TFSF Ventures  ×  Agentic Injections

AI Operations Proposal for AdhereHealth

A custom 12-agent infrastructure layer purpose-built for the leader in medication adherence solutions — designed to amplify Care Navigator capacity, accelerate Star Ratings performance, and scale member engagement across 100+ health plan clients.
Prepared for Kempton Presley & the AdhereHealth Leadership Team  ·  March 2026
100+
Health Plan Clients
20
Years in Healthcare
12
Proposed Agents
HITRUST
r2 Certified

The Opportunity — From Your Assessment

These numbers come directly from your completed operational assessment.*

30+
Clinical and operations staff handling outreach, compliance, and reporting.
5–15
Hours per week your team spends on CMS compliance and reporting tasks.
30+
Days to onboard a new health plan client onto the Adhere Platform.
4.3mo
Projected payback period including new RFP wins.

The ROI math: 10 hours/week compliance labor × $35/hr × 50 weeks = $17,500/year in direct savings. Outreach optimization across 30+ navigators at 20% efficiency gain = equivalent of 6+ additional staff ($120,000+ value). One additional health plan win through the RFP agent = $200,000–$500,000 in new annual contract revenue. Conservative annual value: $280,000. Against a $100,000 investment, payback is under 5 months.

*Assessment completed by Kempton Presley, CEO, on 3/23/2026.

Beyond the Assessment — The Full Automation Picture

Your assessment captured the operational bottlenecks your team manages daily. Looking at the broader medication adherence and health plan services workflow, there are additional areas where agents create compounding value.

Clinical Operations
Predictive Intervention Timing
Your team uses algorithm-based risk scoring. An agent layer adds predictive timing — identifying the exact window when a member is most likely to respond, reducing your 4–8 outreach attempts to 2–3 with higher conversion rates.
Automated MTM Program Enrollment
CMS MTM eligibility screening and enrollment documentation generated automatically from claims data. Eliminates the manual identification and paperwork that scales linearly with every new health plan contract.
Cross-Plan Intelligence
With 2M–10M members across multiple plans, patterns in one population predict outcomes in another. An agent surfaces cross-plan insights your clinical team can act on — adherence strategies that work for Plan Alpha's diabetic population can be applied to Plan Beta's hypertension cohort, compounding improvement across your entire book.
CAHPS Score Optimization
Member experience directly impacts Star Ratings. An agent monitors interaction quality across Care Navigator calls, identifies patterns in low-scoring interactions, and flags adjustments before CAHPS survey season.
Growth & Scale
RFP Response Automation
Your growth comes from RFP responses. An agent pre-builds customized proposals with prospect demographics, projected adherence impact, Star Rating improvement estimates, and outcomes-based pricing models — cutting RFP response time from weeks to days.
Client Onboarding Acceleration
30+ days to onboard a new health plan client means delayed revenue. An agent automates data ingestion, member segmentation, and compliance setup — targeting a 50% reduction in onboarding time.
Outcomes Guarantee Modeling
AdhereHealth's outcomes-based billing model means you need to predict results before committing to guarantees. An agent models expected adherence improvements per population segment giving you confidence to offer stronger guarantees and win higher-value contracts.
Regulatory Change Monitor
CMS rules change annually — Star Ratings methodology, HEDIS measures, and MTM requirements shift without warning. An agent monitors Federal Register updates, CMS final rules, and measure changes in real time, flagging impacts to your operations and contracts before they take effect.

The compounding effect: The 12 core agents address your current operational bottlenecks. These 8 expansion capabilities build on that foundation — each one amplifies the ROI of the others. Predictive timing makes outreach optimization smarter. RFP automation feeds the growth engine. Cross-plan intelligence improves outcomes guarantees. This is how AdhereHealth scales from 100+ clients to market dominance.


Agent Architecture — 12 Agents, 3 Pillars

Each agent is purpose-built for AdhereHealth's world — serving health plan members, Care Navigators, clinical teams, and client success managers across government, commercial, and PBM segments. Built around HIPAA compliance, HITRUST security standards, and CMS regulatory frameworks from day one.

