Bonus Features - December 7, 2025 - 51% of payers use AI to help avoid interop and prior auth penalties, 38% of patients delayed or skipped care due to its cost
This week's roundup is heavy on AI, access, and operational efficiency. Payers are leaning on automation to keep pace with rules, patients are postponing care due to cost, and health systems are scaling tools that cut documentation time and streamline imaging workflows.
Quick take: Compliance isn't optional, affordability still blocks care, and AI is moving from pilots to platform integrations. If you're budgeting for 2026, prioritize governance, staff training, and measurable ROI.
Studies
Regulatory pressure is pushing payers to automate, while patients are still feeling the financial squeeze. Rising acuity since 2019 continues to strain care teams and staffing models.
- HealthEdge: 51% of payers are using AI to avoid penalties tied to interoperability and prior authorization mandates; half plan to implement chatbots next year. For reference on federal requirements, see the CMS Interoperability and Prior Authorization Final Rule here.
- PayZen: 38% of patients delayed or skipped care this year due to cost.
- WellSky: Patient acuity is up 34% since 2019 across its network providers.
Partnerships
Imaging AI continues to consolidate via platform integrations, while payment and scheduling ties aim to reduce friction for patients and front-office teams.
- Aidoc integrated its aiOS with NVIDIA MONAI and partnered with Quibim to introduce Prostate MRI AI.
- CureMetrix integrated its cmAngio mammogram reading tool with Therapixel's MammoScreen.
- Fivos selected Carta Healthcare for clinical data abstraction.
- RADPAIR's agentic AI development framework integrated with Fovia AI medical imaging technology.
- TrustCommerce payment tech is now integrated with Qure4u's patient engagement platform.
- Zocdoc's appointment-booking is integrated with Healthgrades.
Products
Vendors are targeting throughput, documentation accuracy, and education scale. Expect faster handoffs and cleaner data in the record.
- Bamboo Health launched Bamboo Bridge to match behavioral health patients to the right level of care.
- Cleerly unveiled a PowerScribe integration for CT scan reporting.
- Freed (AI scribe) added ICD-10 coding, pre-visit prep, and auto-generated clinical letters.
- UbiSim introduced AI Narrative Analysis to reduce nursing faculty workload.
Implementations
Health systems are moving from trials to enterprise rollouts, with emphasis on smart hospital infrastructure, ambient documentation, and remote monitoring.
- ECU Health selected Artisight smart hospital tech, starting with five hospitals.
- LCMC Health chose Nabla for Epic-integrated ambient AI.
- Brevard Health Alliance (FQHC) selected Rimidi for remote monitoring.
- Inova Health selected Signal 1 to centralize AI governance.
- Community First Health Plans chose Softheon to expand access to individual off-exchange coverage for employers.
- The Greek Ministry of Health selected Sword Health to automate triage for its National Health Information Line.
Company News
Approvals and certifications signal growing maturity, while early outcomes point to real time savings for clinicians.
- Briya's research tech is now available in the Epic Connection Hub on Showroom.
- CMS finalized payment approval for Eko Health's SENSORA platform under OPPS.
- Harmony Healthcare IT earned HITRUST r2 Certification for its ETL Environment, HealthData Platform, Data Center, and Workstation.
- HOPPR added Forward Deployed Services and the Catalyst Program to its AI Foundry.
- Mass General Hospital reported a 41% reduction in after-hours documentation using IKS Health.
- SimplePractice launched a Clinical Advisory Board.
People
Leadership moves center on security, commercialization, finance, and scaled product delivery.
- AdvancedMD named Nupura Kolwalkar-Rana as Chief Product and Technology Officer.
- CentralReach appointed Joseph Adu as Chief Information Security Officer.
- Eon named Tammy Lewis as Chief Commercial Officer.
- Azara Healthcare appointed Eugene Wong as Chief Financial Officer.
- Edge hired Dr. Bob Dokhanchi as Dental Division COO.
Why this matters for your team
- Compliance: Map your 2026 roadmap to the CMS interoperability and prior auth timelines and automate file exchange, prior auth status, and denial reason tracking. Start with high-volume services and measurable penalties to justify investment. Details: CMS Interoperability & Prior Auth.
- Access and affordability: Pair price estimates with financial counseling and flexible payment options. Track care deferrals by service line and follow up with targeted outreach.
- Rising acuity: Adjust staffing models, escalate care pathways sooner, and use predictive flags in the EHR to reduce avoidable admissions and returns.
- AI governance: Follow Inova's lead-centralize model inventory, validation, monitoring, and change control. Publish plain-language guidance for clinicians and patients.
- Workflow wins: Prioritize proven time-savers like ambient scribing, structured imaging integrations, and centralized scheduling/payments to reduce clicks and throughput delays.
Have news?
Send your announcements, partnerships, hires, and study highlights, including any relevant links and embargo details. Submissions received after Thursday may appear in next week's edition.
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