Poor data access, fears around job displacement, and lack of trust in AI is holding back the US health insurance market
The healthcare insurance sector in the US is struggling to make critical decisions due to a severe lack of accessibility, context and trust in their data. That is according to a new international study by ActiveOps, a leading provider of AI-powered decision intelligence for service operations.
According to the Censuswide survey, which gathered insights from 200 Chief Operating Officers, Chief Financial Officers, and Senior Heads of Operations within the US health insurance sector, 90% claim that it takes “significant effort” to get any meaningful insights from their data. More than a third (36%) are forced to base business-critical decisions on data that is almost a week old, and 42% say they simply cannot access the data they need to make informed decisions. This lack of relevant, real-time data is holding healthcare organizations in the US back, leading to a form of decision blindness and stifling their efforts to streamline operations and unlock hidden productivity gains.
These findings are revealed in a report titled Transforming Healthcare Ops With AI, which lays out the current challenges and benefits of AI and real-time data within the US healthcare sector. Four in five of those surveyed believe that if they had trusted data, it would enable them to make more effective decisions, and half of respondents say they want to use AI to identify patterns and suggest likely decision outcomes.
Summary of key findings:
Current challenges:
- 90% of operations leaders take “significant effort” to get insights from their data
- 42% cannot access the data they need to make informed, real-time decisions
- 36% are forced to base decisions on data that is almost one week old
- 33% say they base too many critical decisions on assumptions and human intuition
Perceived benefits of AI:
- 4 in 5 believe that access to trusted real-time data would enable better decision-making
- 46% claim that AI in healthcare service operations would enable more meaningful insights
- 50% of operations leaders want to use AI to predict future outcomes
The report demonstrates an appetite for AI among operations leaders in healthcare insurance but also highlights how the slow pace of adoption may be holding the industry back. A significant number of healthcare insurers (50%) say they are “just starting out with AI,” while 78% believe that AI is key to unlocking gains in operational performance. This gap between ambition and deployment in regard to AI is leading to poor decision-making, with one-third (33%) saying they are relying far too much on assumption and human intuition to guide their choices.
“These findings clearly demonstrate the push-and-pull nature of AI for healthcare insurers in the US,” comments Spencer O’Leary, CEO North America at ActiveOps. “While the benefits of AI, such as its ability to inform and streamline critical decision-making, are well recognized, there are still challenges and barriers to overcome in the US in terms of how AI is perceived and implemented. What’s perhaps more concerning is that it’s revealed a severe lack of real-time data, which is vital for operations teams who need to make quickfire decisions on how their businesses are managed.”
Further research by ActiveOps suggests that the key barriers to AI adoption in the sector are likely due to poor data hygiene, a lack of perceived faith in AI from leadership, and reservations about job displacement. Almost half (42%) fear their job will be replaced by AI, and two-thirds (66%) say their leadership team isn’t interested in investing in AI despite its benefits.
Publication of these findings arrives during a critical moment for AI in the healthcare sector. The global AI market in healthcare is currently worth $28.2 billion but is forecasted to reach $187.9 billion by 2030, indicating a rapid adoption of AI-based solutions that are set to revolutionize all corners of the sector.
AI’s ability to analyze and derive insights from large sets of data, as well as streamline and automate administrative tasks, is already a key differentiator within the healthcare market. AI-powered tools such as Natural Language Processing (NLP) are already enabling operations teams to gather valuable insights from unstructured data sources such as patient records, reducing human error and freeing up staff to focus on critical tasks that demand their attention.
The full report, titled ‘Transforming Healthcare Ops With AI,’ can be downloaded HERE.
Research Methodology
ActiveOps commissioned Censuswide to survey Chief Operating Officers, Chief Financial Officers, and Senior Heads of Operations within the Healthcare Insurance sector, to gather insights on their priorities for 2024, challenges they were experiencing with their operational data and adoption of AI. The research was conducted between February and March 2024 in the United States. Censuswide abide by and employ members of the Market Research Society which is based on the ESOMAR principles and are members of The British Polling Council.
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