The Missing Layer in Healthcare

The GoMo Health behavioral engagement platform leverages MiLD Technology, a microlearning and brain-first model, to bridge the gap between clinical care and real-life health outcomes, delivering personalized, adaptive support for sustained behavior change.

The Missing Layer in Healthcare Integral Actions Connect Clinical Visits to Real-Life Outcomes

Table of Contents Executive Summary......................................................................................................4 The Behavioral Gap in Modern Healthcare............................................................8 A Brain‑First Model for Health Engagement........................................................12 The Microlearning and Doing (MiLD) Framework for Behavioral Reinforcement............................................................................16 What is the GoMo Health Enterprise Engagement Platform?.........................26 Health Care Requires Bold Thinking.......................................................................52 The Future of Health Care: GoMo Health Enterprise Engagement Platform.....................................................................54

Executive Summary

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H ealthcare is in a state of rapid transformation. Advances in artificial intelligence, precision medicine, and digital health technologies have expanded the clinical capabilities of healthcare delivery models worldwide. Yet, despite these advances, many organizations continue to struggle with a persistent challenge: translating medical guidance into sustained behavior change outside clinical settings .

“Health systems spend enormous effort optimizing what happens inside the clinical visit. But outcomes are determined by what happens in the thousands of moments after that visit. If we don’t support those moments, we leave the most important part of care unmanaged.”

The primary determinant of health outcomes is not clinical treatment but the daily behaviors individuals perform between medical encounters. Medication adherence, lifestyle decisions, and care plan follow-through largely occur in homes, workplaces, and communities.

BOB GOLD Chief Behavioral Technologist GoMo Health

The GoMo Health Enterprise Engagement Platform activates individuals in their own health care through the proprietary MiLD (microlearning and doing) model . This framework supports individuals in their lived environments, where health care protocols are actually practiced. By delivering timely guidance, reinforcing small actions, and connecting individuals to relevant resources when they need them most, the platform helps individuals translate clinical advice into daily behaviors. In doing so, it enables health systems to scale behavioral reinforcement and sustained engagement across populations.

WHY TRADITIONAL HEALTH ENGAGEMENT FAILS

1% of traditional health engagement happens in the clinic.

99% of traditional health engagement happens in daily life.

99%

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The Behavioral Gap in Modern Healthcare

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M odern healthcare has achieved remarkable progress in diagnostics, treatment modalities, and predictive analytics. However, these advances often fail to translate into improved outcomes when individuals are unable to follow prescribed care plans. Many individuals face complex barriers, including financial constraints, caregiving responsibilities, mental strain, transportation challenges, and competing life priorities. Unless these real-world barriers are recognized and addressed, even the most advanced treatments cannot achieve their intended impact because care plan success depends on an individual’s ability to carry out recommended actions in daily life.

“We’ve built extraordinary systems for diagnosing diseases, outlining treatment, and prescribing medications, but we have not built systems that consistently help people carry out those instructions in daily life.”

BOB GOLD Chief Behavioral Technologist GoMo Health

Reporting Chronic Conditions U.S. Adult Population

2 / 3 of adults with

76% of the U.S. adult

chronic conditions report more than one condition

population has at least one chronic condition

Among U.S. adults, 76.4% (194 million) reported at least one chronic condition. Of all U.S. adults, 51.4% (130 million) reported multiple chronic conditions, meaning roughly two-thirds of adults with a chronic condition were managing more than one condition. (Watson et al., 2025)

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Traditional engagement strategies often focus on delivering instructions through reminders, portals, or educational materials. While these tools help communicate clinical guidance, they rarely influence the behaviors required to consistently follow care plans, take medications as prescribed, attend appointments, or make recommended lifestyle changes. The challenge is not awareness. Most individuals already know the actions required to manage their health and adhere to care plans. The real challenge is translating medical guidance into specific, repeatable actions that fit within the realities of daily life. Clinical decisions may be made in the exam room, but their success depends on whether individuals can carry them out in the environments where they live and manage their health.

MEDICAID POPULATION

³⁄₄ of Medicaid-enrolled adults have one or more chronic conditions

(Kaiser Family Foundation, 2023)

A Brain‑First Model for Health Engagement

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E very health decision, including those related to health care, originates and is processed in the brain. Motivation, belief, confidence, emotional state, and cognitive load shape how individuals interpret health information and whether they translate that information into action. A brain-first model recognizes that physical health outcomes are driven by underlying cognitive and emotional processes. When the brain perceives high stress, low confidence, or limited capacity, it becomes less capable of absorbing information, making decisions, and sustaining new behaviors. Conversely, when individuals feel capable, supported, and confident, the brain is better able to process guidance, reinforce learning, and support consistent action. These brain-based responses ultimately determine whether care plans are followed and whether outcomes improve.

