AI Summit

June 2-3, 2025 | Atlanta, GA

Renaissance Atlanta Airport Gateway Hotel

Agenda

Join us for the AI Summit 2025, a premier event bringing together healthcare leaders to explore the transformative role of AI in payment integrity and cost containment. Kicking off with a networking reception on the evening of Monday, June 2, the full-day Summit on Tuesday, June 3, will feature impactful keynotes, expert panels, and collaborative discussions designed to inspire and drive a more efficient and effective healthcare system.

Monday, June 2nd
Late afternoon	Attendee arrivals
6:30-8:30 p.m.	Evening Networking Reception (Onsite at the Renaissance Gateway)
Tuesday, June 3rd
8:00-9:00 a.m.	Breakfast
9:00 – 9:30 a.m.	Opening Keynote Address – Pioneering the Future of Payment Integrity Musheer Ahmed, Founder of the AI for PI Community Join Musheer Ahmed, as he sets the stage for a day of collaboration and innovation. In this opening address, Musheer will share the compelling journey of how the AI for PI Community has grown from a vision to a movement of forward-thinking healthcare leaders united in their mission to transform payment integrity through AI-driven early intervention. Drawing from real implementations and community success stories, Musheer will explore: • The industry’s urgent need to shift from reactive to proactive approaches • How early adopters are achieving breakthrough results • The critical role of provider collaboration in successful transformation • Emerging trends and opportunities in AI-driven payment integrity
9:30 – 10:30 a.m.	Industry Keynote: AI Innovation and Early Intervention: Transforming Healthcare Economics U.S. Congressman Jay Obernolte, California’s 23rd District in the U.S. House of Representatives As healthcare organizations seek to move payment integrity upstream through AI-driven early intervention, understanding the policy landscape becomes crucial. Congressman Jay Obernolte, Chairman of the bipartisan House Task Force on Artiﬁcial Intelligence in the 118th Congress, brings unique insight as both a computer scientist and AI policy leader. His keynote examines how emerging AI frameworks can support the industry’s shift from post-payment recovery to pre-payment accuracy while addressing broader healthcare cost challenges. Drawing from his work with the National Science Foundation in developing sector-speciﬁc AI solutions, Congressman Obernolte will explore how policy and innovation can enable operational efficiency while minimizing disruption. His perspective bridges technical expertise and policy leadership, oﬀering guidance on advancing AI adoption in an evolving healthcare landscape. Key focus areas: AI policy frameworks supporting payment transformation Innovation strategies for operational efficiency Balancing technological advancement with implementation challenges Future outlook for AI-enabled healthcare cost containment
10:30 – 10:45 a.m.	Break
10:45 – 11:30 a.m.	From Recovery to Prevention: Modernizing Payment Integrity through AI Lynn Garbee, Principal, HealthScape Advisors This session explores the urgent need to transform traditional payment integrity approaches that have reached a point of fatigue within the industry. As healthcare plans chase affordability through post-payment models that rely on manual review and complex rules, they often create provider abrasion, administrative waste, and strained relationships. Our discussion will examine how AI and machine learning are enabling a fundamental strategic reset—”moving left” (upstream in the adjudication process) and “moving in” (regaining control of outsourced processes). Drawing from HealthScape’s strategic outlook research, we’ll explore how progressive technologies are transforming cost containment while strengthening provider partnerships. Attendees will learn practical strategies for implementing early intervention models that could create “colossal change in SG&A for both plans and providers” while relieving tremendous burden on the system.
11:30 a.m. – 12:15 p.m.	Transforming Payment Integrity: A Major Health Plan’s Journey to AI-Driven Early Intervention *Case Study Presentation* This session features a senior executive from a leading health plan sharing their organization’s journey to implement AI-driven early intervention strategies. Through a detailed case study, attendees will learn how this payer successfully shifted their payment integrity processes upstream—from post-payment recovery to pre-payment accuracy. The presentation will cover their initial challenges, implementation approach, and quantifiable results in both cost savings and provider relationship improvements.
12:15 – 1:15 p.m.	Lunch
1:15 – 2:15 p.m.	Artificial Intelligence for PI Benchmarking Master Class *Industry Panel Discussion* Priscilla Alfaro MD, VP of Payment Integrity, Blue Cross NC Moderator: Jim Brady, VP of Analytics, Codoxo This interactive session provides a comprehensive framework for establishing and optimizing AI-driven payment integrity benchmarks. Participants will learn how leading organizations quantify early intervention success through measurable KPIs, from provider satisfaction metrics to cost avoidance calculations. Attendees will develop actionable benchmarking strategies to measure, validate, and maximize their AI investments as well as evaluate their AI initiatives against industry standards.
2:15 – 3:30 p.m.	Healthcare Executive Perspectives: AI’s Role in Transforming Cost Control and Provider Relations *Executive Panel Discussion* Meghan Dierks, Chief Artificial Intelligence Officer, U.S. Department of Health and Human Services and Professor of Healthcare Informatics, Harvard Join an exclusive panel of healthcare executives for a dynamic discussion on how top payers are harnessing the power of AI to tackle their most critical challenges. Explore strategies for pre-claim cost reduction, network optimization, payment accuracy, strengthening provider relationships, and seamless technology integration. The session will highlight: Strategies for reducing pre-claim costs through AI-driven intervention Innovative approaches to network optimization and provider retention How AI is transforming payment integrity while reducing provider abrasion Real-world examples of successful technology integration in payer operations Future outlook on AI’s role in reshaping payer economics
3:30 – 3:45 p.m.	Break
3:45 – 4:45 p.m.	Building Tomorrow’s Infrastructure: Essential Tech Investments for Early Intervention *Executive Panel Discussion* Matt Pearson, Head of Healthcare and Life Sciences BD, AWS As healthcare payers race to shift payment integrity upstream, the right technology infrastructure becomes critical. This pragmatic session brings together technology and operations leaders to examine the essential components needed to enable effective pre-payment intervention. Key Discussion Points: Technical requirements for moving from post to pre-payment Cloud infrastructure needs and considerations Data integration challenges and solutions Real-time processing capabilities AI/ML model deployment strategies Workflow automation requirements Security and compliance considerations Integration with existing systems
4:45 – 5:00 p.m	Closing

