AI in Value-Based Care: Potential AI Applications for Providers

July 14, 2023

The integration of value-based care is growing in the delivery of care. The goals are to improve delivery of care, enhance patient outcomes (and engagement), and lower costs while improving quality. These are not new long-term goals of the healthcare industry – all the way back to “managed care” and the “Triple Aim.” While value-based care is today’s definition, the goal is similar as before: Coordinated care delivery to improve patient outcomes, promoting patient engagement, and lowering the cost of care while improving quality. 
 
Today there is a new major technology that will assist in providers’ success in value-based care: Artificial Intelligence (AI) and Machine Learning (ML) or AI/ML Do providers have an opportunity to thrive under value-based care? Absolutely. How? With the application of AI, providers develop or acquire and implement AI-driven applications to: 
 
1. Support decision-making 
 
2. Monitor utilization of services against a care plan 
 
3. Coordinate care with active patient engagement 
 
4. Monitor the standards of care delivered to ensure consistency, equity, and quality of practice 
 
5. Negotiate payer contracts with the predictive support of AI/ML financial models and analytical databases in a continuous-learning ML model environment regularly updated with actual outcomes of decisions made and the financial results realized 
 
This scenario of AI-driven value-based care is going to happen. AI solutions are under development for the above applications of AI/ML. How will your organization decide where to utilize this next generation of AI-driven capability to make the goals of value-based care a reality?