Why Healthcare Costs Keep Rising

Send us a textThe digital front door to healthcare is jammed, and it’s costing patients, providers, and payers alike.In this episode of CareTalk Executive Features, host David Williams talks with Dr. Ashish Mandavia, CEO and cofounder of Sohar Health, about how AI and automation can transform eligibility and benefits verification from a frustrating bottleneck into a seamless, real-time process. 🎙️⚕️ABOUT DR. ASHISH MANDAVIADr. Ashish Mandavia is the Co-Founder and CEO of Sohar Health, an AI-powered platform transforming front-end revenue cycle management (RCM) for digital health providers. In his role, Dr. Mandavia is responsible for setting the company’s strategic vision, overseeing execution across products, operations, and partnerships, and ensuring Sohar’s solutions address critical gaps in healthcare administration. With a strong background as a practicing psychiatrist and health tech executive, he leads Sohar’s mission to simplify the insurance verification process, an often-overlooked source of friction for patients and providers.Under his leadership, Sohar Health has developed a proprietary API-based system that delivers real-time insurance eligibility and benefits data with 99% accuracy and sub-30-second processing speeds. This makes the patient intake process almost instant, when it used to take hours or days to complete manually. Dr. Mandavia is deeply involved in client success, innovation, and thought leadership, frequently representing the company at industry summits and guiding its efforts to support digital-first care delivery models. His responsibilities also include talent development and investor engagement, particularly as Sohar scales its partnerships with major behavioral health providers like ZocDoc, Talkiatry, Rula, Cerebral, and UpLift.Dr. Mandavia’s vision centers on building a smarter, more transparent “digital front door” to healthcare, starting with benefits verification. He believes the patient journey begins with financial clarity and uses AI to eliminate administrative burdens so providers can focus on delivering quality care. Through Sohar, he is pioneering how automation can improve access, reduce denials, and enable more sustainable behavioral health operations.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textMedicaid covers nearly 90 million Americans, but coverage doesn’t always equal health.What if the real driver of outcomes isn’t the doctor’s office or an app, but the communityitself?In this episode of CareTalk Executive Features, WiderCircle co-founder and CEO Darin Buxbaum joins David Williams to share how peer-led circles and community engagement are improving health outcomes, boosting member trust, and delivering value for health plans.🎙️⚕️ABOUT DARIN BUXBAUMDarin Buxbaum is the co-founder and CEO of Wider Circle. Previously, he was Co-founder and Vice President of Product at Oration, an insurance tech company, enabling self-insured employers major reductions in prescription drug spending. He also founded HourGlass Technologies, where he served as president and CEO for more than 5 years, and also drove the development of a new medical-device technology.He was recognized as one of the Top 40 Innovators Under 40 in the Medical Device and Diagnostic Industry. Darin graduated Summa Cum Laude from Duke University and earned an MBA from Stanford University. Darin remains active with Stanford as a contributor and mentor to the BioDesign course and textbook.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy.GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textEvery 90 minutes, someone in the U.S. is diagnosed with ALS — a devastating disease that has long resisted conventional research and treatment efforts.In this episode of Caretalk, Tris Dyson, Founder and Managing Director of Challenge Works, joins host John Driscoll to discuss how prize-based innovation and crowdsourcing could unlock new breakthroughs. Dyson shares his personal journey, why shifting incentives matters, and how bold new models can spark hope for ALS patients and families worldwide.🎙️⚕️ABOUT TRIS DYSONTris has led Challenge Works from its origins as a Nesta experiment to being a global hub for expertise and insight on challenge prizes. His aim is to deliver challenge prizes that inspire and enable the development of high impact innovations  Before joining Nesta, Tris co-founded and led the social enterprise Tempo and was included in the first cohort of the Observer’s New Radicals. Tris has also run a Welsh university think tank, founded a social sector consultancy and was a Teach First Geography teacher complete with corduroy jacket.In 2012 Tris was included on the Independent on Sunday’s ‘Happy List’ the alternative to the Sunday Times Rich List. Tris would rather be on the other list.