What You Should Know
Healthcare decision intelligence leader Lyric has announced the acquisition of Concert, a precision health payment accuracy innovator specializing in translating machine-readable clinical policies into real-time claims workflows.The transaction embeds Concert’s proprietary policy intelligence directly within Lyric42, Lyric’s AI-powered Healthcare Decision Intelligence Platform, expanding its scale amid a surge in advanced genetic testing and precision therapies.The
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Health IT | News, Analysis, Insights - HIT Consultant
Capital Rx Rebrands as Judi Health Following $400M Expansion Round
What You Should Know
Transparent pharmacy benefit manager (PBM) industry pioneer Capital Rx has officially rebranded as Judi Health™, unifying its expanding enterprise healthcare software lines under a single, cohesive corporate identity.Backed by a major $400 million financing round, the company is shifting beyond its initial prescription drug core to launch Unified Claims Processing™—consolidating pharmacy, medical, vision, and dental benefits onto a single cloud-native system of record
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The Digital Health Front Door Doesn’t Have a UX Problem. It Has An Honesty Problem
Healthcare didn’t build a digital front door. It built a digital facade.
Over the last decade, health systems invested heavily in the look and feel of modern consumer technology—clean interfaces, frictionless scheduling flows, real-time messaging features, instant cost estimate tools. They borrowed the visual language of companies that had genuinely reinvented consumer experience. What they didn’t borrow was the operational infrastructure that makes those experiences reliable. The result is a
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The New Ethics of Healthcare Data: Rebalancing Privacy and Progress
In the world of healthcare data, there has always been an uneasy balance between privacy and innovation.
The healthcare industry has historically operated under a culture of caution, often withholding data out of fear of HIPAA violations or penalties, which has fostered a "when in doubt, don't share" mentality.
Now, however, the pendulum may be swinging in the direction of innovation.
An information-blocking "crackdown" by the U.S. Department of Health and Human Services (HHS) is
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From Claims to Compassion: Reclaiming Patient Advocacy in Revenue Cycle
I typically start my mornings with a little silence before the hustle and bustle of the day begins. One morning, the silence was interrupted by a frantic call from my father saying something was not right with my mom. For the next 60 seconds, there was a rapid fire of questions that ultimately ended with “Dad, hang up. Call 9-1-1. When they arrive, tell them that due to mom’s history we would like her to be airlifted to Vanderbilt. I will meet you there.” Unfortunately, we lost my mother several
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OpenEvidence Launches EvidenceGrade to Bring Real-Time Source Quality Grading to Clinical AI
What You Should Know
Medical AI leader OpenEvidence has announced the commercial launch of EvidenceGrade, a new system capability that scores and visualizes the clinical certainty of cited medical literature in real time.The feature directly targets a dangerous AI limitation: standard models tend to gloss over differences in source quality, treating small, observational studies with the same weight as randomized, blinded, placebo-controlled trials.Built by a cross-functional team of
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Optum Partners with Anthropic to Deploy Claude Across Healthcare Claims and Revenue Workflows
What You Should Know
Optum, the sprawling health services subsidiary of UnitedHealth Group, has announced a landmark strategic partnership with Anthropic to deploy its frontier model, Claude, across everyday healthcare operations.The enterprise collaboration sits inside a massive $3 billion AI capitalization program slated for 2026 and 2027, aimed at completely automating the transactional core of UnitedHealth’s commercial and public businesses.Led by Optum Insight CEO Sandeep Dadlani, the
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Securing Generative AI in Healthcare: What CISOs Must Get Right
Healthcare remained one of the most targeted sectors for ransomware in 2025, accounting for 22% of disclosed attacks in one widely cited industry analysis. More broadly, 93% of healthcare organizations reported at least one cyberattack in the past 12 months. As of the end of 2025, at least 642 large healthcare breaches had been reported, affecting nearly 57 million individuals.
But the implications for the healthcare industry extends beyond traditional cybersecurity and data
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The Technology Gap Holding Provider-Sponsored Health Plans Back
The price shock from soaring 2026 ACA (Affordable Care Act) premiums is reshaping how Americans think about and shop for their health coverage. This environment creates an opportunity for provider-sponsored health plans (PSHPs) to step in and deliver more patient-focused care and coverage to their communities.
The average unsubsidized premiums for the 2026 exchange-based Open Enrollment Period increased nearly 20% from last year, and the expiration of enhanced tax credits increased
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Health Payers Have Invested in Modern Data Infrastructure. Access Control Hasn’t Kept Up.
Ask any data security leader at a health plan what keeps them up at night and the answer usually isn't a single threat. It's the environment: member data that's among the most sensitive anywhere, regulatory obligations that expand every legislative session, and a data ecosystem that grows more complex every time a new contributing plan comes online or a new analytics use case gets approved.
Many health plans have made the right infrastructure investments. Snowflake and Databricks are
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