Artificial Intelligence Podcast: ChatGPT, Claude, Midjourney and all other AI Tools

 Is Your Next Insurance Agent Going To Be An Artificial Intelligence Agent With Steve Miller

• Jonathan Green : Artificial Intelligence Expert and Author of ChatGPT Profits • Episode 365

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Welcome to the Artificial Intelligence Podcast with Jonathan Green! In this episode, we dive into the transformative power of AI in the insurance and healthcare industry with our special guest, Steve Miller, a seasoned consultant with a passion for revolutionizing healthcare systems.

Steve brings a wealth of experience and insights into how AI is poised to redefine the insurance landscape, emphasizing the shift from outdated systems to data-driven, efficient processes. He discusses the potential of AI to streamline administrative tasks, enhance transparency, and ultimately improve patient care, while cautioning against the misuse of AI for profit maximization rather than patient benefit.

Notable Quotes:

  • "The tricky part with healthcare... there's been no single source of good healthcare information." - [Steve Miller]
  • "It's happening... but we have to be conscious and I don't think people are realizing how fast AI is going to change things." - [Steve Miller]
  • "Imagine that AI already has all those answers... It's going to be game changing." - [Steve Miller]
  • "You start to think of what value is the insurance company actually providing?" - [Steve Miller]

Steve underscores the need for transparency and data accessibility to harness AI's full potential, advocating for a healthcare system that genuinely prioritizes patient welfare. He highlights innovative solutions and startups aiming to disrupt the status quo and foster a more equitable and effective healthcare environment.

Connect with Steve Miller:

Steve shares insights about ongoing efforts to bring transparency to healthcare pricing and how AI tools can empower individuals with comprehensive health data at their fingertips. If you're intrigued by how AI can transform healthcare and want to learn from an industry expert, this episode is a must-listen!

