Himanshu Jain

Insourcing PI with AMS: two engines, one platform, compounding savings. 1) PredictPi - PI nanoscripts plus governance (platform savings): • $70+ PMPY incremental savings directly attributed to AMS software • $400M+ verified annual savings at scale (anonymized national TPA/ASO) • ~90% faster flag → decision; 30-40% higher audit precision • 250+ users unified across PI/SIU/Claims with transparent, rules-based evidence 2) AI-Bill - automated Itemized Bill review (IBR) savings: • Micro-sprint result: ~$7.1M identified in ~12–12.5 hours • >$9.4K–$9.8K per minute in savings; >$0.57M–$0.59M per hour • >11,000× ROI on labor (at ~$50/hr), yes, empirical data and metrics make this attainable. Together (additive impact with one Health Affordability Platform): • PredictPi’s continuous surveillance + nanoscripts deliver broad, recurring PMPY lift across lines of business. • AI-Bill’s high-throughput IBR adds concentrated, rapid savings bursts, without adding headcount. • Subscription model democratizes PI (predictable TCO, aligned with prevention and fiduciary governance) while keeping contingency only for niche retros/capacity spikes. Why it works: • Aligned incentives: prevention + unit-cost reduction, not just recoveries. • Capability transfer: tools + reference directories + nanoscripts move IP in-house. • Operating discipline: governance layer, evidence packs, provider-ready documentation, and enterprise-wide queueing for 200–300 users. The punchline: • Platform (PredictPi): $70+ PMPY; $400M+ verified annually; speed and precision gains. • IBR (AI-Bill): $7.1M in hours; >11,000× labor ROI. • Model: subscription pricing that lowers total cost, scales savings, and strengthens fiduciary posture. Call to action: If you want to insource PI, cut TCO, and run a continuous prevention engine-with rapid IBR savings on top—let’s connect. Summary – You Will Want to Save This Post PredictPi drives recurring PMPY + governance at scale; AI-Bill adds rapid IBR wins. One subscription platform; additive savings; stronger fiduciary confidence. Amspredict.com Pricetransparency.com #PaymentIntegrity #PriceTransparency #ERISA #HealthcareAnalytics #Claims #SIU #TPA #SelfFunded #Automation #Affordability #FiduciaryRisk

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Part 1 of Deloitte’s two-part series shows how agentic AI improves workflows and margins in medtech. I like this discussion in the broader debate on the significance and weight of how AI is reshaping our economies. The discussion highlights how AI agents are evolving from simple tools to digital team members—streamlining HR, supply chain, and R&D processes while unlocking cost savings and productivity gains. Early adopters like Medtronic and Siemens are already demonstrating measurable impact through AI-enabled workflows and digital asset management. This reflects the broader trend—AI is moving beyond isolated use cases toward enterprise-wide operational transformation in companies large and not-so-large.

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Closing 2025 with Perspective, Purpose & Possibility This year has been a powerful reminder that transformation leadership is about orchestrating change with clarity and courage. The pace of innovation continues to accelerate, with technologies like Generative AI, Agentic and intelligent systems reshaping how we deliver value, especially in healthcare and life sciences where outcomes matter most. From my vantage point, several themes have crystallized this year: Strategic Intent Matters Most Innovation must be anchored in clear outcomes. AI, automation, and next-gen technologies unlock value when tied to business goals and patient-centric results. Leadership as a Force Multiplier True transformation happens when leaders empower teams to adapt, learn, and innovate together, fostering an environment where people feel supported to lead and grow. Responsible, Scalable AI Adoption In healthcare, where trust is essential, governance, transparency, and ethical use of AI are foundational to meaningful adoption and impact. Healthcare’s Data Advantage Digital platforms and advanced analytics are enabling us to accelerate insights and improve care decisions, from predictive population health to integrated, data-led care pathways. Importantly, at @QuestDiagnostics, we are actively embracing these themes, helping transform capabilities, strengthen outcomes, and support the broader mission of advancing care. This is compellingly real in precision oncology. Innovations like Haystack MRD™ from @QuestDiagnostics are helping transform cancer care by enabling earlier, more confident clinical decisions through highly sensitive ctDNA detection. It’s a powerful example of technology directly supporting better patient outcomes. I’m proud to be aligned with a vision that champions innovation and operational excellence. A heartfelt thank you to my incredible team, your resilience and dedication are the foundation of everything we achieve. To my colleagues, partners, and broader network, thank you for the collaboration and inspiration.  Here’s to a new year of meaningful impact, resilient leadership, and opportunity realized. Happy New Year All!! #DigitalTransformation #Leadership #HealthcareInnovation #AI #GenAI #LifeSciences #PrecisionMedicine #Oncology #HaystackMRD #QuestDiagnostics #HealthcareIT #FutureOfHealth #InnovationLeadership #AIInHealthcare

