New
Introducing AI Renewal Agent
As redetermination cycles accelerate, maintaining coverage, and revenue, becomes more difficult. Payers and health systems need to scale operations to reach people in the right way, at the right time if they expect to keep eligible members covered and connected to care. Preserve PMPM revenue, close HEDIS gaps, and support your care teams by reducing Medicaid administrative churn.
The Problem: Why Traditional Outreach Fails in 2026
Manual Outreach Can’t Scale to Semiannual Redeterminations.
The Solution: Precision Agentic AI Workflows
Beyond Engagement—Automated Care Enablement via Medicaid Member Retention Automation
Identify
Continuously monitor early risk signals—like SNAP churn and pharmacy adherence gaps—to segment members at risk of missing 6-month recertifications.
Engage
Launch proactive, multichannel outreach (Voice, SMS, Email) in 80+ languages with a culturally sensitive AI agent that matches the member's communication style.
Resolve
Two-way agentic workflows actively guide members through document submission via automated enrollment and recertification workflows.
Escalate
Reasoning AI tracks completion and seamlessly escalates complex cases to human navigators only when the member is truly stuck, optimizing staff bandwidth.
Measurable ROI. Continuous Benefits Coverage.
COVERAGE
Maximized Continuous Coverage
As redetermination cycles accelerate, reaching eligible members in the right way, at the right time is the difference between preserved PMPM revenue and procedural disenrollment. Blooming Health reduces the projected 7.8M–11M procedural disenrollments by scaling outreach operations to keep members covered and connected to care.
