HealthIntel Weekly: Predictive AI Adoption Rises, Small and Rural Hospitals Fall Behind
Welcome to HealthIntel Weekly. Every week, we pull together the latest health care reports, research, and upcoming webinars so you don’t have to dig for them.
What’s New:
About 71% of hospitals were using predictive artificial intelligence integrated with electronic health records in 2024, though small, rural, independent, government-owned and critical-access hospitals lagged behind, according to a report from the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT. From 2023 to 2024, hospitals’ use of predictive AI increased significantly in three areas: simplifying or automating billing procedures, facilitating scheduling, and identifying high-risk outpatients to guide follow-up care. Most hospitals reported evaluating predictive AI models for accuracy and bias, as well as conducting post-implementation monitoring and assessments.
In the Calendar Year 2027 Medicare Advantage policymaking cycle, industry stakeholders should monitor changes to program oversight, payment models and emerging technologies, an Avalere analysis reports. Areas of focus include utilization management, particularly prior authorization, with bipartisan interest in streamlining processes and increasing transparency; reforms to risk adjustment to better align payments between MA and Medicare fee-for-service; modifications to the Star Ratings Quality Bonus program to emphasize health outcomes; expanded oversight initiatives such as Risk Adjustment Data Validation audits; and regulations affecting marketing and agent compensation rates.
Insurers in the Affordable Care Act small group market have proposed a median premium increase of 11% for 2026 nationwide, according to a KFF analysis. Among 318 small group insurers offering ACA-compliant coverage, proposed rate changes ranged from a 5% decrease to a 32% increase, with 216 insurers requesting hikes between 5% and 15%. A review of filings from 16 states and D.C. shows that insurers primarily cited rising health care costs as the main driver of increases, along with higher prescription drug prices and utilization, economic inflation, labor shortages, and ongoing volatility in the small group market.
Next Up:
Trends and Challenges in Medicare Advantage
Society of Actuaries, Sept. 29, 2025, 12 p.m. (ET)
Panelists:
Julia Friedman, FSA, MAAA, Principal & Consulting Actuary, Milliman, Inc.
Jon Housel, AM Best
Bridget Maehr, AM Best (Moderator)
Prior Authorization: Current State and Potential Reform
Health Affairs, Sept. 29, 2025, 1 p.m. (ET)
Panelists:
A. Mark Fendrick, The University of Michigan's Center for Value-Based Insurance Design (Moderator)
Ravi Gupta, Johns Hopkins School of Public Health
Michael Anne Kyle, Perelman School of Medicine at the University of Pennsylvania
Christina Andrews, University of South Carolina Arnold School of Public Health
ICHRAs: The Next Chapter in Employment Based Health Benefits?
Employee Benefit Research Institute, Sept. 30, 2025, 2 p.m. (ET)
Panelists:
Paul Fronstin, Director, Health Benefits Research, Employee Benefit Research Institute
Ben Light, VP of Partnerships, Zorro
Chris Byrd, Senior VP, WEX (Moderator)
Fueling Biosimilar Adoption: What’s in Your Toolkit?
National Alliance of Healthcare Purchaser Coalitions, Oct. 2, 2025, 2 p.m. (ET)
Panelists:
Denise Giambalvo, Executive Director, Washington Alliance (Moderator)
Jonathan Kimball, VP Global Public Affairs, North American Corporate Affairs, Sandoz
Rosa Novo, Administrative Benefits Director, Miami-Dade County Public Schools
Michael H. Shannon, MD, Medical Director, Ventegra