Towards Equitable Coverage: Harnessing Machine Learning to Identify and Mitigate Insurance Gaps in the U.S. Healthcare System

Despite advancements in healthcare access, significant disparities persist in health insurance coverage among vulnerable populations in the United States. These gaps disproportionately affect racial and ethnic minorities, low-income groups, and rural communities, leading to poor health outcomes and increased financial strain (U.S. Department of Health and Human Services, 2022). This research explores how machine learning (ML) can be leveraged to identify, predict, and address these coverage gaps using large-scale datasets such as electronic health records (EHRs), insurance enrollment data, and demographic information. By applying predictive analytics, the study aims to uncover patterns of underinsurance and non-enrollment, enabling proactive outreach and policy interventions (Rajkomar, Dean, & Kohane, 2018). The research evaluates current ML models for their accuracy, ethical implications, and effectiveness in informing targeted outreach strategies. Furthermore, it discusses how health policymakers and insurance providers can use these insights to implement data-driven solutions that promote equitable access to care. This study contributes to the ongoing dialogue on health equity, technology integration, and value-based insurance design in public health policy (Obermeyer, Powers, Vogeli, & Mullainathan, 2019).

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Publication Details

Journal
Journal of Business and Management Studies
Published
2025-04-05
DOI
https://doi.org/10.32996/jbms.2025.7.2.9
Primary Topic
Healthcare Policy and Management
Type
article
Field-Weighted Citation Impact
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article

Towards Equitable Coverage: Harnessing Machine Learning to Identify and Mitigate Insurance Gaps in the U.S. Healthcare System

Ashutosh Roy, Jasmin Akter, Jannat Ara, Sridhar Ghodke
Journal of Business and Management Studies
Healthcare Policy and Management
article

Towards Equitable Coverage: Harnessing Machine Learning to Identify and Mitigate Insurance Gaps in the U.S. Healthcare System

Ashutosh Roy, Jasmin Akter, Jannat Ara, Sridhar Ghodke
article en

Abstract

Despite advancements in healthcare access, significant disparities persist in health insurance coverage among vulnerable populations in the United States. These gaps disproportionately affect racial and ethnic minorities, low-income groups, and rural communities, leading to poor health outcomes and increased financial strain (U.S. Department of Health and Human Services, 2022). This research explores how machine learning (ML) can be leveraged to identify, predict, and address these coverage gaps using large-scale datasets such as electronic health records (EHRs), insurance enrollment data, and demographic information. By applying predictive analytics, the study aims to uncover patterns of underinsurance and non-enrollment, enabling proactive outreach and policy interventions (Rajkomar, Dean, & Kohane, 2018). The research evaluates current ML models for their accuracy, ethical implications, and effectiveness in informing targeted outreach strategies. Furthermore, it discusses how health policymakers and insurance providers can use these insights to implement data-driven solutions that promote equitable access to care. This study contributes to the ongoing dialogue on health equity, technology integration, and value-based insurance design in public health policy (Obermeyer, Powers, Vogeli, & Mullainathan, 2019).

Journal of Business and Management StudiesVol. 7(2)
Gannon University (US)
Openalex Percentile: Top 90%
Healthcare Policy and Management
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Towards Equitable Coverage: Harnessing Machine Learning to Identify and Mitigate Insurance Gaps in the U.S. Healthcare System — Ashutosh Roy, Jasmin Akter, et al. · Journal of Business and Management Studies (2025) | TGRS Research Map | TGRS