In 2025, GenAI will move forward as a critical component in helping clinicians and payers wholistically understand individuals’ health circumstances. There will be a greater focus on GenAI’s applications towards proactive insights for health management, personalized member engagement initiatives, and improving member/client service. For example, GenAI framework will provide deeper visibility into a person’s social determinants of health (SDOH) needs using data insights. Healthcare organizations know that not all members tell their care teams every past and present detail of their health challenges, and that’s where AI will fill in the gaps. Beyond providing a detailed picture of the member’s environmental conditions that affect their ability to heal, AI will also give precise downstream care actions for the member and/or greater cohort.

GenAI will also be a big player in member engagement. It will take the content from the engagement journey and yield insights about areas the members should focus on, what the clinical team should do, and what the future may look like for all involved. It will simplify communication between the members, clinicians, and payers, giving easy-to-understand and precise next best actions. Documentation will be more efficient and accurate because of it.


Regarding risk, GenAI’s ability to consume and analyze complex data from different sources to make key predictions is something the healthcare industry has never seen before. I believe that next year, GenAI will be in full swing, analyzing big data sets and offering a new context of care with deeper clarity and granularity, leading to more positive outcomes. The number of actions it can tackle simultaneously is astonishing, leading me to believe that GenAI is the ultimate pathway to supporting the value-based care model. Like no other advances in medical history, GenAI will quickly and drastically improve member satisfaction, lower costs, enhance the quality of care, and reduce care team burnout.

- Pravin Pant, Vice President of Advanced Analytics, ZeOmega

Business Affairs Homepage