Webinar - The Identity Disconnect: Bridging the Gap Between Data and Real-World Care Presented by Verato

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Featured Story   Abridge Goes Beyond Documentation: 4 Things to Know The skinny On Thursday, clinical AI startup Abridge held an event in New York City to unveil new partnerships and platform capabilities. The company’s announcements signal a deliberate push beyond AI documentation into the broader infrastructure of how care is delivered and paid for. During his keynote address, CEO Shiv Rao said Abridge’s vision centers on shifting administrative work upstream, as well as using the clinical conversation as the connective layer between providers, payers and pharma companies. “Our opportunity right now is to use AI to actually rethink the system, redesign the system. Can we compress workflows? Can we let agents attend the lunch-and-learn about compliant documentation and rely on that? Can we let AI figure out how to get all that clerical work done, so I can spend more time with my patients?” he asked. 4 most notable updates —Abridge and AI powerhouse Nvidia announced a partnership to build what the companies say is the first AI foundation model designed specifically for clinical conversations. The model aims to apply clinical knowledge at every stage of AI training so that it can reason like a clinician rather than mimicking one, explained Kimberly Powell, vice president of healthcare at Nvidia. —The startup received a strategic investment from pharma giant Eli Lilly, though the financial terms were not disclosed. The investment is focused on a specific use case: tapping Abridge's platform to help identify patients who may be eligible for clinical trials directly at the point of care. —Abridge unveiled its new-and-improved clinician intelligence platform, which seeks to support clinicians before, during and after every patient visit rather than just inside the exam room. Before the appointment, the platform prepares clinicians with concise patient summaries pulled from the EHR, and during the encounter, it offers decision support and captures the conversation in more than 28 languages. Afterward, it generates clinical documentation, billing codes and lab orders for clinicians to review and send off. —Both Aetna and Cigna executives sat onstage with health system leaders to discuss the oftentimes adversarial relationship between payers and providers. Rao said that going forward, he hopes Abridge’s technology can be somewhat of a mediator. All three sides agreed — if clinical documentation is grounded in the actual conversation at the moment care is delivered, providers and payers can stop relitigating what happened after the fact and start agreeing on it in real time. — By Katie Adams Sponsored   Webinar - The Identity Disconnect: Bridging the Gap Between Data and Real-World Care Presented by Verato Join us on June 17th for a discussion on the hidden realities of healthcare interoperability. We’ll dive deep into the technical, organizational, and regulatory barriers making cross-network identity sharing so difficult. You’ll hear real-world examples of where identity mismatches go wrong, explore the massive impact of these gaps on Value-Based Care, and learn exactly how to build the business case for investing in identity-driven interoperability. Top Stories   Healthcare Leader to CMS on New Medicaid Eligibility Requirements: Give States an Extension The skinny A little over a week after CMS announced significant changes to Medicaid work requirements set to take effect in January 2027, healthcare leaders speaking at AHIP 2026 raised concerns about implementation, with one calling on CMS to grant states an extension. The changes Last week, CMS issued an interim final rule that adds conditions to the medical frailty exemption of Medicaid work requirements, which allows people with certain health conditions to not have to fulfill the requirements. These include disability, substance use disorder or complex medical conditions. The new rule requires that medical frailty be limited to situations in which a person’s condition impairs their ability to meet the work requirement. This means it’s no longer sufficient to merely have one of these conditions to qualify for an exemption. They now have to prove to state authorities that their condition is serious enough that they can’t fulfill the requirements. An executive’s take During a panel discussion at AHIP 2026 in Las Vegas, healthcare insurance leaders were asked what advice they’d give CMS Administrator Dr. Mehmet Oz over these eligibility changes. One leader noted that while everyone wants healthcare dollars to be spent on people who genuinely need it, it’s important to remember that “people don’t choose to live in poverty.” “People want to thrive, they want to have economic mobility, they want to have pathways, and it is important to recognize that it takes