Artificial intelligence is quickly becoming part of everyday health care – and, increasingly, part of the employee benefits experience.
From helping employees choose health plans during open enrollment to supporting physicians during office visits, AI is changing how people interact with the health care system. While many of these technologies require significant upfront investment, they also have the potential to improve efficiency, personalize care and help manage long-term health care costs.
Here are several ways AI is reshaping employee benefits:
AI is changing how employees interact with their benefits
Health insurance companies and benefits administrators increasingly rely on AI chatbots to answer routine questions, provide claims updates and help employees navigate their benefits. Because these tools can respond immediately, they often reduce wait times while allowing customer service representatives to focus on more complex issues.
AI also is making open enrollment more personalized. Benefits platforms use employee data – such as family size, prior benefit elections and anticipated health care needs – to recommend health plans that may be the best fit for an individual’s situation, helping employees make more informed enrollment decisions.
Beyond enrollment, AI is beginning to support personalized wellbeing recommendations and help employees locate in-network providers, schedule appointments and generally navigate the health care system more efficiently.
AI is improving understanding of risk
Behind the scenes, AI is changing how health insurers analyze data.
Increasingly, insurers use AI to identify trends in health care utilization, assist with claims activity, review prior authorization requests, and support underwriting decisions for employer-sponsored health plans. These insights can help carriers better understand emerging risks and may eventually support more personalized plan designs.
On the employer side, AI plays a growing role in helping employers analyze benefits data, identify workforce health trends and develop future benefits strategies.
AI could help lower health care costs over time
While artificial intelligence has the potential to improve efficiency and reduce health care spending, those savings are not expected to happen immediately.
Today, many health systems are investing heavily in AI technology, data infrastructure and new care models, and those investments initially can contribute to higher health care costs.
One increasingly common example is the use of AI-powered medical scribes that take notes during patient appointments. By reducing administrative work, these tools allow physicians to spend less time documenting visits and more time focused on patients.
Over time, these technologies could help moderate health care spending. AI-assisted diagnostics may allow serious medical conditions to be identified earlier, when treatment is usually less complicated and less expensive. AI also can help providers develop more targeted treatment plans based on a patient’s specific condition rather than relying on broader, trial-and-error approaches.
AI makes planning ahead important
AI is making it easier to market health insurance coverage – which has underscored the importance of planning for open enrollment months in advance.
Because the marketing submission process has become less time-consuming, insurance carriers often are receiving more groups to quote, increasing underwriting workloads and, in some cases, extending response times. Beginning the renewal and open enrollment process well in advance gives carriers adequate time to evaluate each opportunity and allows employers more time to compare options and develop a thoughtful benefits strategy.
AI is expected to continue transforming nearly every aspect of health care and employee benefits in the years ahead. While long-term impacts are still emerging, employers should expect AI to play an increasingly important role in how employees access care, select benefits and engage with their health plans.
Schauer Group’s Employee Benefits team continues to monitor emerging technologies and marketplace trends to help employers navigate an increasingly complex benefits landscape. If you’d like to discuss how these changes may affect your organization’s benefits strategy, please reach out to your Schauer Group benefits advisor.
About Schauer Group
Schauer Group is an independent risk management and insurance advisory firm dedicated to helping people, companies and communities thrive. The firm’s team of insurance professionals works with clients across the country and across a variety of industries, offering expert risk management consulting and customized commercial insurance, employee benefits, personal risk and corporate surety solutions. With offices throughout Northeast Ohio, Schauer Group is committed to attracting and developing the region’s top talent and investing in the communities where associates live and work.
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Sources
- AI in Benefits | Segal
- Technology-Enabled Care and Artificial Intelligence | Centers for Medicare & Medicaid Services
- Toward Responsible AI in Health Insurance Decision-Making | Stanford University
- Health Insurance Artificial Intelligence/Machine Learning Survey Results | National Association of Insurance Commissioners
- Artificial intelligence applications in health insurances: a scoping review | National Library of Medicine
- Unlocking the power of benefits data and AI | Mercer
