Why AI Healthcare Startups Still Can’t Get Paid

Added: 2026-05-15

[00:00:06]Yeah, what do you think is the um the long-term solution here? Do you think it's just going to be like the tech will end up helping the available people perform better and we we may not need more nurses. What do you What do you think the situation might be there?

[00:00:19]Well, they say that, right? Like so since AI's first started coming to market, there's a couple of evolutions I've seen. So, the first kind of round of evolutions I remember being at a thing in in Montana with payers. So, Aetna, Blue Cross Blue Shield, all of these major payers.

[00:00:36]And uh it was it was kind of a different different companies pitching to healthcare payers their product and it was at the very beginning where where payers started to add on products to their policies to reduce their costs.

[00:00:50]So, like tele-mental health, for example, is a good example of a product that reduces a healthcare payer's costs.

[00:00:57]Um so, it was kind of a pitch session.

[00:00:59]And there were several people there from AI organizations that said, "Hey, we can cut your costs and we can do this."

[00:01:06]Which is true, right? We just talked about that.

[00:01:08]And these payers were adamant, "We are not going to pay for that. If it doesn't involve a human provider, we are never going to pay for that." And it's still largely true, okay? And this was I don't know, 10 years ago.

[00:01:21]So, just now this year did our our federal government even start implementing Well, I mean, other than remote monitoring technology for like heart conditions, blood pressure. There are some remote monitoring codes, right?

[00:01:38]But for actual technology where it's where it's just the technology itself with little to no provider intervention or provider I guess interaction, you don't get paid for those.

[00:01:52]So, the hard part in healthcare is we have all these great ideas, but unless a provider can get paid for it, no one's going to buy them or invest in them.

[00:02:02]And it could be a game-changer for how providers can handle patients, you know?

[00:02:09]Maybe simple things, you know, a computer could do, you know, take a picture of the rash, the the you could, you know, uh send the picture to the dermatologist, the dermatologist can say, and I'm sure this exists in some in some way, right?

[00:02:25]But, you know, could it be that AI could diagnose a rash since it's a picture, and then if they can, it can escalate to a provider, and the provider could still get paid for that?

[00:02:37]I I mean, I think so, one day, right?

[00:02:42]But the the component everyone misses is the payer won't pay. And the provider can't get paid, so the we're we're in this loop that we can't get out of.

[00:02:51]So, until that problem's fixed, we can invent all of the greatest AI and move the technology forward as fast as we want, but investors won't invest in things that providers aren't going to get paid for.