There are numerous challenges that insurers face when it comes to deploying artificial intelligence. However, according to one payer exec, insurers need to face these challenges head-on.
“The worst thing we could do is just be paralyzed by these challenges. We have to engage, we have to do something. We have to get ourselves in the space of better understanding,” said Neil Gomes, senior vice president and chief digital officer of AmeriHealth Caritas.
He made these comments during a Thursday panel discussion on AI at the AHIP 2024 conference held in Las Vegas. He was joined by Dr. David Rhew, global chief medical officer and vice president of healthcare for Microsoft, and Miriam Vogel, president and CEO of EqualAI. The session was moderated by Danielle Lloyd, senior vice president of private market innovations and quality initiatives at AHIP.
At ViVE 2024, Panelists Share Prior Authorization Progress and Frustration in Payer Insights Program
At the Payer Insights sessions on Day 1 of ViVE 2024, a panel on prior authorization offered compelling insights from speakers who shared the positive developments in this area after years of mounting frustration. Speakers also shared challenges as they work with providers to figure out how policy developments and technology will work in practice.
Gomes added that this is especially important as healthcare organizations battle ransomware attacks.
“If we do not engage with AI and we do not better understand it and how to protect ourselves, we are fighting a losing battle because hackers coming in are using AI to build code on the fly and then attack systems that are vulnerable,” Gomes argued.
As for what challenges insurers are facing around AI, one is health literacy. Insurers are struggling with getting people to understand what AI can and cannot do, he said. Another challenge is building policy for AI, as many insurers are trying to “self-govern” since there aren’t policies from the government that are “granular” enough, according to Gomes.
Payers are also struggling with finding the right talent to manage AI in their organizations. People in the tech industry aren’t always looking to work in healthcare or at insurance companies, he claimed.
Using Informed Awareness to Transform Care Coordination and Improve the Clinical and Patient Experience
This eBook, in collaboration with Care Logistics, details how hospitals and health systems can facilitate more effective decision-making by operationalizing elevated awareness.
In addition, there is a lack of trust surrounding AI in healthcare. Gomes stressed the importance of engaging with people, including clients and human resource professionals, about new technologies and the impact they could have before actually doing something with the technology.
Lastly, Gomes said it’s important to monitor vendors’ actions when it comes to new technologies.
“A lot of our vendors, partners and collaborators are also very excited about these technologies and the kinds of promises [they have],” he said. “Sometimes they might turn on a feature within your system that you’re using. They are ingesting your data. So please update your legal policies about that because if they are ingesting your data … and they turn on a feature that might be great for a different industry and they turn it on for you too, then you could be violating something. So just be careful about that.”
Photo: Gerd Altmann, Pixabay
