Highmark is partnering with Laguna Well being, a conversational synthetic intelligence firm, to assist ease the executive burden for care managers, the businesses introduced Wednesday.

Highmark, primarily based in Pittsburgh, Pennsylvania, is an impartial licensee of the Blue Cross Blue Defend Affiliation. It has roughly 7 million members in Pennsylvania, Delaware, New York and West Virginia. The corporate provides Medicare, company, particular person and household plans. Laguna Well being has a set of AI-powered merchandise that assist care managers determine sufferers’ danger obstacles.

By way of the partnership, Highmark will combine Laguna’s conversational AI know-how into the insurer’s platform. As Highmark care managers communicate with sufferers, Laguna’s know-how will transcribe the dialog, present a abstract of the affected person points that had been mentioned, and supply actionable solutions for addressing these points. As well as, care managers will obtain recommendations on how one can higher talk with sufferers.

Laguna additionally encompasses a supervisor dashboard that enables supervisors to trace the efficiency of care managers.

In keeping with Yoni Shtein, CEO of Laguna Well being, the collaboration comes at a time when care managers usually wrestle to help sufferers because of administrative challenges.

“They’ve a number of screens, they’ve a number of methods that they need to handle, and all of that mixed with really being attentive to what the member is saying and appearing on it in actual time,” Shtein stated 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, agreed with Shtein. He famous that the partnership with Laguna helps scale back burnout amongst care managers, who are sometimes slowed down in making ready and transcribing calls. It additionally improves the member expertise and makes it simpler for the insurer to show affected person outcomes.

“We predict this can be a no-brainer,” Edelshain stated in an interview. “It delivers buyer worth and helps us run our enterprise extra successfully and effectively. And we will present outcomes not solely to our inside accountants, but additionally, extra importantly, to our exterior prospects who’re all the time asking us for extra info.”

In keeping with Shtein, Highmark Laguna might be charged primarily based on a typical software-as-a-service mannequin, the place there’s a month-to-month subscription.

He famous that there are lots of different conversational AI corporations, however they’re totally on the supplier facet moderately than the payer facet. Conversational AI corporations that work with suppliers embody Abridge, Atmosphere, Nabla, and Suki.

“I believe we’ve seen a dramatic hype cycle, if you wish to name it that, over the previous few quarters on the supplier facet. There’s in all probability simply as a lot want on the payer facet, the well being plan facet,” he stated.

Highmark is affiliated with the Allegheny Well being Community well being system, however Laguna's know-how is presently solely being utilized by the insurer, Edelshain stated.

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