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Products

Products I've Helped Build

Product work across payers, providers, consumers, life-sciences companies and AI-enabled decision support.

HealthcareIRA™ / Original invention

Father / Founder of HSAs

Amit K. Gupta, MD originated HealthcareIRA™, the healthcare-account model on which HSA legislation was written. He wrote the foundational patent and is its sole named inventor.

To commercialize his invention, Gupta brought in David Lenihan, a former banker and financier, and together they co-founded CareGain. The origin of HealthcareIRA™ and HSAs was Gupta’s; the company was built with a business partner.

“Nancy would like your comments on this.”

From Congresswoman Nancy L. Johnson’s office — June 3, 2003
June 3, 2003 fax cover sheet from Congresswoman Nancy L. Johnson’s office to Lenihan and Gupta, requesting comments on the accompanying materials.
June 3, 2003 — Nancy Johnson’s office requests comments from Lenihan and Gupta on the accompanying 26 pages.
May 20, 2003 House discussion draft transmitted June 3, 2003, with handwritten annotations and Section 1 headed HEALTH SAVINGS ACCOUNTS.
May 20, 2003 — Annotated discussion draft: “SECTION 1. HEALTH SAVINGS ACCOUNTS.” Transmitted with the June 3 correspondence.

HEALTHCAREIRA / Historical trademark record

Filing date
May 25, 2001
Serial number
78065925
Registration number
2859097
Registration date
June 29, 2004
Register
Supplemental
Classes
036, 042
Recorded status
Cancelled
Status date
February 4, 2011
CareGain: invention, legislative development & commercialization

33

Products and capabilities

7

Categories

15

Featured

Showing 33 of 33 products.

  • Consumer

    Featured

    HealthcareIRA™ / HSA, HRA & FSA benefit-management portal

    Organization
    CareGain
    Role
    Founder/President/COO
    Problem
    Create the product and infrastructure needed to make consumer-directed healthcare practical for payers and employers.
    Built
    Originated HealthcareIRA™, the model on which HSA legislation was written, and wrote the foundational patent as its sole named inventor. Brought in former banker and financier David Lenihan to co-found CareGain and commercialize HealthcareIRA™. Worked with legislators to develop Health Savings Accounts legislation and advised House Ways and Means Chairman Bill Thomas and Health Subcommittee Chairwoman Nancy Johnson on tax treatment for Health Reimbursement Accounts and HealthcareIRA™ / Health Savings Accounts. Provided further HSA guidance to the U.S. Treasury Department and Internal Revenue Service (IRS) in 2004. Developed healthcare-account and HSA infrastructure for payer and employer distribution. Connected product development, patents, strategy, financing and commercialization. Raised $8M in strategic and venture financing and secured distribution endorsements from AHIP and the Blue Cross Blue Shield Association.
    Outcome
    Acquisition: CareGain was acquired by Fiserv for $40M in January 2006. The CareGain business later traveled through PayFlex to Aetna.
    Market
    Payers and employers
    Also
    Payer
  • Consumer

    Featured

    Pharmacy & provider quality-comparison decision support

    Organization
    CareGain
    Role
    Founder/President/COO
    Problem
    Create the product and infrastructure needed to make consumer-directed healthcare practical for payers and employers.
    Built
    Originated HealthcareIRA™, the model on which HSA legislation was written, and wrote the foundational patent as its sole named inventor. Brought in former banker and financier David Lenihan to co-found CareGain and commercialize HealthcareIRA™. Worked with legislators to develop Health Savings Accounts legislation and advised House Ways and Means Chairman Bill Thomas and Health Subcommittee Chairwoman Nancy Johnson on tax treatment for Health Reimbursement Accounts and HealthcareIRA™ / Health Savings Accounts. Provided further HSA guidance to the U.S. Treasury Department and Internal Revenue Service (IRS) in 2004. Developed healthcare-account and HSA infrastructure for payer and employer distribution. Connected product development, patents, strategy, financing and commercialization. Raised $8M in strategic and venture financing and secured distribution endorsements from AHIP and the Blue Cross Blue Shield Association.
    Outcome
    Acquisition: CareGain was acquired by Fiserv for $40M in January 2006. The CareGain business later traveled through PayFlex to Aetna.
    Market
    Healthcare consumers and benefit administrators
    Also
    Analytics
  • Payer

