Many current utilization management processes lack the transparency, speed and interoperability needed to meet current requirements — and the stakes for health plans are rising as CMS-0057 deadlines loom.

This podcast breaks down new national research on UM practices across payer organizations, offering a clear-eyed view of what’s working, what’s not and where change is most needed.

Leaders will also explore how AI-assisted technologies could help health plans get ahead of future interoperability challenges, including those tied to CMS-0057.

Key insights include:

• Where UM processes are breaking down across health plans and care settings
• How AI-assisted tools could reduce delays and improve alignment now and in the future
• Real-world takeaways to improve speed, transparency and readiness ahead of CMS-0057

Traditional care management strategies are struggling to keep pace with rising administrative burdens, workforce shortages and increasingly complex member needs. Outdated processes — like relying on phone calls — fail to scale engagement and leave care teams overwhelmed.

Health plans are turning to AI-driven technologies, such as co-pilots, to modernize care management. These tools enhance traditional care management by automating outreach, improving data-driven decision-making and expanding digital engagement across all risk levels.

Join industry leaders as they share real-world insights on how AI and automation are transforming care management. Learn how your organization can:

• Expand digital reach and engage more members effectively
• Overcome key challenges, from data quality to adoption hurdles
• Streamline workflows and reduce operational burdens
• Improve member outcomes and measure the ROI of digital strategies

As healthcare evolves, the demand for connected, data-driven, and member- and patient-centric systems is at an all-time high. By 2027, 70% of healthcare organizations are projected to adopt digital-first care management strategies, interoperable workflows, and advanced consumer data platforms to empower individuals, enhance experiences, and build trust, according to IDC.

When providers are seamlessly integrated as essential contributors and collaborators in care management, organizations can unlock significant benefits, including better health outcomes and enhanced operational efficiency.

Join industry leaders from IDC and Medecision for an engaging panel discussion where we will share IDC’s latest research, practical insights, and best practices. These discussions will bridge the gap between payers and providers, laying the groundwork for future-ready care management practices.

Listeners will hear about:

• Techniques for leveraging data interoperability and FHIR-based solutions.
• Best practices for establishing data-sharing transparency.
• Methods for aligning value-based care objectives.
• Approaches for promoting digital tool adoption supported by AI and analytics.
• Frameworks for designing comprehensive wellness and engagement programs.
• Insights into the importance of closed-loop feedback for sustained, coordinated care efforts.

Why Listen?

Gain valuable insights and practical strategies from leading experts to empower your organization’s digital care management initiatives. This session is essential for healthcare leaders aiming to optimize collaboration and harness the full potential of digital care management solutions.