“That all comes to light in our commitment to process 80% of our prior authorizations in real time by the end of 2027.”

In context

“Tim Noel: Yeah. Deployment of AI and other advanced technologies like it are a key and critical focus area across UHC. Also, a big enabler of our modernization agenda that we're advancing rapidly. It's unlocking a lot of game-changing opportunities to improve consumer and care providers' experiences and make the system operate a lot more efficiently at the same time. I agree with your kind of commentary on the pacing, where we're going to see that accelerate into 2027 and even go deeper in terms of the efficiencies provided kind of across the board into 2028. As we're focused on this, you would imagine that we obviously have large-scale capital projects that we're deploying, but perhaps more importantly and significantly, we're infusing AI across all of our administrative activities. A couple of examples just to kind of bring that to light across UnitedHealthcare. First, virtually every provider and consumer interaction uses AI. AI gives us the ability to empower our advocates with predictive insights, real-time data, which all leads to more productive interactions, and importantly, also lends itself to translating some of those experiences into digital experiences that oftentimes, most times, come with better provider and consumer satisfaction as well. Also key to our ability to proactively identify members that are in distress, and reach out to them with concierge-like service models to help them through those moments. Second area is it's providing step function enhancements in our core operations. Things like very complex claims that we never before thought we would be able to automate. We're able to automate those and process those with higher accuracy than we have been able to before, which eliminates cost and also increases turnaround times, which is very important. A very encouraging element to all this is this is facilitating interoperability with health systems and care providers. We've seen a really great appetite for health systems to partner with us in these efforts, and it's providing the opportunity on both sides to eliminate latency with some of this real-time information sharing that's now enabled and now going on. That all comes to light in our commitment to process 80% of our prior authorizations in real time by the end of 2027. In doing so, it creates kind of a touchless environment, which eliminates a lot of the back and forth between health systems, care providers, and health plans, which not only improves experiences, but you can imagine the elimination of the abrasion unlocks a lot of operational efficiencies for both health systems and health plans. The last area to note is it's giving us the ability to provide better data insights because we're able to, in a more real-time basis, look at data sets far broader than what we've been able to look at in the past. This gives us better understanding around our business performance and also lends itself to things like real-time underwriting across both our commercial and Medicare business. As we think about our modernization agenda, one of our focus here is to focus on outlier activity and be able to customize our utilization management programs to reduce prior authorizations and other programs for the broad population because we have the ability to more customize some of those approaches. A couple key reminders, though, as we think about how we're approaching this in UHC is Number one, clinicians will always be involved in these processes. If services are not authorized, that decision will ultimately be made by a clinician. The second thing to note and remind folks of is that our contact centers are getting far more efficient, but they will never be fully automated. Engaging with the healthcare system that we play an important role in will always be deeply personal. We see great opportunity to invest some of the savings that we're getting from these efficiencies in actually enhanced and more concierge service-like models. We're going to always have options for human interactions as we approach this.”