Beyond the Hype: Practical AI Applications from MESC

Since the GenAI explosion a couple of years ago, I — like everyone else — am still grappling with a mixed sense of opportunity and skepticism. New search and summary engines, like ChatGPT, and image generators, like Midjourney, have compelled us all to think about the possibilities and risks more acutely. The apparent suddenness of this technology has focused our attention like no other technological shift before.

However, it’s crucial to think of AI not as a singular entity, but as a collection of tools that will evolve into numerous capabilities and features designed to assist us. We can select the right tools to help solve core problems effectively. At the Medicaid Enterprise Systems Conference (MESC), I gained invaluable insights into how AI is reshaping healthcare, particularly within state Medicaid agencies.

Here are my key takeaways:

Management of Unstructured Data

AI's ability to enhance document scanning and create medical-focused summaries is revolutionizing the management of unstructured data. This is vital for Medicaid agencies as it allows for quicker, more accurate processing of the vast amounts of data they handle, leading to faster and more informed decision-making.

Review of Medical Data

The development of AI models specifically designed for reviewing medical data is a game-changer. It ensures that data handling is not only swift but also precise, which is essential for maintaining the integrity of medical records and patient care. I loved TennCare’s interest in building an early engine for enabling exports to query and summarize 21,000 pages of policy documentation to allow experts to make their reviews happen faster. They looked for projects with a 20x ROI, not just 2x. But they didn’t just build a process that moves faster—they built one that is designed explicitly to help humans make correct decisions faster.

AI leverages automated caller identification to reduce hold times and detects conversational tones to improve responses, significantly boosting the patient experience. For state Medicaid agencies, this means enhanced service delivery, leading to higher satisfaction rates among beneficiaries.

Supporting Modernization Efforts

AI aids in the modernization of Medicaid systems by quickly extracting rules, policies, and workflows. This capability is crucial as it helps cut down the costs associated with modernizing outdated systems, making it financially feasible for state agencies to undertake such projects.

Querying and Summarizing Policy Documentation

AI excels at allowing experts to efficiently query and summarize extensive volumes of policy documentation. This capability significantly speeds up the review process, enabling quicker and more informed decision-making.

AI developments are happening fast! Technical capabilities, states developing legislative guardrails, and organizations wanting to transform their services are all colliding forces. The ability to move forward in a deliberate, planned, safe, and productive manner requires help.

To delve deeper into the NTT DATA experts' insights on AI from the MESC conference, I recommend reading AI Assessments: A Game Changer for Government Agencies.

This blog provides a thorough overview of the systematic evaluation process and its substantial benefits for state agencies.