What Careforce does
Founded in 2024, Careforce builds AI agents that handle care coordination work like outreach, scheduling, referrals, and Medicaid enrollment. The agents can make calls, run data analyses, and use programs like electronic health records (EHRs) and scheduling software. This lets providers and health plans run outreach and enrollment campaigns faster, at lower cost, and at a scale people alone cannot match. That lowers administrative spending and helps more patients get seen across the Medi-Cal delivery system.
Why this matters
Under H.R. 1 passed in 2025, many Medi-Cal members will be required in January 2027 to confirm their eligibility every six months to stay enrolled. That is a huge new burden on plans and clinics that are already stretched thin. Safety-net providers expect major revenue losses as patients lose coverage and visit volumes drop. Health plans face shrinking networks, more members cycling on and off coverage, and rising costs to re-enroll people and keep their care going.
Current staffing cannot keep up. One health plan told us it deployed 30 temporary staff for enrollment work during COVID-19 and still could not clear its backlog. A community clinic said its eight grant-funded enrollment staff already can’t meet demand, and that funding is likely to disappear. Many plans and providers are now turning to AI to fill these gaps and keep members enrolled.
The impact
In 2024, Kern Family Health Care in Bakerfield began using Careforce’s AI agent “Angelica” for re-enrollment. Angelica calls members to remind them of upcoming renewals and hands them off to enrollment managers or county staff who can help with applications.
With the aid of Careforce, KFHC renewed 96% of their members during the first year, compared to 38% before using the AI platform.
Careforce has also signed contracts with Central California Alliance for Health and Ritter Center in Marin County, plus a pilot with Clinica Sierra Vista.
Founder: Huzaifa Sial
Huzaifa has more than 14 years of experience building health care AI. Across health plans, providers, and startups, he built machine learning engines for disease prediction, patient engagement, care delivery search, and care gap closures, and he holds four health AI patents. Most recently, he led AI solutions at UnitedHealth and Optum, working on generative AI applications.
Why the California Health Care Foundation cares
This investment fits our Technology in Medicaid work, which supports responsible AI in the Medi-Cal delivery system. With every-six-month redeterminations now the rule, the risk of eligible members losing coverage is real, and it falls hardest on the communities already facing the biggest barriers to care. Careforce helps plans and clinics reach those members and keep them enrolled.
It also makes care more affordable by cutting the administrative work and coordination failures that lead to costlier care. Careforce’s agents work across different technology systems without integration, so they can support a wide range of workflows.
Read more about Careforce on the CHCF Blog, How AI-Powered Outreach Is Helping Californians Keep Their Medi-Cal Coverage.
See our FAQ to learn how program-related investments work at the California Health Care Foundation and how we reinvest profits in our mission-related work.