Strong health systems and services are the foundation of better health for all. Dr @Ad_Onyango, Director of Health Systems and Services at @WHOAFRO, shares her insights on governance, country ownership, partnerships and the role of data in improving health outcomes across Africa.

Most health systems don't have a UM system. They have four disconnected teams doing four different reviews — utilization review, physician second-level review, payor peer-to-peer, and clinical appeals — with zero shared feedback loop. R1 fixes that with Phare Utilization Management, the latest expansion to Phare, healthcare’s first revenue operating system (Phare OS). Check out my deep dive to see how Phare UM is delivering early results like first-level reviews in under four minutes, half resolved without a human touching them: Written in collaboration with R1 but, as always, 100% my take.

Your health plan costs the same as a Tesla Model Y. I sat down with Ali Diab, CEO and co-founder of Collective Health, to find out what Collective Health is doing to fix it. Ali started the company after his own hospital claim got denied, and has spent the decade since building what he calls the “Stripe” of healthcare benefits — for employers today, and potentially insurers and health systems tomorrow. This episode hits the affordability crisis head-on. Ali makes the case that health insurance itself is the real inflationary catalyst in American healthcare. Ali doesn't do the polite version. He calls the MLR a cost-plus contract, compares network "discounts" to markdowns off the Neiman Marcus price, and told me about the time he was charged $340 in coinsurance for a $125 knee brace on his own company's plan. We dig into why self-insurance and direct contracting are eating the fully-insured market alive, why small employers are legally boxed out of self-funding, and why he thinks healthcare pricing needs an SEC. Also: World Cup takes. Ali's a winger-turned-number-nine and I broke two leg bones playing this sport, so we earned the tangent. Listen on Apple: Listen on Spotify: TIMESTAMPS (04:31) A denied hospital claim, a Stanford doc spending more time fighting insurers than seeing patients, and the founding of Collective Health (08:34) Your family's premium buys a Tesla Model Y every year — and the MLR is the $600 Navy toilet seat problem in disguise (16:35) America is over-insured: stop running windshield wipers through car insurance (and birth control through health plans) (18:55) Network discounts are markdowns off the Neiman Marcus price — the PBM rebate illusion explained (20:19) From 25 lives to Walmart: the self-funding playbook carriers lobbied your state to keep away from you (27:24) The $340 knee brace story (retail price: $125 — and no, he couldn't bring his own) (37:35) Inside the 3.9% vs. 9% trend gap: how routing members in real time actually bends cost (52:44) Give healthcare an SEC: why Ali thinks price discrimination in care delivery is a solved problem we refuse to solve

Longevity medicine moves into academic health systems “The systems are betting that their research ties will set them apart from the hundreds of private U.S. longevity clinics.” @BeckersHR

New paper published in Nature Health today from the Microsoft AI Futures team. After reviewing 1.7m conversations across 109 countries, it’s clear that Copilot is an invaluable resource particularly for people with low confidence in their health systems. We've always known that technology is a great equalizer, driving broader access to better quality services. This is further evidence that AI is giving underserved people around the world access to invaluable support when they need it most. Many thanks to all the authors. Check out the paper here:

Fragmented information systems can limit timely access to health data and hinder effective decision-making. Connecting systems and improving data exchange are essential to stronger health systems. #AfricaHealthDataForum#

Ending polio protects children today and builds stronger health systems for tomorrow. Sustained political commitments and investments from governments and donors are needed to give every child a chance at a healthy future. #UNGA#

Patients have become a top-three payor for most health systems, and they're the worst-performing one on every metric that matters: • 25-30 cents to collect a patient dollar vs. 4-5 cents for a commercial dollar • 30-50% yield vs. 95-97% from payors • $44.9B in uncompensated care coming in 2026-2027 I dug into how brand partner Cedar (@CedarNY) is rebuilding patient financial engagement around this shift, including a stat that should end the propensity-to-pay era on its own: accounts with high P2P scores yielded 51% LESS than bills with no score at all. Get the full breakdown between what works and what doesn't in my latest deep dive:

Is Longevity Medicine Going Mainstream? 👨‍⚕️ As major health systems open their own programs, longevity medicine is gaining credibility and becoming more accessible.