Phil Fasano

𝗛𝗶𝗴𝗵𝗺𝗮𝗿𝗸 𝗛𝗲𝗮𝗹𝘁𝗵 🤝 𝗔𝗯𝗿𝗶𝗱𝗴𝗲 🤝 𝗔𝗛𝗡: 𝗔𝗻𝗻𝗼𝘂𝗻𝗰𝗶𝗻𝗴 𝗥𝗲𝗮𝗹 𝗧𝗶𝗺𝗲 𝗣𝗿𝗶𝗼𝗿 𝗔𝘂𝘁𝗵𝗼𝗿𝗶𝘇𝗮𝘁𝗶𝗼𝗻 𝗮𝘁 𝘁𝗵𝗲 𝗣𝗼𝗶𝗻𝘁 𝗼𝗳 𝗖𝗼𝗻𝘃𝗲𝗿𝘀𝗮𝘁𝗶𝗼𝗻 Built on Highmark Health’s advanced platform and powered by Abridge’s Contextual Reasoning Engine, real time prior authorization approvals at the point of conversation will “ensure that there are no unnecessary delays in covered treatments.” —Tony Farah, MD, Chief Medical and Clinical Transformation Officer, Highmark Health “By leveraging next-frontier technologies and Abridge’s powerful AI platforms, we have a unique opportunity at Highmark Health and AHN to help redefine the patient, member, and clinician experience in our industry.” — Richard Clarke, PhD, SVP, Chief Analytics Officer, Highmark Health As part of this enterprise-wide launch, Abridge’s ambient AI will also be deployed across Highmark Health’s 14-hospital care provider Allegheny Health Network. This paradigm shift for prior authorization accelerates our goal to transform healthcare by delivering intelligence to the point of conversation. Read the full announcement here: https://lnkd.in/gmz4Uify

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Proud to welcome Humbi AI to the Innovaccer family! Together, we're bringing actuarial and contracting copilots to healthcare. 🚀 The magic? Humbi AI's exceptional actuarial intelligence (trusted across over 200 million Medicare/Medicaid lives) integrates with our Healthcare Intelligence Cloud. This union, powered by our recent Series F momentum, opens incredible possibilities for healthcare. What we'll create together: ✅ AI copilots that enhance actuarial expertise ✅ Smarter value-based contract design ✅ Data-driven network insights ✅ Intelligent drug commercialization tools To our customers and partners who trust us with healthcare's biggest challenges: This brings us closer to our shared vision of advancing healthcare outcomes for everyone, everywhere. Read our story: https://lnkd.in/gM4wHKCq #humbiaixinnovaccer #valuebasedcare #healthcareai #actuarialintelligence

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Hospitals and health systems are facing increasing uncertainty — making deliberate, focused strategy more critical than ever. In Kaufman Hall's latest strategy blog, Ryan Gish breaks down how understanding the link between market dynamics and financial performance can help leaders uncover the right strategic questions and plan with confidence. https://lnkd.in/gRzjMsq3

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Not all risk adjustment programs are created equal—and among payers, providers, and vendors, the level of understanding of those programs varies wildly. In this blog post, Edifecs Senior Solution Consultant Betty Stump takes a closer look at the three most common risk adjustment programs and the differences between each: https://lnkd.in/e_95V9NY #riskadjustment #providers #healthcaredata

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AI isn’t coming for your job. But it might be coming for your to-do list. In this blog, Altera experts share how #AI is evolving support, finance and infrastructure—and what healthcare leaders need to do before jumping in. Read more (link in comments). Lindsey Honig

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The future of healthcare revenue cycle management isn’t just automated—it’s agentic. Our new white paper explores how intelligent digital agents are transforming RCM through autonomy, adaptability, and real-time decision-making. Discover how to build a digital workforce that reduces denials, accelerates collections, and scales with your team. Download now: https://hubs.ly/Q03Fdrws0

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Availity’s Michael Taylor was joined by Ranjan Saxena from Humana to provide insight into the hidden pitfalls of implementing Payer-to-Payer exchange and share the real-world success Availity and Humana have had overcoming those challenges. #P2P #HIMSS2025 #Interoperability

