Centene chief executive Sarah London has called for artificial intelligence to be used to expand access to healthcare for underserved communities, warning that much of the current investment is focused on increasing revenue rather than improving care.
Speaking at Fortune’s Most Powerful Women Summit, London said innovation in healthcare was too often directed towards those with the greatest ability to pay, while people reliant on Medicaid were left behind.
“Most of the venture money in health care goes into where the money is, and the money isn’t in Medicaid,” she said. “That means that underserved communities don’t actually benefit from innovation first. Sometimes they never do.”
Centene, a $33 billion company based in Missouri, operates Medicaid plans in 29 states and also provides individual marketplace plans and Medicare Advantage. Its 26 million members include some of the poorest and sickest people in the communities it serves, London said.
London, who became chief executive four years ago at the age of 41, said she joined the company because healthcare and technology had reached an important turning point. She wanted to help bring better care to people who were typically the last to benefit from advances in the sector.
AI in healthcare could shift care into communities
She said artificial intelligence had the potential to transform the way people accessed and received treatment, but argued that its most widespread applications were currently missing that opportunity.
“The part that’s really depressing right now is that where AI is being deployed at scale, and where there’s a lot of investment happening right now, is in inflationary use cases,” London said.
Much of the work was aimed at generating more revenue within a fee-for-medical-service system, she said. Automating paperwork and claims processing could be useful, but did not fundamentally alter how care was delivered or make it more accessible.
In rural areas with few hospitals, AI could help community health workers provide an initial level of triage for non-acute problems, London said. Such tools could help return more care to local communities and give patients a greater role in decisions about their own health.
“That puts community care back in the community,” she said. “It puts individual care back in the hands of patients, and I think that is the thing that is going to fundamentally change how health care works.”
London acknowledged that systems such as ChatGPT were not a substitute for a doctor, although people were already using them to seek information about health concerns. Used appropriately, she said, AI could help patients understand their health and make some early decisions about their care.
“If we can create that level of agency and the ability for individuals to make the first couple of decisions themselves, that is actually how you bend the cost curve,” she said.
Centene is currently using AI in administrative communications with members, London said. The longer-term aim is to develop interactive tools that help patients take initial steps in managing their care, while savings from administrative efficiencies could also be redirected towards benefits.
“Every dollar that we can save in the administration of health care, we can apply to benefits,” she said.
