How Aetna Is Using AI To Simplify Your Healthcare

Navigating the complexities of the healthcare system can often feel overwhelming. Recognizing this challenge, Aetna, a CVS Health company, has announced a significant investment in technology, rolling out new AI-driven programs and digital tools designed to create a simpler, more personalized experience for both patients and medical professionals.

Introducing Aetna Care Paths A Personalized Healthcare Journey

At the forefront of this initiative is Aetna Care Paths, a new feature available within the Aetna Health app. This innovative tool moves away from the traditional, transactional approach to healthcare by offering a holistic, journey-based model. For members with specific health conditions, Aetna Care Paths provides a clear, personalized view of their relevant benefits, connects them with a dedicated care team, and offers tailored recommendations for health and wellness programs. Powered by patent-pending AI technology, it simplifies the process by consolidating crucial information and support into one convenient digital location.

"Aetna Care Paths are one example of CVS Health’s $20 billion multi-year digital investment in making health care simpler to navigate," stated Nathan Frank, Senior Vice President and Chief Digital and Technology Officer at Aetna. "Leading-edge digital tools, including AI, support members at every stage of their health journey."

More Than Just Care Paths Upgrades to the Aetna Health App

The Aetna Health app, already a go-to resource for nearly half of Aetna's active members, has received several other powerful updates to enhance the user experience:

• Easy Vaccine Scheduling: Members can now find and schedule recommended vaccines at their local CVS Pharmacy or MinuteClinic directly through the app.
• Clearer Claims Visualization: A new "donut" chart feature breaks down claim costs, helping members easily understand what their plan covers and what they might owe.
• Instant AI Chat: An AI-powered chat function is now prominently featured, providing quick answers to member questions and seamlessly connecting them to call center staff if more support is needed.
• Smarter Provider Search: The Smart Compare tool uses intelligent matching to give members personalized doctor recommendations based on their unique preferences and health needs.
• Enhanced Accessibility: The app now includes a sleek, low-light dark mode, a first among major health insurance apps, to improve comfort and accessibility for all users.

Empowering Nurses and Improving Efficiency with AI

The technological advancements aren't just for members. Aetna is also leveraging AI to support its own staff. A unique innovation, AI-driven clinical care summaries, is designed to save nurses up to 90 minutes per day. This frees them up to spend more quality time engaging with members.

"We’re giving our nurses more quality time to connect with members, listen to their concerns and help them navigate their health journeys," said Dr. Ben Kornitzer, Aetna’s Chief Medical Officer. "That extra time in one-on-one conversations not only improves physical health outcomes but also supports our member’s mental well-being."

Additional Technology Solutions for Members

Aetna has also rolled out other technology solutions to simplify common healthcare tasks:

• Accurate Provider Availability: Aetna now uses its own claims data to validate whether a provider is accepting new patients, offering more reliable information than ever before.
• Personalized Cost Tracking: New tools help members track their spending, monitor deductibles, and review associated claims to better manage their healthcare costs.
• Simplified Claims Submission: Members can now submit a claim by simply taking a photo of a provider bill. AI technology then automatically matches it with existing claims, clarifying what the member may owe.