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As the use of artificial intelligence (AI) continues to expand within the senior healthcare industry, the Centers for Medicare & Medicaid Services has released its Medicare Advantage (MA) final technical rule, opting not to impose stricter guardrails on the use of this technology. In light of this development, Curana Health's Mark Hassenstab, Vice President of Risk Adjustment and Product Optimization, shared valuable insights with McKnight's Long-Term Care News about striking the right balance with AI. His perspective? Human oversight is essential in harnessing this powerful technology to improve patient outcomes while managing costs. Curious how all parts of the final technical rule will impact MA plans and operators? Dive deeper here: https://bit.ly/4j6mSKp.

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In an industry flooded with promises of AI, it takes clarity to truly scale the technology and unlock its full potential.   At Becker’s 10th Annual Health IT + Digital Health + RCM Conference, Swadhin Khawas and Zachary Madrigal, MBA spotlighted what separates hype from real progress in healthcare transformation.   The conversation moved beyond buzzwords to focus on what really matters — AI-powered foresight that drives smarter decisions, human ingenuity that delivers better outcomes and domain excellence that anchors innovation in accountability.   Because the future of healthcare isn’t built on noise — it’s built on predictive intelligence and human-centered transformation.   #OutsmartTheFuture #HealthcareInnovation #AIinHealthcare #WNS Dennis Thomas | Curt Dunseath | Prachi Bhagra | Shivani Thakur | Craig Cane

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After 20+ years building healthcare AI, our CEO Chetan Parikh saw the pattern: ❖ Risk adjustment teams spending months evaluating vendors ❖ Training models that plateau at 70% accuracy ❖ Coding teams buried in false positives ❖ RADV audits increased 900% This drove us to create our 𝗡𝗼𝘃𝗲𝗹 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗔𝗜 𝗣𝗹𝗮𝘁𝗳𝗼𝗿𝗺, a fundamental rethink of how risk adjustment technology should work. 💡 What Chetan demonstrates in this interview with Dr. Shannon I. Decker, PhD., MBA, MBA, M.Ed., M.Ed.: Uploading real charts during a discovery call and reviewing 92%+ accurate results in the same conversation. 𝗧𝗵𝗲 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝗰𝗲: ✓ No training data required ✓ No implementation cycles ✓ Neuro-Symbolic AI that understands risk adjustment from day one 👇 Watch the moment when healthcare executives realize vendor evaluations don't have to be painful anymore. The industry standard was never inevitable. We just accepted it. Until now. ⚡ Learn more about our autonomous retrospective risk adjustment solution → https://bit.ly/3VI4FJ4 . . . #RetrospectiveRiskAdjustment #NeuroSymbolicAI #NovelClinicalAI

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Modernizing government #healthcaresystems isn’t just about code and compliance — it’s about trust. In this post, we explore why lasting transformation in #Medicaid depends on strong partnerships, shared purpose, and the ability to adapt together. Learn more: http://bit.ly/41YR0B4

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Deepali Narula, Chief Operating Officer of Conifer Health Solutions, shares why traditional ways of managing data no longer meet today’s revenue cycle demands. To stay resilient, healthcare leaders must make a mindset shift: data isn’t optional—it’s mission-critical. The organizations that thrive will be those that transform data into a strategic engine—guiding decisions, securing financial stability, and accelerating growth. It’s no longer enough to collect information. It’s time to let data lead. https://bit.ly/3JW3VgZ

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Simplifying #Medicaid and #VA billing 🔥 For too long, billing and compliance have been barriers to delivering great care. This partnership connects ShiftCare’s real-time visit management with Paradigm’s billing infrastructure, automating Medicaid and VA claims, improving accuracy, and speeding up reimbursements. 1. Less admin 2. Faster payments 3. More time for care. Proud to announce ShiftCare’s new partnership with Paradigm Senior Services, where together we are making the business of care simpler, and the future of care management smarter. Danny Shapiro Amber Monroe, MHA, PMP https://lnkd.in/gmRS_srD #HomeCare #Medicaid #VA #CareInnovation #EVV

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