Treat the Person, Not Just the Perceived Problem

Medical Science: + Biology

BehavioralRx ® : + Behaviors + Emotions + Cognition + Life Factors

+ Chemistry + Anatomy + Physiology

(Social Determinants, Environment of Need)

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A comprehensive engagement model must address: + Cognitive readiness + Emotional resilience + Social environment + Personal routines Supporting these dimensions helps individuals build the confidence and self‑efficacy required to manage their health consistently over time. + Caregiving responsibilities

“Brain health isn’t just about whether someone develops Alzheimer’s or dementia. It’s about memory, cognition, emotional well-being, and overall mental resilience, all of which shape our daily lives.”

BOB GOLD Chief Behavioral Technologist GoMo Health

The Microlearning and Doing (MiLD) Framework for Behavioral Reinforcement

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M iLD is a proprietary behavioral engagement framework designed to help individuals translate clinical directives into consistent daily habits. The name reflects how behavior change works best: through small, manageable activities that encourage hands-on application of learning, delivered at the right moments in daily life , rather than overwhelming people with large amounts of intimidating tasks.

For example, rather than simply advising a new mother to “manage stress and prioritize rest,” MiLD delivers a timely prompt during a high-stress moment, such as a short breathing exercise during a late-night feeding or a reminder to take a five-minute recovery pause when the baby is sleeping. Each time the participant practices that small action in the moment when it is needed, the brain begins to associate stress with a manageable response. Over time, these repeated moments of practice reinforce emotional regulation, build confidence, and help transform coping strategies into sustainable daily routines. It turns abstract advice into something the brain can rehearse in real life, where habit is actually formed.

“People don’t change behavior because they received a 20-page booklet or attended a single appointment. They change because repeated practices of suggested activities accumulate over time and gradually reshape routines.”

At its core, MiLD is grounded in practice: the repeated application of small actions in real-life moments. Information alone does not create change. Change happens through action, repetition, and reinforcement.

BOB GOLD Chief Behavioral Technologist GoMo Health

GoMo MiLD Integrated With Traditional Interventions

Personalized in-the-moment guidance lets them know their stated questions and needs have been heard.

As they begin to practice new learnings daily, it fosters self- trust and self- credibility to act.

“Snackable bites” of nurturing avoid information overload, delivering the right info in the right moment.

The brain begins to reconstruct brain matter into muscle memory (neuroplasticity).

Understand where people believe they are (their current perspective/bias).

Renewed confidence begins to alter outlook.

Creates sustainable change and resiliency.

Let people know their voice matters.

Develop and Foster Resiliency

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Built for Complexity. Delivered for Real Life. From Precision Medicine to Precision Person-Centered Care

Behavior change requires the right level of reinforcement at the right moments. The MiLD framework is designed to adjust engagement intensity based on the complexity of an individual’s health journey. Health care delivery happens in the provider’s office, but most health decisions happen in daily life. The moment a person leaves a medical appointment and returns to their routine is the real test of care plan success. An individual’s lived environment is where clinical advice and prescriptions are put into action through everyday behavior. It is in the kitchen where food choices are made, the bedroom where medications are remembered, the workplace where stress is managed, and the home routine where new habits are practiced. Extending care into these (lived) environments allows health systems to support the moments that truly shape outcomes as they happen.

Precision Medicine

Precision Person-Centered Care

Drugs and therapies

Behaviors and habits

Biomarkers

Personal environment

Clinical pathways

Beliefs and motivation

Treatment optimization

Lifestyle feasibility

GoMo Health program data consistently show that engagement must scale with participant need. Higher- risk programs, such as oncology care and substance use disorder (SUD) recovery, maintain stronger participation when individuals receive more frequent messages and guidance throughout the program. Lower-risk populations, by contrast, benefit from fewer touchpoints.

