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Payer-Ready AI Companion — MA SSBCI & Medicaid MCO

The Companion Program
Health Plans Buy —
Not Just Love.

Social isolation costs Medicare an estimated $1,608 more per beneficiary per year in avoidable hospitalizations and SNF use. Boojee Companion Care delivers validated loneliness screening, care-gap closure, and quarterly outcome reports — the evidence your plan needs for its SSBCI evidence bibliography and Stars/HEDIS story.

Primary buyers MA Plans, Medicaid MCOs, AAAs, PACE
Instruments UCLA-3 · PHQ-2/9 · GAD-7
Infrastructure HIPAA-eligible AWS — BAA available

The Payer ROI Case

Isolation is a $6.7 billion
line item on your claims data.

Health plans don't buy "less loneliness" — they buy Stars lift, care-gap closure, and reduced avoidable utilization. These are the numbers that drive the conversation.

$6.7B
estimated extra Medicare spend per year driven by social isolation — largely avoidable hospitalizations and skilled-nursing use.
Source: AARP Public Policy Institute / Stanford analysis (publicly reported). These are sector-level estimates, not our program outcomes.
$1,608
additional estimated cost per socially isolated beneficiary per year — the gap a companion intervention can close against even a $50/mo PMPM.
Source: AARP Public Policy Institute / Stanford (same analysis). Per-beneficiary figure cited publicly by AARP. Not a guarantee of savings.
1 in 4
adults 65+ are estimated to be socially isolated (NASEM). More than one-third of adults 45+ report feeling lonely — making this a population-scale risk in your MA book.
Source: NASEM Consensus Study Report on Social Isolation and Loneliness; AARP summary (publicly available). Population-level estimates.

Framing note (honest): Isolation drives ER visits, readmissions, SNF admissions, depression, and cognitive decline. The path to ROI for a plan is not a randomized trial — it is a claims-based analysis after 6–12 months showing movement in the right direction. This is exactly the evidence Papa and Pyx Health bring to their plan contracts. We build toward the same artifact: validated screening deltas + care-gap closure + engagement data.

What We Measure & Report

The outcome artifacts
your plan's bid file needs.

CMS's CY2025 SSBCI rule requires plans to show evidence that a supplemental benefit is "reasonably expected to improve or maintain health or overall function." Here is the evidence we build for you.

Screening

Validated Screening Instruments

Public-domain instruments delivered conversationally at intake and on a rolling schedule. Pre/post deltas computed per member for your outcome report. No license fees — all freely usable in practice.

  • UCLA-3 — the industry-standard loneliness screen (Pyx uses this at onboarding). Scored 3–9; positive screen at 6+.
  • PHQ-2 / PHQ-9 — depression screen. PHQ-2 positive triggers the full 9-item. Item 9 triggers immediate escalation.
  • GAD-7 — generalized anxiety screen. Pairs with PHQ-9 in the outcome report.

These instruments screen and track — they do not diagnose. All elevated results route to human escalation. This is not a medical device.

Care Gaps

Care-Gap Closure & Stars Lift

Proactive nudges toward the plan quality measures that actually move your Star rating and close AWV/HRA gaps in your claims data. This is the core lever Papa uses in its plan contracts.

  • Annual Wellness Visit (AWV) reminder and completion tracking
  • Health Risk Assessment (HRA) nudge
  • Covered preventive screening reminders (flu, colonoscopy, mammography)
  • Medication adherence check-ins (documented in the outcome report)
Reporting

Engagement & Outcome Reports

The standing report your plan submits in its SSBCI evidence bibliography and Stars/CAHPS story. Delivered monthly for operational tracking; quarterly clinician-grade summary for the plan file.

  • Members enrolled / activated / retained
  • Engagement frequency and streak (daily/weekly check-in rate)
  • UCLA-3 and PHQ-9 pre/post deltas
  • Care-gap actions triggered and completed
  • Escalations raised, handled, and resolved
  • SDOH / Z60.2 ("problems related to living alone") flags captured for plan documentation
Escalation

24/7 Human Escalation & Crisis Protocol

A hard payer procurement requirement. The companion detects risk language and routes to a human immediately — not a ticket queue. Crisis handling (988 / emergency services) is documented and auditable.

  • Automatic escalation on PHQ-9 item 9 > 0 (self-harm thoughts)
  • Crisis resource delivery: 988 Suicide & Crisis Lifeline (call or text)
  • Staff/caregiver alert with conversation context
  • Full audit log of every escalation event
  • Caregiver dashboard: view alerts →
SDOH

SDOH / Z-Code Capture

Structured detection of social-determinant risk during conversation. Handed to the plan or clinician for documentation — Z-codes support encounters and enrich risk/HEDIS picture but are not a payment source on their own.

