Predict Risk with Greater Confidence with Gradient AI’s Renewal Analytics Solution for Group Health
Manage Your Existing Group Health Business More Accurately
In today’s unpredictable market, the health insurance industry faces an increasing number of challenges, including the rising cost of expensive treatments, evolving consumer expectations, changing demographics, regulatory uncertainty, technology disruption, and increasing market competition.
Managing and accurately pricing risk has become even more important than ever, and the ability to predict rather than react is essential to stay ahead of the competition.
“Our customers have found great success in leveraging our SAIL™ product to help underwrite new business,” says Gradient AI’s Director of Solution Consulting, Jason Oswald. “And it became increasingly evident that the same algorithms could be leveraged for a customer’s existing business utilizing a client’s own claims data.”
Cutting-Edge AI and Machine Learning Algorithms
Gradient AI’s Renewal Analytics solution leverages AI and machine learning algorithms to help manage your existing business. By extracting previously hidden insights from health claims records belonging to your existing groups, our Renewal Analytics (RA) solution enables you to get a more in-depth understanding of your current and prospective group and member-level risk profiles in order to price more accurately for the future, manage current costs, and get ahead of emerging trends.
What are Renewal Analytics?
The ability to track performance across your entire book of business and monitor current and future exposure is critical, particularly as your population can change due to new members, mergers, and acquisitions.
You can now manage and project risk more accurately by utilizing three key components of Renewal Analytics Solution:
1. Renewal Predictive Al Model delivers risk predictions valuable for renewal underwriting or repricing a block of business, early identification of developing trends, and the implementation of risk management and cost containment strategies. The Renewal model utilizes your own historical medical and pharmacy claims data to develop a risk expectation for the upcoming 12 months.
2. Analytics and Reporting Dashboards produce summary and detailed views of group claims, enrollment trends, and performance metrics across factors such as industry, geography, group size, and demographics. Quickly discern underlying cost drivers for groups, members, and high-cost claimants, along with other predictive insights.
3. Rebanding Calculator provides recommendations for group-assigned risk bands, based on client- specific inputs, model predictions, and customer-defined scenarios and business rules at the time of renewal.
“Renewal Analytics provides deeper insights into our customers’ existing book of business, allowing them to project risk with much greater accuracy,” says Vice President of Group Health, Chase Pettus. “This tool provides clients with the flexibility to view performance metrics across the entire book or drill down to the group or member level to optimize plan performance.”
Gradient AI’s Renewal Analytics Solution is Easy to Use and to Access
In-house analytics can be time-consuming and expensive, often limited to select inquiries defined by just a few individuals within an organization, and results can often be skewed if data was not standardized or mapped correctly.
With our Renewal Analytics solution, you can access your data with a click of a button, extract the information you seek, and in the desired format you wish. It allows you to track performance utilizing key metrics across your entire book of business.
What’s Next for Gradient AI’s Renewal Analytics Solution?
RA is evolving into a dynamic reporting and analytics suite allowing clients to:
- identify opportunities for intervention, cost savings, and cost benchmarking
- project group turnover under specific conditions
- automate pricing and payments
- understand and predict treatment pathways at a deeper member level
As this product continues to grow and scale with the creation and expansion of models and new data sources, added features, new reporting capabilities, and more intuitive designs, customers using it will benefit without any additional effort.
Gradient AI’s Lead Product Manager Jennifer Pigott, says, “We are currently only scratching the surface when it comes to Renewal or more broadly, Claims Analytics. Gradient AI will continue to engage our customers and assess the market to target product investments that will bring the most value.”