The Beat

In this episode of the AI at Health series on The Beat Podcast, host Sandy Vance sits down with Vadiraj Guttal, VP and Business Head for Infosys Helix, for a thoughtful and candid conversation about why health plans are still stuck in batch processing, what it actually means to be cloud native versus just cloud hosted, and how a platform-centric approach is delivering two to three times the improvement that incremental fixes never could. With Helix now six-plus years in the making, Vadiraj brings a grounded, practitioner's perspective to one of the most complex transformation challenges in healthcare today. If you are a health plan executive trying to reduce administrative costs, modernize operations, and prepare for an AI-driven future, this episode is essential listening. In this episode, they talk about: Most health plans moved to the cloud without actually taking advantage of what the cloud can do Batch processing is still the norm in healthcare, and it is the root cause of most administrative delays Platform-centric thinking means cloud-native architecture, reusable data, event-driven workflows, and composability Provider credentialing that takes two to three months today could be reduced to one week with the right platform Helix targets a 40% reduction in IT operations costs and a 50 to 60% reduction in workflow fallouts True digital-native health plans do not exist yet, and that is exactly the gap Helix is built to close Tier two and tier three health plans without large digital transformation budgets are the ideal Helix candidates The next big challenge is using AI at scale in production while keeping outcomes deterministic, not probabilistic A Little About Vadiraj: Senior Health-tech and IT Consulting professional with 23+ years of experience in software development, project management, sales, and delivery of strategic consulting engagements, product and solution development for the payer segment of US healthcare. He partners with senior executives to address their business and technology needs through innovative solutions, resulting in IT efficiencies and business outcomes. As Business Head of Platforms at Infosys Healthcare, he is responsible for ideating and developing digital-native, AI- and cloud-run business applications. In this role, he also partners with other healthcare start-ups and academic institutions to industrialize their research and solve problems for large healthcare payers.

Healthcare doesn’t have a technology problem; it has a workflow problem. In this episode, Kshitij Jaggi discusses why healthcare’s digital tools have failed to improve efficiency and how agentic AI can transform operations by completing work rather than creating more of it. He explains the critical difference between task automation and system-level orchestration, and why administrative bottlenecks, such as prior authorizations, delay care. He also explores how governance, traceability, and new oversight roles are essential for responsible AI adoption. Finally, he shares how throughput should define ROI and unlock better outcomes across the healthcare system. Tune in to learn how AI can eliminate friction, improve access to care, and reshape the future of healthcare operations.  About Kshitij Jaggi: Co-founder and CEO of RISA Labs, Kshitij (KJ) leads the company’s mission to accelerate oncology innovation through data-driven collaboration and transformative technology. Things You’ll Learn: Most healthcare software fails because it adds work for users instead of reducing it, making time the primary barrier to adoption. True transformation in healthcare requires system-level orchestration rather than isolated task automation. Embedding clinical intelligence into administrative workflows reduces errors, delays, and inefficiencies in care delivery. Administrative processes are the biggest source of friction in healthcare systems. Integrating agentic AI with EMR systems can significantly increase throughput in a labor-constrained healthcare environment. Long-term success depends on platform-based solutions, governance and oversight of AI, and measuring ROI through throughput, timeliness of care, and reduced treatment leakage while enabling more seamless care and faster innovation. Resources: Connect with and follow Kshitij Jaggi on LinkedIn. Follow RISA Labs on LinkedIn and visit their website.

