2021 Augmented Intelligence (AI) for Health Care Operations Market Trends Report

This report is available to subscribers of the Chilmark Advisory Service via the client portal, or may be purchased separately by clicking below. Check out the podcast Sr. Analyst Jody Ranck did with Beckers Healthcare on this topic – click here.

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Many health systems and hospitals suffered a severe financial shock with the onset of the COVID-19 pandemic in March 2020. With hospital operating margins already slim, such a shock can drive margins into negative territory and impact the survival of the organization. Because of this, the pandemic created an opportunity for a number of AI in Operations (AI4Ops) vendors to demonstrate a measurable ROI during the crisis, and emerge stronger for it.

While most of the attention in the AI space has focused on clinical applications, AI for operations – AI4Ops – is where the real action is today. Smart money is catching on to the potential market for reducing overhead and administrative waste in healthcare, with recent investments and M&A activity in this space reflecting that.

This report takes a closer look at several leading solutions in the AI4Ops space and provides an overview of the trends and dynamics of the market as it evolves post-pandemic:

• Change Healthcare (Flagship Vendor – RCM)
• Codoxo
• Health Catalyst
• HospitalIQ
• Infinitus
• LeanTaaS (Flagship Vendor – Operational Excellence)
• Olive
• Optum
• Qventus (Flagship Vendor – Hospital Operations / Change Mgmt)
• Waystar

The research focused on the largest segments of the operations spectrum from supply chains to hospital operations. We have also included a small number of supply chain and RPA vendors that we believe compose an important, but smaller segment than RCM and hospital operations.

The report covers a number of operational use cases including the following:

• Discharge Planning: ER management, Discharge barriers, Perioperative
• Hospital Operations: Staffing, Hospital beds, Surgery, Asset optimization
• Revenue Cycle Management (RCM): Intelligent claims management/denial prevention, Prior authorizations/eligibility, Patient ability to pay, Fraud detection
• Supply Chains: Predictive caseloads, Supply chain forecasting, Resource prioritization

Many healthcare organizations have been using point solutions for operations as they initially engage with AI, but the leading vendors are building multi-functional, end-to-end platforms across operations and RCM functional areas.

The report provides clear examples of how healthcare leaders can learn from other industries such as airlines and airport capacity management to improve their own operations. We also highlight vendors who excel at the change management component of AI4Ops, which is mission-critical to successful digital transformation.

As an essential piece of digital transformation, AI4Ops will continue to relieve the burden on an already stressed healthcare system, and should prove a testing grounds for developing trust in AI offerings within the healthcare industry.

Healthcare administrators and leaders looking for ways to improve their operations processes will find this report useful in assessing which vendor and solution is right for their organization’s needs. Operations executives can expect to find clear breakdowns on AI offerings that will alleviate many of the stresses facing their organizations today. Investors, solutions vendors will find value in the outlines of market trends as well as the competitive landscape, and the market sizing projections will assist in targeting customers for their products.

Vendors Profiled: Change Healthcare, Codoxo, Health Catalyst, HospitalIQ, Infinitus, LeanTaaS, Olive, Optum, Qventus, Waystar

Length: 84 pages

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Below you can find some of our related coverage of this topic:

• Chilcast Live: Building Responsible AI in Healthcare with John Halamka, Suchi Saria, and Jody Ranck (November 2023)
• Building Responsible AI in Healthcare: A Journey into Automation, Ethics, and Trust eBook (September 2023)
• Generative AI for AI4Ops: Deterministic Models Show Promise for Clinical Operations (July 2023)
• Responsible, Ethical AI through Philosophy and Data Science (July 2023)