How Payers Use Tech to Support Healthcare Transformation

Executives at the ViVE Payer Insights event earlier this year discussed prior authorization, AI, value-based care and the role of tech to help achieve their goals.

From left: Katie Adams of MedCity News; David Dobbs of Hawaii Medical Services Administration; Timothy Law of Highmark Health; and Ginny Whitman of Alliance of Community Health Plans at ViVE Payer Insights 2024

At the ViVE event sponsored by HLTH, the Payer Insights program panel discussions highlighted the different ways tech can be harnessed to reduce friction in communication and data sharing between providers, payers and patients. Executives talked about how healthcare organizations and health tech vendors are working together to improve prior authorization wait times, implement value-based care, and streamline care delivery through AI tools that can be used to automate certain administrative functions.

Healthcare organizations such as Lyric, Workday and Hawaii Medical Services Administration, which works with InterSystems, shared insights on how tech can be applied to solve myriad healthcare challenges and to improve the clinician and patient experience. Looking ahead at CMS rule changes rolling out in the next few years, health tech will be critical to support policy compliance for transparency in coverage, interoperability, and changes to Medicare Advantage plans.

Access to care and health equity were also part of the conversation in the Payer Insights program. The push towards value-based care depends, in part, on obtaining data on race, ethnicity and gender to support health equity and quantify social determinants of health among plan members.

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