This gap between clinically optimized treatment plans and the reality of daily life is where the MiLD framework becomes essential, translating medical guidance into consistent, sustained behavior. MiLD enables this adaptive engagement by delivering personalized learning, in-the-moment support, linked resources, and digital guidance that evolve alongside the participant’s needs. MiLD consists of four core elements: + Microlearning: Short learning experiences designed for rapid comprehension + In‑the‑Moment Support: Timely guidance delivered at the point of decision-making + Linked Resources: Connections to relevant tools and services + Digital Engagement: Continuous interaction through accessible digital channels

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Unlearning and Learning: Health vs. Other Forms of Training

This approach mirrors how individuals learn complex skills. Clinical visits provide (opportunity for) practice, while everyday environments provide practice. Consistent reinforcement enables habits to develop over time. Extending care into these environments allows health systems to support the moments that truly shape outcomes in real time. Ratio of Practice to Performance or Instruction to Practice Practice consistently outweighs performance or instruction time across disciplines. Skill development happens in the repetition, preparation, and daily commitment behind the scenes. + Piano: 30 minutes of instruction to 4 hours of daily practice + Football: 32:1 practice-to-game ratio + Acting: 1 to 8 hours of daily rehearsal over extended periods

Behavior change in healthcare follows the same principles as learning any complex skill: instruction alone is not enough. A clinical visit provides guidance, but lasting change is shaped by repeated practice in everyday life. Just as musicians, athletes, and performers build skill through routine and repetition, individuals must repeatedly apply health guidance in real- world moments for it to become a habit. The environments where people live and work become the true training ground for change. This is where routines are formed, behaviors are reinforced, and outcomes are ultimately determined. Extending care into these daily moments allows health systems to support the repeated actions that drive lasting results. Reality Check People do not deviate from care plans during a brief medical appointment. They disconnect from adherence at home, at work, and under stress, which is when intervention and support are crucial.

MiLD: Bridging Clinical Guidance and Daily Action

Sustained behavior change does not occur through isolated interventions. Individuals must interpret clinical guidance, remember it, adapt it to their routines, and apply it repeatedly in the context of daily life. The GoMo Health Enterprise Engagement Platform provides this operational foundation, enabling organizations to extend behavioral reinforcement into the environments where health decisions are made and to evolve alongside individuals as their needs ebb and flow throughout their health care journey.

“The beauty of the GoMo program is that it really is so specialized to that individual. [Outreach] is at the rate that you want it; it’s the information that you choose to have, the information that you choose to engage with, when you want it.”

BHAVINI SOLANKI, LPC Director of Georgia Families 360 Amerigroup

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GoMo Health Enterprise Engagement Platform

Enterprise Engagement Platform

Largest library of evidence-based and clinically vetted content and care pathways

Professionals: Case/Care Management, Providers, Member Services, Departments, HR, Business Sectors, Divisions, Employees

Program Participants or End-Users Members, Patients, Employees, Persons Served, Caregivers/Families, Consumers

GoMo Campaigns

GoMo Chat

Personal Concierge

Care Companion

A digital resource library and dashboard where participants can access personalized wellness, education, and remote care support, resources, tools, and more

A HITRUST (r2) certified* secure messaging platform that provides a safe environment for care teams to communicate with individuals through text message or HIPAA-compliant secure chat

A HITRUST (r2) certified* automated engagement system that interacts with and delivers personalized Care Communications to audiences through text, email, or voice

A custom campaign platform where clients can schedule and send their own communications by text and email

Electronic Triage: “Care Surveys and Assessments,”Escalations, Device Readings, EMR Data

Third-Party Integration: EHR/EMRs, Telehealth Platforms, Wearable/Health Monitoring Devices, Case Management Systems, Pharmacy Systems, HCM Platforms

Program Engagement and KPI Reporting (Standard Reporting Portal)

BehavioralRx ® Insights Dashboard (Custom-Developed Portal)

Capability

Product

Product End-Users

*Applies to GoMo Chat and the Personal Concierge platforms on Microsoft Azure

BehavioralRx ® : The Science Behind Behavior Change at Scale A brain-based framework that activates motivation, builds confidence, and reinforces habits in real-life environments BehavioralRx (Bx) is the science-based engine behind the GoMo Health engagement model and a key differentiator in driving behavior change at scale. It is grounded in cognitive and behavioral science and focuses on how people think, feel, and act. The model centers on core principles such as self-efficacy, belief, and cognitive load. These factors determine how individuals process information and whether they act on it.

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Together, BehavioralRx ® , MiLD, and the GoMo Health Enterprise Engagement Platform turn clinical guidance into consistent daily action.

BehavioralRx powers the MiLD framework. It shapes how microlearning is delivered, how support is timed, and how engagement adapts to each individual’s needs. Through the Enterprise Engagement Platform, this science is operationalized at scale. Communication is personalized, responses are captured in real time, and support evolves as individuals move through their health journeys.

