Foundation Models to Unlock Real-World Evidence from Nationwide Medical Claims

Evidence derived from large-scale real-world data (RWD) is increasingly informing regulatory evaluation and healthcare decision-making. Administrative claims provide population-scale, longitudinal records of healthcare utilization, expenditure, and detailed coding of diagnoses, procedures, and medications, yet their potential as a substrate for healthcare foundation models remains largely unexplored. Here we present ReClaim, a generative transformer trained from scratch on 43.8 billion medical events from more than 200 million enrollees in the MarketScan claims data spanning 2008-2022. ReClaim models longitudinal trajectories across diagnoses, procedures, medications, and expenditure, and was scaled to 140 million, 700 million, and 1.7 billion parameters. Across over 1,000 disease-onset prediction tasks, ReClaim achieved a mean AUC of 75.6%, substantially outperforming disease-specific LightGBM (66.3%) and the transformer-based Delphi model (69.4%), with the largest gains for rare diseases. These advantages held across retrospective and prospective evaluations and in external validation on two independent datasets. Performance improved monotonically with scale, and post-training added 13.8 percentage points over pre-training alone. Beyond disease prediction, ReClaim captured financial outcomes and improved real-world evidence (RWE) analyses: for healthcare expenditure forecasting it increased explained variance from 0.28 to 0.37 relative to LightGBM, and in a target trial emulation it reduced systematic bias by 72% on average relative to Delphi. Together, these results establish administrative claims as a scalable substrate for healthcare foundation models and show that learned representations generalize across time periods and data sources, supporting disease surveillance, expenditure forecasting, and RWE generation.

Moira: Language-driven Hierarchical Reinforcement Learning for Pair Trading

Many sequential decision-making problems exhibit hierarchical structure, where high-level semantic choices constrain downstream actions and feedback is delayed and ambiguous. Learning in such settings is challenging due to credit assignment: performance degradation may arise from flawed abstractions, suboptimal execution, or their interaction. We study this challenge through pair trading, a domain that naturally combines long-horizon semantic reasoning for asset pair selection with short-horizon execution under partial observability. We formulate pair trading as a hierarchical reinforcement learning problem and propose a language-driven optimization framework in which both high-level and low-level policies are parameterized by large language models (LLMs) and optimized exclusively through prompt updates. Our approach leverages pretrained LLMs as hierarchical policies and uses trajectory- and episode-level textual feedback to adapt abstractions and execution without gradient-based fine-tuning. By explicitly separating abstraction selection from execution, the framework reduces non-stationarity across hierarchical levels and enables targeted adaptation under delayed feedback. Experiments on real-world market data show consistent improvements over traditional and LLM-based baselines, demonstrating the effectiveness of language-driven hierarchical reinforcement learning.

FinTrace: Holistic Trajectory-Level Evaluation of LLM Tool Calling for Long-Horizon Financial Tasks

Recent studies demonstrate that tool-calling capability enables large language models (LLMs) to interact with external environments for long-horizon financial tasks. While existing benchmarks have begun evaluating financial tool calling, they focus on limited scenarios and rely on call-level metrics that fail to capture trajectory-level reasoning quality. To address this gap, we introduce FinTrace, a benchmark comprising 800 expert-annotated trajectories spanning 34 real-world financial task categories across multiple difficulty levels. FinTrace employs a rubric-based evaluation protocol with nine metrics organized along four axes -- action correctness, execution efficiency, process quality, and output quality -- enabling fine-grained assessment of LLM tool-calling behavior. Our evaluation of 13 LLMs reveals that while frontier models achieve strong tool selection, all models struggle with information utilization and final answer quality, exposing a critical gap between invoking the right tools and reasoning effectively over their outputs. To move beyond diagnosis, we construct FinTrace-Training, the first trajectory-level preference dataset for financial tool-calling, containing 8,196 curated trajectories with tool-augmented contexts and preference pairs. We fine-tune Qwen-3.5-9B using supervised fine-tuning followed by direct preference optimization (DPO) and show that training on FinTrace-Training consistently improves intermediate reasoning metrics, with DPO more effectively suppressing failure modes. However, end-to-end answer quality remains a bottleneck, indicating that trajectory-level improvements do not yet fully propagate to final output quality.