1Care Navigator Augmentation
Outreach Optimization Agent
Analyzes member data to determine the optimal time, channel, and language for each outreach attempt. Tells Care Navigators who to call, when, and what to say based on behavioral patterns, refill history, and SDOH data.
Outreach Intelligence
SDOH Barrier Detection Agent
Scans member interactions, claims data, and engagement signals to proactively identify social determinant barriers — transportation, cost, language, health literacy — before a Care Navigator picks up the phone.
Barrier Resolution
Care Navigator Copilot Agent
Real-time AI assistant that sits alongside Care Navigators during member calls — surfacing medication history, prior interactions, SDOH flags, and suggested talking points. Reduces call prep time and improves call quality.
Clinical Support
Multi-Language Content Agent
Auto-generates outreach materials — texts, postcards, call scripts — in each member's primary language. Builds on AdhereHealth's existing multi-language capabilities while eliminating manual translation bottlenecks at scale.
Engagement
2Platform & Analytics Enhancement
Star Ratings Forecasting Agent
Predictive modeling that shows health plan clients their projected Star Rating trajectory in real time, with scenario modeling — if we reach X more members on adherence measure Y, the rating moves from 3.5 to 4.0.
Predictive Analytics
Member Risk Stratification Agent
Continuously rescores member risk levels based on real-time claims, refill data, and engagement signals. Dynamically reprioritizes the Care Navigator queue so the highest-impact members are always contacted first.
Risk Scoring
Care Gap Closure Agent
Monitors all open HEDIS measures and preventive screening gaps across the entire member population. Auto-generates targeted outreach sequences for each gap type and tracks closure rates against CMS deadlines.
Quality Measures
Compliance & Reporting Agent
Automates CMS reporting requirements, MTM documentation, and regulatory compliance tracking across all 100+ health plan contracts. Reduces the manual reporting burden that scales linearly with each new client.
Regulatory
3Client Success & Growth
Client Performance Dashboard Agent
Builds and maintains real-time performance dashboards for each health plan client — adherence rates, Star Rating impact, ROI metrics, and member engagement trends. Replaces manual report generation with always-current data.
Client Reporting
RFP & Proposal Agent
When AdhereHealth pitches new health plan clients, this agent auto-generates customized proposals with the prospect's member demographics, projected adherence impact, and estimated Star Rating improvement.
Business Dev
Contract Intelligence Agent
Monitors all 100+ client contracts for renewal dates, performance thresholds, outcomes-based billing triggers, and at-risk accounts. Alerts the account team before problems surface — not after.
Account Mgmt
Content & Thought Leadership Agent
Powers AdhereHealth's blog, resources section, and event content with first drafts, CMS regulatory update monitoring, and market intelligence. Accelerates the content pipeline that already drives inbound leads.
Marketing

Your Healthcare Command Center — Live Preview

This is what real-time operational intelligence looks like for AdhereHealth. Every metric, every member interaction, every compliance milestone — visible to your leadership team 24/7.

Members Reached Today
0
Target: 2,400 / day
Adherence Rate (PDC)
81.2%
▲ 2.3%vs. last month
Care Gaps Closed
0
891HEDIS measures open
SDOH Barriers Resolved
0
⚠ 23pending resolution
Star Ratings Trajectory — Top Plans
Plan Alpha (Medicare Adv)
3.5 → 4.0▲ ON TRACK
Plan Beta (DSNP)
4.0 → 4.5▲ ON TRACK
Plan Gamma (Commercial)
3.0 → 3.5⚠ AT RISK
Agent Status — 12 Active
LIVE
Outreach Optimizer
Medicare Adv batch
SDOH Detection
4 barriers flagged
Navigator Copilot
Member #47291
Multi-Language
Spanish batch done
Star Ratings
Q2 projection
Risk Stratification
12,400 rescored
Care Gap Closure
891 HEDIS open
CMS Compliance
MTM report done
Client Dashboard
Plan X report
RFP & Proposal
Regional deck
Contract Intel
4 renewals 60d
Thought Leader
CMS update draft
Live Care Navigator Activity

Your Investment & Projected Return

Here's what comparable solutions cost, what your investment with TFSF looks like, and how the math works from your assessment data.

What Comparable Solutions Cost (Annual)
$200K–$1M+
Healthcare AI Consulting
Big 4 + specialty firms (12–18mo timeline)
$150K–$500K+
Healthcare AI Platforms
Implementation + licensing + maintenance/yr
$20K–$100K
AI Consulting (Assessment Only)
Strategy + roadmap, no build included
Phase 1 — Core Deployment (One-Time Investment)
TierInvestmentWhat's Included
Core$100,000Full 12-agent architecture custom-built for AdhereHealth's clinical workflows, CMS compliance, and member engagement operations. Integration, training, and 30-day post-launch support.
Enterprise$130,000Everything in Accelerator + HIPAA-compliant client portal, unlimited agent expansions, 12-month retainer, and quarterly strategy sessions with your leadership team.
How We Deploy
1. Kickoff
One 90-minute session. We map your Care Navigator workflows, Adhere Platform integrations, and CMS compliance processes.
2. Build & Test
We design, build, and test every agent within HIPAA-compliant infrastructure aligned to your HITRUST r2 posture. Zero disruption to clinical operations.
3. Launch & Optimize
Phased rollout with hands-on training. Post-launch monitoring, performance tuning, and quarterly strategy reviews.

