The ACO Show

Dr. Caroline Fife and Dr. Christopher Apostol join us to explore the rising cost of skin substitutes in wound care, which Aledade data suggests is a tenfold increase in the last three years. Dr. Fife explains that rising costs are due to an increase in both cost of the product and increased usage and she addresses the real concerns such as the way many skin substitutes are exempt from FDA review, offer rebates or discounts to clinicians and how some Medicare payment models incentivize the use of more expensive treatments. Dr. Apostol also notes how wound care has evolved through the lens of primary care, including an increase in specialist utilization and mobile wound care teams. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Dr. Amelia Bond and Dr. Dhruv Khullar join us to discuss the long-term savings of accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP). Their recent study in JAMA found that ACOs generate increasing savings over time, with physician-led ACOs demonstrating more significant savings. Learn about their study's methodology, policy implications for The Centers of Medicare & Medicaid Services (CMS) and where Dr. Bond and Dr. Khullar will focus their research next. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Natalie Davis, CEO of United States of Care, joins us to talk about the challenges of discussing value-based care with patients and policymakers. Through extensive research with over 30,000 individuals, Davis shares that the term "value-based care" often evokes negative connotations of low-quality care. When presented with the benefits of value-based care without using the term itself, people were most interested in spending more time with their doctors and receiving personalized, quality care. Join us to learn more about effectively communicating with patients and policymakers about value-based care. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

A majority of those with behavioral health challenges lack access to high-quality care. Gabe Diop, co-founder of Rula, a behavioral health physician group, joins the ACO Show to discuss how Rula is making behavioral health care more accessible by partnering with primary care practices to connect patients with the care they need. Dr. Samantha Cotler, family medicine physician in Wall, N.J., explains how her partnership with Rula has improved patient outcomes and made it easier to connect patients with in-network physicians. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom.

The U.S. faces a significant shortage of primary care physicians, particularly in rural and under-resourced communities. Join Eli Greenspan, policy advisor at Foley Hoag LLP, and Dan Bowles, general manager of Practice Health Solutions at Aledade, to highlight the role that international medical graduates play in addressing this shortage. They explain the complex process that international medical graduates must complete to practice in the U.S., and how the physician shortage is connected to immigration policy. This includes the Conrad 30 Waiver Program, which incentivizes graduates to practice in under-resourced areas. While this program is valuable, it's also limited in scope, so our guests explore additional legislative efforts to improve and expand these programs. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom.

Aledade CEO, Dr. Farzad Mostashari, and best-selling author Geoffrey Moore explore how the concepts in Moore's influential book, “Crossing the Chasm” can be applied to accelerate adoption of value-based care. In order to move to mainstream adoption, it's crucial to focus on the niche market of “pragmatists in pain” who have an urgent need that the current system isn't solving. Our co-host Sean Cavanaugh, chief policy officer at Aledade, points out that oftentimes in the traditional fee-for-service model, the pragmatists in pain are independent primary care clinicians. Moore and Dr. Mostashari also share insights and recommendations for the new administration from their recent article, including focusing on primary care, defining the competition and paving the way for simplifiers who can help clinicians navigate the complexities of value-based care. Using this framework, the Center for Medicare & Medicaid Services (CMS) could accelerate expansion of value-based care to the majority of the nation's primary care clinicians as well as their patients. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom.

