McKinsey & Company<\/span><\/a><\/p>\r\n\r\n\r\n\r\nPayers also need to know that the<\/span> AI trends in health insurance<\/b> can improve overall primary care and provide great opportunities in all-payer domains. Some of the powerful and stand-out domains that can outperform <\/span>AI-driven healthcare solutions<\/b> include claims, network and contracting, utilization management, care management, and information technology.<\/span><\/p>\r\n\r\n\r\n\r\nIn short, to capture the full value of the <\/span>AI opportunities<\/b>, healthcare payers must reimagine the end-to-end processes of each domain. The experience of companies in other industries that are further along the journey shows there is a competitive advantage for those who can harness <\/span>AI Integration in payer systems.<\/b><\/b><\/p>\r\n\r\n\r\n\r\n\r\n- \r\n
Seizing the Opportunity Demands Core Rewiring<\/b><\/h2>\r\n<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n
The second <\/span>McKinsey insights on AI<\/b> found that capturing impact is about much more than just the technology. In <\/span>\u201cRewired: The McKinsey Guide to Outcompeting in the Age of Digital and AI (Wiley, 2023),\u201d<\/span><\/i> the authors outline the six areas that matter the most for companies across industries while integrating <\/span>payers and AI implementation<\/b>. These six areas include – a business-led digital road map, talent, operating model, technology, data, and adoption and scaling.<\/span><\/p>\r\n\r\n\r\n\r\nThe <\/span>McKinsey insights on AI<\/b> further stated that the companies that successfully execute <\/span>AI trends in health insurance<\/b> pursue all six areas. After all, the <\/span>future of AI in health insurance<\/b> is more than just building an operating model or investing in the tech infrastructure. Getting the job done requires a focus on the change management challenges that arise due to the <\/span>AI adoption by payers<\/b>, and it’s a job for the CEO and the entire C-suite, not just the CIO or CDO.<\/span><\/p>\r\n\r\n\r\n\r\nWhat Does McKinsey Insights on AI Mean For The Payers?<\/b><\/h1>\r\n\r\n\r\n\r\n
If the payer CEO doesn’t want to <\/span>miss AI opportunities in healthcare<\/b>, they must quickly create <\/span>AI-driven healthcare solutions<\/b>. The size of the opportunity suggests that those who choose to wait will need to have a ready response plan if competitors move ahead successfully. For example, followers could find themselves in a position where industry leaders have 10 percent lower medical costs or 20 percent lower administrative costs, a daunting prospect. So the ability to be a fast follower will be critical.<\/span><\/p>\r\n\r\n\r\n\r\nIn general, most payers are ill-equipped to pursue this opportunity while <\/span>enhancing payer efficiency with AI<\/b>. To do so, they have to close the gap that exists between their current capabilities and those needed to fully address the six areas outlined above.<\/span><\/p>\r\n\r\n\r\n\r\nKey Questions for Payer CEOs to Assess AI Integration in Payer Systems<\/b><\/h1>\r\n\r\n\r\n\r\n
Payer CEOs could begin assessing their respective situations by answering these questions:<\/span><\/p>\r\n\r\n\r\n\r\n\r\n- How would we respond to a competitor with 20 percent lower administrative costs or one with 10 percent lower medical costs with the <\/span>AI integration in payer systems<\/b>?<\/span><\/li>\r\n\r\n\r\n\r\n
- Where are the biggest pockets of value for our business? Would that be a domain? A business unit? A function?<\/span><\/li>\r\n\r\n\r\n\r\n
- Even if we\u2019re not ready to embrace the <\/span>future of AI in health insurance<\/b> today, can we \u201crewire\u201d a portion of the business so that we know what to do if and when we need to move ahead?\u00a0<\/span><\/li>\r\n\r\n\r\n\r\n
- Do we have access to the talent steeped in the <\/span>payers and AI implementation<\/b>? Does this tech talent understand how our business works?<\/span><\/li>\r\n\r\n\r\n\r\n
- Do our leaders and managers understand how these <\/span>AI trends in health insurance<\/b> work, at least enough to identify opportunities and work collaboratively with our technologists?<\/span><\/li>\r\n\r\n\r\n\r\n
- Do we have the underlying technology infrastructure to allow modeling and innovation thereby <\/span>enhancing payer efficiency with AI<\/b>?<\/span><\/li>\r\n<\/ol>\r\n\r\n\r\n\r\n
Conclusion<\/b><\/h1>\r\n\r\n\r\n\r\n
In essence, capturing the <\/span>AI opportunities<\/b> through <\/span>AI integration in payer systems<\/b> is big leadership for CEOs and their top teams shortly. For successful <\/span>payers and AI implementation<\/b>, CEOs will need to establish a governance and risk framework and mobilize the full organization to pursue the six areas discussed above. They can\u2019t do this overnight, but the combination of opportunity size and the mounting pressure on the industry means it\u2019s time to start asking themselves these tough questions.<\/span><\/p>\r\n\r\n\r\n\r\nLooking for a reliable platform that can provide <\/span>medical updates <\/b>in the <\/span>healthcare sector<\/b>? Discover the latest <\/span>payers’ news updates<\/b><\/a> with a single click. Follow DistilINFO HealthPlan and stay ahead with the timely payer’s news updates. Join our community today!<\/span><\/p>\r\n\r\n\r\n\r\nFAQs<\/b><\/b><\/h1>\r\n\r\n\r\n\r\n
1. What are some key opportunities for payers to integrate AI trends in health insurance?<\/b><\/p>\r\n\r\n\r\n\r\n
Ans.<\/b> Some key opportunities include significant savings in administrative and medical costs, as well as potential revenue increases ranging from 3% to 12%.<\/span><\/p>\r\n\r\n\r\n\r\n2. How can payers prevent missed AI opportunities in healthcare?<\/b><\/p>\r\n\r\n\r\n\r\n
Ans:<\/b> Payers must quickly embrace AI-driven healthcare solutions to avoid being left behind. This involves creating strategic plans and ensuring readiness to respond to competitors with lower costs or higher efficiencies.<\/span><\/p>\r\n\r\n\r\n\r\n3. What steps can payer CEOs take to capture AI opportunities in healthcare?<\/b><\/p>\r\n\r\n\r\n\r\n
Ans.<\/b> Payer CEOs should establish governance frameworks, mobilize their organizations to pursue AI integration, and begin asking tough questions to prepare for the future of AI in health insurance.<\/span><\/b><\/p>\r\n\r\n\r\n\r\n4. What are the key considerations for successful AI integration in payer systems?<\/b><\/p>\r\n\r\n\r\n\r\n
Ans. <\/b>Successful AI integration in payer systems requires understanding the economic opportunities, assessing readiness, accessing AI talent, and reimagining processes in key domains such as claims, network and contracting, utilization management, care management, and information technology.<\/span><\/p>\r\n","protected":false},"excerpt":{"rendered":"Preventing Missed AI Opportunities in Healthcare Payers: Key Findings from the McKinsey AI Report Before you get into deeper about… Continue Reading <\/i><\/a><\/p>\n","protected":false},"author":1,"featured_media":12021,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[373,284],"_links":{"self":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12012"}],"collection":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/comments?post=12012"}],"version-history":[{"count":4,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12012\/revisions"}],"predecessor-version":[{"id":12018,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/12012\/revisions\/12018"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media\/12021"}],"wp:attachment":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media?parent=12012"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/categories?post=12012"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/tags?post=12012"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}