Dive Transient:
- Cigna unveiled quite a few new digital instruments on Thursday meant to enhance buyer expertise with its well being advantages portal, together with a digital assistant based mostly on generative synthetic intelligence.
- The rollout — a part of the insurer’s bigger push to make it simpler for members to entry and afford the advantages they’re due — additionally features a new instrument to match sufferers to in-network suppliers.
- Specialists have raised issues about rising adoption of AI within the healthcare sector as a result of know-how’s tendency to make errors. Cigna stated its new options have been developed with “rigorous” analysis and testing inside an AI governance framework.
Dive Perception:
The overwhelming majority of U.S. adults wrestle with well being literacy. Poor capability to acquire and perceive well being data contributes to worse well being outcomes, extra hospitalizations and a larger use of emergency care, in response to analysis.
Low well being literacy additionally prices the healthcare system tens of billions, if not a whole lot of billions of {dollars} annually, analyses say.
Nonetheless, the U.S. has made little progress simplifying the complicated layers of paperwork that make it tougher to grasp and obtain care. Insurance coverage is one challenge. Many shoppers are unclear what’s coated by their well being plan, how a lot providers will run them out of pocket and why they generally want to attend to get remedies permitted.
That lack of awareness has contributed to rising frustration with insurers that got here to a head late final yr with the killing of UnitedHealthcare CEO Brian Thompson on the streets of Manhattan.
Within the wake of Thompson’s loss of life, main insurers pledged to roll again administrative limitations to care and turn into extra accountable to their members. Cigna was no totally different, asserting in January plans to hurry prior authorizations, develop entry to affected person advocates, simplify advantages and — later — to tie govt bonuses to buyer satisfaction.
Now, Cigna is including to its myCigna member portal, with at the least one of many reforms leaning closely on generative AI. The insurer’s new AI-based digital assistant can reply widespread questions on well being advantages protection, claims and care choices, in response to Cigna.
Greater than 4 out of 5 clients discovered the AI assistant useful in early testing, Cigna stated in its Thursday launch.
Nonetheless, weaving AI into client communications would possibly introduce new issues.
Generative AI fashions, which might create unique textual content and pictures, are susceptible to errors, although the frequency of points is determined by the mannequin. Fashions can cite incorrect sources, exhibit bias or make up data — an error referred to as hallucination. Hallucination charges, for instance, vary from 0.7% to 29.9% throughout a wide range of totally different AIs, in response to one evaluation.
A Cigna spokesperson didn’t reply to questions in regards to the mannequin underpinning its AI chatbot by time of publication.
Nonetheless, the AI can redirect clients to a human consultant if further assist is required, in response to the insurer’s launch.
Cigna additionally introduced Thursday a brand new instrument that provides clients an inventory of in-network suppliers based mostly on their particular well being wants, together with totally different choices for the way care will be delivered.
Cigna plans to ultimately combine it into the digital assistant.
The Connecticut-based payer additionally redesigned a value monitoring instrument that breaks down deductibles, out-of-pocket bills and payments for shoppers, and new options to assist members extra simply add claims and select between employer-sponsored plans.
Lots of the options can be found immediately or will turn into out there to all clients in 2026.
Like different stakeholders within the healthcare trade, insurers have been scrambling to combine AI into their companies to streamline operations and lower your expenses, whether or not by way of bettering claims critiques, optimizing utilization administration or different use circumstances.
Nonetheless, suppliers and lawmakers have raised issues about payers’ use of AI, pointing to incidences when insurers have used the know-how to stop sufferers from accessing medical care, allegedly with a purpose to revenue. Insurers have denied these claims.
