Empowering Government
Sponsored Plan Leaders
Trusted by More Than 25 Leading Health Plans
Identify untapped markets, forecast enrollment shifts, and maintain a winning edge.
Optimize benefit structures to drive higher enrollment, lower costs, and stay competitive.
Leverage precise provider-level insights to enhance your network's strength and marketability.
The competitive intelligence layer for every MA market decision. Real-time enrollment shifts, competitor benefit moves, and market share data across every county — built for strategy, marketing, and growth teams who need to move first.
- Identify counties where competitors are gaining ground before you reallocate resources
- Service area expansion analysis using eligibility, penetration, and contestability data in one view
- Post-AEP breakdown: understand what you won, what you lost, and exactly why
- D-SNP and dual-eligible market mapping for targeted growth plays
The benefit design intelligence platform for plan leaders. Benchmark every competitor's plan benefits and model the enrollment impact of each decision before bid season closes.
- TPV (Total Plan Value) benchmarking: compare your full benefit package against every competitor in your county in one view
- OOPC analysis across Part C, Part D, and supplemental benefits to identify where your plan over- or under-delivers
- Sensitivity modeling: understand how individual benefit changes shift your enrollment position before you commit
- CMS updates reflected in your competitive analysis within 48 hours
NPI-level network intelligence benchmarked against your actual market competitors. True Network Score moves your assessment beyond CMS minimums into a real competitive ranking, so your team can act on gaps before they cost you members.
- One-to-many network comparisons: see how your network stacks up against multiple competitors simultaneously
- True Network Score: the industry's only cross-plan, NPI-level benchmark
- Ghost provider identification before CMS flags your adequacy gap
- Specialist composition analysis to pinpoint exactly what your network is missing
The simulation engine plan design teams use to quantify the enrollment impact of every benefit decision before bid submission. Run scenario-based analysis with actuary-grade precision so every call is backed by data, not assumption.
- 91.2% enrollment forecasting accuracy across benefit scenarios
- Model benefit combinations across OTC, dental, vision, fitness, and Part D simultaneously
- Scenario-based sensitivity analysis: see how each benefit change moves your enrollment position
- CMS-aligned benefit inputs updated within 48 hours of any regulatory change
Share your list of plan bid IDs and HWAI models the probability of each plan winning in its market. Know your competitive position before you finalize your submission.
A natural language AI interface across every HWAI dashboard. Ask a question in plain English and get a direct answer with the data behind it — spanning MarketIntel, ProductIntel, and NetworkIntel simultaneously.
- Cross-dashboard queries in plain English, no SQL or analyst queue required
- Proactive anomaly surfacing: enrollment shifts and competitive moves flagged before you ask
- Instant access for executives who need data before a meeting, not after
- Currently in beta, available to select health plan partners
Market. Product. Network. Three levers, one platform.
Most plans have intelligence on their product or their market. Very few have all three. HealthWorksAI is built for the ones that do.
Get Started
See where your margin is hiding
Thirty minutes with our team, walking your own market across all three levers. No script, just your data and real answers.
Book a Meeting