How AI is transforming payers' business, workforce + member experiences — 3 roundtable takeaways

During an interactive session at Becker's Payer Issues Roundtable, two leaders from Microsoft, Divya Varshney, senior director of global healthcare marketing, and Amy Berk, MSN, RN, director of population health, led a discussion on the potential of artificial intelligence and generative AI in healthcare.

The conversation highlighted the need for AI to address key payer challenges such as modernizing member experiences, solving data utilization issues and increasing access to quality healthcare at lower costs. Participants also touched on the importance of data governance, the need for change management when implementing AI and the potential risks and legal considerations. Ms. Varshney and Ms. Berk also emphasized that AI should be used to augment, not replace, human roles in healthcare. Application of AI in areas like claims processing, risk stratification and improving the provider experience were also discussed.

Editor's note: Quotes have been edited for length and clarity.

Key takeaways:

1: Payers must improve member experiences and satisfaction — and AI is a key pathway.

Divya Varshney: "Members are the heart of everything. So it's critical that your member experience is modernized, that it is increasing satisfaction, as that impacts star ratings and your ability to enroll members — which ultimately hits the bottom line. How can you modernize the way you understand your members and then serve them to improve operations?"

2: Amid the healthcare staffing crisis, AI can play a role in augmenting the payer workforce and improving staff experiences and job satisfaction. 

DV: "Really, it's not just about productivity — it's about improving the employee experience. How can you decrease administrative burdens across functions? How can you make it easier for employees in every function to communicate with one another and focus on the things they love to do in their job? We do all of this through the Microsoft Cloud for Healthcare." 

3: AI is expected to make significant changes and improvements in payer business operations and data. 

Amy Berk, MSN, RN: "What Microsoft is doing in the world of AI is truly transformational for our business as we know it today, and it will bring forth a new way of working, a new way in which we care for our member populations and a new way in which we really coalesce the data and use it for the best opportunities."

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