MHK

MHK Enterprise Software Platform for Medicare, Medicaid, and Exchanges

MedHOK solutions improve clinical outcomes, care management and quality measures, and links reimbursement to improved quality outcomes for accountable care organizations, patient centered medical homes, health plans, public sector agencies, providers, hospital systems and third party administrators.

04/28/2026

PBM reform isn’t on the horizon, it’s already here. From Capitol Hill hearings to new transparency rules, the pressure on PBMs is accelerating fast. Health plans that wait risk falling behind on compliance, visibility, and oversight. What should you be doing right now?
https://hubs.li/Q04dP-jW0

04/22/2026

Earth Day is a reminder that meaningful change doesn’t come from big moments alone—it comes from consistent, intentional action. Across healthcare and beyond, the way we work, build, and operate has a lasting impact. Even small improvements, done at scale, can make a difference.

Today is a good moment to reflect on where we can do better, and then take the next step forward.

04/20/2026

Health plans are stretched thin. Most already know it. Fewer are talking about what to do about it.

The truth is, a significant portion of the work happening inside health plan operations teams right now doesn’t require clinical judgment. It requires consistency, speed, and accuracy, which is exactly the kind of work AI automation is built for.

Prior auth processing. Workflow routing. Compliance reporting. Member and provider correspondence. These are high-volume, rule-based tasks that consume enormous amounts of your team’s time and attention. When automation handles the routine, your people handle the complex. This is what's meant by operating at the top of your license.

In the latest Strategic Insights post, learn what this means in practical terms for health plans exploring AI right now. See link in comments.

04/16/2026

Today is National Healthcare Decisions Day—a reminder of the importance of planning ahead and ensuring healthcare decisions reflect each individual’s values and wishes.

Advance care planning may not be easy to discuss, but it’s essential. When preferences are clearly documented and accessible, care teams can deliver more aligned, patient-centered care.

At MHK, we support solutions that help bring clarity to critical moments—connecting people, data, and workflows to enable more informed decisions across the healthcare journey.

04/15/2026

Health plans are caught in the middle of the PBM–pharma battle. Pharma blames PBMs. PBMs blame pharma. Regulators target both. But plans remain accountable for the outcome—regardless of where decisions are made.

The real challenge isn’t pricing—it’s ex*****on.

How do you coordinate decisions, data, and oversight across a fragmented ecosystem? This week’s Strategic Insights explores how health plans can regain control through orchestration, governance, and AI-driven workflows. Link in comments.

04/13/2026

MHK is on the ground at AMCP Annual 2026 this week. This event brings together the people doing the real work behind pharmacy benefit management: prior auth, utilization review, compliance, and member access.

We’re having great conversations around a common challenge: How do you move from AI experimentation to real, scalable operational impact?

That’s exactly where we’re focused, helping teams streamline workflows, reduce administrative burden, and deliver consistent, audit-ready outcomes.

If you’re here, let’s connect at BOOTH 1422.

03/30/2026

Most AI initiatives don’t fail because of the technology—they fail because workflows weren’t designed for intelligent ex*****on.

Orchestration changes that.

In this week's Strategic Insights, Megan Jones shares how payers can move from pilots to production with governed, end-to-end workflows. Link in comments.

03/24/2026

The member experience doesn’t break in one place—it breaks across the entire healthcare journey.

Delays at intake. Gaps in communication. Friction between systems and teams. AI is starting to address these issues—but only when it’s applied across the full workflow, not as a standalone tool.

So what does that actually look like in practice?

Take a closer look:
https://hubs.li/Q0489fHQ0

03/17/2026

Science fiction is frequently a catalyst for future technological breakthroughs. Today, agentic AI is making many speculative concepts operational in healthcare. From Asimov’s robots to Gibson’s autonomous agents, SF visionaries explored how intelligent systems could assist humans in navigating complex decisions.

Healthcare organizations are now seeing similar capabilities emerge in real workflows—from utilization management to pharmacy operations. The latest Clinical Insights explores the connection between SF and healthcare AI through the lens of a variety of ideas that are becoming reality.

Link in comments.

03/09/2026

Health plans and PBMs are entering Staffing Crisis 2.0. The first wave was about workforce disruption. The second wave is structural: more regulatory complexity, more administrative work, and fewer operational resources.

Teams are being asked to deliver:

• Faster turnaround times
• Higher audit readiness
• Better member and provider experiences

All with tighter staffing.

Forward-looking organizations are responding by redesigning workflows and using AI to reduce administrative burden while preserving clinical oversight. This week's Strategic Insights post provides tips and insights on this emerging strategy. Link in comments.

03/02/2026

Hidden system risk doesn’t show up on a dashboard. It shows up in appeals volume, audit findings, provider abrasion, member dissatisfaction, and operational burnout.

Health plans and PBMs operate amid escalating complexity. Like a suspension bridge under load, performance depends not on the traffic crossing it—but on the integrity of the structure supporting it.

The question isn’t whether pressure will increase. It’s whether the operating model is designed to absorb it.

A new perspective on structural risk in payer organizations examines why sustainable performance is a function of system design—not individual effort. Link in comments.

02/28/2026

Today is Rare Disease Day, recognizing individuals and families navigating complex and often uncommon conditions.

While many rare diseases are individually uncommon, they collectively affect millions worldwide. When cases are anything but routine, clarity and coordination matter—especially when information must be accurate, accessible, and ready when it’s needed most.

Address

3031 N Rocky Point Drive W, 300
Tampa, FL
33607

Opening Hours

Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm
Friday 9am - 5pm

Website

Alerts

Be the first to know and let us send you an email when MHK posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to MHK:

Shortcuts

Share

Our Story

SaaS-based technology that empowers health plans, PBMs, and provider organizations to improve productivity, automate processes, make more confident clinical and operational decisions, increase revenue, and meet the rigorous demands of federal, state, and commercial compliance.