Welcome back to Relocalizing Health, the podcast uncovering how communities can take back healthcare from profit-driven systems and put people first. In today’s episode, host Dave Chase sits down with Dr. Rushika Fernandopulle, co-founder of Iora Health and current co-founder of Liza Health, to discuss the next frontier in primary care innovation. With heartfelt stories from the frontlines, Dr. Fernandopulle exposes the perils of fragmented, transactional medicine, where patients are overwhelmed with prescriptions and disconnected from real human care. Together, they explore how redesigning primary care - focused on relationships, not transactions - can restore the American dream for everyday people, improve outcomes, and even lower costs.
Dr. Fernandopulle shares how Iora Health’s pioneering model brought humanity back to healthcare, using health coaches, technology, and a payment approach that actually rewards better health. You’ll hear compelling examples, from helping a socially isolated patient navigate her city to slashing unnecessary medications for complex patients that highlight just how transformative relationship-based care can be.
Tune in for a compelling conversation on the power of independent primary care, the role of technology (including AI), and how communities can push for the changes needed to make healthcare work for everyone. Whether you’re a clinician, an employer, or invested in your local healthcare system, this episode is packed with actionable insights and hope for a better future in healthcare.
Timestamps:
00:00 Exceptional Family-Centric Healthcare Model
05:23 "Meds Roulette: A Risky Routine"
09:43 Patient Accountability Partnership Model
12:33 Seniors' Isolation Addressed by Community Care
16:20 Building Iora Health: Custom EHR Development
19:00 Specialists Outnumber Primary Doctors in the US
23:07 Rethinking Healthcare Systems
25:39 AI in Healthcare Revenue Management
28:54 "Payment Model Shifts in Healthcare"
32:05 Prioritizing Care Over Profit
35:01 Population Management in Healthcare Practices
38:47 Reducing Healthcare Costs Benefits All
42:21 "Restoring Humanity to Healthcare"
43:43 "Business Diversity at Rosetta Fest"
Restoring Humanity in Healthcare: Lessons from
Dr. Rushika Fernandopulle on the Relocalizing Health Podcast
Healthcare in the United States faces overwhelming challenges: fragmented care, overprescription, burned-out primary care physicians, and ever-mounting costs. The latest episode of the Relocalizing Health podcast, hosted by Dave Chase, brings these pressing issues to light through a candid conversation with Dr. Rushika Fernandopulle, co-founder of Iora Health and Liza Health. Their discussion offers not just critique, but solutions and hope for reclaiming healthcare’s original purpose: making people healthier.
An Unfortunate Reality: Fragmentation and Overprescription
Dr. Fernandopulle shares a powerful story that encapsulates the pitfalls of our current healthcare system. He describes a patient who arrived at his clinic burdened by 37 medications prescribed by 11 different doctors. No one coordinated her care, and her well-being was at risk. This scenario, unfortunately not uncommon, underscores how today’s healthcare too often values transactions over relationships and complexity over simplicity. The primary goal, as Dr. Fernandopulle repeatedly emphasizes, should be health, not just providing more services.
A New Model: Relationship-Based, Community-Focused Care
From his experience building Iora Health, Dr. Fernandopulle argues for redesigning primary care from the ground up. The secret sauce? Fewer patients per doctor, stronger provider-patient relationships, and expanding the care team to include health coaches: empathetic individuals from the patient’s own community. These health coaches, sometimes called “accompanitors,” help patients navigate their daily challenges, from managing medication to overcoming social isolation, even teaching them skills like riding public transit to stay connected. This level of holistic care isn’t just compassion for compassion’s sake; it’s what truly drives better health outcomes.
Innovating with Technology But Keeping It Human
Healthcare buzz is increasingly about artificial intelligence and technology. But Dr. Fernandopulle is clear: technology alone isn’t the answer. We need tech that supports, not replaces, human relationships. At Iora, Fernandopulle’s team built their own care collaboration platform, not just to bill more efficiently, but to help doctors and coaches collaborate around each patient’s needs.
Looking to the future, Dr. Fernandopulle envisions using AI to empower primary care teams to manage larger patient panels without sacrificing humanity. AI shouldn’t be used to automate bad processes or pad billing, but to free up clinicians’ time for what matters: connecting with and helping patients.
Fixing Payment: From Volume to Value
A recurring theme throughout the episode is the need to overhaul payment models. U.S. primary care is hobbled by fee-for-service payments that reward more visits and referrals, not better health. The new vision? Paying doctors to keep people healthy, not just treat illness. This not only restores dignity and purpose to primary care jobs but pays real dividends: studies repeatedly show that investing in primary care saves costs across the system.
Empowering Communities and Independent Practices
Dr. Fernandopulle advocates for community-driven, independent practices rather than further corporatization. With the right payment models and platforms, these practices can thrive, tailoring care to their communities and breaking free from burdensome bureaucracy. Employers, local leaders, and progressive payers have immense power to drive this change.
Conclusion: A Call to Reclaim Healthcare’s Purpose
As Dr. Fernandopulle puts it, restoring humanity is not just a tagline: it’s a movement. We can have a healthcare system where relationships matter, where technology supports care instead of replacing it, and where incentives align with health, not illness. The Relocalizing Health podcast episode is a must-listen for anyone eager to help transform American healthcare from the ground up.
Learn More:
RosettaFest 2025 - https://rosettafest.org/
Health Rosetta - http://healthrosetta.org/
Nautilus - https://www.nautilushealth.org/
Kynexions - https://kynexions.com/
Dave Chase - https://www.linkedin.com/in/chasedave/
Podcast Website - https://relocalizinghealth.com/