Everything you need to deliver better care — and lower the cost of it.
Most platforms wait for data to arrive. Mpowered's Know Your Member™(KYM) actively listens — pulling real-time signals from home devices, care encounters, pharmacy fills, and social risk factors — then orchestrates the right member and provider engagement before costs escalate and outcomes deteriorate. Everything health plans and risk-bearing organizations need to move from reactive to proactive care, at scale.
Cost & Risk
Reduce Avoidable ED / ER Visits
Identify rising-risk members early and intervene with timely outreach, navigation, and care coordination.
Reduce Hospital Readmissions
Coordinate post-discharge workflows and follow-ups to close care gaps and prevent unnecessary readmissions.
Stop-Loss Management
Detect high-cost risk early and orchestrate interventions and documentation to manage stop-loss exposure. Automate stop-loss submission workflows.
STARs, Value-Based Care & Quality Management
Operationalize quality programs with real-time insights, embedded workflows, and continuous performance tracking.
Automated Eligibility, Enrollment & Onboarding
Automate eligibility checks, enrollment, and onboarding workflows to reduce friction, improve application conversions, and reduce downstream operational issues.
Operations
Automated Patient Intake
Automate intake across fax, email & phone — collection of consents, medical records, documents, and bill payments to accelerate access and reduce manual effort.
Automated Prior Authorization
Automate prior authorization intake, status, and decisions to reduce delays and administrative burden.
Interdisciplinary Care Team Collaboration
Align care management, pharmacy, behavioral health, and social services around a shared member view — enabling care teams across organizations to collaborate on individual care.
Care Navigation
Guide people to the right care, at the right time, and in the right setting — based on clinical and benefit context.
Reduce Customer Support Overheads
Shift common inquiries and tasks to digital self-service or AI agent-led support while routing complex issues to the right teams.
Medicaid Eligibility Redetermination
Automate eligibility redetermination processes as per state-specific eligibility and reporting requirements.
Compliance
Patient Access APIs
Expose secure, standards-based APIs to support CMS 9115 requirements.
Electronic Prior Authorization
Expose secure, standards-based APIs to support CMS 0057 requirements.
Price Transparency
Provide real-time visibility into coverage and cost to support informed care decisions and comply with CMS 9915 requirements.
Next-Gen Digital Front Door
All digital endpoints in one place — member self-service, support interactions, care management, scheduling, payments, and assessments.
Member Experience
Unified Member Engagement
Understand how members engage across departments and channels, and optimize engagement to drive the best outcomes.