David Bates, cofounder and CEO of Linus Health
Photo: David Bates
Brain health has been getting more attention as knowledge and understanding about it have come into the mainstream, along with new ways to predict and prevent cognitive decline.
Just as proactive screenings for cancer became common, forward-thinking looks into brain health are coming to the fore.
One kind – AI-enabled digital cognitive screenings – may be poised for a big year in 2026, says David Bates, cofounder and CEO of Linus Health, an AI-driven brain health company focused on early detection of cognitive impairment and personalized intervention. Here's what he had to say when we spoke with him recently.
Q. Medicare pays for proactive AI-based digital cognitive screenings, but most private insurers have not stepped up to cover these, starting at the recommended screening age of 55. What do you predict will happen in the payer space in 2026, and why?
A. We are at a turning point in how health systems view brain health – not as an inevitable decline, but rather as a vital organ system that can be protected and preserved through prevention.
In 2026 and beyond, we hope to see more private payers move toward parity with the Centers for Medicare and Medicaid Services to cover preventive digital cognitive screenings beginning at age 55, which is typically when early indicators of cognitive impairment can be detected.
Several trends are converging to make this coverage important: rising dementia costs, new disease-modifying treatments that require early identification and mounting data showing that proactive screening saves money while improving outcomes. Payers are starting to realize that waiting for symptoms is the costliest option of all.
Currently, most private insurers still require prior authorization or behavioral health pre-certification for simple, five-minute digital cognitive assessments that can be delivered in primary care or other ambulatory settings. This creates needless administrative barriers that prevent early intervention.
Yet the economics are clear. Analyses show that each year of delayed diagnosis adds roughly $18,500 in lifetime care costs per patient, while early screening can generate a $12.50 return for every $1 invested. That level of return will be difficult for any insurer to ignore, especially as employers and members begin asking why cognitive health – a core determinant of quality of life – is not treated as preventively as cardiovascular or cancer care.
For payers, the shift toward proactive brain health coverage is both a cost-containment and a customer-retention strategy. Those who act early can help shape policy and quality measures before mandates arrive.
I believe 2026 will mark a year of voluntary leadership among forward-thinking payers that will recognize that brain health is becoming the next great frontier of value-based care. When screening becomes universal, it will not just reduce dementia costs – it will extend independence for millions of Americans and help payers demonstrate measurable value to their members.
Q. You suggest providers need to let payers know how important it is to have coverage for these screenings starting at age 55, when proactive interventions can actually make a difference in mild cognitive impairment not advancing to full-blown dementia. How will providers handle this area in 2026?
A. Just like payers, provider organizations have a tremendous opportunity to lead in 2026 by reframing cognitive screening as part of routine preventive care. Providers already perform several routine cardiovascular, metabolic and cancer screenings long before symptoms appear, because the science is clear that early intervention can change outcomes.
The same principle applies to the brain. By age 55, the earliest changes associated with Alzheimer's and other dementias can be detected, often five to 10 years before clinical symptoms emerge. The challenge for providers is not whether to act, but how to effectively integrate screening for mild cognitive impairment and dementia into everyday workflows.
Many health systems – such as UMass Memorial Medical Center – already are demonstrating this can be done without disrupting the patient visit. Digital, AI-enabled cognitive assessments can be completed in minutes, interpreted automatically, and the results are integrated into EHRs, allowing clinicians to focus on the consultation with patients rather than the paperwork.
As more organizations participate in value-based care models, these efficiencies align directly with quality and cost goals. Providers will increasingly use population health and analytics teams to show payers that early cognitive screening lowers long-term utilization and acute care events. In 2026, that evidence base will become the foundation for new coverage policies and incentives.
Collaboration between providers and payers will be central to this shift. Health systems can help insurers understand the real-world impact of early detection, including reduced hospitalizations from preventable crises, safer medication management and delayed institutional care. In turn, payers can reward health systems that demonstrate high screening rates and proactive management.
This is the bridge to a shared goal: preventing decline rather than reacting to it. In the same way that blood pressure and pulse oximetry checks have become universal, cognitive health assessments can become a standard of care – but only if providers and payers align around prevention as a measurable, reimbursable outcome.
Q. Similar to cancer care and prevention, cognitive issues need to be caught early for interventions to make a difference. You say AI-based tech is a great way to do this. Patients obviously want any brain health issues flagged before they are obvious. How will AI make a difference in 2026?
A. In 2026, AI will be the most transformative enabler of equitable, scalable and cost-effective brain healthcare. Historically, early detection of cognitive impairment has been limited by time, access and specialist shortages. For example, in Boston, where Linus Health is based, there are more neurologists practicing than across entire states.
AI-based tools now make it possible to bring insightful and actionable cognitive screening into primary care, pharmacies and even community settings – expanding access to tens of millions of older adults who would otherwise never be tested. That is because by capturing subtle changes in behavior, speech or cognition, AI can identify signs of risk years before traditional paper tests or specialist referrals would.
Of course, the promise of AI in this context does not replace clinical judgment but enhances it. Machine learning models can analyze nuanced data – such as speech patterns, reaction times or digital drawing behavior – to provide clinicians with objective and reproducible insights. This is not theoretical.
More than 150 peer-reviewed studies and scientific presentations, conducted by us and our affiliates, have demonstrated the clinical validity and feasibility of digital cognitive assessments and AI-based analytics in diverse care settings. Those insights can guide timely conversations with patients, facilitate referrals to appropriate care and track changes over time.
In the same way imaging and biomarker analytics revolutionized cancer and cardiology, AI-driven cognitive analytics will redefine brain health.
Equally important, AI can democratize access to care. When screening is available in primary care and other common ambulatory settings, patients in underserved or rural areas can benefit without having to wait months for a specialist appointment. That kind of accessibility is essential to closing health equity gaps.
As more payers recognize that AI-based screening can prevent costly downstream care, they will have strong incentives to integrate it into covered preventive benefits. The result will be health systems that help detect problems early, intervene proactively and enable people to maintain independence longer – while receiving appropriate reimbursement.
Ultimately, this overdue change will be a tangible win for patients, providers and payers alike.
Follow Bill's health IT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.
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