Industry Trends
Of the three key drivers of increasing healthcare costs - and downward pressure on health plan profits - this one boils down to two simple letters
What are prescription drugs? (Rx)
AI can help transform this key internal function at health plans by personalizing communications
What is Member Services?
This health plan division is tasked with approving or denying coverage of a member’s healthcare services
What is Utilization Management? (Or U.M.)
This term refers to the Federal health coverage offered to people 65+ and those with disabilities
What is Medicare?
Of the four elements that are adding to the increasing complexity of health insurance in the U.S., this one is a longtime target of more conservative lawmakers.
What is government regulation?
This health plan team would most benefit from leveraging AI to identify members with specific health risks
What is Care Management?
This three-letter acronym represents the key measure of an insurance plan’s financial health
What is MLR? (Medical Loss Ratio)
This is the most profitable type of insurance for many payors in recent years, especially UHG
What is Medicare Advantage?