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Beyond prior authorization: AI in utilization management raises the bar on decision quality 

For years, utilization management has been measured by its ability to answer operational questions. How quickly can requests be reviewed? How consistently can policies be…

The Simplest Experience Wins: What Healthcare Leaders Told Us About AI

"I need help!" said Kate (name changed) as she sat down at the roundtable discussion at the Emids Healthcare Summit ‘26. In an instant, she…

To Win With AI, Enable Continuous Innovation Instead Of Multi-Year Transformations

For years, healthcare modernization has followed a familiar playbook: define a long-term roadmap, secure funding, launch a large transformation program, and expect the organization to…

How Healthcare & Life Sciences GCC Leaders in India Are Scaling Enterprise AI

Beyond Compliance: Why Interoperability Is Becoming Healthcare’s Competitive Infrastructure

For much of the last decade, interoperability has been viewed through the lens of compliance. Healthcare organizations invested in APIs, FHIR implementations, patient access rules,…

Trust at Scale: Operationalizing AI Responsibly Across Healthcare

Across healthcare, organizations are investing heavily in AI to improve operational efficiency, support clinical decision-making, and create better experiences for patients and members. As adoption…

Care Coordination Reimagined: Five Lessons for an AI-enabled Future

Reducing the cost of care means making every interaction count. Whether it's helping a member reach the right specialist, catching a care gap before it…

The State of Healthcare AI in 2026 

75 senior healthcare executives reveal where the industry really stands on AI. The ambition is aligned; the readiness is not. See the maturity gaps, investment…

The Agentic Evolution: The Payer’s Guide to the Next Automation Era 

Payers have hit the ceiling of rules-based automation. The next era is intelligent orchestration across claims, prior authorization, utilization management, and member service. Drawing on…

Managing the Margin Reset in Medicare Advantage

The CY2027 Advance Notice isn’t a routine rate update. A near-flat base update, normalization pressure, revised sources-of-diagnoses policy, and encounter-based validation are collectively narrowing revenue…

The Five Levers That Win CY2027

Medicare Advantage is entering a margin maturity phase. Rate pressures are intensifying, audit scrutiny is tightening, and the gap between top-quartile and average plans could…

CMS-0057: The Interoperability Imperative 

CMS-0057 is redefining how health plans operate, not just what data they expose. With 2026 reporting requirements approaching and full API enforcement in 2027, payers…