Humana will use healthcare technology firm XSOLIS' predictive analytics platform to streamline parts of the utilization review process with providers.
The payer will adopt the company's various processes to identify and extract important data for members receiving inpatient treatment to ensure higher-quality care, according to a July 19 news release. Through the XSOLIS platform, clinical data will be taken from EHRs to make "touchless" status determinations for a subset of inpatient cases. The platform also enables providers to escalate cases to Humana to be reviewed in real time. This helps eliminate administrative work typically associated with the utilization review process, freeing more time for providers to spend with patients, according to the release.
"Our relationship with our providers is paramount," Humana Senior Vice President George Renaudin said in the statement. "XSOLIS offers us the opportunity to significantly reduce provider abrasion, increase our review effectiveness and streamline our efficiency in care management on behalf of our team and health plan members."
Humana is the first payer to use this "new approach to utilization management," Mr. Renaudin said.