Join us this episode as our guests from Aledade, Dennis Liubyvyi, Director of Artificial Intelligence (AI) Research, and Jette Henderson, Staff AI Researcher, explain the world of AI and machine learning and its potentially transformative impact on health care. Dennis shares how AI models at Aledade are reshaping patient care by analyzing vast amounts of patient data to predict critical health events such as kidney disease progression and congestive heart failure. The goal is to provide more timely, targeted interventions to patients who need them most. Jette also notes the challenges that exist in these predictive models, particularly regarding biases within data sets, which can lead to inaccurate predictions and how Aledade is developing tools to help identify and mitigate these biases. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Dr. Sameer Sheth, President and Co-Founder of Chamber Cardio, joins Josh and Sean to discuss the opportunities and challenges for specialists, particularly cardiologists, in transitioning to value-based care. Dr. Sheth notes that cardiologists have traditionally been slower to adopt value-based care because of a lack of financial incentives, but an increasing drive to remain independent is pushing more cardiologists towards value-based models. Dr. Sheth shares how he and Chamber Cardio are working to create a network of cardiologists, health plans, and tools to better incentivize their transition to value-based care. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Join Melanie Phelps, Senior Advocacy Advisor for Health System Transformation at the American Hearth Association (AHA), to discuss her recent research which explores the impact of ACO-driven value-based care from the patient and caregiver perspectives. Melanie explores the overwhelmingly positive results of the study, which found that patients and their caregivers experienced better care, better support, and better patient outcomes as a result of their clinicians' participation in an ACO. Dr. Julie Prosedda, Family Medicine Physician in Wilmington, DE and a participant in the AHA study, joins us to explore the reasoning behind these benefits of value-based care for patients, which is largely due to better relationships with their primary care physicians, as well as access to timely support and resources from an expanded care team. This more wholistic, patient-centered value-based care leads to enhanced patient engagement and a more trusting clinician-patient relationship. While it's clear that patients should be demanding broader access to value-based care, Melanie and Dr. Prosedda also explore the challenges of expansion, including increasing educational opportunities and more alignment among payment models. Learn more about the American Heart Association's research: Understanding Patient, Family Caregiver and Health Care Team Member ACO Experiences Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Value-based care is a team effort, and nurses play a crucial role in coordinating care to achieve better and more efficient patient outcomes. Jacqueline Nikpour, Assistant Professor at the Emory University School of Nursing, and Kathy Samhammer, LPN at Cedar Ridge Family Medicine, join us to discuss the role of nurses in primary care, and how practices can maximize nurses' contributions in the shift towards value-based care. Kathy's role includes managing chronic conditions and preventing hospital readmissions, and she discusses the importance of ongoing, personalized communication with patients, especially after ER visits. This approach has led to better patient engagement and satisfaction, which is crucial for improving health outcomes. As Kathy demonstrates, expanding the role of nurses in value-based care is critical, but Jacqueline also notes the challenges in this expansion, including payment and recognition of nurses' value. By addressing these challenges and better integrating nurses in patient care teams, we can ensure better care coordination and a more patient-centered health care system. Read Jacqueline's article in Health Affairs: To Improve Outcomes Under CMS' ‘Making Care Primary', Focus On Registered Nurses Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Comprehensive Advance Care Planning (CACP) supports individuals in understanding and sharing their values and goals for medical care at the end of life. Kerri Petrin, Vice President and Head of Operations at Aledade Plus, joins us to explore how the CACP program allows patients and their loved ones to have guided, personalized conversations with clinical facilitators and generate legal documents so that patients and their care teams can make health care decisions that align with the patients' values. We are also joined by Marissa McNichols, who shares insights into her role as a CACP facilitator, especially the importance of having open-ended conversations that include family members, allowing everyone the opportunity to ask questions and make decisions outside of a crisis moment. Tune in to learn more about how CACP is transforming end-of-life care planning, ensuring alignment with patient values and reducing unwanted, unnecessary care. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Graduates of the Aledade FIRST Program, Dr. Boone Marois and Dr. Breanna Heard-Pinho, reflect on their experiences in the program and how it helped prepare them to practice value-based medicine. Dr. Heard-Pinho, Family Medicine Physician in Vicksburg, Mississippi, shares how Aledade FIRST taught valuable practice management skills, as well as held in-depth discussions of value-based care not taught in traditional residency programs. While Dr. Marois, Family Medicine Physician in Asheville, North Carolina, reflects on the importance of taking a preventative approach with each patient. Listen as they share unexpected joys and challenges of practicing value-based care in their communities. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

In this episode, Sean Cavanaugh and Josh Israel discuss the complexities of caring for patients who are dually eligible for Medicare and Medicaid. They are joined first by Melanie Bella, whose prior roles include former Director of Indiana Medicaid, Director of the CMS Medicare-Medicaid Coordination Office and EVP at Cityblock, and are then joined by Aledade's Mohamed Arif, and Lahila Pitts. They explore the unique challenges these patients face, including fragmented care and high social needs. They also highlight how value-based care and data-driven solutions are improving outcomes for this underserved group. Tune in for insights into better care coordination for dual-eligible beneficiaries.

Casey Korba, Director of Policy at Aledade, walks us through regulations that were announced along with the 2025 CMS Medicare Physician Fee Schedule, including updates to the Medicare Shared Savings Program. Casey and our host Sean Cavanaugh, who is the former Director of the Center for Medicare, explain policy changes that will support value-based care, including changes to payments for some preventive care services and a new health equity benchmarking adjustment. While there is bipartisan support for CMS's goal of moving towards value-based care, they also explore ongoing challenges like the rebasing process and benchmarking standards.

