Healthcare's utilization management crisis didn't start with artificial intelligence — but AI threatens to make it exponentially worse if we don't change course now.
A recent peer-reviewed study from Stanford University, published in the January 2026 issue of Health Affairs, evaluated 21 predictive and/or generative AI tools currently deployed across the utilization review landscape. The findings should serve as a wake-up call: we're
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Artificial Intelligence in Healthcare | News, Analysis, Insights - HIT Consultant
The RCM Trap: Why Cityblock Health is Pivoting AI Investment Toward Medicaid Care
What You Should Know
The Manifesto: Dr. Toyin Ajayi, CEO of Cityblock Health, has published a comprehensive report, “Medicaid + AI: A New Standard for Innovation,” arguing that the nation's most vulnerable patient population must be the proving ground for generative AI.The Investment Disconnect: Currently, roughly 60% of healthcare AI investment is directed toward revenue cycle management, billing optimization, and risk adjustment. Conversely, less than 20% of health plans use AI to develop
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The C-Suite Squeeze: Why Hospital IT Budgets Are Shrinking While AI Spending Soars
What You Should Know:
The Data Source: Sage Growth Partners released its "Health IT Purchasing Forecast 2026-2027: Where C-Suites are Investing Amid Declining Capital Budgets" report, based on a benchmark survey of 101 hospital and health system C-suite executives.The Budget Squeeze: A significant 41% of C-suite leaders anticipate their capital investments will be reduced over the next two years. Only 5% expect an increase of 20% or more, representing a notable decline from prior years.The
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Zocdoc Report: 26% of Patients Now Use AI for Medical Advice, Creating a ‘Triangle of Care’
What You Should Know
The Data Source: Zocdoc released "The AI-Informed Patient" report, based on a February 2026 survey of 1,186 U.S. adults and 1,000 U.S. healthcare providers.The Adoption & The Access Problem: Over a quarter (26%) of patients have already used AI to ask a health-related question. A massive driver is poor access to care: 65% of patients report using AI simply because it is easier than trying to see a doctor.The Secret Patient: Patients are heavily hiding their AI use
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Viz.ai and Alnylam Pharmaceuticals Partner to Launch AI Care Pathway for Cardiac Amyloidosis
What You Should Know:
The Partnership: Viz.ai, a major player in AI-powered care coordination, has partnered with Alnylam Pharmaceuticals, a leader in RNAi therapeutics.The Clinical Problem: Cardiac amyloidosis (specifically ATTR-CM and AL) is a progressive, often fatal condition where misfolded proteins deposit in the heart muscle. Because its symptoms mimic generalized heart failure, it is chronically underdiagnosed, causing patients to miss the window for life-saving interventions.The
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AI Didn’t Fix HCC Coding—It Made It Harder. This is How to Fix It
Hierarchical Condition Category (HCC) coding is one of the areas in healthcare where AI is the obvious solution. On paper, it makes perfect sense. Use it to scan charts, identify diagnoses, group them into risk categories, and more efficiently predict future healthcare costs. In Medicare Advantage and value-based care, where risk adjustment directly impacts reimbursement, it sounds like a natural fit. But reality tells a very different story.
If you want to understand what is actually
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Rock Health Survey: 32% of Consumers Now Use AI for Health Information
What You Should Know
The Data Source: Rock Health released its 11th Consumer Adoption of Digital Health Survey, polling 8,000 U.S. adults in December 2025 to track behaviors toward virtual care and digital health tools.The Adoption Spike: Consumer use of AI in healthcare is exploding. 32% of respondents report having used an AI chatbot for health information—double the share from just a year ago (16%). Of those users, 64% engage with health AI weekly or more.General Purpose vs. Healthcare
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Clarius Mobile Health Launches T-Mode Heart and Knee for AI-Powered Ultrasound Training
What You Should Know
The Launch: Clarius Mobile Health, a major player in handheld point-of-care ultrasound (POCUS), has released T-Mode™ Heart and T-Mode™ Knee as part of its Clarius App 12.2.6 update.The Core Problem: Handheld ultrasound devices have become cheap and portable enough to sit in a primary care physician's pocket. However, interpreting the grainy, grayscale images of complex anatomy (like the heart) requires significant, specialized training that most PCPs lack.The "T-Mode"
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PromptWell and Ellipsis Health Partner to Transform AI Patient Engagement
What You Should Know
The Partnership: PromptWell, an AI-native patient engagement platform, has integrated with Ellipsis Health, a company known for its clinically validated conversational AI.The Core Problem: Healthcare organizations (payers and providers) spend millions of dollars on patient outreach programs (like scheduling Annual Wellness Visits or conducting Health Risk Assessments), but conversion rates remain abysmal. Patients either ignore the calls or hang up on robotic-sounding
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Elpida Launches AI-Powered Marketing Compliance Platform for Healthcare Brands
What You Should Know
The Launch: Elpida, an AI-powered marketing compliance platform tailored specifically for the healthcare industry, officially launched today.The Core Problem: Traditionally, ensuring that healthcare marketing assets (websites, videos, social media) are compliant requires bloated, manual review cycles. This friction kills campaign momentum and drastically delays time-to-market.The Regulatory Catalyst: The regulatory landscape has fundamentally shifted. The FDA recently
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