The Beat

HLTH
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Dec 19, 2025 • 11min

How Optum Is Using Real-Time Intelligence to Eliminate Avoidable Claim Denials

About Madhu Pawar:Madhu Pawar is a board director and cross-disciplinary technology leader operating at the intersection of healthcare, data, and product innovation. She serves on the Board of Directors at Talkspace (NASDAQ: TALK) and is the Chief Product Officer for Optum Insight, where she drives product strategy and platform innovation across UnitedHealth Group’s most critical assets. Prior to Optum, she spent over six years at Google leading the global SMB Ads product ecosystem—overseeing AI-driven insights platforms, multi-billion-dollar revenue lines, and large-scale engineering, product, and operations teams across multiple continents. Madhu also teaches consumer analytics in healthcare as an adjunct professor at Carnegie Mellon University. Earlier in her career, she was a partner in McKinsey’s Global Healthcare Practice, where she built and scaled technology and services businesses for payers, providers, and fast-growth health companies. She began her career in software engineering at Hewlett-Packard Labs, earning patents in authentication and location-aware computing, followed by roles at PwC in security and technology. Madhu holds graduate degrees from Stanford School of Medicine and Carnegie Mellon University and a bachelor’s in computer engineering from Nanyang Technological University.Things You’ll Learn:Real-time data exchange between payers and providers can significantly reduce the confusion, delays, and costs associated with today’s claims processes. AI-enabled reasoning over contracts and encounters improves accuracy from the start.Optum Real aims to bridge the transparency gap by connecting stakeholders through a multi-party hub, enabling real-time understanding of coverage and reimbursement. Early pilots show tangible reductions in denials and improved patient clarity.The majority of first-time denied claims are avoidable, signaling an industry-wide opportunity to remove unnecessary rework. Solving this problem increases efficiency for providers, payers, and patients.Real-time intelligence opens the door for more effective value-based care arrangements. When providers can see financial implications instantly, incentives align more naturally.The long-term vision includes real-time payment flows, AI-driven clinical decision support, and improved patient engagement. Breaking down paper-based silos will unlock entirely new use cases at scale.Resources:Connect with and follow Madhu Pawar on LinkedIn.Follow Optum on LinkedIn and visit their website.
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Dec 18, 2025 • 26min

AI @ HLTH : Responsible AI in the Clinic: Insights from Microsoft’s Hadas Bitran

In this episode, host Sandy Vance sits down with Hadas Bitran, Partner General Manager of Health AI at Microsoft Health & Life Sciences, for a deep dive into the rapidly evolving world of healthcare agents. Together, they explore how agentic technologies are being used across clinical settings, where they’re creating value, and why tailoring these tools to the specific needs of users and audiences is essential for safety and effectiveness. Well-designed healthcare agents can reinforce responsible AI practices (like transparency, accountability, and patient safety) while also helping organizations evaluate emerging solutions with greater clarity and confidence. In this episode, they talk about:How agents are used in healthcare and use casesThe risks if a healthcare agent is not tailored to the needs of users and audiencesHow healthcare agents support responsible AI practices, such as safety, transparency, and accountability, in clinical settingsHealthcare organizations should look to evaluate healthcare agent solutionsBridging the gaps in access, equity, and health literacy; empowering underserved populations and democratizing expertiseThe impact of AI on medical professionals and the healthcare staff, and how they should prepare for the change?A Little About Hadas:Hadas Bitran is Partner General Manager, Health AI, at Microsoft Health & Life Sciences. Hadas and her multi-disciplinary R&D organization build AI technologies for health & life sciences, focusing on Generative AI-based services, Agentic AI, and healthcare-adapted safeguards. They shipped multiple products and cloud services for the healthcare industry, which were adopted by thousands of customers worldwide.In addition to her work at Microsoft, Hadas previously served as a Board Member at SNOMED International, a not-for-profit organization that drives clinical terminology worldwide.Before Microsoft, Hadas held senior leadership positions managing R&D and Product groups in tech corporations and in start-up companies. Hadas has a B.Sc. in Computer Science from Tel Aviv University and an MBA from the Kellogg School of Management, Northwestern University in Chicago.
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Dec 18, 2025 • 16min

