How AI Might Affect Healthcare Benefits

Artificial intelligence (AI) is infiltrating many areas of our daily lives. For instance, every time you say “Siri” or “Alexa, can you…” you are using AI technology. The goals for AI were to enhance learning, boost speed, precision and effectiveness of tasks that were otherwise done manually.

The impact of AI on employee benefits, health care and insurance industries is going to be significant. It’s not a matter of whether these sectors will be affected, but rather how soon and by how much.
 
For the employee benefits industry, AI is expected to transform the way claims are analyzed, fraud is detected, customer interactions take place and diagnoses are made, among other things. It is intended to lighten the administrative burden by streamlining back-office processes in addition to being a valuable asset to marketing departments.
 
It is anticipated that those who embrace these changes will enjoy a distinct competitive advantage. While AI is not designed to replace key players in the benefits industry, it is anticipated that those who fail to leverage its power will fall drastically behind their competitors.
 
Here are some possible ways brokers can use AI in the employee benefits industry:

• Brokers could use AI driven tools to craft highly personalized benefit packages, tailored to suit the unique preferences and needs of each employee. This level of customization will enable brokers to provide superior service and offer a wider array of services.
• Assisting consumers with price comparisons along with information about providers and health systems.
• Educate consumers regarding their benefit plan-offering explanations and examples on topics like deductibles, coinsurance and in- and out-of-network benefits.
• Risk managers could use AI as a valuable tool for estimating costs and outcomes for specific diseases to model risk and probability scenarios.

 
These are exciting times, and no one is sure how far artificial intelligence will go. It’s safe to assume that AI could eliminate some jobs, make some jobs easier and create new jobs.

There are a couple of things AI cannot do like listen to an exasperated member and help them find answers or express empathy and it can’t deal with complex issues with many moving parts. That is where the human touch is still required.  

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Allied National

Founded in 1970, Allied is one of the nation's oldest and most experienced third-party administrators. As the small group benefit experts, Allied works with small business employers to provide unique and affordable group health benefits.