What You Should Know:
– Ushur, the leader in AI-powered Customer Experience Automation (CXA), announced the launch of pre-built, self-service solutions designed to revolutionize care navigation for health plans and third-party administrators (TPAs).
– The AI-powered tools address the growing need for efficient and effective member support, particularly in navigating complex health journeys like pregnancy and chronic conditions.
Addressing Challenges in Care Navigation
Today’s healthcare landscape presents significant challenges for health plans and TPAs. The current system often relies on stretched live resources, making proactive support for members with complex care needs difficult. This reactive approach is particularly problematic for chronic and mental health conditions, which account for a staggering 90% of the nation’s $4.1 trillion annual healthcare spending according to the CDC.
Ushur’s AI-First Approach
Ushur tackles these challenges head-on with its AI-powered solutions. These tools focus on identifying and automating key communication points throughout critical care journeys. Delivered via secure, interactive, and HIPAA-compliant digital experiences, Ushur’s solutions aim to:
- Improve Health Outcomes: Motivate positive behavior changes and prevent costly complications associated with disengaged patients.
- Streamline Processes: Automate tasks and processes, freeing up live resources for more complex interactions.
- Enhance Member Engagement: Proactively guide members and deliver relevant resources at critical touchpoints.
Pre-Built Solutions for Common Care Journeys
Ushur offers two pre-built solutions tailored to specific member needs:
- Care Navigation for Maternal and New Baby Health: Guides expectant mothers and new parents through prenatal and postpartum care, promoting better health outcomes for both mother and child.
- Care Navigation for Chronic Conditions: Empowers members with chronic conditions, such as diabetes or musculoskeletal issues, to connect with the right resources and adopt healthier habits, ultimately leading to improved health and reduced costs.
Field-Tested Solutions Deliver Measurable Results
Ushur’s pre-built solutions leverage state-of-the-art AI and automation, pre-tested by leading health plans across the country. These tools address key areas to streamline care navigation and member support:
- Education: Proactive guidance and resource delivery at crucial moments in a member’s care journey.
- Outreach: Regular communication and personalized care plans based on member feedback.
- Coordination: Assistance with scheduling specialists and identifying resources outside the health plan network.
- Management: Automated document processing and data upload to core systems, eliminating manual intervention.
Built for Efficiency, Security, and Scalability
Ushur’s CXA platform prioritizes speed to value, enterprise-class security, and operational efficiency. The platform enables effective care management via two-way, digital-first interactions through HIPAA-secure and HITRUST-certified channels.
“The U.S. healthcare system remains incredibly hard to navigate. Payers and members alike pay significantly higher costs when appropriate care and resources aren’t understood and utilized in a timely fashion, especially in complex care situations,” said Yvonne Daugherty, Global Head of Industries for Ushur. “The National Institute of Health (NIH) estimates that failures in care coordination account for nearly $80 billion in costs per year. Ushur launched these care navigation automation solutions to help drive dramatically better member experiences while delivering significant cost savings not only for the health payers but for the entire national healthcare system. Our vision is to continue to alleviate pressures on an overstretched national healthcare system while enabling payers and providers to deliver transformative experiences for their members, especially those in critical health situations.”