Connect with Jonathan Green

Is your next insurance agent gonna be an artificial intelligence agent? Let's find out today's amazingly special guest, Steve Miller. Welcome to the Artificial Intelligence Podcast, where we make AI simple, practical, and accessible for small business owners and leaders. Forget the complicated T talk or expensive consultants. This is where you'll learn how to implement AI strategies that are easy to understand and can make a big impact for your business. The Artificial Intelligence Podcast is brought to you by fraction, a IO, the trusted partner for AI Digital transformation. At fraction a IO, we help small and medium sized businesses boost revenue by eliminating time wasting non-revenue generating tasks that frustrate your team. With our custom AI bots, tools and automations, we make it easy to shift your team's focus to the task. That matter most. Driving growth and results, we guide you through a smooth, seamless transition to ai, ensuring you avoid policy mistakes and invest in the tools that truly deliver value. Don't get left behind. Let fraction aio help you. Stay ahead in today's AI driven world. Learn more. Get started. Fraction aio.com. Now, Steve, thank you so much for being here. We're seeing so many fast changes in the world of AI in the world of healthcare, and I've seen some really interesting things where we've shifted from asking like WebMD and self diagnosing and getting convinced we have something horrible. Now we ask chat, GPT. And we freak out is the next iteration. Now chat, GPT is gonna go. You do probably have it. And here's the insurance I recommend. so I think insurance is gonna change. So it, artificial intelligence is going to change the way people think of insurance and the way insurance interacts, like the way we think today. And I don't know if it's gonna be for, for better or worse but essentially what it comes down to is insurance is. It's like a dinosaur. They're, most insurance companies are operating in a stone age. Their systems are archaic. They use claims systems that are very old. They're not known for the latest and greatest technology. And the tricky part with healthcare, if you think back even the last 10 or 20 years since the dawn of the internet. Healthcare information has been it's, there's been no single source of good healthcare information. So there's, there's hospital groups, there's insurance companies, there's, everybody's storing different types of information about you as an individual. But they don't talk to each other and and that's very different than everything else. We have apps for everything now on our phone. And then you have these clunky insurance apps that don't really do much. They can barely, it's hard to even get an app to tell you what your, deductible is on your health plan and the claims that you've had towards your deductible. I think it's. Going to lead to an age where insurance today is gonna look nothing like the insurance of the future. And. The reason why is a AI is pulling data together in a way that we never could have thought possible even five years ago. So this data that even, so let's take yourself, as an individual, right? So let's say, I have multiple health issues going on. I'm seeing these providers. That insurance company may or may not have any or all of that information, just depending on where you go, you're going. And with AI, it's able to aggregate data in a way that we weren't able to do before. And insurance companies could use that in a couple different ways. They could use it. To make better decisions for yourself as an individual, or, this is what I hope doesn't happen, is they use it to deny claims, right? Because the more that they know, they could theoretically say you don't need to do that because the artificial intelligence says that you don't need this procedure. That that you try these other things. But I think. It's going to a place where that data is aggregated and more accessible. I think it can be used to really bring a lot of efficiency. And that's the other problem is. Insurance companies in general, they're very top heavy, so they spend a lot of money on administration and even in within the healthcare system, I think administration's a huge problem. You look at the amount of staff that a hospital or doctor's office has to have just to file claims with the insurance company. It's insane. Yeah, that's something I'm really interested in.'cause I feel like that's the biggest inefficiency in healthcare is that. Every single doctor has to have a process for every different insurance company.'cause you have slightly different forms and you have to, and if you get a single code wrong, it can come back and you have to, so you have a lot of people that develop this expertise that's necessary in filling out the insurance forms for all their patients. And the biggest use of AI right now is really smoothing processes like that where it could speed that up to where now. The AI just knows how to take the doctor's notes and enter that kind of 75 people. Just have one person who manages all that, and that is something that I find really interesting. Hospitals have, it's the same thing like universities. Like for every teacher at sub universities, there's 50 admin staff and like most of the tuition goes to non-teachers. Like of your tuition. It's 80% is gonna, people that aren't teaching you. It's what's going on here? Do you think that this is where the first biggest opportunity is? Is that kind of the first adopters who capture this efficiency are gonna start to grab new market share? Yes I think if efficiency is good, but I would hope that it's used to put that money back into patients and into the members. So as you mentioned with universities, they're a great example. How much of those