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Tuesday, 11 August 2026 |
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| Quarter after quarter, publicly traded health insurers tout their investments in artificial intelligence. UnitedHealth Group is putting $1.5 billion toward the technology this year; CVS Health earmarked at least $20 billion over the next decade. |
| They’re keen to rattle off many, many examples of how they use AI in their businesses. They say they’re getting more efficient and reducing costs. Automating tasks such as prior authorizations and claims processing, summarizing reports for case managers, and generally reducing documentation burden have been common use cases provided during earnings calls. |
| But in this round of calls, two comments stood out to me. Amid all the AI hype — and in an environment where announcing anything AI-related can boost a company’s stock — some insurers are getting a little more real about their strategies. |
| First, Oscar Health CEO Mark Bertolini seemed to scoff at those investment figures shared by much larger competitors. |
| “In the press you hear of billions of dollars being spent by our competitors,” he said. “And I would just make the point that we have one platform. We have one dataset. As a result, we start with a huge advantage in being able to use AI at scale without having to make the investments in platform integration and data rationalization that a lot of our competitors do.” |
| Oscar’s selling, general and administrative expense ratio was the lowest in its history at 14.2%, and the company attributed that in part to AI initiatives. |
| The other comment was from Centene CEO Sarah London, who told investors and analysts that the insurer is planning to invest in AI only when it guarantees a clear benefit. |
| “I think it's easy to get on an earnings call and say we're doing AI everywhere," she said. "There is also a risk of spending a lot of money on AI and getting no return for it, and that's not something that we can afford to do as a Medicaid-first company in a margin-compressed environment." |
| Our question: How will these investments translate to the bottom line — and ultimately to patients’ costs and health outcomes? |
| - Shelby |
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Quote of the week
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"We've made incredible progress in the last couple of quarters on the clinical guidelines as well as the supply chain. That gives me confidence that if and when the FDA does decide to move these peptides to the Category 1 list, we'll be able to move extremely quickly.” |
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Hims CEO Andrew Dudum |
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This week in health Тech |
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Omada Health is getting a new CEO. President Wei-Li Shao is stepping into the role at the start of 2027 as founder Sean Duffy moves on from the post after 15 years. Duffy will stay on as executive chairman. "My goal is to ensure Omada uses that momentum to go from proving outcomes to helping shape what effective, affordable, and accessible cardiometabolic care should look like, and go from serving millions to serving tens of millions in America,” Shao told us in an emailed statement. |
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GoodRx is watching what the FDA decides to do about wellness peptides. “What we do know is that if they pass all of the rigor through the FDA that our ability to play we think would be strong,” CEO Wendy Barnes said on the company’s second-quarter earnings call Thursday. But, she added, the company would focus on having “clinical integrity” and a “well vetted credentialed compounding pharmacy partnership or partnerships.” |
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Worldwide made. Thanks for reading.
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