Podcasts about CMS

Chris Kline is co-founder of BitcoinIRA, building a full-service platform that enables individuals to invest in cryptocurrency for retirement through secure, turnkey solutions and strategic industry partnerships, nationwide investor access. Top 3 Value Bombs 1. Financial markets are evolving, and getting even a small allocation into crypto can significantly improve long-term portfolio performance. 2. Holding crypto inside a retirement account eliminates capital gains taxes on trades, preserving more of your investment gains. 3. Simplicity wins; using turnkey platforms and expert guidance helps investors avoid costly mistakes and confidently enter the crypto space. Check out the website bitcoinira.com to open an account and explore crypto investing. Take advantage of special offers and referral rewards - Bitcoin IRA Sponsors HighLevel - The ultimate all-in-one platform for entrepreneurs, marketers, coaches, and agencies. Learn more at HighLevelFire.com. 50 Days - Join JLD on his free '50 Days to Something' video series on YouTube and create something special in 50 days. Revenued - Built for small business owners who need fast, flexible access to working capital, without relying on your personal credit score. Apply now at Revenued.com/fire. Framer - A website builder that offers real-time collaboration, a robust CMS with everything you need for great SEO, and advanced analytics that include integrated A/B testing. Get started building for free today at Framer.com/fire. For 30 percent a Framer Pro annual plan use code FIRE.

A 30 to 40 percent Medicare cut just hit the doctors who keep your local hospital running, and the policy meant to stop hospital monopolies is accelerating them instead. John Birkmeyer, president of the medical group at Sound Physicians and a former Dartmouth health services researcher, discusses the KevinMD article "Medicare practice expense cuts will hurt patients." You'll hear how CMS quietly slashed the practice expense portion of Medicare payments for the first time in 20 years, hitting independent hospitalists, ER doctors, and critical care groups with net cuts of 6 to 10 percent. You'll learn why CMS aimed at hospital-owned practices but instead pulled the rug from under the independent groups already operating at 2 to 4 percent margins, why rural hospitals will struggle hardest to staff, and how the resulting consolidation drives up prices for every patient. You'll also hear what CMS could fix in its 2027 rule and why physician advocacy now is the only correction available before more independent practices fold. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Classes are out at CMS for the summer, but tensions over education policy and administration linger. Superintendent Dr. Crystal Hill was put on paid leave while the board investigates administrative oversight matters. We'll discuss the latest from CMS, look back at some of the significant events of the last school year, and examine the growing pushback against classroom technology.

Imagine being penalized for delivering good care to your frailest patients. Medicare's quality scoring program was built for healthy outpatients, not the elderly residents of nursing homes, but it is the system doctors who round in skilled nursing facilities are forced to play. Steve Buslovich, a physician executive and geriatrician, discusses the KevinMD article "How Medicare's MIPS impacts skilled nursing facilities and clinicians." You'll hear how MIPS metrics conflict with the five-star quality measures facilities must report, why tightly controlling A1C in frail elders can cause harm, and how documentation discrepancies between physicians and facilities create financial and legal risk for both. You'll learn which nine measures actually fit post-acute long-term care, why CMS needs frailty-based quality metrics, and how AI and synced EHRs can pull data automatically so clinicians can get back to the bedside. If you practice in or operate a nursing home, this conversation names the rules of a game you didn't choose to play. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Melissa Soliz, Partner, Coppersmith Brockelman PLC, speaks with Brendan Keeler, Interoperability Practice Lead, HTD Health, and Amy Bagge-Smith, General Counsel and Head of Regulatory Affairs, Arcadia, about the cases that are currently shaping interoperability law and how the health care industry is responding. They discuss which legal theories are gaining traction and which ones are appearing more fragile, impacts on national frameworks and CMS' Aligned Networks initiative, and how tech innovators and health care providers can navigate this complex environment. Melissa, Brendan, and Amy spoke about this topic on a recent AHLA webinar. From AHLA's Health Information and Technology Practice Group.Watch this episode: https://www.youtube.com/watch?v=WtCQbMudXmULearn more about the AHLA webinar that Melissa, Brendan, and Amy spoke on: https://educate.americanhealthlaw.org/local/catalog/view/product.php?productid=1772 Learn more about AHLA's Health Information and Technology Practice Group: https://www.americanhealthlaw.org/practice-groups/practice-groups/health-information-and-technology Essential Legal Updates, Now in AudioAHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Comprehensive members. Get all your health law news from the major media outlets on this podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.Stay At the Forefront of Health Legal EducationLearn more about AHLA and the educational resources available to the health law community at https://www.americanhealthlaw.org/. 

Lauren Lapinski is a legal commentator and advocate examining family law, custody disputes, and parental child removal, highlighting the hidden financial, legal, and emotional challenges families face navigating modern custody systems. Top 3 Value Bombs 1. Custody battles often carry hidden emotional and financial costs that can devastate families far beyond initial expectations. 2. Legal gray areas in family law can create confusion and delays, leaving parents and children vulnerable during critical moments. 3. Raising awareness and advocating for systemic change is essential to improving outcomes for children navigating divorce and custody disputes. Connect with Lauren on Instagram for support and advocacy - Lauren Instagram Sponsors HighLevel - The ultimate all-in-one platform for entrepreneurs, marketers, coaches, and agencies. Learn more at HighLevelFire.com. 50 Days - Join JLD on his free '50 Days to Something' video series on YouTube and create something special in 50 days. Revenued - Built for small business owners who need fast, flexible access to working capital, without relying on your personal credit score. Apply now at Revenued.com/fire. Framer - A website builder that offers real-time collaboration, a robust CMS with everything you need for great SEO, and advanced analytics that include integrated A/B testing. Get started building for free today at Framer.com/fire. For 30 percent a Framer Pro annual plan use code FIRE.

This week I Convince You To Prepare For Black Friday in June! [powerpress]

Turning Pain Points Into Innovation | Dr. Prakash Gatta FULL DESCRIPTION Dr. Prakash Gatta is a foregut and esophageal surgeon who built his hospital's surgical program from zero — and then built two healthcare technology companies from the pain points he kept running into in the OR. In this episode of BOSS: Business of Surgery, host Dr. Amy Vertrees talks with Dr. Gatta about what happens when surgeons stop waiting for someone else to solve the problems they see every day. Company #1: Uncover — Dr. Gatta serves as VP of Clinical Affairs for this AI-powered surgical documentation platform. Uncover analyzes intraoperative video in real time and generates detailed, accurate operative notes automatically. Poor operative notes correlate with worse patient outcomes and cause 15-20% undercoding on procedures — a financial gap that affects both surgeon compensation and hospital facility fees. Uncover closes that gap by turning video into documentation, identifying missed CPT codes, modifier 22s, and APC codes that surgeons never capture. Company #2: EmpowerMedical.ai — Dr. Gatta founded this physician financial transparency platform to answer a question most surgeons have never been able to ask: how much money do I actually generate for my hospital? Using publicly available CMS data and hospital-disclosed pricing, the platform converts a surgeon's case list into a complete financial picture — professional fees, facility revenue, payer mix, DRGs, APCs, and contribution margin. A surgeon performing 124 high-level hernia repairs generates $464,000 in professional fees and $12 million in total system revenue. Most surgeons have no idea. Dr. Gatta wants to make this tool free for all trainees entering practice. The conversation also covers Dr. Gatta's remarkable personal story: born in India, raised in Kuwait during the Gulf War, self-evacuating as a 13-year-old refugee, medical school in Bombay, and arriving in the US in 2000 for surgical training under pioneer Lee Swanstrom in Portland.