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textHealthcare sits on mountains of valuable data, but compliance bottlenecks prevent organizations from unlocking its potential.In this Executive Feature episode of Caretalk, Shubh Sinha, CEO and co-founder of Integral, explains how his company is changing that by treating data infrastructure and compliance as one unified system rather than separate processes.🎙️⚕️ABOUT SHUBH SINHAShubh Sinha is CEO and Co-founder of Integral Privacy Technologies, where he's reimagining enterprise data infrastructure by unifying what was traditionally fragmented - the data stack and compliance stack. Under his leadership, Integral has pioneered a platform that certifies, transforms, and activates privacy-regulated data in hours—not months. This transparency-first philosophy has earned trust from top 5 pharma companies and Fortune 500 leaders who now process sensitive data at speeds that weren't possible before. Previously, Shubh led product management for LiveRamp's regulated data analysis, served as an angel investor in AI and health SaaS, and is a Forbes Technology Council member. At Integral, he champions the belief that intelligent software can conjoin what humans traditionally couldn't - making privacy-compliant innovation actually achievable at enterprise scale.Integral Privacy Technologies is reimagining enterprise data infrastructure. We've unified what was traditionally fragmented - the data stack and compliance stack - into a single, intelligent platform. While others build compliance tools, we're building compliant-first data infrastructure that processes sensitive healthcare and consumer data at speeds that weren't possible before. Our AI-powered privacy engine doesn't just check boxes; it understands your specific use cases, data types, and regulatory environment to make smarter compliance decisions automatically. Fortune 500 leaders trust us because we deliver wild performance gains: 10x faster media log processing, dramatically reduced time-to-insight for HEOR use cases, and seamless unstructured data harmonization.See your data's privacy transformation before committing a dollar on data with our Remediation Preview at www.useintegral.com🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textHave you ever had your health plan deny a treatment that your doctor says you need? Well, you're not alone. But there's good news: People who appeal insurance denials often win. In this episode of CareTalk Podcast: Healthcare. Unfiltered., hosts John Driscoll and David E. Williams dig into the history of prior authorization, why denials are so common, and what patients can do to fight back.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textAccess to healthcare in the U.S. is broken, with millions forced to choose between essential needs and seeing a doctor. Traditional clinics are too costly to scale, and telemedicine has hit adoption limits. In this episode of CareTalk, John Driscoll sits down with Karthik Ganesh, CEO of OnMed, to discuss how OnMed’s “clinic in a box” is expanding access to care. Ganesh shares his journey across healthcare, why access has always been his passion, and how OnMed’s innovative care stations blend the trust of in-person visits with the scalability of telemedicine to address one of the nation’s most pressing healthcare challenges.🎙️⚕️ABOUT KARTHIK GANESHKarthik is drawn toward companies that want to challenge the status quo. With a focus on tech-enabled healthcare services, he's built and transformed companies, delivered market-leading results, created significant enterprise and investor value, developed high-performing teams, and driven meaningful M&A transactions with strategic investors and private equity.He's had the privilege of touching our healthcare ecosystem from most angles including payers (Aetna, Cigna), PBMs (EmpiRx Health, Express Scripts), provider-sponsored plans + ACOs + value-based care (QualCare, CareAllies), consulting (EY, Deloitte)...and now OnMed.Making healthcare more accessible is a hugely important purpose that drew Karthik to OnMed. He is the CEO of OnMed, a tech-enabled hybrid care company that is partnering with public and private organizations to reimagine healthcare access in underserved communities across America. OnMed was the top pick at CES 2025 and is a 2025 Inc. 5000 company.A prolific writer and speaker on healthcare, leadership, and resilience, Karthik has been featured in leading industry journals and podcasts. He is also the author of The Happiness Model: A Roadmap to Inner Peace.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textHealthcare spending continues to surge, with pharmacy costs now representing 30-40% of total healthcare spend.   In this episode of CareTalk Executive Features, David Williams speaks with Dr. Alan Pannier, SVP of Product Strategy at SmithRx, about how legacy PBMs’ misaligned incentives drive up costs, the toll on patients, employers, and independent pharmacies, and how a modern PBM model focused on transparency, fair reimbursement, and aligned incentives could finally fix what’s broken in pharmacy benefits.