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For Payers

Close care gaps across your population.Without scaling outreach teams.

Mila helps more members get reached, heard, and connected to the care they need, without adding more outreach burden to your team.


  • Live in weeks
  • No rip-and-replace
  • Configurable programs

Member Engagement Programs

Care gap outreach128
HRA completion94
AWV scheduling156
Rx benefit enrollment72
HRA completed AWV scheduled Screening callback requested

Care gap outreach · Member M.K. · preventive screening due
Prefers SMS · No prior response · SMS-first rule

Mila

Your health plan shows you may be due for a preventive screening. I can help you review options or connect you with someone who can help.

Member

Can someone call me tomorrow?
Callback requested Care team routed

Needs human follow-up

Reason: member requested support. Context attached, routed to care team.

THE REALITY

The real cost isn’t outreach. It’s every unreached member and every missed care gap.

Members miss calls, abandon portals, wait on hold, or go quiet after enrollment. When outreach cannot adapt, care gaps stay open and the needs behind them surface too late.

The Mila Difference

Move the metrics without multiplying manual work.

Mila combines omnichannel outreach, Health Risk Assessment dialogue, live care gap closure, configurable escalation, and continuous navigation, so payer programs can move more members from outreach to completed action.

24/7 omnichannel outreach

Inbound and outbound across voice, text, and chat, with zero-wait handling, after-hours coverage, and HIPAA verification.

Converse & uncover member needs

Open HRA dialogue surfaces medication non-adherence, SDOH, and unmanaged symptoms.

Live care gap closure

Members complete actions in the same conversation, from screenings and AWV scheduling to Rx benefit enrollment.

Intelligent member routing

Routine tasks handled automatically; higher-risk needs warm-transferred to care managers, following your configurable escalation rules.

Continuous care navigation

Context retained across the member journey, so follow-up continues across post-discharge, adherence, and care-program actions tied to Stars, HEDIS, and CAHPS.

Proven Impact

Lower overhead.
Higher response.
Clearer attribution.

Mila helps payer teams reduce outreach spend and see which engagement turns into completed member action.

Traditional Outreach Mila Outreach
Time to launch
Traditional Outreach 6 months
Mila Outreach 6 weeks
Cost per call
Traditional Outreach ~$12
Mila Outreach ~$3
Response rate
Traditional Outreach 15%
Mila Outreach 55%
3.7x
Improvement in outbound reach
4.2/5
Member sentiment score
1 in 3
Surfaced unknown care need
Programs & Workflows

Start with one program. Expand across many.

Mila supports payer workflows across quality, risk, member services, and population health. Whether the goal is plan onboarding, HRA completion, care gap closure, or post-discharge follow-up, Mila adapts to the program rules, member journey, and escalation paths behind each workflow.

Plan welcome and onboarding

New-member onboarding at scale

HRA completion

Health Risk Assessment outreach and follow-up

Preventive screenings

Mammogram, colonoscopy, A1C, and more

AWV scheduling

Annual Wellness Visit scheduling at population scale

Care gap closure

HEDIS, Stars, and quality outreach

Medication adherence

Refill reminders and member check-ins

Inbound response & callbacks

Member services support and routed follow-up

Program follow-up

Close the loop on every touch

Custom workflows

Configured to your programs, populations, and rules

Configured by program Rules Channels Timing Approved content Member context Escalation paths Reporting

Ready to launch your first program?

Book a Demo
See it in action

Watch Mila turn onboarding into action.

In this member onboarding video, Mila helps a new Medicare Advantage member understand their benefits, complete home delivery enrollment, and get routed to the right support when needed.

HOW IT WORKS

Your program rules define the path.
Mila takes the next step.

Mila listens for signals across your payer operations, from new member enrollment to unfinished assessments, open care gaps, missed follow-up, and requests that need review. Then it acts within your rules, completing routine steps or routing issues with context.

Signals across your operations

Pulled directly from claims, eligibility, and care management data. No new login needed.

Unfinished Health Risk Assessment Open care gap Missed follow-up Rx benefit question Transportation barrier Post-discharge check-in Member request needs review
Signal detected
Unfinished Health Risk Assessment
  • HRA started but not completed
  • Last outreach: 3 days ago
  • Member prefers SMS
Rule matched

Restart HRA follow-up after 3 days.

Preferred channel Language preference Approved HRA questions Escalation path Program owner Follow-up timing
Mila acts
  • Member contacted
  • HRA dialogue resumed
  • Medication barrier surfaced
  • Transportation need identified
  • Assessment completed
Outcome
  • HRA completed
  • Needs surfaced
  • Follow-up queued
  • Member context retained
Routed with context
  • Care management need routed with context
  • Summary attached
  • Program owner notified
HRA completion synced to care management platform

EMBEDDED BY DESIGN

Mila starts from the workflow, not just the conversation.

With Mila’s unique API-first architecture, the platform can respond when something changes in your operation, not only when a member reaches out. It works through the systems, signals, program rules, member context, and escalation paths already running your payer business.

That means Mila can act when a member signs up, a care gap opens, an assessment stalls, a benefit question comes in, or a follow-up step is due, then return updates, summaries, and routed issues where your teams can act.

Quality & Care Management

Open item

Member

Angela M.

Program

Quality outreach

Care gap

Diabetes A1C screening

Due

This month

Status Open
Signal detected: care gap opened

Outcome

Member reached Yes
Summary Attached
Reporting Updated
Transportation support needed, routed to care team
Mila Care coordination

Program rules

Applied

Member context

Loaded

Preferred channel

Selected

Outreach

Started

Proof in Practice

One payer team, in their own words.

Our team can only make so many calls in a day. Mila extended our reach across voice, text, and chat without adding headcount, and we launched new programs far faster than our campaign process ever allowed.

Population health leader

Medicare Advantage plan

Why Mila

Embedded.
Governed.
Configurable.

Three things make Mila durable beyond the first program, and the reason payer teams keep expanding after the first campaign goes live.

Embedded

Works inside payer operations.

Mila connects to the systems and workflows already running your business, including care management, CRM, member services, eligibility, benefits, and provider data. Engagement can start from operational signals and return updates where teams work.


No new silo. No disconnected outreach layer.

Governed

Operates reliably within your rules.

Mila follows program rules, approved content, HIPAA verification, compliance requirements, and escalation paths across HEDIS, Stars, CAHPS, quality, risk, and care management programs.


Predictable behavior. Clear escalation.

Configurable

Adapts by program, population, and workflow.

Mila can be configured by plan, population, benefit, language, channel, timing, care gap, and escalation logic, from HEDIS outreach to Plan Welcome.


One platform. Many payer programs.

No rip-and-replace. No new silo. Just connected member engagement where it did not exist before.

See Mila in your programs

Find the payer workflows Mila can move first.

Walk through your highest-impact program: quality, risk, member services, or Plan Welcome. See where Mila can move metrics inside the systems you already run.

Book a Demo
AI care coordination that scales.
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