AI requires a modern data and technology foundation.
Health insurers see significant potential in AI but realizing that value depends on integrated data and modern platforms. Intelligent automation cannot scale on fragmented legacy systems.
Regulatory demands continue to accelerate.
Interoperability requirements, price transparency rules, and evolving reimbursement models require agility that many legacy systems cannot support.
The IT spending model is unsustainable.
Many health plans devote a large share of their IT budgets to maintaining existing systems, leaving limited capacity for strategic investment and innovation.
The competitive window is narrowing.
Health plans that modernize effectively will be better positioned to adapt and innovate, while those that delay risk falling behind.
Several forces are accelerating the need for modernization: