Centene Corporation is a Fortune 23 healthcare enterprise that provides services to government-sponsored and commercial healthcare programs. Serving more than 28 million members across the U.S., Centene is the largest Medicaid managed care organization in the country and a major player in the Medicare marketplace.

With over $163 billion in annual revenue, the company operates across all 50 states, working with providers, local health plans, and government agencies to improve health outcomes and increase access to care.

In part one of this series, Wendy S Batchelder, Centene’s SVP and Chief Data Officer, discussed the company’s approach to data, the challenges of fragmentation, timeliness, quality, and governance, as well as AI ethics and the need for an agile strategy.

In this second part, Batchelder speaks with Sezin Palmer, Partner at EY, to dive deeper into two central themes: how Centene is building trust and transparency in data, and how the organization is approaching responsible adoption of AI in a fast-changing technology landscape.

Trust and transparency at the core

For Batchelder, the foundation of Centene’s data strategy comes down to two principles: trust and transparency. She says that the company is leveraging data and AI to effectively support members, providers, and stakeholders. “We are only as good as our data,” she emphasizes. “Maturity plays a significant role in how effective we can be.”

Adding further, Batchelder states that Centene has spent the past year enhancing its data strategy, with a strong focus on ensuring that high-quality data underpins its AI efforts. At the core of this approach is building trust, which she describes as the anchor for everything the company is doing in this space.

“Data transparency to me is paramount,” says Bathelder. However, she concurs that it does not mean all data elements will have to be perfect: “That would be cost-prohibitive. Prioritize: where are we going to be using data? Which use cases are most important? What level of quality is acceptable, and do we have end-to-end transparency to really understand — where did this data come from? How has it been modified, manipulated, changed, or curated?”

At the same time, Batchelder asks to be intentional and thoughtful about getting to the trusted data model for important things. She reiterates, “You’re never going to have perfect data in an organization. You could spend every dollar you have, and you would still not have perfect data.”

Therefore, rather than chasing uniform perfection, as CDO, Batchelder focuses quality investments on the most consequential use cases. She mentions trust as a critical aspect, adding, “We are holding people’s medical information, the data which requires the right care so that we can provide care for them.”

Data governance at Centene thrives on being transparent with the stakeholders about the outcomes they need and what needs to be done from a data perspective to enable the business stakeholders to get the outcomes.

Circling back, Batchelder stresses, “How are we being intentional about how we’re using information? Do we have all the right guardrails in place to make sure we have the right governance over the right data at the right time? And that we use that data effectively to propel the right AI that’s really aligned with our values.”  

Guardrails for responsible AI

Speaking of AI, Batchelder believes the key is measured adoption. She states that while exploring AI and experimenting with new technologies can drive innovation, Centene avoids rushing into adoption without a clear sense of purpose. Each decision starts with a simple question: “What are we trying to accomplish?”

Batchelder asks, “Are we balancing the risk and reward in a way that if a member, a regulator, or the average human saw the way that we were using AI or data, it would feel aligned with our values?”
This values-based lens drives Centene’s approach to AI. Decisions are made collectively, with leaders from technology, compliance, security, and business functions working together to evaluate potential use cases and their broader implications.

Collaboration across the organization

Moving ahead, Batchelder states that in partnership, it is intentionally ensured that all cross-functional stakeholders are at the table, thoughtfully evaluating the use cases being considered.
This ensures “we’re getting as many people around the table with the business locked arms to say, ‘Is this the right thing to do? What are the pros? What are the cons? Are we thinking about the risk appropriately?’”

Setting hard lines: AI that builds trust

Instead of rushing to participate in the AI moment, the company takes a measured and intentional approach, focusing on what aligns with values and has clear, tangible benefits, says Batchelder.
Sharing an example, she says, “We use AI to help accelerate access to care, such as accelerating prior authorizations. But we do not make decisions with AI that would deny or delay care. We don’t use automation to deny care ever. Period.”

Concluding, Batchelder says that Centene has drawn a firm boundary on how it uses AI, guided by its mission to help people get and stay healthy. The company views denying care through automation as an unacceptable risk. She adds, “We want to make sure that everything we’re doing with AI is trust-building and not trust-eroding.”

CDO Magazine appreciates Wendy S Batchelder for sharing her insights with the CDO Magazine Global community.