RISE National 2026 Highlights: A Bold CMS AI Prediction, Behavioral Science Breakthroughs, and Surprising Industry Players

After years of anticipation, RISE National 2026 proved to be a standout event for stakeholders across the healthcare payer ecosystem. Long regarded as a premier gathering for health plans and related vendors, this year’s conference delivered actionable insights, forward-looking predictions, and a strong focus on real-world challenges.

A Must-Attend Event for the Payer Ecosystem

RISE National continues to solidify its reputation as a highly targeted conference for professionals working with payers, Medicare Advantage plans, and risk adjustment programs. Attendees praised the event’s practical keynote sessions—free of fluff—and an exhibit hall filled with solution-driven companies addressing pressing industry issues.

Notably, many participants found themselves spending more time engaging with exhibitors than attending formal sessions, underscoring the value of hands-on learning and direct industry interaction.

Key themes emerging from the exhibit floor included:

Behavioral science-driven engagement: Moving beyond generic reminders to influence real patient behavior.
Clinical data interoperability: Transforming fragmented data into actionable insights for providers and payers.
Strategic AI deployment: Applying artificial intelligence to fix workflow inefficiencies rather than chasing trends.

CMS Innovation Center Signals a Shift in Healthcare Delivery

One of the most talked-about moments came from Abe Sutton, Director of the CMS Innovation Center. While discussing data models and healthcare innovation, Sutton made a striking prediction about the future role of AI in clinical care.

He suggested that the rise of AI—capable of analyzing vast medical literature and recognizing complex patterns—could reverse the long-standing trend of hyper-specialization in medicine. Instead of navigating multiple specialists, patients in the future may require fewer consultations, as clinicians leverage AI-powered tools to broaden their expertise.

This perspective sparked significant discussion, pointing toward a potential transformation in how care is delivered.

Behavioral Science Takes Center Stage

A major theme at RISE National 2026 was the growing importance of behavioral economics in healthcare engagement.

Industry leaders emphasized that traditional outreach methods—such as automated reminders—often fail because they overlook the underlying reasons behind patient behavior.

Chandra Osborn of AdhereHealth shared a compelling case study: a patient who was non-adherent to medication despite consistent reminders. The root cause was not forgetfulness, but social and economic challenges, including caregiving responsibilities, lack of transportation, and food insecurity.

By addressing these barriers—connecting the patient to a food bank and arranging medication delivery—the health plan successfully improved adherence and reduced emergency care visits.

The takeaway was clear: effective engagement requires empathy, not just automation.

An Unexpected Player: Hallmark Enters Healthcare

Among the most surprising exhibitors was Hallmark, traditionally known for greeting cards. The company showcased its growing role in Medicare Advantage, focusing on member engagement and closing care gaps.

Hallmark presented evidence that simple, personalized gestures—such as birthday or encouragement cards—can significantly enhance member trust and engagement.

Their solutions also enable frontline staff and call center agents to send tailored messages, reinforcing emotional connection in an increasingly digital healthcare environment.

Strong Focus on AI, Data, and Compliance

Across sessions and discussions, several core themes dominated:

AI-powered personalization: Health plans are leveraging AI to tailor outreach strategies based on behavioral insights.
Coding accuracy and compliance: AI tools are being used to prevent both under-coding and over-coding, reducing financial risk and regulatory scrutiny.
Clinical data utilization: There is a growing push to move beyond claims data and harness real-time clinical data for decision-making and risk adjustment.

A Well-Executed, Purpose-Driven Event

Beyond content, attendees highlighted the event’s execution. From thoughtfully designed spaces for virtual meetings to healthy food options and community-focused initiatives—such as charity stations for local causes—the conference experience was both productive and engaging.