Natalie Davis, CEO of United States of Care joins to discuss the organization’s latest polling on healthcare affordability and what it reveals about voter sentiment heading into the next election cycle.

Drawing from research across more than 30,000 Americans, Natalie explains why affordability consistently emerges as the public’s top healthcare concern—not just because of medical bills, but because of the emotional stress, delayed care, and distrust the system creates. She walks through the policy solutions voters support most strongly, including prescription drug affordability, price transparency, site-neutral payments, and anti-competitive merger scrutiny.

The conversation also explores the growing erosion of trust in healthcare institutions and the broader public backlash against a system increasingly perceived as prioritizing profits over patients. Natalie discusses why affordability reform is gaining traction in conservative states, how fragmented incentives make systemic change difficult, and why many organizations no longer have the leverage to independently reduce costs even when they want to. They also touch on AI in healthcare, where patients are simultaneously optimistic and deeply skeptical, with transparency and trust emerging as the key factors shaping adoption.

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Bryan Roberts from Venrock joins to discuss Eli Lilly's acquisition of Kelonia, a gene therapy company Venrock seeded in 2020, for up to $7 billion.

Bryan walks through the original investment thesis: autologous ex vivo CAR-T therapy was producing remarkable efficacy in late-stage multiple myeloma, but everything else about the model was broken: six to seven week processing times, $220,000 cost of goods, and delivery restricted to academic medical centers. The bet was that Kelonia's in vivo platform, developed out of MIT and CNRS in France, could preserve the efficacy while eliminating the rest.

He describes the path to exit as anything but linear. The 2022 biotech financing freeze hit preclinical cell and gene therapy companies especially hard. Kelonia survived through pharma partnership deals with Astellas and J&J that funded operations without giving up the lead program, and by staying focused on getting to clinical data, which they achieved mid-2025.

The conversation closes with Bryan's honest read on the cell and gene therapy landscape: the $2M+ commercial launches have largely failed, the path forward is pricing in the $300-400K range, and the infrastructure required to deliver these therapies broadly is at least a decade away from where it needs to be.

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Eliana Berger, CEO and co-founder of Joyful Health, joins Kevin and Martin following the company's recent $17M Series A. Eliana walks through what she observed spending two years inside provider practices as a fractional CFO, the data fragmentation that sits underneath revenue cycle, and how she thinks about the distinction between AI services and AI agents in denials work.

Topics discussed:

• What Eliana found working inside practices as a fractional CFO, and why finance kept surfacing as the hair-on-fire problem
• Addressing revenue cycle's root problem: the lack of a financial source of truth across EHRs, billing systems, clearinghouses, payer portals, and bank accounts
• Why Joyful shifted from selling software to owning the outcome end-to-end
• The distinction between AI services and AI agents, and where rules-based automation works versus where expertise is required
• The mechanics of working a denial, including ERAs, vague denial codes like CO-16, and the cross-system "detective work" involved
• The payer-provider dynamic and how AI is showing up on both sides
• Joyful's system-agnostic go-to-market and four-to-eight week implementation timeline
• The longer-term vision of integrating from payer contracts through to the bank account

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