Knowing the member
SMARTInsights starts and ends with historical aggregated volume and ratios across your member population, not with last year's staffing budget.
Demand and Supply Intelligence for health plans
Predict demand.
Predict demand.
Protect people.
Preserve margins.
iTAV SMARTOps brings member intelligence into operations now, with predictive forecasting as the platform grows.
What SMARTOps delivers
SMARTOps helps government-sponsored health plans that need accurate demand and supply forecasting, reducing forecast errors and budget overruns to deliver real cost predictability and service consistency.
Connected to the market
Enrollment, attrition, and competitor moves shape your demand signal. SMARTOps accounts for member behavior and the competitive and regulatory forces that move it.
Regulation aware
Enrollment and demand move on a regulatory calendar. SMARTOps accounts for the dates already on it, including annual enrollment, open enrollment, plan exits, and benefit changes, so your forecast reflects the cycle your members actually live in.
Eliminates forecast errors
Forecast errors and budget overruns driven by backward-looking forecasting technology and manual spreadsheets.
Member intelligence first
Forecasts start with who your members are and how they behave, not with last year's call volume. Member mix, enrollment movement, and utilization patterns are the first inputs, because demand follows the population before it follows the calendar.
The forecasting problem
Why demand and supply forecasting is so hard.
2.9M
members forced to change Medicare Advantage plans in 2026
JAMA / Johns Hopkins, 2026
11,200
Americans turning 65 every day through 2027
Alliance for Lifetime Income
34M+
people already enrolled in Medicare Advantage, about 54% of Medicare
KFF, 2025
The Cost of Getting It Wrong
When a health plan cannot predict, people feel it first.
Behind every missed forecast is a member who could not reach anyone and a team absorbing the surge. The following are representative scenarios, not testimonials.
Medicare Advantage Member
"I've been on hold for almost an hour. I just need to know if my prescription is covered."
Representative scenario
Operations Staff
"We went from a normal day to triple the call volume overnight. There was nothing we could do."
Representative scenario
Physician Office
"The prior authorization was submitted days ago. The patient is still waiting."
Representative scenarioForecasting demand and supply is hard. If it were easy, no one would be left waiting.
30+
years in health plan
operations
operations
Built by an Operator Who Lived It
"We planned for modest growth. Reality came in far higher, with a sixteen-week staffing lead time and no way to catch up. It was preventable. That is why I built SMARTOps."
The Platform
One platform, built in sequence.
Purpose-built SaaS platform for government-sponsored health plans, predicting member demand and supply and the staffing to meet it across every function that touches volume. Health plans can purchase one module or the full platform. SMARTOps is a secure, cloud-based platform.
Module 1
SMARTInsights
Understand who your members are and what drives their volume, by segment, cohort, and propensity. Minimal PII needed to start.
Available NowModule 2
SMARTForecast
Predict member demand and staffing supply up to 18 months out, with built-in unlimited scenario planning and macro intelligence signals.
In Development, Target Q4 2026Module 3
SMARTAssist
Detect volume spikes in real time, anywhere in the operation, trace them to a cause, and alert the functions about to feel the impact.
Planned, 2027Who It Is For
Built for government-sponsored health plans.
The plans and partners whose margins live or die on demand accuracy, where a missed forecast is felt in members, staff, and dollars.
Primary market
Medicare Advantage
Underwriting margins turned negative in 2024 while demand keeps rising. Accurate forecasting is now a margin requirement, not a nice-to-have. (Milliman, 2025)
Medicare Part D
Formulary changes and enrollment windows create surges historical models miss.
Managed Medicaid
Eligibility redeterminations and state policy shifts arrive with little warning.
ACA Marketplace
Annual enrollment and competitor pricing reshape member behavior before plans can staff for it.
And the vendors who serve them
Pharmacy Benefit Managers
Benefit changes and utilization spikes cascade across pharmacy operations.
Business Process Outsourcers
They deliver value on demand accuracy, but that accuracy starts with the health plan's own forecast.
Supplemental Benefits Vendors
OTC, Flex Card, Dental, Vision, and Transportation vendors depend on the same demand signal to staff and supply correctly.
Built for every function
Not just the call center. Every function that volume touches.
Telesales, Member Services, Grievance and Appeals, Enrollment, Billing, Claims, Utilization Management, Mailroom. Wherever demand hits your operation, SMARTOps forecasts it.
Telesales
Match staffing to seasonal demand instead of last year's guess.
Live nowMember Services
The function most affected, and the one every other function feeds into.
Live nowGrievance and Appeals
Staff ahead of the surge, not after the backlog builds.
In developmentEnrollment
See annual enrollment demand coming, months before it lands.
Billing
Predict inquiry volume tied to statement cycles and rule changes.
Claims
Forecast volume spikes before they hit adjudication queues.
Utilization Management
Anticipate authorization request volume before it strains review teams.
Mailroom
Plan for correspondence surges tied to enrollment and regulatory cycles.
Member Services and Telesales are live today. Grievance and Appeals is in development.
What the Market Is Telling Us
Buyers are already asking for this.
42
discovery interviews completed
100%
confirmed the problem, with no real solution today
"This solves a problem we have worked around for years."
Chief Experience Officer
"This is what we need to speed up decisions during peak enrollment."
VP, Customer Experience
"When can we actually have it?"
Director of Sales
Source: iTAV primary research, based on 42 interviews with health plan operators conducted through July 2026.
Stop guessing
Government-sponsored plans cannot afford to guess anymore.
With SMARTOps, demand and the staffing to meet it are modeled, not guessed. Members get through. Staff can breathe. Margin is protected.