In this episode, we sit down with Traci Spence, the Chief Operating Officer of Blue Ridge Community Health Center in Hendersonville, North Carolina. Traci shares her  experience managing a health center during a catastrophic hurricane that left the region without power, water, or infrastructure. Despite these overwhelming challenges, Traci and her team found creative solutions to continue serving their community in the midst of chaos. This conversation highlights themes of improvisation, community, and resilience when the healthcare system is pushed to its limits.

Join Dr. Judy Zerzen-Thul as she explains how the Health Care Payment Learning and Action Network (HCP LAN) brings together clinicians, health systems, and payers in a partnership aimed at transitioning from fee-for-service to value-based care models. Dr. Zerzen-Thul is the Chief Medical Officer at Washington State Health Care Authority, and Co-Chair of the LAN Executive Forum. She discusses how value-based care is progressing across different sectors, including common barriers like data exchange and aligning payment methodologies. She also discusses the upcoming HCP LAN summit on November 14th, where stakeholders including payers, purchasers, and patients will gather to address challenges in moving towards value-based care. Health Care Payment Learning and Action Network

In this episode of the Aledade ACO Show, hosts Josh Israel and Sean Cavanaugh speak with Brenda Fore from the East Asheville Family Health Care Clinic and Ashley Austin from Aledade about the impact of Hurricane Helene on their community. They share firsthand accounts of the challenges faced when clinics lost power and water, and how healthcare providers adapted to continue serving patients amidst the chaos. Discover the power of improvisation and community support in times of disaster.

In this episode of the ACO Show, host Sean Cavanaugh and Aledade CEO Farzad Mostashari, sit down with Dr. Ayanna Bennett, Director of DC Health. They dive into the multifaceted role of public health, discussing everything from community health initiatives to tackling local challenges like pest control. Dr. Bennett shares her journey from private practice to public health leadership and emphasizes the importance of health equity, data, and community connection in improving health outcomes. Listen in as we unpack the vital work being done at DC Health and explore how understanding the stories behind the numbers, leads to meaningful change in healthcare.

In this episode of the ACO Show, hosts Josh Israel and Sean Cavanaugh recount their summer road trip, along with Aledade CEO Farzad Mostashari, part 2, visiting primary care practices across America. From camping in Moab to meeting health care leaders in places like Glenwood Springs, CO and St. George, UT they explore the diversity of value-based care primary care delivery. The episode highlights how communities, large and small, benefit from strong primary care systems and previews exciting episodes for the season ahead.

In this season premiere of the ACO Show, hosts Josh Israel and Sean Cavanaugh recount their summer road trip, along with Aledade CEO Farzad Mostashari, visiting primary care practices across America. From camping in Moab to meeting health care leaders in places like Mexico, Missouri, and Salina, Kansas, they explore the diversity of value-based care primary care delivery. The episode highlights how communities, large and small, benefit from strong primary care systems and previews exciting episodes for the season ahead.

Join Josh Israel and Sean Cavanaugh in the season finale of the ACO Show, recorded live at Aledade's North Carolina Value Summit. They engage with three primary care physicians—Dr. Wayne Haga, Dr. Mark McNeill, and Dr. Art Apolinario—about their success in value-based care and how they are using their increased revenue to improve patient care. Submit your questions, comments, or episode ideas to acoshow@aledade.com

Dr. Farzad Mostashari, CEO of Aledade, is joined by Dr. Mark McClellan and Bob Kocher to reflect on the past decade of health care reform, and the early days of Aledade and accountable care organizations (ACOs). Dr. McClellan, director of the Duke Margolis Institute for Health Policy at Duke University, discusses the evolution of legislative policy, sharing how bipartisan efforts led to the integration of shared savings models into health care policy and Bob Kocher, chairman of the board of Aledade, shares his thoughts on Aledade's journey and future direction, emphasizing the importance of maintaining a patient-centered approach, and perseverance in navigating the evolving health care landscape. Submit your questions, comments, or episode ideas to acoshow@aledade.com

 In this episode, Sean Cavanaugh and Dr. Josh Israel sat down with Travis Broome, Alledade's SVP of Policy and Economics, to understand CMS' new ACO Flex Model. Whether you're a healthcare professional or simply interested in the future of healthcare policy, this episode provides a comprehensive look at the ACO Flex Model's potential to transform care delivery. Travis explains how this new model can drive innovation in healthcare by addressing cash flow challenges and offering upfront payments. We discuss the potential benefits for primary care practices, the importance of integrating care management services, and the broader impact on Medicare's goals.    Submit your questions, comments, or episode ideas to acoshow@aledade.com

