Saul Marquez, Host at Outcomes Rocket Podcast

Leveraging Digital Innovations and Data-Driven Insights to Improve Consumer Experience

Tuesday December 22nd 2020

Leveraging Digital Innovations and Data-Driven Insights to Improve Consumer Experience


When should you start seeing a healthcare provider? Is it when you are already sick and manifesting a whole array of symptoms? Or should it be while you are still healthy and in the process of taking care of yourself?


It seems as if healthcare by nature is reactive. A patient only sees a doctor after experiencing symptoms. The provider will then give a diagnosis, then the treatment follows. 


But these days, the world of healthcare is transforming from a reactive to a proactive system. 


Many people are more interested in preventing the disease simply because it is more expensive to undergo treatment than to prevent it. 


The transition from reactive to proactive is not easy, but digital innovations have made it easier to adopt and scale this approach. 


Leveraging Data in the Transition to Proactive Healthcare


One company leveraging AI is Anthem, a trusted health benefits company. Understanding that there is a need for better and more personalized healthcare, Anthem is pushing for solutions that improve outcomes.


In our interview with Rajeev Ronanki, Senior Vice President and Chief Digital Officer, he said that with Anthem’s breadth and depth of reach, the company can make some changes. 


“We serve approximately 43 million consumers. We have several million providers that are part of our network. Everything we do is at scale. What we’re doing is looking at healthcare and saying what could we do to make it more predictive, proactive, and personalized, and using our technologies, artificial intelligence capabilities, and investments in digital technologies to make that change happen.”


Rajeev explained that by leveraging data, they can create insights and take steps to proactively address any issues for consumers before needing acute care. Anthem is in a unique position where they can leverage data to connect consumers to the care they need. 


“We sit at the intersection that connects our consumers to the care that they need. We have such a vast amount of data. We have small claims for over 70 million lives.… We use that data, in a safe and secure way, to create unique insights and can then make those insights available at the right time, at the right place to all of our stakeholders. And in so doing, we can predict what might happen in a person’s healthcare future and then proactively take steps to address it, and then ultimately personalize that care for an individual as well as the community and the caregivers.”


With the challenge of data gathering and analysis out of the way, Anthem can focus on creating specific solutions available to their consumers. In a few steps, Anthem has made transitioning from reactive care to proactive care manageable.


Integrated Solutions


A problem that consumers face is a long list of healthcare solutions. While there are many good solutions in healthcare, they are often fragmented which makes them difficult for patients and consumers to use. 


“There are solutions for diabetes. There are solutions for managing chronic conditions, but there isn’t anything that integrates it seamlessly and makes it so that it’s simple and easy to use,” Rajeev shared. “And that’s what we’re up to. Given our unique ability to harness our data…turn the data into insights and make those insights available to all of our stakeholders – in an appropriate and secure way, we’re able to integrate all these solutions and make them simple to use… And that’s what this is all about.”


Anthem has always been about providing greater value to customers and improving the health of communities in a simple, integrated manner. 

Whole Health 


To reduce the fragmentation of healthcare, Anthem takes a whole-health approach to the healthcare services it provides with consideration to behavioral, mental, physical, social, and financial health. This approach allows Anthem to improve the overall health of an individual by connecting them with the right care at the right time. 


In today’s challenging times, many people are under mental stress. Rajeev explained that with this approach, they can harness all the data available to create digital tools to help people manage mental health, specifically.


“What we’re doing is we’re making a number of digital resources available for mental health. So, we have to harness our data created artificial intelligence and other digital capabilities that are available as guides for our consumers… And then from that resource, you could escalate the care up to a therapist and then seamlessly connect in other factors that may influence your health and bring it all together into the total health picture.”


Anthem’s AI capabilities and voice technology can even detect inflection in a caller’s voice and direct that member to the appropriate mental health resource in a way that does not compromise privacy or security. 

Improving Lives 


Anthem is ticking all the boxes to ensure consumers get the care they need. 


Having embraced digital technologies, Anthem is more efficiently processing claims and other administrative work. This frees up the company’s human resources to focus better on what truly matters — being true health advocates for consumers. Rajeev shared that this is a key part of their strategy. 


“It is the application of technology at scale to automate and make capacity available to really, truly be health advocates. And then in terms of outcomes, it goes back to this notion of having data at scale and applying artificial intelligence, machine learning, and technologies like that to create insights from that data and then making those insights available to our providers and our consumers or communities or employers to enable them to then understand the true picture of health and then measuring that rigorously every month, every quarter, every year, understanding what’s working and what isn’t, and showing a baseline at a population level to say year over year we’re improving the health of the population.”


With Anthem’s AI capabilities, employers can make better decisions and tailor their benefits, and be part of a healthcare solution that is more proactive, reduces unnecessary spending, and ultimately improves health outcomes.


To learn more, listen to my full interview with Rajeev here: https://outcomesrocket.health/anthem/2020/12/. You can also visit https://www.thinkanthem.com/digital-innovation/ to learn more about how Anthem is harnessing AI and other digital capabilities to integrate solutions across the healthcare ecosystem.



Written By

Saul Marquez

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