Keep track of your AEP prep to-do checklist with help from Ritter's certification resources! Listen to find out how to access AHIP, NABIP, carrier MA and PDP certification, product training details, and more! Read the text version   Get Connected:

Sarah Watz är entreprenör, föreläsare, AI-rådgivare och grundare av Business Heroes®. Hon har drivit företag sedan 90-talet, lett internationella organisationer och hjälper idag företagare och ledare att skapa tydlighet, struktur och tillväxt i en AI-driven tid.00:00 EU AI Act förklarad enkelt – vad företag måste förstå03:02 Saras bakgrund: digitalisering, automation och AI-ledarskap06:05 När vanliga företag möter AI – rädsla, möjligheter och första steget09:00 Kommer AI ta jobben? Jurister, rådgivare och kunskapsarbete12:00 AI är inte ett verktyg ovanpå processen – börja med inventering15:00 Risker, transparens och AI-policy för byråer och konsulter21:00 Från policy till vardag: utbildning, ansvar och AI-körkort24:02 AI-stress och upskilling – så får du med medarbetarna30:01 Frigör oss från skärmen: walk & talk, nya arbetssätt och livskvalitet36:00 AI, samhällsansvar och frågan om alla verkligen hänger med42:02 Arbetsgivarens ansvar: stöd, självledarskap och AI-coaching45:01 AI som personlig coach – säljträning, feedback och mikrolärande54:00 AI-adoption i stora bolag: varför du ibland måste konkurrera med dig själv01:00:00 AI och framtidens entreprenörskap – kan fler driva sin lilla idé?01:09:00 Praktiska regler: inventering, GDPR-risk och AI-chattbotar01:15:01 Kundresan i AI-eran – marketing automation, service och mänsklig kontakt01:21:01 SEO blir AEO: strukturerad data, CMS och synlighet i AI-sök01:27:01 Community, open source och globalt ledarskap – Saras Joomla/Vimla-erfarenheter01:42:00 Saras viktigaste medskick: använd EU AI Act som wake-up call

Would you like access to our advanced agency training for FREE? https://www.agencymastery360.com/training Are you trying to sell a service so specialized that closing new clients feels like it can only come from you? What do you think about how AI is reshaping your industry and where that leaves the human at the center of it? Today's featured guest came up through luxury automotive, spent years learning how cultural nuance can derail a campaign that looks perfect on paper, and built a niche precise enough that she can spot from two miles away when someone writing about influencer marketing has never actually run a campaign. In this episode, she'll discuss what makes international influencer work fundamentally different from domestic campaigns and what AI-generated influencers mean for an industry built on human authenticity. Jeanette Okwu is the founder and CEO of Beyond Influence, an influencer marketing agency based in Berlin. Her background spans social media strategy, brand research, and influencer marketing across luxury automotive brands including Jaguar Land Rover and Mercedes-Benz. That global scope became the foundation for her agency's core differentiation: running influencer campaigns that actually account for cultural nuance in each market rather than pushing a headquarters strategy downward and hoping it lands. In this episode, we'll discuss: Building international campaigns understanding regional nuances How to overcome the expert-owner bottleneck problem Can AI influencers replace real ones? Subscribe Apple | Spotify | iHeart Radio Sponsors and Resources This episode is brought to you by Wix Studio: If you're leveling up your team and your client experience, your site builder should keep up too. That's why successful agencies use Wix Studio — built to adapt the way your agency does: AI-powered site mapping, responsive design, flexible workflows, and scalable CMS tools so you spend less on plugins and more on growth. Ready to design faster and smarter? Go to wix.com/studio to get started. Why International Campaigns Break When You Treat Every Market the Same Early in her career, Jeanette managed 24 markets at Jaguar Land Rover, which helped her understand that what works in one country does not translate by default. A TV spot that runs cleanly in Europe cannot air in the Middle East if it shows upper arms or alcohol. A campaign strategy built at headquarters and handed down to regional teams will get implemented, but it will not perform, because every market has cultural specifics that only someone operating inside that market will catch. The agency she built is the direct expression of that knowledge. Beyond Influence does not run German campaigns and call it international work. It builds campaigns from the ground up with an understanding of how audiences in each target market actually consume content and what they expect from the creators they follow. That distinction is hard to replicate without the years of field experience behind it, and it is exactly the kind of institutional knowledge that becomes a real moat when the rest of the market is running generic global strategies. The Sales Bottleneck That Comes With Deep Expertise Jeanette is candid about where she is stuck: sales still runs through her. This is something she has tried to change, but influencer marketing is still a new enough discipline that clients want to hear from someone who demonstrably knows what they are talking about. She frames it as expertise selling and she is probably right that some of it is structural to the space. But she also hears herself in the answer, acknowledging a degree of control that she knows is not fully serving the agency's ability to grow. The necessary shift in cases like this doesn't point toward finding a salesperson who already knows influencer marketing. The real solution will come from finding someone with the right consultative instincts and then giving them the success stories and methodology that let them carry the conversation. Such is the case of Darby, our agency scale specialist, who did not know what an agency was before joining the team. What he had was the ability to listen, qualify, and translate client pain into a path forward. That skill can be trained on the specifics. The instinct behind it cannot. What AI Influencers Actually Mean for the Industry Jeanette knows the question that is currently on every client's mind: will AI-generated influencers replace the real ones? Her answer is more nuanced than the headlines. AI avatars already perform comparably to human creators on certain content types. Brands are building owned avatars that show up on time, never gain weight, never create a scandal, and can post from six locations simultaneously without a travel budget. That part of the market is real and growing. What AI cannot replicate is the reason people follow a creator in the first place. The parasocial relationship that makes influencer marketing work is built on the sense that the person on screen is real and reachable. When a follower knows they will never be able to meet the creator, the connection breaks. That is the line Jeanette draws: AI content can perform well for product exposure, but for the kind of community trust that turns followers into buyers over time, the human at the center still matters. The agencies that understand where that line sits will be the ones helping brands draw it correctly rather than chasing the cost savings of going fully artificial before the audience has stopped caring about the difference. Do You Want to Transform Your Agency from a Liability to an Asset? Looking to dig deeper into your agency's potential? Check out our Agency Blueprint. Designed for agency owners like you, our Agency Blueprint helps you uncover growth opportunities, tackle obstacles, and craft a customized blueprint for your agency's success.

John Dwyer is a direct response marketing expert who convinced Jerry Seinfeld to front a record-breaking banking campaign - and now helps businesses attract customers using powerful incentive-based marketing strategies. Top 3 Value Bombs 1. Discounting is a race to the bottom; smart businesses use incentives to shift focus away from price and protect their margins. 2. The most effective incentives have low hard cost but high perceived value, making them irresistible without hurting profitability. 3. Matching the right incentive to the right audience is critical; relevance drives conversions, not just the offer itself. Check out John's website and register. Receive a free vacation voucher upon signup. Learn how to access vouchers for as low as $32 for business use - Incentive Webinar Sponsors HighLevel - The ultimate all-in-one platform for entrepreneurs, marketers, coaches, and agencies. Learn more at HighLevelFire.com. 50 Days - Join JLD on his free '50 Days to Something' video series on YouTube and create something special in 50 days. Framer - A website builder that offers real-time collaboration, a robust CMS with everything you need for great SEO, and advanced analytics that include integrated A/B testing. Get started building for free today at Framer.com/fire. For 30 percent a Framer Pro annual plan use code FIRE.

Listener feedback, more long-term data on the TAVR/SAVR question, population prevalence of valvular heart disease in the US, and a CMS proposal to expand TAVR coverage are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback ICD Trends and Outcomes: 15-Year Analysis https://doi.org/10.1093/europace/euag110 MADIT-RIT https://www.nejm.org/doi/full/10.1056/NEJMoa1211107 II More Long Term Data on TAVR vs SAVR PARTNER 2 Trial https://www.jacc.org/doi/10.1016/j.jacc.2026.03.169 10-Year Outcomes of SAPIEN 3 TAVR or SAVR in Intermediate-Risk Patients https://doi.org/10.1016/j.jacc.2026.03.170 TAVR at a Decade: Editorial https://doi.org/10.1016/j.jacc.2026.04.042 EVOLUT Trial https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5063 Updated 5-year Outcomes of TAVR vs SAVR in AS https://heart.bmj.com/content/early/2026/02/11/heartjnl-2025-327092 NOTION Trial https://doi.org/10.1093/eurheartj/ehae043 PARTNER 3 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2509766 NOTION 2 Trial https://academic.oup.com/eurheartj/article/45/37/3804/7673297 TAVR vs SAVR Editorial : https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehag407/8708044 III The PREVUE-VALVE Study PREVUE-VALVE Study https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5137 IV CMS has Proposed New Coverage for TAVR CMS Proposal Document https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&ncaId=321 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

The Friday Five for June 19, 2026: Certification for AEP 2027 Coming June 22 Microsoft Teams Location Tracking Medicare GLP-1 Bridge Starts July 1 CMS to Codify Medicare Drug Price Negotiation Federal Judge Vacates Several CMS ACA Provisions   Get Connected:

This episode is presented by Create A Video – Contrary to earlier reporting, it turns out the Superintendent of Charlotte-Mecklenburg Schools is NOT out. Yet. She has merely been placed on administrative leave pending an investigation. Plus, the fight over NCDOT's plan to widen I-77 with toll roads could now cost local governments tens of millions of dollars after they killed the project.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-kaliner-show--6946691/support.Subscribe to the podcast My preferred podcast platform: SpreakerAll the links to Pete's Prep are free!Get exclusive content here!Media Bias Check: GroundNews promo code!Advertising and Booking inquiries: Pete@ThePeteKalinerShow.com  

With Medicare Advantage now covering more than half of all Medicare beneficiaries, Lynn Nonnemaker and Yamini Kalidindi join Anthony Livshen to unpack MA encounter data – what it is, how complete it's become, and the growing role it's playing in CMS payment policy, quality measurement, and program oversight. The episode explores both current uses and the significant policy shifts that may lie ahead, from disproportionate share hospital payments to risk adjustment.

