The Forecasting Frontier: How AI is Reshaping Risk, Revenue, and ROI

02/09/2025 58 min
The Forecasting Frontier: How AI is Reshaping Risk, Revenue, and ROI

Listen "The Forecasting Frontier: How AI is Reshaping Risk, Revenue, and ROI"

Episode Synopsis

Artificial intelligence is no longer just a buzzword, it's a practical tool transforming how healthcare organizations prepare for the future. From evaluating and pricing risk with greater accuracy to identifying rising-risk members and strengthening long-term financial strategies, AI is reshaping the very foundations of forecasting in healthcare. In this episode, leaders from Florida Blue, Premera Blue Cross, Blue Shield of California, and Prealize Health share how they're applying AI across actuarial, clinical, and data science domains to optimize decisions, improve outcomes, and drive organizational sustainability. In this episode, you'll learn: How health plans are evaluating and scaling AI models to improve accuracy in forecasting and underwriting Real-world examples of AI identifying rising-risk populations and transforming engagement strategies Why "next best action" models are becoming central to member engagement and population health How generative AI and workflow optimization are streamlining operations and reducing costs What it takes to embed AI into financial planning, provider contracting, and long-term ROI strategies Panelists: Romilla Batra, MD, MBA, SVP & Chief Medical Officer, Premera Blue Cross Ratnik Gandhi, Senior Director, AI, Florida Blue Emily Allred, Senior Director & Actuary, Large Group Pricing, Blue Shield of California Dean Noble-Tolla, PhD, Chief Product & Analytics Officer, Prealize Health Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here.

More episodes of the podcast Bright Spots in Healthcare