From understanding the fundamentals to exploring new innovations and challenges, join us as Dr. Efrem Castillo, Senior Vice President for Medicare Advantage at Aledade, shares his experience with Medicare Advantage. Dr. Castillo explains the nuances for both patients and providers, including benefits beyond traditional Medicare, network limitations, utilization management, and the STARS program. Dr. Castillo also explores the recent growth in MA and new innovations, while emphasizing that interventions should prioritize improved patient outcomes.   Submit your questions, comments, or episode ideas to acoshow@aledade.com

From navigating insurance barriers to addressing the stigma, this episode dives into timeless issues surrounding obesity treatment, as well as the promise and challenges of new medications like Ozempic. Josh and Sean are joined by Dr. Darrin Menard, a family practice physician in Scott, Louisiana, who shares insights from his personal experience with weight loss alongside his professional expertise. While new drugs offer significant weight loss potential, Dr. Menard underscores the crucial role of behavioral changes, long-term adherence, and nonjudgemental patient care in achieving lasting results.   Submit your questions, comments, or episode ideas to acoshow@aledade.com

Dr. Lonnie Robinson from Regional Family Medicine in Mountain Home, Arkansas explains the challenges surrounding prior authorization faced by both practices and insurance providers, and how this inspired him to become involved in state health policy advocacy. Hear how Dr. Robinson, drawing inspiration from Texas' “gold card” approach, worked with Aledade's policy committee and state legislators to pass similar legislation in Arkansas to reduce administrative workloads.   Submit your questions, comments, or episode ideas to acoshow@aledade.com

Join our hosts along with Dr. Farzad Mostashari on this episode as they dive into CMS's update on the Medicare value-based care strategy. From discussing alignment and growth to equity in healthcare, they provide insights and suggestions for the future of accountable care. Read the update here: Update On The Medicare Value-Based Care Strategy: Alignment, Growth, Equity   Submit your questions, comments, or episode ideas to acoshow@aledade.com

Explore the dynamic landscape of healthcare and technology with hosts Josh and Sean on the ACO Show. Guests Rosemary Weldon and Ritwik Tiwari, from Aledade, share their expertise as they discuss the challenges and innovations shaping the industry, including the advancements in technology that help improve patient care.

Join us for a story tracing the origins and evolution of Community Health Center, Inc. Mark Masselli and president, CEO, of Community Health Center, Inc. in Middletown, CT, alongside Charles Barber, Writer-in-Residence at Wesleyan University, guide listeners through the enthralling narrative depicted in  Barber's book, "Peace & Health." Explore the beginnings of the Health Center amidst the backdrop of social upheaval, legislative reforms, and grassroots advocacy, illuminating the transformative power of community-driven health care initiatives. Uncover the pivotal moments and visionary leadership that propelled the center from modest beginnings to a beacon of excellence in health care provision. And learn about the recent partnership with Aledade, exemplifying a shared commitment to innovation, collaboration, and equitable care delivery. To learn more about the story behind Community Health Center, Inc. and Barber's book "Peace & Health," visit peaceandhealth.com.

Dive into Aaron McKethan's journey from policy nerd to healthcare innovator at Aledade Plus, improving patient care and reducing costs.

Explore the impact and solutions of the Change healthcare cyber crisis with expert analysis and firsthand accounts.

Dive into the world of community health centers and value-based care with Tracy Causey, CEO of Capital Area Health Network in Virginia and Kevin Van Dyke, executive director of Aledade in Virginia. Hear their experience navigating multiple value-based contracts and integrating behavioral health services with primary care. Learn how more accessible patient health data and dynamic support has helped improve preventive care.

Sean and Josh are joined by Dr. Maureen Padden, a family and obesity medicine doctor from Pensacola, Florida, and Dr. Christopher Nunes from Spyglass Primary Care in Melbourne, Florida to discuss how value-based contracts have improved their relationships with Florida Blue, their patients, and their staff. They delve into the benefits and challenges of being independent physicians, the crucial role the Aledade app plays in providing accessible data, and the importance of staff retention on quality patient care.

Sean and Josh are joined by Rachel Lively, Vice President of Community Health Center Operations at Valley Health, to discuss her experience providing substance use treatments to patients in West Virginia. Rachel shares challenges and successes involving decreasing stigma around substance use disorders, the evolution of treatment methods, and the critical role that CHCs can play in providing individualized care to patients on the path to recovery.

Explore the transformative power of ACOs with Nick Phyllis from Florida, revealing positive impacts on patient care and healthcare delivery.

