AI is earning its keep in parts of behavioral health operations. For the care managers and social workers who meet with patients every month, it isn’t there yet, according to Corey Cronrath, DO, chief medical officer and chief technology officer of Nashville, Tenn.-based Mental Health Cooperative.
MHC is an integrated healthcare organization with 12 locations across the state that serves individuals with severe mental illness. Over the last couple of years, it has put AI to work in its contact center, its revenue cycle and its prescribers’ visits. The harder task now, Dr. Cronrath told Becker’s, is building tools that can keep up with the collaborative care planning that drives MHC’s model.
MHC leans on AI most at two points: its contact center, where patients first come through the door, and its revenue cycle. The second use is less about billing than it sounds. Because MHC is paid largely on a per-member, per-month basis, its claims function as a reporting channel to payers.
“We’re not actually making charges to [payers]. We’re doing penny claims because anytime we see [patients] to we make sure they are medication adherent or they’re on their blood pressure meds, we have to tell the payers,” Dr. Cronrath said. “The only way to talk to the payers is to send claims to the exchange through the 835s, 837s back and forth.”
AI makes sure those penny claims carry the right codes so payers can see what MHC is doing to support the population, he said, and the organization plans to extend it across more of its operations over time.
Ambient listening has delivered MHC’s clearest win so far, and it has landed with prescribers — the physicians and advanced practice nurses who use the tools to document visits.
“Our providers are also using ambient listening in order to make sure we get our notes correct, and so that we’re passing information back and forth in an easy, readable manner,” Dr. Cronrath said. “And we’re spending more time with our patients eye to eye versus talking to them but looking at a computer.”
The tools stall with the staff who sit at the center of MHC’s model. Care managers and social workers meet with patients monthly and build care plans with them, not for them — a back-and-forth that today’s tools don’t capture well.
“A care plan is collaborative. It’s the social worker working with the patient in order to develop the plan and what the care is and how that care is going to be followed or implemented,” Dr. Cronrath said. “Right now, the large language models and the ambient aren’t quite working for that population, so that’s what needs to be developed.”
MHC is trying to work with vendors to develop tools for that workforce, he said.
If the technology catches up, the payoff would reach the clinicians whose relationships hold the model together.
“That will then get our care managers and our social workers, who are interacting with our patients on a monthly basis, the ability to be face to face, eyeball to eyeball, instead of looking at a computer,” Dr. Cronrath said. “That’s where we hope to see ambient get much better.”
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