5 benefits of harnessing AI for quality improvement excellence

As value-based care continues to evolve, Artificial Intelligence (AI) is proving to be a game-changer in driving measurable outcomes for payers. Recent studies predict that the global AI market in healthcare will exceed $187 billion by 2030¹, underscoring its rapid adoption and scalability. Here's how health plans are leveraging AI to create measurable value:

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1. Provider outreach efficiency‍

Health plans using AI for workflow automation have reported up to 50% more efficient provider outreach. This translates into quicker creation of provider packets and accessing readily available chart submissions.

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‍2. Time-saving retrieval‍

AI-driven processes streamline medical record retrieval, saving organizations up to 1,400 hours during HEDIS audits. This allows healthcare teams to focus on care quality and strategic decision-making rather than manual administrative tasks.

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3. Simplified HEDIS audit

With the ability to process data at unprecedented speeds, AI helps to build a holistic view of patient health by extracting data at 96,000 pages per hour and routing 85% of charts without human intervention, ensuring clinical alignment for specific conditions and measures alongside any HEDIS engine.

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4. Proactive care management

Combining AI with aggregated data, health plans can identify trends and intervention opportunities that traditional, siloed data systems often miss. By leveraging a 360-degree view of patient health history and delivering actionable insights, organizations can anticipate care gaps, improve quality measures, and strategically target interventions to optimize care.

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‍5. Cost savings

By employing AI for medical record retrieval, clinical abstraction, and operational efficiency, health plans can significantly reduce manual workload, minimize data-entry errors, and maintain a proactive approach with year-round quality improvement strategies.  

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Artificial Intelligence has quickly become a crucial component to manage the cost and quality of value-based care, especially as it continues to grow.

By enhancing efficiency, streamlining processes, and delivering actionable insights, AI empowers health plans across the entire value-based care workflow, from faster retrieval to more productive abstraction and, ultimately, streamlined audit processes that create more time to focus on health outcomes. As the industry innovates, organizations that prioritize AI will set new standards for quality, efficiency, and member-centric care.
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Learn more about improving quality outcomes

Take the next step toward transforming healthcare delivery. Download our comprehensive guide, 5 barriers to excellence in quality improvement and how to solve them, and discover actionable strategies for leveraging Artificial Intelligence to enhance quality measures, improve member satisfaction, and elevate Star Ratings.

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Sources:^‍
_{1- https://www.grandviewresearch.com/industry-analysis/artificial-intelligence-ai-healthcare-market
2- https://www.reveleer.com/resource/hedis-provider-outreach
3- https://www.linkedin.com/posts/reveleer_aws-reveleer-activity-7234258503161294848-29H7}