Simplifying the complex world of healthcare reimbursement. In this episode, Jason Considine, President of Experian Health, discusses shifting the industry's focus from denial management to denial prevention by leveraging AI at the point of registration. He discusses the implementation of the Patient Access Curator, a tool that automates insurance discovery and validation to reduce human error and administrative costs. He also explains how Experian leverages rich data assets, such as employment data, to help providers navigate new regulatory requirements, such as the OBBA. This episode explores the mission of leveraging advanced technology to eliminate administrative waste, enabling resources to be redeployed into direct patient care. Tune in to start from the start with denial prevention.  About Jason Considine: Jason Considine is the President of Experian Health, having taken the helm in April 2025. He previously served as the Chief Commercial Officer for more than 3 years, leading sales, marketing, and business development. With nearly 20 years of experience in the healthcare industry, Jason is dedicated to using data analytics and software solutions to simplify administrative processes for hospitals and medical practices. Things You'll Learn:  How Experian Health aims to simplify healthcare by improving the efficiency of how providers are reimbursed by patients and payers. The industry shift from costly back-end denial management to proactive denial prevention by leveraging AI at the point of registration. How the Patient Access Curator tool automates insurance discovery and updates registration systems in seconds to reduce denials by over 30%. The importance of transparency in AI to build trust and unlock the "black box" of decision-making in highly regulated healthcare environments. How providers can prepare for the OBBA regulation by using employment data to automate Medicaid qualification decisions. Why the AI "arms race" between payers and providers makes adopting intelligent automation essential for an organization to thrive and survive. Resources:  Connect with and follow Jason Considine on LinkedIn. Follow Experian Health on LinkedIn and explore their website.

AI is advancing rapidly in healthcare, but speed without governance can create serious clinical, legal, and enterprise-level risks. In this episode, Peter Bonis, MD, Chief Medical Officer at Wolters Kluwer Health, explores how his team is developing reliable, evidence-based AI tools to support frontline clinicians without compromising trust or safety. He explains why clinicians are adopting AI faster than health systems can govern it, creating risks like the rise of “shadow AI.” Peter highlights the importance of transparency, human oversight, and trusted source material in ensuring safe clinical decision support. He also discusses how even experts can be influenced by faulty AI output and why governance models must evolve with frontline input to keep pace. Tune in and learn how healthcare leaders can approach AI governance more responsibly while still supporting innovation at the point of care. About Peter Bonis: Peter A.L. Bonis, MD, is Chief Medical Officer at Wolters Kluwer Health, where he serves on the executive leadership team and oversees content, informatics, and industry partnerships. He was also part of the founding group at UpToDate, which grew into one of the world’s leading evidence-based clinical knowledge resources.  Dr. Bonis is a physician entrepreneur and academic leader with more than 25 years of experience in healthcare. At Wolters Kluwer Health, he leads teams spanning physicians, pharmacists, engineers, informaticists, and business development professionals focused on clinical content, drug information, and patient engagement solutions. He is also an adjunct professor of medicine in the division of gastroenterology at Tufts University School of Medicine and previously served on the faculty at Yale University School of Medicine. His background also includes healthcare investing, advisory work with venture capital and private equity firms, more than 70 published research articles, and the co-founding of the UpToDate donations program in partnership with Ariadne Labs to expand access in low- and middle-income countries. He earned his AB from Harvard University and his MD from New York University.  Things You’ll Learn: AI in healthcare must be grounded in trusted evidence, transparency, and human oversight to be safe for clinical use.  Shadow AI is already creating enterprise-level risk as clinicians and staff adopt unvetted tools outside formal governance structures. Even experienced specialists may not reliably detect faulty AI-generated clinical information when it appears credible. Healthcare leaders need governance models that focus on safety, privacy, compliance, and real clinical value rather than hype. Effective AI governance must be iterative and shaped by input from frontline clinicians who understand how these tools affect care delivery. Resources: Connect with and follow Dr. Peter Bonis on LinkedIn! Follow Walters Kluwer Health on LinkedIn and visit their website.

