AI Bias in Healthcare for Health Plan CEOs to Avoid Lawsuits & Increase Revenue with January Montaño

In this episode of When Health Freezes Over, Host Omar Haq is joined by guest January Montaño, MPS, CEO and Founder at January's Advisory Group, to explore one of healthcare’s most urgent questions: Can AI improve outcomes without deepening inequities? The conversation dives into AI governance, vendor accountability, algorithmic bias, and the widening gap between healthcare organizations with robust AI infrastructure and those struggling to keep up. January shares why governance not technology alone will determine whether AI becomes a force for health equity or reinforces existing disparities. January’s Advisory Group, a Denver-based AI governance consultancy specializing in equitable, auditable, and revenue-generating AI systems. With nearly three decades of experience in healthcare policy, Medicaid, public health, and healthcare operations, January has advised health plans, hospitals, and government agencies on healthcare transformation, algorithmic accountability, and health equity. January has testified before the Colorado General Assembly on AI bias and serves as a leading voice on responsible AI adoption in healthcare. **Expect to Learn:** \- Why AI governance is becoming a healthcare necessity, not a compliance exercise \- Who is legally accountable when AI-driven healthcare decisions go wrong \- How algorithmic bias can impact access to care, housing, and employment \- Why rural hospitals face a growing AI divide \- How health equity can drive financial performance and better outcomes \- The role of social determinants of health in AI-powered healthcare \- What healthcare leaders should do before deploying AI systems ### **Timestamps:** 00:00 – Teaser 01:26 – Why Healthcare AI Needs More Than Efficiency 00:59 – Setting the Stage: Healthcare’s AI Inflection Point 02:15 – January Montaño’s Journey Into AI Equity 05:22 – Who Is Accountable When AI Makes the Wrong Decision? 06:16 – Why Health Plans Carry the Legal Risk 09:24 – Defining Real AI Governance in Healthcare 10:41 – Building Governance Beyond Policies and Paperwork 13:03 – The Reality of AI Adoption Across Health Systems 16:30 – The Growing Digital Divide Between Large and Rural Providers 18:46 – AI, Social Determinants of Health, and Equity 19:43 – How Biased AI Restricts Access to Care and Services 22:06 – Examples of Responsible AI in Healthcare 23:22 – Introducing the ROI Equity Framework 24:31 – Why Equity Should Be Treated as Revenue 26:02 – Turning Equity Gaps Into Business Opportunities 27:09 – The Mount Sinai Food Insecurity Case Study 29:07 – Early Intervention and Better Patient Outcomes 30:50 – Connecting Food Security to Lower Healthcare Costs 33:08 – Stable Patients Create Sustainable Health Systems 35:04 – Rethinking Incentives in Healthcare Financing 37:20 – Long-Term Investment vs Short-Term Healthcare Economics 49:39 – A Practical Six-Month AI Roadmap for Health Plans 50:22 – The First 90 Days of Building AI Governance 51:11 – Auditing Existing AI Systems and Vendors 57:24 – Reporting AI Risk and Performance to the Board 58:47 – Creating a Defensible and Compliant AI Strategy 59:07 – Why Actuaries Must Move Beyond Accuracy 01:00:13 – Auditing Models for Fairness and Bias 01:02:42 – Closing Remarks **Follow Guest January Montaño, MPS:** LinkedIn: https://www.linkedin.com/in/januarymontano/ Instagram: https://www.instagram.com/january.montano/ Company LinkedIn: https://www.linkedin.com/company/januarysadvisorygroup/ Company Website: https://www.januarysadvisorygroupllc.org/ **Follow Host Omar Haq:** LinkedIn: https://www.linkedin.com/in/omar-haq1/ Company Website: https://www.mushincg.com/ Instagram: https://www.instagram.com/mushincgllc Tiktok: https://www.tiktok.com/@uberactuary **Follow Us On:** YouTube: https://www.youtube.com/channel/UC7CR1wzokjtVdyyWHLziUJQ/ Spotify: https://open.spotify.com/show/3bRobaBZlM3IbCJ5334PJV?si=41aa6416371e4bc2 Apple Podcast: https://podcasts.apple.com/pk/podcast/when-health-freezes-over/id1887501951