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The approach will be used for medical services that are commonly subject to prior authorization, such as orthopedic surgeries and imaging services.

The core issue is a structural mismatch between what it takes to run a primary care practice, versus what the system pays for it, says Elation Health's CEO.

Fifty percent of the payment will be withheld to be reconciled after a 12-month care process, subject to two downward adjustments.

UnitedHealth Group says it plans to invest $1.6 billion in AI this year.

The non-binding committee will make recommendations on, among other issues, ways to modernize MA risk adjustment and quality measurement.

The health plan partnered with mPulse for digital access to physical and mental health support.

McLeod Health approached AI deployment with a focus on removing friction from clinical workflows rather than chasing financial returns, says CMIO Bryon Frost.

AI exposes chaos when fragmented data and broken workflows become more visible during automation, says Michael Vipond of ServiceNow.

CVS Health, Highmark, Waystar and others partner with Google Cloud for agentic AI solutions.

Physicians tell Dr. Amy Bucher they feel a sense of empowerment in being able to offer their patients something that, along with lifestyle changes, reduces weight, lowers the risk of diabetes and high blood pressure, and helps prevent other chronic conditions.