As healthcare organizations accelerate toward value-based care, the ability to turn massive data volumes into actionable insights is no longer optional—it’s mission-critical.
In a recent webinar, Improve Healthcare Quality with Data + AI, experts from Databricks, Excellus BlueCross BlueShield, and Perficient shared how leading organizations are using unified data and AI to improve outcomes, enhance member experiences, and reduce operational costs.
Below are the key themes and insights you need to know.
1. Build a Unified, AI-Ready Data Foundation
Fragmented data ecosystems are the biggest barrier to scaling AI. Claims, clinical records, social determinants of health (SDOH), and engagement data often live in silos, creating inefficiencies and incomplete member views.
What leaders are doing:
- Unify all data sources—structured and unstructured—into a single, secure platform.
- Adopt open formats and governance by design (e.g., Unity Catalog) to ensure compliance and interoperability.
- Move beyond piecemeal integrations to an enterprise data strategy that supports real-time insights.
✅ Why it matters: A unified foundation enables predictive models, personalized engagement, and operational efficiency—all essential for success in value-based care.
2. Shift from Reactive to Proactive Care
Healthcare is moving from anecdotal, reactive interactions to data-driven, proactive engagement. This evolution requires prioritizing interventions based on risk, cost, and member preferences.
Key capabilities:
- Predict member risk and close gaps in care before they escalate.
- Use AI to prioritize next-best actions, balancing population-level insights with individual needs.
- Incorporate feedback loops to refine outreach strategies and improve member satisfaction.
✅ North Star: Deliver care that is timely, personalized, and measurable—improving both individual outcomes and population health.
3. Personalize Engagement at Scale
Members expect the “Amazon experience”—personalized, seamless, and proactive. Achieving this requires flexible activation strategies.
Best practices:
- Decouple message, channel, and recommendation for modular outreach.
- Use AI-driven segmentation to tailor interventions across email, SMS, phone, PCP coordination, and more.
- Continuously optimize based on member response and engagement data.
✅ Result: Higher quality scores, improved retention, and stronger member trust.
4. Operationalize AI for Measurable Impact
AI is no longer experimental—it’s delivering tangible ROI. Excellus BlueCross BlueShield’s AI-powered call summarization is a prime example:
- Reduced call handle time by 1–2 minutes, saving thousands of hours annually.
- Improved audit quality scores from ~85% to 95–100%.
- Achieved real-time summarization in under 7 seconds, enhancing advocate productivity and member experience.
✅ Lesson: Start with high-impact workflows, not isolated tasks. Quick wins build confidence and pave the way for enterprise-scale transformation.
5. Scale Strategically—Treat AI as Business Transformation
Perficient emphasized that scaling AI is not a tech project—it’s a business transformation. Success depends on:
- Clear KPIs tied to business outcomes (e.g., CMS Stars, HEDIS measures).
- Governed, explainable, and continuously monitored data.
- Change management and workforce enablement to drive adoption.
- Modular, composable architecture for flexibility and speed.
✅ Pro tip: Begin with an MVP approach—prioritize workflows, prove value quickly, and expand iteratively.
Final Thought: Data and AI are Redefining Health Care Delivery
Healthcare leaders face mounting pressure to deliver better outcomes, lower costs, and exceptional experiences. The insights shared in this webinar make one thing clear: success starts with a unified, AI-ready data foundation and a strategic approach to scaling AI across workflows—not just isolated tasks.
Organizations that act now will be positioned to move from reactive care to proactive engagement, personalize experiences at scale, and unlock measurable ROI. The opportunity is here. How you act on it will define your competitive edge.
Ready to Reimagine Healthcare with Data and AI?
If you’re exploring how to modernize care delivery and member engagement, start with a strategic assessment. Align your goals, evaluate your data readiness, and identify workflows that deliver the greatest business and health impact. That first step sets the stage for meaningful transformation, and it’s where the right partner can accelerate progress from strategy to measurable impact.
Our healthcare expertise equips leaders to modernize, personalize, and scale care. We drive resilient, AI-powered transformation to shape the experiences and engagement of healthcare consumers, streamline operations, and improve the cost, quality, and equity of care.
- Business Transformation: Activate strategy for transformative outcomes and health experiences.
- Modernization: Maximize technology to drive health innovation, efficiency, and interoperability.
- Data + Analytics: Power enterprise agility and accelerate healthcare insights.
- Consumer Experience: Connect, ease, and elevate impactful health journeys.
We understand that every organization is on a unique AI journey. Whether you’re starting from scratch, experimenting with pilots, or scaling AI across your enterprise, we meet you where you are. Our structured approach delivers value at every stage, helping you turn AI from an idea into a business advantage. Plus, as a Databricks Elite consulting partner, we build end-to-end solutions that empower you to drive more value from your data.
Discover why we have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S. Explore our healthcare expertise and contact us to get started today.
