THE FUTURE IS IN MOTION
Member Engagement Shouldn’t Operate in a Silo
Connecting human-centered engagement with AI-powered health plan operations
Health plans invest significant resources in member engagement, but those initiatives often operate separately from the claims, quality, provider access, and operational strategies that shape performance.
healthplans.ai and URAWARRIOR are bringing together human-led, AI-powered behavioral health and member engagement with payer-focused intelligence, claims processing, provider access, and end-to-end operations.
Together, we’re connecting meaningful member experiences with the operational capabilities and measurable outcomes health plans care about. The collaboration is designed to help plans engage members more effectively, strengthen relationships, improve access to care, and address the challenges that influence quality, retention, and financial performance.
Human Connection. AI-Powered Intelligence. Outcomes That Matter.
The Challenge: Engagement Without Connection
Health plans must improve member experience, support behavioral health, strengthen quality performance, and navigate growing operational complexity. Yet too often, member engagement is treated as a standalone initiative rather than an integral part of how a health plan operates. When engagement programs are disconnected from claims, provider access, quality measures, and operational workflows, opportunities to understand their impact and improve performance can be missed.
It’s Time to Connect Engagement to Performance
Member engagement is more than reminders, wellness resources, or app participation. It’s about helping people take action: scheduling preventive screenings, managing chronic conditions, engaging with care teams, accessing appropriate services, and making informed health decisions.
Those actions can influence quality measures, member experience, retention, and health plan performance.
The partnership is designed to connect member engagement with the processes and intelligence health plans use to understand results—not simply introduce another standalone solution.
Two Powerful Capabilities. One Connected Vision.
URAWARRIOR: Human Connection Drives Engagement
Founded by Dr. Bershan Shaw, URAWARRIOR combines behavioral science, emotional wellness, coaching, community, gamification, and AI-powered personalized engagement.
Built around The Warrior Method™, the platform is designed to encourage participation, resilience, and meaningful behavior change.
This is more than interacting with an app. URAWARRIOR can support focused, care-oriented engagement programs that bring together personalized technology, human connection, and inspiration from trusted leaders and a supportive community.
The goal is to help members feel supported, connected, and motivated to take meaningful action in their health and well-being.
healthplans.ai: Intelligence Meets Payer Operations
healthplans.ai brings payer-specific AI, claims processing capabilities, provider access expertise, and end-to-end operational experience.
With nearly three decades of payer industry expertise behind its leadership, healthplans.ai understands the complexities health plans face—from administrative inefficiencies and fragmented processes to quality performance and member experience.
The partnership aims to connect human-centered engagement with payer workflows, operational intelligence, and actionable insights so health plans can better identify opportunities, coordinate activities, and measure meaningful impact.
From Member Action to Health Plan Impact
HEDIS and Quality Performance
Connecting engagement to the actions that influence quality
Health plans are measured not only by the services they provide, but also by how effectively they help members access care, participate in recommended services, and manage their health.
The partnership is designed to explore opportunities to support preventive screenings, chronic condition management, behavioral health follow-up, care gap closure, and other member actions relevant to HEDIS and quality improvement initiatives.
By combining personalized engagement with payer-focused intelligence, health plans can work toward a more connected approach to identifying opportunities, encouraging participation, and understanding results.
Medicare Star Ratings
Behavioral health and member experience deserve greater attention
Behavioral health, preventive care, and member experience are important components of Medicare Advantage quality performance.
For the 2027 Medicare Advantage Star Ratings, CMS increased the weighting of the Improving or Maintaining Mental Health measure from one to three, underscoring the importance of members’ reported mental health outcomes.
URAWARRIOR and healthplans.ai aim to help health plans address relevant engagement priorities through personalized support, community connection, and better coordination with payer operations.
The opportunity goes beyond increasing outreach. It’s about encouraging meaningful participation and helping members feel supported throughout their healthcare experience.
Behavioral Health and Emotional Wellness
Engagement that goes beyond the app
Behavioral health engagement requires more than providing access to digital resources. Members need encouragement, trusted relationships, and programs that reflect their individual needs.
URAWARRIOR’s combination of human-led coaching, behavioral science, emotional wellness, community, and AI-powered experiences creates opportunities for more personalized and sustained engagement.
Programs can be focused on specific member populations, health priorities, or care needs, bringing together technology and human inspiration to help members take action.
Combined with healthplans.ai’s operational intelligence, this approach is designed to help health plans better connect engagement efforts with their broader care, quality, and performance priorities.
Member Activation and Retention
When members feel better, feel connected, and feel supported, staying becomes the natural choice
Acquiring new members can be significantly more costly than retaining existing ones. But lasting retention isn’t built through renewal campaigns alone. It’s earned through the experiences members have with their health plan throughout the year.
By combining URAWARRIOR’s human-led engagement, targeted programs, and community-building approach with healthplans.ai’s payer intelligence and operational expertise, health plans can create stronger, more meaningful member relationships.
