Capture Insights.
Expand Margin.
Master AEP.
Advanced analytics for government programs payers, built for speed. Game-changing insights across Medicare Advantage, Medicaid, and Marketplace.
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AI-Powered Medicare Advantage Analytics solutions for Medicare Advantage, Marketplace, and Medicaid professionals, delivering competitive intelligence at the speed you need.
Benefit Intelligence
Turn multiple days of work tracking down competitor EOC docs, benefit specifics, and formulary details into a few clicks; easy export functionality supports any workflow.
Key Use Cases:
- Competitive product benchmarking
- Part D and formulary strategy
- AEP disruption response
- TPV reference for actuarial teams
Real-Time Competitive Intelligence
Track 5,000+ plans across 3,300 counties with 15+ interactive dashboards. Identify expansion opportunities using proprietary Opportunity Scores.
Key Use Cases:
- Post-AEP enrollment analysis
- Service area expansion targeting
- Competitive landscape monitoring
- Star ratings improvement planning
Maximize Network Performance
Compare your provider networks against multiple competitors at the hospital, physician group, TIN, and NPI levels — all at the county level. Optimize with HealthWorksAI's proprietary Network Score analytics.
Key Use Cases:
- Network adequacy compliance
- Provider contracting strategy
- Competitive network analysis
- Ghost location identification
Predictive Modeling for Million-Dollar Decisions
Make bid decisions with 91.2% accuracy. Run 1,000+ benefit scenarios with county-level predictions.
Key Use Cases:
- Bid scenario modeling by county
- Enrollment vs. margin tradeoff analysis
- Benefit spend optimization before submission
- Bid validation after pencils down
Conversational Intelligence
Ask questions in plain English and get instant, accurate answers. Our AI assistant is trained on datasets across Product, Market, and Network intelligence, so you can get insights exactly when you need them.
Key Use Cases:
- On-demand competitive intelligence
- EOC document querying
- Enrollment scenario analysis
- Cross-functional team enablement
AI-Powered Advanced Analytics Trusted by Health Plan Leaders
Explore Customer Stories →"NetworkIntel integrates multiple provider data sources into a single, usable view so we can evaluate our network and competitors side by side. The platform delivers actionable insights that improve key performance metrics, and the Medicaid-specific insights have been invaluable."
$1M savings
Restructured high-cost provider contracts
6.4M Incremental Profit
Projected from a 3,000+ member enrollment gain in a single state market.
"HealthWorksAI helps us anticipate what will happen before we commit so we can shift investment to the right counties and act with confidence instead of guessing"
1TB of Provider Data
90% faster insight delivery vs. internal teams
"It's powerful to see product, provider, and marketing scorecards roll up to an executive view—and then drill down by county and plan when we need details"
Ready to Drive Profitable Growth?
See how HealthWorksAI transforms product, network, and marketing strategies with predictive intelligence.
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