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Caroline Catherman

Cassie McGrath

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UnitedHealth Group, Cigna, and Humana all have something in common—besides being major health plans, that is.

They’re all currently facing lawsuits from patients alleging AI programs led to denied care. These suits claim (pun not intended) the insurance companies used AI-based algorithms to deny care without human oversight.

 of healthcare by leaders across the industry. AI scribes have 

 to give clinicians more face time with patients and better work-life balance, while also saving hospitals money. 

, able to carry out complex tasks autonomously, have turbocharged the tech’s potential.

 these tools are being adopted faster than safeguards, despite concerns about 

. Now, with all the emerging lawsuits, the outlook of AI in healthcare is looking even more complicated.

Fawad Butt, former chief data officer of Kaiser Permanente, UnitedHealthcare, and Optum, told Healthcare Brew there’s been a lack of oversight regarding “whether algorithms are behaving as good actors or bad actors.”

UnitedHealth spokesperson Eric Hausman told us it isn’t used for “adverse coverage decisions,” Cigna spokesperson Justine Sessions told Healthcare Brew AI isn’t being used to deny claims, and Humana didn’t respond to a request for comment.

But providers say the opposite—that plans 

 using AI for denials. While bigger health systems have more resources to appeal denials, some experts say independent rural hospitals

could be hit harder. A 2023 Stat investigation 

 UnitedHealth was using predictive algorithms to decide when some patients should be cut off from care.

Alexa McKinley Abel, director of government affairs and policy at the National Rural Health Association, said the research and advocacy organization is hearing rural hospitals are increasingly burdened by responding to prior authorization and claims denials because they have 

“If plans’ use of AI means even more prior authorization denials, then we would have concerns about the increasing paperwork and time associated with rectifying the denials for hospital staff as well as delays for rural patients that need to receive care,” she said.

The Centers for Medicare and Medicaid Services doesn’t require insurance companies to share how prior authorization decisions are made or how predictive technology is used in the process, so most of the evidence comes from providers, patients, or insurers that choose to self-report.

 from the National Association of Insurance Commissioners found 84% of 93 insurers used AI, with 50% saying they use it or are exploring its use to detect fraudulent claims, 68% for prior authorization approvals, 61% for disease management programs, and 45% for sales and marketing.

Only 9 of the 93 (12%) said they used or were considering using it to deny prior authorization requests.

Infinitus is an agentic communication platform that currently works with providers such as Medicare Advantage company Zing Health and Gramercy Surgery Center. The voice agent software can do things like conduct health risk assessments and handle specialty pharmacy prior authorization approvals for plans.

“The direction of travel for the industry is to introduce things that we fundamentally couldn’t do today because of a lack of human capital,” Infinitus CEO and founder Ankit Jain said.

On the other hand, healthcare providers and patients are using AI, too, for tasks like appealing denials. Startups 

 are an example of this, creating tools that collect patient and coverage information, then format and send a letter to the plan.

But insurers say some providers are taking AI too far.

Elevance CEO Gail Boudreaux alleged in a July earnings call “isolated pockets” of hospitals are using AI to “increase documented acuity,” driving up unit costs for the insurer. And Centene CEO Sarah London said in her company’s July earnings call that the insurer uses AI in response to that trend.

“As [hospitals] integrate AI into the revenue cycle, we’re integrating AI into payment integrity to make sure that we are sort of keeping pace with all of that,” London said.

Marc Douek, managing partner and co-owner at physiotherapy chain Renew Wellness, told us the chain cuts hours of work down to minutes by using a tool called Spry to automate prior authorization requests and appeals.

A 2024 American Medical Association survey found physicians and their staff spend an average of 13 hours a week completing prior authorization requests. It’s also an expensive process, as the healthcare industry 

 on prior authorization in 2023, according to the 2024 CAQH Index Report.

“Without using Spry in the automation…we wouldn’t be able to expand. We wouldn’t be able to treat our patients. We’d have to just turn people away,” Douek said.

Based on his conversations with insurers, Butt said providers have adopted AI faster—and insurers, which “haven’t adopted agentic [AI] as quickly,” now feel the tech has them “under the gun.”

