Why does the same prescription cost $15 at one pharmacy and $56 at another? And why does almost nobody standing at that counter know about the savings that could change everything? In this episode of the Advancing Healthcare Innovation Show, host Michael Stamatinos sits down with Miriam Paramore, founder and CEO of RxUtility, operating advisor at Goldman Sachs, limited partner at 7wire Ventures, and one of the most experienced operators in the history of healthcare technology. This is one of the most honest and human conversations the show has ever produced. Miriam has spent 40 years building the infrastructure of American healthcare. She helped write part of the Affordable Care Act. She led enterprise strategy at Emdeon and helped take the company to a $1.2 billion IPO. She served as President of OptimizeRx on the NASDAQ. She has sat in every room that mattered in this industry. And then she watched her father navigate the system she helped build. Jack Paramore was a preacher who left the family farm to devote his life to serving others. He gave Miriam a necklace with an ampersand on it for her 50th birthday, along with a handwritten poem that read, "This is an AND moment, not an ending." When Jack got sick with kidney failure, heart failure, and severe melanoma in rural North Carolina, with no transportation coverage and $500 a month too much to qualify for Medicaid, the system failed him at every turn. In this episode: → The story of Jack Paramore, the preacher who left the farm, and what his life taught Miriam about what it means to be of genuine service to other people → How a napkin sketch in a Congressional cafeteria became healthcare law → Why a drug that costs $600 for a patient in their deductible phase can cost their employer $300 for the exact same bottle, and who is collecting the spread → Why almost 15% of all prescriptions in the United States are now being paid in cash, and why most consumers have no idea cash is often cheaper than using their insurance → The six different price points that exist for a single prescription drug and why the system keeps consumers from ever seeing all of them at once → Mimi, RxUtility's AI companion for prescription pricing, and how it answers the one question every patient deserves a straight answer to: what does this drug actually cost me today? → What Miriam sees in the first five minutes when a founder walks into a room and does not have what it takes https://rxutility.com/ Follow Miriam: https://www.linkedin.com/in/miriamparamore/ 📣 LIKE, COMMENT & SUBSCRIBE If this conversation moved you, challenged your thinking, or sparked an idea, share it with someone who needs to hear it. Subscribe for more episodes with healthcare leaders who are not just thinking differently, they’re building differently. About the Show The Advancing Healthcare Innovation Show is hosted by Michael Stamatinos, a nationally recognized connector, strategist, and advocate for innovation with purpose. Each week, Michael interviews healthcare leaders who are driving meaningful change—highlighting stories of access, resilience, equity, and transformation. The AHI Show started with the idea of wanting to highlight stories of what healthcare innovation truly looks like in action. Our mission, highlight real people who are really innovating within healthcare. Guests include healthcare entrepreneurs, providers, payers, and professionals from the investment community. We showcase little wins as well as valuable lessons learned from setbacks through these interviews. The real innovators in healthcare are often the ones in the trenches doing the work with razor-sharp focus. We find these innovators and bring their stories to light. 🔗 Michael’s LinkedIn: https://www.linkedin.com/in/michaelstamo 🎧 Subscribe for more episodes that move beyond theory and into the heart of what’s really possible in healthcare. Join our group, Advancing Healthcare Innovation Forum on LinkedIn: https://www.linkedin.com/groups/7056196/ Timestamps: 01:18 Introducing Miriam Paramore and RxUtility 04:30 Miriam responds and why she does this work 05:35 Jack Paramore, the preacher who left the farm 10:24 Jack's healthcare journey and how the system failed him 13:17 What fuels Miriam's mission to make medicine affordable 15:55 The Affordable Care Act, the napkin, and how healthcare law actually gets made 23:26 What drew Miriam to the prescription affordability problem specifically 28:57 Explaining RxUtility like you are standing at the pharmacy counter 33:46 Why this information has been hidden for so long and who benefits 37:40 The RxUtility business model and who pays 39:41 Mimi, the AI companion built to surface the best drug price for every patient 41:02 What Miriam looks for in founders as an investor and advisor 43:03 What she would tell her younger self 44:06 How to connect with Miriam and follow RxUtility