How Mary Varghese Presti and Microsoft Are Using AI Agents to Give Nurses Their Time Back

About Mary Varghese Presti:Mary Varghese Presti is a transformational healthcare leader with over two decades of experience spanning clinical care, federal reform, biopharma, and health technology. As Corporate Vice President of Microsoft Health & Life Sciences, she drives growth in complex environments by creating clear strategy, aligning organizations, and operationalizing execution with discipline. Her prior roles include leading Nuance’s Dragon Medical business, overseeing IBM Watson Health’s Life Sciences portfolio, incubating new ventures at athenahealth, and driving digital-health transformation at Pfizer. She began her career as a pediatric nurse at Johns Hopkins and later helped shape national health IT and payment reforms at Booz Allen. Known for navigating complexity with optimism and rigor, she consistently turns ambiguity into strategy and strategy into measurable results.Things You’ll Learn:AI in healthcare is evolving from simple assistants to agentic services that can independently execute predictable workflows, allowing clinicians to regain time and focus. This shift enables a hybrid workforce where human and digital colleagues work side by side.Dragon Copilot for nurses was designed specifically to support the way nurses document care, capturing structured inputs such as vitals, intake/output, and observations through natural speech. By reducing EHR time and ambiently recording bedside interactions, it helps turn “caring out loud” into complete documentation.Nurses spend more than a quarter of their 12-hour shifts documenting in the EHR, often feeling emotionally torn between screens and patients. AI that listens in the background can significantly reduce this burden while allowing for more presence at the bedside.New tools are starting to expose the “invisible work” nurses perform, from constant micro-assessments to coordination with ancillary departments. Making this work visible is a critical step toward properly valuing nursing labor and improving workforce planning.Real-world use cases, such as AI agents assembling data for tumor boards at academic centers, show that agentic workflows can compress decision timelines from weeks to days. These same principles can be extended to many clinical and non-clinical tasks, accelerating care while preserving clinician judgment.Resources:Connect with and follow Mary Varghese Presti on LinkedIn.Follow Microsoft on LinkedIn.Visit the Microsoft and Life Sciences website.Listen to Mary’s previous interview on our podcast here.Watch Mary’s keynote presentation at the HLTH conference here.
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Dec 17, 2025 • 14min

Why Clinical Trials Fail Even When the Science Is Strong with Heather Grey of Omega Healthcare

About Heather Grey:Heather Grey is a healthcare operator and commercial leader who has spent two decades inside the machinery of pharma, life sciences, and clinical research—seeing firsthand where trials break down and why execution matters more than ideas. As SVP and General Manager of Real-World Data and Clinical Trials at Omega Healthcare, she leads CurateIQ, which focuses on transforming messy, fragmented clinical data into FDA-grade assets that accelerate trials, support AI, and expand research beyond academic centers. Before Omega, she held senior leadership roles at Tempus AI, where she built and scaled clinical trial and RWD commercial operations, and at Optum Life Sciences, driving sales and client development across pharma and health systems. Her career spans everything from operating room work to frontline pharma sales to executive leadership, giving her a rare, end-to-end view of how science, data, and operations collide in the real world, and why clean data and operational discipline, not hype, determine whether innovation actually reaches patients.Things You’ll Learn: Clinical trials fail primarily due to operational breakdowns, such as delayed data entry, poor site readiness, and missed timelines, rather than flawed science.Most healthcare data exists in an unstructured and unusable state, making human-led curation essential for generating regulatory-grade insights and training AI.AI should amplify clinical expertise, not replace it, because accuracy and trust depend on continuous human quality assurance.The lack of infrastructure prevents 88% of health systems and most community centers from offering clinical trials.Expanding trials into community settings is crucial for enhancing access, diversity, and the real-world relevance of research.Resources:Connect with and follow Heather Grey on LinkedIn.Follow Omega Healthcare on LinkedIn and visit their website.Email Heather directly here.
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Dec 16, 2025 • 16min

