Member Action Platform · Healthcare
Healthcare Has a Completion Problem.
You know who needs care. The gap is making sure they actually get it.
Health plans have invested billions in analytics, care management, and outreach — and they know more about their members than ever before. The bottleneck was never identification. It's activation. Capillary's Member Action Platform closes the distance between identified opportunity and completed care — at scale, across every member, every channel, every market.
4 gaps
Where value leaks between insight and completed action
↑ RAF
More complete risk adjustment capture
↓ Cost
Reduced avoidable utilization
The Hidden Value Leakage Gap
Value is lost at every step between identifying need and completing care.
Healthcare actions are rarely one step. A mammogram is not simply a mammogram — it requires understanding, provider selection, scheduling, transportation, follow-up, and documentation. Every additional step introduces dropout risk. And friction compounds. Most organizations have addressed identification. Very few have addressed execution.
Identify
Risk / Care Gap / Need Found
Engage
Outreach Begins
Friction
Scheduling · Transport Confusion · Drop-off
Action
Member Participates
Complete
Care Gap Closed
Care Gap Closed
Stars · RAF · Adherence Cost · Retention
Value Leak #1
Limited Relevance or Timing
Generic outreach that ignores member context or timing. Multiple siloed programs — quality, pharmacy, disease management, care — end up competing for member attention.
Value Leak #2
Complexity, Access & Motivation Barriers
Scheduling friction, transportation gaps, and low health literacy prevent members from taking the first step.
Value Leak #3
Incomplete Action or Abandonment
Members start but don't finish — appointments not attended, forms incomplete, follow-through not supported.
Value Leak #4
Documentation, Follow-Through & Provider Gaps
Completed care doesn't get captured — leaving RAF scores understated and Stars measures unclosed.
How the Member Action Platform Closes the Gap
The question is no longer: did we reach the member? It's: did the member complete the healthcare action?