Rightway announced the implementation of artificial intelligence and proprietary machine learning algorithms developed by clinical and data science experts in its risk-scoring technology to increase the precision of identifying “rising-risk” and “high-risk” members.
Rightway is a healthcare company, continuously looking to revolutionize care navigation and pharmacy benefits. The newly implemented AI system ensures early detection and risk assessment, allowing proactive outreach and treatment. The system primarily serves those suffering from chronic or high-cost conditions.
Improved identification methods will be crucial in reducing healthcare costs and improving outcomes. Chronic disease in the United States currently costs around $3.7 trillion annually, which is about 19.6% of the country’s gross domestic product. The new system provides Rightway with insights to identify which members are in need of assistance.
“The ability to leverage AI to help define ‘rising-risk’ members and intervene in addressing these care gaps is the holy grail to prevention becoming the new intervention,” said Dr. Theodore Feldman, Co-Founder and Chief Medical Officer at Rightway. “This will inevitably lead to healthier employees and lower healthcare costs, which is critical to our mission.”
“We know that proactive, targeted outreach to members of interest is key to closing undiscovered care gaps and avoiding adverse diagnoses and events,” said Daniel Feller, Ph.D., Director of Data Science at Rightway. “Over the last two years, the data science team has been laser-focused on improving our analytics capabilities to better identify members with chronic health risks. Now our health guides are equipped with an even more powerful tool to serve the members who need it most.”
Paula Bush, EVP of Advocacy Strategy and Delivery at Rightway, added: “‘Rising-risk’ members rarely realize how close they are to developing a serious ‘high-risk’ condition. Now we can help them get to the most appropriate level of care as fast as possible and at the lowest cost. We proactively empower our members to advance on their healthcare journeys: educating them about their conditions, matching them to high-quality experts, providing them upfront costs, and informing them of additional health and wellness benefits available through their employer.”