How James York Is Redesigning Diagnostics to Make Testing Accessible for Everyone

About James York:James York serves as the Chief Commercial Officer and Head of Government Affairs at Molecular Testing Labs, where he leads the company’s mission to expand access to diagnostics and transform patient engagement with their health. With over a decade of leadership experience at the organization, James drives commercial strategy, strategic partnerships, business development, and market education, championing a consumer-centric approach to laboratory medicine. His work focuses on advancing transparency, affordability, and proactive health management by ensuring that individuals, regardless of their circumstances or geography, can benefit from timely diagnostic insights. James’ career spans executive roles across healthcare, including CEO and president positions, as well as senior leadership in sales and business development, providing him with a deep understanding of both clinical and commercial landscapes. Guided by a commitment to equitable access and meaningful innovation, he continues to influence how advanced diagnostics are delivered and adopted across the healthcare ecosystem.Things You’ll Learn:Making diagnostics accessible requires removing economic, geographic, and emotional friction so patients can participate in their own care. At-home self-collection solves barriers that traditional labs cannot.Affordability is inseparable from access, and transparent low-cost testing is critical for supporting large populations who are “functionally uninsured.” Most patients avoid care because they cannot predict the financial burden.Virtual care has accelerated the need for decentralized diagnostics, as patients who seek care online are unlikely to travel to a physical laboratory. Without accessible testing, virtual clinical pathways break.Pioneering new diagnostic models is challenging, costly, and often met with resistance from incumbents and regulators. Yet these challenges highlight the significance of the innovation.The greatest opportunity in diagnostics lies not in high-tech breakthroughs but in improving everyday tests that influence most clinical decisions. Access, not technology, is the true innovation.Resources:Connect with and follow James York on LinkedIn.Follow Molecular Testing Labs on LinkedIn and visit their website. 
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Dec 15, 2025 • 17min

How Beth McCombs and BD Are Using Connected Intelligence to Transform Patient Care

About Beth McCombs:Elizabeth “Beth” McCombs is the executive vice president and chief technology officer of BD, where she leads the company’s global research and development organization. She oversees the full spectrum of innovation—from early-stage concept development to product launch—and ensures the continued advancement of BD’s existing portfolio. As a member of the BD Executive Leadership Team, she plays a central role in shaping the company’s long-term technology and growth strategy. Beth joined BD in 2019 as Senior Vice President of R&D for the BD Medical segment, co-leading portfolio strategy and major growth initiatives. Before joining BD, she spent over two decades at Johnson & Johnson, including serving as Vice President of R&D for Ethicon, the company’s surgical devices franchise. She holds both a B.S. and an M.S. in mechanical engineering from the Massachusetts Institute of Technology and an MBA from the Wharton School of the University of Pennsylvania.Things You’ll Learn:BD approaches innovation by deeply studying clinical workflows and ensuring new technologies solve meaningful, scalable problems. Real-world evidence and clinical validation are built into the process from the start.Connected medication management solutions can eliminate waste, prevent errors, and free up clinical resources. Tracking drugs from the central pharmacy to the bedside improves safety and system-level efficiency.Vascular access improvements achieved through product design and standardized training dramatically reduced cost, blood exposure, and catheter failure rates. This proves that outcomes hinge on combining the right device with the right practices.AI and machine-learning capabilities, such as predicting hypotension during cardiac surgery, aim to reduce complications, costs, and length of stay. These tools evolve by partnering with health systems to measure real-world impact.BD Incada represents a shift to cloud-based, interoperable, AI-enabled infrastructure that unifies data across entire health systems. This foundation accelerates the future of personalized care and integrated device ecosystems.Resources:Connect with and follow Beth McCombs on LinkedIn.Follow BD on LinkedIn  and visit their website.
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Dec 11, 2025 • 11min

How Priya Abani and AliveCor Are Bringing AI-Driven, Continuous Heart Care to Everyone