🎙️⚕️ABOUT DR. ALAN PANNIERAlan Pannier, Pharm D,MBA has extensive experience in the pharmaceutical industry, with a background in managed care pharmacy. Alan has held various leadership positions at companies such as SmithRx, Magellan Health, and Veridicus Health. Alan completed their Doctorate of Pharmacy and Master of Business Administration at Idaho State University, following a Bachelor of Science in Chemistry at Westminster University.🎙️⚕️ ABOUT SMITHRXSmithRx is a modern PBM dedicated to reducing the cost and complexity of pharmacy benefits. They empower organizations of all sizes to take control of their pharmacy spend with a radically transparent, universal pass-through model, innovative cost-saving programs, and intuitive technology. Unlike legacy PBMs, SmithRX eliminates hidden fees, pass through 100% of rebates and discounts, and provide their clients with real-time prescription pricing and detailed savings reports. This gives them the insights they need to make informed decisions and achieve meaningful savings for both their business and their employees.To learn more about how SmithRx is inventing a new kind of PBM, tune into Alan Pannier’s new Youtube series. Subscribe and keep an eye out for more installments, coming soon.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textForget about the price of eggs. It’s healthcare costs that are rising fast. Double digit increases are coming for 2026 and cost sharing is rising for employees. Weight loss drugs like Ozempic are adding billions to the bill and AI is a wild card, which could bring costs down or make them rise even faster.  In this episode, David E. Williams and John Driscoll unpack what’s driving the rising cost of healthcare and what it means for the future.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textClinical trials are the backbone of medical progress, but they've become increasingly complex, costly, and slow. Can technology smooth the process without compromising rigor?Scott Chetham, Founder and CEO of Faro Health and former clinical operations leader at Verily, explains why outdated processes bog down research and how Faro’s digital trial platform is making studies faster, more efficient, and more patient-friendly. By transforming static documents into connected, intelligent systems, Faro helps sponsors and regulators streamline design, reduce amendments, and improve trial outcomes.🎙️⚕️ABOUT SCOTT CHETHAMCommitted, strongly clinical and technical research executive with proven experience in developing innovative solutions to complex medical problems.Experience spanning private startups, hospitals, university research labs, venture capital and patient advocacy groups.Established strength in forging partnerships between leading academic medical centers, community clinics, advocacy groups and government organizations to solve complex clinical syndromes. Strong technical skills in large complex data sets, electromagnetics and human disease.🎙️⚕️ABOUT HEALTH BIZ PODCASTHealthBiz is a CareTalk podcast that delivers in-depth interviews on healthcare business, technology, and policy with entrepreneurs and CEOs. Host David E. Williams — president of the healthcare strategy consulting boutique Health Business Group — is also a board member, investor in private healthcare companies, and author of the Health Business Blog. Known for his strategic insights and sharp humor, David offers a refreshing break from the usual healthcare industry BS.GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.

Send us a textAccess to mental health care remains out of reach for millions, especially in rural communities. In this episode of Caretalk, John Driscoll speaks with Dr. Tom Milam, Chief Medical Officer of Iris Telehealth, about breaking down barriers through telehealth, tackling stigma, and the promise of technology and AI in expanding timely, compassionate mental health support.🎙️⚕️ABOUT DR. TOM MILAMDr. Tom Milam manages our team of clinicians and guides them in telemedicine and industry best practices. He received his undergraduate degree from WVU in Anthropology, graduating summa cum laude, and received his M.D. from the University of Virginia. His residency training in psychiatry took place at Duke and UVA. Dr. Milam has served in a leadership role throughout his psychiatric career and spearheaded the telepsychiatry initiative at his previous hospital. Dr. Milam is also an ordained Episcopalian priest and got his Master of Divinity Degree from Yale. He is a fan of various sports and traveling with his wife and four children. In his free time, he enjoys DIY projects, “honey-do” lists, and driving his convertible sports car.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHFollow CareTalk on LinkedInBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsletterSupport the show⚙️CareTalk: Healthcare. Unfiltered. is produced by Grippi Media Digital Marketing Consulting.