Although AI shows great promise in the medical field, there is one important opportunity that seems to be missing from these discussions. It’s employer-sponsored health care. That’s according to Morgan Health, a JPMorgan Chase division focused on employer-sponsored insurance, which released a report on Friday about how AI can support this area.
“Half of the U.S. population has employer-provided insurance, and commercial sector stakeholders need more concrete insight into how they can work together to apply AI in meaningful and targeted ways. “We thought we needed more information,” said Dr. Emily Lindemer. said Morgan Health’s executive director of data in an email.
Here are five ways AI can improve employer-driven healthcare, according to the report.
1. Patient Navigation: Patients often struggle to find the care they need, and employers consistently struggle to provide individualized support to their employees, making it difficult for employees to access their health benefits. Involvement is low. AI can help with this by leveraging a patient’s medical history to provide appropriate care.
However, AI is still in its infancy when it comes to patient navigation and advances are needed.
“To drive meaningful change in this area, the industry needs to improve its data infrastructure, starting with interoperability,” the report states. “More collaboration is needed across the health care system, including employers, insurers, providers, and vendors. All stakeholders have varying types and levels of access to a patient’s health history. ”
2. Identify and reduce bias and risk: AI has the potential to provide employers with better insight into the future needs of their employees. For example, AI can present more sophisticated models to predict how complex conditions such as diabetes or heart disease will affect the population over time.
However, this poses some challenges. “Many aspects of an individual’s true health status (physical, mental, social, etc.) are not accurately reflected in the data recorded due to systemic disparities within the health care system,” Morgan Health said. says. Said.
3. Streamline billing and administration: Avoid billing errors by automating billing and coding. According to the report, this “requires both employers and patients to deal with the administrative stress and burden associated with manual corrections, which often involve lengthy processes to review and correct errors.” It will disappear.” AI can also provide real-time transparency into a patient’s current insurance deductible status.
4. Free up provider time: Quality care is a top priority for employers. Provider efficiency tools such as ambient documentation and medical record summaries allow providers to spend more time with patients.
“Patients often share complaints that their health care providers do not take enough time to understand their needs and provide guidance on how to improve their health,” the report states. . “Therefore, it is important to pair these AI-powered tools with value-based contracts that prioritize the quality of the patient-provider interaction (rather than the number of patients seen). In other words, AI could prompt healthcare providers to simply see more patients rather than provide higher quality care to patients if they had more time allotted to them. ”
5. Clinical decision support: AI can also provide higher quality care by capturing medical information and translating it to inform clinical decision-making. This allows healthcare providers to spend more time with patients and make the clinical decision-making process more efficient.
“Some of these tools are already on the market and are reimbursed at higher rates than human clinicians, which will increase costs in the short term,” the report states. “However, the widespread belief is that these tools (if properly scaled and implemented) can ultimately lead to downstream cost savings in the future.”
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