More assessments completed. Each one reviewed with evidence.
Health risk assessments prefilled from plan data, collected on any channel, and reviewed against the plan's own rules.
- Confirm, don't re-enter
- One assessment, every care setting
- AI flags, staff decide
Built for Medicare AdvantageD-SNPsManaged Medicaid
Is this still right?
Filled in from your September 2025 assessment.
Only this answer opens for editing.
Integrated D-SNPs
From October 1 for 2027 coverageOne combined Medicare and Medicaid HRA, set up state by state.
Integrated D-SNPs must use a single HRA that covers both Medicare and Medicaid, and each state sets its own requirements. HRA Intelligence already works this way.
- One core set, a module per stateShared questions sit in the core; each state's requirements are added as a module.
- Versioned by state and yearEvery assessment records the exact template version it used.
- Rules and policies owned by the planReference rules and requirement policies are set by the plan, state by state.
Outcomes
What changes for the plan.
More members finish their HRA
Members confirm prefilled answers instead of starting over, on a channel they already use, and can save and come back.
Prefill · any channel · save and resumeA full audit trail, from answer to decision
Each answer is saved with its source, channel and template version. Each marker links to its evidence, and each decision is recorded.
Versions · evidence links · reviewer decisionsStaff time on review, not data entry
Answers arrive as structured data and agents flag what needs attention, so staff spend their time on evidence and next steps.
Structured answers · AI-flagged markersProduct walkthrough
One assessment, three views.
Started on a phone, finished at a clinic, reviewed by the plan.
Review each assessment with the evidence in view.
See what the agents flagged and why, then record a decision.
- Markers grouped by domain, with what is new since the last assessment
- Each marker links to the question, answer, channel and rule
- History across assessment years, side by side
- Decision recorded by the reviewer; nothing is pre-selected
4 markers across 2 domains · 2 new since 2025
- A1C above plan referenceRule CP-114New
- Answer
- 8.2% · member mobile, Sep 5
- Last HRA
- 7.1% · Sep 2025
- Reference rule
- CP-114 · A1C below 7.0%
- Blood pressure above plan referenceRule CP-101
- Answer
- 152/94 · Riverside Clinic, Sep 18
- Reference rule
- CP-101 · below 140/90
- Shortness of breath reportedRule CP-101New
- Answer
- Yes, with light activity · Riverside Clinic, Sep 18
- Last HRA
- Not reported · Sep 2025
- Family history of heart diseaseRule CP-101
- Answer
- Yes · confirmed from 2025 HRA
Markers are not risk scores, diagnoses or recommendations.
Confirm what the plan knows. Answer only what changed.
Last year's answers are already in place; most take a single tap.
- Each prefilled answer shows where it came from
- Mental health questions are always asked fresh, with a crisis-line note
- English and Spanish, at a 6th–8th grade reading level
- Save and continue later on phone or web
- Invited by secure text or email link, or met inside the plan's app
Members never see markers, analysis or scores, only a submission confirmation.
Your medications
Are you still taking these?
0 of 3 reviewed
Clinic and hospital staff continue the same assessment.
Find the patient, see what the plan requested, pick up where the member left off.
- Staff-assisted, or patient-assisted on a tablet with a staff PIN
- Discharge assessments completed at the bedside
- Every assessment shows which plan requested it
- Verbal, paper or declined consent, with staff attestation
Not a medical record. Providers see status and their own submissions, never markers.
| Patient | Assessment | Status |
|---|---|---|
| John SmithDOB 03/14/1958 | Annual HRA (Adult) | In progress |
| Grace KimDOB 07/02/1961 | Annual HRA (Adult) | Not started |
| Carlos RiveraDOB 11/23/1970 | Cardiac (supplemental) Required | Not started |
How it works
From setup to decision in five steps.
Pick a template, a population or event trigger, the channels, and whether it is mandatory or optional.
Select a step to see what happens.
Members & providers see a confirmation onlyPlan staff see answers, flags and decisions
Plan controls
The plan owns the library, versions and rules.
One core question set, many templates
A clinically approved core is shared by every template; modules add what a situation calls for.
