Beacon Health System is a not-for-profit health system with 146 care sites across seven counties in northern Indiana and Michigan.
In May 2019, the health system implemented Xsolis’ AI platform to enhance their utilization management processes and adopt a more comprehensive approach to patient care, enabling them to better manage the high volume of critically ill patients with chronic conditions.
Xsolis’ AI-powered platform, Dragonfly, enables Beacon Health System’s clinicians to streamline reviews, documentation, and other administrative tasks. Since implementing Dragonfly in May 2019, the partnership has yielded $95 million in savings (an ROI of 22.1X) and $7.4 million recovered through Xsolis’ Denial Services.
“The biggest benefits of working with Xsolis are consistency and standardization… With Xsolis, I am assured that when my nurses review a chart, they’re all reviewing it the same way with the same lens, ensuring a very consistent process and leading to improved outcomes.”
Heather Wagner, MBA, BSN, RN
Director of Utilization Review and Case Management
Beacon Health System
“We’re now able to work more collaboratively, ensuring that the right provider, patient, and level of care are aligned for optimal patient outcomes.”
Brandy Martin, BSN, RN
Utilization Registered Nurse Educator
Beacon Health System
“Connecting with payers through Dragonfly has allowed us to significantly decrease administrative tasks. By utilizing Precision UM with a large national payer, we’ve seen specific cases automatically approved. This enables our clinicians to focus their time and expertise on the more complex, ‘gray area’ cases, ensuring we make the best decisions for the appropriate level of care.”
Heather Wagner, MBA, BSN, RN
Director of Utilization Review and Case Management
Beacon Health System
Forging collaborative partnerships and relationships with health plans is another vital element in enhancing the utilization review and case management process at Beacon Health.
In addition to the three existing health plan partner connections, Beacon Health implemented Precision UM with a large national health plan in December 2023. Using AI and machine learning, Precision UM automates inpatient determinations that are mutually agreed upon by both parties.
“This collaborative approach has significantly improved alignment between the two organizations. According to Heather, “I truly perceive this as the future of collaboration between payers and provider.”
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