Machinify

📢 News from Machinify: We have entered into a definitive agreement to acquire Performant Healthcare, Inc. (Nasdaq: PHLT), an organization with a long track record of tackling challenges in the healthcare payments process. At Machinify, we're laser focused on promoting accuracy and transparency in healthcare payments. By combining our powerful Payer Operating System with Performant’s trusted domain expertise and differentiated data assets, Machinify will be able to further deliver high-quality, timely payments at dramatically reduced administrative costs for payers of all sizes. Read comments from our CEO David Pierre in the release: https://hubs.la/Q03B0Ll10

🧠From "Can this work?" to "Let's scale it." In June, Machinify's Chief Product Officer, Prasanna Ganesan, partnered with Fierce Healthcare to explore what it really takes to operationalize AI at scale in a payer environment. In case you missed the webinar, "A Healthcare Evolution: Modernizing Your Health Plan with an AI Operating System" is now available to stream. 🎧Listen here: https://hubs.la/Q03xs6Xt0 Here's a preview: 🔍Experimental AI = testing feasibility ("Can this work?") ⚙️Operational AI = scaling with confidence ("This works—now how do we scale responsibly?") You'll also get a breakdown of the AI Operating System for healthcare: ✔️Why AI needs governance, monitoring, and retraining—not just algorithms. ✔️How a healthcare-specific OS layers clinical, regulatory, and data precision into every decision ✔️Where top payers are already seeing real ROI from this approach 📈If you're serious about turning AI from an experiment into infrastructure, this is your blueprint. #HealthcareAI #OperationalAI #HealthPlans #Machinify #AIFrameworks #FierceHealthcare #PaymentIntegrity #HealthTechLeadership

⚠️ 𝟵𝟰% 𝗼𝗳 𝗵𝗲𝗮𝗹𝘁𝗵 𝗽𝗹𝗮𝗻 𝗲𝘅𝗲𝗰𝘀 𝘀𝗮𝘆 𝗔𝗜 𝗰𝗼𝘂𝗹𝗱 𝘁𝗮𝗸𝗲 𝗯𝘂𝘀𝘆𝘄𝗼𝗿𝗸 𝗼𝗳𝗳 𝘁𝗵𝗲𝗶𝗿 𝗽𝗹𝗮𝘁𝗲𝘀. 𝗕𝘂𝘁 𝟴𝟴% 𝘀𝗮𝘆 𝘁𝗵𝗲𝗶𝗿 𝗼𝗿𝗴𝘀 𝗵𝗮𝘃𝗲𝗻’𝘁 𝗮𝗱𝗼𝗽𝘁𝗲𝗱 𝗶𝘁 𝘆𝗲𝘁. The future isn’t waiting for you to catch up. We surveyed 100+ health plan leaders, each with $100M+ in revenue, to uncover how they really feel about AI. The results? Eye-opening. 🔍 Where AI is gaining traction 💥 What’s holding plans back 📈 Why payment integrity is a launch point for ROI 👉 𝗚𝗲𝘁 𝘁𝗵𝗲 𝗳𝘂𝗹𝗹 𝘀𝘁𝗼𝗿𝘆 𝗶𝗻 𝗼𝘂𝗿 𝗻𝗲𝘄 𝗿𝗲𝗽𝗼𝗿𝘁: 𝘼 𝘽𝙧𝙞𝙜𝙝𝙩 𝙁𝙪𝙩𝙪𝙧𝙚 𝙛��𝙧 𝙃𝙚𝙖𝙡𝙩𝙝 𝙋𝙡𝙖𝙣 𝘼𝙄 𝘼𝙥𝙥𝙡𝙞𝙘𝙖𝙩𝙞𝙤𝙣𝙨 https://hubs.la/Q03xs3mr0 If AI is on your roadmap (or if it needs to be), you’ll want this intel first. #PaymentIntegrity #AIinHealthcare #HealthPlans #HealthcareInnovation #Machinify

🚧Payment integrity is seeing a major shift, and the best payers are already adapting. For decades, post-payment recovery dominated payment integrity programs. But what if the biggest savings—and the strongest provider relationships—were actually on the front end? Payers are rethinking their strategies. And not just because post-pay is expensive, reactive, and abrasive. It’s because pre-pay is now possible at scale, with precision, and without sacrificing speed. In our latest post, we break down: ✅ Why leading health plans are accelerating pre-pay adoption ✅ What barriers are falling (and which still need work) ✅ How tech-enabled platforms support current staff and workflows This isn’t theory. It’s operational AI, already driving results. 👉 https://hubs.la/Q03xs6Gg0 #PaymentIntegrity #HealthcareAI #PrePay #HealthPlans #OperationalAI #HealthcareInnovation #Machinify

