Executive Summary — one paragraph for the Chair
Meridian is running 187 AI initiatives across the enterprise, up from 41 known at year-start. Governance foundations landed this quarter: policy is live, the Steering Committee has met four times, and the risk register is current. Two shadow use cases stopped. Fourteen initiatives are Tier 1 and under active Committee oversight. The organization is measurably safer, and $6.4M in run-rate value has been realized against a plan of $9.1M. We are on track — but two decisions require the Board this quarter.
AI Readiness Score
42 → 58
Peer median 61
▲ +16 this quarter
Tier 1 initiatives
14
All governed & owned
▲ +6 net (all now covered)
Shadow use cases
41 → 22
Target Q3: <10
▼ −19 this quarter
Value realized YTD
$6.4M
Plan $9.1M · 70%
On track
1 · Risk posture
The enterprise risk profile has improved this quarter but is not yet at peer-median resilience. Fourteen Tier-1 initiatives are under active Committee oversight; nine had material control gaps at Q1 and now have controls in place or scheduled. Two shadow use cases (marketing copy generation, fundraising targeting) were stopped and vendor contracts terminated. One Tier-1 initiative (prior authorization drafting) remains paused by the General Counsel pending CMS-aligned adverse-action documentation — this is intentional and appropriate.
Enterprise heatmap · Consequence × Likelihood
Rare
Unlikely
Possible
Likely
Frequent
Catastrophic
2
4
3
5
2
Severe
4
7
11
9
3
Moderate
6
12
18
14
7
Minor
9
15
11
8
4
Negligible
7
12
6
3
1
2 · Value realized · YTD
Value is measured in Sherlock as documented run-rate impact validated by finance. It excludes forward projections.
Coding copilot
$4.1M
Revenue capture · CFO-attested · 82% of full-year plan
Denial appeals (provider)
$1.6M
Overturn rate ↑ from 34% to 51% · Physician group
Vendor consolidation
$0.7M
31 → 19 vendors · Balance closes Q3
3 · Board decisions requested this quarter
-
1
Approve enterprise AI Policy v1.0 and the Sherlock Priority Score as the standing framework for AI investment decisions.
Sponsor: General Counsel · Steering Committee unanimous
Approve
-
2
Ratify the decision to stop the shadow marketing copy generation and fundraising donor targeting initiatives. Both are terminated; ratification records the Board's view for the record.
Sponsor: CEO · Legal opinion attached
Ratify
-
3
Note the pause of the prior authorization drafting initiative and Management's plan to return with a governed relaunch by Q4.
Sponsor: Plan CEO
Note
4 · What the Board should expect next quarter
Q3 focus. Complete shadow inventory reduction to <10 initiatives. Bring first governed prior-authorization relaunch to Committee. Present the FY27 AI investment slate using the Sherlock Portfolio module. Deliver first cross-peer Sherlock benchmark comparison (18 regulated organizations).
Watch items. CMS AI marketing/TPMO guidance expected mid-Q3; two initiatives may need re-tiering. State-AG activity on ambient scribes elevated — Meridian's controls are ahead of the field but posture will be reviewed.
Prepared: July 2, 2026 · Sherlock Report ID SH-2026-Q2-MHG-BRD
Next briefing: October 8, 2026