This episode is presented by Create A Video – The list of potential replacements for Charlotte Mayor Vi Lyles has been whittled down to five by the City Council. Unfortunately, the one candidate who promised to drink himself to death did not make the cut. Plus, the Superintendent of Charlotte-Mecklenburg Schools is reportedly out of a job... but we don't know if she was fired or if she quit.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-kaliner-show--6946691/support.Subscribe to the podcast My preferred podcast platform: SpreakerAll the links to Pete's Prep are free!Get exclusive content here!Media Bias Check: GroundNews promo code!Advertising and Booking inquiries: Pete@ThePeteKalinerShow.com  

CMS revised the Medicare 60-Day Repayment Rule, changing how overpayments are identified. In this episode, Husch Blackwell's Bryan Nowicki and Andrew Brenton analyze this change and how it affects the time frames applicable to internal investigations and repayment obligations. They also introduce a handy one-page summary of key deadlines. Additional resources: 60-Day Repayment Rule

Healthcare organizations face mounting financial pressures, and grants can be one of the most powerful yet underutilized tools in their funding arsenal. In this episode, EisnerAmper's Tony Davis sits down with Angie Brown, who has extensive knowledge in grants management, to explore how healthcare clients can strategically identify, secure, and steward grant funding to advance their missions. From federal and state programs to private foundations, Angie breaks down the grants lifecycle, the three misconceptions that trip organizations up most, and timely opportunities like CMS's new $50 billion Rural Health Transformation Program. Along the way she explains why winning the wrong grant can set you back, how AI is reshaping grants management, where compliance risk rivals a JCAHO shutdown, and the single first step, a gap analysis, every leader should take before pursuing a dollar. Whether you're new to grants or looking to strengthen your existing program at a hospital, health system, FQHC, or nonprofit, this conversation is packed with practical insight.

CMS settles Freedom of Speech case with student's family; Charlotte mayoral candidates address City Council; Juneteenth's history in Charlotte

In most large law firms, a small handful of clients truly move the needle on revenue, yet BD efforts are still spread thinly across the board. In today's episode of the CMO Series Podcast, Will Eke sits down with Rob Gijsen, Chief Marketing Officer at CMS, who has spent nearly three decades in senior BD and marketing roles at some of the world's largest firms. In the last year, Rob has driven the implementation of a new client and sector strategy to fundamentally change how CMS prioritises and manages its most important relationships. Rob shares the thinking behind it, what rolling out a strategy looks like at a firm of CMS's scale, and what he'd advise other leaders thinking about doing the same. Rob and Will discuss: How Rob's thinking about client strategy has evolved The need for a client categorisation framework Overcoming roadblocks and negative perceptions The quantitative results following the strategy Practical advice for others before implementation

This episode is presented by Create A Video – Andrew Dunn is the publisher of Longleaf Politics and  a contributing columnist to The Charlotte Observer. He had a very lengthy piece at his website about how computer screens became the latest fad in education and why it's time for North Carolina to repent from this mistake. Plus, Charlotte-Mecklenburg Schools settles a lawsuit over a painted rock honoring Charlie Kirk after his assassination.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-kaliner-show--6946691/support.Subscribe to the podcast My preferred podcast platform: SpreakerAll the links to Pete's Prep are free!Get exclusive content here!Media Bias Check: GroundNews promo code!Advertising and Booking inquiries: Pete@ThePeteKalinerShow.com  

Show Notes Your fee schedule is a revenue ceiling. And for most independent practices doing over $3 million a year, that ceiling is set too low in ways that never generate a denial and never appear on a standard report. EP186 covers the five gaps that are quietly capping your revenue, the exact fix for each one, and three actions to run this week. Gap 1 — Billing Below Your Own Allowables: You negotiate a better payer contract. The billing system does not get updated. The payer pays what you billed, not what you are owed. A practice with 20 high-volume CPT codes averaging a $10 billing gap across 800 monthly claims is losing $8,000 a month, $96,000 a year, from a contract they already won. Gap 2 — Inconsistent Fee Schedules Across Locations: A secondary location runs on its legacy fee schedule from before acquisition. Location A bills $210 for a procedure. Location B bills $165 for the same code. A site doing 400 visits a month with a $35 average billing gap is under-billing $14,000 a month, $168,000 a year. Gap 3 — No Medicare Multiplier Anchor: Fees set by instinct drift downward every year while costs move in the opposite direction. The fix: anchor to 200–300% of the current Medicare allowable and recalculate every November when CMS publishes updated rates. Gap 4 — Suppressing Global Fees for Self-Pay Patients: A practice protecting 15% self-pay volume by keeping fees low inadvertently discounts 100% of encounters. 850 commercial patients billed $40 below the correct rate: $34,000 a month, $408,000 a year. The fix: raise the global fee schedule and implement a separate documented sliding fee scale for uninsured patients. Gap 5 — No Annual Fee Schedule Review: A fee schedule that is right in year one becomes the revenue leak of year five. A $4 million practice drifting 3% below where it should be loses $120,000 a year in collectible revenue. Over five years: $600,000. The Five Fee Schedule Gaps at a Glance: Billing below allowable → Payer pays billed charge, no alert → up to $8K/month Location fee inconsistency → Lower site appears compliant on reports → $3K–$15K/month No Medicare multiplier anchor → Fees drift, no logical update trigger → Compounds annually Artificially low global fee → Self-pay policy masks commercial discount loss → $5K–$20K/month No annual review → Costs rise, billed charges flat → 3–5% margin erosion per year Three actions this week: Run the top-20 CPT code comparison — billed charge vs. highest commercial contract allowable Anchor your fee schedule to the Medicare multiplier — recalculate for this year Put the annual fee schedule review on the Q4 calendar today — first week of November, billing manager named as owner Episode breakdown: 00:00 The fee schedule is a revenue ceiling 02:30 Why silence in billing costs more than denials 05:00 Gap 1: Billing below your own allowables 09:00 Gap 2: Inconsistent fee schedules across locations 13:00 Gap 3: No Medicare multiplier anchor 17:00 Gap 4: Suppressing global fees for self-pay patients 21:30 Gap 5: No annual fee schedule review 25:00 Three actions this week 29:00 Free resource + EP187 tease Resources Mentioned NEW LEAD MAGNET  Primary resource this episode: 30-Day Revenue Recovery Plan. Payment Posting Audit Checklist is tertiary. 30-Day Revenue Recovery Plan (free): eligibility.natrevmd.com/nrc/-30day-revenue-recovery-plan Book a free 30-minute call: calendly.com/heather-natrevmd Practice Revenue Leak Scorecard (free): eligibility.natrevmd.com/nrm-revenue-scorecard-v3 Payment Posting Audit Checklist (tertiary): eligibility.natrevmd.com/payment-posting-checklist CMS Medicare Physician Fee Schedule: cms.gov (updated annually each November) 

This week I Talk About The 2026 Mid-Year Business Checkup [powerpress]

This episode of the Agent Survival Guide podcast explores 5-Star Medicare Advantage plans. We'll break down what they are, how they became 5-star plans, and why you can sell them throughout the year!   Read the text version   Get Connected:

Join Todd Rogers, Co-founder and CEO of Moddy AI, for a paradigm-shifting exploration into the true nature of the artificial intelligence boom. For the past decade, building a production-ready predictive sports modeling business required millions of dollars in capital, an elite army of data scientists, and bespoke backend architectures—culminating in complex tools that only other data scientists could decipher. In this episode, Todd maps out how advanced LLMs and automated engineering workflows have completely rewritten this equation, moving past basic software optimization to open up entirely new categories of consumer and business software that were previously impossible to build.

https://www.contrast-connect.com/blog-post/virtual-contrast-supervision-response-time-reaction-management-metrics-explainedContrast reactions escalate rapidly and require immediate intervention—so response time matters more than you think. Discover the KPIs, CMS compliance rules, and technology benchmarks that imaging directors must track to keep virtual contrast supervision safe and audit-ready. ContrastConnect City: Las Vegas Address: Las vegas Website: https://www.contrast-connect.com/

