Health insurers, like most major companies in the U.S., have spent the better part of 2026 talking up the size and speed of their AI investments. Three billion dollars at UnitedHealth Group. More than $1 billion at Elevance Health. A $20 billion decade-long technology commitment at CVS.
Now one insurer is taking a notably different tone.
“I think it’s easy to get on an earnings call and say, ‘We’re doing AI everywhere, and we’ve got all these great partnerships,'” Centene CEO Sarah London said on the company’s second quarter earnings call July 28. “Our view is that there is also a risk of spending a lot of money on AI and getting no return for it. That’s not something that we can afford to do as a Medicaid-first company, in a margin-compressed environment.”
Her candid commentary comes at a moment when some of the biggest companies outside the healthcare industry are reaching similar, sometimes even more explicit, conclusions. Uber burned through its entire AI budget for the year in four months, prompting President and COO Andrew Macdonald to acknowledge on the Rapid Response podcast in May that it is “very hard to draw a line” between the company’s AI spending and measurable improvements in its products.
Ms. London did, however, highlight that Centene has produced tangible results with AI. She cited AI-integrated financial forecasting, fraud and abuse detection algorithms that learn from inbound claims data, and a legal department tool that reviews outside counsel invoices and saves the company roughly 1.5% on its legal bills every month. She also pointed to AI-enabled sepsis coding audits and clinical documentation reviews as areas where the technology is proving to be of “high-value.” But she also made clear the company’s next phase of AI investment will be more foundational than flashy.
“We aren’t just going to deploy AI to talk about AI, we’re going to deploy it where there is very clear, tangible return on that investment,” Ms. London said. “We think the way to do that is by this foundational focus on data and context in the short term.”
She said that means building what was described as trusted data products, dynamic context management and open standards that keep business knowledge reusable as the technology evolves, rather than chasing more individual use cases that aren’t necessarily scalable across the company.
In April, UnitedHealth said it expects a 2-to-1 return on its $3 billion AI commitment through 2027, which has seen the company deploy AI agents to schedule appointments, summarize medical charts and analyze millions of customer calls – not to mention building out an entire division of Optum around AI-enabled software solutions meant for the rest of the healthcare industry. Elevance has described itself as “extremely bullish” on the technology and has been scaling a virtual assistant that now reaches 22 million members. And CVS Health CEO David Joyner said Aug. 5 the company is shifting from a “consumer-based healthcare company to a consumer-based healthcare technology business.”
“We believe long-term differentiation will increasingly come from proprietary data and context as model technology becomes more commoditized,” Ms. London said. “This disciplined approach positions us to unlock the full potential of AI while maintaining a relentless focus on ROI. It also provides a governed, predictable foundation for AI, which is critical in a regulated environment where consistency, auditability, and compliance are non-negotiable.”
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