< + > How Payers Can Modernize Operations With AI and Automation — Without Ripping Everything Out

In a recent video interview, Brian Yavorsky, CTO at Imagenet, discusses how the company helps payers use AI and other data technologies to achieve efficiencies. Emphasizing the difficulties in getting skilled staff, Yavorsky says that automation can reduce labor not by removing people, but by automating areas that are difficult to staff.  Plus, by automating the mundane tasks you allow staff to work on higher value tasks that they enjoy more.

Many payers are burdened with legacy systems and workflows, especially after acquiring other companies. Although the systems work individually, the fragmentation in systems and data introduces inefficiencies and requires more manual work, which adds to costs and slows payer responses.  Organizations that don’t address this fragmentation suffer from inefficient processes and often can’t benefit from new AI technologies.

When looking at addressing legacy technology at payer organizations, Yavorsky does not favor the “big bang” approach to replacing everything at once because it can take operations offline and requires resources that payers might not have. Instead, he recommends taking “smaller bites of the apple,” and modernizing in very specific areas.  This step-by-step approach to modernizing your payer operations allows leadership to see the success of the IT project early so they’ll continue to invest in modernization efforts.

When it comes to leveraging AI with payers, AI offers opportunities especially in handling exceptions to the rules, which normally require the most human labor: “high frustration areas” as Yavorsky puts it. Any problems in process become more expensive as one gets later in that process. So automation can help reduce rework in claims, communications, and risk reduction by helping the payer address problems early in the process.

If you’re an organization looking to modernize your operations and benefit from AI, you’ll enjoy our interview with Brian Yavorsky from Imagenet.

Learn more about Imagenet: https://www.imagenetglobal.com/

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Imagenet is a proud sponsor of Healthcare Scene.

< + > Healthcare Revenue Has a Complexity Problem: Here’s the Cure

As Buying Groups Grow and Care Delivery Spreads Across New Settings, Commercial and Finance Teams are Losing a Shared View of Where Revenue Actually Stands

The following is a guest article by Steve Harding, SVP (EMEA & APAC) at Clari and Salesloft

Currently, more than 70% of healthcare executives say their organizations are becoming more complex due to factors including digital transformation, regulatory changes, and evolving care models. Operations like care delivery have expanded beyond traditional settings. Technology adoption has accelerated across clinical and operational environments. Financial models have moved toward value-based care and long-term outcomes, expanded beyond traditional settings. Technology adoption has accelerated across clinical and operational environments. Financial models are shifting toward value-based care and long-term outcomes.

At the same time, commercial teams are working through longer buying cycles with more stakeholders involved in every decision. Revenue is harder to track, forecast, and manage with confidence. 

Complexity is Increasing Across the Revenue Lifecycle

Revenue in healthcare no longer follows a simple path. It moves across multiple systems, teams, and time horizons.

For example, organizations are now managing multi-year agreements tied to performance. Ernst & Young (EY) highlights that the operational transition from fee-for-service to value-based care is increasing financial and operational complexity, requiring tighter integration across clinical, financial, and IT functions.

They’re navigating payer and provider relationships and working across digital channels that did not exist a few years ago. Each of these factors introduces more variables into how revenue is generated and recognized. 

Buying groups have expanded as well. Decisions now involve clinical leaders, IT teams, finance, procurement, and external partners. This level of coordination slows execution, as it creates more points where deals can stall or lose momentum. It also makes it harder to maintain a consistent view of where revenue stands at any given time.

Without a clear operational structure, complexity compounds quickly.

Data Fragmentation is Limiting Visibility

Most healthcare organizations have invested heavily in technology. They have implemented EHR systems, financial platforms, CRM tools, and analytics solutions. These systems are critical, but they often operate independently.

Data does not always align across platforms. Definitions vary by team. Reporting is inconsistent. As a result, leaders are often working with different versions of the same story. This shows up in forecasting and planning. For example, finance may project revenue based on one set of assumptions, while commercial teams manage pipeline activity in another system and clinical operations track outcomes separately.

