News|Articles|January 15, 2025

MHE Publication

  • MHE January 2025
  • Volume 35
  • Issue 1

AI Soups up Payer Operations | Predictions for 2025

Author(s)Kim Perry

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.

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.

Articles in this issue

9 months ago

Many Believe RFK Jr.’s Views on Vaccination Are Dangerous and Other Findings | MHE State of the Industry Survey Results, Part 1

9 months ago

Lab Power | Predictions for 2025

9 months ago

Here we are Now, Enable us | Predictions for 2025

9 months ago

Advancing Care Coordination, Equity and AI Integration | Predictions for 2025

9 months ago

GLP-1s in a More Mode: More Indications, More Access | Predictions for 2025

9 months ago

Telehealth, the Fully Hybridized Version | Prediction for 2025

9 months ago

Cybersecurity on Health Plan Radar | Predictions for 2025

9 months ago

Simulacra of Data as an Answer | Predictions for 2025

9 months ago

Digital Lifeline | Predictions for 2025

9 months ago

Show us Your Prices | Predictions for 2025

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