For additional insights into the GoMo Health BehavioralRx science, view this discussion with Chief Behavioral Technologist and Founder, Bob Gold and Shelley R. Schoenfeld, Chief Marketing and Client Services Officer: https://youtu.be/bB2eN-YeoZk

What is the GoMo Health Enterprise Engagement Platform?

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T he GoMo Health Enterprise enables organizations to close the gap between clinical intent and real-world outcomes. Powered by BehavioralRx and informed by the MiLD framework, it delivers personalized, adaptive engagement that evolves with each individual’s needs over time. Engagement Platform is a behavior change operating system that Unlike fragmented solutions, GoMo Health provides a unified platform that connects engagement, data, and personalized support across the care journey. Through continuous two-way interaction, the platform identifies changes in behavior, outlook, and risk, then adapts communications, resources, and support pathways to reinforce healthy decisions and improve outcomes.

“Healthcare systems are built to manage clinical information. What has been missing is infrastructure designed to support human behavior. The Enterprise Engagement Platform was created to close that gap.”

BOB GOLD Chief Behavioral Technologist GoMo Health

This transforms engagement from episodic outreach into a continuous, adaptive support experience. By combining BehavioralRx methodologies, including the MiLD framework, with real-time insights and automation, the Enterprise Engagement Platform delivers timely interventions that help individuals overcome barriers, reinforce healthy behaviors, and connect with appropriate resources before challenges become crises. The result is measurable impact across both clinical and operational outcomes, including: + Improved engagement, activation, and adherence + Reduced, avoidable emergency department (ED) utilization and readmissions + Increased efficiency for care management and support teams + Stronger, trust-based relationships between organizations and the populations they serve By centralizing engagement and continuously adapting to each individual’s evolving needs, the GoMo Health Enterprise Engagement Platform extends the principles of MiLD into daily life. The result is sustained behavioral reinforcement that helps individuals make informed decisions, take meaningful action, and achieve better outcomes over time.

Personal Concierge (Automated Messaging) An advanced, automated solution for population engagement and remote care coordination, designed to dynamically adapt and deliver personalized Care Communications to audiences through text, email, or voice

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GoMo Health Enterprise Engagement Platform

02/05/2025 2:30 PM

GoMo Health

Hi Joe. Your prescription is ready for refill, but first we need to get you scheduled for your annual check-up. What day would you like to come in?

02/05/2025 2:33 PM

J.Smith

Hi! I can come in any day this week or next.

Care Companion (Digital Resource Library) A web and app-based hub for personalized wellness, education, and remote care support, offering interactive tools and resources that adapt to each user’s needs

GoMo Chat (Real-Time Communication) A HITRUST (r2) certified* secure messaging platform, providing a safe environment for live messaging between care teams and individuals

GoMo Campaigns (Ad Hoc Message Blasts) A custom campaign platform where clients can schedule and send their own communications by text and email

Reporting and BehavioralRx Insights (Analytics Dashboard) A customizable, interactive reporting platform with analytics and insights to support data-driven decisions and monitor engagement across all products and programs in one place

Platform Capabilities

Personal Concierge The Personal Concierge delivers personalized guidance and support through automated engagement that adapts to each participant’s needs, behaviors, and health journey. Using Integrated Care Management Tracks and Regimens, the platform individualizes content, communication pathways, and outreach across multiple channels, helping organizations extend care beyond clinical encounters and into everyday life.

CAPABILITY HIGHLIGHT Bidirectional Engagement

Real-time feedback drives engagement. Participant responses to simple prompts, surveys, and in-message assessments personalize support, trigger timely interventions, and generate actionable insights across populations. This continuous feedback loop transforms communication into engagement while creating visibility into participant needs, risk factors, and outcomes. Ideal For:

+ Patient and health plan member retention + Treatment and medication adherence + Care cost reduction + Closing gaps in care + Patient and member satisfaction + Improved health outcomes + Appointment reminders and follow-up + Transitional care management

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7:00 PM 43386 ›

100%

Thursday 6:00 PM

Monday 1:00 PM

HALT

You are not alone, Jane. Caregiving can be a challenging journey. Our care managers are here to help you navigate you unique situation (1/2) & provide you resources. In the meantime, tap the link for stress tips that you may find helpful: https://gcv. io.123456789 (2/2)

Don’t look through the rear view mirror. Look out the windshield.

MOOD

Our greatest weapon is our ability to choose one thought over another. Make a choice and smile.

Wednesday 1:00 PM

RELAX

Jane, how are you feeling? Has the program & your case manager been able to help you with your stress? Reply YES, NO, or SOMEWHAT.

You are more than your diagnosis. You’re not a depressed person, you’re a person with depression. Don’t lose your sense of self.

