Administration and automation are not the only AI use cases payers should be focused on this year, according to McKinsey Senior Partner Adi Kumar, who broke down his 2026 predictions for insurers in a Jan. 12 report.
His insights were among a series of points of view in the consulting firm’s “McKinsey perspectives on healthcare industry trends and the year ahead.”
Mr. Kumar posits the three most pressing issues payers deal with are rising healthcare costs and corresponding regulatory shifts, demographic changes and wavering national sentiment, and technological revolution.
Here are five predictions and recommendations from the article:
1. Payers are at a place to look beyond AI administrative use cases. Care management is one opportunity where payers can assert more control.
2. Mr. Kumar said healthcare has been slow to reach a technological revolution, but payers can harness technology to better engage with consumers.
3. The One Big Beautiful Bill Act will raise the bar for payer performance, affecting how much money insurers get from the federal level. Payer financials could either take a hit — hurting risk pools — or payers could play the “productivity game” to get ahead.
4. Mr. Kumar encourages payer CEOs to consider what types of business they want to focus on as the line between payers, providers and services get more blurred.
5. CEOs also need to think about productivity and “how to do more with less.”
