Payer AI Addresses Cost of Care, Too!

Executive Snapshot

• Figure: Executive Snapshot: Payer AI Addresses Cost of Care Too!

Situation Overview

• Payer Traditional Approaches to Addressing Cost of Care

• Adoption of AI

• AI Cost-of-Care Use Cases

• Medical and Clinical Utilization and Spending

• Content Summarization

• Summarizing Patient Status

• Contact and Outreach Optimization

• AI-Enabled Care Quality Improvement

• Sentinel Events

• HEDIS Quality Measures

• STARS Quality Measures

• Predictive Analytics for Risk Adjustment and Care Management

• Tailored Behavioral Care Management

• Improved Care Management Programs to Prevent Readmissions

• Provider Network Design

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• Related Research

• Synopsis