SCAN Health Plan Leverages AI Based Predictive Models to Improve Identification of High Risk Members

Date Posted: 08/11/2020

In collaboration with KenSci, the first phase of the project will deploy solutions that aim to predict preventable hospitalizations among members

LONG BEACH, Calif., Aug. 11, 2020SCAN Health Plan®, one of the nation’s largest not-for-profit Medicare Advantage health plans, today announced the first phase launch of artificial intelligence (AI) based predictive models designed to improve health outcomes and inform benefit and service design. This implementation will improve SCAN’s ability to identify high-needs members and provide tailored interventions to help avoid or reduce hospitalizations.

“At SCAN our goal is to support our members at every stage of their journey and utilizing advanced technology, such as AI, enables us to do so on a much more proactive basis,” said Josh Goode, SCAN chief information officer. “As our members’ needs evolve, the KenSci platform allows us to better interpret the needs behind the data so that we can respond with programs and services to help keep them healthy and independent.” 

As a part of the first phase implementation, SCAN and KenSci, a system of intelligence for healthcare, have launched explainable AI models for healthcare, enabling SCAN to identify members at risk of Hospitalization for Potentially Preventable Complications* (HPC) as well as those eligible for Nursing Facility Level of Care (NFLOC). The platform provides SCAN with insights, proactively identifying members potentially at risk for specific disease states allowing for early interventions. In addition, SCAN is using machine learning (ML) techniques that are routine across consumer applications but new to healthcare in helping identify gaps in care to improve the management of chronic conditions. 

“The volume and veracity of data opens up immense possibilities for healthcare organizations to transform the way they support their plan members,” said Samir Manjure, co-founder & CEO, KenSci. “We are excited to work with SCAN and appreciate their expertise in developing these tools to meet the needs of seniors. Together, there is tremendous opportunity to impact the health of older adults.”

“Data is a critical asset in modern healthcare and harnessing it appropriately provides invaluable insight,” said Moon Leung, SCAN senior vice president and chief informatics officer. “By leveraging KenSci’s AI expertise, we believe we can utilize our data to improve health outcomes and quality of life for many of our members.”

*HPC measure is based on National Committee for Quality Assurance (NCQA) HEDIS® technical specifications. For more details, please visit ncqa.org

About SCAN Health Plan

SCAN Health Plan is one of the nation’s largest not-for-profit Medicare Advantage plans, serving more than 220,000 members in California. Since its founding in 1977, SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent. Independence at Home, a SCAN community service, provides vitally needed services and support to seniors and their caregivers. SCAN also offers education programs, community funding, volunteer opportunities and other community services throughout our California service area. To learn more, visit scanhealthplan.com or facebook.com/scanhealthplan or follow us on Twitter @scanhealthplan.

About KenSci

KenSci's machine learning powered risk prediction platform helps healthcare providers and payers intervene early by identifying clinical, financial and operational risk to save costs and lives. KenSci's platform is engineered to ingest, transform and integrate healthcare data across clinical, claims, and patient generated sources. With a library of pre-built models and modular solutions, KenSci's machine learning platform to integrates into existing workflows allowing health systems to better identify utilization, variation and improve hospital operations. With Explainable AI models for healthcare, KenSci is making risk-based prediction more efficient and accountable.

KenSci was incubated at University of Washington's Center for Data Science at UW Tacoma and designed on the cloud with help from Microsoft's Azure4Research grant program. KenSci is headquartered in Seattle, with offices in Singapore and Hyderabad. For more information, visit www.kensci.com

Media Contact for SCAN: Havas Formula 
scanhealth@havasformula.com
619-234-0345

Media Contact for KenSci:
Abhilash Kumar, Director of Marketing
abhi@kensci.com 
+91 98458 72451