Highmark is collaborating with Laguna Well being, a conversational synthetic intelligence firm, to ease the executive burden on care managers, the businesses introduced on Wednesday.
Pittsburgh, Pennsylvania-based Highmark is an unbiased licensee of the Blue Cross Blue Protect Affiliation. It has about 7 million members throughout Pennsylvania, Delaware, New York, and West Virginia. The corporate affords plans for Medicare, companies, people and households. Laguna Well being has a set of AI-powered merchandise that assist care managers determine sufferers’ danger boundaries.
By way of the partnership, Highmark is integrating Laguna’s conversational AI expertise into the insurer’s platform. When Highmark’s care managers converse with sufferers, Laguna’s expertise will transcribe the dialog, give an outline of the sufferers’ points that had been mentioned and supply actionable options to handle these points. As well as, care managers will obtain tips about how you can higher talk with sufferers.
Laguna additionally has a supervisor dashboard that permits supervisors to trace care managers’ efficiency.
The partnership comes at a time when care managers are sometimes struggling to assist sufferers because of administrative challenges, in response to Yoni Shtein, CEO of Laguna Well being.
“They’ve a number of screens, they’ve a number of techniques that they should function and all of that in tandem with truly being attentive to what the member is saying and appearing on it in real-time,” Shtein mentioned in an interview. “All of that creates a really excessive cognitive load.”
Benjamin Edelshain, vice chairman of scientific engagement and digital innovation at Highmark Well being, echoed Shtein. He famous that the collaboration with Laguna helps scale back burnout for care managers, who are sometimes slowed down with prepping and transcribing calls. It additionally improves the member expertise and makes it simpler for the insurer to show affected person outcomes.
“We expect this can be a no-brainer,” Edelshain mentioned in an interview. “It yields buyer worth and helps us run our enterprise extra successfully, extra effectively. And we are able to display outcomes to not simply our inside bookkeepers, but additionally, extra importantly, our exterior purchasers who’re at all times asking us for extra data.”
Highmark will probably be paying Laguna in a typical software-as-a-service mannequin, by which there will probably be a month-to-month subscription, in response to Shtein.
He famous that there are a lot of different conversational AI firms, however they’re totally on the supplier facet quite than the payer facet. Conversational AI firms working with suppliers embody Abridge, Atmosphere, Nabla and Suki.
“I believe over the past a number of quarters, we’ve seen a dramatic hype cycle, if you’ll, on the supplier facet. There’s most likely as a lot want on the payer, well being plan facet,” he mentioned.
Highmark is affiliated with the well being system Allegheny Well being Community, however Laguna’s expertise is barely getting used on the insurer’s facet in the meanwhile, Edelshain mentioned.
Picture: metamorworks, Getty Pictures