Explore tangible initiatives for health equity with Tamara Thomas, VP of Equity and Inclusion at Aledade

Josh and Brian are joined by Wes Edwards, Chief Financial Officer of Med First Primary & Urgent Care in North Carolina. Wes discusses his clinic's success with value-based care, the financial sustainability of value-based care models, and the crucial link between exceptional patient care and financial outcomes. Plus, a special farewell as Brian says goodbye to the ACO Show.

In this episode we sit down with Leigh Efird, Director of Pharmacy at Aledade, to dive into the world of value-based care from the pharmacy perspective. She shares the ways she interacts with patients to help them better understand their health and how managing medications can impact that.

Josh and Brian are joined by Dr. Christine Meyer and Casey Korba to discuss Hill Day and how to advocate for value-based care to legislators.

Josh and Brian are joined by Aledade's Chief Financial Officer, John Doyle. They discuss the economic incentives associated with delivering primary care on the front lines and why health care professionals need to be able to talk openly about the financial forces in the system. 

Josh and Brian are joined by Blake Madden, writer, editor and founder of the newsletter Hospitalogy, focused on analyzing health care's financing, policy changes and more. They discussed some of the positive shifts he sees in the health care system and how he's making sense of those changes for his subscribers.

Season 5 of The ACO Show kicks off with Josh and Brian joined by Travis Broome, Aledade's Senior Vice President for Policy and Economics to discuss the 2022 Medicare Shared Savings Program (MSSP) results. As the largest and most successful value-based care program in American history, the results of this program tell us a lot about the progress of value-based care, and what that means for patients and primary care professionals around the country.

Josh and Brian are joined by Lightspeed Venture Partners investor, Galym Imanbayev, MD, to discuss Aledade's Series F funding round. They delve into what led to this latest round of funding, the transparency throughout the process and how these funds are going to ensure that primary care practices and health centers are receiving the resources they need to thrive in value-based care.

Josh and Brian are joined by Kevin O'Leary and Ryan Russell, co-founders of Health Tech Nerds, a trusted resource in health care helping their members learn, network, build, and grow to maximize our collective impact on the health care system. They drill down on the various value-based care models, how they work, and what they mean for patients, doctors and clinicians.

Josh and Brian are joined by Al Kushner, author of “Virtual Medicare: 10 Costly Mistakes You Can't Afford to Make.” They delve into the active role patients play in enrolling in Medicare, and the high - and often unknown - costs of delay.

In this episode, Josh and Brian hand over the mic to Aledade's Chief Policy Officer, Sean Cavanaugh, a former Director of Medicare and senior leader at the Center for Medicare and Medicaid Innovation (CMMI) as he talks with the two current leaders of his former offices. Sean is joined by Meena Seshamani, M.D., Ph.D., Deputy Administrator and Director for the Center for Medicare, and Elizabeth Fowler, Ph.D., J.D., Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation (CMMI). Directors Seshamani and Fowler discuss how they view their centers and how they're united by one common strategic vision. 

Josh and Brian are joined by Sachin Gangupantula FACHE, MBA, MS, Director of Operations at Valley Diabetes & Obesity, an Aledade member practice in Modesto, California. They discussed the benefits of value-based care and joining an ACO despite challenges in the health care marketplace, including new tools and data so they can provide even better care for their patients. 

Josh and Brian are joined by Allison Sesso, the President and CEO of RIP Medical Debt, a nonprofit established to reduce medical debt for low-income individuals across the country. They discussed the dark truths behind why medical debt leads so many people to forgo medical care, how RIP Medical Debt uses an innovative approach to fight these trends and how Aledade's recent donation helped abolish nearly $95 million in medical debt for more than 100,000 patients.

Josh and Brian are joined by Lee Fleisher, MD, Chief Medical Officer at the Centers for Medicare & Medicaid Services (CMS) and Director of the Center for Clinical Standards and Quality. They discuss a recent publication, “Aligning Quality Measures at CMS” in the New England Journal of Medicine which Dr. Fleisher co-authored, and the art and science behind the selection of health care quality measures.

Josh and Brian are joined by Doug Jacobs, MD, MPH, Chief Transformation Officer in the Center for Medicare at the Centers for Medicare & Medicaid Services (CMS), and Michelle Schreiber, Deputy Director for the Centers for Clinical Standards and Quality at CMS, and Director of the Quality Measurement & Value-Based Incentives Group at CMS. In the first part of this quality-focused series, they discuss the work they are doing to align quality measures across CMS and improve the system to benefit both clinicians and patients. 

Josh and Brian are joined by Phuong Phillips, Chief Legal Officer at Aledade, where they discuss her personal journey, what drew her to Aledade and how corporate legal teams and leadership interact.