For payers & health plans
Members don't answer their insurer. They answer their clinic.
Plan-branded call centers fight low answer rates and member abrasion. Quaility works the other way: we equip your contracted providers with the data layer and outreach engine to close gaps in their own trusted voice — and the documentation flows back to you, structured.
The plan-side problem
Quality ratings hinge on actions
only providers and members
can take
Ratings money, member behavior
Stars, state quality programs, and accreditation all pay on screenings and visits that happen — or don't — in a clinic you don't operate.
Outreach fatigue is real
Members get plan letters, plan calls, plan texts — and tune them out. The same message from their own doctor's office gets answered.
Supplemental data trickles in
Care happens and never reaches you — gaps stay "open" on your books because the provider's EHR can't or won't report it cleanly.
Provider enablement stalls
You'd gladly fund gap closure at the group level — but the groups lack the data infrastructure to run a program, so the dollars sit.
Equity measures need language
Closing gaps equitably means reaching members in Spanish and beyond — at a cost model plan call centers struggle to sustain.
Attribution friction
Your member lists and the provider's panel never quite agree — and every mismatch is a member nobody calls.
The provider-enablement model
Fund the layer, get the closure — and the data
Quaility deploys inside your contracted provider groups — health centers, IPAs, medical groups — as their population health platform. You sponsor or co-fund the deployment for your attributed members; the gaps close in the provider's voice; the documentation comes back to you structured.
Outreach members answer
AI and staff outreach in the name of the member's own clinic, in the member's language — scheduling real appointments, not leaving plan voicemails.
Supplemental data, structured
Closures documented at the source and returned in your format — fewer gaps open on your books that were closed in the chart months ago.
Measure-aligned reporting
Campaign-level visibility per group: members reached, gaps closed, by measure and language — the program report your quality team actually wants.
Member data is handled provider-side under BAAs; we are a provider-first platform and keep the trust model that makes the outreach work.
Why the provider's voice
The trust is already built. We just connect it.
A member who ignores an 800-number answers "Hi, this is the care team at your clinic — you're due for your mammogram, can we book you Thursday?" That's not a script trick; it's the actual clinic, on the actual schedule, in the member's actual language. Our platform just makes it possible at scale.
At our first deployment — a Los Angeles community health center — that model returned 2,025 staff hours a year to patient care and moved three quality measures past the 75th national percentile.
Measured outcomes at our first deployment. Read the case study.
Questions
What plan quality teams ask us
Provider-first, by design — the platform lives with the group and the outreach happens in their name, because that's what members respond to. Plans engage by sponsoring deployments for attributed members and receiving structured closure data back. We're explicit about this model because it's why the outreach works.
Groups with quality dollars at stake and thin infrastructure: community health centers, IPAs, independent medical groups, ACO participants. If you have a contracted group underperforming on gaps you both care about, that's the pilot.
Closure documentation is captured at the source — visit scheduled, service performed, result recorded — and returned in the format your supplemental data process accepts, with campaign-level reporting per group, measure, and language.
Our first production deployment is provider-side at a Los Angeles community health center, where payer quality program performance is a core use case. A plan-sponsored deployment would be among our first — we say that plainly, and we scope pilots small enough to prove the closure math before you commit further.
See it on your own data
Watch our AI call a patient.
Then imagine it calling
thousands of yours.
A 30-minute demo: live AI outreach, your quality measures on a unified record, and an honest conversation about what we'd build for your workflows.