Becker’s Healthcare Podcast – Episode Summary
Episode Title: Unlocking Specialty Drug Access: Pharmacy Strategy Meets AI Automation
Date: December 8, 2025
Host: Erica Spicer Mason (Becker's Healthcare)
Guest: Will Yin, CEO of Mandolin
Overview
This episode explores the intersection of specialty drug access, pharmacy strategy, and the role of AI automation in transforming complex healthcare workflows. Will Yin shares the origin story of Mandolin and provides in-depth insights into the current challenges in specialty pharmacy—including administrative bottlenecks and payer-driven complexity—and discusses how advanced AI-driven automation can alleviate these pain points. The conversation also touches on practical strategies for adoption, change management, and the future direction of specialty pharmacy operations.
Key Discussion Points & Insights
1. Mandolin’s Origin & Focus in Healthcare
- Personal Motivation: Will Yin was inspired by his family’s history with Alzheimer’s. Initially intending to pursue academic research, he turned his focus to resolving systemic barriers preventing patient access to breakthrough therapies.
- Industry Problem:
"The bottleneck to real patient impact is not in more science...The bottleneck is in a broken American healthcare system." (Will Yin – 01:17)
- Mandolin’s Mission:
Focused on automating the repetitive administrative work that delays lifesaving therapies, Mandolin partners with large healthcare organizations (over $10B annual drug spend) to close gaps between patients and innovative science. - Complexity of Specialty Pharmacy:
Unlike other industries, payers in specialty drugs benefit from complexity, making true automation both more challenging and more impactful.
2. Major Administrative & Operational Bottlenecks
(Timestamp: 04:00)
- Staffing Difficulties: Rapid industry growth makes it hard to hire and retain skilled workers—errors become costly as paperwork demands increase.
- Evolving Site of Care Requirements: Policy and payment reforms create new hurdles for processing specialty drugs.
- Inconsistent Processes & Documentation:
"...there's little consistency across the entire organization on the right process for them to follow in processing paperwork." (Will Yin – 04:44)
- Technology Fragmentation: A patchwork of platforms (EHRs, ePortals, PA portals) forces staff to juggle multiple systems, increasing error rates and inefficiency.
- Expertise Silos: Only workers with decades of experience have a full grasp of the complex system, limiting scalability and standardization.
3. Strategic Implications of AI Automation in Specialty Pharmacy
(Timestamp: 06:20)
- Near-Term Impact:
- Automates simple, repetitive tasks (e.g., data entry, processing).
- Reduces claims denial rates and speeds up turnaround times.
- Prevents costly mistakes; a single error with high-cost drugs can result in losses of hundreds of thousands of dollars.
- Allows health systems to handle increasing patient volumes without linear increases in staffing.
"...with high cost specialty drugs, we've seen single errors costing hundreds of thousands of dollars on a denial." (Will Yin – 07:18)
- Long-Term Vision:
- As AI becomes the norm, operations will fundamentally change (comparable to the adoption of self-driving cars).
- Shift from reactive paperwork correction to automated, robust, error-proof workflows.
4. Change Management & Adoption Challenges
(Timestamp: 09:10)
- Historical Skepticism:
Tech companies have often overpromised and underdelivered, leading to "enormous amounts of pain and scar tissue." - Organizational Complexity:
Slow-moving decision processes, competing priorities (e.g., budgeting season), and coordination hurdles are common in health systems. - Keys to Success:
- Well-documented SOPs lead to faster AI adoption and ROI.
- Consistent answers and processes across teams reduce friction during implementation.
"...the teams that get the most value the fastest are those with well documented SOPs for their patient access workflows." (Will Yin – 10:24)
5. Future Directions & Value Opportunities
(Timestamp: 11:41)
- Process Documentation is Foundational:
Solving denial and prior auth issues starts with clear, codified workflows that enable scalable automation. - Bad Debt Reduction:
- Hospitals are writing off significant revenue (often around 3% of net revenue) due to preventable errors and denied claims.
- Example: One health system lost $750,000 on a single therapy due to missed prior authorization.
"These numbers add up to tens of millions of dollars in preventable bad debt write offs." (Will Yin – 12:55)
- Central Command Opportunity:
Mandolin aims to operate as a "central command" on every script, optimizing not just for revenue but for optimal patient care and site selection.
Notable Quotes
-
On Healthcare’s True Bottleneck:
"The bottleneck to real patient impact is not in more science...The bottleneck is in a broken American healthcare system."
(Will Yin – 01:17) -
On the Complexity of Specialty Drug Infrastructure:
"For [payers], the complexity and confusion in the system is a feature, not a bug."
(Will Yin – 02:19) -
On Automating for Financial & Patient Impact:
“Most of the bad debt increases that we've seen at health systems are driven by denials caused by preventable errors with claims.”
(Will Yin – 07:03) -
On Implementation Reality:
"There's been frankly pretty shameful history of tech companies swaggering into the healthcare space and making outrageous claims."
(Will Yin – 09:39) -
On the Impact of Documentation:
"...the teams that get the most value the fastest are those with well documented SOPs for their patient access workflows."
(Will Yin – 10:24)
Important Timestamps
- 00:50 – 03:14: Will Yin’s background and Mandolin’s mission
- 04:00 – 05:48: Specialty pharmacy’s biggest operational bottlenecks
- 06:20 – 08:45: Strategic implications of automation (immediate and future state)
- 09:10 – 10:50: Change management hurdles and adoption advice
- 11:41 – 13:36: Next frontier for AI in specialty pharmacy and operational priorities
- 13:59 – 14:34: Closing thoughts on the future of specialty drug access
Tone and Style
The discussion is frank, forward-thinking, and solution-focused, marked by Will Yin’s candid critique of industry pain points and pragmatic optimism about what AI-driven automation can achieve for health systems and, ultimately, patient care.
Takeaways
- Specialty Pharmacy’s complexity requires a thoughtfully tailored approach to AI—one that recognizes payer incentives and workflow realities.
- Clear, unified processes and documentation are foundational for successful automation.
- AI holds significant promise for reducing bad debt, improving patient access, and enabling scalable operations amidst rising drug costs and administrative demands.
- Change management and realistic implementation strategies are critical, particularly given the industry's history with tech overpromising.
Listeners are encouraged to tune in to the next episode for a deeper dive into driving revenue and access in specialty pharmacy.