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Health Plan 365

AI agents and a unified command center to automate utilization management, enhance member experience, close care gaps, boost quality, and optimize financial outcomes.

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Skypoint Health Plan 365

Who We Work With:

  • Medicare Advantage Plans
  • Value-Based Care Partnerships
  • Employer-Sponsored Plans
  • Medicare Advantage Plans
  • Value-Based Care Partnerships
  • Employer-Sponsored Plans

Trusted by leading regional health plans

St Charles Health System
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Oregon Health Authority
Oregon PERS
Stanford Medicine Children's Health
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Proven Business Impact

Proven results across diverse health plans, streamlining operations, enhancing outcomes, and driving measurable revenue gains.

25
%
reduction in administrative costs
10-15
%
improvement in member satisfaction scores
2
%

Reduction in MLR within the first year

How Skypoint Works

Unify systems. Predict problems. Automate workflows. Better financial outcomes.

Skypoint Health Plan 365

Unified Data Platform

The Unified Data Platform (UDP) brings together data from 250+ EHRs, claims, and applications into health plan data models. At its core is the AI engine, where a team of AI agents work together to power applications and deliver proactive intelligence. Already have a data warehouse or BI solution? Skypoint integrates seamlessly with it.

AI Command Center

The Command Center is your AI agents hub, monitoring 350+ KPIs across your plan. It automates workflows from data to insights, predictions, and actions resolving routine issues instantly and escalating critical ones. Executives and managers receive daily AI briefings, proactive alerts, and recommended actions, ensuring real-time visibility and control over utilization, quality, and member outcomes.

AI Care Manager

Lia is your point of care AI assistant that overlays any EHR. Powered by UDP, it provides real time insights, predictions, and actions by surfacing clinical risks, compliance gaps, care gaps, payer requirements, and opportunities to improve outcomes so providers can focus on care.

AI Agents That Integrate With Your Existing Systems

Private AI Copilot

Enables teams to ask questions in natural language and get instant answers from unified data, policies, and documents – no analysts needed.
In-EHR Agent Overlays

Risk Adjustment

Improves coding accuracy and documentation to ensure proper risk scoring and optimized revenue under value-based care models.

Quality Measurement

Monitors and improves STAR ratings, HEDIS, and ACO metrics—automating compliance tracking and driving quality performance.

Utilization Management

Automate prior authorizations, accelerate reviews, and improve care decision accuracy with intelligent, real-time insights.

Care Gap Closure

Identifies and closes open care gaps across populations to improve member outcomes and contractual performance.

Member Engagement

Personalizes outreach based on demographics, claims, and past interactions to drive preventive care and satisfaction.

Cost Intelligence

Analyzes spend patterns, utilization trends, and care episodes to uncover high-cost drivers and optimize total cost of care.
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Resource Allocation

Improves care team efficiency by aligning staffing and services to member risk, utilization, and predicted needs.
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Outcome Forecasting

Predicts outcomes for member cohorts using historical and real-time data to guide care strategy and benefits design.

Integrate 250+ EHRs, claims and other applications

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Allscripts
AthenaHealth
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Cerner
Databricks
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Dockhealthnew
DrChrono
Epic EHR Integration
FHIR
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HubSpot
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Medhost
Meditech
Dynamics
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AI-Powered Command Center

From 350+ KPIs to predictive insights, alerts, actions, and automation.

Unified Data Platform

Workflow Automation

Senior Living 365: AI Workflow Automation
Unified Data Platform

Predictive Analytics

Senior Living 365: KPI Advisor
Unified Data Platform

Executive Briefings

Senior Living 365: Executive AI Advisor
Unified Data Platform

Risk Management

Senior Living 365: Risk Management
Unified Data Platform

Population Health

Senior Living 365: Care Analytics
Unified Data Platform

Labor Optimization

Senior Living 365: Labor Cost Percent
Unified Data Platform

Market Intelligence

Senior Living 365: Market Intelligence
Unified Data Platform

Clinical Documentation

Senior Living 365: Clinical Operations
Unified Data Platform

Financial Analytics

Senior Living 365: Financial Performance
AI has enabled Livmor to level the playing field by digesting millions of Medicare data points and structuring them in record time. The Skypoint AI Platform has proven invaluable for solving these data challenges. Without the Skypoint AIP, Livmor would not exist.
David Kohel, CEO of Livmor
David KohelCEO of Livmor
With Skypoint AI, our business partners who have been involved are ecstatic about what’s available now, compared to what they couldn’t do before. It’s a success story that we can build on as we grow and expand into other areas.
Wayne Haddad
Wayne HaddadCIO, Central City Concern
Skypoint AI allows us to connect different data sources like Epic (Caboodle) and CEDR to generate real-time analytics. Now we can evaluate organizational and provider performance more effectively.
David Silverman, COO of NACS
David SilvermanChief Operating Officer, NACS

Case Studies

Your 24/7 AI Workforce for Health Plans

Unify. Predict. Automate. With Skypoint, every health plan runs stronger.

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