How AI Makes Care Management More Efficient

Value-based reimbursement incentivizes providers to deliver high-quality care efficiently, by encouraging greater integration of care teams and better use of existing services and technologies.

You can help providers and care-teams by facilitating the creation, collaboration, and execution of cost-effective care plans.

But the process of creating care plans can get bogged down with back and forth communication and manual data entry. It’s often difficult to collaborate on care plans and share them with all parties involved.

Today, payers can use artificial intelligence to make care management more efficient, so you and your providers can benefit from value-based reimbursement, and your members can receive the best care for the best price.

Here’s how.

Automate care plan creation

Increasing automation is one of the most significant ways you can impact value-based reimbursement. Manually filling out forms takes a lot of time (and therefore, money)—and with the right tools, it’s not necessary.

You already have the data to see what care your members need based on how their demographic data, claims records, and medical history overlap with compliance standards. So when a provider gives your member a new diagnosis, you already have all the analytics and actionable data you need to create a care plan.

By automating care plan creation, you save time and free your members, providers, and care managers to immediately start working through the care plan and taking the next steps.

Engage your members and providers

Once a care plan is defined, you need members and providers to stick to it. Your members have to seek out the care and services they need, and your providers have to deliver that care. You can’t make your members show up, but you can remind them what they need and when. At the same time, you can also give providers better visibility into the care plan and any gaps in care.

Thankfully, artificial intelligence (AI) can help with both member engagement and provider engagement, too. When a member has a gap in care, an engagement platform empowers you to automatically notify them in your member portal, mobile app, or via text messaging, plus provide links to where they can take the next step. You can also flag gaps in care for your providers by sending alerts in your provider portal.

And with AI, your mobile engagement tools can automatically respond to your members’ questions, so they can get all the information they need without the inconvenience of making a phone call.

An engagement platform, like Healthx, gives you more tools to ensure care plans are followed and gaps are closed—before they create more costly issues and negatively impact outcomes.

Drive value-based reimbursement

Value-based reimbursement is the payment model that benefits you and your members the most. If your providers can deliver care and complete transactions efficiently, it’s the best model for them, too. Automating and facilitating care plans is just one of the ways you can help providers become more efficient, which helps them serve your members better and makes value-based reimbursement more appealing.

Talk to an Expert to learn more about how AI can drive value-based reimbursement.