Creating a New Healthcare

Despite the almost universal agreement that the United States healthcare system needs to move to value-based care, forward progress on that movement has all but stalled. Why? A big driver…no surprise…are the contracts. Brian Overstreet, the Co-Founder of Arbital Health, has built an impressive AI-powered platform that combines both an unprecedented depth of data with actuarial expertise to provide transparency in value-based care contracts, helping providers and now, payers, see where they’ve gone awry in real-time so they can course correct quickly and effectively. Brian is a serial entrepreneur with two exits in his twenty-year experience who has launched a number of successful SaaS companies in the healthcare market. He is the Co-Founder, President, and CEO of Arbital Health which was just launched in 2023 but has already undergone two rounds of funding totalling ~$46 M in investment.

How many grams of protein do you need to be healthy? What about fiber? Supplements? It feels like we’re changing our diets daily to adhere to constantly shifting recommendations and none of it is really working to optimize our health. Christopher Gardner, Professor of Medicine in Nutrition Science at Stanford University, and featured advisor on the Netflix show, “You Are What You Eat: A Twin Experiment”, joins us today to talk about how the industry is stacked against us and why the solution to our diet woes is as simple as beans, peas, and lentils. For more than 30 years Christopher Gardner, PhD, has studied what to consume and to avoid for optimal health, and how best to motivate individuals to achieve healthy dietary behaviors. He recently completed a two-year term serving on the US Dietary Guidelines Advisory Committee and is the past chair of the American Heart Association’s Nutrition Committee. He has conducted and published dozens of human nutrition intervention trials, including trials of Mediterranean, Ketogenic, Vegan, Low-Fat and Low-Carb diets and their effects on cardiometabolic health. Some of his current interests include Stealth Nutrition, Unapologetic Deliciousness and Institutional Food Settings. He is currently working on personalized nutrition explorations with several colleagues, with particular focus on the gut microbiome.

Opioid overdose is the #1 killer of 18-45 year olds in America. The crisis is not over, and we are still prescribing these addictive substances for pain management at an alarming rate with little support or anything else in the arsenal to offer.  Until now… Cammie Wolf Rice, the Founder and CEO of the CWC Alliance, has pioneered a new role on the hospital healthcare team, a LifeCare Specialist. These individuals come from a variety of backgrounds, but all undergo specific training to be able to provide patients with opioid education, mental & social wellness support, and effective pain management strategies.  After losing her 32 year old son, Christopher, to opioid misuse, Cammie channeled her grief into action, founding CWC Alliance in 2018 and publishing her story, The Flight: My Opioid Journey, in 2022. This approach has since been adopted in eight hospitals across the country, was selected as the subject of a Harvard Business School case study, and was named the top recommendation by Georgia’s 2024 House Study Committee on Alternatives to Opioids. Is there a LifeCare Specialist at your hospital or healthcare system? 

Guest: Steve Brown, Founder and CEO, CureWise Can ChatGPT cure cancer? If you listen to the news, you would think it’s close. But ChatGPT, just like any data repository, is just one source of information. What if patients could harness the power of many of the AI engines all at once to help them ask better questions, know about the latest treatments, and become a more active player in their treatment journey?  Steve Brown, Founder and CEO of CureWise, ran into this exact challenge when after years of seeking answers, he was diagnosed with a rare blood cancer. He started to explore what the AI models could tell him about his disease, the available treatments out there, and what he could be doing in his own life to minimize the effects. He found that the answers varied from model to model, but what they did do is help him become a more effective patient. He asked better questions, knew about treatments he could name to his physicians, and was able to work more collaboratively with them to find a treatment plan that would work for him, specifically. His own experience is the basis for CureWise, which is currently in beta release but will be available to the public soon. In addition to his role at CureWise, Steve also serves as the Founder and CEO of the independent film/media company Ignite Channel Inc., Chief AI Officer of Peter Diamandis’ Abundance360 and PHD Ventures and partner/Board member of AI platform SignalPop LLC. Steve is an award winning documentary film maker and directed and produced SPARK: A Burning Man Story.

