At UnitedHealth Group Inc., artificial intelligence reads aloud summaries of medical charts as nurses drive to patients’ homes. It listens to millions of customer calls to find the causes of complaints. One trial even has AI agents calling doctors’ offices to schedule appointments for patients.

The largest U.S. health insurer plans to invest $3 billion in AI over 2026 and 2027. UnitedHealth executives say they’re seeing a 2-to-1 return, as AI automates cumbersome manual processes and makes workers more efficient. Executives say the technology can reduce friction for patients while lowering costs.

There’s a lot riding on them being right. UnitedHealth put AI at the heart of its turnaround strategy since profits collapsed last year, to drive efficiency and to address customers’ frustrations such as by speeding up care approvals. Wall Street expects it to boost earnings by cutting expenses. Insurers and medical providers together spend $80 billion a year on administrative transactions, Morgan Stanley analysts led by Erin Wright said in a June research note.

“The cost savings potential is clear, particularly for manual, data-intensive processes such as prior authorization,” they said, adding that UnitedHealth will also profit from selling AI products and services to other healthcare companies.

Many healthcare transactions that have long been digitized in other industries still involve phone calls, faxes and paper. An early example UnitedHealth points to is a system called Optum Real that allows medical providers to check in real time whether a service is covered. The system has processed about a billion transactions since it started last year.

Shares of UnitedHealth have risen 21% this year, after slumping by more than a third in 2025.

AI fears

While investors are bullish on AI’s potential, UnitedHealth faces a challenge to persuade a skeptical public. A Gallup survey last year found 69% of respondents had little or no trust in businesses to use AI responsibly.

Health insurers face an especially high bar in winning people over. Most insured Americans consider companies’ cost-control tactics, such as prior authorization, a burden. About half have encountered barriers to care including delays and denials, according to a poll from health researcher KFF.

UnitedHealth already faces litigation in this area. Plaintiffs in class action cases claim it and others relied on an algorithm to limit care, including admissions to post-acute care following hospital stays. The company has disputed the claims and said the algorithm wasn’t used to make coverage decisions.

But a recent federal inspector general report found companies using the algorithm, from a UnitedHealth subsidiary called naviHealth, had higher rates of denials. Those denials were almost always overturned when patients appealed, the inspector general said.

The company said the algorithm doesn’t dictate how long patients can stay in care facilities, and that it’s used appropriately, in line with regulators’ guidance.

Public frustration with the U.S. healthcare system fueled a backlash against insurers after the 2024 killing of UnitedHealth insurance chief Brian Thompson. The company and its rivals, under pressure from Washington, have been removing some prior approval requirements.

‘Earn trust’

UnitedHealth says it’s committed to using AI responsibly, and that the technology will help alleviate customers’ frustrations.

“You have to gain trust, earn trust through your actions,” said Tim Noel, who succeeded Thompson as head of UnitedHealth’s insurance division. The changes will “take some time for that to actually be felt by people.”

UnitedHealth has said it expects to reduce operating costs by almost $1 billion this year, largely driven by AI. The technology has become an imperative across the company’s many businesses, according to Sandeep Dadlani, chief executive officer of UnitedHealth’s Optum Insight data and technology division.

“The CEOs lead it,” he said in an interview Thursday at the company’s headquarters in the Minneapolis suburbs.

The company has more than a thousand AI uses, 20,000 AI engineers, and 117 large language models available for staff to draw on, Dadlani said.

Under review

An internal review board, including medical ethicists, clinicians, technologists, and privacy and legal experts, also clears proposals to put AI to new uses. Almost 99% of the company’s AI applications are administrative rather than clinical, he said.

“We are not getting into diagnostic AI,” Dadlani said.

It’s also occasionally had to pull back an AI model over unintended behavior — something Dadlani said the company watches closely for. “We have all our alerts firing if something’s beginning to drift,” he said.

UnitedHealth is also tracking whether some workers use AI at least once a day as it pushes to embed the technology into operations. Asked whether the technology has caused job cuts at UnitedHealth, Dadlani indicated it hasn’t. “We don’t have any direct correlation to that,” he said.

UnitedHealth aims to make the case for AI to a country wary of the technology and already and aggrieved at health insurers. This week, it invited reporters to its headquarters outside Minneapolis to show some of its work — an unusual event for a company that historically limited engagement with press.

It was a clear effort to change perceptions, and to convince the public that implementing AI would benefit patients, not just the bottom line.

“We only approve using AI,” Dadlani said. “We never deny using AI.”

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