Paul Kusserow
👤 PersonAppearances Over Time
Podcast Appearances
Obviously, AI connects dots, can find information, piece it together, build good storylines.
We're such a fractured business in U.S.
healthcare.
This will enable that putting together to narratives in things like prior authorization, making sure payments work according to the rules.
So we estimate that the RCM business, the revenue cycle business, which is basically just getting paid, is about a trillion dollars.
And so you look at a trillion dollars of savings just to get paid for work you're already doing.
I think that's where a lot of the initiatives are going to start.
And then not only there, but clinically...
We've been using AI, again, in the home health business.
We've used and invested in a company called Metalogics that enables us to drive utilization, clinical best outcome utilization for each individual.
And it's produced much more efficient care and the quality is higher.
And we're able to save a quarter to a third of what would be normal clinical expenses.
So it's been extraordinary.
If you look at some of the research that's been done out there, actually about 20% of the care that is needed to optimize the outcomes is clinical.
And in the United States, that's all we really focus on.
Everything's got to be clinical, clinical, clinical.
When you're chronically ill and you're fighting this disease or you're living with this disease for 20, 25 years, it's really a long game.
And so if you look at some of the other elements that really drive great outcomes, we view that more as health care, which is pure clinical.
And you obviously have to have that.
You have to have that clinical diagnosis.