    Featured

    Consumer-directed healthcare payment processing & debit-card integration

    Organization
    CareGain
    Role
    Founder/President/COO
    Problem
    Create the product and infrastructure needed to make consumer-directed healthcare practical for payers and employers.
    Built
    Originated HealthcareIRA™, the model on which HSA legislation was written, and wrote the foundational patent as its sole named inventor. Brought in former banker and financier David Lenihan to co-found CareGain and commercialize HealthcareIRA™. Worked with legislators to develop Health Savings Accounts legislation and advised House Ways and Means Chairman Bill Thomas and Health Subcommittee Chairwoman Nancy Johnson on tax treatment for Health Reimbursement Accounts and HealthcareIRA™ / Health Savings Accounts. Provided further HSA guidance to the U.S. Treasury Department and Internal Revenue Service (IRS) in 2004. Developed healthcare-account and HSA infrastructure for payer and employer distribution. Connected product development, patents, strategy, financing and commercialization. Raised $8M in strategic and venture financing and secured distribution endorsements from AHIP and the Blue Cross Blue Shield Association.
    Outcome
    Acquisition: CareGain was acquired by Fiserv for $40M in January 2006. The CareGain business later traveled through PayFlex to Aetna.
    Market
    Payers, employers and financial institutions
    Also
    Consumer
  • Payer

    Featured

    Integrated healthcare strategy & operating model

    Organization
    Fiserv Health
    Role
    EVP, Global Healthcare Strategy
    Problem
    Consolidate multiple healthcare businesses and banking capabilities into a coherent healthcare strategy and operating model.
    Built
    Developed cross-business healthcare strategy spanning CareGain, Wausau Benefits, Avidyn Health and related units. Connected Fiserv banking and healthcare capabilities with healthcare-business integration and operating-model work.
    Outcome
    Acquisition: Fiserv healthcare businesses were acquired by UnitedHealthcare in 2007 for approximately $775M. The Wall Street Journal reported the acquisition agreement on November 2, 2007.
    Market
    Healthcare business units, payers and employers
    Also
    Consumer
  • Clinical

    Featured

    Collaborative specialty utilization-management programs

    Organization
    HealthHelp
    Role
    President, Chief Strategy Officer; previously Chief Strategy & Products Officer
    Problem
    Restructure products, health informatics, client services, strategy and clinical programs while building a scalable healthcare-management business.
    Built
    Restructured product strategy, health informatics and client-service delivery. Expanded specialty clinical programs and product enhancements with responsibility for a book of business exceeding $60M. Advanced an educative, collaborative utilization-management model that guides clinically appropriate care rather than relying only on denial-driven review. Developed the Integrative Oncology program, combining risk assessment, imaging, biopsy, treatment planning, radiation and chemotherapy management, surgery, palliative and supportive care; adopted by two health plans with 2M+ additional members and $6M revenue. Developed Protos, an evidence-based branching-logic rules engine integrating clinical decision support with authorization. Its sleep-program pilot produced a 3× increase in Tier 1 impact, greater provider convenience and lower clinical costs.
    Outcome
    Acquisition: After becoming President, Gupta led HealthHelp to its acquisition by WNS for $95M in March 2017.
    Market
    Health plans and clinical-management organizations
    Also
    Payer, Analytics
  • Clinical

    Featured

    Integrative Oncology

    Organization
    HealthHelp
    Role
    President, Chief Strategy Officer; previously Chief Strategy & Products Officer
    Problem
    Restructure products, health informatics, client services, strategy and clinical programs while building a scalable healthcare-management business.
    Built
    Restructured product strategy, health informatics and client-service delivery. Expanded specialty clinical programs and product enhancements with responsibility for a book of business exceeding $60M. Advanced an educative, collaborative utilization-management model that guides clinically appropriate care rather than relying only on denial-driven review. Developed the Integrative Oncology program, combining risk assessment, imaging, biopsy, treatment planning, radiation and chemotherapy management, surgery, palliative and supportive care; adopted by two health plans with 2M+ additional members and $6M revenue. Developed Protos, an evidence-based branching-logic rules engine integrating clinical decision support with authorization. Its sleep-program pilot produced a 3× increase in Tier 1 impact, greater provider convenience and lower clinical costs.
    Outcome
    Acquisition: After becoming President, Gupta led HealthHelp to its acquisition by WNS for $95M in March 2017.
    Market
    Health plans and oncology care teams
    Also
    Payer
    Read related publication · American Journal of Managed Care — Evidence-Based Oncology (PDF) ↗
  • Clinical

