AI Soups up Payer Operations | Predictions for 2025

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MHE PublicationMHE January 2025
Volume 35
Issue 1

Kim Perry, chief growth officer of Emtelligent, shares her prediction for 2025.

In 2025, AI [artificial intelligence] will play a larger role in driving payer operational improvements and offer health insurers a more comprehensive view of member health.

Perry

Perry

Leveraging medically aligned AI to extract essential insights from vast, diverse patient records will allow for more streamlined prior authorizations, optimized risk adjustment and enhanced underwriting accuracy.

AI will also be seamlessly integrated with clinical programs to proactively identify care gaps and tailor member programs to improve clinical outcomes.

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