With an innovative analytical framework applied on external data, payers can enhance the performance of existing rating modifiers to inform additional risk. Health insurers can leverage new signals from consumer data to predict claims experience to deliver an improved risk assessment process. These new signals include factors indicating buying behavior patterns, socio economic and financial statuses and health interests.
The enhanced rating modifier can help payers create an R-squared lift of up to 15%.
This lift is over and above claims experience typically informed by internal risk factors that payers already assess—such as age, gender, and location.
A few external indicators of additional risk informed by claims experience can include data on economic stability, usage of mobile phones, prime time television usage, smoking, community engagements, derogatory records, and dwelling status.