Can LLM Agents Be CFOs? A Benchmark for Resource Allocation in Dynamic Enterprise Environments

Large language models (LLMs) have enabled agentic systems that can reason, plan, and act across complex tasks, but it remains unclear whether they can allocate resources effectively under uncertainty. Unlike short-horizon reactive decisions, allocation requires committing scarce resources over time while balancing competing objectives and preserving flexibility for future needs. We introduce EnterpriseArena, the first benchmark for evaluating agents on long-horizon enterprise resource allocation. It instantiates CFO-style decision-making in a 132-month enterprise simulator combining firm-level financial data, anonymized business documents, macroeconomic and industry signals, and expert-validated operating rules. The environment is partially observable and reveals the state only through budgeted organizational tools, forcing agents to trade off information acquisition against conserving scarce resources. Experiments on eleven advanced LLMs show that this setting remains highly challenging: only 16% of runs survive the full horizon, and larger models do not reliably outperform smaller ones. These results identify long-horizon resource allocation under uncertainty as a distinct capability gap for current LLM agents.

Conv-FinRe: A Conversational and Longitudinal Benchmark for Utility-Grounded Financial Recommendation

Most recommendation benchmarks evaluate how well a model imitates user behavior. In financial advisory, however, observed actions can be noisy or short-sighted under market volatility and may conflict with a user's long-term goals. Treating what users chose as the sole ground truth, therefore, conflates behavioral imitation with decision quality. We introduce Conv-FinRe, a conversational and longitudinal benchmark for stock recommendation that evaluates LLMs beyond behavior matching. Given an onboarding interview, step-wise market context, and advisory dialogues, models must generate rankings over a fixed investment horizon. Crucially, Conv-FinRe provides multi-view references that distinguish descriptive behavior from normative utility grounded in investor-specific risk preferences, enabling diagnosis of whether an LLM follows rational analysis, mimics user noise, or is driven by market momentum. We build the benchmark from real market data and human decision trajectories, instantiate controlled advisory conversations, and evaluate a suite of state-of-the-art LLMs. Results reveal a persistent tension between rational decision quality and behavioral alignment: models that perform well on utility-based ranking often fail to match user choices, whereas behaviorally aligned models can overfit short-term noise. The dataset is publicly released on Hugging Face, and the codebase is available on GitHub.

The CLEF-2026 FinMMEval Lab: Multilingual and Multimodal Evaluation of Financial AI Systems

We present the setup and the tasks of the FinMMEval Lab at CLEF 2026, which introduces the first multilingual and multimodal evaluation framework for financial Large Language Models (LLMs). While recent advances in financial natural language processing have enabled automated analysis of market reports, regulatory documents, and investor communications, existing benchmarks remain largely monolingual, text-only, and limited to narrow subtasks. FinMMEval 2026 addresses this gap by offering three interconnected tasks that span financial understanding, reasoning, and decision-making: Financial Exam Question Answering, Multilingual Financial Question Answering (PolyFiQA), and Financial Decision Making. Together, these tasks provide a comprehensive evaluation suite that measures models' ability to reason, generalize, and act across diverse languages and modalities. The lab aims to promote the development of robust, transparent, and globally inclusive financial AI systems, with datasets and evaluation resources publicly released to support reproducible research.

