Covered CA's Karen Johnson at Next '24

Speaker A: Coming to you from Google Cloud Next 2024 in Las Vegas, Nevada. I'm Billy Mitchell, Executive editor of Scoop News Group. Thanks so much for tuning in. Today we have a special podcast recorded from the Mandalay Bay Resort and Casino on the Vegas strip, home of next 2024, with more than 30,000 attendees. For this podcast, I'm joined by Karen Johnson, Chief Deputy Executive director for Covered California, the state of California's health insurance marketplace. During our conversation, Johnson shared details on a new partnership using Google's Document AI tool, highlighted the importance of cloud adoption to drive mission success, and shared how the state is securing the information of the millions of enrollees under Covered California. This is one of many interviews captured at Google Next, so make sure to tune into the others released throughout this week. Now, without further ado, here's my interview with Karen Johnson.

Speaker B: Karen, thanks so much for joining me at, uh, Google Next here in Las Vegas. Um, I heard there was a big announcement today for Covered California in terms of the partnership, uh, with Google on the generative AI side. So let's start there. Um, tell me more about Covered CA and um, its mission and how cloud computing and other modern emerging technologies are transforming that mission.

Speaker C: So first I want to say thank you for allowing us to have this opportunity to kind of tell our story. Covered uh, California is a state based marketplace, uh, helping individuals get affordable, uh, high quality health insurance from brand names. And we service about 1.8 million Californians. And so we're focused and the announcement today is really how do we streamline the process to make it easy for our consumers to get the health care that they need. So with this new document AI tool that we partnered with Google, um, leveraging their architects and engineers, we're able to now have real time acceptance of those documents. Instead of waiting days for the documents to go through a manual workaround and to be accepted, we now can get documents accept it within seconds, which then is going to not only streamline the process, but will be able to shorten the amount of application processing times. And it's a game changer because it's all about trying to get health services, you know, provided to these, uh, consumers.

Speaker B: So I mean, it sounds like a pretty transformational, impactful move. I mean, really reducing the burden of submitting applications and the different, you know, pieces of, of whatever people need to file for that. Um, but how did you get to that point? Um, because I would imagine it's not something that necessarily happens overnight, but in today's age it definitely happens a lot quicker than it might have previously. So tell me about the journey to reaching today where you've announced this new partnership.

Speaker C: Exactly. So first I want to tell you about the number of documents that we process in a given month. So it's about 50,000. In a given year it's about 600,000. So that's a lot of you know, documents that need to be processed and having this streamlined, more efficient way of delivering services to our consumers. You know, I think it's, there's high expectations that consumers have on public sector in government and it's a way that we can streamline the operation and bring uh, to bear, you know, basically getting real acceptance of the documents almost instantaneously. So with that I think it's a game changer because we never want our consumers to be frustrated, um, or experience difficulty with completing the application process. Uh, we want everybody to get the health insurance that they need, uh, from these brand name uh, plans that we offer. And I think with uh, us being able to process those transactions um, quickly through this document, AI it's going to make the processing times uh, faster and it's going to I um, think be a game changer for us.

Speaker B: So you know, I know that a lot of obviously this all is sort of stood on top of the cloud. You need the cloud to get to this point. So tell me about your journey to the cloud, what that looks like over the last few years and why you've been successful in moving to the cloud uh, in that time.

Speaker C: So we moved to the cloud and started in the pandemic. So in 2020 and 2021 is when it was completed. I would tell you that by moving to the cloud we're able to uh, not experiencing any kind of significant downtime and we were able to you know, not only do we do the eligibility, uh, determinations for you know, covered California but we also have Medi Cal. So you know that's about 15 million. And during peak times of our open enrollment it can be um, significant. And we never want any of our systems to have any downtime. Uh so it was important that we migrate over to the cloud. And as a result we've been able to enhance our feature widgets by about 45. Um, we've also seen significant um, response time. As a matter of fact we have a dashboard that we actually are tracking on a daily basis and it's always, you know, the dashboards reporting green. Whereas previously we did encounter you know, during the peak um times where we did have um, some, some periods of time where it was slower, um, in Terms of a response for our consumers. So by going to the cloud, we're able to, um, gain these other additional benefits and allow for more rapid, um, transformation and delivery of services and sort of translate that.

Speaker B: And we were talking about this before we started recording and what does that look like in terms of enrollment and making sure, you know, the outcome of your mission is successful? So you cited some statistics that shows things have gotten a lot better in terms of the number of people enrolled in health insurance in the state of California.

Speaker C: Absolutely. So when we were formed, uh, it was about 17 point, uh, 2% in terms of the rate of uninsured in California. And as a result of standing up the Affordable Care act and standing up the state based marketplace, uh, we were able to lower, uh, the percentage of the rate of the uninsured, um, not only from 17.2% but also now today it's at about 6.5%. And this is also not only as a result of COVID California's, um, efforts. It is also with the medical transformation, uh, that the state of California has done.

Speaker B: That's awesome. Those are great statistics. Um, so, you know, we were talking a bit about this, but how does the ability, or how does the cloud provide that ability to really do things more quickly, spin up an AI environment or make changes or to transform things that you need to, um, in the case of the document AI or something else like that, why is it so important to be on that journey to the cloud so that you can do these things now?

