Payers
The Member Engagement Platform Payers Use to Close Care Gaps and Drive Quality Care
WestCX Orchestrate™ is an AI-native platform that works across your existing claims platforms, CRMs, and member communication systems to coordinate proactive, personalized member engagement at scale—reducing cost-to-serve, closing care gaps, and improving quality scores that directly impact plan performance and member outcomes.
Challenges
Your Members Aren't Getting the Right Message. Your Quality Scores Are Paying for It.
Preventive care gaps are widening
When outreach is generic and poorly timed, members delay care and conditions progress untreated, often leading to higher-cost, avoidable interventions.
Enrollment friction drives members to drop-off
Disconnected communication creates confusion during the onboarding process, increasing cost-to-serve, delaying coverage activation, and eroding member satisfaction.
Quality scores won’t budge
Generic or inconsistent outreach fails to engage members, leaving Stars, HEDIS, and CAHPS measures flat and revenue on the table.
Diverse populations are often underserved by one-size-fits-all outreach
When communication fails to reflect language, health literacy, and channel preferences, engagement drops, putting quality outcomes and regulatory performance at risk.
BEFORE
The Status Quo
Members overdue for preventive screenings and chronic care check-ins slip through the cracks, with no visibility into where, when, and why member engagement broke.
AFTER
How WestCX™ Helps
WestCX Orchestrate identifies members with open care gaps and triggers personalized, multimodal outreach across each member’s preferred language and channel to drive timely engagement and close gaps in care.
OUTCOME
Preventive care completion rates grow up to 41% and care gaps close.
Who Uses WestCX
One Platform, Built for Every Team That Touches the Member Journey
Health plan performance is a team effort. WestCX Orchestrate supports every team that plays a role in getting there.
Automate routine inbound inquiries, so your team spends less time on calls they shouldn't have to take and more time on the members who need them most.
Deploy timely, personalized outreach that keeps high-risk members engaged between provider visits.
Execute targeted member acquisition and re-engagement campaigns across every channel with the segmentation, personalization, and performance tracking needed to move enrollment numbers and campaign ROI.
Track, measure, and optimize the member outreach that drives Stars, HEDIS, and CAHPS performance with end-to-end visibility across every campaign, interaction, and member population.
Built to Work Within Your Existing Technology Stack
Resources
Learn How Health Plans Like Yours Are Transforming Member Engagement
Effective Payer Member Engagement: Strategies and Best Practices
Most payers tend to measure engagement by what’s easy to count. But touchpoints, portal logins, and outreach volume don’t say much about whether a member actually did something differently because of them. That’s where the gap starts to show.
From System of Record to System of Action: The New Standard of Effective Engagement
Most customer platforms were originally built to only store information. They kept records clean, searchable, and compliant, but they didn’t do much beyond that. However, that passive nature started to break down as CX leaders began pushing for systems that could actually respond to interactions in real time. The expectation shifted from keeping records to driving outcomes. That’s where the idea of a system of action starts to take hold.
Improving Chronic Condition Management With a Connected Patient Journey
Managing chronic conditions often feels like trying to keep track of a conversation that keeps getting interrupted. You have patients coming in for a visit and receiving a care plan. They’ll then skip their next appointments and unknowingly create major care gaps. Visibility into the patient’s condition eventually drops off and small issues that could have been caught earlier build into bigger ones.
Healthcare Revenue Cycle Optimization: Why It Matters and Best Strategies
Healthcare organizations can do everything right clinically and still struggle financially. The reason most often is that they're bleeding revenue due to broken internal processes.
Let's Talk About What Better Member Engagement Could Mean for Your Health Plan
Whether you're trying to move Stars scores, close care gaps, or simply reach more members more effectively, WestCX Orchestrate is built to help. Let's start with a demo.