    Featured

    Protos clinical rules & authorization engine

    Organization
    HealthHelp
    Role
    President, Chief Strategy Officer; previously Chief Strategy & Products Officer
    Problem
    Restructure products, health informatics, client services, strategy and clinical programs while building a scalable healthcare-management business.
    Built
    Restructured product strategy, health informatics and client-service delivery. Expanded specialty clinical programs and product enhancements with responsibility for a book of business exceeding $60M. Advanced an educative, collaborative utilization-management model that guides clinically appropriate care rather than relying only on denial-driven review. Developed the Integrative Oncology program, combining risk assessment, imaging, biopsy, treatment planning, radiation and chemotherapy management, surgery, palliative and supportive care; adopted by two health plans with 2M+ additional members and $6M revenue. Developed Protos, an evidence-based branching-logic rules engine integrating clinical decision support with authorization. Its sleep-program pilot produced a 3× increase in Tier 1 impact, greater provider convenience and lower clinical costs.
    Outcome
    Acquisition: After becoming President, Gupta led HealthHelp to its acquisition by WNS for $95M in March 2017.
    Market
    Clinical operations and utilization-management teams
    Also
    Payer
  • Payer

    Featured

    Spend-reduction products: Site, Scope, Triage, Direct, Concierge & Access

    Organization
    HealthHelp
    Role
    President, Chief Strategy Officer; previously Chief Strategy & Products Officer
    Problem
    Restructure products, health informatics, client services, strategy and clinical programs while building a scalable healthcare-management business.
    Built
    Restructured product strategy, health informatics and client-service delivery. Expanded specialty clinical programs and product enhancements with responsibility for a book of business exceeding $60M. Advanced an educative, collaborative utilization-management model that guides clinically appropriate care rather than relying only on denial-driven review. Developed the Integrative Oncology program, combining risk assessment, imaging, biopsy, treatment planning, radiation and chemotherapy management, surgery, palliative and supportive care; adopted by two health plans with 2M+ additional members and $6M revenue. Developed Protos, an evidence-based branching-logic rules engine integrating clinical decision support with authorization. Its sleep-program pilot produced a 3× increase in Tier 1 impact, greater provider convenience and lower clinical costs.
    Outcome
    Acquisition: After becoming President, Gupta led HealthHelp to its acquisition by WNS for $95M in March 2017.
    Market
    Health plans and provider networks
    Also
    Provider
  • Payer

    Featured

    Utilization-reduction products: Consult, Access, Inform, Guide & Alert

    Organization
    HealthHelp
    Role
    President, Chief Strategy Officer; previously Chief Strategy & Products Officer
    Problem
    Restructure products, health informatics, client services, strategy and clinical programs while building a scalable healthcare-management business.
    Built
    Restructured product strategy, health informatics and client-service delivery. Expanded specialty clinical programs and product enhancements with responsibility for a book of business exceeding $60M. Advanced an educative, collaborative utilization-management model that guides clinically appropriate care rather than relying only on denial-driven review. Developed the Integrative Oncology program, combining risk assessment, imaging, biopsy, treatment planning, radiation and chemotherapy management, surgery, palliative and supportive care; adopted by two health plans with 2M+ additional members and $6M revenue. Developed Protos, an evidence-based branching-logic rules engine integrating clinical decision support with authorization. Its sleep-program pilot produced a 3× increase in Tier 1 impact, greater provider convenience and lower clinical costs.
    Outcome
    Acquisition: After becoming President, Gupta led HealthHelp to its acquisition by WNS for $95M in March 2017.
    Market
    Health plans and clinicians
    Also
    Clinical
  • Analytics

