vendor
Siftwell was founded in 2022 by former ACAP and nonprofit safety net health plan leaders as the tool they wish they had to better meet the needs of the complex and diverse populations they were serving. Our mission is to drive intentional action for the people who need it most.
We do this by empowering ACAP and other small to midsize plans to better understand the multifaceted needs of their population so they can intervene early and with more precision. Just as a periscope might help one to see beyond their capacity and assess whether to take a certain path, Siftwell’s applied analytics platform equips our partners to “see what is ahead” and target the right individuals with the right set of supports and services to improve outcomes.
Our approach drives measurable results: increased member engagement, improved preventive care utilization, and enhanced operational efficiency. We don’t just predict what will happen, we show you exactly what to do about it, making complex population health challenges manageable and measurable.
The data isn’t revolutionary; it is how we make it actionable in weeks, rather than months.
How Siftwell Supports ACAP Plans
Siftwell’s Pegasus Dashboard is an applied analytics platform that ingests your standard and non-standard data —claims, eligibility, HEDIS/CAHPS/HOS, HRAs, SDOH/HRSN, behavioral and psychographic signals, and more — and returns targeted population segmentation (the who and why) alongside next-best-action campaigns (the what to do about it). Outputs flow directly to the functional teams and existing systems already doing the work.
We work across three core areas where small and midsize plans need leverage most:
1. Population Health & Cost of Care
Match impactable rising-risk members with timely, targeted intervention and reduce avoidable utilization. Our causal-inference models project how your available resources – case management, PCP visits, transportation, medication adherence support, nutrition access, behavioral health – can bend care and cost trajectories at the member level.
• Identify high-cost members that traditional risk tools overlook (in one recent backtest, Siftwell’s top-100 riskiest new members drove 343% more year-end cost than other new members, starting from a near-identical month-one baseline)
• Quantify 12-month cost avoidance opportunities per cohort and per member (Approximately~$200K in avoided unnecessary utilization per campaign — with clients typically running multiple campaigns per quarter, translating to $MM-level annual)
• Monitor campaign performance against projected impact
2. Quality & Care Gaps
Prioritize the members most likely to benefit from outreach and improve compliance across HEDIS, Stars, and CAHPS measures. Siftwell’s Quality models identify who is at risk of noncompliance, who is impactable, and how to reach them (i.e. SMS, care-manager outreach, mailed materials, language-accessible channels, provider-led nudges).
• Stratify by likelihood to naturally close a gap vs. lift potential from intervention
• Segment by language, communication preference, and provider-alignment (Plan client achieved ~3x higher first-time outreach pickup rates and 2.4x or greater improvement in appointment booking through channel- and language-matched campaigns).
• Tie campaigns to measurable gap-closure and quality-score movement (60% lift in targeted populations receiving recommended services, including care gap closure.
3. Retention & Growth
Reduce avoidable churn, improve engagement in existing programs, and optimize product-to-member fit. Siftwell helps plans identify members at risk of disenrollment, members who would benefit from product migration (e.g., to MLTSS), and members whose engagement patterns suggest they’re underutilizing benefits they need. And with Medicaid redeterminations accelerating under HR1, Siftwell’s Pegasus Dashboard shows exactly who is at risk of losing coverage, quantifies potential revenue exposure by member category, and surfaces the right outreach actions before disenrollment occurs.
• Forecast churn risk and prioritize renewal outreach
• Surface growth opportunities tied to enrollment and plan revenue
• Re-engage historical underutilizers in preventive care
• Identify and segment members at risk of coverage loss under HR1 redeterminations, with revenue impact projections by category of aid and targeted outreach guidance — so your team is ready for 2027 go-live
Resources
• Demo
• Checklist
• Quality/HEDIS Blog
• Member retention and growth webinar
Contact:
Trey Sutten
CEO and Co-Founder
202-569-9674
trey@siftwell.ai
1235 East Blvd, Suite E
PMB 1622
Charlotte, NC 28203
www.siftwell.ai