GENERATIVE AI BASED PERSONALIZED WELLNESS PROGRAM AND INCENTIVE PLATFORM FOR HEALTH INSURANCE PROVIDERS

Abstract

GENERATIVE AI BASED PERSONALIZED WELLNESS PROGRAM AND INCENTIVE PLATFORM FOR HEALTH INSURANCE PROVIDERS The present invention relates to using artificial intelligence (AI) to assess and predict health risks for users of insurance plans, facilitating proactive care and optimized insurance management. The artificial intelligence (AI) enhanced predictive health management system for insurance plans includes a data collection module configured to gather user health data from electronic health records (EHRs), lifestyle inputs, and wearable devices, an AI based predictive analysis module that assesses health risks based on the collected data and forecasts potential health conditions for users and a recommendation engine that provides personalized health guidance and preventive care suggestions to users based on the predicted risks.

Specification

Description:which it is to be performed. 
4. DESCRIPTION

Technical Field of the invention

The present invention relates to the field of predictive health management systems. Specifically, the present invention relates to using artificial intelligence (AI) to assess and predict health risks for users of insurance plans, facilitating proactive care and optimized insurance management.

Background of the invention

Current health insurance systems often react to medical claims rather than proactively managing health risks. With healthcare costs rising, insurers and insured parties benefit from a system that predicts potential health issues, allowing for early intervention and preventive care.

This invention addresses these challenges with an AI enhanced predictive system that uses patient data and risk analytics

Brief Summary of the invention

The following presents a simplified summary of the disclosure in order to provide a basic understanding to the reader. This summary is not an extensive overview of the disclosure and it does not identify key/critical elements of the invention or delineate the scope of the invention. Its sole purpose is to present some concepts disclosed herein in a simplified form as a prelude to the more detailed description that is presented later.

It is a primary object of the present invention to provide a method to assess and predict health risks for users of insurance plans, facilitating proactive care and optimized insurance management using artificial intelligence (AI).

The AI Enhanced Predictive Health Management System provides insurers and insured members with predictive insights regarding health risks. Using machine learning models trained on historical and real time health data, the system assesses risk levels, suggests preventive measures, and personalizes insurance plans. This enhances member health outcomes and reduces insurance costs.

Detailed Description of the invention

It is to be understood that the present disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The present disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. In addition, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting.

The use of "including", "comprising" or "having" and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. The terms "a" and "an" herein do not denote a limitation of quantity, but rather denote the presence of at least one of the referenced items. Further, the use of terms "first", "second", and "third", and the like, herein do not denote any order, quantity, or importance, but rather are used to distinguish one element from another.

According to one embodiment of the invention, the artificial intelligence (AI) enhanced predictive health management system for insurance plans includes a data collection module configured to gather user health data from electronic health records (EHRs), lifestyle inputs, and wearable devices, an AI based predictive analysis module that assesses health risks based on the collected data and forecasts potential health conditions for users and a recommendation engine that provides personalized health guidance and preventive care suggestions to users based on the predicted risks

According to one embodiment of the invention, the following are the key features of the invention.
System Overview: Description of components (databases, user interfaces, AI modules), data sources (EHRs, lifestyle inputs, wearable devices).
Predictive Analysis Process: How data is processed, including risk factor analysis, patient profiling, and prediction algorithms.
Adaptivity and Personalization: Details on how AI adjusts recommendations and alerts based on user data.
Integration with Insurance Plans: Explanation of integration with insurance plans for tailoring coverage options and wellness benefits.
User Notifications and Feedback: User interface elements, notifications for high risk conditions, and feedback mechanisms for updating health insights.
Advantages: Proactive healthcare, reduced claim frequency, personalized insurance, and improved health outcomes.

It will be recognized that the above described subject matter may be embodied in other specific forms without departing from the scope or essential characteristics of the disclosure. Thus, it is understood that, the subject matter is not to be limited by the foregoing illustrative details, but it is rather to be defined by the appended claims.

While specific embodiments of the invention have been shown and described in detail to illustrate the novel and inventive features of the invention, it is understood that the invention may be embodied otherwise without departing from such principles.
, Claims:I/We Claim:

1. An artificial intelligence (AI) enhanced predictive health management system for insurance plans, the system comprising:
a data collection module configured to gather user health data from electronic health records (EHRs), lifestyle inputs, and wearable devices;
an AI based predictive analysis module that assesses health risks based on the collected data and forecasts potential health conditions for users;
a recommendation engine that provides personalized health guidance and preventive care suggestions to users based on the predicted risks.

2. The system as claimed in claim 1, wherein the AI based predictive analysis module includes a machine learning model trained on historical health and claims data to identify high risk individuals and predict the likelihood of specific health conditions.

3. The system as claimed in claim 1, further comprising a feedback loop that continuously updates the predictive analysis module based on changes in the user's health data and external health factors.

4. The system as claimed in claim 1, wherein the recommendation engine integrates with the user's insurance plan to suggest preventive services or lifestyle adjustments aimed at reducing long term health risks

5. The system as claimed in claim 1, wherein the AI based predictive analysis module includes an algorithm for calculating health risk scores for individual users, which are accessible through a secure user interface.

6. The system as claimed in claim 1, wherein the further comprising an alert mechanism that notifies users and insurers of any significant changes in health risk levels, prompting early interventions.

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