The customer
Health plans whose member communication is still batch and one-size-fits-all.
The problem
Health plans have to engage members — preventive care, care coordination, inquiries. But generic mailers and siloed channels leave members confused and disengaged. Plans reach out after issues have escalated, refills and screenings are missed, and the fallout shows up as lower CAHPS scores, higher churn, avoidable ER costs and widening health disparities.
What we built
We orchestrate personalized, event-triggered member journeys on the Microsoft cloud: unify member data into a single actionable view, replace batch blasts with predictive omnichannel journeys, and layer agentic AI to automate proactive nudges and routine inquiries.
What changed
- Unified member data powering a single view across the plan
- Predictive, event-triggered journeys instead of batch blasts
- Proactive nudges that close care gaps and improve adherence
- Higher CAHPS scores, stronger retention and protected revenue
- Equity-focused outreach that reaches every population
- Lower cost through avoided emergency visits and earlier intervention
Built with
- Dynamics 365 Customer Insights – Journeys
- Dynamics 365 Customer Insights – Data
- Dynamics 365 Customer Service
- Power Automate
- Power Apps
- Microsoft Fabric
- Copilot Studio
- Azure AI