AHIP 2026 Recap: Rising Digital Expectations for Health Plan Experiences

Corporate Insight attended the AHIP 2026 conference in Las Vegas, where health insurers, technology partners and care delivery organizations gathered to discuss how the industry can build engagement and trust with members and how to build better health plan digital experiences.

One message ran through nearly every session: the bar for a good digital member experiences is no longer set by other health plan organizations. It is set by the digital experiences members have everywhere else, from ordering a ride to shopping online. Clearing that bar will depend as much on connecting a fragmented ecosystem as on adding new tools.

Here are the four shifts that defined the conversation.

The Member Experience Bar Is Set outside of Healthcare

Members do not compare their health plan digital experiences to other health plans. They compare it to the last good digital experience they had anywhere, and by that standard healthcare often looks dated.

• Language matters as much as process. In the opening keynote, Humana’s Jim Rechtin noted that a small wording change, such as showing a claim as pending rather than denied while it is still being worked, can meaningfully improve how members feel about their experience even when nothing about the process changed.
• Experience is how plans compete. CareFirst’s Greg Barber described treating customer experience as a core differentiator rather than a support function. The plan-shopping journey surfaced as the first driver of satisfaction for prospective members.
• A call can signal a digital failure. Blue Shield of California tracks how many members call within 24 hours of using its website or app, on the logic that a follow-up call means the digital experience did not get the member where they were trying to go.

The throughline: Members increasingly expect communications and journeys tailored to them, because they receive that everywhere else, and plans that do not adapt risk losing both acquisition and retention.

Real-Time Drug Cost Transparency Moves to the Foreground

Members often learn at the pharmacy counter that a drug costs more than expected or is not covered at all, and providers often lack the tools to prescribe medications their patients can actually afford. Three plans showed how real-time benefit tools are moving that information upstream:

• Oscar surfaces real-time cost information in its app and member portal to cut down on surprises at the pharmacy counter
• Blue Shield of California delivers real-time benefit checks to providers at the point of prescribing, added a corresponding member-facing tool and more recently layered in prescription alerts
• UPMC built provider-facing benefit checks and more extended member-facing tools through its app

The shared goal is for members and prescribers to see a drug’s price before it is prescribed. The main barrier is mistrust in the underlying data. Members rarely know the exact product code, dosage or days’ supply before filling their prescription, so plans are filling the gaps within common dosages and quantities to keep estimates realistic.

Agentic and Autonomous AI Step into Care and Service

A running theme throughout the conference was that AI is no longer a conversation for the future. It is already widely utilized in care delivery and service today.

• AI is already practicing medicine. Google’s Karen DeSalvo pointed to Doctronic, an agentic prescribing service in Utah, as evidence that AI agents are already operating in the U.S., and argued the industry needs guardrails to match that reality.
• Consumer-style assistants are scaling. Ratnakar Lavu from Elevance Health cited 100,000 weekly searches on the ChatGPT-style assistant inside its Sydney Health app
• Care delivery is moving to real-time care. Sutter Health’s Richard Milani described an AI agent that lets diabetic patients text what they are eating for a real-time read on blood sugar impact, and an AI-led cognitive behavioral therapy tool the organization said matched the effectiveness of a human therapist in testing, with the added advantage of being available around the clock.
• AI targets the work that members never see. Highmark’s enGen and Virtusa described using AI for automatic call summaries and simplifying product information so service agents can focus on members during calls. The panel framed the future as connecting many single-purpose agents into one coordinated system and cautioned that healthcare has little tolerance for an assistant that gives slightly different answers each time.

One of the most concrete examples of AI use came from Medical Mutual of Ohio, which presented Stephanie, an AI voice agent built on Hippocratic AI deployed across 13 use cases. The plan reported:

• 394,000 calls placed across all use cases
• 93.3% resolved without human intervention
• A 360%+ increase in care team capacity
• A 9/10 average member satisfaction score

In one campaign, Stephanie called 25,000 Medicare Advantage members in a single month to encourage annual wellness visits and update primary care provider information, which prompted 4,620 members to update their information or request a visit at an average cost of $2.66 per call, for an estimated $1 million or more in medical loss ratio savings.

Interoperability and the Push toward a Connected Ecosystem

A predominant theme across the conference was that fragmentation, not a shortage of tools, is the real barrier to a better member experience. More disconnected tools can make things harder for the consumer. The real opportunity is bringing benefits, pharmacy, care and coverage into one experience.

• A digital front door ties it all together. CVS Health introduced Health100, which lets members link all their health accounts, including those outside the CVS and Aetna ecosystem, into one profile. An accompanying AI assistant can then use the data to help members navigate their needs and benefits. Speakers noted that the average American manages around six healthcare apps and positioned Health100 as a way to consolidate that into one place by connecting clinical records with wearable data.
• Interoperability over more AI. Aetna and CVS argued that seamless data sharing across pharmacy benefit managers, plans, health systems and providers is what makes cost transparency and timely access to care possible. They positioned the CVS Health app as proof that consumers respond well when multiple stakeholders are connected. In Health100, members build a consented health profile and gain a persistent AI assistant that finds appointments and out-of-pocket costs, guides day-to-day decisions, and conducts proactive outreach based on wearable data.
• Regulation is the backdrop. A session with Aetna, Cigna and CMS walked through the CMS Interoperability and Patient Access framework, including requirements letting patients share their own data with third-party apps, making payer and provider directories public, and enabling the flow of data between providers, between payers when a member switches plans, and for prior authorization queries.

The Takeaway from AHIP 2026

The unifying insight at AHIP 2026 was that members arrive with expectations for digital experiences shaped entirely outside of their health plan, so the industry’s challenge is less about expanding capabilities than about connecting the ones that already exist. The best plans are reducing friction across the whole journey, from shopping for a plan to filling a prescription to getting care, so the experience finally feels as connected and intuitive as everything else in members’ lives.

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