How can health insurers benefit from genAI?

How can health insurers benefit from genAI? | Insurance Business Canada

Life & Health

How can health insurers benefit from genAI?

New report looks at key considerations

Life & Health

By
Terry Gangcuangco

A new Forrester report, led by senior analyst Shannon Germain Farraher (pictured), stresses the need for health insurers to adopt generative artificial intelligence (genAI) and invest in change management strategies to unlock the technology’s full potential.

According to Farraher, health insurance companies are increasingly experimenting with genAI in hopes of streamlining back-office operations and improving both employee and member experiences. However, this transformation is being hindered by outdated IT infrastructure.

To truly capitalize on the potential of genAI, health insurers must not only modernize their technical systems but also build internal capabilities for change management. Farraher’s report, “Generative AI: What It Means for Health Insurers,” highlights how GenAI could reshape the industry and offers guidance on adoption strategies, as well as risk mitigation.

Among the highlighted early benefits of genAI applications include improved care coordination by digitizing the intake process and automating clinical reviews for prior authorizations; contextual insights, helping insurers gain a deeper understanding of how members perceive their products and services; knowledge management, with tools enabling customer service agents to resolve issues more efficiently; and enhanced experience across the member lifecycle.

Despite the rapid evolution of genAI, Farraher advises healthcare leaders to align on organizational values and goals before diving in. She suggests that senior leadership decide whether to transform their operations comprehensively or begin with smaller pilot programs to enhance specific functions.

Forrester will continue to explore the role of genAI in healthcare, focusing not only on the core issues but also on the technology’s security implications and impact on employees. Interested participants can reach out via [email protected].

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