When those views do not align, confidence in the numbers starts to drop. This is where revenue governance becomes critical. Organizations need clear ownership of data, consistent definitions, and alignment across systems to manage revenue effectively. 

Without that foundation, even basic decisions take longer than they should.

AI Adoption is Accelerating, But Results are Uneven

Deloitte reports that more than 80% of health system executives said they are prioritizing agentic AI for clinical operations and care delivery, in addition to revenue-cycle management. The potential is clear, and some organizations are seeing strong results. However, others are not. Deloitte reports that many healthcare organizations are still in early stages of AI maturity, with challenges around data quality, integration, and governance limiting their ability to scale impact.

The difference comes down to how well the underlying systems are structured.

AI depends on accurate data and clearly defined workflows. If data is fragmented or inconsistent, AI reflects those issues. It does not correct them. Instead, it can introduce more noise into the process.

Organizations that approach AI as a layer on top of existing systems often struggle to scale value. Those that focus first on data alignment and process discipline are in a stronger position to benefit.

Leading Organizations are Focusing on Operational Discipline

Healthcare organizations that are improving revenue performance are not relying on a single tool or initiative. They are building a more structured approach to revenue orchestration.

The first step is aligning data across the business. Clinical, finance, and IT teams are working from shared definitions and consistent metrics. Data flows between systems are monitored and validated. Leaders have a clear view of the pipeline, contract performance, and renewal activity. This creates a foundation for better decision-making. Teams move faster because they trust the information they are working with.

The second step is standardizing workflows. Revenue moves across multiple teams, from initial engagement through contracting and into long-term account management. When each team operates differently, execution becomes inconsistent. Leading organizations define how work progresses at each stage. They establish clear expectations for how opportunities are managed and how next steps are tracked. This improves consistency and reduces the risk of delays.

The third step is establishing a consistent operating cadence. High-performing organizations run regular pipeline reviews, forecast checkpoints, and performance discussions. They identify risk early and take action before it impacts outcomes.

This level of discipline improves predictability and empowers leaders to manage revenue proactively rather than reactively.

Revenue Orchestration is Becoming a Core Capability

Healthcare organizations are in no shortage of innovation. New technologies will continue to reshape how care is delivered and how services are sold.

The challenge is integrating those capabilities into a cohesive operating model.

Revenue orchestration sits at the center of this effort. It connects data, systems, and teams. It ensures that the business is working from a shared understanding of performance and priorities.

Organizations that treat revenue orchestration as a core capability are better equipped to manage complexity. They can navigate longer buying cycles with more control, improve forecasting accuracy, and scale growth in a way that is consistent over time.

< + > This Week’s Health IT Jobs – June 17, 2026

It can be very overwhelming scrolling through job board after job board in search of a position that fits your wants and needs. Let us take that stress away by finding a mix of great health IT jobs for you! We hope you enjoy this look at some of the health IT jobs we saw healthcare organizations trying to fill this week.

Here’s a quick look at some of the health IT jobs we found:

• Clinical Engineering/BiomedicalEngineering Cyber Specialist – TechnoSphere, Inc.
• Patient Navigator Business Analyst – Cottage Health
• Senior Director – Data Systems – Cincinnati Children’s
• Quality Assurance Specialist – Wellbox Health
• Clinical Research – Data Entry Specialist – Syneos Health
• Community Outreach Coordinator Physician Liaison – Ellie Mental Health
• Health Informatics Analyst – Alignerr
• Director, GRC Technology and Metrics – Pfizer
• Rural Health Liaison – CareSource
• ROI Medical Records Specialist – MRO
• Clinical Engineering Cyber Specialist – SnapX.ai
• Director, Safety & Corporate Insurance – DaVita Kidney Care
• Associate Chief Digital Information Officer – AMN Healthcare Leadership Solutions | B.E. Smith
• Billing Representative – Accendra Health
• Implementation Specialist – CuraLinc Healthcare
• HIM/Medical Records Technician – Vail Health
• Director of Technology & Information Security – Chapa-De Indian Health
• Healthcare Compliance Analyst – El Camino Health
• Regulatory & Clinical Specialist – LivaNova
• Community Based Care Compliance Specialist (Compliance Specialist 2) – Oregon Department of Human Services

If none of these jobs fit your needs, be sure to check out our previous health IT job listings.

