2019: the year AI breaks down barriers to the health benefits market

New AI tools, say experts, can help consumers understand and shop for the plans and benefits they need, when they need them.

While healthcare providers are understandably focused on determining how best to incorporate artificial intelligence into their hospitals and practices, AI is expected to impact the other side of the provider/patient equation, as well.

In a recent commentary, Steve Auerbach, CEO of Alegeus, a healthcare consumer solutions provider, suggested “AI will guide employees to make smart healthcare decisions and give them the tools necessary to shop for the best price. But, the benefits of AI won’t be limited to the worker – every stakeholder in the health benefits market will capitalize on its value.”

In Auerbach’s view, there are four common use cases where AI can immediately impact the benefits lifecycle as we know it today.

For starters, AI can facilitate better consumer health plan choices “by guiding employees to select the right combination of plan and accounts, educating them on the value and helping them to determine their personalized contribution strategy – all in an automated way that is also cost-effective for the employer and the benefits administrator.”

Similarly, employees can “use AI to open their benefits’ app to find a provider, price and quality-of-care combination that meets their immediate healthcare needs. Imagine the day, which is not too far away, where workers use their smartphone to find the closest retail pharmacy that offers a free strep test while the urgent care three miles away charges $75.”

Moreover, Auerbach thinks AI will help employees save more effectively for their healthcare expenses by tracking and analyzing “consumer healthcare spending to provide personalized recommendations that maximize every dollar while preparing the workers to better save for the future.

Finally, he says, AI will help consumers better manage the myriad strategies available to manage and prevent the onset of chronic disease.  Using AI tools, “employers will be able to set, track, and personalize goals around diet, exercise, and even sleep – often using benefit account contributions as a financial reward” to incentivize healthy behavior and, ideally, reduce overall costs.

“The market is ripe for disruption,” Auerbach believes, and “as financial responsibility for healthcare continues to grow, employees will no longer tolerate poor experiences that are overly complicated and offer limited guidance and support. . . . While some employees have the benefit of an adviser to help make these decisions, in today’s digital world, this is an expensive and slow business model.”

Tapping AI, however, “a consolidated healthcare market will leverage technology to support the entire benefits lifecycle and deliver the same experience that employees have come to expect in their everyday lives.”