In 2023, artificial intelligence (AI), analytics, and automation are rapidly transforming the way businesses operate and serve customers by:
- Creating new opportunities for growth and innovation
- Increasing efficiency
- Reducing costs
- Enabling new levels of customer engagement and service
AI, analytics, and automation are fueling the exponential growth of new industries, such as the Internet of Things (IoT), autonomous vehicles, and smart cities. As these technologies continue to evolve and become more widely adopted, businesses that embrace them will be well-positioned to succeed in the future. Among those industries, healthcare is positioned for unprecedented transformations.
We will briefly define AI, analytics, and automation and consider how they are already impacting healthcare and PBMs. Additionally, we will forecast where these technologies are leading in the future.
AI
AI is a branch of computer science that uses algorithms and systems to perform tasks that typically require human intelligence. These tasks include:
- Recognizing patterns
- Making decisions
- Learning from experience
AI is often used to automate repetitive or routine tasks, freeing up employees to focus on more complex, strategic activities.
Analytics
Analytics is the process of collecting, analyzing, and interpreting data to make informed decisions. Analytics enables businesses to optimize operations and decisions based on valuable metrics.
Automation
Automation refers to using technology to perform redundant tasks that enable businesses to increase efficiency and reduce costs by streamlining processes, reducing errors, and freeing employees to focus on higher-value tasks.
How These Advances Are Transforming Healthcare and PBMs
In the healthcare and pharmacy benefit industries, AI, analytics, and automation are revolutionizing the way patients receive care.
Healthcare
- AI algorithms can analyze patient data to identify potential health risks and provide personalized treatment recommendations. Analytics can track patient outcomes and improve care quality, while automation can streamline administrative tasks and reduce patient wait times.
- AI can intelligently automate tasks related to pre-authorizations, billing, and record-keeping, so employees are able to focus on duties that benefit from the human touch.
- Machine learning (ML) is a specialized subset of AI that uses sophisticated programming to improve accuracy and fine-tune AI for specific tasks. The more businesses use AI and ML, the more efficient and cost-effective it becomes.
- AI-based analytics can improve transparency by providing instantaneous results on costs for procedures and medications across all markets. This can provide patients with better data on what differentiates those costs so they make more informed decisions.
- AI can powerfully enhance diagnosis and treatment decisions made by physicians by training on vast volumes of medical literature to support more informed diagnoses and treatment.
PBMs
- AI and analytics are used to identify high-risk patients, predict medication adherence, and reduce waste in the supply chain.
- Analytics can identify and notify users of red-flag concerns like high-cost claims, brand-heavy prescribers, and doc-shopping.
- AI can automate the rebate process and provide valuable insights that result in lower costs across the board.
- Automation also significantly reduces costs and increases efficiency by streamlining processes such as claims processing and drug utilization management.[KG1]
- Analytics powered by AI can empower PBMs with complex insights that are hard to uncover without such sophisticated technology. This can help with operational efficiency, negotiating better contract terms based on performance or market metrics, and other strategic decisions.
The broader implications of the impact of AI, analytics, and automation are profound. All of these benefits can help drive the direction of healthcare toward a path of value-based care. The more data that is collected and analyzed, the more the entire industry can learn what methods, processes, and prescriptions bring the most desired results.
Future Trends for AI, Analytics, and Automation
So, what does the future hold for AI, analytics, and automation? Recent years have seen massive steps forward, and this breakneck speed of innovation is likely to continue. Experts predict analytics and AI updates in 2023 and beyond that include:
- An increase in open-source innovation. AI isn’t locked away by big corporations, even if they’re leading the charge. Expect to see valuable contributions from passionate individuals and groups.
- Greater cooperation between humans and AI. Automation enables human workers to focus on more complex tasks that require thought and creativity. Advanced analytics means an AI is combing through data and finding patterns, something it does better than people. Expect more collaboration that enables humans to do our jobs better and more efficiently.
- More government regulation. Emerging technologies can initially feel like the Wild West—but it doesn’t stay that way. There are a lot of questions for legislatures to answer in this space, but this is currently a lightning-rod topic, so expect some sort of movement.
The Future of AI, Analytics, and Automation Is Here
What makes this rising technology so transformative is the sheer volume of data it can work with. AI brings exponential changes that continuously improve upon prior models, and over a brief time, the future will likely reveal efficiencies and cost savings that never would have occurred to industry leaders in the past.
AI, analytics, and automation are not going away; they will continue to grow, develop, and transform how businesses operate. Businesses that don’t utilize these tools will fall behind in efficiency, cost-effectiveness, customer satisfaction, and valuable insights.
Xevant has the answers for using analytics automation in the PBM analytics space, now and in the future, and we continue to develop cutting-edge technology for potential cost-saving benefits.
Contact us to schedule a demo today and learn how our intelligent analytics platform can automate your business practices.