How Banking Technology Could Save a Trillion Dollars in Healthcare Costs

Why would a Goldman Sachs Partner and Chief Technology Officer (CTO) walk away from one of Wall Street's most coveted positions? For Boe Hartman, who built Marcus and Apple Card from the ground up, it was seeing how banking technology could transform America's nearly $5 trillion healthcare system - and help millions of Americans who can't access the care they need.  

Now as Nomi Health’s co-founder and CTO, Hartman is applying the tools that process millions of banking transactions daily to tackle one of America’s biggest challenges: healthcare costs. By streamlining healthcare payments through direct provider pathways, this approach could potentially reduce costs by 30-50%.

On a recent episode of the podcast AI and the Future of Work, Hartman shared how modern banking technology—and artificial intelligence—can transform the healthcare industry, making care more affordable and accessible for everyone.

The numbers tell an unsustainable story

The U.S. healthcare system wastes up to $1 trillion annually due to inefficient payments, administrative complexity, and artificial price inflation. Rising premiums, unexpected medical bills, and limited access to care are the consequences of this broken system—affecting families, employers, and providers alike. 

But what if that $1 trillion could be redirected? By modernizing healthcare payments to be direct, digital, and data-driven, this money could flow back into the American economy. For employers, this means better benefits at lower costs. For providers, it means more time for patient care and less time on paperwork. And for millions of Americans, it means finally gaining access to the care they need without financial barriers.

The future of healthcare payments

Healthcare's current payment system builds unnecessary complexity into every transaction, driving up costs for everyone. "I understand payments, I know how to make markets efficient, I know how to leverage technology," Hartman explains. “By creating direct payment pathways - similar to how modern banking handles transactions - employers can reduce costs while improving benefits.”  

This new infrastructure ensures providers get paid fairly and directly, eliminating artificial price inflation while maintaining security and compliance.

"We believe if this country fully adopted the Nomi Health approach—paying in real time, paying for the real cost of healthcare (not the imaginary cost), using data analytics to ground decisions in fact and truth, and enabling providers to do what they went to school to do—practice healthcare—we can actually reduce the overall cost to self-insured employers and the government," Hartman says.

Putting artificial intelligence (AI) to work

At Nomi Health, AI serves multiple practical purposes. The company is developing a specialized Large Language Model (LLM) that integrates healthcare and banking regulations across state and federal levels. This model functions as an expert system, enabling quick, accurate guidance on intricate regulatory requirements.

"We’re creating a system that brings together state and federal regulations, banking laws, and healthcare policies to provide a clear perspective on compliance across different domains," Hartman explains.

AI is already embedded in Nomi Health’s operations. Analysts and engineers use it to simplify coding, enhance infrastructure, and improve customer experiences. It’s also applied in cybersecurity to strengthen defenses against emerging threats.

Looking to the future, Nomi Health is exploring AI for payment integrity—a crucial area in healthcare finance that ensures funds are used appropriately. "Think of it like fraud detection or credit checks in banking," Hartman says. By identifying inefficiencies or misallocations in real time, this approach could help self-insured employers make more informed decisions about their healthcare spending.

"We’re focusing on solving tangible problems—like ensuring healthcare dollars are spent in the right places—rather than chasing trends," Hartman notes. This approach mirrors how AI has successfully evolved in banking, offering targeted, impactful solutions.

Listen to the full conversation

To learn more about banking technology’s role in healthcare, listen to Hartman’s full conversation with Dan Turchin on AI and the Future of Work. What are your thoughts on bringing banking efficiency to healthcare? Join the conversation in the comments below.