time to build those pathways. It takes time to create those systems,” said Martha Santana-Chin, CEO of L.A. Care Health Plan. “So the first thing I'd say is, as we're implementing these, if states are in earnest, demonstrating good faith to implement the requirements, and they need an extension, give them an extension. You can't create systems in six months, in 12 months, I would argue sometimes in even 18 months. Especially not systems where you're thinking about leveraging a safety net benefit to connect people to opportunity.” — By Marissa Plescia Is This the Next Blockbuster Novartis Neuro Med? Promising trial results Novartis’s experimental RNA therapy delpacibart braxlosiran (del-brax) posted Phase 1/2 clinical trial results showing reduction in blood levels of a protein that’s a biological indicator of the neuromuscular disorder facioscapulohumeral muscular dystrophy (FSHD). These data could support an application seeking accelerated FDA approval in FSHD, potentially making the genetic medicine the first therapy for this rare inherited disorder. The drug In FSHD, a genetic mutation leads to activation the DUX4 gene, which in turn expresses proteins that damage muscle. Del-brax belongs to a new class of medicines called antibody oligonucleotide conjugates. These treatments use a targeting antibody to deliver to cells an oligonucleotide that modifies RNA function. Del-brax is designed to reduce expression of DUX4 messenger RNA to reduce the DUX4 gene’s expression of muscle-damaging proteins. Why this matters Del-brax is one of three drugs from Novartis’s $12 billion acquisition of Avidity Biosciences. The two others are in clinical development for the neuromuscular disorders Duchenne muscular dystrophy and myotonic dystrophy type 1 (DM1). Novartis executives have said all three are expected to launch by 2030 with the FSHD and DM1 therapies expected to reach blockbuster status. That’s important for growing revenue in neuroscience, which is currently the smallest of Novartis’s four core therapeutic areas. Soundbite “These results validate the dosing regimen implemented in our Phase 3 trial and lend further evidence of the potential for del-brax to have a significant impact for people with FSHD,” said Nazem Atassi, global head, neuroscience and gene therapy development, Novartis. —By Frank Vinluan AI Is Scaling Healthcare Costs Because the System Was Built That Way Not an AI problem AI is not changing healthcare. It is scaling the economic logic that already exists within it. Across the country, health systems are deploying AI-powered revenue cycle tools designed to maximize billable revenue from every patient encounter. The market for these tools has already surpassed $20 billion and is growing rapidly, driven by one clear objective: capture more from the same clinical interaction.This is not innovation in care delivery. It is optimization of reimbursement. And as that optimization accelerates, the downstream effects are beginning to surface. Stop-loss premiums rose 9.4% in 2024 among tracked health plans, with employers maintaining comparable coverage seeing increases closer to 11.5%. Claims exceeding $1 million per million covered employees jumped 29% year over year. Cost is not just growing. It is concentrating. The industry is calling this an AI problem. It is not. Efficiency amplifies misalignment For decades, healthcare has operated within a simple and largely unquestioned cycle. Clinical documentation determines reimbursement. Reimbursement models reward greater intensity. Greater intensity increases total cost. That cost is then distributed across employers, employees, and public programs, where it becomes a budget problem rather than a design problem. AI does not disrupt this loop. It compresses it. What once required manual review and coding judgment can now be executed at scale, in real time, across millions of encounters. The result is not a new system, but a faster version of the existing one: more precise, more consistent, and more effective at extracting revenue from the same underlying clinical activity. Efficiency, in this context, does not create value.It amplifies misalignment. The system exposed AI is not driving healthcare cost inflation. It is exposing a system that has always been designed to reward it, and making that system more efficient. As long as reimbursement is tied to intensity, every technological advancement will move in the same direction: toward maximizing it. A benefits leader sitting in a plan renewal meeting today is not facing an AI problem. They are facing a design problem that AI has made impossible to ignore. — By MedCity Influencer Dana Y. Lujan Video   Video: Sen. Cassidy vs RFK Jr. Who won? In a Senate hearing, RFK Jr. cited 2 studies to show that mortality had reduced because of public health improvements not vaccines. Senator Cassidy's takedown is epic!

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