dollars are actually going towards education? If you take the insurance world and the healthcare world, how many of those dollars are actually making it back to delivering healthcare? And it's a pretty shockingly low number. But it, I would hope that they it's not like a United Healthcare, for example, which is, I think it's been the number one performing stock. And it's the number one is a percentage of the overall I. I, I think it's a Dow, is it Dow Industrial Average? That they're in? It's literally the largest stock from a volume standpoint that it's been for like the last decade. So I would hope that you don't, companies like that aren't using it just to pad their bottom line, that they're actually putting that back to the member. And I think that's the danger. It's yes, if the efficiency's going to come, but. Where is that going to be redirected? So I think if we're, being honest with ourselves there's a potential to abuse that and redirect it towards, share buybacks and, areas that aren't. Helping people be, live better lives. And I think, so that's the double-edged sword of ai. So I think it's happening. But it, we have to be conscious and I don't think people are realizing I. The how fast AI is going to change things. And, you need to be an advocate for, I think your own, your, the member side and actually healthcare companies delivering healthcare because it's, otherwise they're, you're gonna, they're gonna use it to abuse the sy or, take advantage of people like they're already doing. So what we're seeing a lot of right now is fractioning and fracturing of industries where smaller companies with AI or with tools are able to compete with larger companies.'cause they have that agility, they can do these fast trend. There's a huge opportunity with healthcare, with insurance because these large companies are so archaic, they're so far behind. We're already seeing some companies attempt to do this where they try to do. The no doctors visit health insurance. Those now you don't have to do the blood test, you have to do this and that. And some of those are working and some of them aren't. We're seeing these companies try to one approach. Do you think we're gonna see more smaller companies break into the market because they can now compete because they don't need a hundred years of infrastructure?'cause now they can fill in that gap with technology. Yeah, so that's a, that's an awesome question. There are thousands of I would call 'em, tech startups across the country that are trying to get into the healthcare space. I. Probably evaluate. I'm gonna say on a given week, I probably talk to three or four of them. And as soon as I talk to some, there's new ones that pop up. And what I can tell you is it's okay, are you trying to actually, put a bandaid are using ai. So there's two types of companies, I think there's companies that are using AI to truly do something different and unique that solves a problem in the healthcare space. And then there's companies that simply try to do something that, like the healthcare systems, Al already, that's, let's say the healthcare system is doing something wrong that's not really working, but they use AI to make it more efficient, but it's still not a good practice. That doesn't move, that doesn't help anybody. And so the companies that are out there that are trying to, I would say, we, I refer to it as the status quo. So there's companies that want to, we all, I think we can agree that healthcare is broken in our, in the United States. It's not really working great for, especially like the end user the member. It's not really working. Is the problem perpetuating that broken system? Is it enabling that broken system to continue on and function, or is it like completely using AI in a way that, that changes the healthcare game where it's fixing that broken system? I tend to focus on the platforms that are truly. Changing the game that aren't just trying to perpetuate the, and I would say maybe disrupt the existing broken system, which is completely dysfunctional. And so it, I think that the hard part is everybody uses ai. It's like a, Hey, we're using AI technology. Talk to us. We're solving problems, we're fixing things. And it, a lot of the companies, it's just a buzzword. It's not, or they're using a component of their technology that is AI based, but it's really not an AI platform. So we see a lot of that as well. Yeah it's very interesting. There are a ton of companies out there. I don't know, a lot of them are either private equity backed. That's the other thing is, they have to get funding. They have to show scalability. They, so it's the wild west right now with all these companies popping up. Yeah, and that comes to one of my core issues, which is that AI can accelerate any process. So a lot of companies. We'll say, we don't have a process. Let's start with ai. So they're trying to develop and that just means that it crashes faster, but you're bringing up here, which is very interest to me, this, that it can also accelerate a bad process or a malicious process. And we do see, one of the things that I see a lot with startups is that there's a, I encounter a lot of AI startups, as you can imagine. It's a huge part of my life. And it's so many of them do something cool, but don't solve a problem. The problem is those are the type of companies that as soon as their private equity money dries up, they're gone. Because, Correct. and it's like this is something really critical. I think it's really a struggle in the AI space, and this is something we've seen in previous revelations, is that yes, 3D goggles are cool, but they don't solve a problem like nobody. When have you seen someone wearing those Apple 3D goggles anymore? Like they had that out or the 3D television, like