CVS Health executives on reducing healthcare’s biggest pain points
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This week held AHIP 2026 in Las Vegas, the annual conference hosted by the nation’s leading trade association of health insurers.
The two-day event featured discussions spanning the healthcare landscape, from new industry commitments on prior authorization to the growing role of artificial intelligence to ongoing debates on how to balance pharmaceutical innovation with affordability.
CVS Health He spoke to CNBC about how the company uses artificial intelligence and other technologies to reduce administrative burdens and deliver more personalized, proactive care experiences.
Below are some highlights from the conversation with Katerina Guerraz, Aetna’s chief operating officer and head of Medicaid, and Tilak Mandadi, CVS Health’s chief experience and technology officer.
Real-time data sharing could be a game changer
Guerraz said some of the healthcare system’s biggest pain points could become easier to address over the next few years as insurers and providers work to reduce administrative burdens and share data more seamlessly.
He noted the industry’s current efforts to streamline prior authorization and other insurance processes, but said broader “interoperability” between payers, providers and other health stakeholders could be “the biggest thing that will transform this industry” in the next three to five years.
“When anyone in the healthcare ecosystem starts sharing data in real time, that actually changes everything,” Guerraz told CNBC. “You’re not going through all these different intermediaries that process different types of information.”
This could help patients access care faster, he added.
Conversational AI tool could help patients
CVS launches conversational AI assistant launched in autumn Aetna’s website and mobile app can help members navigate the healthcare system more easily by answering questions, anticipating needs and reducing the need for customer service calls.
The assistant is designed to go beyond the capabilities of traditional chatbots and automated phone systems, Mandadi said. Rather than simply answering a member’s question, the tool aims to understand what the person is trying to achieve and guide them through the next steps. For example, a member who asks whether a surgery is covered may also receive information about expected out-of-pocket expenses, prior authorization requirements and in-network care options, he added.
“We know why people call us most of the time. So how do we solve them and get answers before they reach us?” Mandadi said. “But if they do, it’s conversational AI that can do it faster.”
He said it was a proactive approach that gave members information before they picked up the phone, and the company benefited from it.
Mandadi said the company’s pharmacy business previously received more than 500 million calls a year, many of which involved simple questions such as prescription status. But today, roughly 75 percent of those interactions are resolved entirely through interactive AI, which allows pharmacists and customer service workers to focus on more complex issues, he said.
Personal AI assistant can anticipate patient needs
Mandadi said CVS also envisions a future where patients may have a “persistent” personal AI assistant that actively manages and predicts patients’ needs in real time.
This is one of the key features of CVS and Google Cloud’s Health100 platform, which is scheduled to launch this year.
The AI assistant will encounter a member’s insurance, pharmacy and clinic data and guide health decisions over time, he said. This tool goes beyond today’s chatbots: Mandadi has described a consent-based system that provides a continuous view of a member’s health history, conditions, medications, and benefits, and uses that information to anticipate needs rather than just answer questions.
This is another example of shifting healthcare interactions from reactive to proactive, Mandadi said. Instead of waiting for members to ask questions or miss important steps in their care, the Assistant will flag issues in advance and provide follow-ups and recommendations in real-time.
He said his goal is to reduce the “health homework” that patients often have to do on their own, like understanding benefits, managing chronic conditions or keeping up with appointments and medications.
The assistant can even detect early warning signs, such as missed medication refills or deteriorating health indicators, and intervene before they turn into more serious problems.
If patients consent, the system will eventually integrate multiple data sources, including claims data, pharmacy records, electronic health records and potentially wearable devices, he said.
Mandadi said the assistant could ultimately help patients achieve better health outcomes and reduce out-of-pocket expenses.
“That’s the real beauty of it,” he said.
