September 9, 2026
We have the technology to transform healthcare. Now we need to rethink the system.
By Ylan Kazi, VP of Clinical Analytics and Data Transformation
We’re at a turning point in healthcare. For the first time, we have the data and technology to build systems that can deliver a simpler, more affordable and more personalized experience — at a time when the need for all three has never been greater.
But having the technology isn’t the same as transforming healthcare. The bigger challenge is changing how we think about the problems we’re trying to solve.
There’s a big difference between asking, “How do we make this process faster?” and “Why does this process have to work this way at all?” Part of my role in leading clinical analytics and data transformation is to ask those questions and introduce the kind of productive discomfort that can lead to real change.
Moving beyond optimization
With any new technology, there’s a natural tendency to layer it onto what’s already there. An AI tool can make a process faster. Automation can eliminate a few manual steps. Analytics can help us make better decisions.
Those improvements matter, but they’re not necessarily transformation. A claim might move through the pipeline faster, for example. But a member may still receive a surprise bill weeks after getting care, or struggle to understand an Explanation of Benefits. The process improved, but did the healthcare experience?
That’s the question that pushes us beyond optimization and toward something more ambitious: If we were designing healthcare today, with the technology and data now available to us, what would we build?
Imagine a system where members can understand what their care will cost before they receive it. Coverage issues are identified before an appointment, not after. Prior authorizations happen in near-real time when clinically appropriate. Providers spend less time tracking down information, and members spend less time trying to make sense of a complicated system.
Building the foundation
That kind of future doesn’t happen with a single technology or initiative. It depends on having the right foundation underneath it — including data that can move securely and efficiently across the healthcare system.
That’s why Cambia’s work in areas like interoperability is so important. We’re moving toward flexible open standards and more seamless data integration while deepening our partnerships with providers.
When information can move more easily and securely between health plans and providers, many of the experiences we want to improve become easier to grasp. We can surface coverage information earlier, identify potential issues before they become problems, reduce unnecessary back-and-forth and give members and providers better information proactively.
In other words, our approach to interoperability is less about making data exchange faster within the old model and more about building the infrastructure for a fundamentally different experience.
Shifting from ‘someday’ to now
For years, healthcare transformation has often felt like something just over the horizon. What’s different now is that many of the pieces are coming together at once.
Members increasingly expect the transparency, simplicity and respect for their time that they experience in other parts of their lives. Providers need relief from administrative burden. We have increasingly powerful technology and richer data. And across Cambia, we have people aligned to our Cause and thinking seriously about how to put those capabilities to work.
That creates an opportunity to do more than make today’s system incrementally better. We can rethink core processes with the member experience as the starting point.
That’s the shift I’m most excited about. True transformation isn’t about making the old system run faster. It’s about being willing to question why it works that way in the first place — and then using the tools we now have to build something better.