“They’re left with old technology and humans responding to this deluge of appeals that are coming in from providers who just bought a software or an agent that essentially keeps appealing everything,” he said.

Butt is also co-founder of startup Penguin Ai, a platform intended to be a one-stop shop where both payers and providers can create AI agents. He believes both will need them in the future.

“What I predict is that it’s going to be agent wars galore,” he said.

Virtual Digital hand of Artificial Intelligence (AI). Healthcare technology and innovation concept. Hologram. 3d rendering

The AI arms race between insurers, providers has begun

Health plans have already been accused of using AI to deny patients. 

When you call up a company’s customer service line and are greeted by an off-kilter automated voice, how does that usually go?Personally, the call often ends with us yelling “Connect me to a person!” at a robot that just keeps asking the same questions over and over again.

If you relate, we have good news: That might soon be an interaction of the past.

 promise to flip that script by offering live assistants that remember and build off past queries to personalize and improve service. These agents can be online or even take on human-sounding voices to provide guidance over calls—and unlike chatbots, they can act autonomously without being prompted.

The even bigger news is organizations are already rolling these agents out in one of the domains where it’s most important to get things right: healthcare.

“I envision AI agents becoming the invisible infrastructure that handles background work…so clinicians can spend their time connecting with patients,” Max Solano, hospitalist and clinical informatics advisor at Jacksonville, Florida-based Ascension St. Vincent’s, told Healthcare Brew.

AI agents offer a “natural experience” and “open-ended conversation” compared to the sometimes frustrating 

 systems consumers have battled for decades, Israel Krush, co-founder and CEO of agentic AI company Hyro, told Healthcare Brew.

Patient scheduling company Zocdoc and financial platform Cedar are two healthcare companies that 

 agents earlier this year to assist with scheduling appointments and answering patients’ billing questions, respectively.

Sutter Health, a 27-hospital not-for-profit health system in California, is 

 health organizations to hop on the agent train, announcing Sept. 17 it will use Hyro’s tech to offer HIPAA-compliant AI agent-powered patient communications.

So how do you introduce an AI agent? Very slowly, Jennifer Bollinger, Sutter Health’s SVP and chief consumer and brand officer, told us.

It took about a year to choose a vendor and a bit over a month to integrate Hyro with Sutter’s 

, Epic, she said. Sutter is currently testing the agents for specific tasks, and Bollinger expects the first use case to become available to patients in about 60 to 90 days.

For now, she said the system will focus on using voice agents for basic tasks like authenticating identities, confirming appointments, and giving directions. Patients will be told they’ll be speaking with an AI agent and given the option to opt out, and more complex cases will be reserved for human staff.

Sutter eventually plans to bring Hyro’s agents online and have them take on duties like scheduling and rescheduling appointments, Bollinger added.

“Anything that we have standardized, that’s repeatable at scale across the organization, will be great use cases for the agentic AI,” she said.

To evaluate the tech’s success, Sutter will measure variables like time savings and whether the AI increases first-call resolution, Bollinger said.

These agents aren’t all good news, however.

Experts have warned AI agents could open up a health system to 

Agents are trained to serve, and hackers may try to order the programs to reveal private patient information, for instance, Healthcare Brew previously reported.

Krush said he understands those concerns and that the company kept this in mind when designing its agents, which he describes as “AI on a leash.”

“When you have guardrails in place, the AI agent basically knows what they’re allowed to do and what they’re not allowed to do,” he said.

Headphone of customer service. Support call, live advice, phone bot, chat headphone, service center, helpdesk advisor, virtual contact, care operator, microphone online, expert helpline 3d concept.

Healthcare’s new AI receptionist has arrived

California’s Sutter Health is one of the latest to adopt this new technology for patient communications.

Maia Anderson

Although the psychedelic medicine industry faced a significant setback in late 2024 when the FDA 

 a front-running MDMA-based treatment, healthcare 

In fact, AbbVie, one of the largest pharmaceutical companies in the US, 

 in August plans to drop more than $1 billion to acquire a psychedelic drug in development from Gilgamesh Pharmaceuticals.

