Rick Ramos: What do you see as the biggest issue for companies with employee benefits?

Dave Chase: Put simply, they aren’t applying the same level of care to they do to every other major expense in their business. After all, health care is usually the second largest expense after payroll. It’s odd that the same company that will reject an expense report that is missing a $62 restaurant receipt will blindly pay a $100,000 claim. In 20 years of working on hospital bills, I’m not sure I’ve seen one over $1,000 that didn’t have an error or overcharge. Once they apply the same level of care, they’ll quickly learn that the underlying costs of health care haven’t fundamentally changed (with the exception of some specialty drugs). Thus, you only need to accept hyper-inflating costs if you like redistributing your precious resources to a health care system that is wildly underperforming by virtually every measure. Smart employers have awakened that world class health care is available at half the price of what most employers are paying for mediocre outcomes.

RR: What areas do you think AI has the most potential to change within the benefits space?

DC: AI is most effective when there is clean data to work with. That excludes a large percentage of clinical data. However, in areas such as member benefits or claims processing, there is ample opportunity to apply AI. For example, in my new book, "CEO's Guide to Restoring the American Dream: How to Deliver World Class HealthCare to Your Employees at Half the Cost," I wrote about how criminal fraud is much bigger than people think. It’s easy to imagine how smart AI could flag the massive levels of fraud (estimated at over $300B per year). Just as your use of a credit card has a certain pattern, so too do medical claims. Antiquated systems used by the claims processors (insurance carriers) are ill-equipped to thwart the sophisticated cyber criminals that are having a field day with the U.S. health care system.

RR: Almost all employee benefits today are sold through a benefits consultant, how can AI help them do their job better?

DC: There will be obvious areas, such as customer service, where AI can help. Less obvious is how great benefits consultants can ensure their clients have a modern benefits approaches and technology to help them steward the large investment being made in health benefits. Naturally, in areas such as payment integrity, artificial intelligence can help reduce or eliminate fraud, waste and abuse.

RR: The decisions that employees make when using health care can affect costs massively. What are your thoughts regarding AI and chabot technology and making employee guidance simple?

DC: I think there’s a range of ways AI and chatbots can help employers as well as their employees. They can address the common, rote issues that have definitive answers. They can also be assistive for more nuanced situations where the combination of AI and human judgement is the optimal approach. For example, the inputs on the clinical side may be messy, so a pure AI approach wouldn’t be sufficient.

It’s still early days for AI in the employee benefits space, but companies are already seeing a huge return on investment and it’s only expected to grow. Since health care is such a large part of a company's expenses, these early backers will become more competitive within the market. Companies need to start investing in AI technologies and add them to more business processes to improve service, lower cost and add efficiencies. Companies that fail to implement AI will be saddled with extra costs and legacy processes that will erode their market share.

Rick Ramos is the chief marketing officer for HealthJoy.com, an AI guidance and cost containment platform for employers to manage their health care.