AI-Powered Medicare Advantage Intelligence
From Bid Season to AEP and Beyond
HealthWorksAI's comprehensive AI platform transforms reactive approaches into proactive, intelligence-driven strategies that anticipate market shifts and optimize performance year-round.
- Trusted by leading Medicare Advantage plans
Data to Decision
Prediction Accuracy
than Industry Peers
HealthWorksAI's Year-Round AI Advantage
AI isn’t a buzzword in Medicare Advantage anymore, it’s a margin engine. The fastest-growing plans are using predictive analytics to drive growth and profitability, not just insights
Bid Season Intelligence
Feb-June: Precision Benefit Design
AI isn’t a buzzword in Medicare Advantage anymore, t’s a margin engine. The fastest-growing plans are using predictive analytics to drive growth and profitability, not just insights
- Advanced Benefit Simulator processes millions of market scenarios
- Total Plan Value (TPV) show the member's buying propensity
- 35% improvement in benefit ROI through AI-identified adjustments
AEP Predictive Intelligence
October: The AI Battle Map
Navigate the critical 48-72 hour AEP window with AI-powered competitive intelligence and real-time market responsiveness.
- >91.2% predictive accuracy across three AEP cycles
- 5-10 days competitive time advantage
- $1.8M average revenue protection through early threat detection
Genie AI Intelligence
Year-Round: Conversational Insights
Break silos with our conversational AI trained on comprehensive Medicare Advantage market data.
- Strategic discussions accelerated from days to minutes
- Dataset Included: PBP, Census, EOC, ANOC, SoB, Provider Network Data
- Competitive intelligence accessible to any team member
Quantifiable Impact Across Every Metric
Stop guessing benefit design. Get data-driven insights that translate directly into enrollment lift, revenue protection, and competitive advantage.
Predictive Accuracy
Validated across three AEP cycles
Plan Prediction Accuracy
Precision in enrollment forecasting
New Members Growth
Projected enrollment growth potential
Revenue Protection
Average through early threat detection
Competitive Advantage
Head start on market intelligence
ROI Improvement
Through AI-identified benefit adjustments
The Medicare Advantage Intelligence Gap
Today's reality: Plans remain trapped in reactive cycles while competitive advantage demands proactive intelligence.
The Cost of Delay:
● Sales impact:
Sales people looses targets.
● Loosing early spots:
Not able to pivot faster than competitors.
● Less margin:
Profitability takes a hit even if enrollment increases.
● Investor confidence:
Investors lose confidence and stock prices fall.
Members affected by strategic exits
ACA losses AI could have detected
Why AI-Powered Plans Win
In an industry where UnitedHealth and Humana control majority market share, competitive advantage now hinges on intelligence and execution speed.
Speed to decision & action
Get insights of CMS data within 48 hours from the release.
Lower costs
Cut analysis overhead, avoid misallocated benefits, and improve MLR via targeted product/network changes.
Prioritize the highest-ROI moves
Direct budget and effort to the benefits, channels, and partnerships that actually drive enrollment and margin.
Predictive vs. reactive
Anticipate competitor and member response instead of post-morteming last week’s results.
Unified intelligence
Break silos across Actuarial, Product, Sales, and Network with a shared, explainable AI view.
Scale without complexity
Offload data wrangling and pattern detection so teams focus on strategy.
Continuous learning
Every cycle sharpens accuracy, widening the gap over manual, lagging workflows.
Stop hunting across decks. Ask a strategic question and get a cited, plan/network-level answer instantly.
Get answers in seconds. First conversational intelligence for Medicare Advantage.
Join 25+ health plans already using HealthworkAI
Genie AI - Conversational Market Intelligence
Breakthrough in Healthcare Analytics
A conversational interface trained on HWAI comprehensive Medicare Advantage market data, competitive intelligence, and regulatory insights. Leadership teams simply ask natural language questions and receive immediate, context-rich responses.
Sample Executive Conversations:
Strategic Planning
"Which counties show the highest D-SNP growth potential for 2026?"
Competitive Analysis
"What specific benefits drove Humana's 12% Florida market share gain last AEP?"
Market Intelligence
"Where are Anthem's network adequacy vulnerabilities creating opportunity?"
Regulatory Impact
"How will the new CMS risk adjustment changes affect our East Coast footprint?"
Decision-Making Transformation:
Strategic Discussions Accelerated
From days to minutes
Cross-Functional Alignment
Through shared, real-time insights
Competitive Intelligence
Accessible to any authorized team member, anytime
Stop guessing benefit design. Quantify enrollment lift vs. rebate cost by county, before filing.
Prioritize proven levers and document trade-offs.
Run scenarios on your toughest market to know winning bids.
Join 25+ health plans already using HealthworkAI