you remember the 3D TVs like. yeah, exactly. There was like two movies for 3D TVs. Like I guess if you watch Avatar every day, it's worth it. But like we have these technologies and it's it's really cool. Now we're seeing again, everyone's now you can have AI in your glasses. I'm like, what's, I paid a bunch of money when I was 25 to have Lasik, to get rid of glasses. Why would I go, now I can have glasses on all the time again, but there's a computer inside. It's what? No, I don't want that. I think that this is, it's a different problem, but it's the same idea, which is that if you're not solving a big problem, it's hard to become anything more than either a feature that other companies absorb or something that's lasts for a little while. And we're really seeing this, I'm seeing a lot like the failure rate for AI companies is something like 80, 85%, and that's because they skip over this step. Oh, we thought of something really clever to do. Great. How many people need that? Are you solving a problem for, because you're either moving people away from a problem or towards a solution. Something they want. So that's really important. I think that one of the challenges is in healthcare is that we often look at small pieces of it, right? Which is what if your doctor's visit was five minutes faster? And it's does that gonna expend your lifespan? Like the really big issues is like we have the wealthiest countries in the world, people still don't live very long. Like the how life, like life expect is going down, that should be the kind of things that, there's the big picture, right? It's like the big picture. It's wait, why? And why are certain diseases increasing rather than decreasing? And it's like we're unfortunately that we're seeing a lot of companies that focus on the small thing because it's clever and interesting. Do you think that. We can do a reset for how we interpret insurance.'cause the idea of insurance is really like collective risk and it doesn't seem like that's the core thesis of insurance companies anymore. Right now it's like maximum revenue. Yeah I, I've been involved, so I'm actually involved in a couple or a organization called Health Rosetta, and it's a couple of tech guys. It's actually one of the guys named Dave Chase. I'll give a shout out. He actually was involved in Microsoft's health division and getting that up and going. And they served a lot of healthcare, like hospitals and basically building systems for health systems to use. And he was like, wow. Coming from the tech world, he was like, healthcare is so messed up. He is this is insane. And got done with that. He's I wanna fix healthcare. And it's I would've called him crazy 15 years ago. I've known him now for 10 or 12 years. And but this nonprofit health Rosetta that we've built was really around just Hey, let's create a built a blueprint for fixing healthcare. And it's been enormously successful. But I think one of the pillars of wanting to fix healthcare. It's a industry that has not been transparent. There hasn't been data that, there was data out there, but not in a transparent way. And I think that's where AI is really coming in and changing the game because it's able to take even this data, like data sources that are completely unconnected. It's able to look for patterns and do things in a very efficient way that we just, we couldn't do before. And. I think it ultimately comes down to accountability. And it's like from an insurance, your, where's the value in your current insurance company? They basically have a network and then they are for the most part, they become a barrier to getting the healthcare that you need. Deductibles are going up, copays are going up. Where's the value? What value? People are like, I can't afford this surgery. I have health insurance, but I can't afford this surgery because I have a $6,000 deductible and I make $25 an hour, $20 an hour. Do you know how long it takes that person after taxes to pay their deductible? And they're living paycheck to paycheck, how, tell me how that makes sense. But what it comes down to is your insurance companies, they have these networks, and the networks are actually, people don't realize it. They're like, oh, I have a, I have an insurance company. They're helping me, they're helping make healthcare affordable. And the networks don't manage cost or quality of healthcare. Okay. So that network that you're paying for that insurance company. Okay. You're just getting a discount off of bill charges with the hospital. That doesn't control the cost of healthcare because if, let's say you're getting a 50% discount what happens when the hospital raises prices? 10%, you're getting 50% off of a 10% increase. Like they're not ca, they're not controlling the cost of healthcare. And most insurance companies, you pay them a premium that is associated with what you're spending on healthcare. The theoretically as the cost of healthcare comes, goes up and that insurance company's making a, percent of profit margin. Their profits just it's just going up exponentially. As healthcare costs increase, though, we've created a monster because it, as healthcare costs increase, there's a, an incentive for insurance companies to actually do less. Like why wouldn't they want cost to increase? Because nobody can go without healthcare. Nobody can go without health insurance, so like why wouldn't they just want cost to increase? As long as they have a, a robust network, they're not looking at, okay which ones are the good and bad doctors? They pay 'em all equally. If you're a good doctor, you're a bad doctor, you do a surgery and you screw it up and you have to redo it, oh, guess what? I'm gonna get paid again. Imagine taking your car to an auto shop, you just paid for a new transmission, you