With states continuing to introduce and pass legislation to 

 psychedelics, Healthcare Brew asked leaders from across the industry their thoughts on psychedelic medicines, how they’re being integrated into the healthcare system, and what work still needs to be done.

Rachel Yehuda, endowed professor of psychiatry and neuroscience of trauma at Mount Sinai in New York, told us the healthcare industry is “in a transitional moment with psychedelic medicine.”

“We’re seeing growing interest from traditional institutions, including academic medical centers, government agencies like the Department of Veterans Affairs and National Institutes of Health, and pharma,” Yehuda said.

However, it’s still early days, as it’s hard to conduct clinical trials for psychedelic medicines and there are still “too few,” she added.

Mount Sinai in 2021 opened a psychedelic research center, renamed the Parsons Research Center for Psychedelic Healing in 2024, because the hospital believes it’s “essential to bring scientific rigor, clinical safety, and ethical clarity to this emerging field,” Yehuda said.

In order to safely integrate psychedelics into healthcare, key priorities should be making sure clinicians are trained properly, ensuring historically underserved communities 

 to the treatments, and conducting ongoing research, she added.

Jerry Rosenbaum, psychiatrist-in-chief emeritus as well as founder and director of Mass General Brigham’s Center for the Neuroscience of Psychedelics in Boston, told Healthcare Brew that while there’s uncertainty around the logistics of how psychedelic medicines may be delivered and reimbursed, he thinks it’s very likely several will eventually work their way through FDA approval.

That’s because some research suggests psychedelics are effective in treating or reversing many psychiatric conditions without the need for daily medication and are also often effective for patients who haven’t responded to existing treatments, according to Rosenbaum.

Psychedelics are most poised to treat psychiatric conditions such as treatment-resistant depression, generalized anxiety disorder, PTSD, obsessive-compulsive disorder, and substance use disorders, he said.

 on MDMA as a treatment for PTSD, for example, found 71% of 104 patients no longer had symptoms meeting PTSD criteria after treatment. And a 

 from psychedelic medicine company Usona Institute found psilocybin treatment was associated with a “significant sustained reduction” in depression symptoms.

Mass General Brigham founded the Center for the Neuroscience of Psychedelics in 2021 to “understand how psychedelic molecules act to change the brain in hopes of deepening our understanding of psychiatric conditions and to facilitate the discovery of novel therapies,” Rosenbaum added.

Andrew Whitman, a clinical pharmacist in hematology and oncology at UVA Health in Charlottesville, Virginia, told Healthcare Brew psychedelics have the potential to be particularly impactful for cancer patients.

“A lot of patients are dealing with the distress from cancer diagnosis and existing depression [or] anxiety. There’s a trauma response associated with the cancer diagnosis,” he said.

In his experience, providers in the oncology space are generally open to exploring psychedelic medicines since they work with such a vulnerable patient population, Whitman said.

 from Johns Hopkins found psilocybin therapy helped combat depression and end-of-life anxiety in cancer patients.

A potential benefit psychedelics could have is to allow providers to deprescribe other medications and be more minimalistic when it comes to prescribing, Whitman said. That way, patients don’t have to take medication every day.

“You’re really putting the work into working through the underlying cause…so it shifts that focus from daily use to a more holistic approach to making sure patients are being taken care of,” Whitman said.

However, psychedelics don’t work for everybody. There’s concern for people with conditions such as bipolar disorder or schizophrenia because psychedelics may potentially exacerbate their condition, Whitman added.

Leonardo Vando, medical director for Mindbloom, a telehealth company that provides ketamine therapy, told Healthcare Brew that while stigma around psychedelics still exists, he’s starting to see the healthcare system embrace the treatments.

“Academic medical centers are leading clinical trials, and health systems are increasingly exploring what it could look like to integrate psychedelic care responsibly. Even insurers are 

 closer attention,” he said. “We’re still in the early stages, but momentum is building.”

The three areas of focus to bring psychedelics more into the mainstream are research, access, and education, Vando said.

