Artificial intelligence is nothing new in the world of health insurance, but the speed and scale of its implementation across the industry are ramping up.
With that growth comes new opportunities to boost internal efficiencies and improve members' health outcomes — along with increased scrutiny from lawmakers. Becker's sat down with Anil Bhatt, Elevance Health's global chief information officer, to talk about where one of the nation's largest healthcare organizations is leaning more into AI and how it's building a foundation of transparency along the way.
Question: What excites you the most about the use of AI within the health insurance industry as we head into next year?
Anil Bhatt: When we look at any new technology, we always have a tendency of looking at use cases first. But over the last few years, our journey has been from a technology foundation perspective, or making sure that our data is high quality, scalable and flexible in terms of expanding our solutions. That enables us to make sure that we are now building generative AI and other solutions on top of that foundation.
On the ground, I think that the overall path of conceiving and then deploying a capability is going to shorten, so we are very excited about that. Our quality of products is going to improve because we are already piloting some key capabilities around automation and regression testing. We're also enabling specific use cases, whether it's provider collaboration, program integrity efforts or prior authorization. The areas where I feel personally that we're going to have a very huge uptake and benefit is going to be in the contact and call centers area. We can improve the journey a member takes when they call us or connect on chat and how quickly we are able to respond to them and be their advocate. That's a very important journey where I feel generative AI and AI in general is going to help us do it all.
Q: There are a lot of conversations going on in Washington and the states around how insurers across industries should be implementing safeguards with AI. How do you think health insurers should be implementing those guidelines?
AB: The speed at which we are going to be exponentially using this technology within our ecosystem is going to be huge, and it is at the point for us to make sure that we are taking the steps needed to ensure that we have a very trustworthy, explainable and transparent way of using AI. There's been some great policy discussions happening on this at the White House with many industry leaders participating. Senior leadership at Elevance is all having regular discussions to make sure that we are a responsible user of AI within our ecosystem; that is very, very important to us.
We're making sure that we have a fair and inclusive way of how our AI models are run. We also want to make sure that we continue with the trust our members and our providers have in us. And frankly, we want to be accountable for making sure that what we are trying to do is the right thing. As a technologist, privacy and security in this space is very important for me, too, so we're making sure that we have been very diligent there. We are the bearers of our members' data, and we want to make sure it's used responsibly.
Q: Where are you incentivizing the use of tech platforms to help increase efficiency or speed to market for new products across the company?
AB: I've been with Elevance for a long time, and one of the things that has always been a challenge is quick adoption and engagement with a new digital tool or technology. Within our company, we are incentivizing and creating new training programs. We created certification and recognition programs to make sure that performance goals of a particular business unit are tied to the use of digital capabilities. It's also about creating a regular feedback loop and making sure we're hearing how these tools are being used on a day-to-day basis. We recently launched an initiative where we're assigning AI leads to our business leaders so that they and our business units become more intelligent and efficient.
Bringing excitement and encouraging feedback from our associates and communicating how they can influence not only the efficiency of the enterprise, but also creating a better member experience, is what we continue to focus on as we move forward.
Q: Payers are continuing to develop and launch virtual-first health plans. Can you share a bit more about your strategy in this space for the years to come?
AB: With COVID, it became very clear there was a definite upside to providing this capability to members and making sure that all care options are available. We've seen a huge uptick with virtual visits, so we're working with our partners to make sure that we're continuing to improve that experience. We're also trying to identify the target demographics for these plans to make sure we've created capabilities that are relevant.
We're also forging virtual capability partnerships with health systems because that is a key thing many want to do. Fundamentally, it will be very important to make sure that the infrastructure and the platform that we have is robust enough to offer virtual care to all those seeking it. In the long run, this is going to be a very viable option for a lot of new and individual customers in our national accounts. And our large groups are asking for this capability by default, so I'm excited about where we're going with this.
Q: Final thoughts?
AB: As technologists, you don't often realize the impact that we're creating for members. You don't realize the code that you're releasing can enable or disable medication access at the pharmacy or how somebody may not be able to call us when they need something. What I'm focused on is making sure that our technology is run with empathy and prioritizing the members first. We can develop code and new technology, but if it doesn't resonate and connect with consumers, it's not going to resonate well in the marketplace. My advice for other executives and technologists is to make sure you understand the business that you are in and who you are serving.