Monday, June 2nd
Late afternoon	Attendee arrivals
6:30-8:30 p.m.	Evening Networking Reception (Onsite at the Renaissance Gateway)

Tuesday, June 3rd
8:00-9:00 a.m.	Breakfast
9:00 – 9:30 a.m.	Opening Keynote Address – Pioneering the Future of Payment Integrity Musheer Ahmed, Founder of the AI for PI Community Join Musheer Ahmed, as he sets the stage for a day of collaboration and innovation. In this opening address, Musheer will share the compelling journey of how the AI for PI Community has grown from a vision to a movement of forward-thinking healthcare leaders united in their mission to transform payment integrity through AI-driven early intervention. Drawing from real implementations and community success stories, Musheer will explore: • The industry’s urgent need to shift from reactive to proactive approaches • How early adopters are achieving breakthrough results • The critical role of provider collaboration in successful transformation • Emerging trends and opportunities in AI-driven payment integrity
9:30 – 10:30 a.m.	Industry Keynote: AI Innovation and Early Intervention: Transforming Healthcare Economics U.S. Congressman Jay Obernolte, California’s 23rd District in the U.S. House of Representatives As healthcare organizations seek to move payment integrity upstream through AI-driven early intervention, understanding the policy landscape becomes crucial. Congressman Jay Obernolte, Chairman of the bipartisan House Task Force on Artiﬁcial Intelligence in the 118th Congress, brings unique insight as both a computer scientist and AI policy leader. His keynote examines how emerging AI frameworks can support the industry’s shift from post-payment recovery to pre-payment accuracy while addressing broader healthcare cost challenges. Drawing from his work with the National Science Foundation in developing sector-speciﬁc AI solutions, Congressman Obernolte will explore how policy and innovation can enable operational efficiency while minimizing disruption. His perspective bridges technical expertise and policy leadership, oﬀering guidance on advancing AI adoption in an evolving healthcare landscape. Key focus areas: AI policy frameworks supporting payment transformation Innovation strategies for operational efficiency Balancing technological advancement with implementation challenges Future outlook for AI-enabled healthcare cost containment
10:30 – 10:45 a.m.	Break
10:45 – 11:30 a.m.	From Recovery to Prevention: Modernizing Payment Integrity through AI Lynn Garbee, Principal, HealthScape Advisors This session explores the urgent need to transform traditional payment integrity approaches that have reached a point of fatigue within the industry. As healthcare plans chase affordability through post-payment models that rely on manual review and complex rules, they often create provider abrasion, administrative waste, and strained relationships. Our discussion will examine how AI and machine learning are enabling a fundamental strategic reset—”moving left” (upstream in the adjudication process) and “moving in” (regaining control of outsourced processes). Drawing from HealthScape’s strategic outlook research, we’ll explore how progressive technologies are transforming cost containment while strengthening provider partnerships. Attendees will learn practical strategies for implementing early intervention models that could create “colossal change in SG&A for both plans and providers” while relieving tremendous burden on the system.
11:30 a.m. – 12:15 p.m.	Transforming Payment Integrity: A Major Health Plan’s Journey to AI-Driven Early Intervention *Case Study Presentation* This session features a senior executive from a leading health plan sharing their organization’s journey to implement AI-driven early intervention strategies. Through a detailed case study, attendees will learn how this payer successfully shifted their payment integrity processes upstream—from post-payment recovery to pre-payment accuracy. The presentation will cover their initial challenges, implementation approach, and quantifiable results in both cost savings and provider relationship improvements.
12:15 – 1:15 p.m.	Lunch
1:15 – 2:15 p.m.	Artificial Intelligence for PI Benchmarking Master Class *Industry Panel Discussion* Priscilla Alfaro MD, VP of Payment Integrity, Blue Cross NC Moderator: Jim Brady, VP of Analytics This interactive session provides a comprehensive framework for establishing and optimizing AI-driven payment integrity benchmarks. Participants will learn how leading organizations quantify early intervention success through measurable KPIs, from provider satisfaction metrics to cost avoidance calculations. Attendees will develop actionable benchmarking strategies to measure, validate, and maximize their AI investments as well as evaluate their AI initiatives against industry standards.
2:15 – 3:30 p.m.	Healthcare Executive Perspectives: AI’s Role in Transforming Cost Control and Provider Relations *Executive Panel Discussion* Meghan Dierks, Chief Artificial Intelligence Officer and Professor of Healthcare Informatics, Harvard U.S. Department of Health and Human Services (HHS) Join an exclusive panel of healthcare executives for a dynamic discussion on how top payers are harnessing the power of AI to tackle their most critical challenges. Explore strategies for pre-claim cost reduction, network optimization, payment accuracy, strengthening provider relationships, and seamless technology integration. The session will highlight: Strategies for reducing pre-claim costs through AI-driven intervention Innovative approaches to network optimization and provider retention How AI is transforming payment integrity while reducing provider abrasion Real-world examples of successful technology integration in payer operations Future outlook on AI’s role in reshaping payer economics
3:30 – 3:45 p.m.	Break
3:45 – 4:45 p.m.	Building Tomorrow’s Infrastructure: Essential Tech Investments for Early Intervention *Executive Panel Discussion* Matt Pearson, Head of Healthcare and Life Sciences BD at AWS Panelist on the Building Tomorrow’s Infrastructure: Essential Tech Investments for Early Intervention session As healthcare payers race to shift payment integrity upstream, the right technology infrastructure becomes critical. This pragmatic session brings together technology and operations leaders to examine the essential components needed to enable effective pre-payment intervention. Key Discussion Points: Technical requirements for moving from post to pre-payment Cloud infrastructure needs and considerations Data integration challenges and solutions Real-time processing capabilities AI/ML model deployment strategies Workflow automation requirements Security and compliance considerations Integration with existing systems
4:45 – 5:00 p.m	Closing

Your Title Goes Here

Your content goes here. Edit or remove this text inline or in the module Content settings. You can also style every aspect of this content in the module Design settings and even apply custom CSS to this text in the module Advanced settings.

Full Agenda

Monday, June 2nd

Late afternoon

Attendee arrivals

6:30-8:30 p.m.

Evening Networking Reception (Onsite at the Renaissance Gateway)

Tuesday, June 3rd

8:00-9:00 a.m.

Breakfast

9:00 – 9:30 a.m.

Opening Address – Pioneering the Future of Payment Integrity

Musheer Ahmed,
Founder of the AI for PI Community

Join Musheer Ahmed, founder of the AI for Payment Integrity Community, as he sets the stage for a day of collaboration and innovation. In this opening address, Musheer will share the compelling journey of how the AI for PI Community has grown from a vision to a movement of forward-thinking healthcare leaders united in their mission to transform payment integrity through AI-driven early intervention.

Drawing from real implementations and community success stories, Musheer will explore:

• The industry’s urgent need to shift from reactive to proactive approaches
• How early adopters are achieving breakthrough results
• The critical role of provider collaboration in successful transformation
• Emerging trends and opportunities in AI-driven payment integrity

9:30 – 10:30 a.m.

