The AI-Powered Payer: Leaders’ Perspectives for 2026

Key Highlights

• 75% of payers plan to invest $10M+ in AI-driven care and payment initiatives
• Nearly 80% prefer buying or partnering for AI capabilities over building in-house
• 86% are not fully ready to operationalize AI at scale
• Interoperability is the #1 barrier, cited by 46% of payers
• ~45% view AI as critical to advancing member care outcomes
• 62% prioritize AI-powered personalized member engagement

A data-driven look at how U.S. health plans are investing in AI, where they’re seeing impact, and what’s holding them back. Based on insights from payer executives, this report explores the shift from experimentation to enterprise-scale AI across risk, quality, and member engagement.

Download the full report to see how leading health plans are navigating the AI transformation.