Text Message

9:00 AM

100%

Care Companion The Care Companion provides a personalized destination for education, wellness resources, care support, and self- management tools. Accessible through web and mobile devices, it supports participant learning, discharge education, ongoing engagement, and stronger connections to care teams.

Welcome Jamie!

Let’s Get Started Choose a topic below!

CAPABILITY HIGHLIGHT Digital Resource Library

Program Overview

Read

General Health and Wellness

A personalized collection of educational content, interactive learning experiences, care resources, and participant dashboards available whenever support is needed.

Read

Stress Management and Resilience

Read

Ideal For: + Course training and engagement + Bedside and discharge support + Patient-facing portals and dashboards + Digital education programs + Care team connection

Diabetes Type I

Read

Hypertension

Read

Diabetes Type II

Read

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9:00 AM GoMo Chat

100%

GoMo Chat GoMo Chat connects participants and care teams through secure, real-time communication. Whether answering questions, sharing resources, resolving issues, or supporting care coordination, it creates a more responsive and connected care experience.

Monday 8:00 AM

Hi Joe. Your prescription is ready for refill, but first we need to get you scheduled for your annual check-up. What day would you like to come in?

CAPABILITY HIGHLIGHT Secure Care Team Communication

Hi Susan. I can come in any day this week.

Two-way messaging, document sharing, broadcasts, and alerts streamline communication while keeping participants connected and supported. Ideal For: + Operational efficiency + Patient and member satisfaction + Streamlined clinical support + Secure document and insurance information sharing + Real-time issue reporting and resolution

Does Thursday at 3pm work for you?

Text Message

GoMo Campaigns GoMo Campaigns gives organizations the flexibility to create and manage targeted outreach initiatives across populations. From appointment reminders and wellness campaigns to organization-wide announcements, communications can be delivered quickly, efficiently, and at scale.

Reporting and BehavioralRx Insights Reporting and BehavioralRx Insights transform engagement activity into actionable intelligence. Organizations gain visibility into participation, outcomes, performance, and risk, helping teams identify opportunities, measure success, and make informed decisions.

CAPABILITY HIGHLIGHT Advanced Audience Targeting

CAPABILITY HIGHLIGHT Real-Time Analytics

Create, schedule, automate, and personalize campaigns for specific audiences, programs, and communication goals.

Custom dashboards and reporting tools provide immediate visibility into engagement, risk, outcomes, and program performance.

Ideal For: + Organization announcements

Ideal For: + Clinical testing and evaluation + Provider operational efficiency + Care coordination

+ Enrollment and awareness campaigns + Sweepstakes and engagement initiatives + Keyword opt-in campaigns + Ad hoc and scheduled communications

+ Treatment journey visibility and intervention + Program reporting and performance analytics

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Adaptive Personalization Engine The platform continuously learns from participant interactions and adjusts content, timing, and support accordingly. This intelligence layer helps ensure that each individual receives the most relevant guidance throughout their health journey.

CAPABILITY HIGHLIGHT Dynamic Personalization

Behavioral science and participant feedback work together to deliver the right support at the right moment, increasing engagement and strengthening behavior change.

Enterprise Security and Integration Built for healthcare organizations, the platform supports secure deployment, governance, and seamless integration with existing systems and workflows.

CAPABILITY HIGHLIGHT Enterprise-Ready Infrastructure

HIPAA-aligned security, role-based permissions, multilingual support, custom branding, and third-party integrations provide a scalable foundation for enterprise engagement programs.

GoMo Health Impact

31,649,605

Dynamic Learning and Engagement Engine

Member/patient encounters

348,554 Medical/social issues identified early to help prevent costly events

A structured system delivers MiLD moments across the care journey, aligning behavioral reinforcement with clinical milestones and real-life decision points. The GoMo Health Enterprise Engagement Platform functions as a behavioral operating system for health engagement, continuously adapting to individual needs while delivering measurable outcomes at scale. More than a communications tool, it serves as an intelligence layer that integrates clinical guidance, behavioral science, real-time data, and personalized learning into a coordinated ecosystem.

$330M+

Dollars saved

95%

Participants retained across programs

8,000+

Care/social managers and coordinators utilizing the platform

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The platform translates care plans into timely, personalized actions that fit within daily life, delivering the right message, resource, or escalation at the moment most likely to drive action. Through the Care Companion experience, individuals engage with curated content, behavioral prompts, and support resources tailored to their evolving needs, while secure two-way messaging creates a real-time feedback loop with care teams. Connected devices and remote monitoring further extend this model into daily living, transforming real-world behaviors and biometric signals into actionable intelligence. When elevated risk or behavioral barriers are detected, the system automatically triggers escalation pathways for timely intervention. By combining continuous learning, behavioral reinforcement, and real-time responsiveness, the platform operates as an enterprise-wide system for precision person-centered care, enabling scalable impact across diverse populations.

