What You Should Know
- New data from Accompany Health rejects industry norms that count passive phone calls or consent checkboxes as engagement (which typically yields only 20–30% reach), setting a standard defined by a completed in-home visit conducted jointly by an Advanced Practice Clinician (APC) and a dedicated Health Advocate.
- Accompany Health achieves a 55% engagement rate among attributed dual-eligible and complex Medicare Advantage members, with 99% of engaged patients in 2024 remaining actively engaged throughout 2025.
- While national Medicare benchmarks average ~13 total annual touches (visits and non-visit interactions), Accompany Health generates over 70 patient- and provider-initiated interactions per patient annually, exceeding 100 interactions per year for high-risk cohorts.
- In a Detroit Medicare Advantage D-SNP deployment, the care model elevated the patient population’s CMS Star Rating from 1.7 to 4.5 in Year One.
- Across engaged populations, Medical Loss Ratio (MLR) dropped by 18 percentage points; for the top 20% highest-cost members, average medical spend decreased 36% (from $3,230 to $2,075 PMPM), and inpatient admissions fell 49% (from 86 to 44 per 1,000 member months).
Redefining Dual-Eligible Engagement
Accompany Health has presented a care delivery framework for Dual-Eligible Special Needs Plan (D-SNP) and complex Medicare Advantage populations, demonstrating that deep in-person clinical relationships supported by AI-driven segmentation can address engagement barriers. By redefining member engagement from passive contact to intensive, in-home multidisciplinary care, the organization has demonstrated measurable clinical, quality, and economic gains across high-cost cohorts.
Traditional government-sponsored care management models often accept a 20% to 30% engagement rate, counting individuals as “engaged” merely for answering a phone call or completing an initial consent form. This low-touch attribution leaves the vast majority of high-need individuals unmanaged, contributing to widening care gaps and high emergency department utilization.
Accompany Health replaces superficial attribution with a full-risk, high-touch care model:
- Dual AI Segmentation (Clinical + Engagement Personas): Evaluates clinical risk alongside behavioral “engagement personas” to understand communication barriers, trust-building needs, and personal priorities before outreach begins.
- Pre-Assembled Chart Intelligence: Unifies medical claims, EHR feeds, pharmacy data, and social needs to provide care teams with pre-populated charts and prioritized next best actions before they arrive at the patient’s home.
- Multidisciplinary In-Home Care: Delivers comprehensive primary care, behavioral health, clinical pharmacy, and social care navigation in the patient’s home, supported by a 24/7 engagement hub.
- High-Frequency Touchpoints: Averages over 70 multi-channel interactions per year per member (surpassing 100 annual touches for the highest-risk tier), compared to the national average of 10–13 touchpoints.
Validated Quality and Financial Benchmarks
- 55% Member Engagement: Engages 55% of attributed dual-eligible members de novo, surpassing typical industry averages.
- 99% Longitudinal Retention: Retains 99% of engaged patients year-over-year (from 2024 to 2025).
- CMS Star Rating Transformation: Lifted its attributed Medicare Advantage population across Detroit and Denver from a baseline 1.8 CMS Star composite rating to 4.5 Stars.
- 36% Medical Spend Reduction: Reduced medical spend by 36% among high-cost dual-eligible cohorts.
- Inpatient Admission Reductions: Cut inpatient hospital admissions by 49% (from 86 to 44 per 1,000 member months) in the highest-cost tier.
- 18% Medical Loss Ratio (MLR) Improvement: Harvested operational savings by reducing unnecessary acute utilization under a full-risk payment structure.
“We are a risk-taking provider. We take full risk for outcomes and for the cost of care of the populations that we serve. And the magic of this is that by keeping people out of the hospital, out of the emergency room unnecessarily, we harvest those savings and we use it to power the model. And it’s the intensive care that we provide that allows us to do that.”
— Dr. Rahul Rajkumar, MD, JD, Co-Founder and CEO, Accompany Health
