The Problem

Health plans generate massive amounts of data, but valuable insights remain buried in manual workflows. Quality teams spend hours pulling reports, cross-referencing dashboards, and building member lists—only to react to problems after they've already impacted Star Ratings.

The Solution

inGAGE IQ Copilot is an AI-powered analytics agent co-developed with Microsoft that transforms how health plans interact with member data. Instead of clicking through dashboards, simply ask questions in natural language and receive instant predictions, root cause analysis, and actionable recommendations.

Ask questions like:

"Which members are likely to rate access to care poorly and why?"
"What's driving low satisfaction in our Florida contracts?"
"Suggest members to target for diabetes gap closure and explain why."
"What downstream impact did our Welcome Back campaign generate?"

Get answers in seconds—not hours.

Key Capabilities

Predictive CAHPS Intelligence Identify which members are at risk of rating your plan poorly before the survey. Understand the drivers—whether it's pharmacy complaints, specialist referral delays, or benefit confusion—and take targeted action.

HEDIS Gap Closure Optimization Go beyond lists. inGAGE IQ predicts which members are most likely to close gaps, recommends optimal outreach channels, and generates targeted intervention strategies based on behavioral segmentation.

Root Cause Analysis Connect the dots between complaints, claims patterns, SDOH factors, and satisfaction scores. Surface correlations that would take analysts hours to uncover manually.

Campaign Performance Intelligence Measure downstream KPI impact from your outreach campaigns—track effects on complaint volume, customer service calls, pharmacy utilization, and predicted CAHPS movement.

Instant Outreach List Generation Ask for a targeted member segment and receive a ready-to-activate list with engagement predictions and recommended messaging strategies.

How It Works

inGAGE IQ Copilot sits on top of the inGAGE healthcare engagement platform, leveraging:

Unified Data Lake: Claims, clinical, demographic, behavioral, SDOH, and feedback data consolidated from your existing systems
20+ Predictive Models: Member satisfaction forecasting, engagement propensity, gap closure likelihood, and behavioral trend analysis
Azure OpenAI Integration: 1,800+ AI models from Microsoft's catalog powering natural language understanding and response generation
Real-Time Learning: Models continuously improve based on your plan's specific member population and outcomes

Deployment Options

Copilot Integration: Embed directly into Microsoft 365 workflows for seamless access within Teams, Outlook, and existing tools
Standalone Interface: Access through the inGAGE platform with dedicated conversational UI
API Access: Integrate AI-powered insights into your existing analytics and reporting infrastructure

Results Health Plans Achieve

99% prediction accuracy for member satisfaction scores
10,000 minutes → 10 seconds for campaign audience creation
41% reach rate (vs. 25% industry average) through AI-optimized targeting
40% improvement in care gap closure rates

Built for Healthcare

HITRUST CSF r2 Certified
NIST 800-171 Compliant
HIPAA BAA Ready
SOC 2 Type II Audited
Azure-native architecture (East US region)

Who It's For

inGAGE IQ Copilot is designed for Medicare Advantage, Medicaid, and Commercial health plans with 100K+ members who need to improve Star Ratings, close HEDIS gaps, and transform member engagement from reactive to predictive.

Ideal users:

STARS/Quality Improvement Teams
Member Experience Leaders
Campaign & Outreach Managers
Health Plan Executives

Make your data go from something you search into something that answers back.

inGAGE IQ Copilot

argitaratzailea: Insightin Health