Do you have an open health IT position that you are looking to fill? Contact us here with a link to the open position and we’ll be happy to feature it in next week’s article at no charge!

*Note: These jobs are listed by Healthcare IT Today as a free service to the community. Healthcare IT Today does not endorse or vouch for the company or the job posting. We encourage anyone applying to these jobs to do their own due diligence.

< + > How TPMG Cracked the Value-Based Care Code

Value-based care (VBC) is the goal but getting there has proven to be a challenge. For years, independent groups have struggled to align their technology with risk contracts without drowning in overhead. The financial math of VBC rarely works. TPMG is a rare value-based care success story – a decade in the making.

Healthcare IT Today sat down with Jeff Morrison, Vice President and CMIO at TPMG, to uncover how this independent, multi-specialty group cracked the code. By maximizing their eClinicalWorks platform and being smart with risk contracts, TPMG has successfully navigated VBC for the past 12-years without burying their providers in clerical work.

Key Takeaways

• Stop leaving money on the table for care management. CMS programs like Advanced Primary Care Management offer per-member-per-month revenue for work practices already do, provided the technology can track it.
• Ditch the manual dialer to close care gaps. Pushing bulk messages through a centralized hub to schedule Open Access visits is a faster, more effective way to hit HEDIS measures.
• Automate the reporting slog to maintain momentum. Direct integrations that package and send quality files to an ACO eliminate the administrative friction that usually derails value-based initiatives.

Capture Revenue for Care Management

TPMG did not wait to capitalize on the Advanced Primary Care Management program. They activated the specialized module within eClinicalWorks and rapidly enrolled over 9,600 patients. This added a vital per-member-per-month revenue stream for care they were already delivering.

Morrison recognized the immediate financial benefit of aligning their EHR with CMS incentives. “It’s a great tool. It helps create a revenue stream to help us with activities that help patients,” he explained. The technical execution was straightforward. “We just turned it on and started getting patients to sign up.”

Morrison appreciated how quickly TPMG was able to move from implementation to billing.

Automate Outreach to Close Care Gaps

Chasing down patients with treatment/care gaps in a VBC program is a labor-intensive nightmare. TPMG overcame this bottleneck by using the ProviderHub function of eClinicalWorks to track HEDIS measures like blood pressure control. The system identifies exactly who needs attention and allows the TPMG team to act instantly.

Instead of manual phone calls, the TPMG uses automated, bulk messaging to drive patients into Open Access scheduling.

“We can go to the non-compliant group and with a few clicks of a button, send them all a message saying – ‘Hey, can you call the office or can you make an appointment in open access so we can get you in so we can make sure your blood pressure’s controlled?'”

Eliminate the Quality Reporting Burden

The administrative weight of VBC can crush independent practices. Extracting and formatting data for ACO submission requires significant backend resources. TPMG solved this by using their EHR to handle the heavy lifting.

The process of submitting electronic clinical quality measures (eCQMs) is almost entirely hands-off at TPMG. “It’s called a QRDA I file and it is just processed by eCW,” Morrison stated. “We just tell them [eClinicalWorks], ‘Hey, we need these measures, these eCQMs, submitted back to the ACO,’. They process it and off it goes.”

This removes a significant administrative burden from the TPMG administrative team.

The Bottom Line

Succeeding in value-based care requires more than just clinical excellence. It requires strong commitment from leadership, a willingness to “stick with it”, smartly assessing financial/clinical risk, and IT infrastructure that makes the practice of VBC easier. Through hard work and dedication, TPMG is proving that an independent practice can thrive under risk models without burning out its staff – especially when it has IT systems that can support VBC efforts.