    Featured

    Provider Score, savings valuation & risk / predictive analytics

    Organization
    HealthHelp
    Role
    President, Chief Strategy Officer; previously Chief Strategy & Products Officer
    Problem
    Restructure products, health informatics, client services, strategy and clinical programs while building a scalable healthcare-management business.
    Built
    Restructured product strategy, health informatics and client-service delivery. Expanded specialty clinical programs and product enhancements with responsibility for a book of business exceeding $60M. Advanced an educative, collaborative utilization-management model that guides clinically appropriate care rather than relying only on denial-driven review. Developed the Integrative Oncology program, combining risk assessment, imaging, biopsy, treatment planning, radiation and chemotherapy management, surgery, palliative and supportive care; adopted by two health plans with 2M+ additional members and $6M revenue. Developed Protos, an evidence-based branching-logic rules engine integrating clinical decision support with authorization. Its sleep-program pilot produced a 3× increase in Tier 1 impact, greater provider convenience and lower clinical costs.
    Outcome
    Acquisition: After becoming President, Gupta led HealthHelp to its acquisition by WNS for $95M in March 2017.
    Market
    Payers and healthcare management organizations
    Also
    Payer
  • Consumer

    Featured

    Version 3.0 healthcare-incentives & wellness platform

    Organization
    IncentOne
    Role
    Interim Chief Healthcare Products/Strategy Officer and Sales Leadership
    Problem
    Reset the product vision, technology platform, consumer experience and commercial and operating model together.
    Built
    Substantially redesigned the older platform into an enhanced version 3.0 incentive-driven wellness platform. Reworked architecture, user interface, consumer engagement, employer wellness and rewards management. Reset sales strategy, marketing and operations alongside the product rebuild.
    Outcome
    Acquisition: Welltok acquired IncentOne in 2013. Financial terms: Undisclosed. The product and business transformation preceded the transaction.
    Market
    Employers and payers
    Also
    Payer
  • Payer

    Featured

    NASCO HIPAA EDI transaction solution

    Organization
    NeuVis
    Role
    Founding Member / Exec. Director of Healthcare Solutions
    Problem
    Turn a cross-industry development platform into healthcare applications, partner relationships and a commercial vertical.
    Built
    Led healthcare product and vertical-market strategy, business development, application design, partner relationships, commercialization and implementations. Around 2000, developed an early HIPAA EDI transaction solution for NASCO through IBM using NeuVis. Supported healthcare applications and relationships involving NASCO, Johnson & Johnson, IBM and other healthcare organizations.
    Outcome
    Strategic Acquisition: Rational Software acquired NeuVis; IBM subsequently acquired Rational.
    Market
    Payers and healthcare technology partners
  • Life Sciences

    Featured

    Johnson & Johnson VisionCare ophthalmology practice-management application

    Organization
    NeuVis
    Role
    Founding Member / Exec. Director of Healthcare Solutions
    Problem
    Turn a cross-industry development platform into healthcare applications, partner relationships and a commercial vertical.
    Built
    Led healthcare product and vertical-market strategy, business development, application design, partner relationships, commercialization and implementations. Around 2000, developed an early HIPAA EDI transaction solution for NASCO through IBM using NeuVis. Supported healthcare applications and relationships involving NASCO, Johnson & Johnson, IBM and other healthcare organizations.
    Outcome
    Strategic Acquisition: Rational Software acquired NeuVis; IBM subsequently acquired Rational.
    Market
    Vision-care practices and Johnson & Johnson
    Also
    Provider
  • Life Sciences

    Featured

    Physician eDetailing solution

    Organization
    NeuVis
    Role
    Founding Member / Exec. Director of Healthcare Solutions
    Problem
    Turn a cross-industry development platform into healthcare applications, partner relationships and a commercial vertical.
    Built
    Led healthcare product and vertical-market strategy, business development, application design, partner relationships, commercialization and implementations. Around 2000, developed an early HIPAA EDI transaction solution for NASCO through IBM using NeuVis. Supported healthcare applications and relationships involving NASCO, Johnson & Johnson, IBM and other healthcare organizations.
    Outcome
    Strategic Acquisition: Rational Software acquired NeuVis; IBM subsequently acquired Rational.
    Market
    Pharmaceutical companies and physicians
    Also
    Provider
  • Payer

