Expand into the right counties.
Exit the wrong ones. Know the difference before you file.
Service area decisions are among the highest-stakes calls.
Make them on data, not instinct, before the filing deadline locks you in.
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3,000+ Counties
Modeled for opportunity and risk
6+ Variables
County-level enrollment confidence
Expansion + Exit Model
Both directions in one workflow before filing
What’s at Stake
Most plans make SAE/SAR decisions with incomplete data. The margin impact shows up a year later.
Expand into a county with strong enrollment numbers but a competitive network disadvantage and you’ll spend the year managing losses. Exit a market that was underperforming for fixable reasons — and watch a competitor take those members.
The cost of getting a county wrong is lost enrollment and margin pressure that’s hard to reverse.
Three Intelligence Capabilities
From opportunity identification to
enrollment simulation — before you file.
01
Opportunity Scoring
Weighted county-level scoring across every expansion variable that matters.
Health system competitiveness, payer saturation, double bonus status, demographic growth, and Stars trajectory — ranked and filterable before filing.
02
Competitive Landscape
See who’s operating in your target counties — and how strong they are.
Plan-level enrollment position, network density, competitor SAE/SAR history, and member flow trends — before you enter a market.
03
Enrollment Modeling
Simulate entry or exit before committing capital or filing a change.
County-level enrollment forecasts for expansion scenarios factoring competitor response, benefit positioning, and network adequacy.
Decision Support
Every SAE/SAR question answered before filing.
Which counties are worth entering this cycle?
Opportunity scoring ranks every county on margin-predictive variables, not just enrollment size.
Which markets should we exit — and are we sure?
Model whether underperformance is structural or fixable before pulling out.
What will enrollment look like in year one?
Enrollment simulation generates projections grounded in competitor activity, not historical assumptions.
"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."
Model Your Next SAE/SAR Decision Before You File
Live county analysis with your actual market data.