What Healthcare IT Leaders Are Asking

How can an EHR support Advanced Primary Care Management (APCM) billing? An EHR supports APCM billing by tracking patient enrollment, capturing consent, and logging the required care management activities. By using dedicated modules, IT teams can automate the documentation process, ensuring that providers meet the criteria for per-member-per-month Medicare payments without adding manual data entry to their workload.

What is the most effective way to improve HEDIS measure compliance using technology? The most effective approach is centralizing population health data into a single dashboard that identifies non-compliant patients in real time. From there, IT systems can facilitate bulk messaging, allowing clinical staff to send targeted appointment invitations via patient portals or SMS, directly connecting patients to open scheduling slots.

How does automating QRDA I file submission benefit an ACO participant? Automating QRDA I file submission eliminates the need for manual data extraction and formatting. When an EHR is configured to directly process and transmit these quality files to an ACO, it reduces administrative overhead, minimizes human error, and ensures that the practice receives accurate credit for the quality of care delivered.

Learn more about TPMG at https://tpmgpc.com/

Learn more about eClinicalWorks at https://www.eclinicalworks.com/

Listen and subscribe to the Healthcare IT Today Interviews Podcast to hear all the latest insights from experts in healthcare IT.

And for an exclusive look at our top stories, subscribe to our newsletter and YouTube.

Tell us what you think. Contact us here or on Twitter at @hcitoday. And if you’re interested in advertising with us, check out our various advertising packages and request our Media Kit.

eCW is a proud sponsor of Healthcare Scene.

< + > AI-Driven Quality: The New Standard for Healthcare IT Service Desks

The following is a guest article by Dan O’Connor, VP Partner Success at HCTec

Quality healthcare depends on mission-critical applications and devices being accessible and functional around the clock. That reality puts enormous pressure on the IT service desk, which is expected to resolve issues quickly and keep clinical work moving without interruption.

Recent advances in artificial intelligence (AI) have brought real innovation to service desk workflows. It is now possible to automate password resets and system access requests, and to automatically deliver troubleshooting guides and supporting documentation to end users who need help. As a result, the service desk can respond to high-volume, repetitive requests almost instantly.

Automation clearly benefits the IT service desk, but health systems should remember that speed alone does not improve the end-user experience. Fortunately, AI is poised to make a difference here as well—and there are valuable lessons to draw from how other industries have transformed the customer experience.

By analyzing IT service desk interactions, organizations gain far greater visibility into how users engage with support. Those insights can be applied not only to resolve issues but also to improve service desk efficiency and, ultimately, to enable proactive support.

AI is behind experience-driven outcomes

Organizations do not always think of the IT service desk in terms of customer interactions, but adopting that lens helps leaders understand why, where, and how to elevate the user experience.

It is no secret that consumers prefer simple, convenient, and personalized engagements with the brands they rely on. Forrester describes this as creating outcomes-based digital experiences—an approach that emphasizes a consumer’s needs and goals and focuses on the holistic customer journey rather than isolated transactions.

That stands in stark contrast to making customers complete a series of individual tasks every time they interact with a brand: enter their information, wait for a reply, provide more information, and so on. It sounds a lot like the typical IT service desk experience, doesn’t it? And while that friction is merely frustrating in low-acuity situations, it becomes unacceptable when medical records can’t be retrieved, monitoring devices suddenly go offline, or clinicians on rounds get locked out.

There is a better way. Optimizing how AI is used in the IT service desk provides agents and end users with tools to improve the experience on both sides of the desk. Examples include:

• Call-routing systems that analyze a user’s history to predict their concern and route the request to the agent best equipped to handle it
• Sentiment analysis that surfaces common themes and user behaviors across requests, which can be applied to calls in real time or used to pinpoint recurring causes of disruption
• Chatbots that guide users through simple troubleshooting tasks, allowing them to resolve problems on their own or escalate to a human agent as needed

The next evolution: AI-based quality scoring

AI has already brought clear improvements to IT service desk operations. Simple questions and routine requests are resolved quickly, freeing clinical users to focus on patient care. Agents, in turn, can spend more time applying their skills to complex, critical requests.

But AI’s value to the service desk does not stop there. Once again, health systems can look to how AI is used to assess the quality of customer interactions and apply those lessons to the service desk.

