Survey shows legacy tech and weak ownership block value from digital health investments
Member‑experience spending is climbing fast, but most health plans still cannot show whether it actually improves outcomes or saves money.
According to League and Healthcare Dive’s report Unlocking Value: The 2026 Benchmark for High-Impact Healthcare, nearly all surveyed US payers now have, or are building, a customer experience strategy, yet few can directly link digital and AI investments to clinical or financial results.
The study says most still lean on lagging operational metrics such as retention and complaint or claims resolution, instead of measures tied to quality scores, care‑gap closure, or digital engagement.
League and Healthcare Dive report that health plans are spending heavily on member portals, personalisation platforms, AI tools, and journey analytics, but only a minority say these initiatives are fully aligned with CX outcomes.
Greg Gilbert describes the pattern as “death by 1,000 pilots,” where projects run in silos instead of transforming an entire function like claims, utilisation management, or contact centres with end‑to‑end KPIs and clear P&L accountability.
Legacy infrastructure and data silos remain the biggest structural drag.
As per the report, only about a third of organizations describe their digital environments as modern or interoperable; most operate with a mix of old and new systems.
That fragmentation makes it difficult to build a 360° member view, coordinate outreach, or scale AI beyond narrow use cases such as chatbots, documentation support, or personalised content.
League and Healthcare Dive say the more effective players focus on “minimum‑viable data” and start narrow.
They pick one domain, set leading and lagging indicators, prove value, then reinvest gains into the next use case.
Sarah Hacker notes that the strongest plans align initiatives to four value pillars – revenue growth, operational efficiencies, health outcomes and medical cost savings, and time to value – and concentrate on journeys like care navigation, benefits navigation, health coaching, and care‑gap closure.
The report also stresses ownership.
While many CEOs are seen as leading CX and digital strategy, the report note that durable change usually requires a P&L leader who is accountable for outcomes and works with IT, operations, and clinical teams.
Gilbert says “the person who owns that budget needs to be bought in and held accountable to it,” arguing that only then do CX and AI move from support roles to real drivers of lower costs, better outcomes, and higher member satisfaction.
