xAI - Explainable AI
Make Million-Dollar Decisions with 91.2% Accuracy
With xAI, health plans model benefit scenarios before bid submission, predict enrollment outcomes during AEP, quantify the margin impact of every design decision, and know what will happen before they commit the budget.
- Run 1,000+ benefit scenarios with county-level predictions
- Get enrollment forecasts for all plans within 4 days of CMS releases
- Validate bid decisions with 91.2% historical accuracy
- War game scenarios with key competitors to understand enrollment outcomes
- Evaluate, rank, and prioritize service areas for entry or exit — before the filing deadline
91%+ Accuracy
Across multiple years of validation
3 Simulation Levels
Executive, Portfolio & Bid-Benefit modeling
20% Time Saved
On benefit testing and bid iterations
Every County
Simulate enrollment impact at county-level granularity
Two Critical Moments.
One Predictive Platform.
Model every scenario before you commit and track every signal before the enrollment window closes.
Simulate Scenarios Before You Commit Millions
Bid Season (Jan-June)
Test benefit changes, premium strategies, and competitor responses before finalizing bids. Identify which investments drive enrollment and which drain the budget.
- Identify table-stakes vs. significant benefits by market
- Run benefit sensitivity analysis by county
- Simulate competitor moves and market responses
- Test SAE expansion scenarios with enrollment forecasts
- See where benefit spend hits saturation so you stop overpaying for enrollment you’d win anyway
Track Predictions Against Reality in 96 Hours
AEP (Oct-Jan)
Monitor enrollment performance during AEP. Know which plans are trending ahead or behind—and why.
- Reallocate marketing and sales effort toward markets where you have a competitive edge
- Get enrollment predictions updated monthly
- Identify underperforming plans early
What You Can Do With Explainable AI
Every capability that turns uncertainty into a decision you can defend.
Benefit Sensitivity Analysis
Model changes to premium, MOOP, cost-sharing, and supplemental benefits. See predicted enrollment impact by county before committing millions.
Competitor Move Simulation
Test how competitor benefit changes affect your enrollment. Model defensive strategies before rivals capture share.
Service Area Expansion/Reduction (SAE/SAR) Testing
Evaluate expansion scenarios with enrollment forecasts. Know which counties are worth entering before you file LOI.
County Significance Scoring
Identify which benefits drive enrollment vs. drain budget in each market. Focus investment where you see margins.
Growth Driver Analysis
Understand why plans grew or declined. Decompose results to inform next year’s strategy with data, not guesswork.
"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."