AI-Powered Patient Benefit Management: A Technical Overview

Abstract

The integration of artificial intelligence into Patient Benefit Management (PBM) represents a transformative paradigm shift in healthcare administration and delivery. This technical article explores the multifaceted applications of AI technologies in revolutionizing how healthcare benefits are managed, optimized, and delivered to patients. From sophisticated machine learning algorithms that personalize benefit packages to automation systems that streamline administrative workflows, AI is fundamentally reshaping the PBM landscape. This article examines core technological frameworks enabling these advancements, data-driven approaches to benefit personalization, operational efficiency enhancements, and clinical decision support systems. By addressing both current implementations and future directions, this comprehensive analysis provides healthcare stakeholders with actionable insights for leveraging AI to create more responsive, efficient, and patient-centered benefit management systems.