How Artificial Intelligence Is Reshaping Preventive Care Across the U.S.

AUSTIN, Texas, Oct. 21, 2026 (GLOBE NEWSWIRE) — AINewsWire Editorial Coverage: In today’s healthcare landscape, treating sickness after the fact is giving way to stopping it before it starts. U.S. health spending hit $5.3 trillion in 2024, and Medicare Advantage enrolls 35.2 million people today, equal to 55% of those eligible. For 2026, KFF estimates Medicare Advantage payments will hit $574 billion, giving health plans strong financial incentive to keep their members well. A new category of company is emerging to meet that shift. ECGI Holdings Inc. (OTC: ECGI) (profile) has finalized its purchase of Avanta Group, an emerging platform combining a Medicare Advantage health plan with management services and AI-driven health technology. Through the acquisition, ECGI gains direct entry into coordinated, proactive care right as the broader industry looks for better ways to deliver it. ECGI now operates in the same space as established names in U.S. managed healthcare, including sector leaders Centene Corporation (NYSE: CNC), Molina Healthcare Inc. (NYSE: MOH), Astrana Health Inc. (NASDAQ: ASTH) and Alignment Healthcare Inc. (NASDAQ: ALHC).

• Chronic disease is at the heart of what makes American healthcare so costly, with three-quarters of American adults carrying at least one chronic condition and more than half managing two or more.
• What began as scattered pilot projects for artificial intelligence has turned into standard clinical practice, with AMA reporting that 81% of physicians now use AI in their work.
• ECGI’s proposed healthcare strategy targets this growing sector, with Avanta Health Plan sitting at its core.
• Across much of healthcare, the different pieces that shape a patient’s journey tend to run independently, but ECGI’s Avanta platform is designed to connect the core functions that increasingly shape healthcare performance.
• Organizations that can connect the dots for patients stand to define healthcare’s future, and ECGI Holdings is positioning itself to be one of them.

Keeping Patients Connected Between Visits

Chronic disease is at the heart of what makes American healthcare so costly. The CDC identifies conditions such as heart disease, cancer and diabetes as leading drivers of national health spending. Three-quarters of American adults carry at least one chronic condition, and more than half manage two or more.

Older adults bear the heaviest share of this burden. According to the CDC, more than 90% of people 65 and older live with at least one chronic condition. Many of these patients juggle several different clinicians and depend on consistent follow-up between appointments. Minor issues can escalate into hospitalizations once that follow-up breaks down.

Even when preventive care costs patients nothing, it still goes underused. After the first year of enrollment, Medicare’s Annual Wellness Visit carries no copay or deductible. Still, an actuarial analysis found that from 2018 to 2023, 45% of fee-for-service beneficiaries had just one wellness visit, or none at all. In years when beneficiaries did have a visit, total cost of care ran about $885 lower per person.

Closing gaps like these calls for providers, health plans and care teams to operate from a shared approach. ECGI Holdings is positioning itself to deliver exactly that kind of connected model. Through its acquisition of Avanta Group, the company now brings together a developing health plan, a management-services organization and a health-technology business under one roof.

“Healthcare is one of the largest and most consequential sectors of the U.S. economy,” said ECGI Holdings president Jamie Steigerwald. “Our objective is not simply to participate in that market, but to build an integrated platform capable of using automation and artificial intelligence to improve navigation, identify opportunities for earlier intervention, streamline administrative workflows and support more informed decision-making.”

From Scattered Records to Smarter Outreach

What began as scattered pilot projects for artificial intelligence has turned into standard clinical practice. According to the American Medical Association’s (“AMA”) 2026 physician survey, 81% of physicians now report using AI in their work, more than double the 38% who said the same in 2023.

For care teams, AI earns its keep mainly by pulling together information that would otherwise sit scattered across separate systems. Claims data, visit notes, lab results and pharmacy records typically live apart from one another. AI-enabled tools can consolidate these sources, surface overdue screenings and flag follow-ups that were missed. They can also prioritize which patients most urgently need outreach, directing limited staff time to where it counts most.

