"I can't fathom a world where employers are expected to budget and create a plan for their future without understanding what the costs of their healthcare are. Everything needs to be grounded in fact and truth."

Is the traditional insurance network obsolete?

My guest this week is Amy Wykoff, Chief Product Officer at Nomi Health. After starting her career building foundational AI models at IBM Watson, Amy pivoted to healthcare with a massive new challenge: rebuilding the insurance network from scratch.

In this episode, we explore Nomi’s radical approach to the "Network as a Product." Rather than negotiating opaque discounts off inflated Charge Master rates, Nomi negotiates fair, transparent cash rates with providers and guarantees them 100% payment. In return, self-funded employers can offer their employees a true $0 copay, $0 deductible health plan.

We discuss the logistics of building a direct-contracted network across 40 major MSAs, how to overcome "point solution fatigue" by reassembling the vendor stack, and why the ultimate goal of healthcare innovation should be to stop using AI to fight over claims denials - and start using it to improve actual patient care.

Tune in to this week’s Self-Funded to learn exactly how the free market is finally fighting back!

Thank you to our 2026 sponsors!

ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more.

Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.

Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.

Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.

Chapters:

(00:00:00) Intro: IBM Watson & The Origins of Healthcare AI
(00:02:56) Leaving AI to Build "Network as a Product" at Nomi Health
(00:05:07) The $0 Copay, $0 Deductible Health Plan
(00:07:09) Scaling a Direct-Contracted Network to 40 MSAs
(00:08:44) The Insanity of Traditional Carrier Reimbursement
(00:13:08) Why Providers Actually Want Transparent Cash Pricing
(00:15:10) The Economic Drain: How Bad Networks Hurt Local Economies
(00:19:07) Why Employees Hate Their Health Insurance
(00:23:44) Reassembling the Vendor Stack: Navigation & TPAs
(00:28:13) Why Healthcare is Now a CFO Decision
(00:32:02) "The Tears of Joy": Real Patient Stories
(00:37:31) The AI War: Why "Bots Fighting Bots" is a Waste of Talent
(00:43:51) Closing Thoughts: Unbundling the Health Plan

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