Radial

Health plans and Medicare Advantage

Find rising-risk members early and keep them healthy at home.

Radial Care tunes care management to your MLR and Star measures, finds the members whose risk is rising while it can still be changed, and shares the next best action with plan and provider care teams.

Size your opportunitySee the platform
AI Agents · Today's worklist
Illustrative data
Ranked by risk and actionabilityLive
  • Patient A · Unit 4 WestPlacement agent86
    On the border: SNF or homeStrong home supportPT eval due today
  • Patient B · Unit 6 EastReadmissions agent74
    No follow-up bookedNew medications
  • Patient C · Unit 3 NorthPalliative Care agent69
    Repeat stays this yearRecent decline
  • Patient D · Unit 4 WestHospital Length of Stay agent58
    Past expected stayAwaiting SNF bed

Trusted by health systems, payers and research institutions

National Institutes of Health logoMass General Brigham logoMaineHealth logoHouston Methodist logoElevance Health logoNational Science Foundation logo

What keeps you up at night

We hear it in every first conversation.

“We need care management that finds rising risk before the claim.”

Claims lag the moment a member's health turns; real-time events close the gap.

“Our programs are full of the wrong members.”

Outreach to members who were never going to change wastes nurse time and budget.

“Provider partners and our care managers work from different lists.”

One shared next best action keeps plan and provider teams pulling in the same direction.

How Radial Care helps

Four capabilities, in the order you'd use them.

  1. 1Contract IntelligenceKnow what success pays.Ties MLR and Star measures to the members, providers and interventions that move them.Explore Contract Intelligence
  2. 2Next-Generation BISee where to act.Tracks admissions and SNF days per 1,000 by region and network, with early-warning alerts when they drift.Explore Next-Generation BI
  3. 3AI AgentsReach the right patients.Admission Avoidance and SDOH agents find rising-risk members early, and post-acute agents keep stays appropriate.Explore AI Agents
  4. 4Next Best ActionMake the next best action happen.Steers each member to the right program and routes the action to plan or provider care teams, with staff-supervised outreach in the member's preferred channel.Explore Next Best Action

The agents

Agents that find rising risk before the claim.

Admission Avoidance

1 · Community

Who is rising toward an avoidable ED visit or admission, and what can still prevent it.

Serves: Population health teams and care managers

SDOH

2 · Community

Which social risks stand between a patient and good outcomes, and which program can help.

Serves: Care managers, social workers and community partners

SNF Length of Stay

6 · Post-acute

Which SNF stays can end sooner with a well-supported transition home.

Serves: Post-acute care managers and SNF partners

Readmissions

7 · Transition home

Who is at rising risk of returning to the hospital, and which follow-up lowers it.

Serves: Transitions nurses and primary care teams

Palliative Care

8 · Serious illness

When quality of life is becoming as important as treatment, and a palliative consult should happen.

Serves: Hospitalists, palliative teams and primary care

The measures it moves

Results in the terms you report on.

  • Medical loss ratio
  • Avoidable admissions per 1,000
  • SNF days per 1,000
  • Star measures tied to care transitions

Contracts and programs covered

  • Medicare Advantage
  • Medicaid managed care
  • Provider risk arrangements

A typical first 90 days

  1. Weeks 1 to 6

    The Opportunity Assessment sizes avoidable utilization and program fit on your claims.

  2. Weeks 4 to 10

    Plan claims and ADT feeds connect; programs and outreach rules are configured with your care management leaders.

  3. By day 90

    Care managers and provider partners work from shared next best actions, measured against your MLR and Star goals.

Solutions

One platform for every front door.

Health systems and hospitalsOpen inpatient capacity with safer, faster discharges, and grow into value-based contracts at your own pace.
ACOs and risk-bearing providersLower total cost of care and lift quality scores across MSSP, LEAD and every other risk contract, with the staff you have.
PartnersEmbed Radial's clinical intelligence in your services or platform through APIs and the Radial MCP server.

A partner, not a portal

See Radial Care tuned to your contracts.

Bring one question about your population. We'll show you the platform on illustrative data, then size the opportunity on yours, with the team who would work beside you.

Book a demoSize your opportunity
  • A named clinical and technical lead
  • Quarterly business reviews
  • On-site visits and training