Companies that run customer contact centers increasingly use AI to evaluate every customer interaction—not just the small sample that can be reviewed manually. That makes the review process both thorough and objective, because assessments can no longer be cherry-picked.

With full visibility into customer interactions, companies can detect patterns in agent performance, identify which issues are hardest to resolve, and even assign a quality score to each interaction. Armed with that concrete data, organizations have a clear path for identifying where to improve.

The same strategies apply to the IT service desk. Analyzing the full range of interactions end users have with support—phone calls, chatbot conversations, help desk tickets, emails, and text messages—offers unparalleled insight into the bottlenecks and delays that cause frustration and, ultimately, affect patient care.

Quality that drives proactive support

AI-driven quality scoring delivers several benefits. Leaders can see which types of issues routinely require after-call work and develop strategies to reduce that burden on agents. They can also readily identify high and low-performing agents and implement targeted training plans to address areas of concern.

Quality assessment can also pave the way for proactive service desk support:

• If many employees in the same department request access to the same software application, an automatic installation could save considerable time.
• Repeated reports of connectivity or performance issues could prompt a timely conversation about system upgrades.
• Requests that take little time or effort for agents to resolve could be candidates for automation. Conversely, chatbot conversations or automated workflows that routinely require an agent to step in could be re-elevated to a ticket.

Many health systems have already used automation in the IT service desk to increase speed, maximize efficiency, and improve the end-user experience. Now, organizations have an opportunity to go a step further—leveraging AI to assess user engagements the way companies review customer interactions. The insights that follow can drive meaningful process improvements and create a better experience for everyone, so users can stay focused on healthcare’s critical mission.

About Dan O’Connor

Dan O’Connor is Vice President of Client Experience at HCTec, where he partners with healthcare organizations to improve IT service delivery, operational performance, and end-user experience. With more than 25 years of healthcare and healthcare technology leadership experience, Dan combines a clinical background as a registered nurse with executive leadership experience that includes serving as a Chief Information Officer. His unique perspective across clinical operations, IT strategy, and managed services enables him to align technology initiatives with organizational goals while driving measurable improvements in service quality, efficiency, and user satisfaction.

Throughout his career, Dan has led large-scale healthcare IT transformations, managed services operations, service desk organizations, and clinical technology initiatives supporting Epic, Oracle Health (Cerner), and MEDITECH environments. He is passionate about helping health systems leverage technology, optimize workflows, and deliver exceptional support experiences that ultimately enhance patient care.

HCTec is a proud sponsor of Healthcare Scene

< + > Health Catalyst to Divest Vitalware for $147 Million, Accelerating Strategic Transformation

Transaction Reflects a Sharper Focus on AI and Core Technology; Net Proceeds Expected to Strengthen Balance Sheet and Provide Financial Flexibility

Health Catalyst, Inc., today announced it has signed a definitive agreement to divest Vitalware, LLC and the Vitalware business unit, its mid-revenue cycle business, to Med-Metrix for a total consideration of $147 million in cash. This divestiture sharpens Health Catalyst’s focus on driving measurable improvement for health systems across cost, clinical, and consumer performance, and the Company expects it to accelerate the broader transformation underway.

“This is a big step forward for Health Catalyst. We are concentrating our business around the areas where we have the deepest conviction, and we plan to put the capital structure in place to back our long-term strategy. Vitalware is a great business, and we are pleased to have found a partner in Med-Metrix who is well positioned to carry it forward,” said Ben Albert, CEO at Health Catalyst.

Health Catalyst expects the transaction to strengthen its balance sheet and provide increased financial flexibility to prioritize the core technology and AI investments. At its core, the Company’s strategy is built on 18 years of proprietary healthcare improvement data and $2.8 billion in measured outcomes, a foundation that grows more complete with every outcome measured and that serves as the foundation for an AI roadmap that will enable health systems to turn their own results into specific, prioritized action.