  • Z60.2 — Problems related to living alone (requires documented unmet need)
  • Z55–Z65 social determinant family for food, transport, housing risk
  • Exported in the outcome report for clinician/plan documentation
Engagement

Proactive Daily Check-Ins

The companion initiates conversation — it does not wait for the member to ask. High daily interaction rate is the engagement proof plans require (ElliQ's program cites ~30 interactions/day, 6 days/week as its benchmark in the NYSOFA program report).

  • Companion-initiated morning and evening check-ins
  • Persistent per-member memory (last topics, preferences, milestones)
  • Medication and appointment reminders woven into conversation
  • Engagement streak tracked and reported to plan

Note: ElliQ engagement figure is from the NYSOFA program impact report (vendor/program survey data, not a peer-reviewed RCT). Cited for context, not as our result.

The Program

From signed agreement to
outcome report in 90 days.

1

Intake & Baseline

Consent collection, UCLA-3 and PHQ-2 baselines for enrolled members. Care-gap data pulled from plan's eligibility file.

2

Companion Launch

Custom companion name, voice, and conversation context configured for your population (MA chronically ill, HCBS waiver, PACE, etc.).

3

Rolling Engagement

Daily proactive check-ins, care-gap nudges, and re-screens at 30 and 60 days. Escalations handled in real time.

4

Outcome Report

90-day payer report: UCLA-3 and PHQ-9 deltas, engagement stats, care-gap closures, SDOH flags — formatted for your bid file.

We are in pilot stage. We have no enrolled members yet. We are building this program to be payer-ready from the ground up — not retrofitting a consumer product. The outcome dashboard, escalation protocol, and reporting format are designed for the plan procurement checklist, not for optics. We're looking for one or two plan or AAA partners to run the first 90-day pilot and generate real outcome data together.

Trust & Compliance Posture

Built to the payer
procurement checklist.

Every item below maps to something a plan's compliance team will ask before signing. We say what we have and what is in progress — no false claims.

HIPAA-eligible Infrastructure — BAA Available Lambda, DynamoDB, Polly, and Bedrock are all AWS HIPAA-eligible services. We say "HIPAA-eligible" because compliance is a program, not a product feature — a signed AWS BAA is required before real PHI is stored. BAA available on Enterprise and health-plan contracts.
Crisis Protocol — 988 + Human Escalation Explicit flow: risk language or PHQ-9 item 9 trigger → immediate 988 Suicide & Crisis Lifeline referral + human alert. Documented. Every escalation logged to the audit table. This is non-negotiable for a behavioral-wellbeing product.
Consent-First Architecture No health data is written without explicit user consent. Consent is recorded, timestamped, and gated by the API — not assumed. Consent withdrawal is documented (purge workflow planned for production).
General-Wellness / Non-Device Posture We are a general-wellness companion, not an FDA-regulated medical device. Per FDA's General Wellness guidance (Jan 6, 2026): we screen, track, and connect to humans. We do not diagnose, treat, or name conditions as findings. A general-wellness posture memo is available for plan compliance teams.
Full Audit Logging Every health-data action — consent grant, screening submission, alert creation, acknowledgment — is written to a tamper-append audit table with actor, timestamp, and detail. Required for plan oversight and breach response.
SOC 2 — In Progress SOC 2 Type I is on our roadmap for the first payer contract. We do not have it yet and we will not claim otherwise. Our AWS architecture (scoped IAM, DynamoDB encryption, audit logging, HIPAA-eligible services) is designed to pass Type I controls.

Clinical governance note: A named clinical advisor (MD or LCSW) will govern screening thresholds and escalation rules before we enroll real members. This is a payer procurement requirement we are actively building toward. Clinical advisor is not yet on retainer — we are forthright about this because plan compliance teams will ask.

Programs & Pricing

Transparent pricing.
No hidden per-seat surprises.

Priced for senior living operators and community providers. Health plans and MA/Medicaid payers: pricing is PMPM by enrolled population — request a plan briefing.

Per Resident

$48

per resident / month

Add-on pricing

  • 24/7 AI companion access
  • Daily proactive check-ins
  • Medication & appointment reminders
  • Conversation logs
  • No staff dashboard
  • No outcomes reporting
Inquire

Enterprise

$2,998

per month — up to 100 residents

Up to 100 residents

  • Everything in Community Pilot
  • Business Associate Agreement (BAA)
  • Custom escalation workflow
  • Quarterly outcomes review call
  • Multi-community rollout support
  • Custom companion persona
Request Enterprise
Health Plans & Payers

Payer / MA / Medicaid MCO

PMPM

quoted by enrolled population

MA SSBCI · Medicaid HCBS · PACE

  • Everything in Enterprise
  • SSBCI evidence bibliography package
  • Claims-based ROI model
  • Stars/HEDIS + care-gap reporting
  • SDOH / Z-code capture for plan file
  • RTM/CCM data-export (Phase 2)
Request Plan Briefing →

Apply for a Pilot

Start the conversation —
pilot, payer, or provider.