What if the biggest opportunity in healthcare reimbursement is finally having a clear view of what “fair” actually looks like? In this episode, Dilpreet Sahota, CEO and founder of Trek Health, discusses how his company is helping health systems and health plans turn price transparency data into a strategic tool for payer negotiations. He explains why publicly available reimbursement data is still difficult to use in practice, how AI can simplify both massive pricing datasets and highly complex payer contracts, and why providers need a clearer benchmarking strategy as reimbursement pressures continue to shift. He also shares his perspective on trust, validation, and explainability in AI, along with a future vision in which providers negotiate with greater clarity, and patients can better predict the true cost of care before receiving services. Tune in to learn how better reimbursement intelligence could reduce friction, strengthen negotiation strategy, and increase transparency for both providers and patients. About Dilpreet Sahota: Dilpreet Sahota is the CEO and founder of Trek Health, a company focused on building healthcare payment products that help organizations better understand reimbursement, contracts, and market benchmarks. Since founding Trek Health in 2022, he has worked to make price transparency data more usable for healthcare finance leaders and provider organizations navigating payer negotiations. Before launching Trek Health, Dilpreet held roles across healthcare growth, analytics, operations, and research, including work at Big Health, Health IQ, Massachusetts General Hospital, and Stanford University School of Medicine. He holds an M.Sc. from Stanford University and a B.A. from the University of California, Berkeley. Things You’ll Learn: Price transparency data is now public, but it is still difficult for providers and payers to access and use strategically.  AI can help sift through massive pricing datasets and extract key terms from payer contracts in seconds rather than hours.  Providers need plan-specific reimbursement strategies instead of treating all payer relationships the same way. Trust in AI depends on validation, sourcing, auditability, and the ability to trace outputs back to underlying truth. Lower-cost outpatient alternatives will likely play a major role in reducing total cost of care over the next decade. A more mature transparency ecosystem could help patients predict healthcare costs much more accurately before treatment. Resources: Connect with and follow Dilpreet Sahota on LinkedIn. Learn more about Trek Health on LinkedIn and visit the website here. 

Healthcare payments are often discussed as a transparency problem, but the deeper issue is structural fragmentation across contracts, claims, remittances, and workflows. In this episode, Ted Ferrin, Senior Vice President of Payments Innovation at Zelis, explains how the acquisition of Rivet is bringing provider-facing payment intelligence into Zelis’s broader infrastructure. He discusses why achieving financial clarity between payers and providers has been so difficult due to fragmented systems and legacy technology. Ted highlights that true transparency goes beyond simply displaying data and requires meaningful, actionable insights. He also shares how tools like Claims Insights and Zap Edge embed intelligence into payment workflows to reduce rework, improve visibility, and create a smoother experience for providers, payers, and patients. Tune in and learn how better payment intelligence could help turn transparency from a buzzword into real operational trust.  About Ted Ferrin: Ted Ferrin is Senior Vice President of Payments Innovation at Zelis, where he focuses on building solutions that improve healthcare payments and strengthen financial clarity for providers. He joined Zelis through its acquisition of Rivet, the company he founded and led as CEO for more than eight years. Before Rivet, Ted held leadership and sales roles at Canopy, Instructure, and Qualtrics. His work has centered on building organizations, products, and customer-focused growth strategies, with a particular passion for making healthcare more efficient and easier to use for providers. He studied psychology and business management at Brigham Young University.  Things You’ll Learn: Healthcare payment transparency breaks down when contracts, claims, remittances, and analytics all live in disconnected systems. True transparency requires clean, normalized data delivered in real time within workflows, not just static reporting. Providers still face a major administrative burden because the old payment infrastructure often forces manual reconciliation and rework. Shared financial clarity can improve trust by reducing disputes, errors, delays, and unnecessary administrative effort for both providers and payers. Embedding payment intelligence at the point of transaction can help organizations move from passive visibility to more actionable decision-making.  Resources: Connect with and follow Ted Ferrin on LinkedIn. Follow Zelis on LinkedIn and visit their website. 

