Founder's Story Ep 283: “He Found $500B Hidden in Healthcare Waste — And Built the AI to Fix It”

Guest: Raheel Retiwalla, Co-Founder & Chief Product Officer of Boost Health AI
Host: Daniel (IBH Media)
Date: November 18, 2025

Episode Overview

In this episode, Daniel sits down with Raheel Retiwalla, co-founder and CPO of Boost Health AI, to explore how artificial intelligence can transform the $500 billion administrative waste crisis in U.S. healthcare. The conversation delves into Raheel's personal journey, the pivotal moment that spurred his mission, the power and limitations of generative AI, and what the future of an efficient, interoperable healthcare system could look like. Raheel also shares advice for would-be tech founders and reveals the wider paradigm shift toward explainable, collaborative, and proactive healthcare systems.

Key Discussion Points & Insights

1. The Moment of Realization: $500B in Hidden Waste

[02:07]

• Raheel’s “aha” moment came in 2020, when a JAMA and McKinsey report revealed $500 billion in administrative waste—not in care delivery, but in the “management of how healthcare runs.”
  • Quote: “It wasn’t until in 2020...a study was released...that mentioned $500 billion of waste, administrative waste in just managing how healthcare runs...That stuck in us.” (Raheel, [02:16])
• COVID and its operational disruptions heightened this awareness and urgency.

2. Why AI, Why Now: The Role of Timing and Technology

[03:36]

• Generative AI’s emergence and post-COVID financial strain on health systems converged to create the right timing for Boost Health.
  • Quote: “The need to actually create efficiencies has multiplied and become more urgent...Generative AI as a solution...came about.” (Raheel, [04:02])
• Administrative waste largely stems from human “manual validation of rules” trapped in documents.
  • Quote: “All of those things are essentially rules, rules that are stuck inside PDFs, in guidelines, in policies, in regulations, in benefit statements.” (Raheel, [05:04])
• Boost Health’s vision: Use generative AI to "unlock those rules" and embed them into workflows for consistent, accurate, and rapid decision-making.

3. Explainable, Auditable AI: Moving Beyond the Black Box

[07:07]

• The critical need for AI transparency and explainability in healthcare decision-making.
  • Quote: “Everything that happens in healthcare has to be able to say exactly where it got that from, cite the facts. In our case...which policy statement, what document, what regulation...” (Raheel, [07:34])
• Boost Health’s radical approach: Sharing their IP with clients so they “own their intelligence” rather than relying on opaque, locked-in vendor solutions.

4. Collaboration & Interoperability

[10:10]

• Daniel raises future potential for collaborative, open healthcare data/API ecosystems.
• Raheel offers a pragmatic take:
  • Interoperability is already legally mandated, but most health organizations need to clean up internal efficiencies before true sharing delivers value.
  • Quote: “If one hand doesn’t know what the left hand is doing, it doesn’t work...So there’s an opportunity to clean up stuff, make yourself more efficient while...interoperability...is going to happen anyway.” (Raheel, [10:33])

5. Real-World Impact: Automating & Unlocking Health Policy

[14:16]

• Boost Health’s approach starts with analyzing and extracting rules in “locked” documents like medical policies.
  • Quote: “You unlock a medical policy...imagine if we were able to tell your doctor...when they're submitting an authorization...your submission is incomplete—here’s why—provide this level of information.” (Raheel, [15:20])
• Tangible benefits: Minimized back-and-forth between doctors and payers, faster authorizations, reduced delay in patient care.

6. The Multiplier Effect: Towards Trillion-Dollar Impact

[16:36]

• Daniel summarizes: Addressing $500B is just the beginning—true system transformation could unleash trillions in savings globally.
• Raheel envisions not just incremental efficiency, but “rewiring” processes for 50%+ improvement.
  • Quote: “Our goal...is not to just do what is already being done, just faster. It’s to rewire things...gaining 50% improvement, not 10%.” (Raheel, [17:34])
• Long-term hope: Proactive healthcare, better health outcomes, AI-enabled prevention.

7. Founder's Advice: Become a Deep Domain Expert

[21:37]

• For aspiring founders tackling complex spaces:
  • Quote: “Get to know a domain really well...If you start focusing on those inefficiencies, you’re going to make businesses run better, which just allows them more capital, more ability to invest in different ways.” (Raheel, [21:41])
• Adds practical advice: Leverage AI to handle the mundane—freeing humans for creative, high-value work.

Notable Quotes

• “It wasn’t until in 2020...a study was released...that mentioned $500 billion of waste, administrative waste in just managing how healthcare runs...That stuck in us.”
  — Raheel ([02:16])

• “It’s great that you have a technology, but without a real problem, it becomes...just another thing.”
  — Raheel ([04:04])

• “Everything that happens in healthcare has to be able to say exactly where it got that from, cite the facts.”
  — Raheel ([07:34])

• “We’re giving away our Boost Health IP so that our clients can actually see the code and use it...This allows them to have control over their AI.”
  — Raheel ([08:37])

• “If one hand doesn’t know what the left hand is doing, it doesn’t work...So there's an opportunity to clean up stuff, make yourself more efficient while...interoperability...is going to happen anyway.”
  — Raheel ([10:33])

• “Our goal is not to just do what is already being done, just faster. It's to rewire things...gaining 50% improvement, not 10% or 15%.”
  — Raheel ([17:34])

• “Get to know a domain really well...If you start focusing on those inefficiencies, you’re going to make businesses run better...”
  — Raheel ([21:41])

Important Timestamps

• [02:07] – The $500B healthcare waste revelation and COVID’s influence
• [04:02] – Generative AI meets urgent industry need
• [07:07] – The problem with “black box” AI in healthcare
• [10:10] – Interoperability: hope and current limitations
• [14:16] – How unlocking medical policies with AI transforms care cycles
• [16:36] – Potential for trillions saved and a global healthcare transformation
• [21:37] – Founder's advice: Domain expertise and real problem-solving

Memorable Moments

• Daniel’s reflection on daily reliance on generative AI for health advice:
  “I can't live without generative AI. I use it every five minutes of the day...I don't know if that's a good thing or not, but everything it told me has been factually correct.” ([06:36])

• Raheel’s transparency pitch:
  “We’re giving away our Boost Health IP...so [clients] can have control over their AI.” ([08:37])

• Daniel’s enthusiasm for democratized innovation:
  “You could have people on an island somewhere...that can do something that might solve a problem globally.” ([23:10])

Conclusion and How to Connect

[24:14]

• Raheel invites listeners to connect at BoostHealthAI.com, emphasizing the openness of their team and approach.

Host’s Closing Thought:
Daniel expresses optimism about the massive, transformative potential of AI-driven healthcare efficiencies and hopes for a future conversation when Boost Health AI has realized its vision.

This episode offers a compelling, practical vision for reducing healthcare waste, increasing transparency, and harnessing AI to move from reactive to proactive health—anchored by Raheel’s clear, domain-informed leadership and actionable advice for entrepreneurs.