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Merit Medicine is built for
MGUS
STOP-LOSS CARRIERS
CONSULTANTS & PLANS SPONSORS
POINT SOLUTIONS
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Manage Risk with Merit Predict.
Our AI powered machine learning model leverages billions of datapoints to predict and assess health care risk and spend with an unprecedented degree of accuracy.
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Precision Forecasting
Predict costs for individual members, from small claims to high-cost occurrences.
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Rising-Risk Detection
Identify high-cost claimants early to enable proactive interventions.
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Al Powered Algorithms
Leverage a robust dataset to uncover unique member risk journeys.
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Actionable Insights
Deliver clear, data-driven recommendations to improve financial outcomes.
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Enhanced Underwriting
Achieve greater accuracy and confidence in risk management decisions.
Merit Medicine gives you highly accurate, predictive risk insights to increase underwriting precision and improve health plan performance for at-risk populations.
Identify high risk members and their expected claims spend
Identify future catastrophic claimants 12–18 months in advance, allowing you to confidently set competitive premium rates and maintain profitability.
Predict total first-dollar claims by group, across your book of business
Understand historical spend, total current spend, and total predicted spend distribution with a visibility into high-cost outliers to confidently predict risk.
Optimize your stop-loss spec deductible for each group
Determine excess claims risk at each specific deductible to ensure you preserve this key relationship with carrier partners and health plan sponsors.
Identify gaps in care for proactive health plan management
Uncover clinical risks across all members and track adherence to key preventive screenings, supporting targeted recommendations that improve outcomes and reduce overall healthcare costs.