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Definitely worth a read for any organization considering an Enterprise Imaging strategy: Frost & Sullivan shows how cloud-ready EI simplifies complexity and boosts performance across growing health systems. 👉 https://okt.to/IGv6lC

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A 4.7% net margin versus 1.8%. That's the financial gap between healthcare organizations with excellent patient experience ratings and those with low ones — tracked across seven years by Deloitte. VBC reimbursement bonuses. Avoided readmission penalties. Patients who stay rather than switch. All of it flows from one upstream decision: is your organization built to build trust, or just to process transactions faster? That's the strategy. Watch the full breakdown below. 🎥

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From a patient perspective, some of the most impactful innovations are simple. For example, since joining KP as a member, one of things that "wowed me" was the ability to self-schedule appointments. No need to call a telephone number and wait on hold just to schedule an appointment. While this is tremendously convenient, the primary risk of self-scheduling is missing acute conditions that require an immediate response. While healthcare orgs will include a disclaimer to call 911; it puts the onus on patients. I wanted to highlight this innovative program from the SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP who developed and deployed (at a scale) a technology-enabled service that allows patients to seek the right care at the right time. The online workflow is as follows: 1) A patient who wants to schedule an appointment is directed to enter their reason for visit 2) this is interpreted by the "Clinical Alert System" to detect high-acuity conditions (e.g., chest pain or abdominal pain) that also integrates pt clinical data to provide a customized assessment. 3) This prompts specific clarifying questions and when appropriate, a recommendation is made to contact a human agent for clinical escalation, rather than schedule an appointment. 4) For those with a low-acuity concern; the "Care Navigation System" guides the pt to the appropriate next step - scheduling an appt, conducting an asynchronous visit (e.g. "e-visit) or triage to another non-visit modality (e.g., referral to pharmacy system for med refill). This ensures that high-acuity pts are flagged and quickly escalated (rather than scheduling an appt in the future); and other pts are routed to the right care method to resolve their complaint. See a comprehensive write-up published in NPJ Digital Medicine. https://lnkd.in/gk7KUujq Kudos to the team that developed, tested, deployed and continue to manage this program. Demonstrates, yet again, KP's ability to deploy AI systems responsibly and at scale. Dinh Nguyen, MD, MSHI, Khang Nguyen, Sinjin L.

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Exciting news from WellSpan Health and General Catalyst as they expand their technology partnership via HATCo (via new transformation as a service offering). The collaboration aims to leverage automation and #AI technologies in three key areas: 1. Enhancing revenue cycle and business functions for "financial sustainability" 2. Streamlining workforce automation to address administrative tasks 3. Improving personalized and proactive care delivery through data analytics, AI, and digital health innovations Portfolio companies like Hippocratic AI, Commure, and Aidoc will be instrumental in driving these advancements. #HealthTech #Innovation https://lnkd.in/gRMNyzn5

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As global and adaptive clinical trials become increasingly complex, life sciences organizations are turning to intelligent RTSM platforms to enhance efficiency, maintain compliance, and protect patient integrity. Modern RTSM systems have evolved from traditional IVR/IWRS models to cloud-based, AI-enabled solutions that integrate automation, analytics, and predictive forecasting enabling real-time visibility, faster study deployment, and improved accuracy. Everest Group’s latest Life Sciences Randomization and Trial Supply Management (#RTSM) Products PEAK Matrix® Assessment 2025 evaluates 20 leading RTSM providers, benchmarking them on market impact, vision, and capabilities. 4G Clinical, Almac Group, Atreo.io, Clinion, Cloudbyz, CRScube Inc., Endpoint Clinical, IQVIA, JNPMEDI, KORIO, Medidata Solutions, Zelta by Merative, Octalsoft LLC, Oracle, Perceptive Inc., Signant Health, SyMetric, Suvoda, Veeva Systems, YPrime The assessment helps buyers identify the right partners for their randomization and clinical supply management needs and enables providers to benchmark their maturity and innovation against peers. Read on: https://okt.to/QetdDv Get in touch: Manu Aggarwal, Chunky Satija, Nisarg Shah, Kavya Sai Murki #EverestGroup #LifeSciences #ClinicalTrials #RTSM #Pharma #HealthcareInnovation #PEAKMatrix #DigitalTransformation #ClinicalResearch #Automation #AIinLifeSciences

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