Podcast Summary: Becker’s Healthcare Podcast

Guest: Vinay Kulkarni, Chief Information Officer at SCAN Group

Host: Jacob Emerson

Date: October 31, 2025

Episode Overview

This episode features Vinay Kulkarni, CIO at SCAN Group, an organization focused on supporting older adults’ health and independence. The conversation centers on the evolving role of technology in Medicare Advantage, especially artificial intelligence (AI), automation, and the organization's approach to enhancing clinical care and member experiences. Vinay shares firsthand insights on personalized care, technology-enabled workflows, and offers strategic advice for healthcare leaders navigating technological and regulatory change.

Key Discussion Points & Insights

1. Vinay Kulkarni’s Background and Role at SCAN

• Timestamp: 00:29 – 01:07
  • 25 years’ experience in healthcare technology leadership, spanning both payer and provider systems.
  • Focused on aligning technology transformation with strategic enterprise goals.
  • Aims to deliver secure, seamless digital experiences that improve outcomes, clinician experiences, and member lives.

2. The Impact of AI & Automation on Medicare Advantage

• Timestamp: 01:34 – 03:19

  • AI as an Evolution, Not a Replacement
    • "AI and automation aren't going to replace people. That's the first thing that I want to tell everyone." — Vinay Kulkarni [01:40]
  • Human-First Approach
    • Prioritizes using AI as a tool to enhance personal, proactive, and accessible care, not as an autonomous decision-maker.
    • "Our approach is human plus machine. And notice that I say humans first because that's what really is the core of our ethic..." — Vinay Kulkarni [02:23]
  • Use Cases at SCAN
    • Identifying high-risk members for hospitalization, improving care coordination, and enhancing member experience with smarter service tools for faster, more empathetic responses.
    • Automation is used to remove administrative burden so clinical teams can focus on "relationships, care quality and member trust."
  • Ethical Implementation
    • Emphasis on explainability, fairness, and privacy.
    • "AI @SCAN is designed to support decisions, not to make decisions in isolation." — Vinay Kulkarni [02:58]
    • AI and automation will distinguish health plans delivering both quality and compassion.

3. Personalizing Care Through Technology

• Timestamp: 03:38 – 06:10

  • From Cohorts to "n of 1" Personalization
    • Traditional cohort-based healthcare is giving way to individualized approaches, recognizing each member’s unique needs.
    • "Healthcare is much more personal... We need to have an n of 1 which is basically addressing that everybody's healthcare needs are very different from the other person." — Vinay Kulkarni [03:47]
  • Tailored Support for Diverse Populations
    • Mention of SCAN’s “Embrace” ISNP (Institutional Special Needs Plan) for seniors in high-touch, institutional settings.
    • Example: Automating medical records retrieval, saving over 1,500 manual hours.
  • AI for Care Coordination
    • Automating medical record summarization for hospital discharges and case management.
    • "We also implemented some clinician copilot to improve care coordination by surfacing incomplete tasks... small little things that matter a lot for our members." [05:54]
    • Helps clinicians manage patient panels, improve documentation, and ensure task completion for better population health management.

4. Technology in Medicare Open Enrollment & Care Delivery Expansion

• Timestamp: 06:45 – 09:01

  • Enhancing the Member and Clinician Experience
    • Generative AI and automation used in contact centers to reduce after-call work—AI assists the service teams rather than replacing human interaction.
    • "We are not using technology to talk to our members, but we are using technology and AI to... support more personalized conversation with members." — Vinay Kulkarni [07:06]
  • Clinician Support & Administrative Efficiency
    • Introduction of “Care Ops” to ease clinician workflows (e.g., ambient dictation, automated task flows).
    • AI-based risk stratification enables targeted provider visits and allows for larger, higher-quality patient panels.
  • Relationship Building & Cost Reduction
    • Technology is introduced “slowly,” with the goal of fostering better clinician-patient relationships, improved care documentation, and cost savings.

5. Final Thoughts & Advice for Healthcare Leaders

• Timestamp: 09:12 – 10:29

  • Stay Close to the Business and Regulatory Landscape
    • Highlighted the importance of understanding both technology and regulatory shifts (e.g., interoperability requirements).
    • "There are changes in regulatory too. But the landscape in technology has been changing a lot this year." — Vinay Kulkarni [09:15]
    • Urges leveraging existing and new data through interoperability to enhance coverage and care.
  • Simplicity and Empathy
    • "Keeping it very simple. Many are close to your business. You can predict a lot of problems that they're going to face. We need to be empathetic to our providers and members, make it better for them." — Vinay Kulkarni [09:54]
    • Core suggestion: Simple, empathetic, member- and provider-centric improvements.

Notable Quotes & Memorable Moments

• “AI and automation aren't going to replace people. That's the first thing that I want to tell everyone.” — Vinay Kulkarni [01:40]
• “Our approach is human plus machine. And notice that I say humans first because that's what really is the core of our ethic...” — Vinay Kulkarni [02:23]
• “AI @SCAN is designed to support decisions, not to make decisions in isolation.” — Vinay Kulkarni [02:58]
• “Healthcare is much more personal... We need to have an n of 1…” — Vinay Kulkarni [03:47]
• “We also implemented some clinician copilot to improve care coordination by surfacing incomplete tasks…small little things that matter a lot for our members.” — Vinay Kulkarni [05:54]
• “We are not using technology to talk to our members, but we are using technology and AI to... support more personalized conversation with members.” — Vinay Kulkarni [07:06]
• “Keeping it very simple… We need to be empathetic to our providers and members…” — Vinay Kulkarni [09:54]

Timestamps for Key Segments

• 00:29 – 01:07: Vinay’s introduction and background
• 01:34 – 03:19: AI’s role in Medicare Advantage and SCAN’s principles
• 03:38 – 06:10: Personalization and innovation in clinical models, “Embrace” plan
• 06:45 – 09:01: Technology in member services and clinician workflows during open enrollment
• 09:12 – 10:29: Advice for health plan leaders and closing remarks

Overall, the episode offers an insightful, optimistic look at how technology can partner with people to create more compassionate, efficient, and effective care experiences for Medicare beneficiaries, with SCAN Group serving as a model for balancing innovation and empathy.