BATON ROUGE, La. – Massive amounts of data churn through today’s healthcare system – how can providers, health insurers, caregivers and others use this glut of information to get meaningful insights and treat patients more effectively?
Blue Cross and Blue Shield of Louisiana is using artificial intelligence (AI) and machine learning to turn the vast amounts of healthcare data it has – including claims and labs data, pharmacy benefits and other health records, as well as members’ interactions with Customer Service and Care Management – into rich, timely information. Using this, Blue Cross staff can develop targeted interventions for members, collaborate better with healthcare providers and fulfill their mission to improve the health and lives of Louisianians.
Somesh Nigam, Ph.D., Blue Cross senior vice president and chief analytics and data officer, and Vindell Washington, M.D., Blue Cross executive vice president and chief medical officer, will present the innovative ways Blue Cross is using AI to support members on their journeys to optimal health June 21 at America’s Health Insurance Plans (AHIP) Institute in Nashville, Tenn. More than 3,000 people are expected to attend the annual meeting, representing stakeholders across the healthcare industry.
In their talk, “Artificial Intelligence Enables Clinical Transformation,” Nigam and Washington will describe the cutting-edge ways Blue Cross is using AI to build highly accurate predictive models that can forecast outcomes and show which members are likely to benefit from extra support. Blue Cross identifies and connects those members with resources such as free health coaching with Blue Cross’ in-house clinical team, which includes nurses, dietitians and social workers. This may help members avoid or lower their risks of hospitalization, emergency department visits, expensive procedures and tests or even complaints.
Although these members are only a small percentage of Blue Cross’ overall membership, they have the greatest potential to benefit from earlier intervention and support. These data insights also help Blue Cross make strategic decisions about how to use resources and see which interventions are working successfully, so staff can refine their approach as needed.
Nigam and Washington were invited to speak at AHIP Institute because of Blue Cross’ recognized leadership in using AI for developing clinical interventions and doing more personalized outreach to members. This strategy has led to improved health outcomes, lower costs, higher member engagement and an overall better member experience.
Nigam, who joined Blue Cross in 2017, has more than 25 years of experience at major technology, pharmaceutical, medical device and health insurance companies. Previously, he was vice president of Information and Data Governance and Health Informatics with IBM’s Global Chief Data Office, where he played a key role in establishing data as the foundation of IBM’s cognitive business transformation and was part of the Watson Health team. Nigam was also senior vice president and chief informatics officer at Independence Blue Cross in Philadelphia, where he championed cutting-edge data initiatives and worked with departments across the health plan to use reporting and analytics to cut waste and fraud, reduce costs and manage quality.
Nigam is a sought-after speaker at national healthcare analytics conferences and forums and has published numerous articles in peer-reviewed journals.
Washington joined Blue Cross in 2017, after being National Coordinator for Health Information Technology in the U.S. Department of Health and Human Services during the Obama administration. In that role, he led nationwide efforts to implement and use emerging health information technology and advance the electronic exchange of health records. Washington previously held several positions at the Franciscan Missionaries of Our Lady Health System in Baton Rouge, including president of the medical group, vice president of performance excellence and technology, and chief medical information officer. Washington is an emergency medicine physician who has also served in the U.S. Army.
He recently co-authored the paper “Promoting Interoperability: Rules for Commercial Payers.” It was published May 9 in NEJM Catalyst, a sister publication of the New England Journal of Medicine. Washington was also named a 2019 Healthcare Hero by New Orleans City Business.
About Blue Cross and Blue Shield of Louisiana
Blue Cross and Blue Shield of Louisiana is committed to our mission to improve the health and lives of Louisianians. We invest both time and money in the communities we serve, supporting the health and wellbeing of Louisianians through more than 200 charitable organizations.
With our subsidiaries, HMO Louisiana and Southern National Life, we provide group and individual health insurance plans, life and disability insurance, group voluntary products and administrative services to one out of four Louisiana residents. Blue Cross and Blue Shield of Louisiana also provides Medicare supplement and Medicare Advantage plans and is a partner in offering the Healthy Blue Medicaid Managed care plan. Louisiana is the only state where we operate, with offices in every major region to serve our customers.
Founded in New Orleans in 1934, Blue Cross and Blue Shield of Louisiana is a tax-paying non-profit health insurer. We are a private mutual company, owned by our policyholders, with an independent Louisiana Board of Directors and no shareholders. Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association.
To learn more, visit our website at www.bcbsla.com.