Centene CEO sees health care’s biggest AI opportunity beyond automation

Santa Barbara – During the Fortune Most Powerful Women Summit, Sarah London, CEO of Centene, discussed the potential of artificial intelligence (AI) in healthcare. She highlighted that much of the AI currently deployed in the industry focuses on "inflationary use cases," which aim to generate more revenue within a fee-for-service system rather than reducing the overall cost of care. London believes the greater opportunity lies in transforming the delivery of care and expanding access.

Centene, a $33 billion company serving 26 million members in Medicaid plans across 29 states and marketplace and Medicare Advantage coverage, primarily operates with the poorest and sickest individuals in their communities. London noted that these populations are often overlooked by healthcare innovation. She identified two potential applications for AI: moving care closer to the community and empowering patients to take control of their health decisions.

In rural areas with limited medical services, AI could assist community health workers in identifying non-acute issues and addressing them locally, potentially preventing emergency room visits. For patients, interactive tools could guide them through initial health concerns, allowing them to make decisions without relying on a clinician for every subsequent step. London believes this approach to be crucial in bending the cost curve of healthcare.

The CEO emphasized that while administrative automation remains relevant, its financial benefits should be channeled into improving benefits for patients. For healthcare CFOs, the challenge lies in differentiating AI tools that expedite billing processes from those that enable patients to receive the right care in the most appropriate setting, potentially altering the economics of healthcare delivery.

London concluded that the question goes beyond understanding how much AI can enhance healthcare. It centers on whether AI can help healthcare spend less while delivering better care.