Building the Digital Backbone for Statewide Medicaid Care Delivery

BigHeart is a Chicago-based digital health platform focused on patient engagement through community networks, preventive care activation, and accessible care delivery. Over a six-year partnership, Touch4IT has acted as BigHeart’s long-term product and engineering partner, helping build and scale a HIPAA-compliant platform that combines community outreach, telehealth, virtual health records, interoperability, and advanced reimbursement analytics.

The platform now supports engagement across more than half a million Medicaid recipients in Illinois and enables large-scale preventive and chronic care programs. Following earlier success with national payer programs, including CVS and Aetna, BigHeart entered a major new phase in 2025: a statewide Medicaid engagement program with the State of Illinois (MPCEO). The Illinois program operates as a fee-for-service preventive engagement model with downstream claims reimbursement once patients complete medical services. This model is designed as a prototype that can be scaled to other US states and private insurers.

BigHeart’s mission is to improve health outcomes for underserved populations by activating patients to take preventive health actions before chronic illness develops. The platform is designed for trusted advocates such as non-profits, faith-based organizations, caregivers, and community engagement specialists who work directly with hard-to-reach populations.

Rather than replacing providers, BigHeart focuses on engagement and activation. The platform helps individuals understand their benefits, complete required screenings, schedule appointments, and close care gaps while staying connected to providers and payers.

BigHeart’s journey shows what it takes to move beyond pilots into production environments that involve Medicaid, payers, and state-level programs.

For founders building care-delivery, patient-engagement, or population-health platforms, this case demonstrates that engagement, reimbursement logic, and interoperability must be designed together from the start.

Reaching populations that traditional healthcare does not

Medicaid recipients and underserved populations are among the hardest groups to reach. Many are unaware of available benefits or unsure how to navigate the system. Low engagement leads to missed screenings, delayed diagnoses, and preventable chronic conditions.

Engagement is operational, not just digital

Driving real behavior change requires more than an app. BigHeart’s outreach model combines digital campaigns with human touchpoints, including SMS, phone outreach, and even in-person engagement through mobile teams who actively reach recipients to encourage screenings and identify care gaps.

Scaling engagement requires reimbursement clarity

As BigHeart expanded, the platform needed to support real payment models. Preventive outreach activities are delivered under fee-for-service contracts, while completed medical visits become reimbursable claims. This required robust analytics, reporting, and payer-ready workflows.
 

Touch4IT has been BigHeart’s technology partner for more than six years. Together, the teams built the core platform and evolved it as BigHeart moved from early programs into payer contracts and state-scale operations.

The partnership goes beyond delivery. Touch4IT worked closely with BigHeart’s leadership to design a platform that supports engagement operations, data integrity, reimbursement logic, and compliance under real-world constraints.

Community-driven patient engagement

At the core of BigHeart is a community engagement model. The platform supports outreach specialists and automated campaigns that activate patients across multiple channels, including SMS, phone, and in-person engagement. These efforts encourage preventive actions such as annual screenings, physical exams, and follow-up appointments.

Telehealth and virtual health records

Patients can access virtual consultations, view their health records, communicate securely, receive prescriptions, and complete visits within a single experience. Virtual health records allow engagement teams and providers to track progress and identify gaps in care.

Preventive care activation at scale

The platform enables scheduling and referral workflows for services such as mammograms, physical exams, and chronic condition screenings. Once appointments are completed, the system captures outcomes that feed both program reporting and claims workflows.

Remote patient monitoring

Certified medical devices were integrated to support continuous monitoring for chronic conditions. RPM programs contributed to reduced utilization and improved outcomes, while also supporting reimbursable care models.

Interoperability and real-time data

To operate at a state scale, Touch4IT connected siloed systems across providers, payers, devices, and third-party platforms. This included patient identity matching to reduce duplicates and ensure accurate reporting.

One key integration was Admissions, Discharge, and Transfer (ADT) feeds, providing real-time visibility into patient movement across care settings. This allows care teams to respond quickly to transitions and close gaps that often occur after discharge.
 

The platform is connected to a variety of systems, including medical devices like DexCom, and Withings, as well as a payment gateway (Stripe), social media login systems, a communication platform (Big Marker), etc.

Program scope

The State of Illinois engaged BigHeart to reach over half a million Medicaid recipients and activate them into preventive health programs. The goal is to improve health outcomes while reducing long-term costs by preventing chronic illness.

How the platform is used

The platform supports multi-channel outreach, scheduling, referral management, and care gap identification. Engagement specialists work alongside automated workflows to ensure recipients complete screenings and connect with providers.

Economic rationale

By increasing the completion of preventive care, the program aims to reduce avoidable hospitalizations, chronic disease progression, and long-term healthcare costs. The Illinois model serves as a prototype for expansion into other states and private payer programs.

Toward a joint venture

Six years into the partnership, BigHeart and Touch4IT are evolving their collaboration into a joint venture. Both teams act as co-creators and ambassadors for a healthcare segment built on trust, impact, and scalability, expanding beyond Illinois into other US states and Europe.
 

The platform delivers measurable results in production:

• Engagement across more than 850,000 Medicaid recipients in Illinois
• Over 70 percent of active participation in preventive care programs
• 86 percent completion rate for chronic disease prevention initiatives
• 72 percent reduction in care delivery costs through RPM programs
• Significant reductions in hospitalizations and readmissions
• Reimbursement-ready reporting across five major payers

Engagement drives economics

Preventive engagement is not just a lever for clinical outcomes. It is an economic one. States and payers invest in engagement because it reduces long-term costs.

Reimbursement must be designed early

Platforms that treat reimbursement as an afterthought struggle to scale. BigHeart’s success came from designing engagement, reporting, and claims logic together.

State scale requires operational maturity

Illinois demonstrates what becomes possible when a platform is ready for real-world constraints across technology, people, and payment models.

Touch4IT helps healthcare startups and scaleups transition from pilot programs to production environments involving real patients, payers, and public programs. If you are navigating engagement, reimbursement, or Medicaid readiness, we can share what it took to make this work at scale in Illinois.