AI in healthcare is moving fast, but what does real, operational impact actually look like? In this episode, host Sandy Vance chats with Aditya Bansod, CTO and co-founder of Luma Health, and Michelle Winfield-Hanrahan, RN BSN MHA MSN about this very topic. They share how the University of Arkansas for Medical Sciences is scaling AI beyond the call center and into complex, high-friction workflows like fax processing and patient access. From backfilling missed appointments to transforming referral intake, this conversation dives into what it takes to build trust, move quickly, and turn AI into measurable results across an entire health system. In this episode, they talk about: How UAMS identified a high-impact, low-risk entry point for AI in call center workflows Turning after-hours cancellations into filled appointments and improved patient access Why trust in the partner matters just as much as trust in the technology Expanding from AI call handling to backend fax automation How AI is reducing referral lag time and improving data visibility The power of an EHR-first strategy and working inside existing workflows Avoiding “AI sprawl” and the challenge of managing too many point solutions Real talk on ROI: operational efficiency, revenue lift, and happier patients Why success builds momentum for scaling AI across departments Practical advice for health systems navigating the explosion of AI vendors A Little About Aditya and Michelle: Aditya Bansod is CTO and co-founder of Luma Health. With a lifelong passion for building software, Bansod leads Luma Health’s technical vision and strategic direction for building a Patient Success Platform that empowers healthcare providers to serve their patients better and improve healthcare outcomes. With over 15 years of experience as a product management leader developing mobile solutions at Adobe and Microsoft, and at venture-backed start-ups, Bansod made the transition from B2B software solutions to healthcare in 2015 to have a meaningful and measurable impact on how providers use mobile technologies to engage with and communicate with their patients.   Michelle Winfield-Hanrahan, RN BSN MHA MSN, is a seasoned healthcare clinical operations executive with over 20 years of experience in optimizing patient access, improving patient engagement, and streamlining clinical operations. Throughout her career, Michelle has demonstrated a strong ability to lead cross-functional teams and implement strategic initiatives that enhance the patient experience, increase operational efficiency, and drive sustainable growth. In her current role as Chief Clinical Access Officer and Associate Vice Chancellor of Access at the University of Arkansas for Medical Sciences, Michelle oversees patient access and flow from both the outpatient and inpatient setting, ensuring seamless patient flow and appointment scheduling, reducing wait times, and improving overall patient satisfaction. She has spearheaded innovative solutions that leverage technology to enhance patient communication and engagement, ensuring that patients remain informed, involved, and empowered throughout their healthcare journey. Michelle is dedicated to driving innovation in healthcare operations and is committed to making quality healthcare more accessible and efficient for all.

Healthcare is drowning in documentation and fragmented data, but what if the system worked for clinicians rather than against them? In this episode, Dr. Richa Gupta, Vice President of Care Transformation at Ambience Healthcare, explains how Ambience provides a layer of intelligence on top of electronic medical records to optimize clinician workflow and patient interactions. Ambience’s ambient listening system captures physician-patient interactions, supports documentation, and ensures accurate coding and billing, boosting clinician satisfaction and reducing revenue leakage. ROI is driven by high clinician utilization, validated outcomes, and measurable improvements in documentation burden, coding accuracy, and physician retention. In 2026, Ambience is expanding across the full care continuum, including ambulatory, emergency, and inpatient settings, offering a platform that surfaces real-time insights and enhances patient care. Tune in to hear how Ambience is transforming physician workflows and delivering real ROI across the care continuum.  About Dr. Richa Gupta: Dr. Richa Gupta, Vice President of Care Transformation at Ambience Healthcare. Dr. Gupta partners with hospital leaders to apply AI to the most complex clinical and operational challenges in health systems. She brings more than two decades of experience leading projects and teams at large academic medical centers. Things You’ll Learn: Ambience reduces documentation burden by using ambient listening and chart-aware intelligence. Clinician satisfaction drives ROI, with utilization rates reaching up to 80%. Accurate coding and diagnosis capture prevent revenue leakage and claim credit for physician work. Ambience can improve physician retention, even delaying retirements during labor shortages. In 2026, Ambience is expanding beyond ambulatory care to emergency and inpatient settings, providing insights across the patient journey. Resources: Connect with and follow Dr. Richa Gupta on LinkedIn. Follow Ambience Healthcare on LinkedIn and visit their website.

