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We predict high-cost claimants in health plans using machine learning and AI to enable smarter underwriting.
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is built for

Stop Loss Carriers

Increase underwriting accuracy with insights that help maintain financial resilience and minimize risk.

Evaluate risk profiles by leveraging Merit’s longitudinal patient journey data, providing a clear picture of potential future liabilities.

Benefits Consultants

Design health plan strategies using the latest risk-management technology, ensuring appropriate coverage for your clients' needs.

Use predictive analytics to recommend coverage strategies that shield clients from catastrophic claims while maintaining cost-effective coverage.

MGUs

Reveal precision-based underwriting to drive cost predictions at the member level—from first dollar claims to high-cost occurrences, even with limited data.

 

Boost RFP conversion rates by increasing accuracy in pricing and setting attachment points, ensuring long term profitability while balancing the interests of your carrier, consultant, and reinsurance partners.

 

Leverage data to proactively manage health plan risks and achieve better financial results.

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Unlock Immediate Value with Merit Medicine

Predictive Analytics

Anticipate high-dollar claims and premium fluctuations with our advanced AI tools, ensuring you’re always one step ahead.

Proactive Care

With our immediate insights, support care navigation to promote preventative care, early intervention, and proactive disease management.

Risk Management

 Identify and stratify high-cost events in advance, and support high-risk health plan members before they become high-cost claimants,

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Data on a Touch Pad

The Merit Medicine Difference

Our algorithms are designed to predict high-cost claimants at the member-level, enabling more precise underwriting in health plans for carriers, employers, and risk-bearing providers.
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