Phase 1 ROI: $17,500 in compliance labor savings + $120,000 in outreach efficiency (equivalent of 6+ navigators) + $200,000–$500,000 from one additional RFP win. Conservative annual value: $280,000. At the Core tier, payback is under 5 months.

$280K
Annual Value (Conservative)
4.3 mo
Payback Period
6+
Navigator Equivalents
$500K
Upside Per RFP Win
Phase 2 — Expansion Agents (Optional Add-On)

The 8 expansion capabilities from Section 01b — predictive intervention timing, MTM auto-enrollment, cross-plan intelligence, CAHPS optimization, RFP automation, onboarding acceleration, outcomes guarantee modeling, and regulatory monitoring — deploy on top of your core infrastructure.

Phase 2 PackageInvestmentWhat's Included
Expansion Bundle (all 8 agents)$60,000All 8 expansion agents: predictive intervention timing, MTM auto-enrollment, cross-plan intelligence, CAHPS optimization, RFP automation, onboarding acceleration, outcomes guarantee modeling, and CMS regulatory monitoring.
À La Carte$12,000–$15,000 per agentChoose individual agents based on priority. Most clients start with RFP Automation and Onboarding Acceleration, then layer in predictive timing and outcomes modeling.

Phase 2 ROI: RFP automation alone can double your response capacity — two additional wins per year at $200K–$500K each. Onboarding acceleration cuts 15+ days of delayed revenue per new client. Outcomes guarantee modeling lets you offer stronger commitments and win higher-value contracts. Combined Phase 1 + Phase 2 annual value: $500,000–$1,200,000. Total investment of $160,000 (Core + Expansion) pays back in under 5 months.

No annual licensing fees. No per-seat charges. Custom-built for AdhereHealth — you own every agent. Phase 2 agents deploy on the same infrastructure, zero additional platform cost.

One Session. Then We Build.

Every hour your Care Navigators spend on manual call prep, every week your compliance team spends on CMS reporting, every RFP you don't have capacity to respond to — that's value left on the table. One 90-minute kickoff and we start putting it back.

Tue 3/25
Wed 3/26
Thu 3/27
Fri 3/28
Mon 3/31
Tue 4/1
Wed 4/2
Thu 4/3
Fri 4/4
Mon 4/7
9 AM
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1 PM
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Questions? — support@tfsfventures.com
About TFSF Ventures

TFSF Ventures FZ-LLC is a UAE-licensed AI venture builder specializing in agentic infrastructure for mid-market companies. We design, build, and deploy custom AI agent ecosystems that integrate directly into existing business operations — not generic SaaS platforms, but purpose-built systems tailored to how each company actually works.

tfsfventures.com →
AI Operational Assessment
AdhereHealth — 19 questions, ~8 minutes
1 of 19 — Contact
2 of 19 — Contact
CEO / President
COO / EVP
CTO / VP Technology
VP Clinical / Pharmacy
VP Client Success
Operations / Analytics
Marketing
Other
3 of 19 — Firm Profile
Under 25K members
500K — 2M members
2M — 10M members
10M+ members
4 of 19 — Firm Profile
1 — 5
6 — 15
16 — 30
30+
5 of 19 — Firm Profile
Under 25
25 — 50
50 — 100
100+
6 of 19 — Technology
Proprietary / In-house
Third-party SaaS
Legacy / On-premise
Hybrid / Multiple
7 of 19 — Technology
Salesforce Health Cloud
Custom-built CRM
Dynamics 365
No dedicated platform
8 of 19 — Technology
Tableau / Power BI
Custom dashboards
Looker / Domo
Spreadsheets / Manual
9 of 19 — Technology
Yes, actively
Experimenting
Evaluating
Not yet
10 of 19 — Operations
Algorithm-based risk scoring
Clinical team judgment
Third-party / template content
We don't produce regular updates
11 of 19 — Operations
Under 7 days
7 — 14 days
14 — 30 days
30+ days
12 of 19 — Operations
Predictive model flags them
Clinical team identifies them
We find out when they leave
Building a better process
13 of 19 — Operations
1 — 3 attempts
4 — 8 attempts
9 — 15 attempts
15+ attempts
14 of 19 — Compliance
100% — fully automated checks
Most outreach is reviewed
Manual review is inconsistent
It's an active concern
15 of 19 — Compliance
Under 5 hours
5 — 15 hours
15 — 30 hours
30+ hours
16 of 19 — Compliance
Dedicated compliance team
Automated reporting tools
Manual spreadsheet tracking
Outsourced / third-party
17 of 19 — Growth
Grow member reach
More health plan clients
Care Navigator efficiency
New market segments
18 of 19 — Growth
Existing client referrals
Conference / industry events
Inbound marketing / content
RFP responses
19 of 19 — Growth

Assessment Complete

Thank you. Your responses have been received. Our team will analyze your answers and deliver a customized deployment blueprint within 24 hours.