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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Amanda Rees, CEO and Co-Founder of Bold, joins to discuss Bold's AI-powered healthy aging platform and how CMMI ACCESS fits into a model the company has already been building in Medicare Advantage.

Bold started with falls prevention and has expanded into chronic condition support, weight management, and musculoskeletal pain — delivered digitally and without requiring additional devices. The conversation covers how Bold thinks about behavior change, and why the platform is designed around member agency rather than clinical control.

The bulk of the discussion focuses on ACCESS. Amanda notes that hundreds of thousands of original Medicare members have expressed interest in Bold and been turned away — there was no payment pathway. ACCESS creates one. It also removes the provider referral requirement, which unlocks a channel Bold has been building toward with ACOs and provider groups who already advocate for exercise but couldn't realistically refer original Medicare members into the program.

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Patrick Keavy and Rebecca Springer from Bailey & Company join following the Medicarians conference and the release of their MA brokerage market report.

Patrick walks through how the 606 accounting change in 2019 reshaped the MA brokerage market by requiring brokers to recognize lifetime commission value upfront. Combined with rapid MA enrollment growth, this inflated EBITDA in ways that didn't reflect actual cash economics — drawing significant PE investment and driving a valuation bubble that eventually collapsed as carriers pulled back commissions and decommissioned plans.

Rebecca covers what the market looks like today: a tough AEP, significant churn, and carriers becoming increasingly selective about their broker relationships. The brokers that navigated this period successfully did so by focusing on long-term member retention over volume, generating their own leads, and engaging members throughout the policy lifecycle rather than at enrollment alone.

Looking ahead, Patrick and Rebecca describe a market moving toward product diversification, technology investment, and a fundamentally different value proposition — brokers as trusted, long-term partners for both carriers and members rather than high-volume enrollment engines. Rebecca flags one important gap: brokers are doing this value-add work, but nobody has figured out how to quantify it systematically for carriers yet.

Access the report here: https://bnco.com/insights/medicare-advantage-brokerage/

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Neil Batlivala, CEO and Founder of Pair Team, joins to discuss how Pair Team provides AI-powered care management for safety net populations, addressing social needs alongside clinical care through a virtual medical group model and partnerships with social care providers.

The conversation centers on how Pair Team is thinking about CMMI ACCESS. Neil describes the rates as a feature, not a bug; CMS designed them to push participants to build sustainable, technology-driven models from the ground up. He discusses the role of AI in making
mapping task automation over time, what that means for unit economics, and why channel partnerships with ACOs and PCPs are the right path to patient acquisition in this model.

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Alli Oakes, Chief Research Officer at Trilliant Health, walks through Trilliant's behavioral health report across demand, supply, and emerging treatments.

On demand, roughly one in four Americans is affected by a mental or behavioral health condition, and untreated costs extend well beyond direct care — unmanaged behavioral health issues exacerbate physical conditions and drive expensive downstream utilization including ED visits.

On supply, the picture is more nuanced than a simple shortage story. Psychiatry residency slots have grown 55% since 2018 and fill at 99%, suggesting insufficient positions rather than insufficient interest. Meanwhile, allied health providers and primary care physicians now prescribe two thirds of all behavioral health medications, reflecting how a non-specialized workforce is flexing into the gap.

The conversation also covers AI in behavioral health — where Alli draws a clear line between administrative use cases and the much harder clinical question — and a counterintuitive finding that D2C behavioral health care is on average more expensive for patients than traditional in-network care. Emerging treatments including TMS, psilocybin, and MDMA round out the discussion, where early signals from the Trump administration suggest growing appetite for research and regulatory flexibility.

Read the report here: https://www.trillianthealth.com/market-research/reports/2026-behavioral-health-report

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