Healthcare technology should quietly remove friction and reduce burden so clinicians can focus on what matters most: caring for patients in a more human way. In this episode, Lisa Gulker, Chief Nursing Officer at Oracle Health and Life Sciences, discusses how Oracle is rethinking healthcare technology by building AI directly into the foundation of its systems rather than layering it on as an afterthought. She explains how this approach can help clinicians spend less time in the chart, reduce workflow fragmentation, and make technology feel more seamless in the care experience. Lisa also shares how Oracle is applying these capabilities across providers, life sciences, and payers, creating opportunities to accelerate research, improve clinical trial matching, streamline prior authorization, and reduce administrative burden across the ecosystem. Throughout the conversation, she brings a nurse leader’s perspective to a central question in healthcare innovation: how do we use technology to make care feel more human, not less? Tune in and learn how embedded AI could reshape the healthcare experience for clinicians, staff, researchers, payers, and patients alike.  About Lisa Gulker: Lisa Gulker is Chief Nursing Officer at Oracle Health, where she helps bring the voice of clinicians into product strategy, innovation, and healthcare transformation. With a background that spans nursing, informatics, analytics, and clinical operations, she has spent her career helping health systems use technology more effectively to improve care delivery and workforce engagement. Before becoming Chief Nursing Officer, Lisa served as Vice President of Product Management and Strategy at Oracle, and previously held senior leadership roles at Cerner, Tenet Healthcare, and Detroit Medical Center, where she focused on clinical transformation, data stewardship, and value realization. She works closely with executive leaders, data science teams, and engineering groups to align innovation with the realities of care delivery. Lisa holds a Doctor of Nursing Practice from Wayne State University and brings a strong blend of clinical, strategic, and operational expertise to healthcare innovation.  Things You’ll Learn: When AI is built into the foundation of healthcare technology, it can reduce the burden more effectively than tools simply bolted onto older systems.  Seamless technology should help clinicians focus more on patients and less on screens, documentation, and fragmented workflows. Life sciences organizations can use AI-enabled systems to accelerate research, improve access to studies, and surface insights more efficiently. Payers still rely on slow, labor-intensive administrative processes that AI could help streamline, especially in areas such as pre-authorization and referrals. Human-centered innovation depends on listening closely to end users and designing technology that reflects how clinicians actually work.  Resources: Connect with and follow Lisa Gulker on LinkedIn. Follow Oracle Health on LinkedIn and visit their website.

As digital change accelerates across healthcare, payors face an urgent need to modernize how they communicate, educate, and engage. The AI-Orchestrated Experiences portfolio from Adobe and IBM represents a new paradigm where data, design, and intelligence work seamlessly together to improve outcomes for every stakeholder. In this episode of the AI at Health series on The Beat Podcast, host Sandy Vance sits down with Melissa Geissler, Partner for Healthcare and Life Sciences Strategy and Transformation at IBM, and Ted Roman, Healthcare and Life Sciences Digital Strategy Principal at Adobe, to unpack one of the most exciting partnerships in healthcare AI right now. Together, IBM and Adobe are building AI-orchestrated experience solutions that help payers deliver personalized, seamless, and scalable member experiences without the white-glove price tag. From helping members find the right health plan to automating prior authorization and appointment booking, this episode is a must-listen for any payer, provider, or health tech leader who wants to understand where consumer experience in healthcare is headed next.  In this episode, they talk about: Healthcare is data-rich, but still behind every major retailer when it comes to personalized member experiences IBM and Adobe are combining platform capabilities, agentic AI, and change management into one integrated framework AI agents can now handle health plan selection, appointment booking, and benefits navigation for members Brokers serving small and mid-size employers are one of the most underserved audiences in healthcare technology The best AI strategy starts with defining the business problem first, then building the technology around it Social determinants of health data can now be integrated into personalized member recommendations Organizations that feel under-resourced are the ideal candidates for AI-orchestrated experiences The partnership is already live with clients and expanding into provider and life sciences use cases  A Little About Ted and Melissa: Ted Roman, PhD, brings over a decade of expertise in healthcare and life sciences research, management, technology, operations, and digital strategy to Adobe. He is a principal in the Digital Strategy Group, serving organizations globally pursuing more interconnected experiences. Prior to Adobe, Ted served the needs of Highmark Health and McKinsey & Company's clients. He holds a PhD in Computational Biology from the School of Computer Science at Carnegie Mellon University. He also earned bachelor's degrees in computer science and mathematics from Case Western Reserve University. Melissa Geissle is a Partner at IBM, leading Public Market activities, where she applies experience strategy and service design to solve complex innovation challenges and leads a diverse team of designers, researchers, analysts, and strategists to help organizations create meaningful stakeholder connections while improving market outcomes. Over two decades, she has partnered with healthcare, life sciences, government, and nonprofit organizations to define and execute digital health initiatives, applying data-driven insights and ecosystem platform capabilities to redefine strategic marketing, service, and digital engagement functions. Melissa holds a BA in Economics from Bates College and an MBA from Georgetown University's McDonough School of Business, and has participated in global corporate citizenship initiatives across the UK, South Africa, and Poland.