    Featured

    BPaaS / UM-as-a-Service architecture

    Role
    C-Suite and CEO (Ram Gopalan) Management Consultant for UM Strategy
    Problem
    Create enterprise utilization-management strategy and a service/product architecture across multiple clinical specialties.
    Built
    Created overall UM strategy covering prior authorization, peer review, clinical decision support and care management. Architected BPaaS and UM-as-a-Service offerings, connecting specialty clinical programs with service delivery.
    Outcome
    Pre-Acquisition Transformation: Following the January 2022 BPEA transaction, the healthcare business separated from Hinduja and became Sagility.
    Market
    Payers and healthcare-service organizations
    Also
    Clinical
    Read related publication · First Report Managed Care ↗
  • Consumer

    Digital health & wellness business

    Organization
    Healthper
    Role
    Co-Founder/President
    Problem
    Build a digital health and wellness business with a product and operating model that could be delivered to customers.
    Built
    Co-founded Healthper and built its digital health / wellness business. Developed gamification and employer-funded reward strategies, supported three patent filings, and launched the system in September 2011. Early adoption included Avis Rental Car Company.
    Outcome
    Divestiture: Gupta chose to divest his ownership to pursue other ventures. His CTO acquired the business and continued operating it.
    Market
    Digital health and wellness customers
  • Provider

    KlearHealth concierge patient intake, onboarding & servicing platform

    Role
    Exec. Management Consultant
    Problem
    Give a concierge medicine practice direct digital access and an end-to-end patient-service workflow.
    Built
    Rebuilt the business and product strategy and developed KlearHealth, the retail concierge-medicine platform. Built direct online patient intake, service contracting, payments and onboarding. Designed appointment scheduling, referrals, online prescription requests, social-media conversations and a dynamic personal health record.
    Outcome
    Merger: Helped developed the concierge-medicine online platform to service the patients directly. The practice merged with Atlantic Health subsequently.
    Market
    Concierge practices and patients
    Also
    Consumer
  • AI

    AI + EMR clinical and healthcare-performance strategy

    Role
    Healthcare AI / Product strategy advisor
    Problem
    Expand AI beyond individual clinical alerts toward measurable healthcare-system performance.
    Built
    Advised on product strategy connecting AI and EMR data to clinical, financial, quality and SDOH risks. Helped frame clinical decision support around hospital and ACO performance, with advisory work in operational improvement and fundraising.
    Outcome
    Acquisition: Smarter Technologies acquired Pieces Technologies, announced September 30, 2025.
    Market
    Hospitals, ACOs and healthcare systems
    Also
    Provider, Clinical, Analytics
  • Life Sciences

    Medication-adherence & performance-based risk-sharing strategy

    Organization
    RemindTrac
    Role
    Product strategy advisor to the existing executive / management team
    Problem
    Refine a medication-adherence platform and establish its product strategy across specialty drugs and healthcare markets.
    Built
    Defined positioning for payers, employers, ACOs and PCMHs. Developed strategy around specialty-drug adherence, measurement, value-based pharmaceutical models and performance-based risk-sharing agreements.
    Outcome
    Strategic Advisory: Medication-adherence product and market strategy.
    Market
    Payers, employers, ACOs and PCMHs
    Also
    Clinical, Analytics, Payer
  • Clinical

    Longitudinal oncology & cardiology pathway decision support

    Role
    Focused product-design consultant
    Problem
    Move utilization management from isolated authorization transactions toward longitudinal clinical decision support.
    Built
    Designed a new Oncology and Cardiology decision-support system based on care pathways. Changed authorization design from an episodic model to a pathway-driven model that anticipates appropriate downstream services.
    Outcome
    Clinical Program Design: Focused pathway-based product-design assignment.
    Market
    Oncology and cardiology utilization management
    Also
    Payer
  • Provider

