Rajeev Ronanki – Anthem Inc.

Do you know how many ways there are to treat someone with diabetes?

Sydney Health can answer that, says Rajeev Ronanki, the President, Digital Platforms for Anthem Inc.

However, Sydney Health does not wear a stethoscope, tell a patient to say “ahh” or screen blood sugar levels—it’s an app that reminds people of health care appointments or treatments. It also recommends lifestyle or care options for the conditions they face. If its diabetes you’re facing, it can give 387 treatment options.

Rajeev Ronanki | President, Digital Platforms | Anthem Inc.

Launched in October 2019 and now in version Sydney Health 3.0, the app is part of the wave of the future for the health insurer, Ronanki adds.

“Sydney Health is just one example of the things we’re doing. It’s the front door for all things health,” he says. “Anthem is transforming to be a digital platform for health. We need to be more predictive instead of reactive.”

A deep data pool

Headquartered in Indianapolis, Anthem is an independent licensee of the Blue Cross and Blue Shield Association, operating in 14 states. It’s also a provider of specialty plans, including Anthem Workers’ Compensation and Unicare. With 42 million plan members, Ronanki says the amount of available information for machine learning and artificial intelligence doubles every 70 to 80 days.

“You’re dealing with a staggering scale here,” Ronanki says. “But there’s the benefit of predicting what can happen in the state of someone’s health. It can help determine what proper interventions are needed, with a privacy-first approach.”

He joined the company in June 2018 as Sydney Health was being developed for members of Anthem’s affiliated health plans and their caregivers, providing information on available health care providers, co-pays and medical records.

Sydney Health can schedule appointments, recommend in-person versus virtual care, and as in the case of treating diabetes, offer  recommendations—and possibly avoid the expense of emergency room visits or the need for surgeries.

AI and automation

The immensity of data Anthem continues to gather is also leading Ronanki and his teams to help employees and health care providers work more efficiently.

For instance, providers can now use Anthem’s Health Operating System for patient care. Health OS is designed to be a secure, comprehensive digital platform to drive digital health convergence and cohesion, Ronanki says.

For instance, Health OS allows providers to process prior authorization requests faster, access a patient’s claims and clinical history in real time, see patterns, and gain insights to improve care. For instance, Health OS lets providers see what medications patients are taking and whether they have allergies. It also reduces redundant paperwork and ensures a provider knows all the relevant changes since a consumer’s last appointment, Ronanki says.

Anthem also employs AI and machine learning for the customer service and administration portions of the business. That’s an ambitious effort, too, with the aim of automating 50 percent of administrative work—underwriting and authorizing care, processing claims, making referrals—while scaling solutions that would make 90 percent of interactions digital, he says.

“We see new opportunities to use AI and digital tech and need to have the right of first refusal to address the scale,” Ronanki says.

A virtual future

Those opportunities also include a joint venture with digital health startup K Health and Blackstone Growth announced in April called Hydrogen Health. As described in a press release, Hydrogen Health, a company funded in part by Blackstone and Anthem, will use AI provided by K Health to provide “digital first health care” to employers and consumers.

While telehealth has been used more frequently during the COVID-19, Ronanki says covering certain visits and expanding the use of virtual technologies can be complicated by state and federal regulations. Some restrictions were waived in 2020, but it’s unclear whether the waivers will become permanent.

Though access and use of telehealth can also vary for patients depending on many factors, including availability, internet connectivity, device access, and privacy (or lack of) in their home setting, Ronanki sees improving access and use as vital to Anthem’s transformation.

Along with enabling more virtual visits, he says Anthem is working on how providers can triage patient conditions virtually, share electronic health data quickly and securely, and determine whether care needs to be provided in-person or online. A first step will be creating better ways for people to research their own symptoms and treatment options, he adds.

A native of India, Ronanki says his interest in technology developed as a sci-fi fan who especially enjoyed “Star Trek.” He earned his bachelor’s degree in production engineering at Osmania University in Andhra Pradesh, then came to the U.S. to earn his master’s in computer science from the University of Pennsylvania.

In June 2018, he joined Anthem, looking to apply his skillset to change how Anthem operates—and how its perceived as well.

“While insurance in the past might have been adversarial with a view of gatekeepers as opposed to advocates, Anthem wants to be a lifetime trusted partner and needs to help people access health care where and when they need it,” Ronanki says. “We’re laying down the foundation for a cultural mindset for the future with capabilities that position to us be a leader in our industry.”

View this feature in the Fall II 2021 Edition here.