A GenAI Maturity Guide Written for Healthcare Payers
If your Enterprise AI investments aren’t translating to results, and CMS mandates and industry benchmarks are shifting, this guide brings clarity.
Most payer organizations are piloting GenAI. Few have reached scale. We wrote this guide to help leadership teams pinpoint what’s holding them back, and where to focus next. Our insights are based on real-world patterns across five critical dimensions: architecture, models, compliance, cost, and talent.
The Stakes Are Real
Most payer orgs are stuck. A few are breaking through
87%
of pilots stall before reaching production
$300B+
in savings left unrealized across the industry
CMS
mandates are closing in.

The 5% leading on GenAI are already seeing faster claims, lower costs, and better member outcomes.

What You’ll Get
A Blueprint
A benchmark across
five critical AI maturity
dimensions

A self-assessment based on what’s working
for the 5%

Actionable next steps grounded in real payer challenges
Who It's For
This is for you if:
You're leading GenAI at a payer org under pressure to deliver

You're battling integration issues, compliance risk, and unclear ROI

You need a framework to show the board you're executing

Don’t wait for mandates to force your hand
CMS compliance is approaching. Competitors are scaling real-time infrastructure. This is the only GenAI forecast that shows what’s actually working in enterprise-grade AI.
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