Supporting health plan members who can't speak for themselves

Every health plan has members it struggles to reach: not because they are unwilling, but because they cannot speak. After a stroke, with ALS, with a brain tumor, in the weeks after a breathing tube, a member may understand everything the care manager says and be unable to answer. Usually a family member steps in, and that family member is also the one managing the medicines, the appointments and the aides.

This article describes how ExpressAgain supports those members and their families, what a health plan can do today, and how a pilot works.

The measures plans are rated on

The CMS 2026 Star Ratings fact sheet explains that CMS publishes Medicare Advantage and Part D Star Ratings each year to measure the quality of health and drug services, and each measure receives a one to five star rating. The measures it lists include Medication Reconciliation Post-Discharge, Plan All-Cause Readmissions, Transitions of Care, Care Coordination, and medication adherence for diabetes, blood pressure and cholesterol medicines. Several of these depend on what happens at home, between visits, which is exactly where a member who cannot speak is hardest to support.

What ExpressAgain is built for

We say it plainly: these are the outcomes ExpressAgain is built for, each next to the feature that does the work. None is a promise, and a pilot measures these with you, in your own members.

• Lower cost of care: the family and the Home Team log readings every day, and with care alerts on, a reading outside the targets from the member's doctor reaches the Care Team at once, not at the next visit.
• Fewer avoidable admissions and readmissions: a practice or hospital enrolls the member at discharge, the follow-up visit is booked where the Care Team sees it, and the weeks at home are logged on the same record.
• Medication adherence: every dose is logged as given, skipped, refused, missed or late, with who and when, and counted in the Medications report.
• Higher star ratings: a member who cannot speak can tap a phrase, build a sentence or spell a word, and answer the care manager's questions out loud.

Targets and care alerts and Prescriptions and the dose log describe the two mechanisms most plans ask about.

What members and families get

Members get a voice: tap-to-speak, the sentence builder, the Letters board, the emergency phrases and, on a paid plan, their own cloned voice, in the web browser on a phone, tablet or computer. Families get one place to run care at home: the Care Team and the Home Team on one record, the day plan, the shared chart, medications and appointments, and a private circle that keeps the rest of the family informed without more phone calls. Communicating is never behind a paywall for the member, sponsored or not.

What the plan gets today

A health plan can sponsor a member's access. When it does, the family is never asked to pay while the sponsorship runs, and the app reads Covered by your plan's name. When a practice or hospital also enrolls the member, the plan's sponsorship pays for base access first. If a sponsorship ends, a grace period keeps the circle open, and nothing the family recorded is taken away. Our team records each sponsorship on the member's circle today. Sponsorship, in plain words has the details.

Families control their record. A plan reads what a family records at home only if the family shares with the plan by share code, only the parts they choose, and they can revoke it at any time. The Partner API that carries that data is built; its keys are issued after a signed Business Associate Agreement, which waits on our vendor agreements, now in progress.

What is scoped in the pilot

Some things a plan may expect are not built today, and we would rather say so than imply them. There is no plan dashboard and no aggregate plan-level reporting, and there is no eligibility-file import. What a plan receives at the program level, and how eligible members hear about ExpressAgain, are scoped with each plan in the pilot and written into the agreement.

How a pilot works

• A 30-minute briefing on what members and families use at home and how sponsorship works today.
• Agree the scope, the member population and what we measure together.
• Launch to members, who start in the web browser with nothing to install.
• Review the results together at the points agreed, and decide the next step.

ExpressAgain for health plans sets out the ways to work with us. Health plan pricing is set with each plan and is not published.