Wellness Intelligence™ for Insurance & Medicare Advantage
Member wellness programs that directly improve Star Ratings and reduce claims costs.
Move from reactive claims to proactive wellness
Traditional risk models rely on claims data, lagging indicators of health that has already deteriorated. NextGen Wellness scores members in real-time across 269 drivers, catching decline before it becomes a claim.
Improve Star Ratings
Wellness engagement programs with measurable outcomes data. Track member participation, health improvements, and program effectiveness across your entire population to directly support CMS Star Rating metrics.
Risk Stratification
269-driver scoring identifies high-risk members before costly events. Go beyond claims data with real-time wellness signals across 8 dimensions: physical, emotional, financial, social, and more.
Reduce Claims Costs
Predictive risk detection catches declining health trajectories early. Members flagged for intervention weeks before an ER visit, hospitalization, or skilled nursing admission.
Member Engagement
Voice AI companion drives daily engagement without survey fatigue. Members have natural conversations, not form fills, that surface wellness signals your HRA process misses entirely.
Population Analytics
Cohort-level dashboards, risk prevalence, and outcomes reporting. Slice by geography, plan type, chronic condition, or any custom segment. Board-ready exports with one click.
From data integration to outcomes in weeks
Integrate with Member Data
Connect claims, eligibility, HRA, and clinical data feeds. Our platform normalizes and enriches data from any source format. Setup takes days, not months.
AI Scores Across 8 Dimensions
Every member receives a real-time wellness profile across 269 drivers: physical health, emotional well-being, financial stress, social isolation, and more.
Predictive Alerts Flag At-Risk Members
Declining trajectories trigger automated alerts before costly events. Your care management team gets actionable intelligence, not just data.
Population Dashboards Prove ROI
Track program effectiveness, member engagement, cost avoidance, and quality measure improvements in real-time dashboards your actuaries will trust.
What sets us apart for payers
Far beyond claims-based risk scoring. Real-time signals across every dimension of health
Members talk naturally with AI, no app downloads or survey fatigue required
Programs and data mapped directly to CMS quality measures and HEDIS metrics
No hardware, no on-site installs. Integrate with existing data feeds in days
Stop waiting for claims data to tell you what went wrong
See how NextGen Wellness gives your plan real-time member wellness intelligence that improves Star Ratings and reduces costs.
Book a Demoor email us directly at sales@nextgenwell.org