    Core telemedicine platform

    Organization
    DockedIn
    Role
    Core platform builder; company operated by others
    Problem
    Build the technology foundation for a telemedicine venture.
    Built
    Built the core pediatric telemedicine platform and advised the founders on product strategy. Designed telekit connectivity using Wi-Fi, Bluetooth and USB monitoring devices for real-time examinations. Managed requirements, development, prototyping and hospital pilot testing through launch.
    Outcome
    Did Not Scale: The venture did not achieve sustained commercial scale.
    Market
    Providers and patients
    Also
    Consumer
  • Consumer

    Social learning & payments platform

    Organization
    SLAP
    Role
    Platform builder / Named patent inventor; company managed by others
    Problem
    Build the platform connecting social learning and payments.
    Built
    Built the company’s social learning / payments platform, developing the core concept with the founding members. Developed a social scoring system for challenges, activities, donated rewards and team participation; led product development through its January 2015 launch. Wrote the associated patent and is named on it. The company itself was managed by others.
    Outcome
    Did Not Scale: The venture did not ultimately gain meaningful commercial traction.
    Market
    Social learning and payments users
  • Consumer

    Stress, anxiety & consumer-wellness formulations

    Organization
    R3SET
    Role
    Scientific Advisory Board member / Investor / Formulation advisor
    Problem
    Support consumer-wellness product formulation grounded in scientific and Ayurvedic knowledge.
    Built
    Advised on Ayurvedic formulation and product development for stress, anxiety, stress eating and consumer wellness. Contributed as a Scientific Advisory Board member and investor.
    Outcome
    Scientific Advisory: Scientific advisory, investment and product-formulation engagement.
    Market
    Consumer wellness
    Also
    Life Sciences
  • Clinical

    MSK clinical-program development strategy

    Organization
    Cohere Health
    Role
    Management Consulting & Product Strategy / Clinical Program Development Strategy
    Problem
    Define product and clinical-program development strategy for the initial MSK program, followed by Cardiology and additional specialty programs, moving utilization management toward pathway-driven clinical decisions that let appropriate care proceed with minimal friction.
    Built
    Consulted with the initial founding team — CEO, COO and product lead — in 2019, leading to development of Cohere Health’s MSK program. Provided management consulting, product strategy and clinical-program development strategy for the MSK program. Subsequently provided further consulting on product strategy and clinical-program development strategy for Cardiology. Contributed product strategy for pathway-based, AI-supported management across specialty programs. Developed AI-driven algorithms for sleep testing and genetic testing. Designed a specialty-drug management program focused on targeted therapies, immunotherapies and monoclonal antibodies. Helped define clinical decision support and an educative UM model that reserves friction for cases where intervention changes the result.
    Outcome
    Strategic Advisory: Management consulting, product strategy and clinical-program development strategy spanning MSK, Cardiology and later pathway-driven clinical intelligence, testing algorithms and specialty-drug programs.
    Market
    Health plans and utilization-management organizations
    Also
    Payer
  • Clinical

    Cardiology clinical-program development strategy

    Organization
    Cohere Health
    Role
    Management Consulting & Product Strategy / Clinical Program Development Strategy
    Problem
    Define product and clinical-program development strategy for the initial MSK program, followed by Cardiology and additional specialty programs, moving utilization management toward pathway-driven clinical decisions that let appropriate care proceed with minimal friction.
    Built
    Consulted with the initial founding team — CEO, COO and product lead — in 2019, leading to development of Cohere Health’s MSK program. Provided management consulting, product strategy and clinical-program development strategy for the MSK program. Subsequently provided further consulting on product strategy and clinical-program development strategy for Cardiology. Contributed product strategy for pathway-based, AI-supported management across specialty programs. Developed AI-driven algorithms for sleep testing and genetic testing. Designed a specialty-drug management program focused on targeted therapies, immunotherapies and monoclonal antibodies. Helped define clinical decision support and an educative UM model that reserves friction for cases where intervention changes the result.
    Outcome
    Strategic Advisory: Management consulting, product strategy and clinical-program development strategy spanning MSK, Cardiology and later pathway-driven clinical intelligence, testing algorithms and specialty-drug programs.
    Market
    Health plans and utilization-management organizations
    Also
    Payer
  • AI