Virtual contrast supervision laws changed permanently in 2026. We break down CMS's new rule, state-by-state legislation, and the technology, compliance, and training updates imaging practices must implement now to stay compliant and expand patient access. Learn more at https://www.contrast-connect.com/blog-post/virtual-contrast-supervision-state-legislation-2026-updates-practice-impact ContrastConnect City: Las Vegas Address: Las vegas Website: https://www.contrast-connect.com/

Would you like access to our advanced agency training for FREE? https://www.agencymastery360.com/training Have you ever lost a pitch you were sure you had won on merit? Or if you did win the account, have you ended up with clients that only want to talk to you? Today's featured guest came up through seven years as head of marketing at a lean e-commerce company, where wearing every hat was not optional. In this episode, she talks about how a story about sorting fish as a child became the deciding factor in a competitive pitch, why genuine connection is not a soft skill but a structural advantage, and what happens to your agency when you never learned to let clients connect with your team instead of just with you. Bianca Beatty is the founder of Raven+Co, a full-stack boutique agency based in San Francisco offering everything from events to go-to-market strategy, social media, and brand communications. Before launching the agency in 2018, she spent nearly seven years as head of marketing at the largest online marketplace for antiques and vintage, where she built her foundation in SEO, paid ads, email, product placement, and revenue-driven decision making inside a lean team. She is also a licensed realtor, a fly fisher, and a former child caviar industry worker. In this episode, we'll discuss: The story that won Bianca an account over portfolio The double-edged sword of being the person clients want to talk to You do NOT have to work with everyone Subscribe Apple | Spotify | iHeart Radio Sponsors and Resources This episode is brought to you by Wix Studio: If you're leveling up your team and your client experience, your site builder should keep up too. That's why successful agencies use Wix Studio — built to adapt the way your agency does: AI-powered site mapping, responsive design, flexible workflows, and scalable CMS tools so you spend less on plugins and more on growth. Ready to design faster and smarter? Go to wix.com/studio to get started. A Story Can Win the Room Before the Work Does Bianca walked into a pitch for a caviar client with strong work and solid positioning. She almost did not mention that as a child, she spent a summer on her father's commercial fish house on the water in Florida, separating fish by sex for roe sold to China. She mentioned it. She won the pitch. The client told her afterward that the story, not the portfolio, was the deciding factor. The reason that moment is worth examining is not that personal stories win pitches. It is what the story actually communicated. It showed the client that Bianca understood the product from a level most marketers never will, that she had genuine curiosity about the industry, and that she was someone the client wanted to spend time around. A competitor with equally strong work and no story was indistinguishable. Bianca was not. Proof of capability opens the door. The story is what makes the client hold it open. When Your Personality Becomes the Bottleneck Bianca is honest about the double edge of being the kind of person clients want to talk to for two hours. The connection that wins the pitch is the same connection that makes clients want to route everything through you. Calls that run long, decisions that wait for your availability, relationships that belong to you and not to your agency: these are not signs that you are doing something right. They are early symptoms of a founder dependency problem that compounds as the agency grows. When the founder is most connected person in their agency, they're also the most trapped. Every client relationship that runs through him is a ceiling on how much the business could grow without him. The structural fix is not to become less personable. It is to build a team that is also personable, to hire for the same quality of human warmth and genuine curiosity that wins clients in the first place, and to let those people develop their own relationships. The goal is a team that holds the relationships well enough that the clients stop thinking about whether you are in the room. Picking Clients Before Clients Pick You Bianca is clear on something that most agency founders only learn after absorbing a nightmare client or two: you do not have to work with everyone. Early on, the answer is yes to almost everything because the pipeline is thin and the pressure to cover costs is real. As the agency develops a track record and a clearer sense of its own values, the ability to be selective is not a luxury. It is a structural protection for the team. The version of this that holds up over time is not just about avoiding difficult clients but about actively going after the clients you want, pitching yourself to companies that interest you even when they are not publicly looking, and staying honest about fit before contracts are signed rather than after scope has been blown. When clients align with what the team genuinely cares about, the work is better, the relationships last longer, and the agency does not spend the Monday morning meeting talking about which client made last week miserable. Do You Want to Transform Your Agency from a Liability to an Asset? Looking to dig deeper into your agency's potential? Check out our Agency Blueprint. Designed for agency owners like you, our Agency Blueprint helps you uncover growth opportunities, tackle obstacles, and craft a customized blueprint for your agency's success.

Health Affairs Publishing's Jeff Byers welcomes Alison Barkoff of George Washington University to the pod to explore the evolving landscape of Medicaid work requirements. They break down who is impacted by these policies, how the requirements are structured across states, and the real-world challenges of implementation. The conversation also explores concerns about administrative burden, potential coverage losses, and what these changes mean for beneficiaries, policymakers, and providers.Topics covered:What Medicaid work requirements are and how they workWho qualifies—and who may lose coverageState-level variations and policy designAdministrative complexity and compliance challengesPotential impacts on access to care and health outcomesJoin us on June 23 for an exclusive Insider virtual event examining how antitrust policy in health care is evolving at both the federal and state levels, featuring insights from Katherine Gudiksen, Leemore Dafny, and Nathan Hostert.Related Links:Medical Frailty Rule Contravenes HR 1, Burdens The Health Care System, And Threatens Public Health (Health Affairs Forefront)States balk at the high price of Medicaid work requirements amid budget crunch (POLITICO PRO)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

The Friday Five for June 12, 2026: Apple WWDC 2026 Takeaways Instagram Grid Arrangement Feature IntegrityCONNECT Annuities & What's Coming Soon KFF MA Enrollment Stats & Trends for 2026 CMS Medicaid Work Requirements   Get Connected:

Join Todd Rogers, Co-founder and CEO of Moddy AI, for a paradigm-shifting exploration into the true nature of the artificial intelligence boom. For the past decade, building a production-ready predictive sports modeling business required millions of dollars in capital, an elite army of data scientists, and bespoke backend architectures—culminating in complex tools that only other data scientists could decipher. In this episode, Todd maps out how advanced LLMs and automated engineering workflows have completely rewritten this equation, moving past basic software optimization to open up entirely new categories of consumer and business software that were previously impossible to build.

-El microbioma del hombre de hielo (00:00)-La IA no es el fin de los médicos (16:00)-Llega el final de las colisiones en el LHC (38:30)-CMS confirma que los quarks son fundamentales hasta 1E-20 metros (58:20)-Evidencia de que la dinamo solar se origina en la tacoclina (1:14:00)-Señales de los oyentes (1:34:00)Contertulios: Luisa Achaerandio, Gastón Giribet, Francis Villatoro, Héctor Socas Hosted on Acast. See acast.com/privacy for more information.

As Modi becomes India's longest-serving continuously elected Prime Minister, #CutTheClutter looks at where BJP stands, with 17 CMs and what it did to reach this place. ThePrint Editor-In-Chief Shekhar Gupta explains how BJP turning India into a single-party state. The episode also looks at how numbers stack up in both Houses of Parliament.

In episode two, Dr. Berwick challenges some basic assumptions: Does competition truly drive innovation in health care? He argues that cooperation often outperforms competition, citing VA-led safety advances and national patient-safety collaboratives at CMS (like the Partnership for Patients) that rewarded results and spread what worked. He also identifies some of the issues that both health care and politics face in lobbying and the undue influence of moneyed interests. Northwell is New York State's largest healthcare provider and private employer, with 28 hospitals, 890 outpatient facilities and more than 16,600 affiliated physicians. We're making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. Get the latest news and insights from our experts in the Northwell Newsroom: Press releases Insights Podcasts Publications Interested in a career at Northwell Health? Visit our career site and explore our many opportunities. Watch episodes of 20-Minute Health Talk on YouTube.  For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Instagram, X and LinkedIn.

In the first episode of this two-part 20-Minute Health Talk, Chethan Sathya, MD, sits down with Don Berwick, MD — former Center for Medicare and Medicaid Services administrator (CMS) and founder of the Institute for Healthcare Improvement (IHI). Dr. Berwick traces his path from early harrowing medical experiences to a career dedicated to improving patient care and healthcare delivery. The conversation moves to how patient solidarity could become a force for change and why simplifying to a single, public payer could create conditions that could fix the delivery of health care while actually improving patient choice and lowering costs. Northwell is New York State's largest healthcare provider and private employer, with 28 hospitals, 890 outpatient facilities and more than 16,600 affiliated physicians. We're making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. Get the latest news and insights from our experts in the Northwell Newsroom: Press releases Insights Podcasts Publications Interested in a career at Northwell Health? Visit our career site and explore our many opportunities. Watch episodes of 20-Minute Health Talk on YouTube.  For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Instagram, X and LinkedIn.