Clinical judgment still has to lead, with the technology serving in a supporting role rather than replacing it. Among AMA survey respondents, 88% called rigorous safety and efficacy validation essential before AI adoption can expand further, and 85% said they want a direct voice in decisions involving AI. Seventy percent view AI as a way to offload tasks that fuel burnout, freeing clinicians to spend more time with patients.

ECGI intends to weave these capabilities into its healthcare platform, with Avanta Tech handling the underlying data, automation and AI-enabled functions. Applications the company has identified include spotting care gaps, automating member services, analyzing providers and networks, supporting claims and workflows, detecting fraud and guiding personalized health navigation.

A Massive Market, Still Growing Fast

Few sectors operate at the scale of U.S. healthcare. National health spending climbed 7.2% to reach $5.3 trillion in 2024, or $15,474 per person, amounting to 18% of gross domestic product. Medicare made up $1.118 trillion of that total, or 21%.

Growth isn’t expected to slow either, with forecasts set to continue outpacing the broader economy. CMS projects that health spending will rise 5.4% annually on average between 2025 and 2034, compared with 4.1% for GDP, pushing healthcare’s share of GDP to a projected 20.6% by 2034. Among major payers, Medicare is expected to grow the fastest, at 7.7% per year.

The money moving through these plans is considerable. KFF projects $574 billion in Medicare Advantage payments for 2026 alone, with quality bonuses expected to reach at least $13.4 billion, more than quadruple the $3 billion paid out in 2015. Those bonus figures illustrate just how closely plan performance is linked to revenue.

This is precisely the segment ECGI’s proposed healthcare strategy targets. Avanta Health Plan sits at its core, a developing Medicare Advantage, commercial and individual health plan. Per ECGI’s announcement, Avanta will first need to secure applicable approvals and licenses, including from the California Department of Managed Health Care and the Centers for Medicare & Medicaid Services, before operating or enrolling members. Once those approvals come through, growth would hinge on enrollment, expanding services and tightly managing medical and administrative costs.

When Administration Works for the Patient

Across much of healthcare, the different pieces that shape a patient’s journey tend to run independently. Health plans oversee benefits and claims. Clinics manage scheduling and treatment. Billing, referrals and authorizations fall to administrative teams, frequently on systems of their own. Every point where these pieces connect is also a point where a patient can slip through unnoticed.

Those breakdowns come with real costs for health plans. Quality bonus eligibility under Medicare Advantage hinges on star ratings, and that bar keeps rising. Studies show the number of contracts earning four stars or better dropped to 209 in 2026, down from 261 the year before. Enrollment in bonus-eligible plans fell to 68% of members, the lowest share since 2018.

The goal of an integrated model is to line up administrative work with what patients genuinely require. A management-services organization (“MSO”) can take on the operational load for clinics, leaving clinicians free to focus on care. Administrative tasks start supporting continuity of care instead of hindering it once that MSO shares its data and goals with a health plan. Technology then serves as the link between them, moving information from plan to clinic and back again.

ECGI is proposing to build exactly this kind of structure through Avanta. Within Avanta’s medical network, Avanta MSO would handle administration and operations. ECGI states that this arm will put Avanta Tech and Avanta Health Plan innovations into practice at the clinical level. Rounding out the platform are Avanta Mart, a consumer-health and wellness channel built for member engagement, and Avanta Properties City Parkway, a real-estate entity supporting healthcare infrastructure.

“The Avanta platform is designed to connect the core functions that increasingly shape healthcare performance: insurance, administration, technology, member engagement and the infrastructure required to support delivery,” said Steigerwald. “We believe that combination can give ECGI a scalable foundation for growth while keeping the member experience and responsible use of data at the center of the strategy.”

