Milliman MedInsight expert perspective: AI trends and predictions for payers and providers

By Milliman MedInsight

11 March 2024

The emergence of generative artificial intelligence (Gen AI) brings forth a powerful tool that has the potential to revolutionize the healthcare industry. With its ability to process unstructured healthcare data and transform the delivery of care, Gen AI holds immense promise for payers and healthcare systems alike.

In a recent conversation with Iyibo Jack, Principal and EVP of Product Development at Milliman MedInsight, we explored how healthcare organizations can harness this groundbreaking technology to convert vast and diverse data into valuable assets.

Q. In your experience working with various organizations, how tangible is Gen AI and its impact?

A. Gen AI is a hot topic that arises in every client discussion. While many individuals have experimented with various Gen AI services, the transition from considering it a mere curiosity to recognizing its true relevance in the enterprise is currently underway. At Milliman MedInsight, as we began using different large language models (LLMs) and exploring their potential, we discovered their significant implications for reducing administrative burdens and enhancing value delivery. We have observed that our clients are also adopting a similar approach with Gen AI, primarily concentrating on administrative and non-clinical use cases.

For example, our payer partners are actively exploring the potential of AI, whether it be predictive AI or Gen AI, to alleviate administrative burdens and enable their teams, especially clinical professionals, to focus more on providing exceptional care and making critical decisions. Additionally, deploying predictive models to identify the most effective treatments for specific populations is an area of great interest. The ultimate objective is not to completely replace existing work, but rather to leverage AI to streamline administrative tasks, allowing payers to dedicate more time to exciting and impactful endeavors. The reality of AI is tangible, and we are committed to harnessing its potential to drive positive change within our organization and alongside our customers.

Q. What do you foresee as the primary challenges or obstacles in the adoption of Gen AI within healthcare organizations?

A. I have identified three key obstacles in my experience that organizations must overcome to advance their adoption of Gen AI.

Skills and capabilities: The Gen AI space is evolving rapidly, and many organizations do have staff with the necessary skills and training to leverage this new technology effectively. Recruiting efforts to bring in additional new talent and upskilling existing staff are crucial. The market for AI professionals is highly competitive and some organizations have partnered with consulting firms and vendors to access additional skills while building their in-house capabilities.

Use cases: Often, organizations struggle with defining clear use cases and success criteria. Defining good use cases can be challenging but it is imperative. Otherwise, you are experimenting without a purpose. While AI professionals might have no problem doing this,  it can alienate their work from the rest of the organization. Defining a use case that aligns with a known problem or strategic goal is ideal.

Security and compliance: Implementing AI engines must adhere to rules and regulations, especially when it comes to handling sensitive patient information, diagnoses, and medical histories. Maintaining data privacy and security is of utmost importance to ensure compliance and protect patient confidentiality.

Q. What predictions do you have about Gen AI’s impact on healthcare in the next 1-3 years?

A. Gen AI is going to have a significant impact on healthcare. By automating time-consuming tasks, such as note-taking and administrative duties, Gen AI can provide healthcare organizations with more time to focus on making strategic decisions that lead to improved efficiency, quality care and optimal outcomes.

While these developments hold promise, Milliman MedInsight is actively working towards being a frontrunner in this area. Curating and disseminating knowledge about Gen AI requires building partnerships with trustworthy organizations that prioritize Gen AI. Milliman MedInsight is already taking this approach to ensure we align with our customers’ values and goals. Continual learning is also essential, as the field of Gen AI is constantly evolving. It’s important for everyone involved to stay updated and adapt their approaches accordingly.

Watch our panel discussion

Discover the future of AI in healthcare analytics by watching the webinar titled “Navigating the Future of Healthcare: AI Trends and Predictions for Payers and Providers.” Gain insights from industry experts, including Milliman MedInsight, AmeriHealth Caritas, and Databricks, as they explore the transformative power of AI in healthcare.

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