CVS Health is growing its partnership with Salesforce, leveraging its agentic AI-driven Agentforce Health to boost personalization in its call centers.
The companies announced on Thursday morning that the platform will connect data across CVS, including Aetna and Caremark, to make it easier for call center teams to address a member's unique needs in a single interaction when possible.
The Agentforce tool will surface critical insights to call center teams in advance, preparing them more effectively for conversations. The goal, the partners said, is to improve the experience for both the member and the workers through a more streamlined interaction.
Pushpendu Pal, senior vice president and chief digital technology officer for pharmacy services at CVS, said in an interview that the effort fits squarely within the company's push to build technology that puts the member at the center of the experience.
For example, he said that before the company was able to integrate data between its Caremark and Aetna teams, a member could call with a challenge that relates to both their coverages. That would require a call center worker to pass along a different number to contact the other side.
Then that evolved to a phone transfer, putting the patient on hold or a warm handoff, where the initial worker stayed on the line to introduce the member to their colleague.
Pal said that with AI surfacing insights in the background, it makes that process simpler and eliminates the need for handoffs and transfers.
Ultimately, improving routine interactions like this has a positive effect on member trust in their plan, Pal said.
"When they reach out to us, they know they will get the accurate answer," he said, "and the call center agents are confident about providing their answers to the member."
Over time, Pal said, the goal is to have ambient listening for the AI agents so that they can answer questions or surface data in real time, rather than needing the call center agent to prompt the tool.
Amit Khanna, senior vice president and general manager for Agentforce Health at Salesforce, told Fierce that there is a significant opportunity in this space for AI to really innovate and drive positive change.
For one, the technology can efficiently sift through data to find key information at the point of care, making for more informed call center teams. And by streamlining the process, it can also help reduce the administrative work necessary to keep healthcare functioning.
For example, a call center worker in the past may not have been able to quickly sort through a lengthy document to find the information the patient needs, so they'd have to call them back—lengthening the encounter and making for a worse experience for both parties.
"We are not thinking about, oh, let's build something that the people will adopt," Khanna said. "It is an actual problem that we are solving together."
Both Pal and Khanna said that the final form of work like this is to make the process self-service when possible for the member, with Pal calling that the team's "north star."
That level of convenience has also become the norm in other industries, Khanna said. It's rare for a consumer looking for financial information to need to call their bank when they can pull up that information quickly on their own through a mobile app or website.
Or for massive retailers like Amazon, it's not likely that a user would need to call a 1-800 number to resolve an issue with an order or find information that they need.
"It removes the friction points," Pal said. "It's efficient, it's one-and-done. Quick, accurate and highly consistent information."