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The public conversation surrounding AI today feels deafening and like a pendulum, swinging wildly between utopian promise and dystopian panic. In healthcare, an industry that is both deeply human and notoriously complex, the stakes are simply too high to be overtaken by hype, in either direction. And, more generally, as is commonly said, “the truth typically lies somewhere in the middle” of these extreme visions of the future.
At Collective Health, our focus has never been on chasing headlines, but on the real, practical application of technology to solve the problems that affect millions of people trying to get the care they need.
But here is where it can become transformative. Because Collective Health is a member-centric TPA platform, we won’t just provide information; we will take action.
As I head to one of our industry’s leading conferences, HLTH, this week to present Collective Health’s and my own personal view on this important topic alongside our strategic partners at Google, I know I’m not alone in thinking about the opportunities and ramifications of this tremendous transformation we’re witnessing. And not unlike other massively transformative technology waves that I’ve had the fortune of having witnessed—the personal computer, the Internet, mobile, search—it the dystopian-utopian tension and fears of what these new technologies might do to our societies and how we work feels all too familiar.
AI allows us to fundamentally reshape our approach to data and to the traditional “front end” and “back end” of systems to create a new type of experience for members and employers. For Collective Health, it enables us to fully connect our company’s “left brain”—the powerful technology platform that ingests, interrogates, and fetches data on a user’s behalf—with our “right brain,” our best-in-class member experience that presents information with clarity and empathy to help people take action. AI is the connective tissue that allows us to wholly reimagine this architecture and deliver an effortless experience.
Building with Principle and Purpose
From our founding, our north star has been simple: help people better understand, navigate, and pay for their healthcare. That mission dictates our approach to AI. Every initiative is grounded in four core AI principles:
- AI must always enhance the customer experience, never diminish it
- Ai must be at least as accurate as a human, and ideally a lot more
- AI can never catastrophically wrong, respect the boundaries of human interaction
- AI can do no harm—to our customers, to our workers, and to society more generally
These aren’t just ideals; they are our guardrails. Because of this, we are very deliberate in the choice of our partners. We’re working with Google because their team shares our commitment to moving with urgency, but never at the expense of responsibility. In an industry built on trust, our members and customers deserve nothing less.
Beyond the Bot
Many companies are approaching AI by building a simple chatbot and layering it over the same broken infrastructure. That’s not our way. One of the many ways we are using AI is to re-architect our data foundations to build an integrated companion that connects the front end with the backend in a new way. By using natural language, it can understand the member, access the right data and then take action to handle the grinding work of research, tracking prior authorization approvals, and logistics that would otherwise burden a member.
Let me give you an example of our vision, inspired by one of our members—a mom whose son was newly diagnosed with Autism. A complex diagnosis is overwhelming enough without having to navigate one of healthcare’s biggest pain points: prior authorizations.
In our new experience, this mom can ask a simple question in her own words. Our AI agent won’t just perform a keyword search; it will interpret her need. It reads client-specific plan data to surface the right in-network providers, including preferred tiers and covered point solutions, all with upfront cost information. But here is where it can become transformative. Because Collective Health is a member-centric TPA platform, we won’t just provide information; we will take action.
Our AI companion will identify that the needed service requires a Prior Authorization. It confirms when the request is received from the provider and alerts our internal Utilization Management (UM) team, flagging the member’s upcoming appointment timeline. Our team then acts to review and move it through the process. The complexity is stripped away from the member’s view, and her child gets the care he needs. This is what it means to go beyond a chatbot—it’s the fusion of our technology and our TPA capabilities, powered by AI.
AI Will Empower People, Not Replace Them
At Collective Health, the human and the digital have always gone hand-in-hand, and they always will. Our goal isn’t automation for its own sake. It’s about giving our teams the superpowers they need to deliver the human-centered support our members deserve. We are already using AI to change the capabilities of our Member Advocate team—a team that consistently earns NPS scores above 70. By automating search and documentation tasks, we can free them up to be more present and listen with care and empathy.
Our AI companion is also built to understand sentiment. It can recognize when a member is worried or frustrated and needs more than just an answer. In those moments, it knows the most important thing it can do is offer to connect them with a Member Advocate, because sometimes, you just need to talk to a person.
What’s Past is Present, and Future
Through all of this, I’m reminded of a past moment in tech transformation during my time at Google during the search revolution. Before Google’s approach to reinventing disparate data sources, we were limited to rigid database and SQL queries. Radically rethinking how to process data led us to take a new approach and to manipulate vast, disparate sets of data at scale to understand context and intent in ways that hadn’t been done before. The onset of generative AI is a similar paradigm shift, but for rethinking reasoning and action. It gives us the ability to not only connect data but to form relationships between concepts and processes, supercharging our ability to deliver a seamless, simplified member experience and to streamline the crushing complexity of health plan administration.
AI is not a one-time transformation; it’s an ongoing evolution. Like the cloud or mobile before it, it’s a technology with the potential to fundamentally change how people engage with their health. We are committed to leading that change with care, clarity, and the conviction that technology’s highest purpose is to serve humanity.
Ali Diab
Ali Diab is the CEO and Co-Founder of Collective Health, the world’s leading employer health benefit plan administration platform. Ali has more than 25 years of experience leading high-growth technology organizations, and prior to co-founding Collective Health, was Vice President of Product Management and Business Operations at AdMob by Google. Previously, Ali held executive and management positions at Goldman Sachs, Microsoft, and Yahoo!. Ali is a graduate of Stanford and Oxford Universities and is a Member of the Board of Advisers of the Stanford Institute for Economic Policy Research (SIEPR) and a Trustee of San Francisco Day School.
