2026 Benchmark Report Reveals Health Plans Struggle to Measure CX ROI Effectively

New insights show that while investments in digital consumer experience (CX) are rising, agentic AI offers a scalable way to connect engagement to enterprise value.

TORONTO, Dec. 9, 2025 /PRNewswire/ – A new benchmark report, Unlocking Value: The 2026 Benchmark for High-Impact Healthcare, published by League and Healthcare Dive, reveals a critical gap between health plans’ growing investments in digital and AI solutions and their ability to measure the resulting business and clinical impact. While customer experience (CX) remains a top strategic priority, most payers lack consistent frameworks and data maturity to quantify value realization.

The report, based on a survey of 100 healthcare leaders from predominantly large US-based payer organizations, highlights that while health plans recognize CX as a top strategic priority, the value realization from growing digital and AI investments remains limited. The challenge shifts from one of intent to one of impact.

Key Findings on Investment vs. Impact:

• Investment is High, Measurable ROI is Low: Health plans are making significant investments in portals, personalization, AI tools, and journey analytics. However, only 27% of respondents report being able to directly connect digital and AI investments to CX outcomes.
• Legacy Systems are Holding Health Plans Back: Legacy infrastructure (58%) and data integration challenges (50%) remain the leading obstacles to progress, keeping many health plans trapped in pilot mode rather than scaling innovation across their organizations.
• AI Maturity is Early, But Agentic AI Shows Promise: AI dominates industry conversations, but impact still lags. While 73% say they are currently piloting agentic AI, the report reveals that these efforts often remain limited in scope. True impact requires moving beyond pilots to focusing on key areas for business transformation to deploy agentic AI in an orchestrated way that connects data, automates workflows, and drives measurable value, accelerating CX transformation across the enterprise.

“The data shows that member experience is broad and multifaceted, making measurement a challenge,” said Sarah Hacker, VP, Solution & Value Engineering at League. “The most successful health plans align their key initiatives to the four pillars of value: revenue growth, operation efficiencies, health outcomes and medical cost savings, and time to value. By anchoring digital and AI investments in critical member journeys like care navigation, benefits navigation, health coaching, and care gap closure, health plans can more clearly define measurable impact and build a self-sustaining cycle of innovation.”

“For 2026, the focus must shift to driving enterprise-wide value through connected digital and AI strategies,” commented Greg Gilbert, Managing Director, Accenture. “Agentic AI is proving to be the catalyst that breaks through data silos, enabling smarter, continuous engagement needed to truly close care gaps, reduce spend, and significantly improve satisfaction.”

About the Report

Unlocking Value: The 2026 Benchmark for High-Impact Healthcare explores how leading health plans are modernizing their digital foundations, redefining CX success, and applying agentic AI to bridge the gap between innovation and measurable CX outcomes. The report provides actionable intelligence on:

• Connecting CX, digital, and AI strategies to drive enterprise-wide impact.
• Breaking through legacy and data barriers to enable smarter, continuous engagement.
• Using agentic AI to close care gaps, reduce spend, and improve satisfaction.

The full research report is now available for download on League.com.

About League

Founded in 2014, League is the leading healthcare consumer experience (CX) platform, powered by artificial intelligence (AI), reaching more than 63 million people around the world and delivering the highest level of personalization in the industry. Payers, providers, and healthcare innovators build on League’s platform to deliver high-engagement healthcare solutions proven to improve health outcomes. League has raised over $285 million in venture capital funding to date, powering the digital experiences for some of healthcare’s most trusted brands, including CareSource, HCSC, SCAN, and Highmark Health.

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SOURCE League Inc.