AI Predictive Analytics Improve Health Underwriting by 29%
A new white paper from Merit Medicine demonstrates that its AI-powered predictive analytics improved medical loss ratios in group health underwriting by 29% in pilot studies. The company's AI risk stratification tools are being used to enhance the accuracy of assessing health insurance risk. The results showcase a practical application of AI in the financial and administrative side of healthcare.
- The Medical Loss Ratio (MLR) represents the percentage of premium revenue that a health insurance company uses to pay for medical claims and activities to improve healthcare quality. Under the Affordable Care Act, insurers must spend at least 80-85% of premium dollars on care, depending on the plan type, or issue rebates to their customers. - The analysis in the white paper, which was validated by independent actuarial firm Axene Health Partners, retrospectively examined 19 employer groups that included 16,82
