2023年2月27日

分享這篇文章分享這篇文章提供的新聞創新環境敏感欺詐,浪費,濫用和錯誤檢測由領先的人工智能實時防止低價值關懷和驅動更高質量、安全和健康計劃成員的負擔能力聖何塞,2月27日,2023年健康從規模、機器智能的領先供應商價值保健交付和管理,今天宣布與房衛生合作計劃,Inc .提供的醫療保險優勢計劃為大約30000成員在俄勒岡州和內華達州。合夥企業將利用健康規模最先進的人工智能和機器學習技術,防止低價值關懷對應欺詐,浪費,濫用和實時錯誤;和驅動更大的質量、安全性和可購性計劃成員支持房健康計劃的使命交付高質量的健康保險醫療保險受益人優勢。在一個合理的價格的日益普及和不斷進化的模式欺詐,浪費,濫用和錯誤在醫療保健行業,AI-powered技術的使用已成為必不可少的工具來幫助健康計劃識別和消除浪費,往往不安全支出。超過3450億美元的醫療花費是每年浪費了低級的護理服務。這些服務提供很少或根本沒有好處,帶來不必要的成本,浪費有限的資源,有可能造成傷害。消除欺詐,浪費,濫用和錯誤是至關重要的為納稅人優化醫療結果和支出,提供者、雇主和tpa,但曆來難以完成使用基於規則的支付完整手動密集的係統開發和維護,局限於檢測的低價值關懷模式明顯的和已知的,和受到高的假陽性和假陰性率。健康量表的智能AI-powered欺詐,浪費,濫用和錯誤檢測技術超越了傳統的基於規則的支付完整係統和識別低價值保健使用clinically-nuanced深深環境敏感和對病人的理解要極致個性化才行,提供者,時間和護理。通過分解在360 -視圖的醫療服務和事務,健康規模的人工智能可以減少假陽性和假陰性而不斷學習新模式出現的低價值關懷,萎靡不振的欺詐,浪費,濫用和錯誤以前所未有的精度和可控訴的情形。“我們是興奮與房衛生合作計劃在我們的行業領先的能力減少欺詐,浪費,濫用和錯誤,“Zeeshan Syed說,健康的首席執行官。 "Our technology has been able to meaningfully reduce low-value care for health plans – something that has been a hard problem to solve for decades and continues to drive up costs. We look forward to working with ATRIO Health Plans to bring this innovative capability to their Medicare Advantage plans and to support their mission of providing high-quality, cost-effective healthcare to their members." "After completing substantial due diligence of the market landscape, we have found that the tools and technology that Health at Scale offers health plans is best-in-class based on what we have seen, and look forward to working with Health at Scale across our entire book of business," said Jennifer Callahan, Chief Operating Officer of ATRIO Health Plans. About Health at Scale Health at Scale uses advanced AI to drive smart, hyper-personalized, context-aware care delivery and management. Founded by machine learning and clinical faculty from MIT, Harvard, Stanford and the University of Michigan, the company brings precision to healthcare across a broad range of use cases, including: fraud, waste and abuse prevention, reduction of medical and drug errors, provider navigation and network curation, and early targeted prediction and prevention of adverse outcomes. For more information, please visit healthatscale.com. About ATRIO Health Plans ATRIO Health Plans is a Medicare Advantage (MA) plan established in 2004 that offers Preferred Provider Organization (PPO) options as well as a Health Maintenance Organization (HMO) Special Needs Plans for Dual Eligible. The health plan is supported by the trusted physicians who care for Medicare beneficiaries in Oregon and Nevada. For more information, visit atriohp.com. SOURCE Health at Scale Corporation ×