Incentivize Health

Platform

Four modules. One operating system.

Incentivize Health is a system, not a service. Four named modules: Signal, Reach, Ledger, and Proof, ingest plan data, orchestrate outreach, pay rewards, and reconcile every dollar back to a measurable outcome.

Architecture

Data in. Behavior out. Proof back.

A single vertical stack. Every member event traverses the same four layers, auditable from the eligibility file to the paid reward to the measure it moved.

Inputs
Plan & partner data
Eligibility · 834Medical claims · 837 / 835Pharmacy · NCPDPClinical · HL7 v2 / FHIR R4Labs · ELR / LOINCCCLFCare mgmt & CRMVendor APIsProvider worklist
01
Signal
Data engine
  • Ingest & identity resolution
  • Code standardization
  • Cohort & gap generation
02
Reach
Orchestration layer
  • Journey engine · SMS / IVR / email / print
  • Two-way dialogue & conversational AI
  • Provider worklist
03
Ledger
Rewards system of record
  • Multi-rail fulfillment
  • Tax & escheatment compliance
  • Budget controls
04
Proof
Measurement layer
  • Measure-level ROI
  • Cohort attribution
  • Warehouse & CMS export
Outputs
Measures moved
Closed gapsStar measure movementCAHPS liftRetentionAdherence (PDC)CDH utilizationReconciled reward spendAuditor-ready ledger
HIPAA-aligned
PHI minimization at every join.
Auditable end-to-end
Immutable event log per member.
API-first
Every module addressable via REST + webhook.
Attribution built-in
Every dollar tied to a measure.

The modules

Deploy the whole platform. Or the module you're missing.

Modules run as a full stack, or independently alongside existing vendors. Each ships with a REST + webhook surface, sandbox, and separate pricing.

Signal
The data engine.
01

Ingests eligibility, claims, clinical, pharmacy, lab, and vendor feeds. Resolves identity across sources. Standardizes codes into cohorts, activities, and gaps a rules engine can act on, without a warehouse project.

  • Identity resolution across payer, provider, and vendor keys
  • HL7 v2, FHIR R4, 834 / 837 / 835 / CCLF, ELR, and REST
  • Retro-term reconciliation and evidence-completeness flags
  • Real-time and batch ingest paths
Reach
The orchestration layer.
02

Routes the right ask to the right member through the right channel: SMS, IVR, email, secure inbox, push, and print, with two-way dialogue, conversational AI, and provider-side worklists.

  • Journey orchestration with channel, language, and consent inheritance
  • Dialogue-based surveys and conversational AI with clinician-safe guardrails
  • Provider worklist and evidence upload for non-integrated FFS practices
  • Live-agent handoff on regulated and complex asks
Ledger
The rewards system of record.
03

Runs the incentive program end to end, issuance, fulfillment, tax handling, escheatment, and reconciliation, across gift cards, premium reductions, HSA/FSA/HRA deposits, and CMS-compliant reward rails.

  • Multi-rail fulfillment: card networks, CDH accounts, premium credits, charity
  • CMS 2024 rewards-and-incentives guidance built into the rule engine
  • 1099 handling, escheatment, and audit-grade transaction history
  • Program-level and member-level budget controls
Proof
The measurement layer.
04

Attributes every closed gap, completed activity, and paid reward back to the measure, campaign, and cohort that produced it, so finance, quality, and clinical can read from the same numbers.

  • Measure-level ROI: cost per gap closed, cost per Star point, retention lift
  • Cohort attribution across channels and touches
  • Export to plan warehouse, CRM, and CMS submission pipelines
  • Read-only auditor and regulator views

Developer surface

An API where the vendor stack usually is.

Every module is addressable. Your engineering team ships against a documented REST API and webhooks, not a queue of ticketed configuration requests.

  • Webhooks for gap closed, activity verified, reward issued, and reward redeemed events.
  • Sandbox with synthetic member and claims data, available on request.
  • Read-only reporting views for finance, quality, and audit teams.
POST /v1/events/gap-closed
{
  "member_id": "M-8823410",
  "measure": "CBP",
  "evidence": {
    "source": "provider_worklist",
    "verified_at": "2026-07-08T14:22:00Z"
  },
  "reward": {
    "rail": "gift_card",
    "amount_cents": 2500
  },
  "attribution": {
    "campaign_id": "cbp_q3_ma_west",
    "touches": ["sms_1", "ivr_2", "provider_1"]
  }
}

Want the full architecture walkthrough?

Our team runs a 45-minute technical review, data model, integrations, security posture, and where each module drops into an existing plan stack.

Book the review See the data pipeline