Vanesa Barahona received a call from Angelica at Kern Family Health Care in Bakersfield, California, to renew her coverage under Medi-Cal, the state’s version of Medicaid. Angelica helped Barahona schedule an appointment to complete her paperwork, which was then submitted to Kern County officials for approval.
Barahona, 41, finished the process a little later than planned but early enough to avoid an interruption in her coverage. “It was easy,” she said via a translator. “The fact that Angelica spoke Spanish when we were on the phone made it better. It felt like I was talking to a real person.”
“Angelica” is the name assigned to an AI program deployed by Kern Family Health Care to facilitate rapid and repeated outreach to members when it’s time to renew their coverage. Kern Family has spent about $370,000 on the software from Careforce, a San Francisco startup.
An estimated 52% of residents in Kern County rely on the safety net program for health coverage, among the highest enrollment rates in the state. Kern Family and other similar health plans have an interest in keeping people enrolled, since they’re paid through managed care contracts with Medi-Cal.
Kern Family officials say that Angelica helps people set up appointments with the plan’s staffers, who make sure that applications are filled out correctly and delivered to county health officials for verification and processing. Careforce CEO Huzaifa Sial said Kern Family is one of a few health insurers using his company’s software to help boost its Medi-Cal enrollment.
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The rise of AI in the healthcare industry has prompted worries about who’s overseeing these tools and whether people are being improperly denied treatments or cut off from care. Unions have raised concerns about workplace surveillance.
Anthony Cava, a spokesperson for the state’s Department of Managed Health Care, said Medi-Cal health plans have flexibility in how they handle member renewals, including with the use of AI tools.
Cesar Delgado, Kern Family’s chief information officer, said Angelica is already being used to make general greeting calls to new members and can discuss plan benefits and answer basic questions.
Kern Family officials are exploring other potential uses for Careforce’s software, including using it to help patients organize their paperwork. As the healthcare industry continues to evolve, the use of AI tools like Angelica is likely to become more widespread, raising important issues about the role of technology in patient care, such as tracking health outbreaks and ensuring continuity of care.
