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  • Professor Andrea M. Armani, University of Southern California
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70%+ of Payers and Providers Anticipate Greatest Impact of Gen AI on Health Outcomes and Member Experience, According to HFS Research and Cognizant Report

By: via Business Wire

New Report: Re-energize Health Consumer Engagement and Bridge the Payer-Provider Divide with GenAI reveals potential healthcare trends, including:

  • Over 64% of health plans believe generative AI (gen AI) will be a game changer in healthcare.
  • 50% of healthcare enterprises, including health plans and health systems, have engaged in vertical integration or consolidation over the last three years to stay relevant, overcome competitive threats and mitigate loss of high-margin risk businesses.
  • 39% of health plans and health systems ranked price transparency as the top priority for their consumers.
  • Over 70% of health plans and healthcare providers see the greatest impact of gen AI on consumer health outcomes and experiences.

HFS Research, in partnership with Cognizant, recently released a report entitled Re-energize Health Consumer Engagement and Bridge the Payer-Provider Divide with GenAI that reveals potential healthcare trends. C-suite (CXOs) and senior leaders at 350 US health plans and health systems were asked for their insights to explore the impact of vertical integration and generative AI (gen AI) on payer-provider friction and consumer experience and engagement. Six actionable opportunities for healthcare are highlighted in the report.

These opportunities are critical for the United States healthcare system, which is flanked by deteriorating health outcomes―a declining life expectancy, increasing prevalence of chronic conditions and opioid and mental health epidemics―and accelerating technological innovation due to adoption of artificial intelligence (AI) at scale, new care models and a resurgence of digital-health-fueled primary care. These conditions create opportunities for the triple aim of care, which are reducing costs, enhancing the experience of care, and improving health outcomes.

Specific report findings include, among others:

  • 60% of health plans and health systems admit to lacking an understanding of their evolving member or patient needs, yet 50% of health plans and health systems claim they have the digital capabilities to meet consumer needs.
  • 25% of providers intend to deploy gen AI to enhance patient engagement, including personalizing experiences in an acute care setting, customizing content for recovery and wellness, and generating medical summarization.
  • Lack of gen AI skills―programming, statistics, machine learning, data processing and visualization, and certain domain understanding―is a top challenge cited by payers and providers in adopting gen AI.
  • While leadership across healthcare is keen on making progress on gen AI, senior leaders and practitioners often express reservations about true impact.

“The report highlights the disconnect between payers and providers and its impact on patient engagement and health outcomes,” said Patricia Birch SVP and Chief Strategy Officer for Cognizant Health Sciences and report co-author. “We believe this research will encourage healthcare stakeholders to embrace gen AI as a strategic asset for driving value from high priority investments, including vertical integration.”

“This report quantifies the struggles of health plans and their relevancy with their members, and how health systems are focused on improving health outcomes,” said HFS Research Executive Research Leader Rohan Kulkarni and report co-author. “We see that gen AI has a lot of potential to meet many of the healthcare ecosystem’s objectives.”

“It’s clear, based on our research, that the healthcare system must explore different approaches of delivering care, and lean into leveraging gen AI to make paradigmatic shifts versus simply addressing legacy challenges,” said HFS Research CEO and Chief Analyst Phil Fersht.

About Cognizant

Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com or @cognizant.

About HFS Research

HFS is a leading global research and analysis firm trusted at the highest levels of executive leadership. Our mission is to help our clients—major enterprises, tech firms, and service providers—tackle challenges, make bold moves, and bring big ideas to life by arming them with accurate, visionary, and thought-provoking insight into issues that impact their business. HFS analysts and strategists have deep, real-world experience in subjects they cover. They’re respected for independent, no-nonsense perspectives based on thorough research, demand-side data, and personal engagements with industry leaders. Visit www.hfsresearch.com.

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