About Priya Abani:Priya Abani is the CEO, president, and a board member at AliveCor, where she leads the company’s mission to advance patient-centric remote cardiac care using cutting-edge AI and machine learning. With over 20 years of experience driving innovation across global technology organizations, she has built and scaled high-performing teams, launched industry-shaping products, and forged strategic partnerships that accelerate growth. Her leadership has earned recognition across the health tech landscape, including being named one of The Healthcare Technology Report’s Top 50 Healthcare Technology CEOs of 2022. Priya also serves on the Board of Directors for Jacobs and the Board of Trustees for TIAA, extending her influence across various sectors and shaping the future of technology, healthcare, and infrastructure.Things You’ll Learn:AI-powered cardiac monitoring is enabling earlier detection of subtle abnormalities that patients and clinicians often miss, improving the likelihood of timely intervention. These tools empower patients to monitor their own health without waiting for episodic visits.Affordability is crucial for expanding access, enabling individuals in underserved regions to utilize medical-grade ECG technology at home. This reduces unnecessary hospital visits and helps bridge geographical care gaps.Portable devices and continuous monitoring shift cardiac care from reactive to proactive. Real-time data sharing creates a tighter feedback loop between patients and clinicians.New clinician-facing tools offer advanced diagnostics in a pocket-sized form, enabling high-quality cardiac assessments to be performed anywhere. This supports healthcare workers who lack access to full clinical equipment.AI models trained on massive ECG datasets are evolving from simple detection tools into comprehensive health companions for the whole person. They synthesize patterns, prompt actions, and help guide personalized preventive care.Resources:Connect with and follow Priya Abani on LinkedIn.Follow AliveCor on LinkedIn and visit their website. Learn more about Kardia 12L here.
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Dec 10, 2025 • 14min

How Web Golinkin and Babson Diagnostics Are Reinventing Blood Testing - One Finger at a Time

About Web Golinkin:Web Golinkin is a seasoned healthcare executive, entrepreneur, and author with more than 35 years of leadership experience, including six CEO roles and three companies he co-founded. Over the last two decades, he has focused on expanding access to affordable, basic healthcare, establishing himself as a pioneer in both retail-based clinics and urgent care. His insights into the evolution of consumer-focused healthcare have been featured in The Wall Street Journal, Forbes, The Today Show, Fox Business, and numerous industry conferences. Web is also the author of Here Be Dragons, published by Forbes Books in 2024. His career spans leadership positions across healthcare delivery, population health management, medical communications, and consumer health media, including his current role as president of Babson Diagnostics and previous leadership at FastMed Urgent Care, Health Dialog, RediClinic, America’s Health Network, and American Medical Communications. A graduate of Harvard University, Web continues to shape the future of healthcare through innovation, accessibility, and patient-centered design.Things You’ll Learn:Better Way can deliver 67 clinically equivalent tests from a fingertip blood sample, covering more than 80% of common primary care needs. This allows patients to avoid the traditional needle-based blood draw.Nearly a decade of validation, including thousands of study participants and hundreds of thousands of tests, demonstrates the scientific rigor behind the technology. This long research runway enabled FDA clearance and strong clinical confidence.About one-third of patients avoid blood testing due to needle phobia or inconvenience, contributing to major gaps in preventive care. A more straightforward, painless collection method directly addresses this barrier.Health systems can increase patient adherence and reduce reliance on phlebotomists by cross-training staff to use the system within 2.5 hours. This unlocks staffing flexibility and operational efficiency.Better Way focuses on reducing friction across the entire testing journey, including simplified, graphic-rich patient result reports. This empowers patients to understand their health without having to decipher complex medical language.Resources:Connect with and follow Web Golinkin on LinkedIn.Follow Babson Diagnostics on LinkedIn  and visit their website.
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Dec 9, 2025 • 25min

