Overcome the complexities of health insurance pricing to achieve profitability, affordability and sustainability
Health insurance pricing is a critical aspect of insurance management, ensuring that premiums cover costs while remaining affordable for consumers. With healthcare costs on the rise, insurers face the challenge of adjusting their pricing strategies to maintain profitability and sustainability.
The pricing of health insurance involves a complex web of factors, including demographic shifts, changes in health status, and economic trends. Traditional methods like Generalized Linear Models (GLM) and newer machine learning techniques are available, yet many insurers still rely on basic one-way or two-way portfolio analysis. This simplistic approach can lead to significant mispricing risks, affecting the overall profitability of health insurance portfolios.
WTW’s innovative technology and experienced consultants are at the forefront of transforming health insurance pricing. Through a combination of actuarial, healthcare, and data science expertise, WTW supports insurers in meaningfully modeling and thoroughly understanding the drivers of claims in their portfolios.
WTW’s approach includes predictive modeling of future claims incidence and severity, with detailed breakdown by care setting, condition, and other relevant factors. This allows insurers to optimize premium rates, balancing claims risk, target margins, and customer affordability. The use of WTW’s platform enables low-code implementation of advanced modeling and pricing techniques, facilitates stakeholder communication, and lays the groundwork for future integration with existing systems.
As the landscape of health insurance continues to evolve, insurers equipped with the right tools and expertise can significantly reduce mispricing risk and achieve target profitability. WTW’s comprehensive solutions offer a pathway to enhanced efficiency and robustness in health insurance pricing.