Members who feel heard, supported, and part of a community have more reasons to stay engaged and fewer reasons to consider leaving. When members see their health plan as a partner in their well-being, renewal can become a natural continuation of that relationship rather than a separate retention effort.
For health plans, the opportunity extends beyond member satisfaction. Stronger relationships can support greater loyalty, reduce avoidable acquisition and replacement costs, and encourage positive word-of-mouth that may attract new members.
Retention becomes more than a marketing or enrollment activity. It becomes part of the overall member experience, supported by meaningful engagement, better access, and stronger relationships.
The goal isn’t simply to retain members. It’s to create an experience they want to stay with—and recommend to others.
Claims and Operational Intelligence
Connecting member experiences with the operations behind them
Meaningful engagement is only part of the equation. Health plans also need the ability to connect member activity with the operational processes and information that support performance.
healthplans.ai brings payer-specific AI and operational expertise to explore how engagement activities can be connected with claims-related insights, provider access, quality priorities, and end-to-end workflows.
The goal is to help health plans move beyond counting engagement activity toward understanding how member actions contribute to broader organizational priorities.
Specific integrations, capabilities, and measurable results will be established as the partnership develops.
From Member Engagement to Measurable Business Value
Better experiences can create value across the health plan
When member engagement is connected to payer operations, its potential impact extends well beyond participation rates.
Meaningful engagement can create opportunities to support:
Quality Performance: Encouraging actions relevant to HEDIS, preventive care, behavioral health, and Medicare Star Ratings
Member Loyalty: Building stronger relationships that support satisfaction, retention, and positive referrals
Operational Efficiency: Connecting engagement initiatives with payer workflows and intelligence to reduce fragmentation
Access and Coordination: Helping members navigate services, overcome barriers, and connect with appropriate providers
Financial Sustainability: Exploring how stronger retention, quality performance, and operational coordination can contribute to long-term business value
The opportunity is to make member engagement part of how a health plan delivers value—not a disconnected activity measured in isolation.
Two Female Founders. Two Visions. One Mission to Transform Healthcare.
Rachel Spilo
Founder & CEO, healthplans.ai | Founder & Chairperson, Catalyst Solutions
Rachel Spilo has spent more than 27 years transforming health plan operations, combining entrepreneurial leadership with a deep understanding of the payer industry.
She built Catalyst Solutions into a trusted partner to health plans nationwide, helping organizations address operational complexity, cost pressures, and fragmented processes.
She launched healthplans.ai to bring practical, responsible AI into the core of payer operations, with a focus on reducing administrative burden, improving efficiency, and driving measurable value.
Recognized for her entrepreneurial leadership, Rachel has received honors including the Small Business Administration’s Entrepreneur of the Year award and recognition among the Inc. 5000 fastest-growing companies.
Her leadership extends into the YPO community and philanthropy through The Impact of One, the nonprofit she founded to expand opportunity and improve lives.
Rachel brings a proven record of building businesses and advancing meaningful transformation for health plans.
Dr. Bershan Shaw
Founder & CEO, URAWARRIOR | healthplans.ai Advisory Board Member
Known as “The Warrior Coach,” Dr. Bershan Shaw is a dynamic entrepreneur, two-time Stage IV breast cancer survivor, AI technology founder, international speaker, and passionate advocate for mental wellness.
Her ability to connect with people has helped her turn personal adversity into a mission of empowering others to take meaningful action.
A New York City native, she built her career as a restaurateur and entrepreneur before Oprah Winfrey handpicked her for OWN’s Love in the City. She later appeared on The Real Housewives of New York City and HGTV, bringing her whole-person wellness perspective to broader audiences.
Her television appearances span ABC, CBS, NBC, Fox, and other networks. She has shared stages with Tony Robbins, Les Brown, Daymond John, and Grant Cardone.
With more than one million social media followers, Bershan has built a community around candid conversations about cancer, resilience, behavioral health, and asking for help.
Drawing on nearly two decades of coaching, advocacy, and healthcare engagement, she founded URAWARRIOR around her proprietary Warrior Method™.
As a member of the healthplans.ai Advisory Board, she brings the perspective of a patient, entrepreneur, and healthcare innovator to the partnership.
AI Built for Health Plans. Engagement Built for People.
Technology can make engagement more accessible and intelligence more actionable. But meaningful transformation requires understanding both the people behind every interaction and the operations behind every health plan.
healthplans.ai and URAWARRIOR are bringing these capabilities together to explore a more connected approach—one that helps health plans move beyond standalone engagement initiatives toward stronger member relationships, improved operational coordination, and measurable business value.
Beyond the Promise. Into the Proof.
Discover What’s Possible for Your Health Plan
Looking to strengthen member engagement, support quality improvement initiatives, improve retention, or explore how AI can connect member experience with payer operations?
Let’s talk about how human-led engagement and payer-focused intelligence can support your organization’s priorities.
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