The industry needs to continue conducting rigorous research on psychedelics, as well as make sure the medicines are “affordable, scalable, and available to people from all walks of life, not just those with privilege or proximity to major research institutions,” he said.

And education is needed to combat misconceptions that psychedelic medicines are experimental or risky, Vando added.

“If we can deliver these treatments with compassion, structure, and integrity, they won’t just join the mainstream; they’ll help reshape it,” he said.

Healthcare execs on the state of psychedelic medicine 

While there’s still a long way to go, the industry is starting to embrace psychedelics. 

Nicole Ortiz

Recent years have highlighted how extreme weather events are becoming 

, which means patients are experiencing increased health risks like heat-related illnesses, mental health struggles, respiratory issues, and more.

 from the Commonwealth Fund ranked states to determine how prepared they were for extreme weather events and their role in contributing to greenhouse gas emissions. The healthcare research foundation analyzed publicly available federal and state data between 2020 and 2024 to show how states stacked up in categories including 

 11,755 people worldwide had died as a result of natural disaster in 2019, with 95 million additional people impacted, at a cost of almost $130 billion. And a 2023 study projected that if there were an electrical grid failure in Phoenix, Arizona, during a two-day heat wave, nearly 800,000 people would 

 for heat-related illness and nearly 13,000 people would die in the city.

In May, a group of health organizations including the American Public Health Association, Physicians for Social Responsibility, and 

 signed an open letter urging “leaders at every level take swift action to address the health impacts of climate change and reduce the pollution driving it.”

“What I hope the scorecard helps health systems understand is that they need to be leveraging their voice in these policy decisions on clean energy because it both affects their operations and it affects the health of their populations,” Lisa Patel, executive director of environmental and health group the Medical Society Consortium on Climate and Health, told us.

 To get to the good news first, Vermont, New York, Washington, New Jersey, and Maine all had top scores in the study, meaning these states are at a lower risk of environmental hazard, have cleaner and greener energy policies, and emit lower emissions across healthcare.

West Virginia, Kentucky, Louisiana, Florida, and Mississippi all scored among the lowest.

Arizona, Nevada, and New Mexico see higher temperatures and worse air quality, with Arizona topping the latter list, something that surprised Northeastern University Associate Professor of Environmental Engineering Matt Eckelman, who was also an author on the study.

“For a long time, we’ve known California has had the most serious air pollution issues in the nation,” he told Healthcare Brew. But when it came down to population density and air quality index numbers, he said, “Arizona came out even worse.”

As far as states that are at a higher risk for environmental hazards like floods, hurricanes, and severe winter weather, Florida and South Dakota scored the worst while West Virginia, Wyoming, and North Dakota had the highest greenhouse gas emissions per capita.

 Already, hospitals in some states are taking measures to better prepare for extreme weather.

 showed the preparedness of Florida health systems, like Tampa Bay General Hospital and its new 

, which helped provide a barrier against flooding. On the other side of the country, California-based Kaiser Permanente is 

 with community awareness and support. And nonprofit Americares recently 

 it would award grants to clinics and community health centers across the country to combat extreme heat.

“For new facilities, this is the best opportunity there is to plan for the future, to make sure that not just the hospital, the physical building, but all the systems that support the hospital, including all the access and connected infrastructure, are also protected,” Eckelman said.

Without preparations in place, hospitals have to take measures like evacuating patients or closing entirely—in addition to “disruptions in the supply chain,” like what happened last year with 

—all of which “really does impact their bottom line,” Lovisa Gustafsson, VP of the Making Health Care Affordable program at the Commonwealth Fund, who also contributed to the study, said.

 across healthcare and federal agencies focusing on climate change, which can complicate tracking efforts and 

for states most impacted by climate change.

“We as healthcare providers are seeing the impacts of climate change today, right now,” Patel said. “We need to take climate change out of the realm of politics, understand that this is about the health and well-being of our communities, and empower our health leaders to act.”

global warming climate change abstract art spiritual mind watercolor painting illustration design hand drawing

Commonwealth Fund ranks which states are best, worst for health and climate change preparation

Regions prone to extreme weather events like heat waves, hurricanes, and severe winter weather scored the worst.

