Rapport
Artificial intelligence in managed care: Trends from 2024 to 2026
Artificial intelligence is moving from early experimentation to more practical application across managed care. In this report, Cencora examines how payer perspectives and adoption patterns evolved from 2024 through 2026, highlighting where artificial intelligence is gaining traction, where organizations are seeing measurable value, and which barriers continue to slow broader scale.
Drawing on three years of survey data from healthcare decision-makers, the report explores how managed care organizations are applying artificial intelligence across administrative, analytical, and clinically adjacent workflows. It also examines the growing importance of governance, transparency, system integration, and human oversight as organizations work to adopt artificial intelligence responsibly.
Drawing on three years of survey data from healthcare decision-makers, the report explores how managed care organizations are applying artificial intelligence across administrative, analytical, and clinically adjacent workflows. It also examines the growing importance of governance, transparency, system integration, and human oversight as organizations work to adopt artificial intelligence responsibly.
Key highlights
- AI adoption is progressing from awareness to implementation, with many organizations now scaling beyond pilot programs.
- Prior authorization is emerging as one of the strongest use cases, particularly in documentation review, clinical decision support, and turnaround time.
- Administrative operations currently show the broadest measurable value, including improvements in claims processing, reporting, and documentation.
- AI is expanding into drug utilization review and medication safety, supporting high-risk member identification, drug-drug interaction detection, and alert optimization.
- Governance remains critical as organizations address data quality, privacy, compliance, explainability, and accountability.
- Future opportunities are expected to center on more predictive, proactive, and connected workflows across managed care.
