PHOENIX – June 2, 2025 – Solera Health, the premier digital health delivery company creating flexible solutions to seamlessly connect people to on-benefit care via health plans and employers, today announced the launch of its Enhanced AI Governance Framework, a new system designed to ensure the responsible, transparent and ethical use of artificial intelligence (AI) across its partner ecosystem.

As AI’s presence grows across all aspects of healthcare, organizations are faced with increasing scrutiny and pressure to ensure it is used responsibly and securely. The Solera AI Governance Framework sets a new industry standard that proactively addresses client concerns, regulatory compliance and risk mitigation. The system is built on three core pillars: Governance and Oversight, Privacy and Protection, and Security and Training. Full implementation across Solera's partner network is expected by the end of Q3 2025.

“In response to anxiety around AI, we’ve seen a wide spectrum of legal and compliance requirements, including outright bans on AI to mandates for strict pre-approval. But neither extreme is sustainable for business or innovation,” said Mike Levin, general counsel and chief information security officer at Solera Health. “This AI governance charter takes a comprehensive, risk-based approach focusing on transparency and accountability, particularly when it comes to high-stakes areas like healthcare decision-making.”

A Three-Pronged Approach to AI Governance

This new capability addresses three main areas to ensure responsible and transparent AI use:

1. Governance and Oversight: Led by senior leadership, a cross-functional AI governance committee defines risk levels, enforces human-in-the-loop oversight and conducts quarterly compliance reviews focusing on high-risk AI, such as use cases impacting clinical decisions. Based on initial assessments of partners, Solera expects to improve average governance maturity scores from current levels by at least 25% following framework implementation. The framework requires client approval, proactive communication and audit-ready documentation for all AI use cases, ensuring transparency and accountability at every stage.

2. Privacy and Protection: The framework enforces strict HIPAA-compliant robust access controls and authentication protocols to prevent unauthorized access or use of confidential information. All AI outputs undergo legal and IP reviews, with controls in place to prevent infringement, protect proprietary code and ensure full licensing compliance.

3. Security and Training: The system takes a security-first and HIPAA-compliant approach, including support for vendor business associate agreements (BAAs), adversarial defenses and ongoing risk assessments. To prevent bias and promote fairness, AI systems must meet diverse data standards, undergo regular validation and edits, and be closely monitored for equitable performance, especially in high-risk situations impact health. Solera will establish baseline demographic parity metrics with targets for likely 20%+ improvement across partner AI applications by end of 2025.

Setting the Standard for Transparent, Responsible AI in Digital Health

Solera’s framework fills a critical gap in healthcare technology, where many payers and digital health providers lack defined AI policies. This risk-based, compliance-focused model addresses both present and emerging challenges by focusing on transparency and avoiding opaque “black box” AI models. Solera's commitment is to ensure that any AI involved in healthcare decisions is safe, explainable and human-validated.

In addition to immediate protections, Solera is developing AI maturity scoring capabilities for its digital health delivery partners, with interactive dashboards for security and compliance expected to roll out to platform customers by Q1 2026.

The goal of this framework is to strike a practical balance across innovation,patient safety, data integrity and client trust,” Levin said.

Solera’s Enhanced AI Governance Framework is already being communicated across its partner network and is expected to serve as a blueprint for responsible AI integration across digital healthcare solutions.

About Solera Health

At Solera, we're redefining and streamlining digital healthcare delivery with a value-based, on-benefit solution that measurably drives down the total cost of care. The curated Solera Network and platform integrate seamlessly with payers’ on-premises operations, intelligently guiding participants to best-fit care providers via a flexible — all in a single digital space. For more information,visit www.soleranetwork.com.

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