The Layoff Tracker, Cigna's GLP-1 Cut & What Happens When Compliance FailsJune 8th, 2026. Bo and Luke break down three stories connected by the same thread: what happens when organizations wait too long to act.

David King from Gulf Wind Technology returns to discuss serial uptower blade repairs, passive load shedding, and data-driven testing. Sign up now for Uptime Tech News, our weekly newsletter on all things wind technology. This episode is sponsored by Weather Guard Lightning Tech. Learn more about Weather Guard’s StrikeTape Wind Turbine LPS retrofit. Follow the show on YouTube, Linkedin and visit Weather Guard on the web. And subscribe to Rosemary’s “Engineering with Rosie” YouTube channel here. Have a question we can answer on the show? Email us! Welcome to Uptime Spotlight, shining light on wind energy’s brightest innovators. This is the progress powering tomorrow Allen Hall : David, welcome back to the program.  David King: Yeah, I’m so glad to be here. A lot’s happened since the last time I was on, so, uh, this is gonna be great.  Allen Hall : It’s been about a year. Mm-hmm. And last year we were at OM&S in Nashville, and you were talking about root fusion, and this is the insert fix uptower for the blade inserts, right? So we’re having a lot of blade bolt issues, and the inserts are starting to pull out or become loose, and the blades are moving around. A lot of our operators in the States are trying to solve that problem, and they don’t wanna remove the blades and bring anything down tower. They would like to fix it uptower. That’s where your solution came in. How’s that going?  David King: Yeah, so I mean, it, it’s really been a five-year journey for us. I mean, we’ve been doing this- I remember that, yeah … for a [00:01:00] very long time. You know, it started like any process does, with a problem statement. Sure. And we’ve been working through from problem statement, you know, going through process development, going through structural development, going through pilots. Uh, we did a, a huge pilot deployments about three years ago, where those were being monitored. Um, we’re now in a position where we’re in serial deployment, and that’s what’s really exciting. You know, we’re doing about 200 blades a year, uh, of, of serial deployment. We’ve, we’ve done that now, uh, we’re going into our second year of that. Nice. So we’re extremely excited by that. That comes with its own sets of challenges as you scale up. How do you maintain quality? We even touched a little bit on a few of these things last year. Um, but yeah, we’re really excited to be doing that. Uh, we’re trying to keep it, you know, again, process-driven. How do you simplify a process that allows you to scale up appropriately, train people appropriately? A- a- and that’s what we’re really excited about this year, is being able to bring this, uh, so that we’re not, um, you know, basically supply constrained, ’cause there is a lot of demand for this, and still able to maintain a very high level of, of quality as we, [00:02:00] we scale up. Allen Hall : Yeah, and that’s the key to all sort of repairs in the wind industry. You like to do it once and be done with the life of the turbine. Now, so you’re going uptower. You’re drilling some holes up along the blade, injecting those with a resin system, curing it, basically reinforcing what is already there That all makes sense to me. Engineering-wise, that makes sense to me. But a- again, it goes back to the technicians and the training and the deployment of it. Are you starting to train technicians, bring them in, show them how to use the, use the machines and, and get them out in the field so they are ready to go? It, it… ‘Cause it seems like you’re at that threshold now. David King: No, absolutely. So we, we believe in people first, right? Yeah. People at the end of the day make things happen. And so, you know, the best ways to do that is give people the right tools to be successful, and where that comes from is training. That’s a huge part of it. We have a, a certified training program that we run. Uh, it started out as an internal program we were running. It basically has five levels to it. Uh, we’ve now extended that to, uh, enabling, uh, you know, basically [00:03:00] preferred partners to be able to take part in that training, uh, to be able to utilize modular kits, pumps and equipment, to be able to, you know, go out and meet that demand that’s out there, but do so in a way that’s, uh, controlled. Yeah. And so really that comes back to that certified training program. And really, you know, level one is about a lot of your basic safety, procedural base type, uh, you know, making sure people are competent, uh, they’re not gonna get themselves hurt. Right. They’ve got the right personality traits about focus, uh, you know, detail focus and things like that. Yeah. Uh, level two to that program is, is really about, um, basically getting people to a stage in which they can be a, uh, team member. Uh, they’re able to be on a team and contribute to that team in an effective manner, be in the field.  Allen Hall : That’s really important. A lot of-  David King: Absolutely …  Allen Hall : companies miss that aspect of being a team member instead of an individual. Yeah, you have to work with other people. Yeah. It’s, it’s critical.  David King: It’s massively important. Personalities clash. You’ve got to be able to work through that sort of thing. And so that level one to level two is really kind of taking your green horn hat off and putting, “Okay, I, I, I can be on this team and I’m, I’m a, a contributing [00:04:00] member.” And then at level three, that’s your team leads. Those are people that are leading teams. They’re leaders. They’re up and coming. They’ve got a career path, career trajectory. Level four is our mentors. That’s the people that are going out there and that are basically qualified to now actually mentor other people in the field. Allen Hall : Yeah.  David King: And then your level five is train the trainer. How do you grow more trainers so that you’re not constrained on that training factor? And that, that’s kind of how we, we typically run training.  Allen Hall : Uh, and Gulf Wind has the ability to do that. I mean, I’ve been to your facilities, they’re impressive, and that’s one of the limitations for a lot of companies. They don’t have the facilities to train people, and they don’t have the resources you do. That opens up a lot of opportunities. Obviously, you’re in the composite repair business. You have crews out fixing wind turbine blades. Some of the more complex ones is what I hear. I mean, I hear it secondarily, but I assume that’s what’s happening. What are, are the areas that you get called in on to do composite repairs?  David King: We, we really do anything that stops somebody else. Okay. So we wanna be there when there’s a problem where you’re like, “I don’t know where to go next. Uh, this is a big [00:05:00] problem. We’re unsure. Maybe there’s a new technology at play. Maybe it’s, uh, a carbon spar cap. Maybe it’s something, uh…” You know, obviously the root stuff that’s very complicated. Sure. And, uh, it’s just gonna require a little bit more engineering. It’s gonna require a little bit more rigor, and that- that’s where we say, look, we, we can, whether it means testing something, verifying something, training somebody on a process, developing a process- Yeah or just doing something complicated, that’s where we excel.  Allen Hall : Well, that- that’s what I hear from the road is, uh, Gulf Winds here and I think, “Uh-oh. You must have a really serious problem because you’re calling in the experts to do the, the difficult things.” Carbon pultrusions, carbon fabric in, in blades today is such a massive problem because it’s not, it’s not fiberglass. It’s just a lot more to deal with, and some of the loading issues we’re finding and, boy, it’s just all over the place. They need Gulf Winds Technology to, to come on site to give them a hand. Now, a- as part of the growth of the business, and you guys have been growing. Every year I, I see they’re just… it’s just a little bit bigger, a little more [00:06:00] people. I walked on LinkedIn and hiring some engineers and some people to work over the summertime. That’s all great. What’s the structure look like now? How are you trying to organize yourself as a business?  David King: Yeah, so we really break down into three different structures. We have our service division, and that’s, um, putting people out there to solve problems in the field. As simple as it gets, right? It’s like you’ve got a problem, we’ve got the right people with the right solutions, and they’re gonna go deliver, uh, a result. Um, and then we’ve got an engineering division. That’s about developing problems. It also has a lot to do with IP. You know, things like root fusion, that’s a pat- protected technology. Sure. All of our technology, we do a lot of investments in, in, you know, patent protection and IP work, and so that sits inside that engineering division. Uh, it’s how we, we have the smarts of the company kinda sat in there. Uh, it also is what allows us to really get into some of these, uh, kinda juicy problem statements that are a little bit prickly maybe. Uh, and we love getting into those and solving them. Yeah. And then the third and final thing is the composite side of things, and that’s the, the manufacturing. That’s that 30,000 square [00:07:00] foot composite manufacturing facility where we wanna be the best in vacuum infusion. We wanna be the best in prepreg, the best in pultrusions, complex assemblies, and be trying to de- uh, just deliver really high-quality composites to the industry. Allen Hall : Yeah, and you have the equipment to do a lot of testing. And I think a, a lot of operators don’t realize what you have And the knowledge that’s sitting there, when I run into operators across the country that have complicated issues, particularly if they have carbon, I mean, oh my gosh, you, you need to be calling experts here. And if they have issues they haven’t really sussed out, they don’t know, they don’t understand the engineering that went into that blade, they need to be talking to you guys about Why is this blade designed the way it is? How should I approach this? Do I need to be turning my turbines off until I figure out a solution? A lot of times there’s not a lot of resources there because the, the designs are more complex than ever. But on the, on the same hand, I would say they’re not doing a lot of testing of their own materials. [00:08:00] David King: Yeah, and there’s a huge space for that. And which is crazy. Absolutely. Yeah. It’s, it’s, uh, it’s definitely a gap. It is. And we see it as a gap that needs to be filled. Yes. And so that’s where, you know, we, we say you’ve gotta give the engineers the tools to be successful. Sure. And so what are those tools? You know, that could be anything from what does an aerodynamicist need? They might need a metrology scanner. Right. So we do 70 million plus point scans of full blades. We’ve done now a full blade scan and, uh, I think we did it in about an hour, which was a, a new record of how quickly you could get 70 million points on a blade. Wow. And then that allowed- Uptower  Allen Hall : or  David King: downtower? It was downtower. Okay. Okay. It was outside in the field, but it was downtower. Okay. It’s still impressive. So that was a little, little, little bit easier than uptower. Sure. Maybe that’s next. Um- Yeah. But, um, no, and then so what can you do with that? Well, then you can go, uh, really analyze, you know, the performance of that blade. Maybe you can go do something in a wind tunnel with it. So coming back to that toolkit- Yep … an aerodynamicist needs a wind tunnel. We have aerodynamicists, so we have a wind tunnel. Then going on to, like, a structural engineer. What does a structural engineer need? Well, they need their FE tools. They need some good first principle approaches to, to structures. But they also need test equipment. Right. They need to be [00:09:00] able to develop and characterize materials both in static and fatigue. And so we’ve made a lot of investment in those sort of test equipment, uh, so that we can, we can put numbers to things. You know, I think the wind industry needs more data. Less speculation and more data-driven decisions, and the, where that starts is really building up that test base. And we, we believe in this thing called the testing pyramid, and what it is is, like, you’ve gotta characterize the material. That’s where you’re gonna have thousands of samples. Right. That’s your tensile, double lap shear testing, all the basics. Then you do your subcomponents. Add some geometry into that, that- Add some shape. Exactly. Maybe that’s hundreds of samples. And then you’re gonna go on top of that to, like, your full component. And look, we don’t have a blade test stand yet, but- Right … that’s kind of that, that space. And then the final top of that pyramid is go do it in the field, get results- Run it … and then run that back into your design cycles. And I think the more we can do that as an industry, the more successful we’re gonna be as an industry.  Allen Hall : Yeah, and I think a lot of operators don’t think they have to participate in that, and they’re sadly mistaken. And the fact that the industry has grown as fast as it has means [00:10:00] there’s some holes in some of the engineering that maybe they didn’t consider the, the site assessment properly or they didn’t understand some of the manufacturing variability. Now you own this product, you’re gonna have to do some of the homework that maybe the OEM should have done. It’s your site. You own it. And a lot of times I think, uh, as an owner/operator, they don’t realize there’s resources. Like, okay, well maybe do some mechanical testing. Maybe the repairs I had last summer aren’t working out the way that I think. Maybe I need to look at some materials  David King: and see if- And we want you to own your data. Well, that’s exactly it, right? That’s really what it comes down to is like you wanna own the data, know your blades, know your products, whether it’s, you know… I know you’re very, uh, you know, uh, specialized in lighting, really know your stuff. Everybody’s gotta take that same approach. Know your stuff- You need to know it … or go find the experts that know it- Right … and work with them. Yeah.  