State of the Payer Industry: Regulation, Redetermination, and the Race Toward Tech-Enabled Transparency

Payers are going through a moment of profound transition. They are adapting to CMS’s evolving mandates around interoperability, price transparency, and health equity reporting, while also navigating shifting rules on Medicaid redeterminations and heightened Medicare Advantage oversight. At the same time, payers are under pressure to modernize member engagement through technology-first approaches that improve access, satisfaction, and retention. How are leading payers balancing compliance with innovation, leveraging interoperability frameworks, data analytics, AI and digital tools to deliver more transparent, equitable, and connected care experiences? Hear from top healthcare leaders who are transforming complexity into strategic advantage and redefining what it means to be tech-enabled in 2026 and beyond.