It's not a secret that navigating the healthcare system is complicated, and the UnitedHealthcare team has rolled out a tool backed by artificial intelligence that aims to make it easier for members to shop around.
The Find Care & Costs tool allows members to find in-network services they need and arms them with clear cost information. The platform uses AI to offer personalized recommendations and education based on the member's benefits package.
The tool can also tailor results to an individual's health concerns as they search for providers and services.
Craig Kurtzweil, chief data and analytics officer for UnitedHealthcare's commercial unit, told Fierce Healthcare that the team tapped into what's made the member experience work in its Surest plan as it built Find Care & Costs.
Surest, which offers employer-sponsored plans, is designed with the goal of easing navigation. It also eliminates deductibles to make cost information clearer for members.
"If you could make the experience simple and convenient for members, you can give them the insights to be able to drive a better healthcare journey," Kurtzweil said.
The tool is accessible through both the member's app as well as UnitedHealthcare's website, he said, and users can search without needing to know complex medical jargon to find the right provider. That's where AI comes in, as the tech translates the member's terms into more clinical wording to connect them.
The tool also provides cost estimates and out-of-pocket expenses based on "transparent analytics," Kurtzweil said, based on provider coding and the insurer's contracts with healthcare organizations.
Members can also access information like feedback from other patients and quality metrics when they're available, he said.
And the tool is resonating, with its number of users doubling since launch. It's also pushed a 267% increase in consumers' net promoter scores among those who have interacted with Find Care & Costs, Kurtzweil said.
"We see better patterns of care, more utilization of preventive care, things like lower utilization of ER, those types of things start to pop out for members that can leverage this experience," he said. "So making it really convenient and something that they actually enjoy is a win-win."
Kurtzweil said the Find Care & Costs tool fits neatly into UnitedHealth's broader strategy around AI, as the ultimate focus is simplification, whether that's the consumer experience or internal administrative functions.
Other examples of the technology at work include multiple applications at its call centers. When a member calls in for any reason, even for general questions around networks or their benefits, AI tools can elevate information to patient advocates about care gaps or other concerns that can be discussed to make the call more "well-rounded," he said.
AI can also assist advocates in call centers, he said, by automating dictation of conversations, which allows them to stay focused on interacting with the member rather than intensive documentation.
"Whether it's the digital experience or the advocacy experience, it's all about simplifying the system so that the consumer is directly in our focus," Kurtzweil said.