Underwritten: AI-Powered Lease Performance Insurance for Healthcare CRE

Mia Franklin interviews an AI-insurance founder and a specialty insurance credit director about Lease Performance Insurance (LPI): an emerging product that uses machine learning to underwrite operator revenue, staffing stability, reimbursement risk, and compliance signals to guarantee lease cashflows. The episode explains how AI inputs (EHR usage patterns, billing cadence, claims denials, staffing churn, foot traffic) turn operational uncertainty into actuarial risk curves insurers can price and reinsure. Guests walk through structuring LPI for clinic and outpatient portfolios, lender acceptance criteria, impacts on borrowing costs and capitalization, and a practical pilot case showing how LPI unlocked mezzanine capital and widened investor pools. Listeners leave with an LPI readiness checklist, data integration essentials, and negotiation tactics for embedding performance insurance into leases and financing packages — a pragmatic playbook for owners, operators, lenders, and investors who want bankable healthcare cashflow without depending solely on operator credit.