The rapid evolution of artificial intelligence (AI) and natural language processing (NLP) is transforming health care at an unprecedented pace. As hybrid HEDIS® methodologies are phased out, AI and NLP offer powerful tools to improve compliance tracking, quality measurement and the development of new measures that go beyond traditional claims and structured EHR data.
This session features real-world insights from two leading health plans—Capital District Provider Health Plan (CDPHP) and UPMC Health Plan—who are at the forefront of applying AI and NLP to quality improvement and measurement. Together, they’ll share their experiences deploying innovative programs, including:

• Moving to year-round HEDIS® medical record review
• Implementing measure surveillance and quality improvement initiatives (e.g., Osteoporosis Measurement in Women)
• Addressing member complaints and experience challenges
• Delivering real-time information directly to the point of care

Health care leaders, data and analytics teams, quality improvement professionals and anyone interested in the practical application of AI and NLP in HEDIS® operations and quality management are encouraged to attend this session to hear each health plan discuss their journey from concept to rollout. 

Learn How To:

• Apply AI and NLP technologies to enhance HEDIS®® medical record review, measure surveillance and quality improvement initiatives.
• Build leadership buy-in, align programs with regulatory and audit standards and prepare teams for workforce changes driven by AI adoption.
• Aggregate the right types of data from providers to fuel AI and NLP solutions.
• Address complex challenges such as member complaints and experience measures with innovative data strategies.
• Deliver actionable insights at the point of care to support clinical decision-making and improve patient outcomes.