Head-to-head comparison
new century health (now evolent) vs optum
optum leads by 30 points on AI adoption score.
new century health (now evolent)
Stage: Nascent
Key opportunity: Deploy predictive AI models to identify rising-risk patients earlier in their care journey, enabling proactive interventions that reduce hospitalizations and improve value-based contract performance.
Top use cases
- Predictive Risk Stratification — Use machine learning on claims and clinical data to predict which patients are at highest risk for costly events, enabli…
- Automated Prior Authorization — Deploy NLP and rules engines to auto-adjudicate prior auth requests, reducing manual review time and accelerating care a…
- Clinical Documentation Improvement — Apply generative AI to suggest more specific diagnosis codes and capture missed HCCs during encounters, improving risk a…
optum
Stage: Advanced
Key opportunity: Leverage AI to automate prior authorization and claims adjudication, reducing administrative costs and improving provider experience.
Top use cases
- Automated Prior Authorization — Deploy NLP and machine learning to instantly approve routine prior authorization requests, reducing manual review time f…
- AI-Powered Claims Adjudication — Use deep learning to auto-adjudicate high-volume, low-complexity claims, cutting processing costs by 30-40% and accelera…
- Predictive Health Risk Scoring — Analyze longitudinal patient data to predict disease onset and guide proactive interventions, improving outcomes in valu…
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