Where Will AI Deployment Benefit Payers the Most?
A five minute survey from MedCity News asks payers what they think of AI and how it is being implemented. Participate today and we will reward you!
Menopause Is an Overlooked Driver of Cost in High-Risk Populations
For someone already managing chronic disease, menopause can disrupt stability and complicate treatment plans in ways that aren’t always immediately visible but show up over time in outcomes and utilization.
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Inside an Automated Healthcare Practice: Redesigning Care Around People, Not Paperwork
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
The AI Playbook for Health Plans: 5 Steps for Leaders Who Don’t Know Where to Start
It starts with a simple mindset shift, realizing that a successful AI journey begins with identifying a business problem, not with technology. The plans that make real progress embrace this mindset first then follow these five steps.
Why the Office of Personnel Management Needs Access to Government Employee Health Plan Claims Data
Without knowledge of the exact amount providers billed and middlemen charged in fees, OPM can’t fix payment discrepancies.
Alternative Health Plan Designs Are Reshaping Employer Benefits
Alternative health plan designs represent much more than a passing trend. They are actively testing long-standing assumptions about how benefits should be structured, delivered, and experienced.
The Myth of Insurance Networks
How America's outdated insurance model is failing at its most important job
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New Webinar: The Payer AI Readiness Gap: Why Better Data Will Define the Next Era of Health Plan Performance
We'll explore why the next era of payer performance will depend on building a trusted data foundation that connects people, providers, and relationships across the enterprise.
Lack of Trust, Not Technology, is What’s Stopping Health Plans from Meeting Their Mission and Financial Objectives
Healthcare often expects consumers to contort themselves around processes that were never built with them in mind — and that’s where the trust issue begins. With the looming arrival of HR1, how to fix it.
The Next Era of Payment Integrity: Earlier Clinical Validation, True Transparency
By using AI-powered intelligence to shift clinical and coding validation earlier in the healthcare continuum, and unlocking upstream clinical data to inform downstream payment workflows, organizations can proactively prevent errors, reduce downstream churn and friction, and support more predictable, accurate, and timely payments.
ACA Stress Test: Four Key Takeaways from This Year’s Open Enrollment
With data from open enrollment now coming in, we no longer need to rely on guesswork. Let's take stock of where the ACA Marketplace stands today and what it means for our healthcare system.
AI Is Fueling a New Arms Race in Healthcare: Here’s How We Stop It
Rather than using AI to compete, we must design AI to collaborate. As the regulatory landscape evolves and industry pledges push for real-time, electronic, and transparent authorizations, the imperative is clear: technology must bridge the payer-provider divide, not widen it.
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Top 7 Modern AI-Powered EAP Providers for Global Workforces in 2026
Discover the top AI-powered EAP providers for 2026. Compare platforms like Kyan Health and Spring Health on triage speed, global reach, and clinical quality to transform workforce wellbeing.
Individual Coverage Is Reshaping Health Insurance. Agents Are the Key to Making It Work
As individual enrollment grows, agents must evolve to meet a more complex, consumer-driven market.
Housing is the Next Frontier in Proactive Care. Here’s How Health Plans Can Help
Just as health plans have learned to identify and intervene early with chronic conditions like diabetes or heart disease, they can and should do the same for housing and other health-related social needs.
The Referral Is Broken: Why Healthcare’s Last Bottleneck Still Lacks Innovation
We've automated everything but the one workflow that most directly determines whether patients actually get the care they need. The gap between knowing what works and implementing it at scale reveals the real problem that healthcare treats referrals as an administrative burden to manage, not a critical workflow to optimize.
Changes Are Coming to 2026 Medicare Benefits
Here are three things providers should consider when it comes to Medicare.
The OBBBA Is Creating Uncertainty and Disruption: What Health Plans Need to Know
Health plans are being asked to adapt quickly, to reconfigure technology, reimagine operations, and anticipate ripple effects that stretch across claims, member engagement, compliance, and workforce strategy.