Disrupting Healthcare's Billion-Dollar Leak With Matt Seefeld
The U.S. healthcare revenue cycle is a multi billion-dollar problem plagued by inefficiency. MedEvolve CEO Matt Seefeld explains how generative AI and human accountability can reduce administrative waste, achieve "zero touch" claims, and ultimately improve patient access to care across the nation.
TAMPA BAY, Fla., Dec. 4, 2025 /PRNewswire/ -- The U.S. healthcare revenue cycle management (RCM) market is a staggering $172.24 billion industry, yet it's plagued by inefficiencies that cost providers billions. (1) Claims adjudication alone costs healthcare providers over $25.7 billion, with nearly $18 billion wasted on claims that are eventually paid. (2) In a recent episode of the Disruption Interruption podcast, host Karla Jo Helms (KJ) sat down with Matt Seefeld, CEO of MedEvolve, to discuss this financial chaos. Seefeld explains how his company is using generative AI and a unique focus on human accountability to transform one of the most bureaucratic parts of healthcare. "The amount of human touches and handoffs and waste on the administrative side is the billion-dollar problem," Seefeld states. "Payers are making it so hard to interpret what a provider can do, and they use that leverage to deny you."
The High Cost of a Broken System
The U.S. healthcare system is in a state of crisis, with providers, payers, and patients caught in a web of misaligned incentives. This makes it nearly impossible to determine the true cost of care. Seefeld points out that this lack of transparency leads to enormous administrative waste, with providers touching claims multiple times before they are paid, if they get paid at all. "I can go to a provider and say that you're not even getting paid on half your claims without a human intervention," he says.
The problem is compounded by what Seefeld calls "payer games," where insurance companies intentionally create complexity to deny claims. "They're investing billions of dollars in AI to deny medical claims knowing that the providers won't have the workforce to keep up with all that," he explains. The consequences are dire: as costs rise and reimbursements fall, small and rural hospitals are forced to close, limiting healthcare access for millions of Americans.
Seefeld warns that without fundamental change, the system is unsustainable. "We're only buying time. And, uh, while AI, AI, AI and all these amazing AI companies and clinical AI and all that, I'm telling you right now, who can afford to pay for those?" he questions. "There are a lot of smart people building really amazing companies with great vision that can't be bought because there's no money left."
A Path Forward with AI and Accountability
Despite the grim reality, Seefeld believes there is a solution. His company, MedEvolve, focuses on bringing accountability to the forefront by tracking every human touch on a claim. By combining this data with generative AI, they can identify and eliminate wasted effort, dramatically reducing labor costs and improving revenue. Seefeld notes that an astonishing 63% of claim touches are wasted effort due to system inefficiencies.
However, he cautions that AI is not a silver bullet. "More than half, 53% of the errors that we see that humans have to get involved with come from AI solutions, so they're not smart enough yet," Seefeld reveals. He sees MedEvolve's role as a feedback loop, using human interaction data to make AI engines smarter and more effective.
By targeting inefficiencies, Seefeld aims to help providers achieve "zero-touch" claims, where a claim is paid without any human intervention. This not only improves a provider's financial health but also allows them to continue serving their communities. "If I can keep the doors open to a small critical access hospital in a small community in Wyoming, and those patients don't have to drive to Cheyenne to get treated… let's do it," he says. "Because there's still a lot of waste that we control."
Links
Disrupting Healthcare Revenue Cycles: From Human Burden to Intelligent Automation, with Matt Seefeld
LinkedIn: https://www.linkedin.com/in/matt-seefeld-521319/
Company Website: https://medevolve.com
Disruption Interruption is the podcast where you will hear from today's biggest Industry Disruptors. Learn what motivated them to bring about innovation and how they overcame opposition to adoption.
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About Disruption Interruption™
Disruption is happening on an unprecedented scale, impacting all manner of industries— MedTech, Finance, IT, eCommerce, shipping, logistics, and more—and COVID has moved their timelines up a full decade or more. But WHO are these disruptors and when did they say, "THAT'S IT! I'VE HAD IT!"? Time to Disrupt and Interrupt with host Karla Jo "KJ" Helms, veteran communications disruptor. KJ interviews badasses who are disrupting their industries and altering economic networks that have become antiquated with an establishment resistant to progress. She delves into uncovering secrets from industry rebels and quiet revolutionaries that uncover common traits—and not-so-common—that are changing our economic markets… and lives. Visit the world's key pioneers that persist to success, despite arrows in their backs at www.disruption-interruption.com.
About Matt Seefeld
Matt Seefeld is a visionary leader in healthcare revenue cycle management, transforming one of the most bureaucratic parts of the industry with innovative technology and a focus on human accountability. As the CEO of MedEvolve, Matt is pioneering solutions that empower providers to achieve a "zero-touch claim" process, eliminating inefficiencies and enabling them to focus on delivering high-quality care. His work addresses the multi-billion-dollar leak caused by unnecessary human intervention in claims processing, giving providers the tools they need to streamline operations and improve financial outcomes.
With over 20 years of management consulting experience in the healthcare industry, Matt has a proven track record of designing and implementing process improvement programs and intelligent workflow automation. Before joining MedEvolve in 2017, he founded Interpoint Partners, LLC, where he developed an intelligent workflow automation and analytics solution, serving as Chairman and CEO until its acquisition by Streamline Health in 2011. He has also held senior roles at Stockamp & Associates (now Huron Consulting Group), PricewaterhouseCoopers (PwC), and Deloitte Consulting, where he honed his expertise in healthcare and life sciences.
Beyond his professional achievements, Matt is the founder of myLifeLink, a free virtual community app designed to support individuals struggling with addiction. In his spare time, he channels his passion for mentorship by coaching track and field and youth baseball. Matt's innovative approach to revenue cycle management and his commitment to improving both healthcare systems and individual lives make him a true disruptor in the industry.
About Karla Jo Helms
Karla Jo Helms is the Chief Evangelist and Anti-PR® Strategist for JOTO PR Disruptors™. Karla Jo learned firsthand how unforgiving business can be when millions of dollars are on the line — and how the control of public opinion often determines whether one company is happily chosen, or another is brutally rejected. Being an alumnus of crisis management, Karla Jo has worked with litigation attorneys, private investigators, and the media to help restore companies of goodwill into the good graces of public opinion — Karla Jo operates on the ethic of getting it right the first time, not relying on second chances and doing what it takes to excel. Helms speaks globally on public relations, how the PR industry itself has lost its way, and how, in the right hands, corporations can harness the power of Anti-PR to drive markets and impact market perception.
References
- Grand View Research. "U.S. Revenue Cycle Management Market Size Report, 2030." Grandviewresearch.com, 2023, grandviewresearch.com/industry-analysis/us-revenue-cycle-management-rcm-market.
- Alkire, Michael J, et al. "Claims Adjudication Costs Providers $25.7 Billion - $18 Billion Is Potentially Unnecessary Expense." Premier, Premier Inc, 24 Feb. 2025, premierinc.com/newsroom/policy/claims-adjudication-costs-providers-257-billion-18-billion-is-potentially-unnecessary-expense.
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SOURCE Disruption Interruption
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