Humana, IBM Watson Health Collaborate to Improve Health Benefit Transparency

Humana and IBM Watson Health announced a collaboration today that will deploy IBM’s artificial intelligence (AI) solution, known as IBM Watson Assistant for Health Benefits, to Humana employer group members, agents, and employers.

Through the AI-enabled virtual assistant built in the IBM Watson Health cloud, members will now have access to transparent and accurate information on benefits, health care costs, and providers. The service will initially be available to Humana’s 1.3 million employer group medical members and 1.8 million of Humana’s employer group dental members.

“At Humana, we strive to use technology to better serve our members with simple and convenient health care experiences,” said Chris Hunter, MBA, segment president of Humana’s Group and Military Business. “By harnessing the power of artificial intelligence fused with embedded analytics in the Watson Health platform, we can help our employer-customers, members, agents, and broker partners enhance their knowledge so they can all make more informed decisions.”

Noted as a conversational AI solution, IBM Watson Assistant for Health Benefits is designed to understand the logic of health plan eligibility and integrate it into member conversation, in which each answer, based on active or future member benefits, coverage, claims, referrals, and health care costs, will be personalized to the Humana member.

“Navigating our health coverage without the right support can potentially serve as a barrier to care. An AI-enabled conversational agent that is trained to understand health plan benefits logic can play a role in helping to simplify complex or possibly confusing plan information,” said Paul Roma, General Manager, IBM Watson Health.

The collaboration was cited to improve several aspects of the Humana employer group member benefits experience, including addressing questions directly from members with speed, accuracy, and personalized answers, and assisting Humana employees and call center personnel to accurately answer questions quickly. This, in turn, helps to free up more time for customer care representatives to provide concierge-level customer service

With the goal of creating a cloud native AI platform powered by IBM Watson Assistant for Health Benefits, Humana members will be able to leverage historical claims and provider data to calculate personalized cost estimates for medical services in their health care spending decisions.

“Humana is excited to team up with IBM Watson Health to help our employer-customers and their employees better manage their healthcare benefits and costs through a more innovative, personalized experience,” said Hunter.