Transforming Healthcare Advocacy with AI

Healthcare

AI & Data Engineering

Enterprise Deployment & Optimization

The Opportunity

Navigating a Shifting Healthcare Landscape

Between 2020 and 2022, healthcare payers faced mounting challenges. Medical loss ratios were climbing, threatening profitability. The shift to value-based care brought new operational complexities. Members expected seamless, personalized experiences, while administrative costs continued to erode margins. Traditional advocacy models-reliant on human expertise and legacy systems-were no longer fit for purpose. Sharecare recognized this inflection point as an opportunity to reimagine member advocacy for the digital age.

Value-Based Care Acceleration
Payer-provider convergence requires real-time risk adjustment, data integration, and intelligent care coordination tools.
Unsustainable
Administrative Spend
13–25% of total spend is tied up in admin processes—ripe for automation, AI, and workflow optimization.
Digital
Infrastructure Gaps
Legacy platforms lack the intelligence, scalability, and personalization required for modern care navigation and advocacy.
Escalating Medical Loss Ratios
Payers face tightening margins as MLRs trend toward 90–92%, demanding cost-efficient models that also improve care quality.

The Vision

A Digital Front Door for Every Member

Sharecare’s leadership saw the future early: AI—and specifically Large Language Models (LLMs)—would redefine how people engage with healthcare. Recognizing that traditional advocacy models couldn’t keep pace, they set out not just to improve access, but to reinvent the entire member experience.

Their vision was bold: create a single, intelligent digital front door—a unified platform that makes healthcare as seamless and personalized as a five-star concierge experience.

As CEO Jeff Arnold put it, the goal was clear: “Treat every member like a guest in a five-star hotel.” That meant combining the warmth of human expertise with the intelligence of AI to deliver deeply personalized, proactive support—at scale.

Enter Sharecare+: An integrated, AI-powered platform that consolidates every benefit, every service, and every touchpoint into one connected, intuitive experience. From preventive care to complex case management, Sharecare+ supports members across digital, in-home, and in-person channels.
With AI serving as the smart digital nervous system of the platform, Sharecare+ doesn’t just react to member needs—it predicts them. It drives down costs by anticipating care gaps, eliminating friction, and routing members to the right resource at the right time.

Vision Pillars

AI-Powered
Precision
LLMs and advanced models drive intelligent, real-time insights—powering next-gen member navigation and decision-making.
Personalized, Whole-
Health Experience
Every member journey is tailored across clinical, behavioral, and benefits domains—meeting people where they are, and guiding them where they need to go.
Hospitality-Level
Care at Scale
Blending AI with human advocacy to deliver warmth, clarity, and confidence—turning healthcare into a guest-grade experience.
A Unified Digital
Front Door
One seamless entry point for all services, benefits, and support—designed to simplify complexity and elevate care.
Efficiency Through
Intelligence
AI acts as the digital nervous system—reducing waste, closing gaps, and enabling smarter, faster decisions across the ecosystem.
Predictive, Proactive Engagement
Anticipates needs before they arise—using AI to close care gaps, reduce friction, and route members to the right support at the right

The Solution

Building Sharecare+ with Torsion

To bring the Sharecare+ vision to life, Sharecare partnered with Torsion—selecting us as the strategic implementation partner to translate vision into scalable AI-powered execution. Sharecare+ was launched as a whole-health, payer-agnostic advocacy layer built on top of Sharecare’s digital infrastructure and rapidly scaled across populations and services.

Technical Implementation

To support the launch of Sharecare+, Torsion designed and implemented a modular, AI-native architecture across data, automation, and platform layers.

Key elements of the solution included:

WeCare GPT AI Chatbot

Launched in March 2023, this always-available, multilingual chatbot was built using large language models to automate and personalize member interaction

Why: To enable scalable, real-time natural language processing for member-facing communication.

Advocacy ETL Pipeline

A custom pipeline was developed using Python and Airflow to ingest and transform claims, eligibility, risk, and utilization data.

Why: To ensure high-frequency data processing and enable downstream analytics and automation.

Caregaps Analysis Tool

Engineered an automated rules engine to apply clinical criteria to member data for identification of preventive and chronic care gaps.

Why: To operationalize codified clinical logic within the platform and support rules-based event detection.

Database Optimization

Refactored and indexed the Postgres data architecture to support complex filtering, joins, and analytics on large-scale member datasets.

Why: To increase query efficiency and maintain system performance under high-load conditions.

NLP Engine Transition

Replaced the underlying chatbot LLM from ChatGPT to Llama-2.

Why: To enable greater model customization, improve control over deployment environments, and optimize for cost and infrastructure flexibility.

The Impact

By The Numbers

Metric
Before Sharecare+
After Sharecare+
ETL Processing
Time
7 hours
ETL Processing Time
20 minutes
(21x faster)
ETL Processing Time
Member Support
Availability
Limited
Member Support Availability
24/7, multilingual AI chatbot
Member Support Availability
Report
Generation
Manual, slow
Report
Generation
Mostly automated, rapid
Report
Generation
Care Gap
Analysis
Manual, error-prone
Care Gap
 Analysis
Automated, timely, data-driven
Care Gap
 Analysis

Delivering Meaningful Results

The Sharecare+ platform rapidly demonstrated tangible value:
Enhanced Member Experience
Members enjoyed seamless, 24/7 virtual assistance and personalized health guidance through a unified digital platform.
Operational Excellence
Manual effort and processing times dropped dramatically. Care gap identification became more accurate, and advocate productivity soared with AI-powered decision support.
Strategic Advantage
Sharecare+ positioned Sharecare at the intersection of payer sustainability and member-centric care, standing out in a competitive digital health market and laying a robust foundation for future AI-driven innovation.
Scalable Platform Growth
By the end of 2022, Sharecare+ had contracted over 900,000 eligible lives and integrated with CareLinx, expanding the platform’s reach from digital to in-home care environments—building a truly end-to-end ecosystem.

Looking Ahead

Sustaining Innovation and Responsible AI

Sharecare’s journey with Torsion is ongoing. With an AI council ensuring responsible governance, the organization is poised to expand LLM applications in advocacy and member engagement, further optimize its data infrastructure, and enhance personalization through advanced predictive analytics.

Sharecare+ is a testament to what’s possible when vision meets execution-and when technology is harnessed to make healthcare more human, efficient, and effective.