Allen Hall : Well, at, at this point in the industry’s growth, you realize who’s all percolated towards the top, right? You, you, you see the companies like Goldwind that have the expertise in-house and, and have established themselves as a [00:11:00] knowledge center, as a resource for the US and globally, and there’s only a couple of those spread around the world in that- We as an industry need to be utilizing you more to help us solve problems. Because if I don’t tell Gulf Wind what’s going on, Gulf Wind can’t help come to a solution.  David King: And we find that really, like, just the more you know, you start finding all sorts of new opportunities. Yeah. ‘Cause we almost learn what you don’t know, in a way. You kind of realize that, like, there’s so much more out there. Yeah. And that’s where it gets really exciting. That’s where it’s like you can get these novel solutions, people who take creative approaches. Um, and, and I really think that’s what’s gonna take this industry forward, especially now when, you know, there are some headwinds for wind. And all that means is we’ve gotta get sharper, and we’ve gotta be, uh, more agile. And I think it’s actually almost times like this that create some of the best, uh, behaviors in an industry to, uh, take it forward into the future really.  Allen Hall : Yeah. Wind’s not gonna go anywhere, but it’s being stressed a little bit. And in those stress points, we need to take the time to reflect and to make the industry [00:12:00] stronger. But in order to do that, we need to be relying upon the sources that we have. There are global sources. There are so many resources to touch into. I think you guys are, are doing amazing things. Obviously, being down in your facility, seeing the wind tunnel, just blown away by that. Seeing the mechanical testing, seeing the, the 3D printing of air foils and all that work you’re doing, plus the ability to scan blades, do large scale studies. I remember one was on CMS at the time, thinking, “All right. Somebody’s, somebody’s actually doing the right thing. There’s a study happening so we can understand what’s happening in CMS.” Like, those things need to happen as an industry to grow.  David King: Oh, absolutely. And I know you and I were at WOMA- Yes … quite recently. Yeah. And we heard about that LEP study. Yes. And what a prime example- … of people going out there, getting real life data. Yes. And then, uh, making it accessible so that people can make smart decisions, and again, drive the cost of energy down and make wind successful. It’s, it’s amazing.  Allen Hall : It, uh- Yeah. Yeah, yeah. But the transfer of knowledge is the key, right? And you guys are involved [00:13:00] in looking at some, what LEP will do to improve a blade, but also what leading edge damage will do to erode performance. Those are some of the things that a lot of operators don’t understand. Like, is that blade being in that damaged form even affecting my AEP? It depends on the turbine, I think, a lot of times. But you better be asking the question at least. Talk to somebody who knows.  David King: Yeah. ‘Cause it, it’s really interesting. I mean, you know, I think it so much drives back to that business case for the operator, and they all have their own approaches. And, and really- Yeah you know, most people are repairing LEP when it becomes structural. That’s the- That’s right … that’s the predominant approach. And, you know, I understand that approach very… You know, I, I get it from an operator’s point of view. Um, but yeah, there’s definitely, uh, other things you could do to try and make a, a data-based business decision. Um- Sure.  Allen Hall : Sure. Now, what are some of the cool new things that Gulf Wind is working on, that you haven’t announced to the world yet, but you’d like to announce? I know you’ve been working on things. I’ve seen all the white papers being published. There’s some things- Back behind the scenes, what’s new?  David King: Yeah. I mean, so, you know, you take something like Roof [00:14:00] Fusion, right? Right. Which is a long process to develop. So we, knowing that everything that, uh, you have as an idea is gonna take almost maybe three, four, five years to actually bring to market- Sure … we’re always starting on this constant cycle of development. Right. And so the things- You know  Allen Hall : it’s gonna be five years. David King: Exactly. Yeah. And so, you know, I mean, it’s like the patents on this stuff take three, four, five years to work out. Yeah. And so it- it’s a very important part of the entire process. Yeah. But to, to answer your question, we do have some exciting things both in the aero side, uh, side of the world. Uh, we have been doing a lot of development work around, uh, basically, uh, passive load shedding, so the ability for a turbine, or actually any structure, to be able to react to the wind in a passive manner. Uh, so you don’t need any sort of mechanicals. You don’t need anything, uh, that’s going to break in the field, and the structure itself is able to actually react to the load that’s coming onto it and change its aerodynamic, uh, profile and change its load that it’s experiencing. So you get these… Uh, that’s a very interesting new technology. Yes. Uh, it’s something that we’ve been working on for about three or four years now. It’s now, uh, [00:15:00] getting demonstrated, uh, which we’re very excited about. Uh, we also have some technologies, uh, around new connection types between metal and composites. So this is, uh, something that’s, uh, probably got a lot of, um, application in aerospace, but I think it’s also gonna find its way into wind. And this is just a new way of really trying to fix some of the problematic joints that we’ve been dealing with now for the last few years, but looking forward, not looking backward. Yeah. Right. Sure. Not being retroactive. Right. But how do we do that next generation of roof pushing design, for example? And we’ve got a really exciting method for that, that, uh, is been tested now. We have test results for it, and they look extremely good. Uh, we also are making some major CapEx investments this year into- Sure … new manufacturing equipment. So we have, um, some… I, I would say some, some pretty advanced, um, automation we’re trying to bring to composite manufacturing- Okay … around pre-preg carbon fibers and things like that, which is gonna be very, very exciting I think. Uh, I hope it finds its way into the wind industry. It’ll probably start in other industries. Sure. Maybe kind of this, uh, [00:16:00] subsea, you know, and, uh, and air, uh, space first- Sure … you know, around UAVs, ROVs- Sure … that sort of thing. But I think it’s also gonna have applications in wind, and we’re really, really excited about that. Well,  Allen Hall : that’s good because it, it does seem like wind is downstream of a lot of aerospace things ’cause it does, definitely costs money to develop those, and aerospace is a place where that can happen. However- If you work out all the kinks and you solve all the manufacturing issues, it is directly applicable to wind. David King: And it’s massive volume. The beautiful thing about wind is that the volume, when you get something right and you do it right, you get to deploy technology. Yeah. Yes. You, you get to take it off the shelf- Right … and put it in the world and make it happen, which is, there’s nothing more exciting as an engineer. Allen Hall : Well, I mean, in, in terms of blade manufacturing, how many times have we talked about automating that so we have less things like wrinkles and some ply issues, overlaps, those kind of things where automation would help, but we just haven’t really refined it enough to i- implement it at a large scale in a blade factory. David King: Exactly. And it’s always usually too bespoke, you know? It is. It’s like you solve the problem for the, the 40-meter blade, and now- Right … there’s a [00:17:00] 45-meter blade, and we need all new CapEx. Right. And then it doesn’t, uh, doesn’t scale well.  Allen Hall : That doesn’t scale at all. No. Right. So that’s why they haven’t done it, is because they know the next generation of blade is coming. It’s another 10 meters longer, and that’s not gonna fit in this building, and doesn’t make sense- We’re in trouble … to buy the equipment.  David King: Yeah, exactly.  Allen Hall : Right. So it, it, it’s a- Yeah … it’s a constant evolving industry. Now, I, I had looked at your load shedding patent application or patent. Maybe it came out as a patent. David King: Yep.  Allen Hall : Mm-hmm. Okay. I wanna understand that a little bit since I’m here talking to you now. The load shedding piece was because, uh, you’re in Louisiana, that’s where hurricanes- Come up … every once in a while, if people haven’t read the papers. But the load shedding technology makes sense because now you can deploy wind turbines in places that you otherwise may not do it because of the risk of typhoons, hurricanes, even tornadoes on some level, some odd wind situations. You wanna explain what that technology is? Yeah.  David King: Really what it’s doing is it’s trying to decouple the, uh, turbine’s ability to protect itself from its requirement to maintain power and maintain [00:18:00] control. So if you have something that relies on electrical hydraulics or anything like that- Yeah … it’s gonna be extremely susceptible to failing, uh, when- Yes there’s a grid outage or when you have a battery that fails or, you know, most airplanes require, like, dual redundancy or triple- Triple … triple redundancy because of that very reason, and we just can’t afford to do that in wind. No. And so the innovation then that gets required is you have to have something that’s passive, something where the structure itself has been designed in a way where the laminate is designed in a way where it’s going to not react progressively like a linear fashion as you apply load, right? It keeps bending and bending and bending. Right, right, right. But it’s gonna have quite a sudden reaction to a very particular load case. And so that’s what we’ve been able to do is-  Allen Hall : Okay …  David King: basically construct that laminate in a way where when it, the right load is applied, in this case, that’s the, the hurricane load or the extreme load- Right we can shed that load, uh, completely by the structure simply reacting to the load, and that’s very exciting for wind. It has a lot of other applications ’cause- Sure it does … basically allowing you to hinge composites. We now can- Right … with [00:19:00] composites almost in an origami fashion, hinge them any way we want, which is really, really exciting. Nice. And we’re excited to bring that now to other areas besides just wind and, and wind will be a key one as well.  Allen Hall : Sure it will. Yeah. Wow, okay. That’s cool. I mean, that’s why I follow Gulf Wind Technology on LinkedIn to see all the cool things that are coming out because, uh, if, if you’re thinking about- What’s new, what’s next. There’s probably three or four places, honestly, in the world that I rely upon, DTE being one, Fraunhofer being another, and then Gulf Wind Technology. Like, okay, let’s… So they tram for it here. I… Let’s, let’s see what’s going on this week. That’s amazing. And I, I know that as you guys get more experience out in the field and people will start to recognize the name, it’s just only gonna grow to something even bigger. So that, that’s fantastic. I know you, you spend a lot of time making  David King: this business go. We’re de- definitely very excited about it. Yeah. But with, with growth comes, you know, a, a discipline. Right. You have to be very disciplined. Yes. And so that’s something, you know, we’ve gotta be very focused on. Yeah. That’s where things like that certified training program are important. Yes. It’s where [00:20:00] how we patent things is very important. Yes. How we, uh, you know, kind of set up company structure is very important. So I know we touched on a few of those subjects today. Yeah. But those are really just about trying to be able to maintain quality as we grow. A- and that’s really important to our customers, it’s important to us, and it’s how we maintain the brand. Allen Hall : We gotta get back down to Louisiana. I’m really curious to see what’s happening inside the buildings and see where you’re at, because, uh, I know there’s great things happening there. And I really appreciate the time. Thank you for coming over to Australia. I thought your, your talks and your, your presentation and being on panels in Australia was really insightful to a lot of Australians, because you’re just bringing a different viewpoint into that marketplace. And, and that’s what Gulf Wind does. So I, I appreciate all that effort. And, uh, yeah, we should connect up this summer. Come down and check out what’s going on.  David King: Absolutely. If you’re willing to brave the heat- Oh, no. … you are always welcome. And our aim is that every time you come to that factory, hopefully it’s like a, a whole new world. We wanna surprise you with something new, because, uh, that’s the only way we can demonstrate progress.  Allen Hall : Oh, that’s a deal.  David King: So.  Allen Hall : Okay, great. Well, thank you,  David King: Dave. Great to see [00:21:00] you. Thanks  Allen Hall : for being on the  David King: podcast. Thank you very much.

