Empara President Markus Waite Discusses Healthcare Innovations on Startup Hustle Podcast
The healthcare industry faces unique challenges when it comes to reducing costs and improving system efficiency. On a recent episode of Startup Hustle, host Matt Watson invited Markus Waite, President of Empara, to discuss how emergent technologies can address these challenges. The conversation highlighted the challenges and inefficiencies within the U.S. healthcare system, the high cost of healthcare in the United States, and how generative AI helps consumers navigate the complex world of healthcare. Below are some highlights.
Listen to the full episode on Apple Podcasts, Spotify, or wherever else you listen to podcasts.
On the complexity of healthcare systems:
Waite, with over three decades of experience in healthcare technology, explained that despite advances in technology, core healthcare processes, such as claims processing, have changed little over the years. He noted, “I can't say healthcare has changed that much…the processing and the business rules and how you process the claim and price the claim, a lot of that stuff really hasn't changed too much since I got my start."
On the use of generative AI in healthcare
Waite shared insights into how Empara uses generative AI to simplify healthcare for consumers. "You open up your plan documents, and they almost look like a legal contract. Using generative AI, we can ingest complex plan documents and provide a highly curated response," Waite explained, adding that this allows patients to make informed decisions without facing unexpected medical bills. "For example, ‘I broke my knee. I need to go to urgent care. How much is this going to cost me?’ We bring back a nice, curated response to help members navigate the system so they can avoid some of the landmines that may result in a nice big bill at the end of the day.” However, Waite also emphasized that generative AI is only used for operational efficiencies: "We do not use any generative AI for clinical type recommendations."
On the cost of healthcare in the U.S.
Watson opened the conversation on healthcare costs by stating, “Every business in America, and really every person in America is at a huge disadvantage at this point simply because of the cost of health insurance… Health insurance is just crazy, crazy expensive.”
Waite agreed, saying, “Healthcare is just so complicated. There’s so many layers… we need to bring strategies that help employees and individuals understand their benefits, engage with the system, and ultimately drive down costs.”
On Goodroot’s innovation in healthcare solutions
Waite also explained how Goodroot incubates new ideas to solve healthcare problems. "We bring these companies in, empower them, and amplify them through the Goodroot team," he said. One of his favorite innovations comes from Breez, another Goodroot company that helps patients access hospital financial assistance, a program most people are unaware of despite the fact that nonprofit hospitals are required to offer it.
Waite concluded the episode by urging listeners to educate themselves about their healthcare benefits, as well as highlighting the importance of technology in reducing medical debt and healthcare costs: “People need to better understand their benefits to avoid medical debt, and technology can help with that. Healthcare is highly complicated, but with the right tools and platforms, we can simplify the process and empower individuals to make informed decisions. The system needs to change, and technology is key to driving that change.”