Managed Care Research in Action

(R1) Can Artificial Intelligence Help Managed Care Plans Make More Sense of Their Pharmacy Data?

Tuesday, October 17, 2023

8:30 AM – 9:45 AM East Coast USA Time

Location: Sabal

ACPE UAN:0233-0000-23-046-L04-P | Contact Hours: 1.25 | Activity Type: Knowledge-based

Faculty(s)

Jessica Hatton, PharmD, BCACP

Associate Vice President, Pharmacy
CareSource
Dayton, OH
Nick Trego, PharmD

Senior Vice President of Clinical Analytics and Client Services
HealthPlan Data Solutions
Columbus, OH

Moderator(s)

TH

Theologia Horchani, PharmD, BCPS

Director, Pharmacy Clinical Services
Healthfirst
New York, New York

Artificial Intelligence (AI) and ChatGPT, Machine-Learning (ML), Natural Language Processing (NLP) and Blockchain; these are some of the most overused, and frankly misunderstood, terms in business today. But what do these technologies really do, and how do they work? Could AI make your time more efficient? Are AI/ML safe to use for health care applications?

In this session, faculty will pull back the curtain and discuss what AI/ML are, how they work, and dive into live examples of how these technologies are being used in the pharmacy payment integrity industry. Learn from pharmacy experts about how AI/ML could be tailored to help managed care pharmacists better understand and track their pharmacy benefit performance. Attendees will leave with a foundational understanding of these key technologies and their potential to drive cost-savings in the pharmacy benefit, increase member engagement/experience, and continuously identify potential instances of fraud, waste, and abuse.

Learning Objectives::

At the completion of this activity, participants should be able to:

Explain what Artificial Intelligence (AI) and Machine-Learning (ML) are as technologies.
Identify the main differences between AI and ML.
Discuss key applications for AI and ML technology in the managed care pharmacy setting.
Describe ways AI and ML technology are being used to improve pharmacy benefit performance including increasing member engagement and identifying areas of fraud, waste, and abuse.