Artificial Intelligence in Healthcare

Healthcare AI is growing at an exponential rate, and is expected to create a potential $150 billion in annual savings for the U.S. healthcare economy by 2026.1 Machine learning and AI have the power to truly change the cost and quality curve in healthcare. As pattern recognition algorithms become more complex, machines can perform additional tasks without the need for programming – with ever-increasing accuracy. We believe now is the time to use AI to tackle our industry’s financial and administrative processes. Eventually, healthcare AI will be able to reduce physician workload, protect patient safety, and provide diagnostic support.

1Accenture. Artificial Intelligence: Healthcare’s New Nervous System.

Our Claims Lifecycle AI
capability can identify

6.8 billion

in forecasted allowed
amounts pre-submission*

AI Can Help Improve the Healthcare Cost/Benefit Curve

In 2012, Health Policy Brief identified $300 billion in unnecessary healthcare costs associated with fraud, waste, and abuse; no- or low-value-added work; and lack of collaboration between stakeholders.2 At Change Healthcare, we are using AI to reduce those costs. By embedding AI into our financial, clinical, and engagement solutions, we are steadily eliminating inefficiencies from our customers' workflow and removing the barriers to collaboration. Our practical approach to AI focuses on making healthcare more efficient and cost-effective. For example, our application of AI models in the claims lifecycle management process reduces the cost burden for both payers and providers by creating new efficiencies.

We are also using AI within medical coding. By replacing manual coding with machine learning coding, we have successfully increased both coding speed and accuracy at a lower cost. In our member engagement solutions, we're exploring the use of AI and behavioral science to improve the consumer experience. By combatting inefficiency and waste, we strive to help our customers achieve better outcomes, grow their business, and improve patient health.

2Health Affairs and the Robert Wood Johnson Foundation. "Health Policy Brief: Reducing Waste in Health Care," Health Affairs, December 13, 2012.

Our Results with Artificial Intelligence

  • 500M

    service lines, representing $268B, used to train Claims Lifecycle AI model*

  • 35%

    of denials can be identified and flagged pre-submission*

  • 7.2Mx

    faster speed of auto-coding vs. manual coding EMS claims*

  • 50+

    data scientists and developers dedicated to AI*