Health Highlight: Thu. 4, May.
Today’s Highlight(s): A peek into the role AI is assuming in shaping the future of the health insurance industry.
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THE BRIEF
Because it is Star Wars™ Day (May the 4th be with you), I decided to look to the future of healthcare and instead crash-landed on the topic of AI and health insurance.
In a two-minute video excerpt snipped from a lengthier @progressntwrk interview, TikTok creator Baratunde Thurston (@baratunde) recounts feeding ChatGPT his health insurance coverage policy in an attempt to level the playing field between himself, the consumer, and the insurance company.
“It was never meant for me to understand this document. These businesses, so many of them, they make money by making sure I don’t understand how to get what they’re actually offering me; and they hope I won’t figure it out.” 1
While the clip ends without revealing what the results were, it did prompt me to look deeper into how AI is starting to find a foothold in the health insurance industry.
Looking deeper
In a 2022 Forbes article, Albert Pomales, Co-Founder and CEO of KindHealth, an AI-powered navigator aimed at providing personalized insurance recommendations 2 3, discusses how insurance companies and providers are looking to AI to “potentially improve the accuracy of treatment protocols and health outcomes” 4 while helping to mitigate internal risk and costs.
Addressing complexities and reducing risk and cost while improving health outcomes seems like a win for everyone.
However, when looking at how these big insurance providers have been operating in recent years, those claims should be met with a healthy dose of skepticism.
In 2018,
a former public relations officer at Humana and Cigna, told Fierce Healthcare about his experience discussing the goals and targets for the firms he worked for long before AI became a feasible choice.“I can’t recall a single time in my career in the health insurance industry—in 20 years of investor relations meetings—where there was a conversation about how can we really benefit the end user of our products? It was all about enhancing shareholder value.” 5
So what is it going to be?
One thing we can count on is AI being a disruptor in the health insurance space. Whether it’s used as a tool to empower individual consumers or as a mechanism for better-assessing risk and lowering costs for operations, AI is going to change things.
More reading
3 Ways AI is Changing the Health Insurance Sector in 2023
Intelligent document processing with AWS AI services in the insurance industry: Part 1
Intelligent document processing with AWS AI and Analytics services in the insurance industry: Part 2
The Big Seven health insurers spent $26.2 billion buying back their own stocks in 2022 to enrich CEOs [and] shareholders.
Keywords 🏷️: HealthInsurance AI MachineLearning TheFutureOfHealtcare
NOTES
“This week on What Could Go Right? We sat down with @Baratunde Thurston to talk about whether AI is pulling us apart or bringing us together.” [Video]
“KindHealth Overview” https://pitchbook.com/profiles/company/223429–60#overview
“KindHealth Insurance Discovery Platform Helps Consumers Find Insurance That Provides Care and Financial Security” https://www.globenewswire.com/en/news-release/2022/04/28/2431202/0/en/KindHealth-Insurance-Discovery-Platform-Helps-Consumers-Find-Insurance-That-Provides-Care-and-Financial-Security.html
“Using AI And Machine Learning To Improve The Health Insurance Process” https://www.forbes.com/sites/forbesbusinesscouncil/2022/01/10/using-ai-and-machine-learning-to-improve-the-health-insurance-process/?sh=6ae17ef042b1
“UnitedHealth ramps up stock buybacks, hitting $3.2B in the first half of 2018” https://www.fiercehealthcare.com/payer/unitedhealth-buybacks-stock-finance-3–2-billion-earnings-shares-profits