Guest: Neal Shah, Co-Founder, Counterforce Health Have you ever had a medical claim denied for a procedure or service that should have been covered by your insurance? You are not alone. Yet, 99% of people choose not to appeal that denial because of the laborious, manual process required. After going through this dehumanizing experience with his wife, Neal Shah decided to bring the power of automation to the good guys. Counterforce Health is a service that helps clients leverage the speed and efficiency of AI to prepare their denial letter in literally minutes. Find out more at www.counterforcehealth.org.  Neal started his career as a hedge fund manager and pivoted to healthcare after the deeply personal experience of caring for his wife during her illness. He is the Founder and CEO of CareYaya Health Technologies, a social enterprise and applied research lab advancing health equity for aging populations and is also the Founder and Chairman of Counterforce Health. He serves as Principal Investigator on multiple federally-funded innovation grants and has recently authored the book, Insured to Death: How Health Insurance Screws Over Americans – And How We Take it Back.

Deborah Ault, known to most as “Nurse Deb”, has been a Registered Nurse for over 30 years. Before getting into Care Management, her bedside nursing experience included ER, ICU, Doctor’s Office, Home Health, and Telephone Triage. Now she is the President of Ault International Medical Management (AIMM). AIMM’s team of nurses and physicians help patients navigate both the health delivery and the health insurance systems. Her passion and dedication to managed care has driven her success in the industry, saving employer-sponsored health plans countless dollars and improving the quality of patient care. During this conversation, Nurse Deb and I dive into the hidden complexities of employer-sponsored health insurance. She shares that those in the C-suite are often making “life and death decisions” for their employees by selecting inadequate health plans. Deb relays shocking examples of price gauging in healthcare and explains how her company helps employers and employees navigate this broken system. Her team’s approach of aggregating hundreds of metrics to identify high-quality, affordable care has literally saved companies and individuals hundreds of thousands of dollars in unnecessary expenses.  This is such important work, and I was particularly taken by Deb’s insistence that this type of patient advocacy requires human clinical expertise, not just technological solutions. It is the combination that is truly the secret sauce. As I tell Deb in the episode, I wish AIMM had more competition because we certainly need many more advocates like her and her team. 

Obesity in America. Is there any other diagnosis as relevant, timely, or important when we think about the impact on our healthcare system? I doubt it. So, today we are talking with Dr. Meghan Garcia-Webb, who is triple board-certified in internal medicine, lifestyle medicine, and obesity medicine. Her weekly YouTube series, “Weight Medicine with Dr. Meghan,” aims to provide audiences with medically-based information about weight loss drugs and weight management. In addition to being an internist at the prestigious Beth Israel Deaconess Medical Center, Dr. Meghan runs an innovative private practice that combines concierge weight medicine with life coaching.  This concept of the “one big thing” that Dr. Meghan speaks about intrigued me. She explains during our conversation that what is often missing in her work as an internist is the time to dig into what is actually blocking people from what they want. To help address this, she pursued a certification in life coaching and ultimately began her own self-pay coaching practice to add her extensive knowledge about the medicine of weight loss to the human connection that’s so critical in achieving real behavior change.  The deck is seriously stacked against us. In this episode, we discuss how Americans are at war for their health and how our society is poised to prevent us from achieving and maintaining health. Dr. Meghan shares some of her own “systems” that allow her to live the life she wants without having to overthink or overdo it. As someone who spends a lot of time thinking about primary care, this conversation brought back to me how much we’ve missed the boat in American healthcare when it comes to the way we treat health. It’s such a fantastic example of how we can’t medicine our way out of this problem; we must engage with the human side if we want to see real change. 

