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Payer AI Addresses Cost of Care, Too!

Publisher IDC
Published May 07, 2024
Length 11 Pages
SKU # IDC18780649

Description

Payer AI Addresses Cost of Care, Too!


This IDC Perspective takes a look at artificial intelligence for payer cost of care. In the past decade, health insurance companies have been looking to artificial intelligence and machine learning to identify at-risk individuals and reduce rising costs in the healthcare sphere.Consumers pay for health insurance, which includes the cost of care and related administration. While the focus of most of the AI adoption is headed toward the administrative side of the house, there are significant areas in the "cost of care" sphere that can advance with the use of AI."The use of AI in health insurance is quickly driving improvements and changing the relationship between payers, providers, and members. It helps enhance care, streamline the member/patient experience, and make internal operations easier," says Jeff Rivkin, research director, Payer IT Strategies at IDC Health Insights. "While there is still plenty of room to enlarge scope of this technology, it is clear that AI has a foothold in payers, both in care and administration."

Please Note: Extended description available upon request.

Table of Contents

11 Pages
Executive Snapshot
Situation Overview
Payer Traditional Approaches to Addressing Cost of Care
Adoption of AI
AI Cost-of-Care Use Cases
Medical and Clinical Utilization and Spending
Content Summarization
Summarizing Patient Status
Contact and Outreach Optimization
AI-Enabled Care Quality Improvement
Sentinel Events
HEDIS Quality Measures
STARS Quality Measures
Predictive Analytics for Risk Adjustment and Care Management
Tailored Behavioral Care Management
Improved Care Management Programs to Prevent Readmissions
Provider Network Design
Advice for the Technology Buyer
Learn More
Related Research
Synopsis

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