Insights and opportunities
Working analysis on healthcare strategy, payer economics, market access, AI and SaMD, MedTech commercialization, and policy, all sitting in the gap between what medicine can do and what the system will pay for. Longer, formal research lives on the research hub.
Price Is Choosing the Drug, Not the Evidence
At current Medicare pricing, four-pillar heart failure therapy nets $3,600 to $6,900 in savings per patient, yet prior authorization and copay design suppress it. Price, not evidence, is choosing the drug.
Cardiovascular & Imaging April 22, 2026Heart Failure and SGLT2 Inhibitors: Access Has Improved, Utilization Has Not
Access to SGLT2 inhibitors has improved, but heart failure utilization has not. Why the GDMT gap in 2026 is an identification, inertia, and accountability problem.
Cardiovascular & Imaging March 13, 2026New BCBS Analysis on AI-Powered Clinical Documentation: Upcoding Crisis or Long-Overdue Accuracy?
A BCBS analysis tied AI hospital coding to a 1.8% claims cost rise. The real issue is not upcoding, it is billing codes that cannot capture clinical reality.
AI & Digital HealthOutpatient POCUS and AI: Why It Has Not Scaled
Biosimilars and Patient Out-of-Pocket Costs: The Hidden Affordability Problem
Biosimilars lower net payer cost, but commercial benefit design can raise patient out-of-pocket costs, driving abandonment. Net price is not the same as patient price.
Market Access & Reimbursement January 22, 2026AI's Looming Path to Failure in Healthcare: As We Automate, We MUST Renovate
Healthcare's AI obsession ignores the real bottleneck, legacy infrastructure. A PESTLE analysis run through ChatGPT and Claude reaches the same conclusion.
AI & Digital Health January 19, 2026When Cost Savings Aren't Really Savings: The Hidden Economics of Non-Medical Switching in Ankylosing Spondylitis
Mandated non-medical switching from originator biologics to biosimilars in stable ankylosing spondylitis carries real clinical risk and often erases the projected savings.
Market Access & ReimbursementCapital Sales: MedTech's Business Model and Growth Problem
- Part 1 of 4Part 1 | Capital Sales: MedTech's Business Model and Growth Problem
- Part 2 of 4Part 2 | Capital Sales: MedTech's Business Model and Growth Problem
- Part 3 of 4Part 3 | Capital Sales: MedTech's Business Model and Growth Problem
- Part 4 of 4Part 4 | Capital Sales: MedTech's Business Model and Growth Problem
Modernizing Eosinophilic Esophagitis Care: When Evidence Meets Real-World Feasibility
EoE evidence is strong, but the care model is not always feasible. A hybrid approach pairs noninvasive monitoring and targeted elimination with guideline rigor.
Quality & Value-Based Care December 9, 2025The Hidden Cost of "That's How We've Always Done It": Warfarin Edition
A 1960s dosing schedule still governs inpatient warfarin. Aligning administration and INR draws to modern lab capability can improve safety and cut length of stay.
Quality & Value-Based Care November 7, 2025The (Respectfully) Roasted Erik Abel, Healthcare Edition
I asked ChatGPT to roast me. What the joke got right about purpose, value-based care, and why the whiteboards and late-night ideas keep coming.
Perspective September 10, 2025GLP-1 ROI Starts With Stage B Heart Failure
GLP-1 and SGLT2i spend only pays off when you first find the 1 in 4 employees with silent Stage B heart failure. A prevention-first coverage strategy for employers.
Cardiovascular & Imaging July 8, 2025The AI Leadership Credibility Gap: When Fear Poses as Governance
Blanket bans on AI recording and transcription tools signal fear, not governance. Closing the gap between what leaders say about AI and what they allow internally.
AI & Digital Health May 2, 2025Healthcare Needs Solutions, Not More Products
Healthcare's pipeline is not short on products. It is short on purpose. Why solution building, not feature wars, wins the next decade of medtech and digital health.
MedTech & Commercialization January 30, 2025Evolving the RVU Model: A Technology Adoption RVU
A proposal to modernize physician reimbursement with a Technology Adoption RVU, so the payment model recognizes and rewards the adoption of AI and digital health tools.
Market Access & Reimbursement January 2, 2025The Hidden Costs of 'Free' Preventive Care: When Coding Meets Patient Reality
A fully covered screening colonoscopy became a $1,500 bill. How medical coding, unbundling, and misaligned incentives undermine the ACA's promise of free preventive care.
Market Access & ReimbursementWorking on something in the gap?
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