Humana and IBM Watson Health are joining forces on a new collaboration, one that will use IBM’s conversational artificial intelligence platform to achieve greater clarity and transparency on benefits and other related matters for Humana Employer Group members. The goal, said Humana, is to provide a better member experience.
Research shows consumers who don’t understand how their health plan works, or how to estimate out-of-pocket costs, are more likely to delay or avoid essential care. Watson Assistant for Health Benefits aims to help address this issue by leveraging conversational AI to streamline the engagements between agents, employers and Humana Employer Group members with clear and accurate information on benefits, healthcare costs and providers.
The agreement stipulates that Humana will begin to deploy the tool, a virtual assistant that was built in the IBM Watson Health cloud.
Initially, the service will be available to all of Humana’s 1.3 million Employer Group medical members, and 1.8 million of Humana’s Employer Group dental members. The solution utilizes a conversational virtual assistant with member benefits, coverage, claims, referrals and healthcare costs for Humana Employer Group members, agents and employer-customers.
The objective is the creation of a cloud-native AI platform powered by IBM Watson with the conversational AI virtual assistant solution.
IBM Watson Health General Manager Paul Roma said an AI-enables conversational agent is trained to understand the logic of health plan benefits, and can help to simplify complex or confusing plan information.
The two companies ticked off some of the benefits of the Watson assistant. One way it helps, they said, was by addressing questions directly from members with speed, accuracy and personalized answers.
It can also help Humana employees and call center personnel answer questions quickly and accurately, helping to free up more time for customer care representatives to provide concierge-level customer service. It uses historical claims and provider data to calculate personalized cost estimates for medical services they said can help Humana members better manage their healthcare spending.
THE LARGER TREND
It’s been a busy few days for Humana. Also this week, the insurer began evaluating a new way of offering hospice services to members of select Medicare Advantage plans in an attempt to provide greater continuity of care, additional transitional services and access to palliative support for patients with advanced illness.
As part of a four-year demonstration created by the Centers for Medicare and Medicaid Services, Humana’s program is intended to help the company and CMS learn whether hospice services provided within the benefits package of Medicare results in additional innovation, enables a more seamless care continuum and improves quality and timely access to palliative and hospice care. Humana started offering the new benefit on select plans on January 1.