Challenge
Federal and state programs serve more than one hundred million Americans through Medicare and Medicaid, yet outreach and enrollment remain difficult. Mailers, call centers, and static sites often miss the households that need benefits most, including lower-income families, seniors, and non-English-speaking communities. The result is underutilized benefits, missed prevention, and higher long-term cost.
Governments required communication that is inclusive, scalable, and timely, with eligibility and enrollment guidance delivered in the right language and channel.
Solution
We engineered a cloud-native engagement platform that pairs SMS-first accessibility with multilingual AI agents grounded in program rules.
Platform capabilities
Messaging infrastructure
Twilio and AWS Pinpoint support SMS and MMS delivery at national scale with reliable delivery telemetry.
Generative AI layer
GPT-4 and Llama-class agents trained on program FAQs and eligibility rules support two-way conversations.
Translation and NLP
Neural machine translation and hosted models enable sustained multilingual coverage across twenty or more languages.
Eligibility integration
Secure APIs connect to state Medicaid and Medicare data sources to personalize outreach where policy allows.
Workflow automation
LangChain and crewAI agents coordinate reminders, follow-ups, and escalation to human staff with preserved context.
Analytics and compliance
Power BI on Snowflake surfaces engagement and enrollment metrics alongside HIPAA-aligned encryption, audit trails, and role-based access control.
Process flow
- 01Targeting and personalization from resident records and campaign design by demographics, language, and program.
- 02SMS and conversational AI that keeps language plain and supports natural-language replies.
- 03Agent responses for eligibility questions and enrollment guidance.
- 04Escalation paths for complex cases with full conversation context.
- 05Feedback loops into BI dashboards to refine campaigns and measure return on outreach investment.
Impact
- Higher program participation within months of launch.
- Reduced language barriers to understanding and enrolling in benefits.
- Faster resolution of common questions without call-center load.
- Lower manual communication overhead through automation.
The platform functions as a public-health engagement system: agentic workflows, accessible channels, and data-driven optimization of how governments deliver policy in the field.