Blue Cross Blue Shield launches AI tool to help people navigate their healthcare plans

Understanding the healthcare landscape has traditionally been a significant challenge for most people, but artificial intelligence may be the bridge the population needs. 

Fifty-three percent of employees don't think they're getting the most out of their healthcare plan options, according to a recent survey from the Harris Poll, and another 54% don't fully understand what their current health insurance offers. As a result, around one in three adults say they are worried about being able to afford unexpected medical bills, as well as the cost of healthcare services for themselves and their families, according to KFF. 

"Firms are expecting another increase in healthcare costs this year, on top of the increases from last year," says Matt Hunt, chief experience officer at Blue Cross and Blue Shield of Minnesota. "These higher costs are adding to the inflationary pressures that consumers are already feeling, and my team and I were looking for ways they can reduce their healthcare costs."

Read more: 40% of Americans are delaying healthcare visits despite having insurance

Blue Care Advisor, a new digital solution available to Minnesota plan holders, uses AI to manage the entirety of an employee's health journey, including filing claims, navigating benefits, understanding deductibles, finding health and wellness programs and engaging with customer service. The program also ranks over 140 clinical conditions by need and identifies personalized follow-up steps based on a member's individual health goals, their health assessment and claims data. 

"It's really a digital front door for them to walk through," Hunt says. "The goal is to keep the member on a path toward a healthy life that focuses on preventive care to help members avoid expensive health events later." 

The AI tool also helps users search for doctors, clinics and prescriptions, with an option to filter by price, enabling them to estimate the likely cost for treatment. It also shows the member how much a prescription will cost at each pharmacy, and provides a generic equivalent to price-compare. 

The ability to source and provide users with all of this information quickly and seamlessly is critical to ensuring that patients are making the right health decisions for them in both the short-and long-term. 

Read more: 9 ways employees are using AI at work

"There is a proven correlation between an employee population that is proactively engaged with their health and a lower total cost of care for the member and their employer," Hunt says. "Members using our program are twice as likely to schedule mammograms, wellness exams, cervical cancer tests and colorectal cancer tests compared to those who are not." 

Already, 86% of healthcare providers, life science companies and tech vendors use AI, according to an AI and healthcare trends study from Tata Consultancy Services. And that number is still expected to rise, according to Hunt. 

"Leveraging data to enable new technology will be critical for proactively addressing health issues and keeping healthcare costs under control," he says. "With continued improvements, we can put tools into employees' hands that will help them through every step of their healthcare journey."