9:00 AM 43386 ›

100%

Monday 8:00 AM

Hey there, Jamie. We want to check in and see how you’re doing. Are there any resources or services that you could use help with? We can help connect you to them. Please reply with the number: 1 = Financial, 2 = Housing, 3 = Food, 4 = Education, or 5 = Child Care.

Text Message

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Enhanced Engagement and Adherence Enhanced engagement and adherence are critical because outcomes depend on what individuals do outside of clinical settings. The GoMo Health Enterprise Engagement Platform delivers personalized, real-time support that adapts to each individual’s needs. This helps individuals remain engaged long enough for routines to form and behaviors to stick. As adherence improves, outcomes strengthen, and avoidable utilization decreases. Improved Clinical and Operational Outcomes By reinforcing behaviors in everyday environments, organizations can reduce avoidable utilization, improve quality measures, and support value-based care goals. Data-Driven Insights Real-time engagement and participant-reported data provide organizations with actionable insights.

Content Management Infrastructure

Centralized governance enables organizations to manage educational materials, engagement workflows, and program content that support clinical protocols across large populations while maintaining consistency and quality control. Two-way digital communication allows individuals to interact with programs, access resources, respond to prompts, and remain connected to care teams through mobile and web channels.

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case study Fidelis Care Concierge Program The GoMo Health Enterprise Engagement Platform enables organizations to deliver scalable, measurable, whole-person engagement.

Unlike fragmented solutions, GoMo Health provides a single, enterprise-ready platform that integrates behavioral science, real-time data, and dynamic content delivery into one seamless experience. Through ongoing two-way engagement, the platform captures changes in outlook, behavior, and risk, then automatically adjusts messaging, resources, and care pathways using configurable business rules.

The Fidelis Care Concierge program demonstrates how the GoMo Health Enterprise Engagement Platform translates strategy into measurable organizational impact. By centralizing engagement within a single platform, Fidelis delivers personalized, continuous support to high-risk members while integrating seamlessly into existing care management workflows.

Through coordinated communications, real-time interaction, and adaptive learning, the GoMo Health Enterprise Engagement Platform enables members to stay connected, access resources, and take action in their daily lives. At the same time, care teams gain timely insights into member needs, allowing for more efficient, targeted interventions. These capabilities have already driven significant improvements across key performance areas. Emergency department (ED) utilization declined substantially, care gaps were closed, and case management efficiency improved through reduced time and cost per case. Member activation also increased, with strong engagement, high retention, and clear evidence that participants felt supported in managing their health. At an organizational level, this program reflects the core value of the GoMo Health Enterprise Engagement Platform. It aligns engagement, data, and care delivery into a single system that improves outcomes, enhances member experience, and increases operational efficiency at scale.

“The GoMo Health Chat feature has taken the way we interact with our members to an entirely new level. Having that instantaneous communication, while providing timely assistance and guidance in the comfort of the member’s home, makes each member feel supported. This innovative approach has significantly enhanced how I do my job.”

DENISE KENNEDY Fidelis Senior Care Manager

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PROGRAM OBJECTIVES:

PROGRAM OUTCOMES:

73% decrease in ED claims (referred) after starting the program 77% decrease in ED claims (not referred) after starting the program

+ Decrease emergency room utilization

6-7% closure in gaps in care for engaged members in multiple categories

+ Close care gaps

+ Enable case management to provide a more personalized member experience while increasing the efficiency and effectiveness of member service delivery

88% decrease in number of hours per month spent by case management 42% reduction in case management costs due to less time spent per case 67% of members who responded to surveys said the program is helpful in managing their health Over 11,400 enrolled with 95% program retention rate 16% of participants clicked the links in messages for additional content and support

+ Increase member activation and adherence

case study Amerigroup Early Intervention Program Amerigroup’s Early Intervention Mobile Concierge Program supports children with autism spectrum disorder and their caregivers through an interactive digital engagement program focused on early identification, intervention, and family support. Personalized guidance, developmental milestone tracking, autism screening reminders, and resource navigation help families access services sooner and connect with appropriate resources. The program also provides psychosocial support and specialized care management to promote continuity of care and improve outcomes for children and families.

