The members hardest to reach are the ones your measures depend on.

Butler keeps contact going with members between visits, interprets what comes back against their conditions, and closes the gaps that only close through sustained contact. Your network keeps the clinical relationship. You get the reach and the record.

An older couple sitting together on their couch at home.

Another app is not the answer. A text they answer is.

Plans already run outreach programs, apps, and vendor point solutions. The members who most affect cost and quality are the ones who engage with none of them. They answer a text from someone who already knows their medication list, and they answer it again next month.

We are not a second care team competing with the one your member already has. We run the contact, and we route what matters to the clinician who owns it.

Where the gaps actually are

After the hospital

The window after discharge is where medication errors and avoidable readmissions live, and it closes fast. We start contact the day after discharge, compare what the member is actually taking against the discharge list, confirm the follow-up visit, and route differences to the treating clinician while there is still time to act.

Transitions of careMedication reconciliation post-dischargePlan all-cause readmissions

Between refills

Adherence is logistics before it is behavior. A member who stops filling has a reason, and the reason is usually a pharmacy, a cost, a ride, or a prior authorization nobody finished. Sustained contact finds the reason in time to fix it, and documents what was in the way.

Diabetes medication adherenceHypertension medication adherenceStatin adherenceStatin use in diabetes

Before the emergency room

Most avoidable emergency visits are preceded by a week of small signals: a weight change, a missed dose, a symptom the member was not sure was worth a call. We ask the questions their care plan says to ask, on a cadence, and escalate the answers that cross a threshold.

Emergency department utilizationGetting needed care

Before coverage lapses

Health risk assessments, recertifications, and benefit deadlines are paperwork problems with clinical consequences. Contact that is already running is the cheapest way to catch a deadline before it passes, and to find out which members need help completing the form rather than another reminder.

Health risk assessment completionAnnual wellness visit

Measures named here are the ones this work touches. For 2026, the medication adherence measures carry triple weight while patient experience and CAHPS were cut from weight four to two, so adherence and outcomes are where contact pays back fastest. CMS paid $13.4B in quality bonuses in 2026, and four stars lifts your benchmark by 5%, doubled in some counties. We will walk through your current performance and which measures you are actually losing points on.

Why members answer us

It is a text, not an app

No portal, no download, no login, no password reset. A question arrives, the member answers in their own words, and that is the whole interaction.

It already knows their plan

The questions come from their care plan, so nobody is asked to repeat their medication list or explain their conditions again.

Answering changes something

When a member reports a problem, it reaches the clinician who can act on it. Members keep answering programs that produce a response.

What comes back to the plan

Contact at this cadence produces structured information about a population you otherwise only see in claims, months later.

Confirmed clinical detail

Diagnoses and conditions confirmed by the member, with dates, rather than inferred from a claim that arrives a quarter late.

Documented social needs

Transportation, food, cost, and caregiver barriers captured in the moment they blocked care, in a form that supports coding and program referral.

Gap closure with evidence

Which member, which gap, what was in the way, who it was routed to, and whether it closed. Produced as the work happens.

Reach data on the unreachable

Who responded, who did not, and what worked. The members your existing programs never touch are the ones this tells you the most about.

How we contract

Per member, per month

A defined population, a set cadence, and reporting on reach and routing. The simplest way to start on a segment you are already worried about.

Through your network

We run the contact under your contracted practices, who bill Medicare for the care management. The plan gets the engagement and the data without paying twice for the same work.

Tied to performance

Fees connected to the measures we affect, once we have run long enough on your population to know what the contact actually moves.

We would rather start on one segment, on a real population, than sell a plan-wide program on a slide. Tell us the members you are most worried about and we will scope the pilot around them.