HealthEM.AI leverages AI/ML in combining clinical data and social determinants of health to predict future utilization for patients

SAN JOSE, California—HealthEM.AI, an artificial intelligence (AI) driven care management data platform company committed to streamlining care delivery and optimizing cost of care, announced a strategic partnership with WellBe Senior Medical, an organization delivering home-based medical care for older patients with multiple comorbidities.

WellBe's patients are primarily served by Medicare and Medicare Advantage programs, which are scheduled to transition fully to value-based care models by 2030. WellBe is transforming its business to participate in the benefits of these risk-sharing programs and alternative payment structures.

WellBe leverages HealthEM.AI to integrate claims and electronic health record data in multiple formats and normalize data. HealthEM.AI provides complete member 360 across records, files, service locations and states. HealthEM.AI uses advanced AI and machine learning (ML) risk models that integrate social determinants of health with clinical data to reimagine workflow. These models provide insights WellBe medical staff can use to tailor patient and population interventions, enhancing clinical engagement and improving outcomes.

"Nearly all—90%–of the $4.1 trillion health care spending the U.S. spends each year is focused on managing patients' chronic conditions. These patients are heavy service users, visiting multiple providers and locations, complicating health care organizations' ability to drive to insight," said Pradeep Kumar Jain, chief customer officer at HealthEM.AI. "WellBe uses HealthEM.AI's data layer to solve one of the complex industry issues—bringing fragmented and siloed data together to create a unified record. HealthEM.AI provides a 360-degree view of patient data that WellBe team can use to coordinate, personalize care and impact overall cost of care."

"WellBe's mission is to strengthen health care access, empowering patients to manage their health proactively," said Denise Hatzidakis, CIO/CTO, WellBe Senior Medical. "HealthEM.AI enables WellBe to harness the full power of its data to enhance home-based medical care service delivery. HealthEM.AI derives valuable insights our clinicians use to make informed decisions and work with patients to manage and improve their health conditions."

"HealthEM.AI's risk scoring tools and workflow, gives us the opportunity to predict patients' disease progression and the risk they will be admitted or readmitted to the hospital with emergency or other medical events," said Bill Leister, SVP clinical and data solutions, WellBe Senior Medical. "This information enables us to deliver targeted interventions, enhancing population planning and patient outcomes and reducing the need for costly emergency services."

"Health care organizations want to seize their share of the value-based care market, which is projected to reach $1 trillion in enterprise value by 2030, while government-covered home-care services will reach $265 billion by 2025," said Praveen Soti, CEO, HealthEM.AI. "Our platform, HealthEM.AI, provides the normalized data, analytics, and risk-based tools firms like WellBe need to model and improve care delivery, streamline back-end processes, and drive new revenues and cost savings."