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BETHESDA, Md., Aug. 15, 2024 /PRNewswire/ -- HiLabs announced today that it was recognized in the 2024 Gartner® Hype Cycle™ for US Healthcare Payers. HiLabs was mentioned in three categories:Provider/Partner Network Management Platforms Provider Data Management LLMs for Healthcare PayersHiLabs believes that recognition in these three categories showcases how the universe of provider data management is evolving."AI is creating efficiencies for payers that were previously unattainable," says Amit Garg, HiLabs CEO and Co-founder. "When rosters become fully automated, and directory accuracy improves, it opens up a world of possibilities."In addition to cost savings, Garg also credits new advancements in AI technology, such as specialized large language models (LLMS), for increased innovation in the field.These advancements in provider data management capabilities come at a time when ghost networks created by provider directory inaccuracies are under increased public scrutiny. Given their impact on patient access to care, payers, providers, and regulators are actively working to fix them.Garg believes that HiLabs' inclusion in the 2024 Gartner® Hype Cycle™ for US Healthcare Payers highlights the new possibilities of AI technology in solving the provider data problem."The need for new solutions to help providers, payers, and regulators address the ghost network problem has existed for years. What changed is that we now have the ability to create these solutions," says Garg.Download the 2024 Gartner® Hype Cycle™ for US Healthcare Payers here.Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation

What You Should Know:– Incorrect data in health plan physician directories is a pervasive problem, according to new research conducted by researchers at University of Colorado and HiLabs.– The study, published in BMC Health Services Research, leverages HiLabs AI algorithms to compare data for >40% of US physicians across five large health plan directories.Key Findings:Limited variation in data quality between insurers suggests the issue goes beyond individual insurer practices.Physician practices, burdened with updating information across multiple platforms, contribute to the problem.Specialties like primary care and dermatology have higher data accuracy, potentially due to greater patient interaction.Considerable variation exists between states, with reasons unclear and requiring further investigation.The Impact:Patients can face delays in care due to incorrect contact information.Surprise billing can occur if a network-listed provider is out-of-network.Consumers struggle to compare health plans based on inaccurate provider listings.Proposed Solutions:Centralized Directory: The Centers for Medicare and Medicaid Services’ proposal for a unified national directory is an option, but challenges exist, including ensuring accuracy and requiring a major shift in data exchange practices.The Centers for Medicare and Medicaid Services’ proposal for a unified national directory is an option, but challenges exist, including ensuring accuracy and requiring a major shift in data exchange practices. National Standards: Establishing national standards for how provider information is exchanged could be a less disruptive solution.Establishing national standards for how provider information is exchanged could be a less disruptive solution. Engaging Physician Groups: Future policy solutions should involve both insurers and physician groups to improve data accuracy.International Comparisons:Many countries have centralized directories, but inaccuracies have been documented even in government-run systems.Australia’s recent launch of Provider Connect Australia (PCA) is a model to watch for its potential to improve data quality and access.The Takeaway:Inaccurate provider directories are a major problem in the US healthcare system. Novel policy solutions are needed to address this issue and ensure patients have reliable information to access the care they need.“We are proud to collaborate with University of Colorado researchers to use our AI for this important study,” said Amit Garg, CEO of HiLabs. “At HiLabs, we have seen tremendous interest from health plans in using AI algorithms to uncover provider directory inaccuracies in recent years and have seen substantial improvements in directory accuracy as a result.”For further information and to access the full study, please visit https://doi.org/10.1186/s12913-024-11269-5

BETHESDA, Md., June 27, 2024 /PRNewswire/ -- HiLabs, a leader in AI-powered solutions for healthcare data management, is proud to announce that a study utilizing HiLabs technology and conducted by its Chief Medical Officer, Dr. Neel Butala, has been prominently featured in the Medicare Payment Advisory Commission's June report to Congress in its discussion of Medicare Advantage Provider Networks. The Medicare Payment Advisory Commission (MedPAC) is an independent congressional agency that advises the U.S. Congress on the Medicare program.The HiLabs study, initially published in the Journal of the American Medical Association (JAMA), highlights significant discrepancies in provider directories, raising concerns about the impact on patients' access to timely care. The study examined data from 449,282 U.S. physicians and found that 81% of provider entries had inconsistencies across five major health plans