Highmark Leverages Laguna Health's AI to Improve Care Manager Efficiency and Patient Outcomes

Highmark is partnering with Laguna Health, a conversational AI company, to reduce the administrative workload on care managers. Highmark, an independent Blue Cross Blue Shield licensee based in Pittsburgh, serves around 7 million members across Pennsylvania, Delaware, New York, and West Virginia, providing various health plans. Laguna Health offers AI-powered tools to help care managers identify patient risk factors.

The partnership will integrate Laguna's conversational AI technology into Highmark's platform. This technology will transcribe care managers' conversations with patients, summarize the issues discussed, and suggest actionable steps. It will also offer tips to improve patient communication and includes a supervisor dashboard for tracking care manager performance.

Laguna CEO Yoni Shtein highlighted the high cognitive load care managers face due to multiple systems and screens, which the AI technology aims to alleviate. Highmark's VP of clinical engagement, Benjamin Edelshain, noted that the partnership reduces care manager burnout, enhances the member experience, and facilitates proving patient outcomes. Edelshain described the collaboration as a clear benefit for both customer value and business efficiency.

Highmark will pay Laguna through a monthly subscription under a software-as-a-service model. Shtein pointed out that while many conversational AI companies focus on providers, Laguna addresses needs on the payer side. Currently, Laguna's technology is being used solely on Highmark's insurer side, despite Highmark's affiliation with the Allegheny Health Network.

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