Bakersfield Medi-Cal plan's AI 'Angelica' helps push renewals to 94.9%

Key Takeaways

Kern Family Health Care uses an AI agent named Angelica to call Medi-Cal members about renewals.
The plan reports a 94.9% renewal rate in April after deploying the tool.
The software cost about $370,000 and replaced roughly 40 full-time callers.
State officials say plans may contact members, but counties decide eligibility and must protect privacy.
Vendor Careforce says it’s also working with Central California Alliance for Health, which serves Merced County.

Vanessa Barahona picked up the phone this spring and scheduled a Medi-Cal renewal appointment with someone named Angelica at Kern Family Health Care in Bakersfield. "It felt like I was talking to a real person," she said. She wasn’t.

Plan executives say Angelica, a software program, is one reason Kern Family’s renewal rate hit 94.9% in April. That matters in Kern County, where an estimated 52% of residents use Medi-Cal and where new federal work rules and more frequent renewals start in 2027.

What Kern Family built

Angelica is a multilingual calling system that reaches members when renewals come due, books in-person help if needed, and routes questions to staff. Kern Family Health Care says the system has placed more than 800,000 calls to its 387,000 members since late last year. The plan paid about $370,000 for the software from San Francisco startup Careforce and estimates it would have needed 40 full-time employees and roughly $2.4 million in staffing to match that volume.

Careforce and Kern executives say the point is to prevent eligible people from slipping off coverage as rules change. Another AI assistant, David, helps internal staff find answers faster. And the settings are tuned, they say, to avoid swamping the human team that finishes the paperwork.

What the rules allow

California’s Department of Health Care Services says managed care plans can contact members about renewals, including with AI tools, as long as they follow privacy, data security, and consumer protection laws. Counties still decide who qualifies. Kern County Human Services has stationed workers inside Kern Family’s main office and shares some eligibility-timing data with the plan so the calls land when they should.

The federal backdrop is changing too. Under last year’s One Big Beautiful Bill Act, most adult Medicaid enrollees will have to show 80 hours a month of work or qualifying activities, and many will renew twice a year instead of once. Plans say that means more reminders, more documents, and more chances to miss a deadline.

Who else is trying this

Careforce CEO Huzaifa Sial says the company is also working with the Central California Alliance for Health in a similar way. The Alliance runs Medi-Cal managed care in Santa Cruz, Monterey, and Merced counties. If the Bakersfield results hold, Merced families could see more outbound calls and quicker scheduling before their renewal dates hit.

The push and the worries

Workers didn’t lose jobs at Kern Family, according to the plan, though unions have raised concerns elsewhere about surveillance and cost cutting. Some health policy researchers warn that AI-guided processes could misroute patients or hide bias. Stanford economist Mark Duggan said the incentive is clear for plans to keep eligible people covered, but he added a caution: "When you have a new technology like this, you need to police it."

Emily Duran, CEO of Kern Health Services, said early skepticism faded after demos and early data. Barahona, who cleans offices on swing shift, said the Spanish-language calls helped her avoid a gap. It was 93 degrees in Bakersfield on Friday afternoon.

"This will always be, in my opinion, an AI-human combination," Sial said.

Central Valley AI is produced by the CVAI Newsdesk team and developed by Kaweah Tech, a regional firm that builds, deploys, and integrates AI solutions for businesses across California's Central Valley.

Source

https://themercedfocus.org/ai-is-being-used-to-boost-medicaid-enrollment-but-not-without-concerns/