Licensed nurses reach members 60 to 90 days before a claim is filed, AI does the intake, scheduling and follow-up, and employers keep more of the savings

SAN FRANCISCO, Sept. 2, 2026 /PRNewswire/ — World Class Health today introduced The AI Specialty Clinic™, the first AI-native specialty care platform for large self-insured employers and third-party administrators, with implementations going live in January 2027. The platform has two parts: a model that identifies members likely to need specialty care months before a claim exists rather than after a procedure has been scheduled, and Eva™, the AI member surface that engages them and routes them to top-performing providers at prices disclosed against an independent benchmark.

Centers of excellence and specialty care platforms have existed for more than a decade under a common constraint. Reaching members is expensive, so programs wait for members to select into the benefit or rely on plan design to steer them, and the program typically learns about a procedure once it has already been scheduled. World Class Health built its platform to remove that constraint. Prediction replaces mandates, which produces a better member experience. AI takes over the non-clinical work, which lowers the cost to serve. Higher engagement at a lower cost to serve produces larger savings.

Member engagement 60 to 90 days before a claim

The AI Specialty Clinic reads eligibility, claims and clinical signals to identify members heading toward a specialty episode 60 to 90 days before a claim appears. A licensed Nurse Navigator reaches the member while the questions are still open: what the member is facing, whether the procedure is warranted at all, whether a second opinion is worth getting, and which providers do the procedure well. Reaching a member this early makes conservative care possible, and World Class Health is paid on verified savings rather than on procedure volume. Every person a member speaks with on the platform is a licensed nurse.

Members also meet Eva, the platform’s AI member surface. Eva answers questions about a diagnosis or a procedure at any hour, shows transparent information on providers in the member’s area including procedure-specific quality scores and outcomes, and shows what a procedure will cost the member before they choose. When a question calls for clinical judgment, a licensed Nurse Navigator takes over. Eva does not diagnose and does not tell a member what care to have.

Cost to serve

Eva handles intake, records retrieval, scheduling, benefit and cost questions, and routine follow-up. Nurses spend their time on clinical work, and the same team reaches a multiple of the members it could otherwise reach without a proportional increase in cost to serve.

Other specialty care platforms carry that operational load in staffed operations, routing member contact through non-clinical care advocates, and their fees carry it with them. Plan sponsors and members keep more of the savings.

Savings, and the benchmark they are measured against

Providers are selected on procedure-specific volumes, outcomes and independent appropriateness measures, evaluated at initial enrollment and on an ongoing basis. The network covers more than 90% of the top 50 U.S. metropolitan areas for planned surgery, and the average employee in a client census sits within 20 miles of a World Class Health center of excellence.

Every provider charge is disclosed beside the local procedure-specific rate the employer was already paying, drawn from federally mandated price transparency data, so savings are audited rather than asserted. On the company’s current centers of excellence program, clients reduce spend on covered procedures by 40% to 50% and see 90% fewer readmissions, and World Class Health backs those results with a hard-dollar savings guarantee.

“Specialty care platforms have existed for a decade, and they all carry the same cost structure,” said Sid Nambiar, Chief Executive Officer of World Class Health. “We built ours AI-native. It predicts rather than mandates, it runs at a fraction of the cost to serve, and the difference goes to the employer. Better experience, at lower cost, producing larger savings.”

“Anything that calls for clinical judgment on this platform is handled by a licensed nurse,” said Kumar Dharmarajan, MD, Co-Founder and Chief Medical Officer. “What AI changes is how much of a nurse’s day is available for clinical work, and how early we reach the member. Reaching someone months before a procedure is what creates room for a second opinion, for conservative care, or for the conclusion that no procedure is needed at all.”

The platform covers orthopedics, spine, cardiac, bariatric surgery, general surgery, gynecologic surgery, imaging and infusions.

About World Class Health

World Class Health is the largest AI-native cost containment lever for self-insured employers. It is the only fully transparent, exclusively medically led specialty care centers of excellence platform on the market. The company discloses exactly what a provider charges and the benchmark against which savings are calculated, so employers know precisely what they are paying and why. Every case is governed by a clinical team, with licensed nurses serving as dedicated Nurse Navigators from eligibility through recovery. The platform uses predictive intelligence to identify employees likely to need high-cost specialty care before a claim is filed and to confirm that the care is appropriate, routing them to the right provider, at the right site, at a price their employer can verify. Learn more at worldclasshealth.com.

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SOURCE World Class Health