Healthcare Innovation and Thought Leadership

Using Technology to Improve Health Outcomes  

Centene is investing in artificial intelligence (AI) and machine learning (ML) technologies to help improve the health of our members and contain rising healthcare costs. We recognize we have a responsibility to use these powerful tools carefully and ethically. To facilitate this, Centene has established an AI Governance Committee, accountable to the Audit and Compliance Committee of the Board of Directors, that is comprised of senior leaders representing key functional areas and stakeholders across the company. The Committee’s mission is to foster an environment of ethical AI innovation by overseeing the development, deployment, and impact of AI technologies across all areas of the company’s operations.

Some of the key areas where we are using AI/ML at Centene to provide more innovative care for our members are:

• Emergency Room (ER) Diversion

  We developed a new standardized screening tool to identify the root cause of our members’ ER use. This tool allows us to better customize associated interventions and assist members in engaging with appropriate care options to support their physical, mental, and social needs. 

• Identifying Those at Risk

  Our NEST (Neighborhood, Economic, and Social Traits) model uses member data, characteristics of the neighborhoods in which members live, detailed individual demographics, and other public and internal data to help care managers identify members most at risk of poor health outcomes so we can assist with their needs.  

• Suicide Prevention

  Our innovative predictive risk model in the Choose Tomorrow program identifies members who may be at risk before a crisis occurs, which prompts care management outreach for early screening, support, referral, access to resources, and provider engagement.