SNF Fraud or Perverse Incentives? Hunterbrook Investigates Understaffing, Self-Reported STAR Ratings, and Medicare Dollars at Skilled Nursing Facilities Is it fraud — or is it just a perverse incentive? That question sits at the center of Hunterbrook Media's latest investigation into skilled nursing facilities (SNFs), and the answer, as Stacey Richter puts it, matters to self-insured employers and anyone else paying for healthcare. In this episode, Stacey speaks with Michelle Cera, PhD, investigative reporter at Hunterbrook Media, whose investigation — triggered by a tip from an overwhelmed elder abuse attorney — uncovered a pattern of systematic understaffing, self-reported CMS STAR rating manipulation, executive bonuses tied to expense-cutting, and related-party financial engineering that funnels Medicare and Medicaid dollars straight back to corporate, while the most vulnerable patients pay with their health and their lives. WHAT YOU'LL LEARN ✅ How for-profit SNF chains systematically recruit the sickest patients to maximize Medicare and Medicaid reimbursement, then staff below what those patients actually need — keeping the difference as profit and, in some cases, doubling executive bonuses in a single year ✅ How Hunterbrook analyzed millions of publicly available CMS data points across roughly 14,000 skilled nursing facilities, applying a UCSF-developed expected-hours formula tied to patient acuity, to quantify the gap between staffing hours billed and care hours actually provided ✅ Why CMS STAR ratings — the primary tool consumers use to choose nursing homes for loved ones — are largely informed by self-reported, unaudited facility data, and how former employees described manipulation of those ratings as rampant ✅ How related-party transactions allow SNF chains to route Medicare and Medicaid dollars through owned subsidiaries for goods and services like pharmacy, equipment, and insurance — with CMS flagging the overcharges as disallowed costs but lacking any mechanism to recoup them ✅ How a 2024 CMS final rule establishing a federal minimum of 3.48 HPRD (hours per resident day) and a 24/7 on-site registered nurse requirement was ultimately rescinded after industry lobbying — and what that rescission reveals about regulatory capture in the SNF sector ✅ Four concrete policy fixes: codify federal minimum staffing hours adjusted for patient acuity, strengthen reporting standards and auditing so no quality metric is entirely self-reported, create a recoupment mechanism for flagged related-party overcharges, and reform STAR ratings so consumers can distinguish independently verified data from self-reported data WHY THIS MATTERS Right now, Stacey argues, we are endlessly trying to keep up with thousands of profit-extracting geniuses and creating mazes of complexity to regulate actors who have no societal construct keeping them in check. The SNF sector is a case study in what happens when there is no agreed-upon definition of harm — when perverse incentives are just incentives. These are taxpayer, employer, and patient co-insurance dollars potentially going into someone's pocket while a patient is simultaneously being hurt. The 65-plus population is growing, the market is expanding, and — as Hunterbrook's research shows — the model that works from a profit perspective is to take sicker patients, cut the highest-paid staff first, and grade your own homework so no one notices. That playbook, once proven, spreads fast. === LINKS ===

