Health insurers are under enormous economic pressure as ultra-expensive specialty medications become widely used for chronic conditions. These drugs already account for more than half of overall pharmaceutical spending, and the upward trend is likely to continue as the FDA approves new drugs in the category. Exorbitant costs have already forced some insurers to drop certain specialty drugs from their formularies.
An effective new approach to underwriting can refine how health insurers assess and manage risk for costly chronic conditions in their patient pools. Modern strategies that incorporate alternative health data can help optimize pricing and improve loss ratios, while improving health outcomes. AI-driven predictive analytics can layer nontraditional data, like social determinants of health (SDOH), on top of traditional risk assessments to provide more in depth assessments.
To learn how SDOH can help health underwriters understand and manage risks for diabetes, cardiovascular disease and other chronic illnesses, download this timely ebook.