    AI-supported specialty pathway intelligence

    Organization
    Cohere Health
    Role
    Management Consulting & Product Strategy / Clinical Program Development Strategy
    Problem
    Define product and clinical-program development strategy for the initial MSK program, followed by Cardiology and additional specialty programs, moving utilization management toward pathway-driven clinical decisions that let appropriate care proceed with minimal friction.
    Built
    Consulted with the initial founding team — CEO, COO and product lead — in 2019, leading to development of Cohere Health’s MSK program. Provided management consulting, product strategy and clinical-program development strategy for the MSK program. Subsequently provided further consulting on product strategy and clinical-program development strategy for Cardiology. Contributed product strategy for pathway-based, AI-supported management across specialty programs. Developed AI-driven algorithms for sleep testing and genetic testing. Designed a specialty-drug management program focused on targeted therapies, immunotherapies and monoclonal antibodies. Helped define clinical decision support and an educative UM model that reserves friction for cases where intervention changes the result.
    Outcome
    Strategic Advisory: Management consulting, product strategy and clinical-program development strategy spanning MSK, Cardiology and later pathway-driven clinical intelligence, testing algorithms and specialty-drug programs.
    Market
    Health plans and utilization-management organizations
    Also
    Clinical, Payer
  • AI

    AI-driven sleep-testing & genetic-testing algorithms

    Organization
    Cohere Health
    Role
    Management Consulting & Product Strategy / Clinical Program Development Strategy
    Problem
    Define product and clinical-program development strategy for the initial MSK program, followed by Cardiology and additional specialty programs, moving utilization management toward pathway-driven clinical decisions that let appropriate care proceed with minimal friction.
    Built
    Consulted with the initial founding team — CEO, COO and product lead — in 2019, leading to development of Cohere Health’s MSK program. Provided management consulting, product strategy and clinical-program development strategy for the MSK program. Subsequently provided further consulting on product strategy and clinical-program development strategy for Cardiology. Contributed product strategy for pathway-based, AI-supported management across specialty programs. Developed AI-driven algorithms for sleep testing and genetic testing. Designed a specialty-drug management program focused on targeted therapies, immunotherapies and monoclonal antibodies. Helped define clinical decision support and an educative UM model that reserves friction for cases where intervention changes the result.
    Outcome
    Strategic Advisory: Management consulting, product strategy and clinical-program development strategy spanning MSK, Cardiology and later pathway-driven clinical intelligence, testing algorithms and specialty-drug programs.
    Market
    Payers and utilization-management organizations
    Also
    Clinical
  • Clinical

    Targeted therapy, immunotherapy & monoclonal-antibody management

    Organization
    Cohere Health
    Role
    Management Consulting & Product Strategy / Clinical Program Development Strategy
    Problem
    Define product and clinical-program development strategy for the initial MSK program, followed by Cardiology and additional specialty programs, moving utilization management toward pathway-driven clinical decisions that let appropriate care proceed with minimal friction.
    Built
    Consulted with the initial founding team — CEO, COO and product lead — in 2019, leading to development of Cohere Health’s MSK program. Provided management consulting, product strategy and clinical-program development strategy for the MSK program. Subsequently provided further consulting on product strategy and clinical-program development strategy for Cardiology. Contributed product strategy for pathway-based, AI-supported management across specialty programs. Developed AI-driven algorithms for sleep testing and genetic testing. Designed a specialty-drug management program focused on targeted therapies, immunotherapies and monoclonal antibodies. Helped define clinical decision support and an educative UM model that reserves friction for cases where intervention changes the result.
    Outcome
    Strategic Advisory: Management consulting, product strategy and clinical-program development strategy spanning MSK, Cardiology and later pathway-driven clinical intelligence, testing algorithms and specialty-drug programs.
    Market
    Specialty-drug benefit management
    Also
    Payer
  • Analytics

    Relational database demonstration applications

    Role
    Lead Enterprise Sales
    Problem
    Demonstrate an early relational database platform through working applications and commercial adoption.
    Built
    Developed demonstration medical and prescription-drug databases, library catalog systems and other business applications. Combined hands-on application development with technology sales.
    Outcome
    Acquisition: DataEase was acquired by Sapphire, UK in 1991.
    Market
    Medical, library and business database customers
  • Analytics

