Advantage plan's overall Star Rating. Outreach that actually reaches members and closes care gaps has a direct line to those scores.
Yes. Zappix runs the Quality Engagement Suite and the Care Management Suite on the same platform and member record.
Yes. Zappix is built compliance first, not compliance added later, and is certified for SOC 2, HIPAA, and GDPR. This is a core reason healthcare, insurance, financial services, and government organizations choose the platform.
Zappix designs, builds, launches, and continuously optimizes the deployment as a managed service, so a plan's team isn't staffing or maintaining the platform itself.
