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.”
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
33
Products and capabilities
7
Categories
15
Featured
Showing 33 of 33 products.
Consumer
FeaturedHealthcareIRA™ / 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
FeaturedPharmacy & 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
FeaturedConsumer-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
FeaturedIntegrated 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
FeaturedCollaborative 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
FeaturedIntegrative 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
Clinical
FeaturedProtos 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
FeaturedSpend-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
FeaturedUtilization-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
FeaturedProvider 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
FeaturedVersion 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
FeaturedNASCO 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
FeaturedJohnson & 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
FeaturedPhysician 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
FeaturedBPaaS / UM-as-a-Service architecture
- Organization
- Hinduja Healthcare Services → Sagility
- 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
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
- Organization
- Healsa / Partner Medicine
- 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
- Organization
- Pieces Technologies
- 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
- Organization
- New Century Oncology / Evolent Health
- 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
- Organization
- DataEase International
- 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
- Organization
- Rapid Enterprise Inc. / REI
- 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
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