One member record. Clear answers. Better Stars. Built for Medicare Advantage.
Unify EHR, claims, labs, and wearables in your brand. Built to move Stars, CAHPS, and RAF recapture.
Designed to improve CAHPS proxies, support RAF recapture, and reduce avoidable ED visits.See methodology & sources.
“What do my recent lab results mean?”
Your HbA1c is 5.8%, slightly elevated but within pre-diabetic range...
How this ladders to Stars and RAF
- Access and patient experience measures carry weight 4 through 2025. Weight 2 from 2026. We focus on those domains with plain‑language answers and frictionless access. Source
- 4 Stars typically raises your benchmark by about 5 percent. ROI calculator models this effect. Source
- +1 percent RAF ≈ $141 to $282 PMPY at $1,175 to $2,350 PMPM revenue. We show your PMPM assumption inline in the calculator. Source
Patient experience and access measures weight 4 through 2025 and weight 2 beginning in 2026.
What Vytivo moves financially
Measurable impact on the metrics that drive your bottom line
Stars & CAHPS
Crossing to 4 Stars typically yields a benchmark bonus (5% or 10% in double‑bonus counties). We model this transparently with rebate interaction; validate with your actuaries.
- •Plain-language explanations improve satisfaction proxies
- •Care gap nudges tied to each member’s history
- •Self-service answers reduce friction and complaints
Experience gains via clear, member-specific explanations.
Risk Adjustment (RAF) capture
A +1% RAF lift is worth ~$141–$282 PMPY. Vytivo's doctor-ready packets support annual recapture.
- •Pre-reads surface uncaptured diagnoses
- •Member-specific annual recapture tasks
- •Complete longitudinal context for documentation
Automated chronic condition documentation and annual recapture workflows.
Avoidable utilization
Device‑supported care programs show reduced hospital service use in a majority of trials; we model a conservative range and let you set the final assumption.
- •Event-triggered outreach from trends
- •Member education in context to reduce ED use
- •Care coordination via unified record
Vytivo gives plans a branded, context-rich channel to deliver these interactions.
Why choose Vytivo?
See how Vytivo compares to other healthcare solutions in delivering comprehensive, actionable health insights.
Features | 🏥EHR Portals | 🔗HIE & Data Pipes | 📱Generic Apps | 🤖AI Scribes |  |
|---|---|---|---|---|---|
Unifies EHR + claims + labs + RPM per member | |||||
Context-aware Q&A for members | |||||
Doctor-ready pre-visit reports | |||||
Personalized action plans | |||||
White-label mobile + web |
All member data in one record your members understand
Seamless integration with existing systems and data sources
EHR Provider Integrations
Wearables & Claims Data
FHIR, CDA, PDF, CSV/XLSX ingestion
Context-aware Q&A for members
Doctor-ready summaries
Personalized action plans
Population analytics & RAF capture
FHIR R4, USCDI v3, SAML/OIDC authentication. Nightly EHR/claims sync with de-duplication & normalization to build a longitudinal health graph.
Standards & Compliance
- •FHIR R4 & USCDI v3 compliant
- •HIPAA-compliant data handling
- •Supports CCDA, HL7v2, X12 formats
Identity & Security
- •SAML/OIDC authentication
- •Okta, Azure AD, Auth0 support
- •End-to-end encryption at rest & in transit
Data Refresh & Processing
De-duplication and normalization build a longitudinal health graph per member— a comprehensive, connected view of their health journey that powers context-aware answers, doctor-ready reports, and personalized recommendations.
What members can do
Empower your members with tools that make health management intuitive and actionable
Get context-rich answers
Ask natural-language questions grounded in the member's complete record.
Fewer support calls and clearer next steps improve experience measures.
Prepare doctor reports
Auto-generated pre-reads and structured summaries for the visit.
Cuts clinician pre-read minutes; supports RAF recapture.
Generate a health action plan
Diet/exercise/sleep/stress steps tailored to context.
Member-specific steps reduce avoidable utilization.
See biomarker trends
Track changes, learn "why it matters," and what to discuss with clinicians.
Explain "why it matters" to improve adherence.
Multi-language support • White-label design • WCAG AA accessible
How it works
A simple three-step process to transform your member engagement
Connect & unify
SSO + FHIR queries across your cohort; optional device connectors; nightly refresh.
Explain
Graph-first model relates meds, labs, diagnoses, lifestyle, and claims to explain the "why" behind each insight.
Act
Doctor-ready packets, member action plans, and population analytics tie directly to Stars/RAF/utilization levers.
