CVS Health’s Aetna launched the next generation of its claims assist manager, an agentic AI claims adviser. Using claims adjuster AI agents, the tool reduces processing time by more than 20% for complex claims that need manual review, according to…
Virtual Care
It’s no secret that one of AI’s greatest use cases has been to streamline internal operations and administrative tasks at healthcare organizations. But, for some payers and their parent companies, these technologies are going even further, now serving as a…
Medicare Advantage insurer Clover Health is aiming for Counterpart Health — a subsidiary bringing the carrier’s AI-powered clinical decision support tool to external payers and providers — to serve “as a long-term growth engine,” a Clover executive said on a…
Blue Shield of California debuted its virtual-first Virtual Blue healthcare plan just over three years ago. Now, the data is rolling in. The program began in 2023 through a collaboration with tech-enabled healthcare platforms Accolade — now owned by Transcarent…
When it comes to attempts at insurance fraud, the story behind claims could be a major threat. In a 2025 issue brief shared with Becker’s, the National Health Care Anti-Fraud Association outlined several possibilities for fraud that AI could spur:…
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Cigna’s predictive, high-cost claimants model is saving the company an average of $2,000 per participating member each year, incoming CEO Brian Evanko said during an April 30 earnings call. Cigna’s insurance business has been leaning into AI-enabled risk prediction models…
AI was front and center during recent earnings calls for UnitedHealth Group and Elevance Health, as leaders discussed their companies’ respective $1.5 billion and $1 billion tech investments. Both organizations, along with Centene, made Fortune‘s top companies for AI adoption…
Elevance Health is the latest insurer to tout hefty tech investments on an earnings call, with President and CEO Gail Boudreaux boasting a $1 billion spend across digital and AI capabilities. “We’re not approaching AI as a separate technology element…
UnitedHealth Group is betting big on AI in 2026 — $1.5 billion to be exact. During the company’s Q1 earnings call, leaders fleshed out how that investment is materializing. “Think about it this way: A third of this is explicitly…
Cigna Healthcare offers the best digital experience to commercial members, while UPMC Health Plan provides the best experience to Medicare Advantage enrollees, according to JD Power’s 2026 U.S. Healthcare Digital Experience Study. Both plans topped their respective segments in last…