Health plans have invested millions in identifying risk. Actera is the AI platform that closes the gap between insight and intervention.
HCC gaps flagged, HEDIS measures open, rising risk members detected in dashboards.
Member contacted, enrolled in the right program, appointment booked, and followed through to completion.
Six AI agents share a unified context layer and work in concert — not as a pipeline, but as an orchestra where every agent can see, signal, and respond to the others in real time.
Actera meets your existing infrastructure where it is. No rip-and-replace.
The AWV is the single highest-leverage intervention in Medicare Advantage — touching risk adjustment revenue, HEDIS compliance, and Star Ratings simultaneously.
Actera identifies every member missing their AWV, handles outreach and scheduling, confirms completion, and ensures resulting diagnoses are captured for HCC coding — end to end.
We deliberately operate in the care management lane — enabling aggressive AI automation while competitors in utilization management face increasing regulatory headwinds.
Most platforms stop at 'here's what you should do.' Actera executes — outreach, enrollment, scheduling, and follow-through happen inside the platform.
We don't compete with your point solutions. We make them work — routing the right member to the right program and ensuring they actually engage.
Start with AI-assisted workflows where your team approves every action. Increase automation as trust builds. You control the dial from copilot to fully autonomous.
We don't sit in the background running batch jobs. Actera is the screen your care team opens every morning — a unified workspace replacing 6+ disconnected tools.
The industry built the intelligence layer. Now it needs the action layer. Actera is purpose-built for this moment.
We're working with a small number of forward-thinking health plans to design the future of care activation.
30-minute conversation · No commitment · VP Care Management & VP Population Health