Building the Intelligent Health Plan – How HealthCheck Helps Payers Win on Value, Experience, and Engagement

As the healthcare industry undergoes a seismic shift toward consumerization and value-based care, health plans face mounting pressure to do more with fewer resources. It’s no longer sufficient to simply process claims or offer a static member portal. Today’s payers are expected to deliver proactive, personalized, and accessible care experiences that improve outcomes, reduce costs, and build lasting member relationships in an increasingly competitive environment.

Meeting the New Demands

HealthCheck is built to meet this exact need. It’s a modular, AI-powered platform that gives health plans the ability to deliver intelligent, connected, and cost-effective digital services—without the overhead of traditional infrastructure or the long timelines associated with custom development.

Smarter Member Engagement

At the heart of the platform is a commitment to smarter engagement. HealthCheck empowers plans to transform how they interact with members—guiding them from enrollment to preventive care, chronic condition support, and benefits navigation with AI-enabled precision. Members can:

  • Book appointments

  • Order at-home tests

  • Receive medication reminders

  • Understand their health coverage

—all through an intuitive digital experience that’s tailored to their needs and powered by real-time data.

Simplifying Complexity

Rather than adding complexity, HealthCheck removes it. The platform uses embedded logic and clinical guidelines to surface the right action at the right time. Members receive nudges to complete wellness visits, refill prescriptions, or close care gaps, helping drive performance in quality programs like STAR, HEDIS, and CAHPS. For plans managing Medicare Advantage or Medicaid populations, these tools aren’t just useful—they’re essential to meeting compliance benchmarks and maximizing reimbursement.

Streamlining Operations

Beyond engagement, HealthCheck simplifies operations. Prebuilt workflows support everything from behavioral health triage to chronic care coordination to lab fulfillment logistics. The platform integrates seamlessly with:

  • EHRs

  • Pharmacy systems

  • Transportation providers

  • Lab networks

…allowing payers to offer a decentralized yet cohesive care experience.

Reducing Administrative Burden

It also tackles backend complexity. HealthCheck automates:

  • Prior authorization

  • Claim denial management

  • Formulary navigation

  • In-network provider lookup

This streamlines tasks that often burden both call centers and clinical review teams—resulting in less friction, fewer bottlenecks, and a better experience for everyone involved.

“We’re redefining what it means to be a health plan in the digital age,” said Ken Mayer, CEO of HealthCheck. “This platform gives payers the ability to engage members with the same personalization and intelligence consumers expect in every other part of their lives—without building it from scratch.”

A Strategic Evolution for Payers

For forward-thinking plans—whether commercial, Medicare, or Medicaid—HealthCheck represents not just a platform upgrade but a strategic evolution. It offers a path to scalable innovation, built on a foundation of interoperability, flexibility, and compliance.

Shaping the Future of Care

HealthCheck doesn’t just help plans manage care. It helps them shape it—collaboratively, proactively, and intelligently. Because when the system works for everyone—patients, providers, and payers—we all win.