Highmark Health is again collaborating with Verily to provide member clinicians specific treatments and other solutions for COPD and congestive heart failure, the companies said Tuesday.
The six-year venture builds off of Highmark's current partnership with Alphabet's life sciences arm, Verily. The company's subsidiary health management company Onduo offers type two diabetes management to Highmark clinicians and members.
Verily will use Highmark member data to build AI and machine learning algorithms to target patients' chronic conditions. Clinicians including doctors and health coaches will engage patients with various solutions in an effort to prevent conditions from worsening.
Highmark has 5 million members on its insurance rolls.
Onduo piloted a diabetes care management model with Highmark in 2020. The two companies will use Google Cloud to integrate patient solutions into Highmark's Living Health Model, which member health providers have access to, according to Dr. Tony Farah, Highmark Health's executive vice president and chief medical and clinical transformation officer.
"When we talk about congestive heart failure or COPD, those are hundreds of thousands of people that end up in the emergency rooms all the time; Having this machine learning and AI in the background will help us predict — based on a number of different factors, whether they're clinical, based on their demographics (or) behavioral patterns — ahead of time when to intervene," Farah said.
Verily and Onduo will pull data from patient claims, direct care and patient inputs. Then, a clinical insights platform will produce solutions for the patient. Machine learning and AI will also help determine what kind of provider is best positioned to engage with each individual. It could be a doctor in an office setting, but could also be a health coach or educator, according to Dr. Vindell Washington, chief executive officer of Onduo.
"So for COPD, it might be a medication intervention, it might be coaching on how to best handle triggers, it might be advice on over the counter medications, it could be education, and across the health spectrum there many individuals who might provide those particular interventions," Washington said.
Neither Highmark or Onduo could provide an estimate on how many members will engage out of the hundreds of thousands of members with the two conditions. Highmark's Farah said engagement can range from the single digits, to about 70% when a clinician or other provider is involved. That buy-in from providers to execute the solutions is crucial; Onduo held sessions with clinicians at the start of the diabetes pilot last year.
"This is a collaboration among thought leaders on the clinical staff, as well as the technology we bring to the table," Washington said. "We had great planning sessions with their primary care doctors. Our plan is to continue that kind of deep collaboration as we go forward."
Farah said that the tool will reduce the total cost of care.
Last year, Highmark signed another six-year contract with another Alphabet-owned company, Google Cloud, to build its Living Health platform, which includes centralized scheduling, care management and analytics and artificial intelligence tools.
Onduo has also partnered with many other payers, including Blue Cross and Blue Shield Association plans in 2017 and self-insured employer Walgreens in 2018.
