LAS VEGAS – As AI is transforming all aspects of healthcare, it’s affecting the care model for payers. Health insurers have end-to-end visibility into individual care needs and utilization patterns across providers and settings. Virtual care, technology and AI have helped payers define a more active role in care delivery.

Denials are the bane of patients and providers, but without them, healthcare costs would rise, says Christine Stetler, a registered nurse and AVP of Solution Engineering at MedeAnalytics.  

LAS VEGAS – Seema Verma, executive vice president and general manager of Oracle Health and Life Sciences, gave an update of her company’s work on the U.S. Department of Veterans Affairs’ Electronic Health Records Modernization project.

The Center for Medicare and Medicaid Innovation (CMMI) is planning on ending four payment models by the end of the year in a bid to achieve a projected $750 million in savings, though the agency did not say where the savings would take place.

Cutting Medicaid funding and halting the program’s expansion would result in providers revenues decreasing by about $80 billion, and uncompensated care on behalf of uninsured people would increase by $18.9 billion in 2026 due to declines in health insurance coverage, finds a report from the Urban Institute and the Robert W

Combining agentic AI to robotic process automation allows clinicians to go after more complex use cases, says Dr. Jonah Feldman of NYU Langone Health System.  

Teladoc Health has entered into a pharmacy integration agreement with Eli Lilly’s LillyDirect pharmacy partner, Gifthealth, which is intended to help streamline access to Zepbound medication for members enrolled in the Comprehensive Weight Care Program. The move is meant to provide safer and more seamless access to GLP-1 medications for members without insurance coverage.

Physicians are again shortchanged in a spending bill proposal to avert a government shutdown by the end of this week. The continuing resolution that passed the House on Tuesday, and which now moves on to the Senate, contains no provision to stop the 2.8% Medicare physician pay cut that went into effect on January 1.

The Centers for Medicare and Medicaid Services, in a break from Biden-era policies, is proposing to shorten the open enrollment period for Affordable Care Act marketplace plans in a bid to curb “improper enrollments.” The proposed regulation would see open enrollment for the individual marketplace end on December 15 rather than in January.

House Republicans’ previously proposed budget looked at $880 billion in spending cuts from programs overseen by the House Committee on Energy and Commerce.