Speaker C: Well, the first thing I wanted to mention is that, uh, our open enrollment season, which is about over 70% of our transactions, occurs in a short period of time, so from about October through the end of January. And so when we're processing the amount of transactions during that period of time, over 70%, it was important that we have the ability to scale up, um, and we were able to do so without any kind of interruption of service, um, because we could have major fluctuations, uh, from day to day. And so leveraging, um, the cloud allows us to implement these newer technologies, um, that we couldn't have done, um, previously. And so document AI, which is again part of our transformational journey, um, it is only going to help us just improve upon, uh, the delivery of services to Californians, um, and again, the expectations that consumers have on us in terms of the experience that perhaps they're getting, uh, through the private sector, you know, is the expectation that they have of government. And so we're trying to deliver those services in the most efficient manner. Um, uh, the other Thing is, is that I think that document AI is going to free up, uh, um, time to allow staff to really focus on the complex issues that maybe somebody is experiencing rather than dealing with a mundane, routine, repetitive task. So that's going to be a game changer for us.

Speaker B: That's incredible. Are there other areas that you've thought about or would target next or maybe areas that you've already tried in the AI space? I mean, document AI and sort of that application process is a huge one, but are there others out there?

Speaker C: Absolutely. So part of our AI journey is really going to be focused, um, internally first. And the reason I want to start internally is because every, the employees and individuals have different understanding of AI. And we're in the process of educating our staff and bringing them up to date in terms of the, of leveraging the new technology and what it can do, uh, for you in the workforce. AI is going to augment human potential. Potential is not going to diminish it. And to me it's like a dynamic assistant, a, uh, thousand interns at your disposal. And so. But recognizing that and acknowledging there's concerns that staff may have, uh, introducing AI tools, uh, with staff, educating them, communicating, having an organizational change management, um, is I think, going to help us along in this journey, gain broader acceptance with our staff. So it's going to. I look at AI as a complement to the workforce. Other AI, uh, tools that we're thinking about. This is a big one for me, uh, is actually, um, a policy concierge in government. There's a lot of policy documents we have covered. California Administrative Manual. We have our HR manual, human resources Manual. We have our, you know, travel manual. And finding ways to serve up the information to our employees is going to make a huge difference because a lot of times it's like, well, our procedure manual might be, you know, over a thousand pages long. And so we've been on the trade show floor talking with providers about, uh, their capabilities and how they perhaps could, uh, help assist us. So that is, uh, one, um, other additional item that we're focused on. Another item that we focused on is we have a call center. And I'd like to highlight, um, some of the proof of concepts that, that we've done there. Uh, one of the things, uh, average time handling is about 20 minutes per, um, call during, uh, the open enrollment season. And each consumer, uh, service agent has, uh, 20 minutes of time and four minutes for the summarization of the call. Imagine having an AI tool who in real time can actually do the transcription between the agent and the consumer and then do the summary of the call in almost real time and then also be able to do a sentiment analysis in real time between the agent and the consumer. So I think with that tool it will provide for the agent to have empathetic and improved upon communication. And also we can kind of get an understanding of how the consumer is feeling like their issues are being addressed or being handled. So I think by providing these tools internally so that our employees could be more effective and efficient in is going to make a difference. So I want to equate in terms of the time. If you have 25,000 calls that you're receiving in a given day, 20 minutes, that's maybe 500,000 minutes. And if you have four minutes that is being um, allocated for the summary of the call, that's about 25,000 um, calls, that's about 100,000 minutes. So imagine being able to improve upon the consumer experience by providing a personalized email back to the consumer summarizing kind of the discussion of what actually took place. And to me that would be um, just great service to our consumers.

Speaker B: Yeah, definitely a less burden integrator experience. At the same time it sounds like a, a great idea. Um, I imagine that cyber security is a big focus for your organization as well. Just because you're a health insurance program with really, you know, sensitive information and a huge, you know, group of people who are subscribers. So um, how has the cloud enhanced your security and what are you, what steps are you taking, particularly as healthcare in the health industry has become a real like battleground I guess are a critical place for um, cybersecurity. So what, what does cyber security look like for um, your organization today?

Speaker C: Well, I know that we have leveraged the Google tools, you know, to help us um, ensure that our information is protected. So maintaining confidence of our consumers is really important, Confidence and trust. And we take that very seriously. So by going uh, to the cloud, we have also leveraged additional tools that Google has offered and we've been able to benefit from those uh, protections and monitoring and those uh, tools that are being offered, um, to identify where there's any kind of vulnerabilities, um, is really important, uh, for our teams, um, because the last thing that we want is to have any kind of cyber security issue, especially with um, the sensitive data that we have.

Speaker B: Yeah. So as we close out, um, is there anything else out there, Anything else on your mind as you look to modernize um, health insurance in California?

Speaker C: I just want to sum it up by saying AI is here to stay. Uh, we're going to be on this transformational journey. I think it's going to augment the human potential and not diminish it. I think, uh, we'll be able to automate the mundane, uh, tasks, repetitive tasks. I think you'll find that employees, uh, is going to have greater, um, job satisfaction because we're able to refocus their efforts on more complex or more creative kind of content. So I think the employees are going to be excited about it. Um, and I'd say that obviously, with, uh, regulations, that is a moving target right now. We're tracking and monitoring, and we want to make sure that we're implementing, uh, responsible innovation. Sam.