Build vs. buy: the AI-driven healthcare solutions payers can’t afford to get wrong

Business of Healthcare
Written By The Pager Health Team

How payers close the gap between AI ambition and trusted care navigation

AI-driven healthcare solutions have moved past experimentation. For health payers, the question is now how to adopt AI in care navigation safely, at scale, and in a way that protects members, network performance, and revenue. 

Most organizations get caught between two extremes: overconfidence in building internally, and underuse of purpose-built AI-driven healthcare solutions that could accelerate time to value. Gartner estimates fewer than 30% of agentic AI use cases will deliver their expected value and the reason is rarely the technology itself. 

Learn:

  • Why care navigation is one of the highest-value and highest-risk use cases for AI-driven healthcare solutions 

  • The demo vs. production gap, and the critical questions a demo doesn't answer 

  • The full cost of building AI internally, including the hidden costs most business cases miss 

  • A four-step decision framework covering problem definition, readiness assessment, governance, and total cost of ownership 

  • The four pillars of best-in-class AI navigation and the signals that it's time to act 

The Pager Health Team
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Build vs. buy: Evaluating AI care navigation that works in the real world