AI Soups up Payer Operations | Predictions for 2025
Kim Perry, chief growth officer of Emtelligent, shares her prediction for 2025.
In 2025, AI [artificial intelligence] will play a larger role in driving payer operational improvements and offer health insurers a more comprehensive view of member health.
Perry
Leveraging medically aligned AI to extract essential insights from vast, diverse patient records will allow for more streamlined prior authorizations, optimized risk adjustment and enhanced underwriting accuracy.
AI will also be seamlessly integrated with clinical programs to proactively identify care gaps and tailor member programs to improve clinical outcomes.
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
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Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
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Most Patients With HS Aren’t Aware of Approved Treatments
May 1st 2025Treating hidradenitis suppurativa is complex and often requires taking a number of medications, including antibiotics, hormone therapies and immunosuppressants. However, many of these treatments are used off-label, and at this time, only two biologic therapies—Humira (adalimumab) and Cosentyx (secukinumab)— are approved by the FDA for HS treatment.
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