Ebisu: Benchmarking Large Language Models in Japanese Finance

Japanese finance combines agglutinative, head-final linguistic structure, mixed writing systems, and high-context communication norms that rely on indirect expression and implicit commitment, posing a substantial challenge for LLMs. We introduce Ebisu, a benchmark for native Japanese financial language understanding, comprising two linguistically and culturally grounded, expert-annotated tasks: JF-ICR, which evaluates implicit commitment and refusal recognition in investor-facing Q&A, and JF-TE, which assesses hierarchical extraction and ranking of nested financial terminology from professional disclosures. We evaluate a diverse set of open-source and proprietary LLMs spanning general-purpose, Japanese-adapted, and financial models. Results show that even state-of-the-art systems struggle on both tasks. While increased model scale yields limited improvements, language- and domain-specific adaptation does not reliably improve performance, leaving substantial gaps unresolved. Ebisu provides a focused benchmark for advancing linguistically and culturally grounded financial NLP. All datasets and evaluation scripts are publicly released.

MedViz: An Agent-based, Visual-guided Research Assistant for Navigating Biomedical Literature

Biomedical researchers face increasing challenges in navigating millions of publications in diverse domains. Traditional search engines typically return articles as ranked text lists, offering little support for global exploration or in-depth analysis. Although recent advances in generative AI and large language models have shown promise in tasks such as summarization, extraction, and question answering, their dialog-based implementations are poorly integrated with literature search workflows. To address this gap, we introduce MedViz, a visual analytics system that integrates multiple AI agents with interactive visualization to support the exploration of the large-scale biomedical literature. MedViz combines a semantic map of millions of articles with agent-driven functions for querying, summarizing, and hypothesis generation, allowing researchers to iteratively refine questions, identify trends, and uncover hidden connections. By bridging intelligent agents with interactive visualization, MedViz transforms biomedical literature search into a dynamic, exploratory process that accelerates knowledge discovery.

EHRNavigator: A Multi-Agent System for Patient-Level Clinical Question Answering over Heterogeneous Electronic Health Records

Clinical decision-making increasingly relies on timely and context-aware access to patient information within Electronic Health Records (EHRs), yet most existing natural language question-answering (QA) systems are evaluated solely on benchmark datasets, limiting their practical relevance. To overcome this limitation, we introduce EHRNavigator, a multi-agent framework that harnesses AI agents to perform patient-level question answering across heterogeneous and multimodal EHR data. We assessed its performance using both public benchmark and institutional datasets under realistic hospital conditions characterized by diverse schemas, temporal reasoning demands, and multimodal evidence integration. Through quantitative evaluation and clinician-validated chart review, EHRNavigator demonstrated strong generalization, achieving 86% accuracy on real-world cases while maintaining clinically acceptable response times. Overall, these findings confirm that EHRNavigator effectively bridges the gap between benchmark evaluation and clinical deployment, offering a robust, adaptive, and efficient solution for real-world EHR question answering.

FinCriticalED: A Visual Benchmark for Financial Fact-Level OCR Evaluation

We introduce FinCriticalED (Financial Critical Error Detection), a visual benchmark for evaluating OCR and vision language models on financial documents at the fact level. Financial documents contain visually dense and table heavy layouts where numerical and temporal information is tightly coupled with structure. In high stakes settings, small OCR mistakes such as sign inversion or shifted dates can lead to materially different interpretations, while traditional OCR metrics like ROUGE and edit distance capture only surface level text similarity. \ficriticaled provides 500 image-HTML pairs with expert annotated financial facts covering over seven hundred numerical and temporal facts. It introduces three key contributions. First, it establishes the first fact level evaluation benchmark for financial document understanding, shifting evaluation from lexical overlap to domain critical factual correctness. Second, all annotations are created and verified by financial experts with strict quality control over signs, magnitudes, and temporal expressions. Third, we develop an LLM-as-Judge evaluation pipeline that performs structured fact extraction and contextual verification for visually complex financial documents. We benchmark OCR systems, open source vision language models, and proprietary models on FinCriticalED. Results show that although the strongest proprietary models achieve the highest factual accuracy, substantial errors remain in visually intricate numerical and temporal contexts. Through quantitative evaluation and expert case studies, FinCriticalED provides a rigorous foundation for advancing visual factual precision in financial and other precision critical domains.