Underwriting Risk Predictor Solutions

Why curve your way to predicting underwriting accuracy when Prognos can give you straight answers — now.

Move on from Rx data only. Clinical lab data is the leading indicator of a member’s health trajectory.

The path to accurate underwriting risk prediction doesn’t have to be a long and winding road. Prognos’ Underwriting risk predictor solution straightens the curve by harnessing the power of machine learning algorithms applied to the Prognos Health Registry, the industry’s largest registry of multi-source harmonized laboratory data. The Registry contains laboratory values on over 325 million Americans. Laboratory values are an unambiguous indicator of  the presence of disease and inform over over 70% of clinical decisions. Unlike solutions that rely primarily on prescription history, our Underwriting product leverages the clinical and diagnostic value of laboratory data to predict the future cost of medical care. Clinical laboratory and pathology values provide clear insight into the health of an individual, unlike prescription data, which can be ambiguous with respect to specific disease states.

Fully account for the actual health of your group
Harness the power of lab values.

Insurers are faced with the challenge of how to rapidly and accurately quote group insurance. Only relying on traditional actuarial sources of information can wreck your underwriting effectiveness. These sources do not fully account for the actual health of the groups to be quoted, but instead rely upon statistics and probability to predict the financial impact of an uncertain future state.  

Get started quickly
Prognos’ Underwriting Risk Predictor Solution is Easy to Operationalize

Getting started is simple and the results are unequalled in the industry. Upon receiving a de-identified employer census, it is matched against our clinical registry where highly-trained models produce a reliable risk score that captures clinically-based health insights. The risk prediction score for each employer group is based on relative projected per member annual cost and a projected per member per month (PMPM) cost. 

Prognos’ underwriting risk predictor solution has provided us with formerly elusive member insight that is now effortless to operationalize. We consider this [product] an integral part of our ongoing underwriting risk efforts.

Actuarial lead, Underwriting, Top 5 Payer

Benefits
Enhance the ability to assess risk and cost in the coverage of prospective health plan members.

Prognos’ underwriting risk predictor solution delivers a group-level risk score and projected PMPM medical spend that can be easily integrated into your risk calculations. Set premiums that will give you greater confidence in pricing group health insurance cases.

  • Address the lack of information on small and medium sized employer group members head on
  • Overcome the latency and limitations of medical claims 
  • Leverage the most current clinical member information including insights on their exact and most recent health condition, its progression and severity, and co-morbidities that impact prediction confidence 
  • Built on the AI-driven prognosFACTOR™ platform that harmonizes and enriches the clinical test results of over 325M lives

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