Chelsea Ryckis is the award winning founder and president of Ethos Benefits, a firm dedicated to advancing health insurance strategies for employers nationwide. Their approach effectively eliminates fraud, waste and abuse from employer healthcare plans while increasing savings for both employers and their employees. Chelsea is the co-host of the Ethos Effect Podcast with her husband, Donovan, and producer of the documentary “It’s Not Personal, It’s Just Healthcare”. Chelsea regularly speaks on the industry’s most coveted stages including: ALM Benefits Pro Expo, SHRM HR Florida, and the ISCEBS Symposium.  This is one of the most important episodes we’ve ever aired, especially for employers. During this conversation, Chelsea and I discuss how traditional health insurance brokers profit from ever-increasing premiums, and how that traps employers and, subsequently, employees, in a broken system. The downstream effects of astronomical health care costs will inevitably get passed down to consumers when employers are unable to absorb the increase, resulting in lost wages, layoffs, and an inability for workers to contribute to their retirement. This system is unsustainable but it does not have to operate this way.  At Ethos Benefits, Chelsea and her husband, Donovan, have implemented a revolutionary approach to healthcare consulting. An approach that prioritizes transparency and fiduciary responsibility and which results in significant cost savings. Listen in as they share their methodology and how they can create a system that benefits employers and employees.  Healthcare will not change until the business of healthcare does, and Ethos Benefits is paving the way. 

On the show today, we are honored to have Dr. John Halamka, the Dwight and Dian Diercks president of the Mayo Clinic Platform, a digital initiative that brings together solution developers, data partners and healthcare service providers to transform healthcare. Trained in emergency medicine and medical informatics, Dr. Halamka has been developing and implementing healthcare information strategy and policy for more than 40 years. He continues to practice emergency medicine and is Professor of Emergency Medicine and the Michael D. Brennan, M.D., President’s Strategic Initiative Professor at Mayo Clinic College of Medicine and Science. Dr. Halamka has written 15 books and hundreds of articles. He and his wife run Unity Farm Sanctuary in Sherborn, Massachusetts, dedicated to the lifetime care of ill, disabled, senior, orphaned and surrendered farm animals. The work John and his team at the Mayo Clinic Platform are doing is nothing short of extraordinary. Leveraging their access to Mayo’s massive data set and employing the full breadth of AI capabilities, they have been able to create a platform that allows rapid innovation by de-identifying and sharing medical data while still protecting patient privacy. To give you a sense of the magnitude of this project – the platform currently has 250 predictive algorithms and 8 foundation models in production with a goal of impacting the health of four BILLION people by 2030. As you’ll realize by the end of this interview, Dr. John Halamka is an extraordinary individual, physician, informaticist and leader. He has a tremendous platform and influence but my hope is that his humanitarian influence expands as far, as wide, and as deep as possible within the national and international healthcare domains. If there is anyone I would trust to guide us into the future of AI in healthcare, it would be Dr. Halamka.  

Our guest today is Jasmine Bhatti, the founder and CEO of Navi Nurses, a rapidly growing, private-duty nursing company that’s redefining at-home care. Navi Nurses has been recognized as one of the top startups to watch in Arizona. Jasmine herself was named Phoenix Female Founder of The Year, a Healthcare Hero of Nursing by the Phoenix Business Journal, and was the recipient of the prestigious Jeannine Rivet award from the American Nurses Association. She was also granted a $1.5 million grant to study her work through the Re-Imagining Nursing Initiative from the American Nurses Foundation.  At-home care is such a salient issue for many of us these days. In fact, the inspiration for Navi Nurses came from Jasmine’s own experience with her grandmother’s cancer care journey where she recognized significant gaps in the hospital-to-home care transition. NaviNurses offers flexible nursing care, from simple one-hour check-ins to 24/7 in-home support with hospital-based nurses, often the same nurse that worked with the patient during their hospital stay. Beyond just reducing hospital readmissions, NaviNurses aims to support caregivers by quickly and accurately identifying issues so they can be addressed before they become more significant. The service is currently self-pay, but Jasmine and her team are conducting research to demonstrate the cost savings of this type of program. Beyond the obvious benefit to the patient and their family, I was intrigued by Jasmine’s data regarding the impact on the nurses themselves. Through research with their own nursing staff matched with similarly skilled hospital nurses, Jasmine found that NaviNurses report burnout on the mild end much more frequently than the hospital-based nurses. By providing a more flexible and engaged work environment that demonstrates the full value of nurses, Jasmine hopes to retain more nurses in the workforce. Jasmine’s data-based approach is both smart and admirable and her enthusiasm for this work is palpable. I look forward to seeing this model make its way across the country.