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Through Member collaboration, MCRA helps drive performance improvements, deliver exceptional service, transform care, and champion the health and wellbeing of the communities we collectively serve.

Ushur Launches Prebuilt Care Navigation Solutions for Maternal and New Baby Health Journeys and Chronic Condition Management

Read the press release published by MCRA Member, Ushur

Healthcare companies stand to benefit from the pre-built digital experiences to handhold new mothers through prenatal and postpartum care, as well as guide members through the management of their chronic conditions

Ushur, the leader in AI-powered Customer Experience Automation™ (CXA), today announced prebuilt AI-powered digital self-service solutions for health plans and third-party administrators (TPA) looking to improve member health outcomes by automating digital care navigation for two key member journeys:

  • Care Navigation for Maternal and New Baby Health: Helps guide expectant and new mothers through prenatal and postpartum care to improve health outcomes — for both the delivering parent and the child — by keeping members engaged and informed.

  • Care Navigation for Chronic Conditions: Enables health plans and third party administrators guide members with chronic conditions (such as diabetes and musculoskeletal conditions) to the appropriate resources to adopt behaviors that inspire better health outcomes and drive cost savings.

Today, health plans and TPAs face significant challenges in supporting members with complex care navigation needs within the current healthcare landscape, primarily due to the reactive nature of the system's overly stretched live resources (clinical and non-clinical). According to the CDC, 90% of the nation's $4.1 trillion annual healthcare expenditures is directed towards chronic and mental health conditions.

Ushur’s AI-first solutions focus on identifying and automating communications during critical points of care journeys via secure, interactive, and HIPAA-compliant digital experiences. The solutions are purpose-built to securely and compliantly inspire patient behavior change and prevent spiraling costs associated with disengaged patients during their care journeys.

“The U.S. healthcare system remains incredibly hard to navigate. Payers and members alike pay significantly higher costs when appropriate care and resources aren’t understood and utilized timely, especially in complex care situations” said Yvonne Daugherty, Global Head of Industries for Ushur. “The National Institute of Health (NIH) estimates that failures in care coordination account for nearly $80 billion in costs per year. Ushur launched these care navigation automation solutions to help drive dramatically better member experiences while delivering significant cost savings not only for the health payers but for the entire national healthcare system. Our vision is to continue to alleviate pressures on an overstretched national healthcare system while enabling payers and providers to deliver transformative experiences for their members, especially those in critical health situations.”

Ushur’s pre-built digital experience templates use state-of-the-art tasks and process automations, powered by purpose-built artificial intelligence, to engage with members to help them navigate their pregnancy or chronic condition journeys. These AI-powered automation solutions have been field tested by some of the largest health plans in the country. They are designed to help health plans and TPA’s improve engagement and streamline processes across:

  • Education: Proactively guide members and deliver resources throughout critical care journey touchpoints.

  • Outreach: Collect feedback and check-in regularly to assess progress for personalized care plans.

  • Coordination: Assist members with scheduling specialists and sourcing resources outside of their plan.

  • Management: Automatically process documents and upload data to core systems without any rip and replace.

Built for speed to value, enterprise-class security and operational efficiency, the Ushur CXA platform improves care management with two-way, digital-first engagements through HIPAA-secure and HITRUST-certified channels.


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