Routine check-ins
Stay connected to symptoms, concerns, and day-to-day progress.
Understand the member beyond the claim.Scale the relationship beyond the call center.
Hygia for Payers
Members with chronic conditionsneed ongoing support.
Hygia helps health plans maintain an ongoing relationship with members, extending support at scale and bringing care managers into the process when human attention is needed.
The payer blind spot
The claim tells you what happened.It rarely tells you why.
Health plans are increasingly good at identifying care gaps, missed services, medication fills, utilization patterns, and changes in healthcare activity. The harder question is what those signals mean for the individual member.
The plan can see
The relationship can help reveal
Prescription not filled
Cost? Concern? Confusion? Access?
Screening not completed
Did not understand? Could not schedule? Competing priority?
Referral remains open
Transportation? Network issue? Unclear next step?
Member does not respond
Timing? Channel? Trust? Other priority?
Utilization changes
What changed in the member's life?
Identifying the gap is not the same as understanding the gap.
The member experience
Gia becomes the health plan’s continuing presence in the home.
Members can engage Gia conversationally around the healthcare needs that arise between formal touchpoints. The interaction feels simple to the member while Hygia connects it to the larger care relationship.
Medication follow-through
Surface questions, barriers, and changes that can affect adherence.
Appointments and care gaps
Help members prepare, navigate next steps, and follow through.
Questions when they occur
Give members somewhere to turn before the issue becomes another delayed signal.
From Signal to Action
Finding the opportunity is only the beginning.
Hygia helps move from the signal the plan can see to the barrier the member is actually experiencing, then connects that understanding to the appropriate next step.
The plan sees
A preventive screening remains open.
The member has not completed it.
Gia learns
The member intends to complete it but does not know where to schedule.
Hygia helps
Gia can support the next step or surface the barrier to a care manager with relevant context.
Then
Gia can continue appropriate follow-up afterward.
For the care team
Who needs me today, and why?
Continuous member interactions become a prioritized, manageable workflow. The care manager sees why a member was surfaced and can access relevant context before reaching out.
Hygia
Care coordination
AM
Alyssa Morgan
Care manager
Good morning, Alyssa
You have 8 members who may need your attention today.
Who needs me today, and why?
Queue settings
A view of members based on recent activity and care gaps.
All reasons
All programs
- 1JBJames BrownID: 12345678Transportation barrierJames mentioned he missed his last appointment because he didn’t have a ride.
- 2MLMaria LopezID: 87654321Screening overdueMaria is due for a breast cancer screening. She expressed concern about scheduling.
- 3RWRobert WilliamsID: 23456789High blood pressureRobert’s recent BP reading was high. He’s open to coaching on diet and exercise.
- 4TSTina SmithID: 34567890Medication adherenceTina shared she sometimes forgets her evening medication.
- 5DCDavid CarterID: 45678901Diabetes managementDavid is working on A1C goals and requested nutrition resources.
Showing 1–5 of 8 members
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Illustrative workflow
One relationship. Multiple payer priorities.
Close important gaps
- Care-gap closure
- Preventive care
- Appointment and referral follow-through
Support ongoing care
- Medication adherence
- Chronic-care engagement
- Post-discharge follow-up
Help members navigate
- Benefits and healthcare navigation
- Member education
- Social and practical barriers
Bring people in when needed
- Caregiver engagement
- Clinician awareness
- Care coordination
- Member experience
Built for the realities of Medicare Advantage.
Members with complex needs may be managing multiple conditions, medications, appointments, benefits, and care transitions, often with help from family caregivers. Hygia is designed to make ongoing engagement easier to access at home.
No smartphone required
Members can receive a Hygia tablet for home use.
Multilingual
Gia supports 42 languages and can transition when a member requests another language.
Natural conversation
Members can engage conversationally rather than learning another healthcare interface.
Value to payers
Scale member relationships more efficiently.
Use ongoing engagement to extend reach while helping care managers focus on the situations where human attention matters most.
Scale Reach More Efficiently
Maintain continuity with more members without requiring staffing to grow at the same rate as engagement volume.
Better Understanding
Learn why members do or do not move forward, not simply that something happened.
More Focused Human Intervention
Help care managers concentrate their time where judgment, coordination, or human support is needed.
A More Distinctive Member Experience
Create a familiar, continuing relationship that can support member satisfaction, loyalty, and plan differentiation.
Scale the relationship, not the call center.
See how Hygia can help your health plan stay connected to members, understand what is getting in the way, and bring people into the process when it matters.