Personalizing Senior Care through AI (SCAN Health Plan)

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Archie Dey, Director Consumer Insights, SCAN Health Plan

Abstract:
10,000 Americans will turn 65 every day through 2030. The Silver tsunami is here and when compared to the general population, seniors are often more likely to have chronic conditions. We will discuss how Health Insurance plans can utilize AI to manage the quintessential challenge in healthcare of disintermediation of resources. In this session we will discuss three use cases where Machine Learning, Deep Learning and NLP is used to identify members at risk for Hospitalization due to Preventable Conditions, requiring nursing level facility of care and at risk for disenrollment. With the support of Big Data infrastructure, clinical data and the advent of social determinants of health data, health insurance payers are able to optimize resources, such as health plan care managers, used to communicate with high needs members and identify outcome-specific high needs members. The outcomes from each of these models will enable to organizations to create a holistic picture of a high needs Seniors which in turn will enable delivery of Person centered care to the Senior in need, where they need and when they need.