Lifers with Christina Farr Michelle Carnahan, Arbiter CEO: From Eli Lilly to solving healthcare's $100B fragmentation crisis
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Dec 2, 2025 Michelle Carnahan, a 25+ year healthcare leader who moved from Eli Lilly to startups and now runs Arbiter, talks about the GLP-1 revolution and how those drugs changed expectations. She explores shifts in insurance and three models for paying for high-cost therapies. She explains Arbiter’s AI-powered orchestration to connect fragmented systems and improve referral and prior-auth workflows.
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Choose Roles With Direct Impact
- Do focus on roles where you can lead and directly impact outcomes rather than staying only in very large organizations.
- Try to move into areas where you can improve patient access and the healthcare experience.
Prefer Too Much Care Over Too Little
- Michelle prefers erring on the side of more care when it comes to loved ones' health, saying 'over is better than under.'
- She argues technology should reduce unnecessary friction while preserving safety and appropriate follow-up.
Early Skepticism Around Tirzepatide
- Michelle describes early conversations at Eli Lilly about tirzepatide and skepticism from clinicians about changing weight 'set points.'
- She says the teams had to grow into understanding the drug's wider metabolic benefits beyond weight loss.