🔎 Is your COB process costing you more than you think? For most health plans, Coordination of Benefits (COB) is viewed as a back-office task. But in today’s high-cost, data-driven environment, it’s a strategic imperative. ✅ Reduce overpayments ✅ Ensure compliance with MSP and ERISA regulations ✅ Protect member satisfaction and retention ✅ Streamline operations and reduce FWA In our latest post, we break down how smarter, AI-powered COB can deliver significant financial and operational value—and why traditional methods are no longer enough. 📥 Dive into how Machinify helps identify other coverage before you pay a claim. Read the full post here: https://hubs.la/Q03xs6Kt0 #HealthPlans #PaymentIntegrity #COB #HealthcareAI #PayerStrategy #RevenueOptimization

⛳ Great game, greater cause. In June, our team—Chris Powers, Jeremy Hartlage, MBA, and Billy Brand—hit the course at the Healthy Drives Golf Tournament hosted by Johns Hopkins Health Plans. Held at The Timbers at Troy, the event raised funds for the United Way of Central Maryland and its mission to expand access to education, employment, health, and housing. We were honored to be part of it—and even more honored to leave a few birdies out there in pursuit of first place 😉. Thanks to our hosts for a fantastic day of community and purpose.🏌️ #HealthyDrives2025 #HealthcareCommunity #UnitedWay #TeamMachinify #PaymentIntegrity

📍 Finance Team IRL | Kentucky What happens when you bring a remote-first team together in one place? You get ideas flying, insights clicking, and a lot of laughs along the way. Check out our Finance team who got together in La Grange to go deep on working styles (shoutout to the 💿DISC assessment), build trust, and tackle tough problems face to face. We also made time for a little Kentucky culture with a trip to Churchill Downs. At Machinify, we know tight execution starts with strong connection. When our people know how to work 𝘸𝘪𝘵𝘩 each other, they move faster and think smarter. To the Finance team: thanks for showing us what modern collaboration looks like.🎉 Shoutout to: TG Ganeshan, Brian Moore MBA, CPA, Lindsey H., Karen Bertram, Heather Makowsky, Alexandra Etholm, Kristen Miller, Jamie Muhlenkamp, Lydia Tanuku, PMP, Surya Srikumar, Rebecca Streur, Zachary Schneider, Manuel Donnay, Christopher Kidd, CPA, Stewart Wells, Julianna Corbett, George Claiborne, Evan Leeper, and Blake Holsclaw, CPA!

🎙 What does it take to reimagine payment integrity in healthcare? Our CEO, David Pierre, shares the inside story on Bloomberg's Vanguards of Healthcare podcast. From integrating four industry leaders into one powerhouse platform to doubling audit productivity with machine learning, David outlines how Machinify is executing its vision. If you're a payment integrity leader—or just want to hear how AI can actually work in practice—this is a must-listen. 🎧 https://hubs.la/Q03wCZdw0 After you’ve had a listen, we’d love to hear: 💭 What resonated with you most? 💡 How are you tackling similar challenges? Drop your thoughts in the comments. #paymentintegrity #healthcareAI #healthplans #Machinify #valuebasedcare #healthtech

💊 Pharmacy spend isn’t slowing down. Neither is CMS oversight. If you’re leading pharmacy operations or payment integrity at a health plan, you need more than headlines. You need insight that helps you act. Machinify’s monthly newsletter is designed for pharmacy decision-makers who want to stay ahead of: 🔹 Medicare Part D compliance risks 🔹 COB and retro term recovery strategies 🔹 AI-powered tools for high-cost drug oversight 🔹 Payer perspectives on what’s working—and what’s not No noise. Just expert-backed intelligence built for people managing real complexity. 📬 Subscribe to the newsletter → https://hubs.la/Q03tyR2R0 #PharmacyPI #MedicarePartD #PaymentIntegrity #PharmacyOperations #HealthPlans #HealthcareCompliance #Machinify #PharmacyLeaders #COB #CMSAuditReady

💊The poll results are in. And the message is clear: Pharmacy waste is a system-wide problem. When we asked where health plans see the biggest need for smarter pharmacy payment solutions, here’s what we heard: 🔹 Top concern: High-cost & specialty drugs 🔹 Tied at 14%: Pharmacy COB and Medical Pharmacy Benefits Management 🔹 But here’s the kicker: 29% of you said “we need help across the board.” It’s no wonder. The complexity is rising. Visibility is limited. And standard systems weren’t built to solve for this. So how should payers think about fixing pharmacy payment operations? 💡 We asked Derek McMahan, President of Pharmacy at Machinify, to weigh in. In this Q&A, he unpacks: ✔️Where the biggest leaks in pharmacy spend happen—and how to stop them ✔️What most plans overlook in their strategy ✔️Why the smartest leaders are rethinking their vendor expectations 📖 Read the full interview now: https://hubs.la/Q03vC5s70 #PharmacySolutions #HealthPlanStrategy #PaymentIntegrity #SpecialtyPharmacy #DigitalTransformation #HealthcareIntelligence #Machinify