drive out of the transmission, flight fails, and then they're like, oh yeah, you only bring it back. We'll throw another one in, for $4,000. And you say, wait a minute. You guys didn't do it right. In any other business, in any other industry it, it, it's insanity, but it's a, but it's the status quo and completely accepted in healthcare. So it's just you start to think of what value is the insurance company actually providing? And take on top of it all the extra, labor that you have with the people dealing with the billing. And, it's how much of the healthcare resources are is insurance eating up? It's a huge problem. But I struggle, doing employee benefit consulting for over 20 years. I struggle to find the value that insurance companies truly provide, but they're a necess, they're a necessary evil. So AI and automation tools can only accelerate any processes we talked about a little bit earlier. So it seems like. When the system itself needs restructure, we need to reapproach, like even from a governmental level because so much of healthcare and so much as we've seen of like news channels, were sponsored by health companies. So obviously that's gonna create a slant because where your revenue comes from affects what you do. And we see so much, with lobbying and. Affecting government. Is there a way that we can, do we have to solve that before AI can solve it? Do we have to like restructure how we approach it and what the rules are like from a top down thing? First, is that the first phase? Yeah, so I, I think I started off this conversation talking about data. Okay. And AI needs data, right? Essentially if AI doesn't have any data to work with or you don't give it some direction, it can't really do anything. And if you give AI bad data. AI is going to give you a bad output. There's, it's, or if you give AI incomplete information your output from AI is going to be limited. And I think the, consolidated Appropriations Act, I think it was 2018 or 2019 that was passed. I know Health Rosetta did a lot of work and there's a lot of lobbying efforts, but it's dubbed the Transparency Act. And basically what that was is like, hey, we wanna try to bring transparency in he in the healthcare space. So we're going to require hospitals too. Provide. And they all did this. There was no data format requirements, but basically they had to post all of their agreements, all of their pricing with all of the insurance companies that they operated with. Okay. And there was a penalty for noncompliance. It's a pretty minimal penalty. And I think what they didn't expect is how many hospitals just would not comply, and they'd rather pay the penalty because they don't wanna publish the data. And then you had a lot of hospitals that did publish the data, but it was in a previously unusable format. Enter ai. Now AI can actually use that. Unusable human data and turn it into something that's actually useful, but it still doesn't solve the problem that not all hospitals are providing that data. So there's holes. So even if you were trying to, piece things together you can make some assumptions and AI can do really good guessing. But and it's only gonna get better. But I think from a federal government standpoint, they have to mandate the transparency. It's Hey do whatever you want, but at least, give us the data so that we can start putting AI to work to fix some of these problems, because it's, it comes back to having that data, having good data, and having that transparency without it. It, AI is going to you, it's just gonna be limited to what you can do. But there are a lot of companies out there that have figured out how to use the data that's available. There's a company that I'm working with right now outta Chicago it's amazing. I remember the first time I sat on the phone with 'em, I was like, wait, you're doing what? But for years we were trying to collect member data basically for the purpose of managing health plans better for like people's actually healthcare, we call it population health management. So for example you have members let's say you have a member that's diabetic and has high blood pressure. We probably wanna know that they're getting their insulin or they're taking their high blood pressure medication, right? And we call these gaps in care. If they can't afford their medication, they're obviously not gonna take it. Or if they aren't, don't have a doctor because, for whatever reason, there's a lot of reasons why they may not have a doctor. They're obviously probably not gonna have a prescription and, but we know they have the diagnosis, so we can piece things together using data and using some, analytics platforms that help us help people help themselves. That's the best way I can explain it. And we also can bring in clinicians. So if we're in an area that the healthcare system's not working, we can bring in clinicians and we can give them access to information so they can help people. And. One of the neat things this company was doing in Chicago, and I hope this isn't like too long of a story for you, is we've struggled getting that information.'cause insurance companies we're usually getting that information from the insurance companies and they don't wanna share it. And because they don't wanna share it, because it allows, having that information allows us to hold them accountable. And when I talked to you earlier, they don't really have incentive to actually make people better. They want cost to go up, not down. There's really not an incentive other than the other insurance companies that they compete with. And in a state like Michigan we have Blue Cross Blue Shield. They have a 70 o over a 70% market share here. It's, so take that out. There's they don't really have an incentive, but they don't really wanna