Improving the Cost of Wellness vs Cost of Care
How Can We Optimize the Cost of Care?
Resources must instead be directed to the “cost of wellness.” This is where an organization has the greatest opportunity to make a difference in the cost of care. The “cost of wellness” is that portion of the MLR devoted to keeping the population as healthy as possible. Rather than jumping from one claim to the next and paying for the consequences of unmanaged chronic illness, investing in the cost of wellness is easy and has an ROI. “Cost of wellness” activities are predictable, replicable, and generalizable to large segments of the population. Automation is a key component of these actions, and Artificial Intelligence/Machine Learning (AI/ML) can play an enormous role in managing the organization while allocating resources. Rather than case managers scrambling from one urgent situation to the next, their time can be more efficiently managed, cutting down on administrative burden and costs. This presents a true opportunity to control the cost of care, optimize the organization, manage administrative expenses, and positively impact the margin.