Artificial intelligence helps insurers identify Medicare members who also qualify for Medicaid

Garrett SchmittNo Comments

Medicare Advantage insurers that miss enrolling dual-eligibles are missing an opportunity, said Change Healthcare, which has introduced a combination of artificial intelligence and behavioral science to identify candidates. WHY THIS IS IMPORTANT Enrolling individuals dually-eligible for Medicare and Medicaid is good business for insurers who are already in the Medicare Advantage space. While this population…

Improving Health Plan Customer Service Through Technology

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High quality health plan customer service is critical for payers who want to create meaningful, positive beneficiary interactions. Customer service plays several important roles for health plans.  In addition to the stand-alone goal of leaving members with a satisfactory experience, the quality of customer relations is included in NCQA’s HEDIS measures, one of the most…

Value-based care will reinvigorate EHRs, boost AI, advance home telehealth

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The state of value-based reimbursement efforts has been uncertain. Many healthcare organizations are indeed pursuing newer strategies to replace traditional fee-for-service care while reducing costs and improving quality, but progress has often been halting. Still, experts from Cedars-Sinai, CVS Health, Blue Cross NC and Harvard Pilgrim Health Care say they’re quite optimistic for the future…