Engage members between visits. Reduce avoidable utilization.
Nudge gives health plans a configurable engagement layer that improves medication adherence, closes care gaps, and supports behavioral health, all while generating measurable ROI.
The gap between coverage and engagement
Health plans invest heavily in benefit design, network adequacy, and care management programs. But most member engagement happens reactively, after a hospitalization, a missed refill, or a quality gap flag.
The members who cost the most are the ones who engage the least with prevention and follow-up. Generic outreach gets ignored. Manual care management cannot scale. The result is avoidable utilization, lower quality scores, and members who feel unsupported between the moments that matter.
Annual cost of medication non-adherence
Morbidity and mortality from poor medication adherence costs the U.S. healthcare system an estimated $528.4 billion annually in avoidable hospitalizations and preventable deaths.
Annals of Pharmacotherapy, 2023Chronic patients don't take meds as directed
Approximately half of patients prescribed chronic medications do not take them as directed, missing doses or discontinuing treatment within the first year.
World Health Organization, 2023Adults with mental illness receive no treatment
Among 61.5 million U.S. adults with any mental illness, 48% did not receive any mental health treatment in the past year.
SAMHSA NSDUH, 2024How Nudge works for health plans
A configurable engagement platform that delivers personalized interventions across populations, conditions, and care settings.
Population-scale engagement
Enroll thousands of members into automated workflows segmented by condition, risk level, or program. No per-member manual effort.
Adherence programs
Medication reminders, side effect monitoring, and refill nudges that reduce non-adherence across chronic conditions.
Behavioral health support
Between-visit engagement for members with anxiety, depression, and substance use disorders. Evidence-based exercises included.
Quality measure improvement
Targeted interventions that move HEDIS, Stars, and CAHPS scores through better follow-up and member satisfaction.
Purpose-built for population health
From member onboarding to quality measure improvement. Nudge handles the engagement layer so your team can focus on strategy.
Target the right members with the right programs
Use groups and enrollment triggers to segment members by condition, risk tier, or care gap. Each segment receives tailored workflows that adapt based on member responses.
Automated care journeys at scale
Multi-step workflows deliver medication reminders, symptom check-ins, and care gap closures across entire populations. Branching logic personalizes the experience without manual intervention.
Measure what matters
Track engagement rates, adherence improvements, and care gap closure across programs. Exportable reports for quality measurement and stakeholder reporting.
The economics of proactive engagement
Structured between-visit engagement reduces avoidable utilization, improves quality scores, and generates measurable savings across populations.
Return on collaborative care investment
Collaborative care models integrating behavioral health save approximately $6 for every $1 invested, with 11% fewer hospital admissions and 23% fewer ED visits.
JAMA Network Open, 2025Employer behavioral health ROI
Every $100 invested in employer-sponsored behavioral health programs was associated with a $190 reduction in medical claims costs in the first program year.
JAMA Network Open, 2025Text messaging doubles adherence odds
A meta-analysis of 16 RCTs found text-message interventions doubled the odds of medication adherence and increased overall adherence rates by 17.8%.
PMC / a:care Congress, 2024One platform, many programs
Nudge supports multiple engagement programs across conditions and populations from a single configurable platform.
Medication adherence
Dosing reminders, side effect monitoring, and refill nudges for chronic condition populations.
Behavioral health follow-up
Structured between-visit support for members with depression, anxiety, and substance use disorders.
Post-discharge engagement
Recovery check-ins, medication reconciliation reminders, and follow-up scheduling after hospital stays.
Chronic condition management
Ongoing symptom monitoring and self-management support for diabetes, COPD, heart failure, and more.
Preventive care gaps
Nudges for screenings, vaccinations, and wellness visits that improve HEDIS and Stars scores.
Caregiver support
Education, resource referrals, and stress monitoring for family caregivers of high-needs members.
Enterprise-grade compliance
Health plans operate under strict regulatory, contractual, and reputational requirements. Nudge is built for that environment from the ground up.
Patients want digital health tools
76% of patients are interested in using digital health tools, but trust in data privacy remains the top barrier to adoption.
Rock Health / Stanford, 2024Average healthcare data breach cost
Healthcare has the highest average data breach cost of any industry at $10.93 million, more than double the global average across all sectors.
IBM / Ponemon Institute, 2024HIPAA-aligned architecture
Data handling, access controls, and delivery channels designed around HIPAA minimum necessary standards.
Documented consent management
Members provide consent before enrollment with clear records of what they agreed to and when.
Full audit trail
Every member interaction, opt-in, opt-out, and data access event is logged with timestamps.
Instant opt-out
Members can unsubscribe at any time. Workflows pause automatically and the event is recorded in the compliance log.
Role-based access control
Workspace-level permissions with admin, manager, and subscriber roles. Provider-scoped visibility for clinical users.
Custom branding
White-label the member experience with your plan's colors, logos, and identity to build trust and recognition.
Expected outcomes
Reduce avoidable utilization
Proactive engagement catches issues early, reducing ED visits and preventable hospitalizations.
Improve quality scores
Targeted interventions move HEDIS, Stars, and CAHPS metrics through better follow-up and satisfaction.
Increase medication adherence
Structured reminders and monitoring reduce non-adherence across chronic condition populations.
Scale without headcount
Automated workflows engage thousands of members without proportional growth in care management staff.
"We went from chasing patients with phone calls to having every patient get the same quality of follow-up without anyone on the team touching it."
Founder, KuduCare
See how Nudge works for health plans
Book a walkthrough and we'll show you how Nudge drives member engagement, closes care gaps, and delivers measurable ROI across your population.
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