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Providers and payers play key roles in healthcare delivery. More often than not, the two must collaborate to ensure that patients and beneficiaries move through their care journeys as efficiently as possible while complying with state and federal regulations.
Despite this shared goal, the relationship between providers and payers can be strained by information exchange issues, siloed data, and administrative burdens. To address these problems, some providers and payers have turned to artificial intelligence (AI) and data analytics solutions to help streamline processes and enhance data exchange.
MultiCare Health System and Coordinated Care are two such organizations. They spoke with HealthITAnalytics to share what the strategy looks like from the provider and payer perspective.
MultiCare is a Tacoma, Washington-based not-for-profit healthcare system with more than 20,000 employees and 11 hospitals. Coordinated Care is a managed care organization that provides healthcare services to more than 200,000 members across Washington state.
Debbie Schardt, assistant vice president of revenue cycle and utilization management at MultiCare Health System, and Alana Llewellyn, concurrent review nurse manager at Coordinated Care, shared insights into how an AI platform has helped improve information exchange and streamlined the utilization management process.