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Doubling down on what I said

admin-clinical slide of the week
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In Union's recent Board Briefing on where the smart money is going in 2024 (members can access the on-demand webinar here), I made a bit of a buzzkill comment that for my money, much of the near term benefits offered by generative artificial intelligence (gen-AI) would be in the administrative space, in particular provider revenue cycle and health plan claims management. If you read the trade press or literally anything that came out of Vive this year, that might be a surprise, given the attention that clinical applications are getting (or more to the point, patient care innovations). And it's not like we at Union are bearish on the potential for AI to diagnose, interact, and even make recommendations or decisions about patient care. Far from it. But let's follow the money. Literally.


Our chief research officer, Yulan Egan, recently published a report on the Future of AI in healthcare (members can access it here) that includes a feasibility calculator as a decision guide for AI investment. And honestly, revenue cycle and its counterparts tick most of the boxes, as seen in this week's Slide[s] of the Week. And yes, I know that administrative functions don't seem to offer much excitement, but AI has the potential to make new leaps forward in documenting, preparing, submitting, evaluating, denying, appealing, and resolving claims. In fact, it's all reminiscent of the gains in automation made in the mid-2000s, which drove a revenue cycle arms race, and resulted in drastically lower AR days for providers, higher denial rates for payers, and a whole lot of new costs for everyone. But when one considers the vital role days cash on hand plays in the ability to secure debt and invest in the new capabilities, it's hard to overstate the impact that cash acceleration/deceleration can have in our industry. So I'll say that the excitement factor really is there, if you know how significant it can be. One caveat that could alter my view here: AI's use in MA denials has received some recent political scrutiny, and invited a few lawsuits, so we could eventually see some regulatory hurdles there.


Which is a long way of saying I'm doubling down on what I said in the webinar, with our reasoning laid out more fully in this week's slides. And by the way, I am aware of how narcissistic it looks to publish a slide with my own quote on it. But for what it's worth, I didn't make it. Our chief education officer, Amanda Berra, thought it a good encapsulation for her upcoming AI Bootcamp. Sign up if you're a member! (And if you want to make fun of me anyway, go ahead, because you can't insult a narcissist.) Last, if you're a non-member looking at all these links and want to know how to get access to them, click here.





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