4
min read
October 30, 2024

AI in Healthcare: Why Clients Will Drop You Without AI | Medefy

Anaye Milligan

Don’t risk losing clients. Discover how AI improves benefits guidance, reduces costs, and boosts satisfaction for better results.

Key takeaway

Embracing AI is vital for staying competitive in today’s market. When you begin to view AI as a necessity for clients, rather than some take-it-or-leave-it add on, you will open your clients up to a crucial asset. Moreover, your knowledge and endorsement of AI will render you as someone who keeps up with trends, has their eyes fixed on what’s ahead, and values efficiency and precision.

AI is especially critical when it comes to benefits guidance—a field in which benefits experts guide health plan members towards smarter care decisions. As health plans have become more robust and complex, benefits guidance is no longer as simple as it once was. Now, benefits guides are forced to steer members through increasingly complex mazes of health plan options. Even the best guides are struggling to break through this complexity and process the exhaustive data and information. Thus, they must turn to the bots.

Benefits guidance, sans AI, is simply no longer efficient. Benefits experts must now lean on AI to master every detail of a member’s plan and empower guides to lead members to the best, most cost-effective care decisions for them. This heightened level of guidance not only improves health outcomes among members but saves clients exorbitant costs.

Resisting AI, on the other hand, will have some immediate, dire consequences for you and your clients.  Your clients’ bottom line will quickly plummet. They will think of you as dated and out of touch. They’ll move onto younger, edgier, AI-happy consultants. You’ll wake up adrift in regret, wishing you hadn’t given into your tendency to cling to old comforts.

Still feeling AI-averse? Let’s delve deeper into what an AI-free future might mean for you and your client:

1. Inefficiencies in Benefits Utilization

The Kaiser Family Foundation reports that the average health plan document stretches over 200 pages. Even with the guidance of care experts, members often struggle to fully grasp their benefits, leading to underuse or misuse of services. After processing and organizing the member’s plan, AI will simplify the complexity for benefits guides, empowering them to provide almost instant, personalized steerage to the lowest-cost, highest-quality providers available to the member. They can analyze provider performance data, patient reviews, and other metrics to drive smarter decisions that save members–and your clients–money.  Not leveraging AI, on the other hand, can lead to poor utilization of benefits, increasing client spend. The client will then blame you for selling them a bad plan or failing to strategize how to get members to use their plan.

2. Inadequate Access to High-Quality Care

When it comes to more serious or rarer health concerns, finding top-tier care is key. With the support of AI, benefits guides can quickly steer members to the highest-quality, board-certified, licensed specialists available to them; these providers are more likely to offer earlier and sustained relief, reducing the costs of long-term care. Without AI, benefits guidance is less precise and personalized. The providers might not have the specialized training needed to develop a more nuanced and in-depth treatment plan, leading to quick fixes, rather than lasting gains. Minor preventable issues might worsen into more serious and expensive conditions, increasing the client’s overall health spend.

3. Missed Opportunities for Preventative Care

To stay healthy, members need to get ahead of their health. By analyzing the historical utilization, demographics, and claims data of plan members, AI can identify common health patterns, predicting issues before they arise. This information helps benefits guides recommend preventative measures such as screenings. It sets members on a path of consistent, preventative care, covered by their plan. Without the integration of AI into their guidance, your clients’ members miss out on key interventions, leading to higher incidences of preventable and costly conditions.

4. Lower Member Satisfaction and Retention

Keeping clients happy is often the guiding aim of your work. But at times, the task can feel elusive, which is where AI comes in. AI-enhanced guidance will enable care guides to provide personalized, immediate benefits support, enhancing the member experience. By analyzing plan member data, AI helps the guides more precisely answer queries, provide recommendations, and even schedule appointments, all while tailoring responses to members’ specific plans and needs.  Without AI, members are likely to encounter frustrating delays and less personalized responses, leading to higher costs and lower satisfaction. Worst case scenario: your client might even move onto a more advanced, member-centric solution.

How We Can Help

Embracing AI might feel like you’re stuck in some surrealist horror film where the machines win. But getting past this initial reluctance is vital to facing the shifting winds of the market. Resisting AI could expose your clients to escalating costs, inefficient systems, and lower quality care. Put simply: your AI anxiety could put your clients, and yourself, at significant risk.

Instead, you can choose to move with the tide of progress and think of AI as an asset rather than a threat. AI works by mastering every detail of members’ plans and then using those insights to empower benefits guides to steer members towards the best care. Embracing AI-supported guidance will create a happier, more productive work environment for your clients, not to mention a steep, steady climb in their ROI.

Sound enticing? Contact us today to learn how our AI-enhanced benefits guidance can bring your clients powerful, quantifiable results.