Interview
In conversation with
Sebastian Gruber
Dr. Sebastian Gruber is rebuilding the rails of health insurance with hi.health—a white-label payment and card platform that lets insurers issue virtual and physical cards so members don’t pay upfront and claims data flows in structured, real time from the point of care. Think smoother reimbursement for patients, cleaner data for payers, and a business model that blends SaaS with interchange and FX at scale. Following its April 2025 acquisition by Pliant, hi.health continues independently inside the group to focus on insurance-native infrastructure.
Let’s stop building workarounds for broken processes—and start redesigning the system around the people it’s meant to serve.
Gruber’s thesis starts with incentives: patients, payers, and providers optimize for different outcomes, so solutions must align value across all three or they stall. Payment infrastructure is a leverage point—remove upfront burden for patients, deliver clean, timely data to payers, and embed into clinical and financial workflows rather than sitting beside them. He is allergic to one-size-fits-all “move fast” mantras; in healthcare, trust, safety, and compliance set the pace. The path he outlines is long-cycle but practical: design for cross-border standards, outcome-based reimbursement, and transparent data rights; build adaptable, digitally fluent teams; and treat VC as fuel for sustainability, not growth theater. Above all, resist app-for-app’s-sake thinking: durable impact comes from the rails that make every transaction simpler, safer, and more human.
Lessons from Health Payments at Scale:
Infrastructure, Not Apps
What we cover
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How a white-label card and payment platform eliminates upfront pay while streaming structured claims data to insurers
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Why aligning incentives across patients, providers, and payers beats “disruption” rhetoric in healthcare
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What sustainable economics look like—SaaS plus transaction revenue—and how acquisition can accelerate scale without losing focus
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Where regulation must evolve—cross-border standards, outcome-based reimbursement, clear pathways for digital and AI tools
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Which team qualities matter most now—adaptability, digital fluency, and system-level thinking anchored in patient impact
Sebastian Gruber is the co-founder of hi.health, a company transforming how insurers handle payments through a white-label payment platform. Since 2019, he has scaled the business and raised over €10 million in venture capital. In 2025, hi.health was acquired by Pliant and now operates independently within the group. Before founding hi.health, Sebastian worked in strategy consulting and holds a PhD in game theory.
About
Dr. Sebastian Gruber
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