Typical implementation timeline: 6-12 weeks to SSO, branding, and initial data onboarding
Workflow in your environment
- Data hop: Plan APIs + EHR FHIR R4 + pharmacy + labs
- Pre‑read drops as structured note and tasks for annual recapture
- Member app shows plain‑language status, coverage and next steps
Supports SMART on FHIR launch when exposed; otherwise EHR receives pre‑reads by file upload. Provider‑side write‑back via structured notes/tasks.
Opens architecture diagram
Why this still matters after 2026 re‑weighting
CAHPS and access weights drop from 4 to 2 in 2026 and to 3 in 2027. Star movement still drives rebates and QBP. Our calculator separates QBP from RAF to avoid double counting. CMS 2026 weights
Platform value for plans, providers, and members
One platform that unifies data, explains insights, and drives outcomes;
white-labeled for your organization
Move the Metrics That Matter
Stars, CAHPS, RAF capture, and utilization — all in one platform
Member-First Experience
Context-aware answers grounded in each member's complete health record
Doctor-Ready Intelligence
Auto-generated pre-visit summaries that save clinical minutes
Population Health at Scale
Surface risks, close gaps, and manage cohorts efficiently
AI That Explains Itself
Every insight traces to source data with citations for full transparency and auditability
Enterprise-Grade Security
SOC 2 Type II [In progress], HIPAA BAA, data residency — built for healthcare compliance
Ready to see how Vytivo can transform your organization?
Join leading healthcare organizations leveraging AI to improve outcomes
Packaging & pricing (directional)
Flexible enterprise pricing aligned with your organization's scale and needs
Core white-label platform
Tiered by lives • 36-month minimum
- Full white-label app & web
- SSO & brand customization
- FHIR-first integrations
- Member Q&A & action plans
- Doctor-ready reports
One-time implementation
Based on complexity
- SSO configuration
- Brand customization
- Data onboarding
- Custom language setup (cohort-specific LLM prompting; language complexity adjustments)
- Launch communications
- Training & documentation
Pricing examples are directional; final quotes via SOW. Volume tiers and minimums available in pricing schedule.
Risk-free pilot programs available
90-120 day pilots with full conversion credit toward year-1 platform fees
SLAs & security
Enterprise-grade reliability, security, and compliance
Uptime
99.9% monthly; service credits up to 99.95% for enterprise
Support
24×7 critical incidents; 1-hour response (Sev-1), same-day (Sev-2)
Data refresh
Nightly ingest for EHR/claims; near real-time for member-initiated data
Portability
Export on request (FHIR & bulk formats)
Contract flexibility
Termination for convenience with defined hand-back window
SOC 2 Type II audit in flight
Report target: Q4 2025. HIPAA BAA available.
HIPAA Safeguards
HIPAA-aligned safeguards; BAA available during contracting
Data residency
Regional data residency as required; backups stored in-region.
Backups & recovery
RTO 4h / RPO 1h; daily snapshots; access restricted to SRE on-call.
Access control
SSO (SAML/OIDC), least-privilege access
Encryption
At rest and in transit
PHI boundary
Member app, intake, and graph process PHI; marketing site and static assets do not. Subprocessors listed in Trust Center.
Prompt & chat logging
Off by default for PHI. Redacted prompts; 30‑day default retention; access limited to security/quality reviewers. Opt‑out available. Model providers never train on your data.
Pen‑test summary
Latest executive summary available in Trust Center; remediation SLA: Critical 7d, High 14d, Medium 30d.
Log retention
App logs retained 30 days. Security event logs retained 365 days. Export artifacts retained 7 days.
ROI Calculator
Estimate your potential return on investment with Vytivo's platform
Frequently asked questions
Everything you need to know about implementation, security, and platform capabilities
Yes—export on request; standard FHIR & bulk formats.
Default managed; BYO key available via your cloud/marketplace.
Typical 8–12 weeks for SSO, branding, and initial data onboarding.
Both (iOS/Android + responsive web), fully white-labeled.
We de-duplicate and clean across data sources to avoid double counting.
Typical pilots stand up in weeks once feeds are ready. Full rollout depends on data readiness and branding.
Member UI supports plain language, multilingual content, and WCAG-aligned patterns.
Yes. We ship a white-label app and web experience for your brand. You can link from your current app via SSO and deep links.
Yes. Access, experience, and complaints move from weight 4 to 2 in 2026, but still influence QBP and are member-facing. We model the weight change and keep RAF alongside Stars.
The ROI output shows QBP and RAF as separate line items. QBP depends on crossing 4.0 and rebate; RAF depends on PMPM and documentation completeness.
Metrics shown are illustrative. Results vary by population and benefit design; confirm with your actuaries.
Still have questions?
Our team is here to help with technical specifications, security requirements, and custom implementations.