The Company plans to use net proceeds from the divestiture upon closing, combined with cash on hand, to fully repay and terminate its existing senior secured term loan facility of approximately $160 million of outstanding principal as of March 31, 2026, plus additional amounts in interest, prepayment premiums and costs.

Med-Metrix, a technology-enabled revenue cycle management company serving provider organizations across the country, will acquire Vitalware. Med-Metrix’s resources and focus in revenue cycle management position it to invest in the business more deeply. A best-in-KLAS leader with approximately $37 million in fiscal year 2025 revenue, Vitalware provides software for the financial operations of a health system, a category distinct from the clinical and operational improvement work at the core of Health Catalyst’s strategy.

The transaction is expected to close in 2026, subject to the satisfaction of certain specified closing conditions, including the expiration or termination of regulatory waiting periods. Additional details regarding the divestiture are included in Health Catalyst’s Form 8-K filed with the Securities and Exchange Commission (SEC) on June 4, 2026.

About Vitalware

Vitalware by Health Catalyst is a suite of mid-revenue solutions that help hospitals and health systems improve coding compliance, chargemaster management, charge capture, and price transparency across the mid-revenue cycle. It combines healthcare-specific data models, applied AI, and expert support to deliver measurable financial and operational results.

About Health Catalyst

Health Catalyst, Inc. is a healthcare intelligence company that accelerates measurable improvement for health systems across cost, clinical, and consumer performance. Backed by deep domain expertise, proprietary AI-driven technology, and $2.8 billion in documented outcomes, Health Catalyst helps health systems move from data to confident, measurable action.

Advisors

Raymond James served as the exclusive financial advisor, and Latham & Watkins LLP served as outside legal counsel for Health Catalyst.

Originally announced June 4th, 2026

< + > The Myth of the Single Healthcare Decision-Maker and Other Reuters Digital Health 2026 Insights

Sometimes you only need a morning to get a read on a room.

I dropped into the Reuters Digital Health 2026 event in Chicago for just a half-day, and honestly? I regret not carving out more time. To me, the event felt like a mashup of CHIME, a scientific symposium, ViVE and HIMSS’s hosted buyer meetings, and a good old-fashioned networking event.

Here is what digital health and IT leaders need to know from the ground.

Core Insights from Reuters Digital Health 2026

1. Traditional sales strategies of focusing on a single executive decision-maker is no longer effective in healthcare. Vendors now must secure both an executive sponsor and a separate clinical champion to navigate complex innovation pipelines.
2. Incumbent solutions also hold a massive advantage, meaning challengers must be significantly better to displace an existing system that is just 60% good enough.

The 70/30 Networking Advantage

I tip my virtual hat to the organizers: instead of a standard exhibit hall, they set up a buzzing networking room anchored by a barista. Not only was the caffeine a hit (get it?), but the purposeful ratio of 70/30, provider to vendors ratio was too.

The networking room was packed with executives from both sides having deep conversations. Every vendor I spoke with felt they got tremendous value for their sponsorship dollars, which in today’s environment is a big win.

The “Double Champion” Rule

It is rare that a single executive makes large buying decisions in isolation. Most healthcare decisions are by committee. That was starkly highlighted in a standout session from Dr. Cheng Kai Kao, CMIO at UChicago Medicine.

He laid out his organization’s innovation pipeline and made one thing crystal clear: to get project consideration today, you need both an executive sponsor and a project champion. Oh, and they cannot be the same person. You can’t just pitch the CIO and expect magic; you need clinical or operational alignment to push it through.

The Incumbent Bias

Dr. Kao explained that when UChicago performs a market assessment, incumbent systems have a massive edge.

If an existing vendor has a solution that is just 60% good enough, it gets serious consideration. To displace them, a new digital health vendor must be at least 40% better than everything else in the organization’s tech stack. It’s a brutal math equation for challengers, but it has been the truth in these uncertain economic times.

The Bottom Line

Reuters put on an incredibly effective event. It seemed valuable for many participants, but for those that listened intently during the sessions, there were several key insights from the speakers that were pure gold.

Learn more about Reuters Events at https://events.reutersevents.com/reutersevents