The AI Book

CHAPTER 21Moving the AI Needle: Strategies for Health Insurers to Put AI into Practice

By Hendrik Abel¹

¹Consultant, Roland Berger

and Dr Ulrich Kleipaβ¹

²Partner, Roland Berger

What’s the Problem with AI in Health Insurance?

The healthcare sector is one of the biggest digital data providers, accounting for one third of global digital data volumes. Insurers in particular have acquired unique and elaborate customer data sets. Leveraging this data through the use of AI applications can enable new ways of generating profound impacts on both customer experience and provider efficiency. Data-based forecasts allow, for example, for the better identification of individual risk profiles and customer inclusion in special preventive check-ups and suitable care programs.

However, insurers struggle to adequately develop use cases and use their data. Decentralized data management, paper-based patient data, legacy IT systems and stringent regulatory boundaries make it hard to apply modern data analytics solutions. At the same time, big digital incumbents such as Apple and Samsung have recognized the power of AI in digital health, and smaller startups are entering this space with disruptive use cases, for example Berlin-based ADA Health and their symptom checker apps. This chapter aims to identify relevant AI use cases that really move the needle for health insurers and give an overview on key strategic imperatives to derive an AI strategy that can best utilize their untapped data treasures. ...