A new vision for health plans

We made this campaign because we think health plans can change healthcare on a scale no one else can, and because we worry that chance could be wasted just making the current system run a little faster.

There would be plenty of value in that. Anyone who has waited for an approval, chased a missing record, or spent an evening finishing notes knows what ordinary inefficiency costs. But we would be disappointed if, five years from now, clinical AI’s great achievement was getting through the same paperwork in half the time.

We can ask more of this technology.

Healthcare has always been about the moment a person who needs care meets a person who can provide it. But so much of what we have built around that encounter now gets in its way: the clinician has another form to fill, the patient has to recount the symptoms again, and inevitably, somewhere, a nurse is on hold, trying to get information that already exists in our systems.

For all AI might change in other industries, this is why its promise in healthcare feels special to us. Clinical AI could take on much of the work that keeps people occupied with the machinery of care, and give them more time for care. That would be an extraordinary thing to get right.

And health plans are best placed to make it happen. They follow members across years, conditions, and places of care. They can connect information across separate offices and systems. Through what they pay for, and how they pay for it, they influence what the rest of healthcare can do. Few institutions have comparable reach, or a greater opportunity to put those pieces together.

Peggy’s story in Chapter Two of this campaign makes that opportunity concrete. A request about knee pain enters a system designed to answer the request, but other things in her record deserve attention, too. What would it take for the system to notice them, and for someone to act?

We wanted to hear what people who have spent their lives in healthcare made of this possibility. So we brought together our partners and customers: physicians and nurses, health plan and health system CEOs, people who have served in government and regulation, and technology and product leaders. Between them, they have more than two centuries of healthcare experience, and it is their voices that this campaign represents.

Across five chapters, we examine what clinical AI can now do; what it could change in a member’s care; the infrastructure needed to make it dependable; what happens to the work and the people doing it; and where the industry will have to act together. We have tried to give the difficult parts as much attention as the possibilities.

Of course, Anterior has a vested interest. We build clinical AI, and we want our company to succeed. Some plans will build internally; others will work with us or other partners. However they do it, patients and clinicians need them to do it well; we care more about that.

This campaign was a labor of love. We hope you find something here to take back to your colleagues. And if you think we have something wrong, please tell us. There is too much at stake to keep the conversation among those who already agree.

Abdel, Tahseen, and Ali