Data Sheet: Scale Member Engagement with Sage, the AI-Powered Virtual Nurse
Health plan leader expect technology investments to deliver measurable operational and clinical value. Sage is bult to do exactly that - supporting priorities like cost, quality and member engagement.
Meet Sage, the AI-powered virtual nurse from HealthEdge® and Ellipsis Health. Sage helps health plans extend clinical capacity, close care and engagement gaps faster, and deliver a more consistent member experience across large populations. By automating high-volume, routine outreach through autonomous voice conversations, Sage frees nursing teams to focus on the complex, high-touch members who need them most. The result is lower administrative costs, stronger quality and regulatory performance, and improved member satisfaction.
Overcoming the Challenge: Why Nursing Teams Can't Scale Alone
Health plans face a widening gap between the volume of member outreach required and the clinical staff available to execute it. This challenge is especially critical for Medicaid and Medicare Advantage health plans, where performance depends on consistent outreach across large populations.
Routine, phone-based workflows consume a disproportionate share of nursing time. These can include:
- Enrollment follow-ups
- Post-discharge check-ins
- Assessment reminders
- Information gathering for care management programs
- Outreach tied to Health Risk Assessment (HRA) completion, risk profiling, and gap closure initiatives
When nurses spend too much time on routine outreach, they have less time for members who need clinical assessment, escalation, and high-touch intervention. For many health plans, hiring additional staff isn't a sustainable answer. Plans need a more scalable operating model—one that expands outreach capacity without compromising quality or trust.
The Solution: How Sage Expands Nursing Capacity
HealthEdge partnered with Ellipsis Health to deliver Sage, an AI-powered virtual nurse. Sage conducts autonomous voice conversations with members over the phone, adapting in real time across a range of clinical and administrative use cases.
Advanced Conversational AI Foundation
Sage isn't a basic chatbot or a static outreach script. It's built on a clinically grounded, emotionally intelligent foundation:
- Patented Empathy Engine: Sage analyzes vocal cues in real time to assess emotional signals and adapt its responses accordingly.
- Trained on Millions of Calls: Sage brings clinically informed conversational depth to every interaction.
- Highly Configurable: Health plans design conversation flows aligned to specific clinical goals, populations, and workflows.
A Practical Example: Before and After Sage
Consider a health plan with 4,200 members with an open Breast Cancer Screening (BCS) gap.
- Before Sage: The plan could realistically reach 800–1,000 of these members. The remaining 3,200 would only receive a letter, and most care gaps would remain open.
- After Sage: Sage works the full list of 4,200 members, providing consistent, documented outreach. It handles rebuttals, captures attestations, and closes clinical exclusions, with every interaction written back to GuidingCare®. Care managers can then focus on the escalations Sage surfaces.
Proven Outcomes for Health Plans
Health plan leaders expect technology investments to deliver measurable operational and clinical value. Sage is built to support key priorities like cost, quality, and member engagement.
|
Metric |
Outcome |
|
Call Completion |
92% of calls complete all tasks on the first enrollment call |
|
Call Time Reduction |
52% reduction in average enrollment call time (from 29–33 min to 12–17 min) |
|
Escalation Rate |
60% lower escalation rate than goal |
|
Caller Hang-Up Rate |
4.31% vs. industry benchmark of 5–8% |
|
Agent Transfer Rate |
0.59% of calls transferred to an agent |
*Outcomes based on work with Ellipsis Health.
Core Capabilities of Sage in Practice
Sage supplements existing care management staff by offloading targeted, high-volume phone outreach.
- Engagements and Enrollment: Sage automates program enrollment outreach and follow-up, reducing backlogs and accelerating member onboarding at scale.
- Assessments and Surveys: Sage executes large-scale HRA campaigns, risk profiling, and gap-in-care closures across entire member populations simultaneously, which is valuable for meeting fixed reporting deadlines.
- Clinical Support: Sage manages post-discharge check-ins and routine care follow-up. This frees clinical staff to focus on high-acuity cases where their expertise has the greatest impact.
What Makes Sage Different from Other AI Solutions?
Sage is designed for practical execution within health plan workflows. Here is what sets it apart:
- Seamless Ecosystem Integration: Sage is available to GuidingCare customers through a referral partnership. Ellipsis Health manages implementation and support, extending the ecosystem with AI-powered capabilities that plans can use quickly.
- True Conversational Autonomy: Unlike basic chatbots, Sage conducts real, autonomous voice conversations, offering a scalable way to engage members by phone.
- Nurse Efficiency by Design: Sage is built to augment clinical teams, not replace them. By handling routine outreach, Sage enables nurses to operate at the top of their license.
- Health Plan Configurability: Plans control their own conversation flows and outreach parameters without vendor bottlenecks or dependency on HealthEdge development resources.
A Strategic Partnership for Scalable Member Engagement
The HealthEdge and Ellipsis Health partnership positions health plans to meet growing engagement demands with precision and efficiency. By integrating AI-driven virtual nursing into the GuidingCare ecosystem, health plans can expand their clinical reach, improve operational performance, and deliver a more consistent member experience.
Frequently Asked Questions (FAQ)What is Sage?
Sage is an AI-powered virtual nurse, developed through a partnership between HealthEdge and Ellipsis Health. It automates high-volume, routine member outreach for health plans using autonomous voice conversations to improve efficiency and scale member engagement.
How does Sage help health plan nursing teams?
Sage helps by offloading repetitive, administrative tasks like enrollment follow-ups, assessment reminders, and post-discharge check-ins. This frees up nurses and care managers to focus their expertise on high-touch, complex member cases that require human judgment.
Is Sage just another chatbot?
No. Sage is a sophisticated conversational AI that conducts real voice conversations. It’s built with a patented Empathy Engine to detect and respond to emotional cues, is trained on millions of clinical calls, and is highly configurable to meet specific health plan goals.
What kind of results can we expect with Sage?
Based on work with Ellipsis Health, Sage has delivered significant results, including a 92% task completion rate on first enrollment calls, a 52% reduction in average call time, and an escalation rate 60% lower than the targeted goal.
How does Sage integrate with our existing systems?
Sage is available to GuidingCare customers and is designed for seamless integration. Ellipsis Health manages the implementation, training, and ongoing support to minimize the operational burden on health plan teams and extend the existing ecosystem with AI-powered outreach.
