Deliver optimal product solutions
quickly and efficiently

Pioneering AI/ML technology
helps optimize MA plan designs
to gain market share

Get an integrated view of the impact of new design(s)
Go beyond siloed data. Get an integrated view across features of the impact of proposed plan designs on potential market share
Optimize plan design(s) based on growth objectives
Run tens of thousands of scenarios by Region and Plan Type/Tier/Segment. Make better decisions efficiently
Analyze proposed benefit designs by geography
Predict which Counties will be most receptive to new Plan designs. For both existing as well as new markets
Streamline development of benefit packages
Utilize our proprietary algorithms to bundle designs into packages by Customer Segment to maximize outcome

Fine tune
marketing by plan
and county
Localize your marketing efforts. Focus on Plan features which will get the most traction in a given County or geography

Gain market share
in new and existing markets

Optimize Cost-sharing
Our AI/ML Models run tens of thousands of scenarios (or more as needed) to determine optimal levels of cost-sharing in order to maximize defined outcomes.
Premium, Deductibles, Copays, Coinsurance, MOOP, Doctor visits, Inpatient stays and many more features
Focus on potential Market share, Enrollment, Revenue or another outcome
Analyze by Region and Plan based on your go-to-market strategy
Assess Supplementary Benefits
Supplementary benefits are an integral part of plan benefits packaging. We can help in deciding which ones to offer by Plan Type and Market segment.
Dental, Vision, Hearing, Part B Premium Reduction, Meals, Transportation, Fitness and many more...
Potential impact of coverage / non-coverage on market share / enrollment
Analyze by Supplementary Benefit, Plan and Geography
Improve Formulary Tiers
Many Plans (and Contracts) share the same formulary even if their targeting and markets are quite different. Are your Formularies designed as needed? We can help fine tune their cost-sharing, tiers and coverage.
Optimize formulary tier Copays and Coinsurance. Run thousands of scenarios
Tier Suitability Index, by Region or County
Coverage recommendations to improve suitability index and gain market share
Explore different geographies
Predict outcomes by County or Regions based on your roadmap and strategy. Venture into new geographies. Analyze by State. We offer a plethora of options.
Evaluate by County or client-defined Regions
Explore new markets as well as existing ones
Streamline development of benefit packages. Improve package suitability for defined geographies

Frequently Asked Questions
We have a lot of data already. Where does Lighted Road add value?
Carriers are awash in data. They gather data from various sources in order to come up with proposed changes to Plan benefits. However, a lot of this data is in silos.

Our AI/ML Models provide an integrated view across features of the impact of proposed plan designs by county, using a goal-oriented metric like potential market share. As a result, Carriers can better evaluate various alternatives for optimizing MA Plan design(s).
What does "optimal" Plan design mean? Our goals may be different from others.
We work with our Clients to define what "optimal" means to them by 1) specifying boundaries for various Plan features and 2) identifying a goal-based metric like "potential market share" to compare outcomes.

Our AI/ML Models then run tens of thousands of scenarios for plan variations across needed geographies. Maximizing the desired outcome determines the "optimal" positioning for a Plan within defined feature boundaries.
What does Lighted Road mean by "potential market share"?
A lot of factors impact market share. Marketing spend and Competition's offerings are just a couple of them, whose data is usually not available during the plan design process.

In reality, "potential market share" is most useful as a comparison metric for evaluating various plan design alternatives.

How accurate are the Models? We used our AI/ML Models to predict 2023 enrollment by MA Plan and County, while AEP was still in its early stages. Take a look.
What does a typical engagement look like?
A typical engagement starts with a FREE requirements session during which we understand the Client's needs and where they are in the Plan design process. We quickly turn this around into a proposal.

Timelines vary based on the work involved. It is highly recommended to start the engagement as early in the design process as possible as our AI/ML Models can help at every stage of the plan design lifecycle.
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