XSOLIS is a healthcare technology company that is developing an artificial intelligence-based network for payer-provider utilization management that is objective and data-driven. A new partnership with Humana will allow the company to deliver its real-time, predictive analytics platform to Humana and its collaborating providers.
- Effective partnership: Alongside and in collaboration with participating XSOLIS client health systems, Humana will be adopting Precision Utilization Management (Precision UM), a process by which XSOLIS analytics identify and stratify a subset of member cases for “touchless” status determinations for medical inpatient treatment.
- On-demand: XSOLIS’ SaaS platform, CORTEX®, extracts data directly from the hospital electronic medical record and analyzes the full clinical picture for each patient throughout their hospital stay. CORTEX is available online and on-demand to staff at both hospital and insurer and provides a complete, analytics-driven view of patients.
- Efficiency: “Our relationship with our providers is paramount,” said George Renaudin, Senior Vice President at Humana. “XSOLIS offers us the opportunity to significantly reduce provider abrasion, increase our review effectiveness and streamline our efficiency in care management on behalf of our team and health plan members. We were the first of our peers to pilot this new approach to utilization management and we are proud to engage a growing list of participating providers in adopting this framework.”
- Approvals: With CORTEX, providers can escalate certain cases to Humana to be reviewed and approved in real-time. CORTEX facilitates interaction between payers and providers during the utilization review process, eliminating the friction and much of the administrative work typically experienced during review activities.
- Unprecedented opportunity: “We have an unprecedented opportunity to create a future where each person – as a patient and a member – receives care that is adequately and efficiently managed,” said Joan Butters, Chief Executive Officer at XSOLIS. “Our partners at Humana saw the opportunity to create this change in the industry and together with their provider partners have made a leap forward with true innovation. Together, we are seizing the opportunity to reframe how payers and providers determine medical necessity and manage utilization to create a smarter future for healthcare.”
