Drive Quality & Reduce CostsWith AI-Powered Intelligence
Peregrine helps health plans improve Star Ratings, optimize risk adjustment, and deliver better member experiences while reducing administrative costs. Built for Medicare Advantage, Medicaid MCOs, and commercial plans.
Complete Solution for Health Plans
Everything you need to succeed in value-based care
Star Ratings Optimization
Achieve and maintain 5-star ratings with AI-driven gap closure
- Real-time HEDIS tracking
- Predictive gap identification
- Automated member outreach
- Provider performance scorecards
Risk Adjustment
Maximize accurate risk capture while ensuring compliance
- Suspect condition identification
- Chart review prioritization
- HCC coding optimization
- Audit risk management
Member Engagement
Personalized outreach that drives action and satisfaction
- Multi-channel campaigns
- Behavioral nudges
- Preferred language support
- Engagement scoring
Care Management
Identify and manage high-risk members proactively
- Predictive risk models
- Care plan automation
- Clinical pathways
- Outcome tracking
Cost Management
Reduce medical costs while improving quality
- Utilization analytics
- Network optimization
- Prior auth automation
- Cost prediction models
Compliance & Audit
Stay audit-ready with built-in compliance tools
- Automated reporting
- Audit trail tracking
- RADV preparation
- Regulatory updates
Tailored for Every Plan Type
Medicare Advantage
Comprehensive tools for MA plans to excel in Star Ratings and grow membership
- Part C and Part D Star measures tracking
- CMS compliance reporting automation
- Risk adjustment optimization
- Special needs plan (SNP) support
MA Plan Results
MCO Impact
Medicaid Managed Care
Address complex social needs while meeting state requirements
- Social determinants tracking and intervention
- State-specific quality measure support
- Care coordination across providers
- Population health management
AI That Understands Healthcare Economics
Our AI models are trained on millions of claims and clinical records to predict costs, identify risks, and optimize interventions
Predictive Analytics Engine
Cost Prediction
Forecast member costs 12 months out with 85% accuracy
Risk Stratification
Identify high-risk members before acute events
Gap Prediction
Know which members will have care gaps before they occur
Intervention Optimization
Recommend the most effective outreach for each member
Real-World Impact
Calculate Your Potential Savings
See how much Peregrine can save your health plan
For a 100,000 member plan:
- Annual medical cost savings$22.1M
- Quality bonus increase$4.5M
- Administrative savings$1.8M
- Total annual value$28.4M
Ready to Improve Quality and Reduce Costs?
Join health plans achieving 5-star ratings with Peregrine