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.

MCRA member Simplify Healthcare explains why generic contract management software falls short in provider contracting and how specialized solutions can improve claims accuracy, compliance, and payer operations.

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

The Managed Care Resource Alliance is pleased to welcome Simplify Healthcare as our newest Member. Simplify Healthcare® brings 17+ years of experience supporting U.S. health plans, with a clear focus on modernizing payer operations across benefits, provider data, claims, and member engagement. Through a unified, AI-powered platform, they help plans navigate complexity, improve data integrity, and execute faster—without increasing operational burden.