ECGI Finalizes Avanta Deal, Eyes a Larger Healthcare Opportunity

This week marked the close of ECGI’s full acquisition of Avanta Group and its subsidiaries. In exchange for all outstanding Avanta shares, ECGI issued 17,160,000 shares of Series A Voting Convertible Preferred Stock. At closing, 10,296,000 of those shares (60%) vested immediately, while the remaining 6,864,000 (40%) carry transfer restrictions and vest based on performance.

Avanta arrives with an operating team experienced in Medicare Advantage. Its founders have backgrounds in healthcare operations, having previously built other Medicare Advantage plans and medical clinics, and the team brings an understanding of health-benefit needs across diverse ethnic communities.

Building out the platform still requires several more steps. Avanta has filed a letter of intent with the California Department of Managed Health Care but hasn’t yet submitted its formal license application. Later in October 2026, it plans to file a notice of intent with the Centers for Medicare & Medicaid Services, though a formal CMS application is still pending. ECGI has also been shoring up its balance sheet ahead of this next stage: earlier in the month, it cleared a $2.556 million convertible obligation, advancing its goal of shedding derivative liabilities and cutting debt that could otherwise dilute shareholders.

Organizations that can connect the dots for patients stand to define healthcare’s future, and ECGI Holdings is positioning itself to be one of them. Given $5.3 trillion in annual U.S. health spending and 35.2 million Medicare Advantage enrollees, the payoff for coordinated, proactive care is substantial. What sets ECGI’s proposed Avanta platform apart is its integration, bringing together a health plan, management services, AI-enabled technology, consumer health and real estate in a single structure.

Healthcare Leaders Advance Access, Innovation

The healthcare industry continues to evolve as leading organizations pursue new strategies to expand access, improve quality and offer greater flexibility in coverage and care. From innovative insurance options and expanded provider networks to government-sponsored health programs and quality-focused initiatives, companies are adapting to changing patient needs and market demands.

Centene Corporation (NYSE: CNC) announced the expansion of its CHOICE Arrangements benefit program (formerly ICHRA) to employees in Ohio and Oklahoma for plan year 2027. Building on the successful implementation of the program for Indiana-based employees in 2026, the expansion reflects Centene’s ongoing commitment to providing employees with greater flexibility and choice in their health coverage.

Molina Healthcare Inc. (NYSE: MOH) announced that the Illinois Department of Healthcare and Family Services (HFS) intends to award a HealthChoice Illinois Medicaid Managed Care program contract to Molina’s Illinois health plan subsidiary, Molina Healthcare of Illinois. The go-live date for the new contract is expected to be January 1, 2027. The contract is expected to have a duration of four-and-a-half years, with the option to extend the contract up to an additional five-and-a-half years at the discretion of the state. 

Astrana Health Inc. (NASDAQ: ASTH) announced a provider arrangement with Alignment Health Plan that will expand in-network access to primary and specialty care for Medicare Advantage beneficiaries across Southern and Northern California. Beginning Jan. 1, 2027, the collaboration will serve members in Los Angeles, Orange, Riverside, San Bernardino, San Francisco, San Mateo and Santa Clara counties. The collaboration will expand access to many physicians who offer multilingual and culturally responsive care.

Alignment Healthcare Inc. (NASDAQ: ALHC) reported that its Alignment Health Plan has been named a 2027 Best Insurance Company for Medicare Advantage by U.S. News & World Report in all five states where it operates. The plan is offered in Arizona, California, Nevada, North Carolina and Texas. This marks the seventh year the company has received this recognition. For the award, U.S. News considered CMS data and quality measure results for every evaluated insurance company’s Medicare Advantage health coverage for the 2027 calendar year. As the healthcare landscape becomes increasingly complex, flexibility, accessibility and quality remain central to the industry’s long-term direction.

Organizations that successfully balance these priorities while responding to regulatory changes, shifting demographics and evolving consumer expectations may be better positioned for sustainable growth. Continued investments in coverage options, care delivery networks and patient-centered services are helping shape a healthcare system designed to meet the needs of an increasingly diverse population.

For more information, visit ECGI Holdings.

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