How Elevance Health uses AI

Elevance Health, a health insurer, could not see a member's dissatisfaction until a CAHPS survey result arrived up to eighteen months later, by which time the member may already have disenrolled. It built a unified, AI powered member view with Qualtrics that turns every survey, call and chat signal into a real time flag on at risk members, feeding a closed loop recovery process that connects each signal to a specific intervention. What began as a proof of concept in January 2024 has grown into a program that Qualtrics reports now analyzes more than 10 million member calls, chats and surveys a year.

Elevance Health expanded its Virtual Assistant, available through the Sydney Health app and Elevance Health affiliated health plan websites, to about 22 million members with commercial plans. Elevance Health describes it as using conversational technology, not as an AI system; it answers plain language questions such as whether a surgery is covered and what it will cost, returning in network providers, a personalized cost estimate and a coverage breakdown, and it integrates with the company's Find Care platform and supports Spanish. Expansion to Medicare members was planned for 2026. Elevance Health says early pilot results showed nearly 9 out of 10 pilot users were able to use the Virtual Assistant to find answers to their questions.

Elevance Health, a US health insurer, partnered with Syndio in 2020 for a gender and race pay equity analysis and began using Syndio's Pay Finder tool in 2021 so that more than 200 internal and external recruiters can check a candidate's proposed salary against an equitable, competitive range before an offer goes out, instead of only auditing pay equity after the fact.