Generative artificial intelligence has taken healthcare by storm.
Healthcare organizations ranging from vendors to health systems have begun using generative AI to solve some of their most fundamental challenges. As more companies continue to integrate AI into their products, health systems and federal agencies are working to create guardrails and draft new regulations.
Read more: What the healthcare AI sector wants from Congress
The word efficiency popped up during many calls with financial analysts when executives discussed AI. However, experts say customers of companies that have invested in AI long before it was en vogue could benefit more. Aaron DeGagne, a senior analyst covering healthcare at market research firm Pitchbook, said companies that have significantly invested in AI over time could benefit, but those attempting to ride the wave of hype could be left behind.
"There are a lot of initiatives in health tech that are AI-based that have been building over time,” DeGagne said. “If you're just kind of throwing it on there, or mentioning it and not explaining it, then that hurts you."
Here are four takeaways on how public companies are embracing AI based on comments from this quarter’s earnings calls.
1. GE HealthCare ‘actively pursuing’ AI for all products
GE HealthCare is among a growing number of radiology companies embracing AI. The company is developing its App Orchestrator, a technology that it said would help providers manage imaging software from different technology vendors.
The company said it plans to invest in AI technologies tied to physical devices and others that are cloud-based software.
“We’re actively pursuing AI across our product portfolio with a focused effort to expedite product development in 2024,” GE HealthCare CEO Peter Arduini said during a call with financial analysts earlier this month.
Last month, the company announced plans to acquire medical imaging AI company MIM Software for an undisclosed amount. It intends to fold MIM’s imaging analytics and digital workflow capabilities into its precision medicine offerings.
In February 2023, it acquired Caption Health, a software company focused on AI-assisted ultrasound scans. The company plans to use Caption Health’s AI to integrate real-time guidance into ultrasound systems for clinicians and non-expert users to capture better quality images of the heart.
2. Hims & Hers says AI can help retain customers
Telehealth company Hims & Hers announced in November it was testing an AI and machine learning clinical decision support feature that could suggest treatments for some mental health conditions.
During a call with financial analysts on Monday, Hims & Hers CEO Andrew Dudum said the company's AI-driven MedMatch technology, which can recommend clinicians prescribe certain medications and doses, could contribute to customer retention.
“The trial and error that comes with mental health treatment is quite brutal. So, I think, over time, we're going to see a stickier relationship with those customers,” Dudum said. “Specifically on the clinical excellence side, MedMatch and our AI capabilities [allow the company] to be able to better predict how a patient is going to respond with different medications.”
3. Insurers using AI to improve customer service
Large insurers like UnitedHealth Group and Elevance Health outlined their plans for AI to help improve customer service. Dirk McMahon, president and chief operating officer at Minnetonka, Minnesota-based UnitedHealth, said during the company’s call with financial analysts on Jan. 12 that the company's investments into AI will help streamline a number of processes.
“We are removing repetitive tasks from our workflows by using AI to help with tasks such as responses to consumer inquiries, updating provider directories and summarizing interactions with customers and patients,” McMahon said.
Indianapolis-based Elevance Health is also using AI to simplify the customer experience, CEO Gail Boudreaux said during the company's call with financial analysts on Jan. 24. She said the insurer has used AI and machine learning to improve the rate in which member questions are resolved when someone reaches out to their customer service team.
Mark Bertolini, CEO of the New York City-based insurtech Oscar Health, touted the company’s AI capabilities during a call with financial analysts on Feb. 8. He said its investments included the launch of an AI-powered secure messaging feature for its members.
“Self-service features like these make it faster and easier for members to get the answers they need and allow our care team to support more complex member needs,” Bertolini said.
UnitedHealth and Cigna, another large health insurer, have been separately accused of using automated tools to deny some claims, which plaintiffs say reduces the insurers' labor costs. Both policymakers and physician leaders are asking insurance companies to open up their AI playbooks.
The allegations come as more insurers are interested in using AI to automate their claims processing capabilities. On July 13, Health Care Service Corp. said it was expanding a pilot integration of AI into its prior authorization process. HCSC, a nonprofit that operates Blue Cross and Blue Shield plans in five states, said the technology will make the approval process for many procedures quicker and easier. Insurers say such technology can also help predict the necessity of care, expedite physician reimbursement and reduce fraud.
4. R1 RCM examines AI for denials, eligibility and more
R1 RCM, a tech company that handles providers’ billing and claims management services, was mum on its call with financial analysts about a proposed buyout offer from private equity firm New Mountain Capital. But CEO Lee Rivas and his executive team were more than happy to talk about the company’s AI capabilities.
Rivas said that R1 RCM has developed AI models that can help clinicians identify a patient’s insurance eligibility more efficiently. They also help health systems streamline writing an appeal for a complex clinical denial, he said.
In the future, Rivas said he sees autonomous coding as an opportunity for generative AI use cases. “We are increasingly excited about our right to win with AI and large language models given our access to large structured and unstructured datasets,” he said.