Welcome back to Signed and Scrubbed, a monthly roundup of hospital deals, developments, and bankruptcies.

We pulled together a list of provider transactions from September, including transactions from TriHealth in Cincinnati, Ohio and Hartford HealthCare in Hartford, Connecticut. Here’s the rundown.

Lebanon, New Hampshire-based Dartmouth Health signed a letter of intent on Sept. 12 to acquire 25-bed critical access center Littleton Regional Healthcare, also in New Hampshire.

Hartford HealthCare signed an agreement to acquire 249-bed Manchester Memorial Hospital and 102-bed Rockville General Hospital for $86 million from real estate investment trust Prospect Medical Properties, which is in bankruptcy proceedings, 

 On Sept. 2, Scottsdale, Arizona-based HonorHealth signed an agreement to acquire Evernorth Care Group, which has 20 care centers around the state. If the health system obtains the necessary regulatory and legal approvals, the deal is expected to close in early 2026.

Tallahassee locals Florida State University and Tallahassee Memorial HealthCare signed an agreement on Sept. 16 to turn the hospital into an academic medical center, a plan underway for a decade, according to a release.

 Cincinnati, Ohio-based TriHealth acquired its sixth acute hospital on Sept. 2: 140-bed Clinton Memorial Hospital based in Wilmington, Ohio.

Farmington, Connecticut-based UConn Health is in talks to acquire three other Connecticut hospitals: 154-bed Bristol Hospital, 104-bed Day Kimball Hospital, and 357-bed Waterbury Hospital for $400 million, according to the 

Hospital building split in half collaged with briefcase and $100 bill. Credit: Illustration: Anna Kim, Photos: Adobe Stock.

Signed and Scrubbed: September 2025 hospital M&A

TriHealth, Hartford HealthCare, and UConn Health announced M&A this month. 

 showed hospital executives are still holding strong to sustainability-related commitments regardless of 

. University of California, Irvine (UCI) Health is embodying that with its new all-electric hospital, set to open Dec. 10.

 is the first all-electric acute care hospital of its size in the country, featuring renewable solar park structures, electric instead of gas for utilities like heating and hot water systems (which also extends to water used in sterilization and humidification), and even all-electric appliances in its kitchen, Joe Brothman, UCI Health’s director of facilities and general services, who has overseen portions of this new project, told Healthcare Brew.

And electricity isn’t the only sustainable feature at the 350,000-square-foot, 144-bed hospital, Brothman said.

The hospital also has rainwater collection built into its landscaping that uses recycled water, bird-friendly glass, around 87% outdoor water reduction and about 38.5% indoor water reduction, and energy efficient equipment for lighting along with other building components.

“It’s a significant cost to make this all-electric [hospital], but we do anticipate, in the long run, that we will have a cost savings, especially with the rising costs of natural gas,” Brothman said.

A big impetus behind this project has been reducing healthcare’s impact on the community, Brothman said.

“Hospitals, typically, are significant burdens on the local community with their output, both with carbon emissions and with waste,” Brothman said. “This hospital is going to be different.”

 analyzing how health systems impact the environment concluded their global greenhouse gas emissions are equivalent to that of 514 coal power plants.

On top of that, Brothman noted, California is particularly keen on environmental initiatives, especially as the state often bears the brunt of climate change-driven 

“We wanted every aspect of sustainability. Our priorities here at UCI Health is to model environmental stewardship, and we wanted this [hospital] to be an example of that in all aspects,” Tony Dover, energy management and sustainability officer at UCI Health, told us.

A rendering of a single-occupancy hospital room with sliding glass doors.

According to Madhura Dhayagude—assistant VP with engineering consultancy WSP and an energy and sustainability consultant on the UCI project—the project beat expectations and stretched goals.

Engineers aim to meet the American Society of Heating, Refrigerating, and Air-Conditioning Engineers’s 90.1 standards, which is an industry guideline for measuring energy use, and the new hospital saw a 43.7% reduction over that number, she said. Further, the builders set out to achieve a minimum 160 energy use intensity (EUI), which measures how energy efficient a building is (a lower number means it’s more energy efficient), and achieved 110 EUI when including the solar panels atop its parking garage.

