Gravie’s forward-looking approach to underwriting
The traditional approach to underwriting health benefits is falling short. The rather unsophisticated process focuses on projecting employees’ past claims history forward to determine a group’s rates. This process doesn’t take individuals’ unique medical situations into consideration, and it also doesn’t account for all the ways today’s innovative plan designs empower members to access care and improve their health.
At Gravie, our approach to underwriting determines rates in a more efficient and accurate way. Instead of just looking in the rearview mirror, we leverage innovative tools like machine learning and intelligent data processing, giving us a more robust database for predicting claims. This means, we’re looking out the front windshield – to better predict what’s going to happen with a group’s claims in the future.
Our Surgical Underwriting® process unites this forward-looking approach with detailed reviews using the latest AI technology and sophisticated probability models to dial in pricing for prospective and existing clients. Of course, there will always be unexpected claims, but an extensive review ensures that each group is reaping the greatest value from their health benefits each year.
Gravie’s underwriters have access to actionable data that they can leverage to make strategic business decisions in collaboration with our broker partners and customers. This integrated model is the backbone of our ever-evolving health plan that will soon include a care navigation program. Our dedicated team of nurses work with our underwriters to analyze data to see where high-cost claimants might be, and to determine potential interventions and how best to support higher-risk members’ paths forward.
For instance, if we know an individual experienced a lower back injury last year, their situation could potentially be flagged as high-risk. But if we look closely at that individual’s health history, we may find they could benefit from interventions like virtual physical therapy that are covered by Gravie’s innovative plan design, before jumping into surgery or another invasive treatment option. We could also connect that member with our care navigation program to help them find the right solution to reduce their low back pain in both the short and long terms. Once we look deeper like this, the risk may be categorized differently. Our goal is to be as precise as possible in our predictions, rather than being overly conservative.
By taking a more robust and detailed approach to how we assess risk, we are better meeting the needs of businesses, especially those in the small and midsize range. More accurate risk and probability models lead to more cost certainty, while tailored clinical solutions can provide a higher value product that’s typically only attainable by larger companies.
A thoughtful, proactive approach to underwriting means fewer surprises with claims down the road, and better health and financial wellbeing for both employers and their employees.
Interested in learning more about Gravie’s forward-looking underwriting process? Listen to the latest episode of the It’s a Gravie Thing podcast.