The transformative role of AI in health and benefits
As employers seek innovative solutions to mitigate rising costs, enhance employee well-being and streamline operations, generative AI is emerging as a powerful tool. There’s a lot to be excited about as we think about applying artificial intelligence and GenAI in the health and benefits realm.
Before we go further, it’s important to understand that AI has been around for decades. It’s the recent focus on GenAI that has captured our imaginations and generated a lot of attention – including some concerns. Traditional AI uses algorithms — sets of rules or instructions — to analyze data and make predictions or decisions based on that data. It is structured, rule-based, constrained and supervised. GenAI, on the other hand, uses large data sets, such as large language models, to create new content similar in style or content to the original materials. It’s a totally different technology than the rules-based algorithm, but it’s all AI.
Several benefit applications of GenAI are already in the market:
- AI agents for benefits navigation and customer service. Chatbots powered by GenAI can reduce or even eliminate the need for tier-1 human customer service agents by accurately responding to inquiries and providing assistance such as sending forms that the customer needs to complete
- Personalized health management. By analyzing data from wearable devices, health records, and employee surveys, AI can generate tailored health recommendations. Companies are leveraging AI to create personalized wellness programs that adapt to employees' unique health profiles, encouraging healthier lifestyles and reducing costs.
- Internal efficiency for HR and benefit teams. HR professionals can use AI with existing foundational large language models to extract and transform data, compare and identify language in communications and policy documents, and generate new copy for HR communications.
Looking ahead, GenAI will play a crucial role in the pharmacy and behavioral health spaces – both areas that employers are closely watching due to growing costs. Could AI replace your pharmacist or therapist ? While that may seem far-fetched, the disruptive force of AI could rearrange healthcare landscape as it exists today.
As interesting as it is to ponder the disruptive potential, employer plan sponsors have a responsibility to think about the risks associated with this technology. Given the many uncertainties that surround AI, employers should work with their vendor and plan partners to establish guardrails to promote responsible usage, beginning with careful selection and monitoring of AI service providers. Additionally, they should work with legal resources to review any internal AI applications used within their health plans to ensure compliance with existing legal requirements and stay vigilant for emerging legislation and regulations that may necessitate plan adjustments.
As more organizations explore ways to incorporate this technology into their benefit operations, there will be more questions than answers – for a while, anyway. But it’s clear that from personalized health management and behavioral healthcare to streamlined claims administration and robot-powered prescriptions, the potential applications of AI in healthcare are innumerable.
This post is one in a series of resolutions to guide benefit strategy. If you found this article helpful, check out these posts:
