MedeAnalytics and Basys.ai have announced a strategic partnership aimed at transforming healthcare utilization management and improving medical loss ratio (MLR) and administrative loss ratio (ALR) outcomes across payer organizations. The collaboration combines MedeAnalytics’ enterprise healthcare intelligence platform with Basys.ai’s agentic AI capabilities to deliver a scalable, AI-powered solution that enhances decision-making, reduces costs, and strengthens payer-provider alignment. Steve Grieco, CEO of MedeAnalytics, emphasized the partnership’s impact, stating it enables clients to identify issues earlier, manage utilization with greater clarity, and improve both MLR and ALR across all lines of business. MedeAnalytics brings its Health Fabric™ platform, a cloud-native, multi-cloud (hybrid public cloud) data infrastructure built on AWS and Snowflake, which unifies vast amounts of clinical, claims, financial, administrative, and social determinants of health (SDOH) data. This platform serves as a single source of truth, enabling deep insights and actionable intelligence. Basys.ai contributes its expertise in explainable, agentic AI, with mature capabilities in prior authorization, utilization management, risk adjustment, and payment integrity. The combined solution integrates directly into existing payer workflows, offering rapid deployment—typically within 4 to 6 weeks—using out-of-the-box functionality. The platform meets strict security and compliance standards, including HIPAA, SOC 2, and HITRUST. The partnership targets key operational and clinical workflows such as medical necessity reviews, documentation accuracy, appeals management, and high-cost case mitigation. By embedding transparent AI into these processes, the solution helps reduce administrative burden, accelerate decisions, and ensure patients receive timely, appropriate care. Amber Nigam, CEO of Basys.ai, highlighted the synergy between the two companies, noting that combining Basys.ai’s generative AI—trained on millions of real-world patient records and claims—with MedeAnalytics’ rich data ecosystem creates a powerful, responsible AI platform. The solution identifies documentation gaps, predicts high-cost scenarios, automates routine tasks, and supports compliance across Commercial, Medicaid, Medicare, and Medicare Advantage plans, including state Medicaid agencies. The collaboration is seen as a significant step forward in responsible AI adoption in healthcare. By turning data into actionable insights through AI-driven workflows and expert-guided playbooks, the partnership delivers measurable improvements in financial performance, clinical quality, and operational efficiency. MedeAnalytics has served as a trusted healthcare intelligence partner for over three decades, helping organizations reduce costs, improve revenue, and enhance care quality. Its Managed Action™ and Strategic Advisory™ services turn data into impact by activating next-best-action workflows and expert guidance. Basys.ai, founded by Harvard alumni and based in Cambridge, MA, is a leader in agentic AI for healthcare operations. Recognized in Gartner’s Hype Cycle and featured in Forbes, Harvard Business Review, STAT News, and Fierce Healthcare, the company is at the forefront of using explainable AI to transform prior authorization, utilization management, and payment integrity.