Healthy Rewards

VOL. I Quality · Engagement · Experience 2026

Closing the Gaps:
Advancing Timely Access to Care

Integrated Quality Performance, Member Engagement, and Experience Measurement — built around the member, wired into the program.

In partnership with

·

Mission frame The plan serves the largest publicly operated Medi-Cal population in the country. This program is designed to make that mission more measurable — closer-to-the-member, faster-to-respond, and built for the communities you serve.

N · Member M

Mobile-first, multilingual, accessibility-grade

Mobile-first — designed at 390px first
WCAG 2.1 AA conformance across critical flows
Multilingual from screen one — eight languages live
Privacy-respectful by default — Privacy Mask universal

E · Care & CHW C

A workforce-grade view of every panel

Three-column member care view for CHWs
Languages — Spanish, Vietnamese, Korean, Mandarin, Tagalog, Armenian, Persian, Russian, Khmer, Arabic and 80+ more available
Privacy Mask universal across every UI layer

S · Plan Admin A

Financial literacy at the admin layer

Stars uplift · Member Engagement Insights
Open-priority KPIs · ledger-grade activity
Live activity ledger · DHCS APL 16-005 episode-band annotations
Auditable at the moment of closure — no reconciliation pass

W · Foundations F

A program that operates, not a feature set

Member-care plans aligned to clinical priorities
Clinical signals routed in the same beat
Reward fulfillment built for compliance
Audit-ready activity ledger across every action

Live walkthrough

Eight things on her home screen

1
Welcome + portrait. Spanish greeting. Maria's photo on her own home screen.
2
Wallet, CarePoints, next visit. Money-in-pocket and her annual rewards balance, plus the date of her next appointment.
3
Diabetes Care Triple Episode. Three steps that move together — A1C lab, kidney check, eye exam. 5,000 CarePoints when all three close.
4
Engagement opportunities. Annual Health Risk Assessment and short learning modules — quick wins.
5
Support through her care team. TAP transit credit and her Promotora — already available, not earned.
6
Cultural Cohort Engine. Same module — narrator and example aligned with her stated preferences.
7
Featured rewards. Curated catalog — no cash equivalents, all health-aligned.
8
Language toggle. Eight languages live — English, Español, Tiếng Việt, 한국어, 简体中文, Հայերեն, Tagalog, العربية (with full RTL).

Open Maria's live page ↗

Cultural Cohort module with Boyle Heights variant selected

Live walkthrough

Same module, member's preferences

1
Variant selector. Three tabs — General · English, Boyle Heights · Español, Vietnamese-language community · Tiếng Việt. Maria's selection drives what renders.
2
Module title, duration, reward. Identical across variants — 90 seconds, video + 3-question quiz, +50 CarePoints on completion.
3
Narrator changes. Boyle Heights → Rosa, Promotora. General → a clinical educator. Vietnamese-language community → a different narrator anchored in that context.
4
Example anchored in stated context. Daily routine and mealtime cues reflect the family table — not assumptions, the member's stated context.
5
Quote in preferred language. Spanish, Vietnamese, or English — the same clinical guidance in the member's own voice.
6
What stays vs. what changes. Clinical content, reward, compliance posture, accessibility, captioning — identical. Narrator, example, language — adapt.
7
Member-selected, not algorithmic profiling. Footnote at the bottom of the module makes this explicit: stated choices, not inferred demographics.

Open the Cohort module ↗

Live walkthrough

Rosa's day, on one screen

1
Rosa Martínez. Signed in to her own panel, Spanish-default UI, training badges, today's outreach window.
2
Priority banner. "3 members are due for diabetes labs this week" — the first thing Rosa sees.
3
Member panel. 12 assigned members, each with care priorities, last contact, next visit, and preferred language.
4
Risk-tier chips. Low · Rising · High support need — visible at a glance, never a clinical label.
5
Intervention plan. Five-step playbook for Maria — open priority, draft outreach, support available, closure, reward credit.
6
Privacy Mask card. One member appears as "Care follow-up available" — care-team-only routing, no diagnosis cue anywhere.
7
Preferred-language outreach preview. One click drafts an outreach in the member's preferred language for Rosa to review before any real send.

Open Rosa's live view ↗

Member-to-plan loop — four panes updating in the same beat

Live walkthrough

One trigger, four systems

1
Trigger. A single click — "Run the loop" — fires the event. In production this is a real clinical event posting to the program.
2
Member wallet. CarePoints credit +5,000 with a Spanish congratulations banner. Member sees the win in her language, in the same beat.
3
Admin compliance ledger. A new line posts — "Diabetes Care Triple Episode closed · HBD A1C control verified · 5,000 CarePoints credited · DHCS APL 16-005 episode-band annotated." Auditable at closure.
4
Plan-wide trajectory. Open-priority KPI ticks down. HBD HEDIS measure ticks up. Stars trajectory updates without a manual reconciliation pass.
5
Preferred-language outreach preview. A Spanish SMS draft slides in for Rosa to review — no real message is sent until the care team approves.

Open the live loop ↗

DHCS APL 16-005 Revised — Medi-Cal incentives

Non-monetary, restricted, mission-tied rewards. $15–25 single-action band · $40–100 episode band.

42 CFR 422.134 — Medicare R&I

Uniform offer · cash-equivalent prohibition · admin cost in bid.

OIG nominal-gift policy

$15 per item, $75 per member per year. No cash-equivalent gift cards.

CA SB 22 (effective April 2026)

No expiration. No inactivity fees on permitted gift-card formats.

HIPAA Security Rule · 45 CFR 164.308 + .312

TLS 1.2+ · AES-256 · role-based access · audit logs · breach SOPs · MFA. HIPAA BAA executed.

42 CFR Part 2 (2024 final rule)

Single TPO consent. Separate SUD counseling notes. Privacy Mask enforced at the UI layer across every program surface.

DHCS APL 25-005 · APL 26-004

Threshold and concentration language coverage. Real-time behavioral health data sharing. ATA-certified or NCQA-accepted with back-translation on clinical content.

Section 504 / WCAG 2.1 AA

Effective May 11, 2026. Critical flows tested for keyboard and screen-reader access. Mobile-first design.

Plan-supplied requirements

Space for the plan to add regulations, contract clauses, or internal controls the program will honor.

Closing the Gaps:
Advancing Timely Access to Care

Stars trajectory matters

Stars trajectory matters

Engagement compounds

Engagement compounds

Motivation, not the product

Motivation, not the product

Built around the member. Wired into the program.