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.

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Member Q&A

“I've been feeling really tired lately, what could be causing this?”

Your recent labs show a slightly underactive thyroid (TSH: 6.1 µIU/mL, above normal range). Your wearable data also indicates reduced sleep quality and less than 20 minutes of deep sleep on average. Both can contribute to low energy.

Action Plan
Take magnesium glycinate 200–400 mg before bed
Maintain consistent bedtime and wake-up time
Discuss thyroid support with your doctor
Doctor Pre-Read

Patient reports persistent fatigue despite maintaining healthy routines. Labs indicate mild hypothyroidism (TSH 6.1), and wearable data confirms suboptimal sleep. Consider evaluating thyroid replacement therapy and sleep hygiene reinforcement.

What Vytivo moves financially

Measurable impact on the metrics that drive your bottom line

4+ Stars

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.

+1% RAF

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.

Fewer admits/ED

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.

Unifies EHR + claims + labs + RPM per member

Complete health data integration

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EHR Portals
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HIE & Data Pipes
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Generic Apps
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AI Scribes

Context-aware Q&A for members

Not generic tips, but personalized insights

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EHR Portals
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HIE & Data Pipes
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Generic Apps
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AI Scribes

Doctor-ready pre-visit reports

Structured, comprehensive summaries

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EHR Portals
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HIE & Data Pipes
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Generic Apps
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AI Scribes

Personalized action plans

With longitudinal context

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EHR Portals
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HIE & Data Pipes
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Generic Apps
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AI Scribes

White-label mobile + web

Your brand, SSO integration

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EHR Portals
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HIE & Data Pipes
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Generic Apps
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AI Scribes
Full support
Partial support
Not supported

All member data in one record your members understand

Seamless integration with existing systems and data sources

Epic EHR

EHR Provider Integrations

Fitbit

Wearables & Claims Data

FHIR, CDA, PDF, CSV/XLSX ingestion

Vytivo Logo

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

Nightly batch: EHR & claims data sync
Near real-time: Member-initiated data pulls
De-duplication: Advanced entity resolution
Normalization: Unified terminology mapping

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

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

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

Generate a health action plan

Diet/exercise/sleep/stress steps tailored to context.

Member-specific steps reduce avoidable utilization.

See biomarker trends

See biomarker trends

Track changes, learn "why it matters," and what to discuss with clinicians.

Explain "why it matters" to improve adherence.

Works under your brand (mobile & web)

Multi-language support • White-label design • WCAG AA accessible

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

Enterprise pricing

Per member per month model; pricing varies by use case and scope. One-time implementation included.

Full white-label app & web
SSO & brand customization
FHIR-first integrations
Member Q&A & action plans
Doctor-ready reports
SSO configuration
Brand customization
Data onboarding
Custom language setup (cohort-specific LLM prompting; language complexity adjustments)
Launch communications
Training & documentation

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.

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.