For weeks, Sharon from Louisiana texted with our AI health coach, Ramona, believing she was a real person. When a friend suggested the truth, her response was instant: "I didn't feel bad at all. You did an outstanding job."
That's when we knew our core hypothesis was correct: You can build a real, trusted relationship with AI. And that relationship is the foundation for a fundamentally different - and better - kind of health insurance.
The Real Problem with Medicare Advantage
We're not building a wellness app. We are building new clinical infrastructure to attack the central flaw in the $400B Medicare Advantage market. Today, incumbents profit by restricting care and cutting benefits, not by improving health.
Our model flips that script. We are focused on prediction and prevention, using an insurance plan as the business model to capture the value we create when members get healthier. Our financial success is directly linked to better health outcomes.
But this model hinges on one critical question: Can you create a daily, proactive relationship with seniors at scale? That's what we tested.
What We Learned: Seniors Will Form Real Relationships With AI
We ran an 8-week pilot with 11 seniors. The headline result: 78% Weekly Active Users.
This wasn't a novelty that wore off. Engagement held steady through week 8 and increased after the pilot ended. Users texted with Ramona about health-specific issues 2.4 times per week, sharing symptoms, discussing anxieties, and setting health goals. They described it as an "always-on, judgment-free" companion. Sharon gave it a 10/10 likelihood to recommend.
This isn't just "good engagement." This is the clinical and financial flywheel for our entire company. This is how we:
- Detect early warning signs before they become a 911 call.
- Reinforce clinical care plans between doctor visits.
- Prevent costly hospitalizations through proactive, daily support.
Every text is an opportunity to improve health and lower our Medical Loss Ratio (MLR).
Here's what the research shows: When you text someone about their health, they're 90% more likely to respond than if you send an app notification. More importantly, those texts drive real results. Diabetic patients using text-based coaching can drop their A1C by over 1% in three months. People are twice as likely to take their medications. They show up to doctor appointments 23% more often.
These aren't small wins. These are the interventions that keep someone out of the emergency room at 2am.
Real Outcomes, Real Impact
Gayle used the pilot to manage anxiety during a stressful family situation. She told us the coach was "helpful in guiding her to set boundaries and step back." She reached her goal of reducing anxiety - not through medication or therapy appointments, but through daily text conversations with an AI that understood her context and provided consistent support.
This is the model at scale: proactive, personalized, persistent support that prevents small problems from becoming medical crises.
The Data Behind the Engagement
The numbers tell a compelling story:
- 91% of users rated the experience 4 or 5 out of 5
- Average recommendation score: 8 out of 10
- 10 unique user weeks where a user ent
- Of the 88 unique user weeks (11 users over 8 weeks)
- Users sent 5 or more messages in 61 weeks (69%)
- Users sent 21 or more messages in 38 weeks (43%)
- Users sent 49 or more messages in 11 weeks (13%)
- Top single week by a user was 233 messages
- 73% reported making "significant progress" or "reaching their goal" during the 8-week pilot
- 82% reported increased confidence in reaching their health goals after using the coach
But the real signal wasn't in the numbers. It was in what users said.
Gayle from Louisiana described it this way: "It was like I was actually talking to a real person...I didn't feel uncomfortable at all." She preferred Ramona to a human health coach because she could "go there anytime and talk" without scheduling appointments or feeling judged.
One user wrote: "Ramona kept up with our goals, how we were able to reach them and stayed in line helping me out with kind thoughts. It's a great system and found it quite enjoyable."
Another captured the core value: "How they learned my feelings, thoughts and health results."
This wasn't surface-level engagement. Users were sharing real health concerns, emotional struggles, and daily wins. The AI wasn't just collecting data, it was building relationships.
What We Fixed: From Insights to Execution in 6 Weeks
The pilot revealed critical flaws. We didn't spin the data, we fixed the problems.
- The Flaws: We built a "death loop" where the AI always ended with a question, trapping users in conversations. We also had a "persona conflict," where a coaching-style AI frustrated users who wanted direct information.
- The Fixes: In the six weeks since the pilot, we've re-engineered the conversational model to end chats gracefully. We've expanded our AI's memory 10x to ensure continuity. We've added local intelligence, providing concrete information from community events to local resources.
- The Signal: A user in Tulsa is now engaging 5 out of 7 days a week, using these new features.
This is our operating rhythm: Pilot → Brutal Honesty → Rapid Fix → Validation. This is how we'll win.
This Isn't a Chatbot. It's the Future of Care Delivery.
The AI coach isn't a replacement for doctors. It's a force multiplier for our virtual clinical team.
It's the daily touchpoint that connects a member to our Ramona Medical Home, where our telemedicine Primary Care Providers manage panels aided by AI. The AI handles the routine, freeing up our human clinicians for the high-value, relationship-based care that actually reverses chronic disease.
The smaller panel size matters. When doctors have fewer patients, those patients go to the emergency room 40% less often and get hospitalized 20% less. Emergency room costs drop by half.
Our model combines that intimacy with technology speed - we can expand our AI capabilities weekly while still giving members the relationship-based care that actually works.
When a diabetic member's A1c improves, their health improves, and our bottom line improves. That alignment is everything.
We're Moving Fast. This is Your Invitation to Join Us.
We have:
- Our MA operations lead (15+ years at Centene/Molina)
- Our CMO (preventive medicine specialist, built care models at Nurx)
- State licensing and CMS applications in progress
- Network development contracts ready to execute
The math works. When you combine better primary care with daily AI coaching, you save more than $26 per member per month. That's $300,000 a year for every 1,000 members. And the members are healthier.
This is how we change the game: better health, better economics, better experience. Everyone wins.
We're executing toward our 2027 launch. State license application goes in Q4 2025. CMS Notice of Intent in November. First members January 2027.
If you're someone who believes health insurance should make people healthier, let's talk.
email me at: charles@ramona.care