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Lumiata helps health plans and providers with risk management through the use of AI
Steven Loeb interviews Dilawar Syed, CEO of Lumiata, a platform that uses artificial intelligence to help health plans and providers make more accurate predictions for underwriting and risk management. The company has raised roughly $50 million, including a recent $14 million round.
For these digital health podcasts, our goal is to also understand these three high-level questions: How are we empowering the consumer? Are we creating productivity that also allows us to see overall economic costs go down? How is this advancement changing the role of the doctor?
Highlights from the interview:
- There's a move toward value-based care, which means that health plans and providers have to modernize their approach when it comes to managing risk. However, many organizations have been using legacy methods, so Lumiata brings data science so they can use big data and AI to help them manage risk better by providing predictions built off of much larger data sets.
- The COVID has made it even more challenging to accurately assess risk in healthcare, because there are millions of Americans who now have pre-existing conditions. That makes Lumiata's insights even more important.
- Lumiata works off of claims data, as well as EHR and electronic records. As new datasets emerge, such as as the use of devices that can be used to provide a real-time view of somebody's risk, Lumiata's software platform is able to quickly ingest these new datasets as well to create a holistic view of each patient.
- Because of COVID, there has been a rise in telemedicine, which is creating new data streams and insights that can also be used by Lumiata.
- Lumiata has been able to reduce risk capital by tens or hundreds of billions of dollars with health plans by predicting future risk with more accuracy. In some cases it is identifying twice as many future high cost members as they are able to internally or by using a consulting firm.
- Healthcare systems are under severe strain, and it won't end with the pandemic, and products like Lumiata can help doctors prioritize care better.
- At the end of the day, this is all about lowering the cost of care. Today, a family of four, with an income of $110,000 a year, is spending a quarter of their income on out of pocket healthcare costs, and that's rising every year. Lumiata is able to predict future costs with a lot more precision, and its predicted cost is lower than what internal models are.
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