Welcome back to Care Decoded, the podcast where we break down the complexities of healthcare technology, documentation, coding, quality, and clinical AI to help organizations work smarter, not harder. In this special New Year’s episode, hosts Dr. Sunil Nihalani and Mark McKeown turn the spotlight inward, reflecting on everything 2025 taught the industry and their own team at Inferscience.
This year was nothing short of a stress test for healthcare, marked by evolving CMS expectations, tougher audits, turbulence in risk adjustment, and a critical shift for AI from pure hype to real accountability. Dr. Sunil Nihalani and Mark McKeown discuss why flashy new tools often fell flat and how true progress came from technology that reduces clinician burden, works seamlessly inside clinical workflows, and, most importantly, earns trust.
Join them as they unpack the year's biggest lessons, share the real-world feedback they heard from hundreds of clinicians and leaders, and preview the themes that will define success in 2026: audit readiness, real-time intelligence at the point of care, and building genuine trust across the industry. Whether you're a clinician, health plan leader, or health tech enthusiast, this episode is packed with insights to help you navigate the ever-evolving landscape of healthcare innovation.
Timestamsp:
00:00 "Care Decoded: Healthcare Insights 2026"
03:29 "Compliance Evolution and Clinician Support"
06:38 "Clarity, Speed, Confidence"
09:46 Enhancing Healthcare Workflow Intelligence
12:59 "Decoding Care in 2026"
Care Decoded Podcast: Key Healthcare and Technology Insights from the 2025 Stress Test
The latest episode of the Care Decoded podcast offered listeners a deep dive into pivotal takeaways from 2025, a year described as a true “stress test” for the healthcare industry. Hosted by Dr. Sunil Nihalani, CEO of Inferscience, and joined by colleague Mark McKeown, the conversation focused on evolving CMS expectations, regulatory crackdowns, AI accountability, and the urgent need for solutions that genuinely support clinicians and health plans. Here are the key insights and strategic themes discussed, perfect for healthcare leaders and technology innovators aiming to thrive in 2026.
The Challenges and Lessons of 2025 for Healthcare
Reflecting on the previous year, both hosts agreed that 2025 fundamentally changed the landscape for payers and providers. Dr. Sunil Nihalani summed it up by noting, “2025 was not just another year; it was a stress test for healthcare.” The industry faced evolving and tougher CMS expectations, intensified audit scrutiny, and a palpable push for risk adjustment improvements. Notably, AI began to shift from hype to a tool where real accountability was demanded.
One of the biggest takeaways was the realization that simply deploying more technology or collecting more data is not enough. As Mark McKeown shared, “AI without workflow is just more noise. More data isn’t helpful, but more actionable intelligence is.” Many organizations had invested in flashy dashboards or layered new tech onto stretched clinicians, only to find that these solutions often created more complexity rather than solving core problems.
Technology Must Work for Clinicians, Not Against Them
A recurring theme throughout the conversation was the importance of integrating technology into existing clinical workflows. The tools that made the biggest impact were those “integrated directly into clinical workflows, surfaced intelligence at the right moment, and earned clinicians’ trust,” according to Mark McKeown.
Dr. Sunil Nihalani echoed these insights, especially from his work with health plans facing increased audit pressures and rising documentation requirements. He highlighted that documentation accuracy is now “completely existential,” and the shift in 2025 moved compliance from a one-time event to a continuous mandate. The message from clinicians was equally loud and clear: Do not overload us with more tools; instead, provide reliable support embedded in our workflow.
Breaking Down Silos for Better Outcomes
Both speakers emphasized the danger of operational silos within health plans, separating quality, coding, compliance, and documentation. Mark McKeown shared, “Health plans have finally started to realize that they really had to put these silos together. Not only did it improve, but it also produced better and more appropriate healthcare.”
This integration leads to more clarity, speed, and confidence across the board. Clinicians reported that when the right support was in place, they felt less like they were being surveilled and more genuinely supported.
Priorities for 2026: Compliance, Real-time Intelligence, and Trust
Looking forward, the hosts mapped out the essential priorities for healthcare leaders in 2026. Compliance precision stands out as non-negotiable, with accurate, defensible, and audit-ready documentation now required before any claim enters processing. Real-time decision enablement is another must, with intelligence provided during the actual care encounter, not after the fact in lengthy dashboards or spreadsheets.
Equally critical is building technology that inspires trust. Dr. Sunil Nihalani concluded, “Trust between clinicians and the data, trust between health plans and providers, and trust between patients and the healthcare system is what will define success.”
Inferscience’s Direction for 2026: Usability and Partnership
As Inferscience looks ahead, the focus is on embedding actionable intelligence directly into EHR workflows, prioritizing clinician-first usability, and ensuring documentation is accurate and audit-ready before leaving the EHR. They’re also working on enhancing user interfaces to provide relevant, timely recommendations with minimal noise.
Expanding partnerships with health plans and providers who want proven, responsible AI is also a core goal for 2026. Inferscience aims to reduce burden while improving precision and give clinicians back “a little time at the end of the day,” according to Mark McKeown.
Final Word: Smarter and More Human Technology
The episode wrapped up with a commitment to clarity, innovation, and more human-centric technology in healthcare. The team at Inferscience and the Care Decoded podcast invite leaders to connect for collaboration and to create smarter systems that support real people, every day.
Stay tuned to Care Decoded for more episodes focused on clarity, real conversation, and actionable guidance for healthcare's most complex challenges.
Podcast's Website - https://caredecoded.com/
Dr. Sunil Nihalani - CEO and Founder at Inferscience - https://www.linkedin.com/in/sunil-nihalani-a6983a5/
Inferscience - https://www.inferscience.com/
Podcast Powered by TopHealth - https://tophealth.care/
“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”