Example: share of questions in Annual HRA (Adult)
Versions are kept, compared and reusable
Every assessment records the template version it used. Archived versions can be compared and sent again.
- 2027 · DraftAwaiting clinical reviewEdit
- 2026 · PublishedApproved by the clinical leadLive
- 2025 · Archived6 added · 3 removed · 4 rewordedCompare
- 2024 · ArchivedFrozen, read-onlySend again
Mandatory or optional, set by policy
Switch the policy to see what the member sees.
Urgent help is never gated.
One quick step first
Before we book your ride, Acme Health Plan needs a few minutes of health questions. We've already filled in what we know.
Channels & triggers
Collected where members are. Started by events that matter.
Where it's completed
Member
Point of care
What starts one
Each member's due window starts the annual assessment, prefilled from last year.
A discharge event starts the discharge assessment within two days by text and email, unless one was completed in the last 30 days.
An event file entry starts the pregnancy assessment.
A new diagnosis, such as diabetes, starts the matching condition-specific assessment.
Six months after the annual assessment, a short update on what has changed.
Opening a gated topic in the app presents the assessment first, when policy requires it.
Analysis
AI flags markers. Plan staff decide.
Domain agents check answers against the plan's rules. Every marker links to its evidence.
Threshold
A1C 8.2%, reference below 7.0%
Change since last
Transportation barrier: no, now yes
Reported
Shortness of breath reported
Inconsistency
Diabetes in 2025, not in 2026
Data gap
No cardiology visit in 12 months
Not risk scores or diagnoses. Agents never contact members, and their output stays with plan staff.
What it is, and what it is not.
HRA Intelligence is
- An HRA platform run by the plan
- Prefilled and adaptive
- A version-traceable record
- AI-assisted, staff-decided review
It is not
- An EHR or core admin system
- A clinical decision system
- A risk-scoring engine
- Analytics for members or providers
HRA Intelligence is
- A health risk assessment platform run by the plan: templates, versions, triggers, requirement policies and reference rules are the plan's to set.
- Dynamic: prior answers and plan data are prefilled for the member to confirm or update, and the question set adapts to the situation.
- A structured, version-traceable record of every assessment, ready for reporting and year-over-year comparison.
- AI-assisted review: markers with evidence, labelled as such, interpreted by plan staff.
It is not
- An electronic health record or a core administration system.
- A clinical decision system. It produces no diagnoses and no recommended actions.
- A risk-scoring engine. There are no risk levels and no overall risk rating.
- A member- or provider-facing analytics tool. Those users see only their own submissions.
FAQ
HRA questions, answered.
What is a health risk assessment (HRA)?
A questionnaire a health plan uses to understand a member's health, daily needs and risks. The plan uses the answers to plan care and follow-up.
What is an integrated HRA for D-SNPs?
Starting October 1, integrated D-SNPs must use one combined Medicare and Medicaid HRA for 2027 coverage. Each state sets its own requirements, so the assessment has to meet the state's needs as well as Medicare's.
Which health plans is HRA Intelligence for?
Medicare Advantage plans, D-SNPs (including integrated D-SNPs) and Managed Medicaid plans.
How does it handle state-specific requirements?
Each template is a shared core question set plus modules, so a state's requirements become a module. Templates are versioned, and the plan sets its own reference rules and requirement policies.
How are answers prefilled?
From the member's previous assessment and the data the plan already holds. The member confirms each answer or updates what changed, and each prefilled answer shows where it came from.
Where can members complete an HRA?
By text or email link, in the plan's app or member website, or with staff at a clinic, hospital bedside, pharmacy counter or waiting-room tablet. Progress is kept across channels.
Does the AI make clinical decisions or score risk?
No. Agents flag markers where answers meet the plan's reference rules or differ from the last assessment. There are no risk scores, diagnoses or recommendations, and plan staff make every decision.
Who can see the analysis?
Plan staff only. Members and providers see a submission confirmation and their own submissions, never markers or analysis.
See HRA Intelligence with your own template.
Bring your current assessment. We'll map it, apply your rules and walk through all three views.