Hasan Shanawani, Associate Chief Medical Officer at Horizon Blue Cross Blue Shield of New Jersey

Dr. Hassan Shanawani, Associate Chief Medical Officer at Horizon Blue Cross Blue Shield of New Jersey, joins Scott King on the Becker's Healthcare Podcast to discuss the evolving role of health insurers in managing rising healthcare costs while improving member experience. Drawing from his extensive background in patient safety, federal healthcare IT, and quality improvement—particularly during the VA's massive EHR transition—Shanawani emphasizes the need to shift from adversarial prior authorization practices to collaborative, transparent care coordination. He highlights Horizon’s strategic use of AI not to deny care, but to accelerate approvals, reduce administrative burden, and empower providers and members. By leveraging AI for real-time documentation review, voice-enabled IVR systems, and digital front doors for primary and specialty care, Horizon aims to make high-quality care more accessible, equitable, and efficient. Shanawani also addresses the growing role of AI in member interactions, noting that while trust remains a challenge on the provider and payer side, AI has the potential to democratize healthcare information and decision-making—much like the printing press revolutionized access to religious texts. He envisions a future where AI fosters alignment among members, providers, and payers, transforming the healthcare ecosystem from one of conflict to one of shared purpose. Key takeaways include: 1) Use AI to approve, not deny—automate routine decisions to reduce delays and provider frustration; 2) Simplify care navigation by standardizing site-of-service pricing and steering members to high-quality, lower-cost options; 3) Invest in digital front doors and voice-enabled tools to improve access and equity, especially for underserved populations; 4) Build agentic governance models to ensure AI accuracy and accountability; 5) Prioritize transparency and education to build trust with members and providers. The episode concludes on an optimistic note, framing AI not as a threat but as a transformative force for equity, efficiency, and human-centered care in health insurance.