Payers and Providers Plan to Use Generative AI to Improve Patient Engagement
Generative AI (genAI) has tremendous potential in healthcare, with payers enthusiastic about using genAI to enhance the patient experience and improve patient engagement and outcomes. A recent survey of CXOs at 350 U.S. health plans and health systems by HFS Research and Cognizant explored the impact of genAI on consumer experiences and engagement. The U.S. healthcare system is experiencing deteriorating health outcomes, declining life expectancy, an increase in chronic conditions, and opioid and mental health epidemics. At the same time, technological innovation is accelerating, AI systems are being adopted at scale, there has been a resurgence in digital-health-fueled primary care, and the introduction of innovative care models. Together there are significant opportunities for reducing costs, enhancing the experiences, and improving health outcomes.
One of the ways that these goals can be realized is through the use of genAI. Surveyed payers were convinced that gen AI was a game changer and would be invaluable in improving the efficiency of administrative functions, especially customer service and claims management, and they were also planning to use genAI to improve member engagement, health and wellness, and the value of coverage.
18% of payers plan to apply genAI to address member management, including hyper-personalization to improve member engagement and streamline interactions with providers. 16% said they plan to use genAI to address the needs of multiple generations and help them with disease prevention and wellness. 14% said they plan to use GenAI to develop dynamic health plans that can adapt throughout the year based on member needs and circumstances, gleaned from social determinants of health (SDOH) while tailoring plans to the individual. Providers generally accepted that genAI has the potential to have a positive impact on care delivery but were less convinced than payers about the impact genAI will have.
Across these two groups, more than 70% of respondents anticipated that the greatest impact of genAI would be on health outcomes and the consumer experience. Approximately 50% of payers and providers said they plan to invest between $1 million and $10 million in genAI, with around 70% of respondents saying that money will be invested in the next two years. While there is a great deal of enthusiasm around genAI and significant investment, only 20% of payers and providers have a GenAI vision, and that must change if they are to improve the success of their investments.
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One of the main challenges highlighted by the survey will be the lack of appropriate skills. Payers and providers will need people with programming, statistics, machine learning, data processing, and visualization skills, and those skills are in high demand for other emerging technologies and managing current operations; however, using systems such as ChatGPT, which use plain English language, will reduce the demand for high skills without competing with applications that require technical skills. Further, since the skills to deploy genAI are geography agnostic, providers and payers will be able to recruit from the global talent pool.
