Dive Brief:
- Humana is launching an artificial intelligence tool that aims to help its call center workers answer beneficiaries’ questions about their coverage, the insurer said Tuesday.
- Agent Assist, developed in partnership with Google Cloud, can summarize conversations between workers and enrollees in real time while highlighting relevant information, like the member’s benefit and eligibility details and important context from the call, Chris Sakalosky, vice president of strategic industries at Google Cloud, said via email.
- The insurer began rolling out Agent Assist in October, and plans to implement the tool across Humana’s service centers this year.
Dive Insight:
The tool should help Humana’s more than 20,000 support workers more quickly and accurately handle the 80 million calls the insurer receives each year, according to a press release.
It provides guidance to call center employees while they help enrollees navigate their benefits and eligibility questions, with the goal of reducing manual work and improving consistency across calls, Humana said.
Workers won’t have to sift through multiple systems to find information about beneficiaries, and Agent Assist can summarize the call so they don’t have to pause to take notes, Sakalosky said.
The tool could also save Humana money. The company’s agentic AI platform, along with other efficiency initiatives, should “generate greater than $100 million of savings over a few years while also improving the quality of our operations,” CEO Jim Rechtin said on a third-quarter earnings call in November.
Still, AI can provide inaccurate or misleading information, and its performance can degrade over time — meaning users need to continually keep an eye on the tools’ output, experts say.
Humana’s tool is built with guardrails, the company said. Agent Assist is continuously reviewed and monitored to ensure ongoing performance.
The tool is also built on internal health plan information and policy documentation, so it only shows verified material, Sakalosky said. Additionally, call center workers can see citations and source references for the information the tool provides.
“Importantly, the model operates within a human-in-the-loop framework: the technology handles the data retrieval and summarization, while the advocate remains the final reviewer and the person responsible for what is communicated to the member,” Sakalosky said
Humana’s AI tool comes as the technology has become increasingly popular in the healthcare sector. The industry has adopted AI products that help clinicians draft documentation, sift through vast amounts of data and help doctors find clinical information.
Payers have been slower than providers to implement the technology. Nearly 30% of health systems have adopted AI products, compared with just 14% of payers, according to an October report by venture capital firm Menlo Ventures.
But insurers may be on track to roll out more AI tools this year, as payers look to turn around consumers’ low trust in health plans, experts say.
