FL Health System Leverages AI to Streamline Utilization Management

Florida-based Halifax Health deployed an artificial intelligence-based solution to streamline utilization management workflows across its three hospitals this week.

The health system will leverage a combination of XSOLIS' CORTEX platform and Physician Advisory Services to address administrative challenges and inefficiencies between its utilization management and physician advisor teams.

"As the healthcare industry continues to face staff shortages, health systems need to be able to do more with less to continue providing superior patient-centered services," said Lottie Odom, vice president of clinical integration at Halifax Health, in the press release. "After confirming XSOLIS is the market leader in solving these problems and mitigating revenue risk associated with misaligned care level status, we worked to quickly implement its CORTEX platform. XSOLIS' solution and service have already been phenomenal, leading to early positive results."

The platform enables real-time clinical data sharing across networks, helping healthcare organizations target inefficiencies, improve provider-payer relations, and reduce the manual work and subjectivity associated with traditional case review through advanced case management analytics and reporting capabilities.

According to the press release, these capabilities can also be shared beyond the utilization management and physician advisor teams to help health systems leverage data effectively system-wide. In Halifax Health’s case, XSOLIS has established a relationship with multiple Florida-based payer networks, allowing the health system to benefit from more streamlined connections with some of its payer organizations.

"As we enter a new era of healthcare, more payers and providers need to be equipped with the tools to increase efficiency and communication with one another," said Joan Butters, CEO and co-founder at XSOLIS, in the press release. "We're excited to continue supporting Halifax Health in this next phase and create new opportunities to expand its high-quality patient care."

Providers and payers outside of Florida are also leveraging XSOLIS’ solutions to streamline their working relationships and reduce friction.

Last month, AnMed, a nonprofit health system serving residents of upstate South Carolina and Georgia, deployed XSOLIS’ AI and machine learning (ML) offerings to help drive greater clinical staff efficiencies and modernize its utilization management process across its four hospitals through inbound and outbound integration with the health system’s EMR. This integration enables the continuous generation of objective medical necessity scores and helps assess the anticipated level of care for each patient.

Last year, Debbie Schardt, assistant vice president of revenue cycle and utilization management at MultiCare Health System, a Tacoma, Washington-based not-for-profit healthcare system with more than 20,000 employees and 11 hospitals, and Alana Llewellyn, concurrent review nurse manager at Coordinated Care, a managed care organization that provides healthcare services to more than 200,000 members across Washington state, shared insights into how the CORTEX platform has helped the two improve information exchange and streamline the utilization management process in an interview with HealthITAnalytics.