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Money Matters: Reducing Insurance Claims with Artificial Intelligence

Rose Watson Dec 1, 2021 3:48:26 PM
A desk scattered with financial documents, a calculator, and invoices.

Managing a long-term care community comes with a host of challenges—from administrative and logistical details to the serious work of providing peak care around the clock. Along with those challenges, the financial health of a long-term care community often exists in tandem with the health of its residents—making the consequences of a fall, even a minor one, ripple through the whole organization.

Falls were one of the top resident-cited reasons for insurance claims in LTC communities1, and on average, organizations will pay $238,000 in insurance claims, per 100 beds, per year2. But what if an organization could eliminate those falls and put money back into their operation? VirtuSense Technologies™ offers that opportunity.  

Catching Falls Early

Prolonging healthy mobility and catching regression early are huge factors in reducing falls. VSTBalance™ provides a definitive Fall Risk percentage by using artificial intelligence (AI) and machine vision to objectively identify deficits in balance, gait, and function. VSTBalance collects data with speed and precision beyond what the human eye can register. Residents undergo a 2-minute evaluation, and results are available as soon as the test is complete. This data allows a clinician not only to personalize a resident’s treatment plan and show overall health trends with greater specificity, but the system also provides overarching data on community health. Long-term care communities have seen up to an 80% improvement in mobility when using VSTBalance—meaning residents are healthier, more independent, and much less at risk for a fall, especially one resulting in injury and a claim.  

Preventing Falls with Injury 

However, for residents that qualify as a high fall-risk, the VirtuSense ecosystem provides a more immediate layer of protection with VSTAlert™. The only fall prevention solution in the world that alerts caregivers up to 65 seconds before a fall occurs, VSTAlert demonstrates how AI can elevate floor management and staff coordination by facilitating preemptive responses. High fall-risk residents are the most likely to experience falls that result in injury and claims, but VSTAlert helps caregivers arrive just-in-time, every time.  

Friendship Village of South Hills (a Lifespace Community in Upper St. Clair, PA) instituted VSTAlert in just 18 of their highest fall-risk rooms in their skilled nursing unit. After using VSTAlert, Falls with Injury had been reduced by 96% for the entire unit of 89 rooms. In 2020, the unit experienced 55 Falls with Injury—in 2021, they've recorded only two, saving hundreds of thousands of dollars in insurance claims, emergency care, and liability. That is exactly how powerfully VirtuSence’s AI ecosystem can impact a long-term care community.  

“Partnering with VirtuSense has allowed us to make a profound impact on residents’ rehabilitation, safety, and treatment. It has been especially beneficial for many of our admissions who are coming to us under an orthopedic category of ‘fall with fracture’ and already a high risk of falls,” says Director of Nursing, Dawn Tatko. “Using VSTAlert is a relief to families, staff, and residents. Our results with VSTAlert speak for themselves, and we could not be happier with the outcomes and quality that working with VirtuSense has provided to our organization!” 

AI doesn’t just create better resident care and staff support; it reduces costly and unnecessary insurance claims that impact an organization’s financial health. VirtuSense’s ecosystem provides layered support and continuous data on reduced fall-risk, making it a valuable tool when engaging with insurance companies. Give yourself freedom to allocate your resources where they are needed most, while boosting staff support and resident care.  

Request a Demo of VSTBalance and VSTAlert today and innovate with VirtuSense Technologies.  



1 2020 Oliver Wyman and Marsh Professional and General Liability Benchmark for Long-Term Care Providers, Published February 2021, Countrywide Findings, page 15 

2 2020 Oliver Wyman and Marsh Professional and General Liability Benchmark for Long-Term Care Providers, Published February 2021, Countrywide Findings, page 7