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Health Plans Need Help. Now.

March 4, 2026

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Health Plans Need Help. Now.

Incrementalism Is the Enemy.

Medical Loss Ratios climbing to 90%, 95%, and higher. Major health plans reporting quarterly losses in the hundreds of millions. CMS reimbursement policies have executives scrambling. Employers done with double-digit cost increases and openly exploring alternatives.

Something has to change. Now.

As 4L CEO Clay Wilemon observed at a recent payment integrity conference — when a session moderator asked the audience how many of their health plans ran on a claims platform more than 25 years old, almost everyone in the room raised their hands.

That’s the problem.

“Systems must change in a big way for health plans to change their fiscal trajectory.” — Clay Wilemon, CEO, 4L Data Intelligence

In their opening keynote at the Millennium Alliance Transformational CFO Healthcare Payers Assembly, Clay and Christina Hedge, VP at Booz Allen Hamilton, presented five guiding principles for meaningful fiscal performance improvement — ones that don’t require massive capital commitments, but do require abandoning incremental thinking for good.

Read the whitepaper. The Power of Now starts here.

See What You’re Missing.

Most health plans discover significant FWA exposure in the first 30 days. Request a demo and find out what your current approach is leaving on the table.

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