AI Solutions for Healthcare

AI Summit for Healthcare Payment Integrity Attracts Top Industry Leaders; Explores the Transformative Potential of AI in Revolutionizing Healthcare Cost Containment


AI Summit for Healthcare Payment Integrity Attracts Top Industry Leaders; Explores the Transformative Potential of AI in Revolutionizing Healthcare Cost Containment

In-person event sparks dynamic discussions about the potential and challenges of adopting AI and generative AI to manage healthcare costs efficiently and effectively

Duluth, GA. (July 11, 2024) – The AI for PI Community, the premier group for healthcare payment integrity professionals seeking to learn about and accelerate the adoption of artificial intelligence (AI) to improve payment accuracy and reduce fraud, waste, abuse, and error, concluded an in-person summit specifically focused on AI in the payment integrity industry. Held June 6 and 7 in Atlanta, the AI Summit featuring industry experts from across the payment integrity and healthcare cost containment ecosystem, including policy makers, academics, healthcare payer and PBM executives, and top AI experts and solution providers. 

The agenda focused on many of the industry’s most pressing topics:

  • Latest breakthroughs in generative AI and its implications on healthcare
  • Best practices for building a compelling business case, evaluating solutions, and implementing them effectively
  • Necessary people, process, and technology changes for the successful adoption of AI
  • Regulatory and technical risks associated with implementing AI solutions
  • Necessary governance to ensure ethical use and application of AI
  • Regulatory and legislative considerations for healthcare providers and consumers

Key Takeaways Highlight AI Adoption Enthusiasm and a Call for Industry-Wide Collaboration

The summit spurred critical discussions from various presenters, interactive conversations among attendees, and Q&As. Key insights uncovered at the summit include: 

  • Data still dominates: Healthcare data is highly complex yet essential for advancing healthcare cost containment and requires good, clean, aggregated data to help with transparency, decision making, and innovation. This proves to still be a major challenge.
  • Healthcare payment integrity AI solutions are being adopted cautiously and thoughtfully:  Organizations are at different phases of AI adoption, with most still trying to validate use cases and prove ROI. Many are readily seeking more information, relevant industry examples, and implementation roadmaps to advance their payment integrity programs with greater AI automation.
  • Success with AI technology adoption exists: Those who have successfully achieved some level of AI adoption emphasized the importance of obtaining buy-in early, delivering appropriate training, establishing governance, and demonstrating the value AI solutions bring to the organization.
  • Governance is critical: While varying levels of AI application adoption exist, experts agree the right guardrails must be in place to ensure the ethical use and application of AI and generative AI.
  • Privacy and security around data sharing persists: Protecting data is paramount. Healthcare organizations and vendors must work together to ensure data is secure and does not put personal health information (PHI) at risk.

“The discussions focused on business use cases and considerations for implementing AI, especially within payment integrity, were incredibly beneficial and educational. Healthcare AI is evolving so rapidly that it’s important for everyone involved with healthcare payment integrity to get out of their silos and better understand the business impacts of AI,” stated Sean Kelly, Director of Cyber Governance, Risk, and Controls, and Data Protection at Highmark Health.

Leaders and Technology Experts Offer Fresh Insights and Practical Tips on Using AI to Transform Outcomes

Congressman David Schweikert delivered a powerful keynote on “AI for Improved Healthcare Outcomes,” sharing his unique perspective on how AI can revolutionize the industry by enhancing patient care and making complex healthcare costs easier to understand. Schweikert emphasized the importance of transparency and the role of AI in driving down expenses to create a more equitable healthcare system. 

Other industry leaders on the agenda representing a variety of leading healthcare organizations included Highmark Health, Centene, Elevance Health, Capital Rx, BlueCross BlueShield South Carolina, BlueCross Blue Shield of North Carolina, BlueCross BlueShield of Louisiana, Health First, and many more.

“The AI Summit for Payment Integrity Professionals was a huge success and not just because of the stellar guest speaker lineup. There seemed to be an enormous benefit for the attendees to come together and have open and candid discussions, realizing that many in the payment integrity space are still early in their adoption of AI,” stated Dr. Musheer Ahmed, Founder of the AI for PI Community and CEO of Codoxo. “It was very exciting to see attendees, academics, and innovators coming together to share AI successes, concerns, and challenges for payment integrity and for healthcare organizations at large. We are proud to be a part of this necessary collaborative effort to join together a growing community.”

AI Summit sponsors and partners included AWS, HealthEdge, Wipro and DRG Claims Management

For more information, check out Codoxo’s recent blog, “Transformative Insights from the ‘AI for Payment Integrity’ Summit Ignite Optimism for the Future of Healthcare Cost Containment.” To learn more and stay connected, payment integrity professionals and industry stakeholders are encouraged to join the private community at the AI for PI LinkedIn Group and follow the public AI for PI LinkedIn Page.

About the AI for PI Community 

The AI for PI Community brings together healthcare payment integrity professionals to learn about and accelerate the adoption of artificial intelligence technologies and solutions that collectively and actionably reduce the rising cost of care. Through education, networking, and shared best practices and use cases, AI for PI aims to inform and inspire thousands of healthcare payer, government agency, and pharmacy benefit manager (PBM) teams seeking innovative “shift-left” strategies that safeguard their bottom lines and contribute to a less costly U.S. healthcare system.