    Client/server rapid application development platform

    Role
    Led rapid application development group (won PC Week Magazine Award)
    Problem
    Commercialize an early rapid application development platform and demonstrate its capabilities against competing products.
    Built
    Participated broadly in the startup and product commercialization. Represented the product in a live PC Week Labs Database Challenge Shootout, building the required working application in approximately 10 hours.
    Outcome
    Acquisition: Symantec Corporation acquired the Rapid Enterprises division from DataEase International in January 1994 for $7.5M.
    Market
    Enterprise application developers
  • Consumer

    Community Internet health information & education

    Organization
    COHIS
    Role
    Co-Founder & Director
    Problem
    Bring health information and education to underserved communities through early Internet-based access.
    Built
    Co-founded and directed one of the earliest Internet-based community health-information organizations. Grew the organization to 150 members and 20 physicians, public-health and literacy experts. Built alliances with 15 Boston-area community and health centers serving as Internet access points. Developed early Internet-based health information, health education and disease-management content for underserved communities.
    Outcome
    Community Health Innovation: Community-health innovation and recognition.
    Market
    Underserved communities, physicians and students
    Also
    Provider
  • Clinical

    Healthcare product strategy & management consulting

    Organization
    Clinical UM, LLC
    Role
    Owner/Management Consultant
    Problem
    Connect healthcare strategy, clinical knowledge and product execution for healthcare and technology ventures.
    Built
    Provided product strategy, management consulting and advisory services across utilization management, AI-assisted decision support and healthcare innovation. Engagements include Cohere, Sagility, R3SET, New Century Oncology, HealthHelp/WNS, Pieces Technologies, Novartis and RemindTrac.
    Outcome
    Ongoing Practice: Current management consulting practice.
    Market
    Healthcare businesses and investor portfolio companies
    Also
    Payer, AI
  • Life Sciences

    Outcomes-based chemotherapy reimbursement model

    Organization
    Novartis
    Role
    Advisor — value-based reimbursement strategy
    Problem
    Structure drug reimbursement around measurable clinical outcomes and precision-treatment decisions.
    Built
    Advised on an outcomes-based compensation and reimbursement structure for a chemotherapy drug. Integrated genomic and precision testing with measures of overall survival and progression-free survival to determine appropriate reimbursement.
    Outcome
    Strategic Advisory: Outcomes-based oncology drug reimbursement advisory.
    Market
    Pharmaceutical companies and payers
    Also
    Clinical, Analytics

Organization, role and outcome appear where confirmed. Each organization links to its company record on the Career page.

Breadth of work

Products & capabilities

The broader capability portfolio is preserved here. The company records above explain specific contributions and outcomes.

AI

  • AI UM Intake
  • Clinical Decision Support
  • Risk Algorithms
  • Predictive Analytics
  • Rules Engines

Payer

  • AI UM Intake
  • Radiology UM
  • Cardiology UM
  • Oncology
  • Sleep
  • MSK
  • Specialty Pharmacy
  • Provider Scorecards
  • Network tools

Provider

  • Clinical Decision Support
  • Community Care Coordination
  • Referral Management
  • Telemedicine (provider)

Consumer

  • Telemedicine (provider)
  • HSA / HRA / FSA platforms
  • Provider comparison
  • Pharmacy comparison
  • Health incentives
  • Gamification
  • Concierge
  • Telemedicine (consumer)
  • Phire mobile-payment technology — now part of Mango Money at mPower Labs

Clinical

  • Clinical Decision Support
  • Rules Engines
  • Radiology UM
  • Cardiology UM
  • Oncology
  • Sleep
  • MSK
  • Specialty Pharmacy
  • Medication adherence

Analytics

  • Risk Algorithms
  • Predictive Analytics
  • Provider Scorecards
  • Provider comparison
  • Pharmacy comparison
  • Value-based pharmaceutical models

Life Sciences

  • Value-based pharmaceutical models
  • Physician eDetailing
  • VisionCare
  • Medication adherence

Next step

Need a product built, rescued or focused?

Rapid Product Deployment™ is the method behind much of this work.