F107 AI driven health insurance (Rajeev Ronanki, Anthem)
Health insurance companies are not exactly a popular entity in the US. People are underinsured, claims get denied, etc. Anthem is striving to become a digital AI-first enterprise and make healthcare far more predictive, far more proactive, transparent, and personalized than it currently is.
"We want to see our consumers, our providers, and stakeholders have a seamless, simple, and delightful experience. To do that, we have to use data, insights, analytics; predictive technologies use exponential technologies to change every part of our business, our core business processes. Our stakeholders need to change things like claims adjudication, claims processing, billing, enrollment, new product capability, creation. All of those things have to be much more automated and efficient and simple," says Anthem's Chief Digital Officer Rajeev Ronanki. He believes one of the more significant healthcare issues in the US is that consumers lack information and accurate insights about health care costs and what's effective. Anthem's mobile application Sydney Health enables consumers to type in and look up prices of procedures and compare prices based on quality reviews and outcomes. They can then make informed choices.
The basic component of becoming an AI-first enterprise is large quantities of data and the power to analyze it. AI has a huge potential in precision therapeutics and personalized therapy. To get there as soon as possible, Anthem launched a digital incubator in September 2020. Chosen companies can access anonymized data Anthem has to test their solutions.
The era of personalized clinical trials
Rajeev Ronanki.
Anthem is also running a pilot program where members can sign up for virtual clinical data trials. "We're using the data that's available on my phone, genomic data and other omics data were available, combined with clinical claims and lab and other types of data. That gives us a unique profile of a person, and based on that we have algorithms that can then match you to clinical trials. At some point in the future, we will be able to scale technology like this, where the personalized clinical trials identify the therapies. Once that's there, I think the change that needs to happen on the manufacturing side will be relatively fast," explains Rajeev Ronanki.
Promising future in AI, blockchain and VR/AR
Asked about the technologies he sees as most promising in the future Mr. Ronanki expressed high hopes for foundational technologies that enable a better experience. "From the foundational side, I'd say, artificial intelligence, machine learning, and blockchain are the ones that continue to have great promise already showing lots of good results, and excited to see you know what that evolution is going to be in the next five years as those things tend to become more and more sophisticated. On the more interesting consumer engagement side, I think virtual reality will have a big role. In augmented reality, the data and the insights could be overlaid on an augmented reality experience and delivered through whatever is the appropriate channel. The channels could be voice, could be television, could be your phone, it could be a watch, could be your glasses. In the visualization of the engagement, augmented reality will become a seamless and ubiquitous part of that experience."
Tune in for the full discussion:
Some questions addressed:
Health insurance companies are not exactly a popular entity in the US. People are underinsured, claims get denied, etc. What is your opinion of health insurance and healthcare costs in the US in general?
How is COVID affecting Anthem since less regular procedures get done?
How can healthcare be more efficient, less plagued with intermediaries?
You are leading the transformation of Anthem to become a digital/AI-first enterprise. Let's stop there for a bit - what does this actually mean, what is the grand vision and what the roadmap?
What are the examples of your new value proposition with this mindset? How is the relationship with your customers changing? Can you name any examples of introduced and planned solutions?
HBR recently posted a survey where 40% of executives said that the obstacle to AI initiatives is that technologies and expertise are too expensive. AI has a lot of potentials, but to what extent can its use curb healthcare costs - for example, precision/personalized therapies can be highly effective but carry insane price tags…?
Do you have any negotiation power about the prices of drugs and services?
On September 16th Anthem launched a digital incubator. Your value proposition is - "we have anonymized data, you bring your tech to test your solution with the help of our data". What is the big picture?
What is going to be the relationship with the companies (equity?), are there any more specific goals as in what you wish to achieve - what is your selection process, focus?
Based on your experience, what is in your opinion, the hardest thing to digitalize in healthcare? When will we get rid of fax machines?