AI @ HLTH: AI-Powered Healthcare: From Hype to Measurable Impact

In this episode, host Sandy Vance sits down with someone who has been shaping the future of digital health long before AI became the headline Mike Serbinis, Founder and CEO of League.League was built on a simple but ambitious idea: if companies like Netflix can instantly understand what we need next, why can’t healthcare do the same? Now, more than a decade into transforming the way people access and experience care, Mike joins Sandy to talk about how his team is helping organizations deliver truly personalized healthcare at scale.Together, they explore Mike’s path into the world of AI, the early sparks that led to League’s creation, and the lessons learned from 11 years of reimagining patient and member journeys. They delve into how League works alongside existing EHRs and health systems, not replacing anything, but weaving intelligence and interoperability through the cracks that slow down care.It’s a thoughtful, future-forward discussion with one of the industry’s most seasoned innovators—and a must-listen for anyone curious about where healthcare AI is truly headed.In this episode, they talk about:Mike’s journey into AI and the origin story of LeagueHow League integrates with EHRs and other core health technologiesLessons from 11 years in healthcare—and why speed and scale matter more than everIf Netflix can recommend your next show, why can’t healthcare do the sameReducing AI hallucinations and improving reliability for healthcare organizationsHow League delivers coverage, oversight, service, and increased productivityWhat different countries can teach us about healthcare modelsWhy we’re entering “pilot season” for AI in healthcareA Little About Mike:Mike Serbinis is widely recognized as an innovative leader and serial entrepreneur who has built transformative technology platforms across many industries. Serbinis founded and helped build Kobo, Critical Path, DocSpace, and now League. Founded in 2014, League is a platform technology company powering next-generation healthcare consumer experiences (CX). Payers, providers and consumer health partners build on the League platform to accelerate their digital transformation and deliver high-engagement, personalized healthcare experiences. Millions of people use and love solutions powered by League to access, navigate and pay for care.Serbinis is also Chair of the Board of Directors for the Perimeter Institute for Theoretical Physics, the world’s leading center for scientific research in foundational theoretical physics. He is a founding board member of the Vector Institute for Artificial Intelligence, an institution co-founded by Nobel Prize winner Geoffrey Hinton.
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Dec 8, 2025 • 14min

Seth Cohen on Why Financial Care Is the Next Frontier in Patient Experience

About Seth Cohen:Seth Cohen is a seasoned business leader with a long record of driving growth across healthcare, technology, and finance. As president of Cedar, he leads strategy and execution for a fast-scaling health tech company, building on over a decade of leadership in the industry. He also serves on the boards of Firefly Health and previously served on the board of Castlight Health, reflecting his deep credibility in the healthcare ecosystem. Before joining Cedar, Seth co-founded OODA Health and served as its CEO, introducing innovative payment solutions to the market. His earlier career includes senior commercial roles at Castlight, where he helped large employers adopt modern health benefits, as well as consulting work at McKinsey, focused on healthcare reform and consumerism. Seth began his career in investment banking, private equity, and international development, providing him with a broad strategic and financial foundation. He holds an MBA from Harvard Business School, an MPA from Harvard Kennedy School, and a BA from Stanford University.Things You’ll Learn:Patient out-of-pocket costs have been rising faster than the overall medical trend for two decades, pushing most Americans into high-deductible plans they cannot realistically afford.A relatively small percentage of uninsured patients, roughly 5–12% depending on the state, accounts for approximately 35% of the dollars owed to providers. The episode challenges providers to rethink the concept of “healing” by asking whether repairing someone’s heart while ruining their credit can truly be considered care.Cedar Cover is positioned as a proactive digital coverage safety net that identifies patients in need and connects them to Medicaid, ACA plans, financial assistance, and pharmacy copay programs. Looking ahead, the guest expects affordability pressures to intensify and plans to expand into areas such as workers' compensation and Social Security benefits. The goal is to ensure that patients are not forced to choose between groceries and medical bills by making financial support an integral part of the core care experience.Resources:Connect with and follow Seth Cohen on LinkedIn.Follow Cedar on LinkedIn and discover their website.Learn more about Cedar Cover here.Email Seth directly here.

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