Care Communications

Care Companion

GoMo Chat

Secure Data Collection and Reporting

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“Early diagnosis and intervention for children with autism can provide long- term benefits for children’s health, wellbeing, and their ability to develop to their fullest potential. We look forward to the program’s continued, positive impact in our communities to help ensure our members can live happy, healthy, and fulfilled lives.”

Amerigroup Community Care of Georgia helps improve health care access and quality for more than 500,000 Medicaid recipients in Georgia by developing innovative care management programs and services. Through health education programs, members are empowered to choose and sustain a healthy lifestyle. Amerigroup and GoMo Health partnered to launch an early intervention mobile concierge program for families with an autism spectrum diagnosis. This program supports members with autism and their caregivers by ensuring they are getting the resources they need at the earliest point of intervention, and by providing psychosocial support to ease the strain on caregivers.

MEL LINDSEY President of Amerigroup Georgia

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PROGRAM OBJECTIVES:

PROGRAM OUTCOMES:

+ Support members with autism and their caregivers by ensuring that they receive the necessary resources at the earliest point of intervention. + Provide psychosocial support to parents, foster parents, and adoptive parents to reduce the burden associated with caring for a child with autism.

11,400 participants enrolled , with 65% actively engaged 3,964 automated escalations provided invaluable intel to care coordinators, enabling real-time intervention and prevention of downstream adverse outcomes. A 10% improvement in caregiver assessment of child’s health and well-being (from baseline survey). 89% of participants report confidence in caring for their child (a 13% increase from baseline). 87% of caregivers are satisfied with the quality of care and support received from Amerigroup.

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case study Mom’s Heart Matters

Mom’s Heart Matters supports high-risk mothers through an interactive digital therapeutic designed to address the disproportionately high hypertension-related mortality rate among postpartum women of color. The program combines Bluetooth-enabled blood pressure monitoring, personalized engagement, and health management resources to address both clinical needs and social determinants of health. Remote monitoring and ongoing data collection allow care teams to identify elevated readings and intervene early, creating a continuous safety net for maternal health. Program outcomes include: 88% decrease in case management hours per month 42% reduction in case management costs due to reduced time per case 100% 100% of participants would recommend the program 95% participant retention rate

of participants were extremely satisfied with the program’s engagement tools and content

An interactive digital platform that delivers tools and resources to participants to guide them along their perinatal journey, reducing hypertension-related mortality and improving overall health and wellness. Using Bluetooth-enabled blood pressure cuffs, the clinical care team is able to remotely monitor patient status 24/7 via real-time readings. Sophisticated logic and business rules identify hi-risk readings and escalate concerns to avoid potential adverse events. The evidence-based program creates a safety net for high- risk moms that seamlessly integrates physical, behavioral, and social drivers of health with the power of technology and behavioral science.

“This is a wonderful program, and it really has made a huge difference. Even if you can save one mom, it is priceless. Our patient can now watch her child graduate high school you can’t put a price on that.”

HEATHER DANIELS, R.N./B.S.N. Perinatal Services Director at Liberty Regional Medical Center

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PROGRAM OBJECTIVES:

PROGRAM OUTCOMES:

+ Reduce hypertension related maternal mortality + Earlier intervention to reduce SUD/OUD related adverse events + Reduce SDoH related disparities, including blood pressure monitoring, breastfeeding initiation and continuation rates, maternal functioning and mental health

Of the participants opted into remote blood pressure monitoring, 23% had escalations of which 100% were successfully addressed with real-time interventions The most common causes for escalations: SUD, Mental Health, SDoH, Breastfeeding

100% felt they were being “actively engaged” through this platform

+ Increase active engagement with target audience

100% were “extremely satisfied” with the platform’s engagement tools, content, and interactions 95% retention rate among all enrolled participants 100% of participants would recommend the program

+ Improve patient and member experience

Health Care Requires Bold Thinking What’s at Stake for the Industry in Five Years: A System That Works, or One That Breaks

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T he future of health care will depend on whether the industry shifts the foundation of responsibility and support. Providers guide treatment, but outcomes are determined in the daily lives of the people they serve. Real progress happens when individuals and families are equipped and supported in playing an active role in managing their health. In practical terms, a healthcare system that succeeds at scale will look fundamentally different from today’s model, which relies on brief clinical interactions and assumes individuals will carry out complex care plans on their own. In this proposed model, these changes become standard operating practices. In the United States, healthcare is one of the largest sectors of the economy and represents one of the highest expenditures relative to the gross domestic product (GDP). As of 2024, U.S. healthcare spending reached 18% of GDP and is projected to rise to 20.3% by 2033.

