The U.S. spends $280 billion annually on healthcare billing! It's an irrationally complex and outdated system in which most claims are adjudicated manually, resulting in massive inefficiencies and bogus claim rejections. Why is it so broken? How do we fix it? And what would healthcare look like if it functioned properly?
That's what I discuss with Nick Perry and Doug Proctor, co-founder & CEO and COO of Candid Health, respectively. Two talented Palantir alumni, Nick and Doug represent a trend I'm watching closely: leading technologists with a top culture, the right software, and new breakthroughs in machine learning taking on the most broken areas of our economy.
In this episode, they explain the origins of Candid and how they first learned the billing process by hand in order to build the information architecture necessary to process myriad types of claims with extremely low denial rates. At scale, Nick & Doug envision Candid as Stripe or Shopify for healthcare: the infrastructure layer that automates revenue cycle management and dramatically lowers the barrier to entry for new healthcare startups. And if we ever want the U.S. to move from its broken fee-for-service model to value-based care, we'll need platforms like Candid to enable that shift — another reason I'm bullish on Candid and the leaders behind it.
Ep 73: How Candid Health Is Fixing the $280B Healthcare Billing Fiasco, With Lessons from Palantir