Emerging technologies like generative AI and predictive analytics will be a difference maker in terms of health plans operating more efficiently in the very near future.
Becker’s connected with ten health plan leaders to learn what innovation they think will most impact health plans in 2026.
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Editor’s note: Responses have been lightly edited for clarity and length.
Question: What innovation will most impact health plans in 2026?
Hillary Galyean. Chief Growth Officer, St. Luke’s Health Plan (Boise, Idaho): One of the most impactful innovations for health plans in 2026 may not be a new technology — it’s trust. For decades, payors and delivery systems have been positioned against each other, creating silos, friction, and costly administrative processes that leave patients caught in the middle. True innovation will break down these silos, increase transparency, and build stronger partnerships. When trust leads, the system improves financially, operationally, and, most importantly, for the member experience.
Prashant Shanti Kumar. Managing Director, Enterprise Data Solutions, Blue Cross Blue Shield Association (Chicago): In 2026, the fusion of AI and cost-containment strategies will redefine health plans. AI will streamline diagnostics, billing, and personalized care, while remote monitoring and digital platforms enhance access and efficiency. As inflation pressures margins, this shift isn’t optional but rather it’s inevitable. We’ll look back and say, “That was the turning point.”
Christina Rassi. Chief Growth Officer, Evry Health (Dallas): In 2026, AI-powered diagnostics and personalized care platforms will reshape how health plans manage care—making it faster, smarter, and more tailored to everyone. While these innovations will drive efficiency, the continuum of care remains complex and often overwhelming for members. This is where Evry will play a vital role: blending intuitive technology with real human connection, offering personalized tools and a team of compassionate nurses who guide members through the complexities of healthcare, making every step feel more manageable and meaningful.
Conrad M. Vial, MD. President, Sutter Health Network (Sacramento, Calif.): 1. The implicit health-promoting promise of value-based care (VBC) has long been linked to the two-fold opportunity to gain actionable insight into human vulnerabilities and to translate that insight into meaningful interventions that avoid and/or mitigate the intensity of adverse impacts on member-patient well-being. (Note that the right form of care deployed at the optimal time has always been the key to producing enhanced clinical benefit at a lower total cost of care over the proper temporal horizon.)
- Significant barriers to broad fulfillment of VBC’s promise have a common root; namely, the juxtaposition of poor data set integration — often between payors and providers but also between providers — with deficient prospective risk models and weak predictive analytical capabilities.
- However, the most impactful innovations in favor of realizing the transformative potential of VBC will be catalyzed not merely by AI-powered advances in more accurately predictive risk stratification and automated workflows, but instead by the combination of such technological empowerment with up-skilled or re-skilled people engaged in partnerships that drive performance beyond the linear sum of parts.
- These partnerships may take on a variety of particular expressions but will have one underlying common denominator: more substantive, more empowered, more agile and, frankly, more authentic payor-provider partnership.
Nishant Anand, MD. President and Chief Executive Officer, Altais (Oakland, Calif.): Artificial Intelligence. AI’s biggest impact will come from reducing administrative friction and improving engagement and simplicity for both members and providers. By automating manual work, it gives clinicians and patients something invaluable back — time and connection. The key is using AI responsibly, as a partner that enhances judgment and empathy rather than replaces it. When designed thoughtfully, AI can help make healthcare feel more personal, not less.
Erin Henderson Moore. President and Chief Executive Officer, Fidelis Care New Jersey (Newark): One of the most significant innovations that I think will shape Medicaid health plans in 2026 is the application of AI and predictive analytics to improve care management.
For Medicaid plans, where resources are limited and member needs are complex, being able to predict who is at risk and intervene earlier is critical. These innovations allow us to do more with less while staying aligned with our goals of improving member experience.
Of course, the real impact will depend on how well we integrate these tools into clinical and operational workflows and ensure they’re transparent and equitable. But if implemented thoughtfully, I believe AI-supported care management could be a true inflection point for our industry in 2026.
Bret Voith. Chief Strategy Officer, NCD (Addison, Texas): In 2026, health plans will grapple with the many trade-offs that stem from introducing AI into consumer facing workflows while also aiming to not only maintain but build trusted relationships with their members. Done well, the introduction of AI into member communications can foster greater efficiency for front-line team members at plans as well as serve as an extension of this team. Done poorly, it can further disconnect the plan from the consumer. Over 2026, plans will need to be highly thoughtful about layering in the many internally built and vendor-driven solutions into their workflows to make this a positive for both their members’ experience and plan performance.
Angela D. Flippin-Trainer, MD. Medical Director, Total Health, Wellness and Supplemental Health, Cigna Healthcare (Bloomfield, Conn.): When considering the innovation that will most significantly impact health plans by 2026, I am convinced that artificial intelligence will be the key driver of change. Although AI technology has been around for decades, its integration into the healthcare sector promises to revolutionize the industry. AI is set to enhance our efficiency and productivity, extending its transformative influence to the provider level.
This technology is likely to reshape both the inputs and outputs within health plans, leading to more streamlined processes and improved patient outcomes. Additionally, we are exploring numerous ways to utilize generative AI to further optimize our operations and deliver even better results to the clients and customers we serve. However, it is important to note that effectively leveraging generative AI requires time and dedicated effort to learn. Its potential benefits are immense, but maximizing its impact necessitates a thorough understanding and strategic implementation.
Kenny Bramwell, MD, Senior Medical Director, Select Health (Murray, Utah): I think that this is a singularly disruptive time within health plans. I’ve not heard of anything else quite like our current set of problems.
The innovation that I feel is most needed at this point is cooperation. We need to work better with our providers, with our hospitals, and with our legislatures to navigate these upcoming headwinds.
Trent Nate, MBA, Vice President, Idaho Market, Select Health (Murray, Utah): In 2026, the most impactful innovation for health plans will be the widespread adoption of generative AI to streamline operations and enhance member engagement. Health insurers are leveraging AI to automate claims processing, personalize care recommendations, and reduce administrative burdens. Predictive analytics will also play a critical role in identifying at-risk populations and enabling proactive, preventive care. These technologies support the shift toward value-based care, especially as new CMS models like TEAM take effect. Together, these innovations are transforming health plans into more agile, data-driven organizations focused on outcomes and member experience.
Daniel Knecht, MD, Chief Medical Officer, EmblemHealth (New York City): The innovation that will most impact health plans in 2026 is the integration of artificial intelligence in upstream population health interventions. At EmblemHealth, we’re already seeing the impact though our Weather Resilience Program, which uses AI to synthesize clinical, claims, and public data to identify and support at-risk members before weather-related health crises occur. AI-powered voice agents can conduct conversational phone calls in multiple languages, reaching thousands of members with preventive guidance.
This information includes where to find nearby cooling centers, how to stay safe during extreme heat or air pollution events, and even pet safety tips. AI agents can also recognize when a member may need additional care management or emergency support, allowing us to intervene proactively and effectively at scale while keeping humans in the loop when appropriate. The responsible application of AI, particularly in preventive care, has the power to exponentially amplify public health messaging at critical, and potentially lifesaving, touchpoints.
Jennifer St. Thomas. Senior Vice President, Commercial and Medicare Markets, Mass General Brigham Health Plan (Somerville, Mass.): At Mass General Brigham Health Plan, we have unique opportunities as part of an integrated healthcare system to leverage innovative care management technology and improve the end-to-end healthcare experience. We are currently implementing an integrated care management platform to allow for more customized and tailored approaches to meeting the health needs of our members. This will help to optimize collaboration and data-sharing across our teams and deepen our support for members across their entire healthcare journeys.
