“American medicine is the best in the world, but the American health-care system is not,” Akasa CEO Malinka Walaliyadde says. In this Vanguards of Health Care episode, Walaliyadde joins Bloomberg Intelligence analyst Jonathan Palmer to explore how Akasa is tackling the chaos of revenue-cycle management with AI. He explains why America’s overlapping payment models create inefficiency, how large-language models read massive patient records in minutes and why custom models built for each health system outperform off-the-shelf AI. They also discuss Akasa’s performance-based business model and the path toward real-time payer-provider communication, as well as the role that grit and conviction play in building a transformative company.