Disrupting Healthcare's Billion-Dollar Leak With Matt Seefeld
The
The High Cost of a Broken System
The
The problem is compounded by what Seefeld calls "payer games," where insurance companies intentionally create complexity to deny claims. "They're investing billions of dollars in AI to deny medical claims knowing that the providers won't have the workforce to keep up with all that," he explains. The consequences are dire: as costs rise and reimbursements fall, small and rural hospitals are forced to close, limiting healthcare access for millions of Americans.
Seefeld warns that without fundamental change, the system is unsustainable. "We're only buying time. And, uh, while AI, AI, AI and all these amazing AI companies and clinical AI and all that, I'm telling you right now, who can afford to pay for those?" he questions. "There are a lot of smart people building really amazing companies with great vision that can't be bought because there's no money left."
A Path Forward with AI and Accountability
Despite the grim reality, Seefeld believes there is a solution. His company, MedEvolve, focuses on bringing accountability to the forefront by tracking every human touch on a claim. By combining this data with generative AI, they can identify and eliminate wasted effort, dramatically reducing labor costs and improving revenue. Seefeld notes that an astonishing 63% of claim touches are wasted effort due to system inefficiencies.
However, he cautions that AI is not a silver bullet. "More than half, 53% of the errors that we see that humans have to get involved with come from AI solutions, so they're not smart enough yet," Seefeld reveals. He sees MedEvolve's role as a feedback loop, using human interaction data to make AI engines smarter and more effective.
By targeting inefficiencies, Seefeld aims to help providers achieve "zero-touch" claims, where a claim is paid without any human intervention. This not only improves a provider's financial health but also allows them to continue serving their communities. "If I can keep the doors open to a small critical access hospital in a small community in
Links
Disrupting Healthcare Revenue Cycles: From Human Burden to Intelligent Automation, with
LinkedIn: https://www.linkedin.com/in/matt-seefeld-521319/
Company Website: https://medevolve.com
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Disruption is happening on an unprecedented scale, impacting all manner of industries— MedTech, Finance, IT, eCommerce, shipping, logistics, and more—and COVID has moved their timelines up a full decade or more. But WHO are these disruptors and when did they say, "THAT'S IT! I'VE HAD IT!"? Time to Disrupt and Interrupt with host Karla Jo "KJ" Helms, veteran communications disruptor. KJ interviews badasses who are disrupting their industries and altering economic networks that have become antiquated with an establishment resistant to progress. She delves into uncovering secrets from industry rebels and quiet revolutionaries that uncover common traits—and not-so-common—that are changing our economic markets… and lives. Visit the world's key pioneers that persist to success, despite arrows in their backs at www.disruption-interruption.com.
About
With over 20 years of management consulting experience in the healthcare industry, Matt has a proven track record of designing and implementing process improvement programs and intelligent workflow automation. Before joining MedEvolve in 2017, he founded Interpoint Partners, LLC, where he developed an intelligent workflow automation and analytics solution, serving as Chairman and CEO until its acquisition by Streamline Health in 2011. He has also held senior roles at Stockamp & Associates (now Huron Consulting Group), PricewaterhouseCoopers (PwC), and Deloitte Consulting, where he honed his expertise in healthcare and life sciences.
Beyond his professional achievements, Matt is the founder of myLifeLink, a free virtual community app designed to support individuals struggling with addiction. In his spare time, he channels his passion for mentorship by coaching track and field and youth baseball. Matt's innovative approach to revenue cycle management and his commitment to improving both healthcare systems and individual lives make him a true disruptor in the industry.
About
References
- Grand View Research. "
U.S. Revenue Cycle Management Market Size Report, 2030." Grandviewresearch.com, 2023, grandviewresearch.com/industry-analysis/us-revenue-cycle-management-rcm-market. - Alkire, Michael J, et al. "Claims Adjudication Costs Providers
$25.7 Billion -$18 Billion Is Potentially Unnecessary Expense." Premier, Premier Inc,24 Feb. 2025 , premierinc.com/newsroom/policy/claims-adjudication-costs-providers-257-billion-18-billion-is-potentially-unnecessary-expense.
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