Suggestions
Nikhil Krishnan
Founder of Out-Of-Pocket
Nikhil Krishnan is the founder and "Thinkboi" at Out-Of-Pocket, a platform aimed at making healthcare more accessible through humor and relatable content. He has a background in sustainable development and business management, having graduated from Columbia University in 2014. His professional experience includes roles such as the Strategic Partnerships Manager at TrialSpark and Senior Industry Analyst at CB Insights, where he focused on digital health and biotechnology trends.
At Out-Of-Pocket, which he founded in February 2020, Krishnan uses memes and humor to educate people about the complexities of healthcare operations. His approach aims to demystify the healthcare system and engage a broader audience.14 He is also active on Substack, where he publishes a newsletter that has gained significant traction, reaching tens of thousands of subscribers.23
In addition to his current venture, Krishnan previously founded Get Real, a platform designed to facilitate structured online-offline friendships, and has held various internships in organizations like Uber and the Earth Institute.14 His work emphasizes a blend of humor and critical analysis of healthcare, making complex topics more digestible for the general public.
Highlights
I know I gotta save for retirement and all this shit but I feel like I could do so much cooler and more fun things with money today
it’s been surprising to me how little innovation there’s been in the fraud waste and abuse space in healthcare despite a massive amount of fraud happening in the space. This seems to be some combo of:
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very few people have access to the data needed to make a fraud claim or even build the models to detect fraud (e.g Optum and Change are the largest players here I believe because they have access to claims data)
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The business model kind of sucks, you need to either demonstrate that something didn’t happen because of you (e.g. fraud avoided) or you get paid only when you do detect fraud and take a % of collections (very lumpy and hard to build a big business around)
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There’s very little incentive to find fraud and lots of disincentive - orgs obviously don’t want to root out fraud in their own companies because it looks bad on them, and counterparties in a lot of cases or the dollar amounts the fraud is dealing with are too small for massive orgs to care about.
