At the Fall 2025 Becker’s Payer Issues Roundtable, CareSource Senior Vice President Todd Carlson participated in a fireside chat on how the nonprofit payer is modernizing its technology infrastructure to deliver more personalized, efficient and scalable healthcare.
In partnership with Microsoft, CareSource is undergoing a sweeping transformation aimed at embedding artificial intelligence and cloud-native solutions into its core operations — not just to cut costs, but to improve care access and outcomes for the 2 million members it serves.
Here are four key takeaways from the session:
Note: Quotes have been edited for length and clarity.
1. CareSource is scaling fast — and AI is central to its growth strategy
CareSource has grown 30% in the last year and expects 70% growth over the next 18 months. To support this expansion without proportional increases in administrative overhead, the organization is leaning heavily on automation and AI. The foundation of this transformation includes a unified digital front door — the My Life app — designed to personalize engagement, streamline member services and consolidate fragmented communication channels.
2. The goal is augmentation, not replacement
A defining principle of CareSource’s AI strategy is enabling employees rather than replacing them. The organization’s internally built CareSource GPT tool, layered over Microsoft’s OpenAI platform, now supports 1,500 weekly users across the enterprise.
“Our strategy is to augment our people,” Mr. Carlson said. “Nobody knows our members better than our employees. We just need to give them the right tools.”
To ease fears and accelerate adoption, the organization invested heavily in training, communications and internal storytelling — even producing an AI-generated rap video to demonstrate what the technology can do.
3. Governance and vendor control are mission-critical
From hallucinations to hallucinated efficiencies, AI can create risks without thoughtful oversight. CareSource implemented a cross-functional AI Governance Committee — including privacy, compliance, IT and legal leaders — to vet each use case and control vendor sprawl.
“It is important to partner with the right vendors,” Mr. Carlson said. “You also want to be very strategic … because not all vendors are created equal.”
By requiring vendor use cases to pass through a centralized body and reusing previously approved patterns, CareSource has streamlined decision-making and accelerated implementation.
4. Clinical transformation is next
Early wins focused on back-office operations and documentation — including a 75% reduction in documentation time, $125,000 in annual savings and a 30% increase in developer productivity — but the next wave of innovation will target clinical care.
For example, CareSource is piloting tools that allow care managers to record home visits, summarize interactions using AI and auto-populate clinical systems. This shift allows more human connection during visits while reducing administrative burden.
Looking ahead: Disruption or displacement
Mr. Carlson closed with a bold prediction: “In five years, 80% of operations and call centers will be automated.” He likened today’s AI moment to the early internet — transformative, misunderstood and inevitable. Payers that hesitate, he warned, risk falling behind.