“Value-based care needs to shift from just the provider and payer to the consumer. In any other system, it comes down to truth or consequences. It has to pass to the person, not just the person trying to fix the person.”

BOB GOLD Chief Behavioral Technologist GoMo Health

Projections National health expenditures are expected to rise from $5.3 trillion in 2024 to $8.6 trillion by 2033, growing faster than the overall economy (CMS, 2024) .

The Future of Health Care:

GoMo Health Enterprise Engagement Platform

54 | THE MISSING LAYER IN HEALTHCARE

W ithout a shift toward continuous, real-world engagement, costs will continue to rise while outcomes remain inconsistent. The path forward requires extending care beyond the clinical setting and into the realities of daily life, where health outcomes are truly determined. This is the environment where individuals must translate clinical guidance into real-world action, balancing care plans with the demands of work, family, stress, and everyday decision-making. It is in these lived moments that medications are remembered, meals are chosen, stress is regulated, and sustainable routines begin to form. This is where precision person-centered care becomes real.

It is also where social determinants of health (SDoH), such as access to food, transportation, housing stability, and time constraints, can either support or block progress. If these barriers are not addressed, even the best care plans will fail to translate into adherence. The MiLD framework helps make this possible by delivering microlearning, in-the-moment guidance, linked resources, and digital engagement that reinforce healthy behaviors in real time. The GoMo Health Enterprise Engagement Platform is a critical part of this solution. By integrating behavioral science, real-time data, personalized learning, and responsive communication into one connected system, the platform enables organizations to translate clinical guidance into sustainable daily action. This approach has already demonstrated meaningful clinical and operational impact, including reduced ED utilization, lower case management costs, and improved care team efficiency. Programs built on this model have shown up to a 73% decrease in ED claims, a 42% reduction in case management costs, and an 88% decrease in care management hours.

Beyond the measurable savings, greater value lies in improving everyday lives. Individuals feel more supported and confident in managing their health, while providers are able to focus less on reactive follow-up and more on high-value care. This creates a more resilient system for organizations, a sustainable workflow for care teams, and a person-centered experience for the individuals they serve. The future of health care belongs to systems that do more than treat conditions. It belongs to systems that help individuals build healthier routines, strengthen confidence, and sustain better outcomes in real life.

56 | THE MISSING LAYER IN HEALTHCARE

References 1. Centers for Disease Control and Prevention. (2024). Chronic Disease in America. https://www.cdc.gov/chronic-disease/about/index.html 2. Watson, K. B., et al. (2025). Trends in Multiple Chronic Conditions Among U.S. Adults. Preventing Chronic Disease, CDC. https://www.cdc.gov/pcd/ issues/2025/24_0539.htm 3. Kaiser Family Foundation. (2023). 5 Key Facts About Medicaid Coverage for Adults with Chronic Conditions. https://www.kff.org/medicaid/5-key-facts-about- medicaid-coverage-for-adults-with-chronic-conditions/ 4. Centers for Medicare & Medicaid Services. (2024). NHE Fact Sheet. https:// www.cms.gov/data-research/statistics-trends-and-reports/national-health- expenditure-data/nhe-fact-sheet 5. National Alliance for Caregiving & AARP. (2025). Caregiving in the United States. https://www.aarp.org/pri/topics/ltss/family-caregiving/caregiving-in-the- us-2025/ 6. World Health Organization. (2023). Adherence to Long-Term Therapies: Evidence for Action. https://www.who.int/chp/knowledge/publications/adherence_report/en/

7. Chapman, S. B., Aslan, S., Spence, J. S., Hart, J., Bartz, E., Didehbani, N., Keebler, M., Gardner, C., Strain, J., DeFina, L., & Lu, H. (2013). Neural Mechanisms of Brain Plasticity with Complex Cognitive Training in Healthy Seniors. Cerebral Cortex, 25(2), 396–405. https://doi.org/10.1093/cercor/bht234 8. Harvard Health Publishing. (2024). Understanding the Stress Response: Fight or Flight Physiology. Retrieved from Harvard Health. https://www.health.harvard. edu/staying-healthy/understanding-the-stress-response 9. Center for BrainHealth, The University of Texas at Dallas. (2024). Brain Health and Stress Resilience Educational Resources. https://centerforbrainhealth.org

footnote cluster for data boxes: • CDC Preventing Chronic Disease • CDC Chronic Disease Overview • Kaiser Family Foundation • AARP Caregiving in the U.S. Report • RAND Corporation Chronic Condition Research

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