Published on January 22, 2024, 1:40 pm

Artificial Intelligence (AI) is a transformative technology that has the potential to unlock significant benefits for organizations. In particular, generative AI is expected to revolutionize the healthcare industry, changing the way operations are conducted and improving customer experience.

According to a recent analysis by EXL, a leading data analytics and digital solutions company, healthcare organizations that adopt generative AI can expect lower administration costs, reduced provider abrasion, and improved member satisfaction. By fully embracing digital strategies and optimizing the use of technology, these organizations could reduce administrative expenses by 40% to 50% within the next five years.

Generative AI has the power to establish a new level of benchmark performance in healthcare operations. While industries like banking and finance have already embraced AI-backed digital technology, healthcare has been slower to adapt. However, there is now a growing interest among healthcare payers and providers in leveraging generative AI and experiencing the benefits of digital transformation.

The timing couldn’t be better for this technological shift in healthcare. Payers and providers are facing financial challenges that cannot be resolved simply by cutting costs or reducing labor. Fortunately, advancements in cloud technology and data utilization have created an opportunity to enhance productivity and lower costs through automation with generative AI.

Healthcare payers face external and internal challenges related to customer experience, such as navigating health plans, understanding benefits, and accessing services. They are also looking for ways to incorporate digital solutions across the care continuum to improve coordination and health outcomes. On the other hand, providers aim to differentiate themselves by offering personalized patient outreach that addresses individual health issues and care plans.

Both payer and provider activities heavily rely on data-driven interactions that can be complex. Generative AI solutions make these interactions more efficient by utilizing natural language processing, speech recognition, summarization of vast amounts of data, and even generating new content from unstructured data sources. This shift towards AI-based customer issue resolution is gaining acceptance as it provides more accurate and desirable outcomes compared to traditional human interaction.

EXL, with its expertise in healthcare operations, data analytics, and technology, partners with healthcare organizations to offer professional insights and digital solutions that drive transformation. The company has helped payer organizations achieve significant cost reductions by deploying generative AI-enabled digital solutions for customer experience capabilities. For example, one payer organization achieved a 40% cost reduction through EXL’s guidance on prioritizing the best use cases.

EXL has also developed its own AI solution called EXELIA.AI™ to address contact center issues. This pre-trained healthcare solution mimics human-like interactions through voice and chat and has successfully contained calls by artificial intelligence between 60% to 80%. Healthcare providers have reported an 80% satisfaction rate with this frictionless AI experience, surpassing typical live agent experiences.

Looking ahead, EXL is working on implementing generative AI for in-context clinical summarization within utilization management workflows. This development has the potential to significantly enhance registered nurse productivity.

To learn more about how generative AI and digital transformation can reduce operational costs over the next five years, EXL offers a white paper for further reading. Additionally, their case study showcases the optimization of healthcare call centers through generative AI. If you are interested in leveraging generative AI for your business, EXL can provide valuable insights and solutions tailored to your needs.

In conclusion, generative AI is poised to revolutionize the healthcare industry by streamlining operations and improving customer experience. Embracing this transformative technology will enable healthcare organizations to lower costs, enhance productivity, and ultimately deliver better outcomes for patients.


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