The hospital is also on its way to a platinum 

, a tiered sustainability certification, which would make it the sixth hospital in the country to receive this designation (the highest possible), she added.

Ultimately, having an all-electric hospital is a solid step in sustainability goals, but if execs aren’t looking to Scope 3 supply chain emissions, then it’s not making as significant of a difference, Tinglong Dai, Bernard T. Ferrari business professor at Johns Hopkins University, told us.

“[Hospitals] may be switching to all-electric operations, but if their suppliers, if their vendors are still creating a lot of emissions, it probably will not matter as much as is advertised,” he said.

 published in Health Affairs, about 82% of emissions were Scope 3, which are those that come from indirect sources like manufacturers and suppliers. Comparatively, only around 7% make up the Scope 1 emissions that come directly from hospital operations.

To take things to the next level, Dai added, hospitals should look at emissions created by utility suppliers, transportation deliveries, where drugs are made, where medical devices come from, software and hardware vendors, and whether they’re using data centers for AI.

Dover said UCI tracks and reports Scope 3 emissions for employees’ commutes, business travel, and waste. Some vendors and suppliers the health system contracts with “prioritize sustainability,” he added, and UCI Health is “collaborating with [suppliers] to identify opportunities to reduce emissions,” such as by reducing packaging waste and cutting transportation-related carbon emissions.

Though, Dai said, moving things around with manufacturers could ultimately hurt a hospital’s bottom line and shift too much of the focus away from its main priority—which is, of course, serving patients.

“A lot of things are really completely outside [a hospital’s] control. Most hospitals have no clue about the sources of supplies,” he said. “If we do not have that kind of transparency, it’s very difficult for us to make any informed decision. But that’s precisely what most hospitals, most health systems, are facing.”

A 3D rendering of a gray modular 6-floor building.

UCI Health’s new all-electric hospital reinforces system’s commitment to sustainability

The facility focuses on reducing its direct carbon emissions by cutting reliance on fossil fuels.

Wondering who’s in and who’s out at major health companies, emerging startups, hospitals, and more? We’ve got you covered.

Have a job announcement to share? Drop Caroline an email at 

The CEO of Duke University Health System has stepped down and moved West to join Oakland, California-based Kaiser Permanente as president of integrated care and coverage, effective Sept. 29. Duke President Vincent Price announced earlier in the month a search has begun for his successor.

Period-tracking app Clue announced the ob-gyn and specialty-certified pediatric and adolescent gynecologist as its new chief medical officer on Sept. 24. In addition to her medical qualifications, she boasts 260,000+ followers on Instagram, where she’s known as “The Period Doctor.”

The former Harvard Medical School professor of medicine and Dana-Farber Cancer Institute medical oncologist is leading the National Cancer Institute, effective Sept. 29.

Alloy Health, a digital midlife women’s health care platform, announced Parker as chief technology officer in a Sept. 30 

 post. He comes to the position from digital health company Everlywell.

Nonprofit CareQuest Institute for Oral Health announced Rakes as its CEO Sept. 15. He previously served as chief growth officer for Centene and CEO of its Georgia-based subsidiary Peach State Health Plan. He will now help CareQuest in its mission to advocate for and advance dental care.

Remote cardiac monitoring platform company PaceMate announced Shoffstall as its inaugural head of AI, innovation, and data strategy on Sept. 16. He’s previously held executive positions at AI-focused companies Teradata and Beginly Health.

Amgen recruited the Genentech exec to become its VP of research and co-head of research biology, effective Sept. 29. She will oversee the biotech company’s therapeutic areas of oncology and immunology.

Pfizer’s former global president of oncology and rare diseases is now CEO of a new biotech, Intent Biologics, the company announced Sept. 9. The clinical-stage company focuses on developing exosome therapies for inflammation and immunology.

 CEO is leaving the role she’s held since 2017. Walmsley will step down from her position at GSK on Jan 1, and current chief commercial officer, Luke Miels, will replace her.

Healthcare Brew's August on Rotation editorial feature