Opening Keynote: AI Innovation and Early Intervention: Transforming Healthcare Economics

U.S. Congressman Jay Obernolte,
California’s 23rd District in the U.S. House of Representatives

As healthcare organizations seek to move payment integrity upstream through AI-driven early intervention, understanding the policy landscape becomes crucial. Congressman Jay Obernolte, Chairman of the bipartisan House Task Force on Artiﬁcial Intelligence in the 118th Congress, brings unique insight as both a computer scientist and AI policy leader. His keynote examines how emerging AI frameworks can support the industry’s shift from post-payment recovery to pre-payment accuracy while addressing broader healthcare cost challenges. Drawing from his work with the National Science Foundation in developing sector-speciﬁc AI solutions, Congressman Obernolte will explore how policy and innovation can enable operational efficiency while minimizing disruption. His perspective bridges technical expertise and policy leadership, oﬀering guidance on advancing AI adoption in an evolving healthcare landscape.

Key focus areas:

AI policy frameworks supporting payment transformation
Innovation strategies for operational effeciency
Balancing technological advancement with implementation challenges
Future outlook for AI-enabled healthcare cost containment

10:30 – 10:45 a.m.

Break

10:45 – 11:30 a.m.

From Recovery to Prevention: The Early Intervention Revolution

Lynn Garbee,
Principal, HealthScape Advisors

An intimate conversation exploring healthcare’s critical shift from reactive to preventive approaches through AI innovation. This session examines how early intervention strategies can simultaneously improve patient outcomes, strengthen provider relationships, and reduce system-wide costs. The discussion will explore practical frameworks for implementing AI-driven early intervention across clinical, operational, and financial domains, offering insights on building a more proactive and efficient healthcare ecosystem.

Key Themes:

Transforming patient care through early intervention
Building sustainable provider partnerships
Balancing innovation with operational efficiency
Creating frameworks for system-wide implementation
Impact on healthcare economics and quality outcomes

11:30 a.m. – 12:15 p.m.

Transforming Payment Integrity: A Major Health Plan’s Journey to AI-Driven Early Intervention

Case Study Presentation

This session features a senior executive from a leading health plan sharing their organization’s journey to implement AI-driven early intervention strategies. Through a detailed case study, attendees will learn how this payer successfully shifted their payment integrity processes upstream—from post-payment recovery to pre-payment accuracy. The presentation will cover their initial challenges, implementation approach, and quantifiable results in both cost savings and provider relationship improvements.

12:15 – 1:15 p.m.

Lunch

1:15 – 2:15 p.m.

Artificial Intelligence for PI Benchmarking Master Class

Industry Panel Discussion

Priscilla Alfaro MD,
VP of Payment Integrity, Blue Cross NC

Jim Brady,
VP of Analytics

This interactive session provides a comprehensive framework for establishing and optimizing AI-driven payment integrity benchmarks. Participants will learn how leading organizations quantify early intervention success through measurable KPIs, from provider satisfaction metrics to cost avoidance calculations. Attendees will develop actionable benchmarking strategies to measure, validate, and maximize their AI investments as well as evaluate their AI initiatives against industry standards.

2:15 – 3:30 p.m.

Healthcare Executive Perspectives: AI’s Role in Transforming Cost Control and Provider Relations

Executive Panel Discussion

Meghan Dierks,
Chief Artificial Intelligence Officer and Professor of Healthcare Informatics Harvard
U.S. Department of Health and Human Services (HHS)

Join an exclusive panel of PBM Chief Executive Officers for a dynamic discussion on how top PBMs are harnessing the power of AI to tackle their most critical challenges. Explore strategies for pre-claim cost reduction, network optimization, payment accuracy, strengthening provider relationships, and seamless technology integration.

The session will highlight:

- Strategies for reducing pre-claim costs through AI-driven intervention
- Innovative approaches to network optimization and provider retention
- How AI is transforming payment integrity while reducing provider abrasion
- Real-world examples of successful technology integration in PBM operations
- Future outlook on AI’s role in reshaping PBM economics

3:30 – 3:45 p.m.

Break

3:45 – 4:45 p.m.

Building Tomorrow’s Infrastructure: Essential Tech Investments for Early Intervention

Executive Panel Discussion

Matt Pearson,
Head of Healthcare and Life Sciences BD at AWS
Panelist on the Building Tomorrow’s Infrastructure: Essential Tech Investments for Early Intervention session

As healthcare payers race to shift payment integrity upstream, the right technology infrastructure becomes critical. This pragmatic session brings together technology and operations leaders to examine the essential components needed to enable effective pre-payment intervention.

Key Discussion Points:

- Technical requirements for moving from post to pre-payment
- Cloud infrastructure needs and considerations
- Data integration challenges and solutions
- Real-time processing capabilities
- AI/ML model deployment strategies
- Workflow automation requirements
- Security and compliance considerations
- Integration with existing systems

4:45 – 5:00 p.m.

Closing