McKinsey June 5, 2024
AI and automation could lower administrative and medical costs and increase revenue. But payers have yet to mobilize to transform their organizations to capture this opportunity.
Payers currently face economic pressures that are likely to last a few years. Utilization of medical services has been higher than expected, providers are passing along higher costs through rate negotiations, and Medicare Advantage reimbursement rates are facing the most substantial downward pressure that payers have seen in years. In the face of these issues, artificial intelligence and automation present untapped opportunity for payers.
The opportunity is sizable and available now
The opportunity to improve affordability, quality, and patient experience is substantial. To better understand the economic opportunity, we analyzed each function or process...
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