Healthcare moves at the speed of trust™
Sunny Care Gaps
Concierge-level outreach and action that closes care gaps.
Bringing concierge-level outreach to every member
Sunny Care Gaps brings a health concierge experience to every member, using phone and chat outreach to nudge members about upcoming or overdue care before they become crises, explain why it matters in simple, culturally attuned language, and help them take action to get it done.
Outbound reminders and support covers office visits, labs and imaging, medications, allied health like PT/OT and speech therapy, and social work check-ins. Plans can focus these campaigns on priority hot spots such as high‑risk chronic disease, post‑acute transitions, or members in specific geographies or benefit designs.
Why plans invest in closing gaps
Sunny Care Gaps helps payers turn missed preventive and chronic‑care touchpoints into completed care that supports good member health as well as revenue and cost goals. By closing gaps in measures like colorectal cancer screening and diabetes eye exams, plans can lift quality performance that feeds into Medicare Advantage bonus payments and more attractive Star Ratings, which in turn support enrollment and retention. At the same time, improving adherence for conditions such as diabetes and hypertension reduces avoidable ER visits and hospitalizations, cutting high‑acuity spend even if pharmacy costs rise slightly.
An equitable, member-first design
Sunny Care Gaps is built to reach the members who are hardest to engage:
Multilingual outreach so members can talk about their health in the language they are most comfortable with.
Phone and chat based interactions that work even with limited bandwidth or older devices, not just app users.
Locally tuned messaging that respects cultural norms and trust dynamics while still moving members toward evidence based preventive and follow‑up care.
The result is fewer missed opportunities for prevention, less reactive high‑acuity care, and lower total cost of care without shifting burden onto already stretched providers or HR teams.
How It Works
Step 1
Reach out at the right moment
Sunny calls or messages members about specific open care gaps, tailored to their situation.
Step 2
Explain what’s needed and why
The AI concierge explains which gap is open, why it matters for that person, and which in‑network options are available.
Step 3
Guide the next step
Members can confirm benefits, choose an option, and get help scheduling needed appointments or services.
Step 4
End with clear next steps
Each interaction feels like a short, guided conversation that ends with concrete actions, not another to‑do.
Powered by the Sunny AI platform
Sunny Care Gaps runs on the same AI orchestration and data intelligence that power our entire product suite. That means:
Consistent security, privacy, and governance across inbound and outbound experiences
Shared provider, benefits, and member context so messages are accurate and aligned with network and benefit strategy
Unified analytics so health plans can see which outreach closed which gaps and what that meant for utilization and cost
