California looks to AI to automate health insurance enrollment
A woman wears a button promoting open enrollment with Covered California, which will use AI to automate some of the enrollment process. Justin Sullivan via Getty Images
The state will use artificial intelligence after a pilot found it significantly sped up processing times.
Fresh off a multiyear migration to the cloud that California officials described as a “game-changer,” the state is looking for another win by deploying artificial intelligence to streamline its health insurance enrollment process.
The marketplace, Covered California, has formalized an agreement with Google Public Sector to use its cloud AI solution to automate portions of the enrollment document and verification process residents must complete when applying.
“What this means for us is that instead of a couple of days working with the consumer, or employees, or staff connecting with the individual in manual workarounds, we’re now able to process a health insurance application within seconds,” Karen Johnson, Covered California's chief deputy executive director, told Route Fifty in an interview at the Google Cloud NEXT conference in Las Vegas.
Johnson said Covered California launched a pilot program with Deloitte and Google Cloud last year to test the solution—Document AI—to “try and provide a better experience” for both its customers and employees. Covered California receives about 50,000 records per month—600,000 per year—from residents that it must verify. Johnson said the current software can only verify “15% to 20%” of the documents coming in, resulting in application delays as state employees manually verify those documents.
In the pilot, Covered California achieved document verification rates of between 80% and 96% depending on the type of document, moving most applicants along the process in seconds.
“And that’s just with our user acceptance testing that we have done,” said Johnson, noting the solution will officially go live in June.
By that time, she expects even higher verification rates along with beefed up cloud security features necessary to safeguard sensitive, personally identifiable information uploaded during the application process.
“So I expect that with refinements, we will be closer to 98%,” Johnson said. “[Google Public Sector was] able to deliver a solution that is going to help address our workload and make us more efficient.”
Johnson said Covered California’s shift to AI has raised concerns among some staff members who wonder whether AI will eventually take their jobs.
“In acknowledging those concerns, I’ve been communicating that these AI tools are going to be an enhancement,” she said. “That we’re going to augment our human potential and not diminish it, and that we’ll be able to automate the mundane, repetitive tasks, allowing time to be freed up for employees to work on more complex issues.”
Johnson said she believes some small wins with AI will drive broader acceptance among staff, allowing for more experimentation and potential use cases. In the near future, she said she believes the technology will “be like a dynamic assistant or thousands of interns at your disposal,” perhaps even allowing state and local governments to personalize the services they deliver to customers.
AI, Johnson said, is not here to steal jobs. “For me, AI is a complement to the workforce.”
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