As health plans confront rising medical and administrative costs, payment integrity is evolving from a collection of discrete interventions into an enterprise-wide strategic capability. In this sponsored episode of Podnosis, host Irena Luo speaks with Michael Axt, CEO of ClarisHealth, about why adding specialized vendors alone does not guarantee stronger performance. Without orchestration and end-to-end visibility, payers risk duplicative findings, missed savings, fragmented workflows and greater provider abrasion.

Axt explains how technology and AI can help payers improve payment accuracy, move more determinations earlier in the payment cycle and coordinate interactions with providers. He also considers how orchestration platforms such as Pareo can connect data, give internal teams a shared workspace and provide vendor-agnostic analytics for stronger program oversight. His perspective points toward a future in which payment integrity, utilization management, risk adjustment and other cost-management functions converge around a more connected view of the claim and episode-of-care lifecycle. Listen to the interview to learn more about the operating model shaping the future of payer performance.

As health plans confront rising medical and administrative costs, payment integrity is evolving from a collection of discrete interventions into an enterprise-wide strategic capability. In this sponsored episode of Podnosis, host Irena Luo speaks with Michael Axt, CEO of ClarisHealth, about why adding specialized vendors alone does not guarantee stronger performance. Without orchestration and end-to-end visibility, payers risk duplicative findings, missed savings, fragmented workflows and greater provider abrasion.
Axt explains how technology and AI can help payers improve payment accuracy, move more determinations earlier in the payment cycle and coordinate interactions with providers. He also considers how orchestration platforms such as Pareo can connect data, give internal teams a shared workspace and provide vendor-agnostic analytics for stronger program oversight. His perspective points toward a future in which payment integrity, utilization management, risk adjustment and other cost-management functions converge around a more connected view of the claim and episode-of-care lifecycle. Listen to the interview to learn more about the operating model shaping the future of payer performance.

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.

Podnosis

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.