give you that data. So there's other company that we're working with. And I was explaining the problem. They're going directly. So the state of Michigan actually set up it's a data exchange of medical records on the individual level that, so I'll give you an example. They set it up originally because if you let let's say you see a specialist for your diabetes and you see another specialist 'cause you have arthritis and then you see a dermatologist. Okay? And. All three of those dermatologists are with different health systems. Maybe they're not all with the health, same health system. They're not able to actually see, so let's say your one of your physicians prescribed you a drug and this other prescription, the other physician prescribes you a drug. They don't know that other physician maybe prescribed you another. There's no visibility into that. Sometimes the pharmacy can go and check and say, oh wait, if you take these two drugs, another you're gonna die. But they may not go well together, and there's nobody really overlooking, there's not, there's a there's holes in the data. So State of Michigan does have a data exchange, and some of, and nationally there are some data exchanges that are getting up and running. So this company in Chicago said. Instead of fighting with the insurance companies to get this data, the members we're just gonna go to these exchanges and we're gonna go through the medical billing systems on the provider, on the healthcare provider side to get this information problem solved. All we need to do is create an app and the employee logs in, clicks a button, and it downloads all of their information into the app. It's incredible and it's got AI built in. They can literally ask. AI questions and AI has access to all of their medical records. So it's going beyond you started the conversation where you can, right now, I can go to ChatGPT and say, Hey, I'm having these symptoms. And chat. GPT may ask you some questions and say what are your lab values for this? What are your lab values for this? It knows what to ask for. Imagine. So this, imagine that AI already has all those answers and you type in, Hey, I think I have something going on with this. It's, imagine the accuracy that it's already gonna have all your lab values. It's gonna know your doctors and where you're going for care and what you're doing. It's gonna know and see, hey, we think you might have a knee surgery coming up based on your, medical records that last week. Do you want me to help you decide which doctor to pick or where to go? But that technology already exists and it's, it was mind blowing to me that Hey, we had a problem. We couldn't get this information. We were struggling to get it, and they just went a completely different direction to solve the problem. And that's the innovation that I'm talking about. Like that's, it's going to be game changing. So you put the power of that in a person's hand. It's incredible. Hopefully that wasn't too long of a story for you. No, that's good. I think that's what we want to see is that while there are downsides, there are opportunities and that there is like some, there are some really cool ways that AI can overcome these existing hurdles and maybe do this type of end run where they, it creates the transparency because it's able to. Kind of see through these things. Like we've seen AI tools now transcribe or break like decipher languages that we haven't been able to figure out for thousands of years. We've seen some really cool breakthroughs there. I think this is all very exciting that there's, sure there's the downside, but there's also the upside and that's like what I wanna focus on. So for people that are interested in what you do and what kind of excited by some of these innovations you've talked about, where's the best place to find you and see some of the amazing things that you're working on? Yeah, so I, I actually consult for a company called Kanick. But I would say my LinkedIn profile I go by Eeb, EB guru. And I help companies implement these types of strategies. And really my goal is to turn healthcare back on its head and make it work for your members or human beings. And turn it into what it's supposed to be and making people healthier and live more productive lives. That's my goal. And I help larger employers with that every day, and I love what I do. But it's, that's my way of impacting and putting a dent in the universe. And and fixing healthcare in our country. And hopefully we do get some legislation or more legislation around transparency, because like I said, the more data we get, the, that's where you're gonna see big things change and the better quality data that you get it's going to really feed up. I, and I don't wanna say, we don't want band-aids on the broken system. We want to actually create solutions that completely change the game and fix our broken system. And that's what we're working on. That's amazing. I think that's really cool, and thank you so much for being here today for another amazing episode of the Artificial Intelligence Podcast. Thanks, Jonathan. Thanks for having me. Thank you for listening to this week's episode of the Artificial Intelligence Podcast. Make sure to subscribe so you never miss another episode. We'll be back next Monday with more tips and strategies on how to leverage AI to grow your business and achieve better results. In the meantime, if you're curious about how AI can boost your business' revenue, head over to artificial intelligence pod.com/calculator. Use our AI revenue calculator to discover the potential impact AI can have on your bottom line. It's quick, easy, and might just change the way. Think about your bid. Business while you're there, catch up on past episodes. Leave a review and check out our socials.