CertifyOS provider data management

THE CERTIFYOS PODCAST

How 20 Years in Medicine Convinced Him Healthcare Can't Be Fixed (Only Rebuilt)

Episode 5 · July 7, 2026 · 51 min

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ABOUT THE SPEAKERS

Meet this episode’s guests

Nick Helfrich
Nick HelfrichChief Commercial Officer, CertifyOS
Mitch Gorodokin
Mitch GorodokinSenior Vice President of Business Development, CertifyOS
Dr. Ankoor Shah
Dr. Ankoor ShahVP of Clinical Excellence, Included Health

EPISODE DESCRIPTION

Every health tech company promises AI will make you healthier. Dr. Ankoor Shah says that's not what the technology is being built to do. He is a pediatrician who co-led Washington, DC's COVID-19 response and now serves as VP of Clinical Excellence at Included Health. His view: healthcare technology has historically widened disparities, and today's AI is funded to optimize the revenue cycle, not patient outcomes. From there, Nick and Mitch get into the part that decides your care: finding a doctor who is safe. Ankoor explains why the biggest quality gains come from moving people out of the bottom quartile, how sanctioned providers slip across state lines, and why even he has no real incentive to keep his own data accurate across a dozen health plans.

Key takeaways

Revenue cycleMost healthcare AI today is built to serve a business purpose, not to make patients healthier.
Bottom quartileThe biggest quality gains come from moving patients away from the lowest-performing providers, not from chasing the top tier.
NPI levelIncluded Health measures provider quality at the individual NPI level, not just by practice or network.
A dozen plansProviders carry the credentialing burden across many plans with little incentive to keep each record current, so directory data goes stale.
“Current AI usage in healthcare is not trying to solve a patient outcome problem. It's not trying to make anyone healthier.”

— Dr. Ankoor Shah, Included Health

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