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PREDICT HEALTH Results AND Outcomes
Quality and Stars Ratings
Drove STAR rating to 4.5 (vs. 3.12 market average) by redesigning key program elements. Generated $9.8M in CMS Quality Bonus Payments (QBP) and helped the plan rank as the #1 market performer in quality and member experience.
Solution: Advisory Group Management
Market: Medicare Advantage
New Member Insights and Smart Retention Improvement
Increased member ROI 12.7x by predicting pre-AEP churn, uncovering root causes with predictive member intelligence, and driving targeted actions that boosted retention and margin.
Solution: Retention Improvement / New Member Insights
Market: Medicare Advantage
Sales Channel Efficiency and Cost of Acquisition Improvement
Plan and Benefits Design
Accurately predicted 94% of e-broker member churn before AEP, revealing key drivers and enabling targeted retention and smarter acquisition that improved channel economics 24.7x and lowered CAC.
Solution: Acquisition / Retention Improvement
Market: Medicare Advantage
Identified 4 plan design benefits changes and helped refine messaging leading up to open enrollment. Plan membership grew by 10% in market that year.
Solution: Advisory Group Management
Market: Medicare Advantage
Smart Retention and Stars Life Time Value
Drove margin gains and helped the Client outperform competitors, exceeding retention in 70% of counties and Stars in 67%, by transforming limited member visibility into targeted, scalable action powered by predictive intelligence.
Solution: Advisory Group Management / Retention Improvement
Market: Medicare Advantage
Daniel, 81,
El Paso, TX
Case Studies:
For illustration only; not an actual member.
What the plan knows:
Joined 3 years ago (via online broker)
No engagement, no completed HRAs, or onboarding
PCP visits in year 1 and 2, none after that
What Predict knows:
Change in his living situation (lives alone since the last year)
Has no car or access to transportation
Has low technology literacy
Responds to mailings and surveys
Has moved to a new address 6 months ago
Is likely to respond to CAHPS and HOS surveys
800M+
Records
CUSTOMER ROI:
Predict Health is a no brainer for our customers with substantial, immediate, and long-term ROI
300M+
People
1K
Data Characteristics
Impacted
Members
34,000
Saved
Margins
$9.8M
Return on Investment
30.5x
White papers
Discover how predictive analytics, AI, and social determinants of health (SDOH) data are solving key healthcare problems and transforming the industry. Our white papers deliver expert insights, actionable strategies, and real-world impact across acquisition, retention, member engagement, and healthcare delivery.
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