Clinical
Recognition
PharmD and cardiothoracic critical care. I know what medicine can now identify, and why it matters earlier than the system acts on it.
Erik Abel, PharmD, MBA
Medicine keeps learning to see more. The system that pays for it cannot recognize most of it.
I work in that gap. Clinical science advances faster than the coding, payment, and delivery infrastructure meant to represent it. Guidelines move and vocabularies do not. Capability exists and reimbursement infrastructure does not. Contracts change upstream and the incentive never reaches the point of care.
Two decades on multiple sides of that gap, as a clinician, inside a health plan, and as the executive who built the operating model that carried an AI-guided diagnostic service to national scale and an acquisition.
20+
Years across provider, payer, and MedTech
44
States reached, scaled from 11 in two years
5.6M
Members in the payer enterprise transformed
1
Series B exit, Caption Health to GE HealthCare
The recognition gap
A 2022 guideline redefined Stage B heart failure and asked clinicians to catch structural disease before decompensation. The vocabulary they document it in still traces to 2013. The at-risk patient maps to no risk weight, and the codes that do carry weight assert a heart failure the patient does not yet have.
That pattern repeats everywhere once you know to look for it. It is why value contracts stall before reaching a physician, why cleared products never reach a patient, and why an entire sector can adopt care pathway language without building the coordination that language implies.
The system cannot pay for what it cannot recognize. Naming that gap is the easy half. Creating the path to close it is what I bring.
Three things, usually held by three different people
The seams between them are where most healthcare strategy fails.
Commercial
System fluency
Utilization management, coverage policy, and payer economics inside a plan covering millions. I know what the payment layer can actually represent, and why it says no.
Product
Built correction
An MSO-PC operating model that turned a cleared device into a commercially offered clinical service, scaled nationally, carried through an acquisition.
Recognized across the healthcare innovation ecosystem
Digital Medicine SocietyIntegrated Evidence Plan contributor
HLTH FoundationTechquity case study author
University of Pittsburgh Health and AI ConferenceFireside chat, 2026
Northwestern Querrey InQubation LabCommercialization advisor and guest lecturer
LifeXSubject matter expert
WVU School of Pharmacy Hall of Fame2024 inductee
Where the thinking gets pressure-tested
A growing body of independent analysis, written for operators and investors who need the picture rather than the slogan. Three clusters carry most of it.
Imaging and diagnostics
Why the outpatient imaging floor was never built, why vendors cannot orchestrate a pathway they were not designed to coordinate, and who actually owns delivery.
Explore →Cardiovascular and coding
Risk scores clinicians can compute and payers cannot adjudicate. Pre-heart-failure patients the code set cannot represent. Guideline science outrunning claims infrastructure.
Explore →Payer mechanics and access
Prior authorization transparency, health plans as complex adaptive systems, biosimilar total cost, and where value contracts stop reaching the clinician.
Explore →Speaking and media
Keynotes, executive briefings, webinars, and accelerator sessions for clinicians, health plans, ACOs, investors, and founders. Recent work covers heart failure detection, AI in clinical workflow, and the payer economics that decide whether any of it reaches a patient.
Advisory work
Client engagements run through OneAnother Health, an independent advisory practice serving MedTech, digital health, biopharma, and value-based care organizations on reimbursement strategy, evidence architecture, and commercialization.
This site is where the thinking lives. That one is where the work gets scoped.
Common questions
Who is Erik Abel?
Erik Abel, PharmD, MBA, is a healthcare transformation executive and the founder of OneAnother Health, LLC, a strategic advisory practice in Pittsburgh, Pennsylvania. He works across clinical, commercial, and product strategy, and his most significant proof point is architecting the strategy behind Caption Health's acquisition by GE HealthCare.
What does Erik Abel do?
He advises MedTech, digital health, biopharma, and value-based care organizations on market access, reimbursement, evidence strategy, and commercialization. His differentiator is running clinical, commercial, and product strategy at the same time, which is where coverage, adoption, and revenue are actually decided.
How is erikabel.org different from OneAnother Health?
erikabel.org is Erik's personal platform for independent writing, research, and frameworks published under his own name. OneAnother Health, at oneanother.health, is the advisory practice where engagements are scoped. The two are kept separate so the analysis stays independent of the commercial work.
What is Erik Abel's background?
Erik is a clinician-executive with more than two decades across payer, provider, MedTech, and digital health. He served as Vice President of Clinical Strategy and Innovation at Caption Health and then GE HealthCare, Director of Clinical Transformation at Highmark Health, and Clinical Transformation Officer at The Ohio State University Wexner Medical Center. He holds a PharmD from West Virginia University and an MBA from The Ohio State University.
Working on something in the gap?
I take a small number of advisory engagements, board seats, and speaking invitations each year.
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