Ron Kuerbitz
speaker
111 appearances
1 recordings
1 series
first heard Jul 2019
last heard Jul 2019
Ron Kuerbitz’s voice in public audio — every appearance, attributed to the second.
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Appearances
what kinds of activities are expected of them, for which patient and at what time.
That's a much higher order value of UM than simply screening for unauthorized activities and care.
And we see similarly in claims adjudication.
There's a wealth of knowledge and information that comes back into the system out of intelligent claims adjudication.
It tends to be treated as a commodity activity of simply processing paper.
But in many ways, it is the culmination of a long process of organizing care.
And when you think of it that way, the intelligence that you can pull back out of it is really important.
And that's where I think we need to rethink, why is this a commodity?
What elements of it are we overlooking when we treat it as just a commodity activity?
That's a great question.
Markets offer tremendous opportunity.
You can bring initial skills and initial enablement into that kind of a market and have a tremendous effect.
Very highly organized, very sophisticated groups.
have the opportunity to plumb the depths of data and use new tools in AI and predictive modeling in ways that they haven't done before, and they can find great improvements in quality for very small subpopulations at very high cost.
were very high mortality rates and drive fantastic improvement in very small populations that mean a lot both to the providers and to the patients.
We have decades of opportunity and that means there isn't a marketplace in the country that has reached its optimum state yet.
I think the fact that a market is a PPO market shouldn't discourage
providers from engaging in risk and engaging in population health.
In fact, in some ways, those are the markets that need it the most.
They already have some steering tools.
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