AI-backed platform provided operational efficiency and improved payer relations, leading to expansion
NASHVILLE, Tenn., Sept. 19, 2023 – Xsolis, the artificial intelligence (AI) technology company creating a more efficient healthcare system, announces an expansion of its collaboration with UMC Health System, building on a successful track record of improving the provider’s operational efficiency and reducing administrative waste. The 500-bed hospital and Level 1 trauma center in Lubbock, Texas, was able to better streamline patient placement to support the growing percentage of observation patients.
Since implementing Xsolis’ Dragonfly Utilize platform, formerly known as CORTEX in October 2020, as well as its award-winning Physician Advisory Services and Denials Management Services, UMC Health System has harnessed the power of AI and predictive analytics to reduce time conducting utilization review case reviews and better allocate staff members. Bidirectional integration of CORTEX [Dragonfly] with UMC Health System’s electronic medical record has also allowed for broader adoption of Xsolis’ proprietary Care Level Score™ (CLS™) – a predictive, AI-driven numerical representation of medical necessity.
“CORTEX [Dragonfly] analytics are accessible in shared views which has created continuity across teams, making it easier for everyone to work toward the same goals versus our previous, more siloed approaches,” said CIO Bill Eubanks, UMC Health System. “Physicians, nurses and utilization review teams now have more efficient conversations and increased alignment on patient status and discharge readiness.”
More seamless information sharing was expanded when UMC Health System added a national payer to Xsolis’ connected network in May 2021. This has resulted in increased and earlier alignment with payers during case reviews, a decreased exception rate, and increased operational efficiency. Xsolis’ AI-driven platform and provider-payer network has allowed both UMC Health System and its payer partners to focus on the right cases at the right time.
“We were so pleased with our results with Xsolis that we stopped using previous utilization review solutions, as well as another outside Physician Advisory group,” said UMC Health System director of case management, Kayla Long, MSN, RN, ACM. “The data transparency we now have access to is unprecedented and has constantly illuminated areas for improvement. As a result, we’ve shifted our focus to mitigate denials, which improved our financials and strengthened payer relations.”
As part of UMC Health System’s renewal, expanded services include additional payer connections as well as case management analytics to drive further staff efficiency and cost savings to the organization.
“UMC Health System has been a shining example of the transformation that can occur for providers and health plans when they apply AI-driven insights with a comprehensive approach to address challenges within their organization,” said Xsolis CEO Joan Butters. “We recognize that each customer has distinct needs, and we are thrilled to continue partnering with UMC Health System’s leadership as they navigate some of the industry’s most pressing issues, such as missing revenue opportunities and enabling limited staff to operate with unparalleled efficiency.”
When health systems embrace technology solutions in conjunction with services, UMC Health System highlights how benefits can be maximized across all stakeholders, driving more collaboration with payer partners to better serve the patient and member populations.
About UMC Health System
UMC Health System is a national award-winning health system comprised of over 4,900 team members and more than 60 care locations. We are proud to be the primary teaching hospital to Texas Tech University Health Sciences Center and to provide the best care to West Texas and Eastern New Mexico. Whether you are managing a chronic condition, dealing with an unexpected illness, or simply working to stay healthy, we are passionate about getting you well and helping you stay that way. To learn more, visit umchealthsystem.com. At UMC, Our Passion is You.