Centene CEO sees health care’s biggest AI opportunity beyond automation

Sarah London thinks a lot of the AI being rolled out in health care is solving the wrong problem. Speaking Monday with Fortune, the Centene CEO called many of today’s deployed systems “inflationary use cases” because they help providers bill faster, automate paperwork and pull in more revenue, without making care cheaper.

That’s not a small distinction for a company like Centene, which operates Medicaid plans in 29 states and also sells marketplace and Medicare Advantage coverage. The insurer says it serves 26 million members, and London described those people as among the poorest and sickest in their communities. That is exactly the group she thinks health care innovation has too often skipped.

Her bet is that AI’s bigger value lies in changing where care happens and who can access it. In rural places with few doctors, she sees room for community health workers using AI to sort out non-urgent problems locally instead of sending people to emergency rooms. She also wants tools that help patients make early decisions about a health issue without forcing every next step through a clinician visit.

That, London argued, is how health care actually bends the cost curve. Administrative automation still matters, but mostly because the savings can be redirected. “Every dollar that we can save in the administration of health care, we can apply to benefits,” she said.

The practical test for health care executives is no longer whether AI can make a process faster. It’s whether it helps people get the right care in the right setting, and whether that changes the economics underneath the system. Billing software is nice. Changing the bill is better.