The core of our work at Healthmine is driving member behaviors that result in increased gap closure — improving health plan quality scores, resource allocation and return on investment (ROI). Continuous product innovation allows us — and our plan partners — to meet performance goals quickly as market dynamics shift.
We’ve been busy in 2025 so far developing high-impact product enhancements. Here are a few highlights.
Patient scheduling
Healthmine’s on-platform clients can now provide appointment scheduling for members, facilitated by an artificial intelligence (AI) agent.
Studies show that 20% of adults do not have a primary care provider (PCP), 30% of patients abandon care because scheduling is too difficult, and more than 80% of all eligible Medicare Advantage enrollees do not receive their annual wellness visit (AWV).
With Healthmine, members can find new in-network providers based on specific criteria, choose preferred dates and times for appointments, and allow the AI agent to do the rest. For members who have an established PCP, they can schedule with their provider through the online scheduler, and select alternates, in case their provider doesn’t have availability. Appointments are booked without the member ever needing to get on the phone, and text confirmations close the loop with appointment details.
In-home assessment connectivity
As in-home assessment (IHA) practices continue to generate scrutiny from the Centers for Medicare & Medicaid Services (CMS), we can now help plans more strategically and with greater compliance leverage IHAs. Our three-pronged approach includes:
- Increasing provider visits early in the year, reducing the volume of IHAs and audit risks.
- Connecting the right members to IHA vendors for easy scheduling.
- Delivering relevant, timely post-visit outreach to drive members back to their provider for appropriate follow-up care and Hierarchical Condition Category (HCC) verification, if necessary.
Our platform ensures you have the tools and data tracking in place to justify IHAs when used, increase risk coding accuracy and connect more members to PCPs.
120+ outreach templates
We know how critical it is for our clients to get engagement campaigns out quickly, especially during mid- to end-of-year sprints to close as many care gaps as possible.
Our library of ready-to-use, compliant templates facilitates quick engagement. We have more than 120 templates spanning digital and direct mail outreach to members — and we’re just getting started. This library will continue to grow to encompass more health actions, more languages and better segmentation, so we can continue to offer faster speed to execution and more engagement flexibility than any other engagement vendor in the market.
Rewards
Rewards are a fundamental component of an effective engagement program. Healthmine deploys member outreach, manages analytics and administers an end-to-end rewards program from a single platform, and we’re continuing to refine our platform to be even better for your members and easier for your plan operators to manage. We’ve made three notable changes:
- Smarter budget management. Multiple teams can — and should — work out of Quality Relationship Management™ (QRM®), but we know most teams don’t want to share budgets. You can now administer one rewards program across teams but manage rewards redemptions from multiple budgets. Most notably, that means quality and risk teams can work together to incentivize gap closure and reduce member abrasion but still manage their dollars independently.
- More flexible reward redemption. We’ve added more ways for members to redeem rewards so now they can do so on platform and off platform, so app registration doesn’t have to interfere with incentives or gap closure.
- Additional app security. Compliance is at the forefront of every enhancement, and when it comes to rewards, we want to ensure your members rewards are secure. We’ve added additional layers of security to the in-app experience to prevent fraudsters from accessing your members earned rewards.
Ready to see the impact?
Estimate the impact of Healthmine’s platform on your quality and risk performance. Try our value calculator or, if you’re ready to see Healthmine in action, book a demo.
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