The rising healthcare costs present a significant challenge for the Swiss healthcare system. AI holds the potential to enhance various touchpoints along the patient journey, improving both efficiency and treatment quality. AI can analyze claims data to predict health outcomes and recommend alternative treatments. However, regulatory constraints position insurers primarily as payers in the healthcare system. Thus, the application of AI in insurance currently focuses on claims management and customer service leading to efficiency gains and the prevention of unjustified costs. Generative AI adds new possibilities, but to unlock the full potential of AI in healthcare all stakeholders along the patient journey need to collaborate in order to improve the effectiveness of treatments and manage costs effectively.

Key Takeaways:

1) The Swiss healthcare system is complex, fragmented and heavily regulated therefore it is difficult to materialize the full potential of AI

2) Current regulation restricts the application of AI in health insurance, the implemented use cases focus on efficiency and cost savings instead of optimization of the patient journey.

3) All players along the patient journey need to cooperate to improve the quality of treatments and to prevent unnecessary costs.