Operators, community providers, and AAAs: use this form. Health plans and MA/Medicaid payers: the Payer Brief has the right form for you (SSBCI package, PMPM model, compliance posture).

Request a Pilot Program

Fill in what you know. We'll work out the rest on a short discovery call. Two-business-day response.

Health plan or payer? View the Payer Brief →

Prefer email? care@boojee.estate

Frequently Asked

Questions from plan teams
and care operators.

How does a health plan actually pay for this?

The model is a vendor contract — the plan pays a per-member-per-month (PMPM) fee, similar to how Papa and Pyx Health are contracted across 70–100+ MA plans respectively. We are a supplemental/value-added benefit, not a billed medical service. Medicare Advantage plans can include us under SSBCI (Special Supplemental Benefits for the Chronically Ill) or standard supplemental benefits. Medicaid MCOs contract us as an HCBS-adjacent support. PACE programs can bundle us under their capitation. We do not bill CPT codes ourselves — a clinician-billed RTM/CCM pathway is a Phase 2 option for provider-group partners.

Is this HIPAA compliant?

We say "HIPAA-eligible" deliberately. The AWS services underlying Companion Care — Lambda, DynamoDB, Polly, Bedrock — are covered under Amazon's HIPAA BAA program. Full HIPAA compliance is a program, not a product feature: it requires signed BAAs, staff training, and policies on both sides. A signed AWS BAA must be executed before we store real PHI — we have not done this yet for production. On our Enterprise and health-plan contracts we execute a BAA with your organization. We will not claim "HIPAA certified" because no such certification exists.

What does the CY2025 SSBCI evidence requirement mean for us?

Since CY2025, CMS can deny an MAO's bid unless the plan demonstrates with an evidence bibliography that an SSBCI benefit is "reasonably expected to improve or maintain the health or overall function" of chronically-ill enrollees. We build the artifact for that bibliography: validated screening (UCLA-3, PHQ-2/9) with pre/post deltas, care-gap closure data, engagement metrics, and escalation outcomes. This is not peer-reviewed RCT evidence — we do not claim that. It is impact-survey and engagement evidence, the same category of evidence ElliQ, Papa, and Pyx use in their plan contracts today.

Is this a medical device? Does it require FDA clearance?

No. We operate in the FDA "general wellness" lane per the agency's Jan 6, 2026 guidance on low-risk general wellness products. We do not diagnose, treat, or name conditions as findings. We screen, track, engage, and connect members to qualified humans when a screen is elevated. This design choice (the companion always routes to a human for clinical interpretation) keeps us wellness-exempt and simultaneously satisfies the payer's crisis-escalation requirement. A general-wellness posture memo is available for your compliance team.

Do you have clinical results yet?

No — we are in pilot stage with no enrolled members. We will not fabricate outcomes or claim results we have not measured. The evidence we cite for sector ROI ($6.7B isolation cost, $1,608/beneficiary) comes from AARP Public Policy Institute / Stanford analysis, publicly reported. The engagement benchmarks we reference (ElliQ 95%/80% loneliness-reduction, Pyx 2.5:1 ROI) are those vendors' own program impact reports — not our results, and not peer-reviewed RCTs. We cite them as market precedent for the category, labeled as such. Our first pilot will generate the first real data point for this program.

What screening instruments do you use and why those?

We use UCLA-3 (the 3-item Loneliness Scale, Hughes et al. 2004), PHQ-2 / PHQ-9 (Kroenke, Spitzer, Williams), and GAD-7 (Spitzer et al. 2006). All three are public domain and freely usable in practice without license fees — important for a scalable PMPM model. UCLA-3 is the instrument Pyx Health uses at onboarding and is the recognized standard for loneliness screening in health plan contexts. PHQ-9 is the behavioral health screen CMS recognizes for Stars/HEDIS quality measures. GAD-7 pairs with PHQ-9 in the quarterly outcome report.

What is your crisis protocol?

Any conversation containing risk language, or a PHQ-9 with item 9 (self-harm thoughts) scored above zero, triggers immediate escalation. The companion delivers 988 Suicide & Crisis Lifeline information (call or text 988) to the member and raises a CRISIS-severity alert to the caregiver/clinical dashboard in real time. Every escalation is audit-logged. A human reviews every crisis-flagged conversation. This is a hard design requirement, not an optional feature.