Insights & Perspectives

When a health plan’s AI isn't working, the instinct is to blame the technology. Wrong model, wrong vendor, wrong use case. But in most cases, the AI itself isn't the problem. The problem is what the AI was built on top of, and the fact that nobody fixed that first. To understand why, it helps to understand where your plan actually sits today, and what it truly takes to move forward. That's what the CX Maturity Scale was built to show.

AI is becoming a bigger part of the conversation around how health plans operate, but the real opportunity is in turning that technology into practical, measurable improvements. We’re excited to see MCRA Member Simplify Healthcare continuing to expand in this space with the growth of its Payer AI Platform. The company’s latest announcement highlights its focus on helping health plans connect data, workflows and intelligent automation across key areas of the payer enterpris

Avalere Health shares the second episode of One the Record—A rapid-fire series delivering expert clarity on major CMS and HHS rules. In five minutes, get the insights, implications, and decisive perspective leaders need now.

Explore how payers, providers, and PBMs are moving AI from pilot projects to real operational impact. Learn the top use cases, barriers to scaling, and the key metrics and strategies driving successful AI adoption across the healthcare ecosystem.

Ushur presents a case study on a leading PBM that sought to elevate its member experience by extending support.

Epstein Becker Green explores the legal and ethical challenges when AI goes wrong — investigating liability for chatbot harm, recent lawsuits, regulatory trends, and best practices for safer design.