Aetna CTO talks prior auth AI strategy, AI governance
Aetna's chief technology officer discussed the insurer's approach to using AI in prior authorization decisions and how the company governs those systems. The conversation touches on one of the most consequential uses of AI in American healthcare.
Why this matters: Prior authorization is where insurance companies decide whether your doctor's recommended treatment gets approved or denied. Automating that with AI is not a back-office efficiency story. It is a story about whether an algorithm can override a doctor's judgment and delay or block your care. AI governance sounds abstract until it is your surgery on hold. The real accountability question is who reviews the AI when it gets it wrong, and whether patients ever find out the tool was involved at all.
Who should care: AI governance · Lawyers · Administrators · General readers · Policy
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