Join host Eve Cunningham, MD, Chief Medical Officer at Cadence, in conversation with Brian Stein, MD, Vice President and Chief Quality Officer at Rush University System for Health. Rush is a leading academic health system in Chicago with a national reputation for quality — ranked in Vizient's top 10 among academic medical centers for 13 consecutive years and a six-time U.S. News & World Report Best Hospitals Honor Roll honoree. In this episode, Drs. Eve and Brian explore how Rush has embedded quality into its organizational identity, what it takes to maintain consistent care in an academic medical center, and why remote patient monitoring became a strategic priority. Their conversation focuses on: How Rush treats quality as a brand differentiator rather than a compliance exercise — and the operational principles that make that sustainable Why academic medical centers face a unique quality challenge with trainee turnover every 2–4 years, and how tight processes compensate for that churn What made Rush an early adopter of remote patient monitoring, and the three-part filter Dr. Stein uses to evaluate any new technology Why patient retention on RPM surprised him more than the clinical outcomes — and what's driving long-term engagement How to think about short-term clinical wins versus long-term cost savings, and the payer misalignment that makes proving ROI difficult Where patient stratification is heading — matching the intensity of remote intervention to individual patient needs Where Rush is placing its bets on AI, from diagnostic radiology and pathology to virtual nursing and operational efficiency Dr. Stein is a partner of Cadence and not compensated for this podcast. Segments: [00:05] Introduction — Eve welcomes Dr. Stein to Cadence Conversations [00:39] Origin story — How research on administrative claims data led to a career in quality [04:02] Crew resource management — Team-based training and hardwired safety tools at Rush [05:46] Blood administration errors — How barcoding through Epic reduced a recurring safety issue [07:47] Quality as brand — Why Rush treats quality as a competitive differentiator, not a compliance exercise [09:47] Telling the quality story externally — CMS star ratings, US News rankings, and public credibility [11:36] Quality in an academic medical center — The trainee turnover challenge and why tight processes matter [14:52] Innovation and new care models — Why care beyond the walls became part of Rush's strategy [17:28] The case for RPM — Better outcomes, easier provider workflows, and not breaking the bank [20:34] What surprised him — Patient retention and engagement exceeded expectations [22:13] Evaluating the data — Blood pressure control, goal-directed therapy, and the cost-effectiveness question [24:30] Patient stratification — The future of high-touch vs. lighter-touch remote interventions [28:05] Research priorities — Short-term clinical wins vs. long-term cost savings and the payer challenge [31:50] Chronic disease as a lifetime journey — Why sustained engagement matters [33:09] AI at Rush — Augmented intelligence in radiology, pathology, virtual nursing, and access centers [36:23] Closing — Optimism grounded in a strong quality culture Key Takeaways: Quality becomes sustainable when it's treated as organizational brand identity, not a regulatory requirement — and when you make it easy for clinicians to do the right thing. Academic medical centers face a unique challenge: trainee turnover every 2–4 years means quality can't rely on individual education alone — it must be embedded in process and systems. The most surprising outcome of Rush's RPM journey was patient retention — patients stayed engaged for years in a program category where attrition is typically high. The future of remote care delivery is patient stratification: matching the intensity of the intervention (high-touch human + tech vs. lighter-touch tech-enabled) to the patient's needs. AI's near-term impact in health systems will be augmented intelligence — creating efficiency in diagnostics, operations, and access — not replacing clinical judgment.

Learn more about the NABIP Medicare Advantage Certification. This program is another way agents can satisfy their Medicare & Fraud, Waste, and Abuse training requirements.   Read the text version   Get Connected:

In this episode of The Dish on Health IT, Tony Schueth, CEO of Point-of-Care Partners (POCP), welcomes Pooja Babbrah, Executive Vice President of Strategy and Industry Alignment at NCPDP, and Anna Taylor, Associate Vice President of Population Health and Value-Based Care at MultiCare Health System and Steering Committee member of the HL7 Da Vinci Project, for a discussion on the relationship between standards development and policymaking.  Using the CMS “Interoperability Standards and Prior Authorization for Drugs” Proposed Rule (CMS-0062-P) as a backdrop, the conversation explores how standards communities, implementation accelerators, pilot programs, and industry collaboration influence healthcare interoperability long before requirements appear in federal regulations. Tony opens the discussion by asking how organizations should think about the relationship between standards development and policymaking today. Pooja and Anna explain that organizations such as the HL7 Da Vinci Project and NCPDP Standards are often viewed as technical standards bodies, when in reality they serve as collaborative forums where providers, payers, vendors, pharmacists, regulators, and other stakeholders work through real-world operational challenges. The conversation then shifts to the value of participating early. Tony asks what organizations miss when they wait for final rules before becoming involved. Anna discusses the operational, strategic, and financial advantages organizations can gain by participating in standards development activities, implementation guide development, pilots, testing events, and implementation communities. As part of that discussion, Tony and Anna touch on the growing body of production implementations supported by Da Vinci. Organizations interested in understanding how these implementation guides are being deployed across the industry can explore the Da Vinci In-Action Implementation Tracker, which documents real-world adoption efforts and implementation progress. Pooja expands on the importance of creating opportunities for broader industry participation. She describes NCPDP Collab, an interactive forum open to both members and non-members that provides a venue for discussing workflow challenges, implementation barriers, and emerging industry needs before formal standards development begins. The discussion naturally progresses into the CMS “Interoperability Standards and Prior Authorization for Drugs” Proposed Rule (CMS-0062-P), which directly references standards and implementation approaches developed by both NCPDP and Da Vinci. As Tony guides the conversation toward implementation, Anna discusses how Da Vinci's collaborative testing model and initiatives such as Trebuchet help organizations evaluate interoperability workflows in real-world settings before widespread adoption. The discussion then turns to one of the central themes of CMS-0062-P: the convergence of pharmacy and medical benefit workflows. Pooja explains that while patients and providers simply want access to treatment, healthcare organizations continue to operate within separate medical and pharmacy benefit structures. She argues that future interoperability efforts must focus less on the underlying standards and more on creating workflows that deliver a seamless experience for providers and patients regardless of where coverage resides. Building on that theme, Tony asks how healthcare organizations should think differently about workflow design. Drawing on her background in human factors engineering, Anna argues that healthcare has historically allowed technology to dictate workflows rather than designing technology around how people actually work. She advocates for starting with desired outcomes and user experience, then working backward to determine how standards, automation, and technology can support those goals. The conversation then moves to trust, adoption, and data quality. Tony observes that interoperability is no longer simply about moving data but about delivering the right information at the right time and within the right workflow. Anna discusses the importance of consistency and reliability in building trust, while Pooja shares examples of how incomplete implementations can undermine provider confidence even when standards and technology are technically available. Together, they argue that adoption depends as much on usability and trust as it does on technical capability. Returning to CMS-0062-P, Tony asks where organizations should focus their feedback beyond timelines and compliance concerns. Both guests encourage stakeholders to look closely at the broader strategic questions embedded throughout the proposed rule, particularly the requests for information that may signal future policy priorities. Rather than focusing solely on implementation challenges, they encourage organizations to use the comment process as an opportunity to help shape how healthcare workflows should function in the future. The episode concludes with Tony's signature question: what should healthcare stakeholders think differently about or start doing differently tomorrow? Pooja highlights the expanding role pharmacists can play in care coordination, medication management, and prior authorization workflows, arguing that pharmacists remain an underutilized resource within the healthcare ecosystem. Anna closes with a call for broader participation across healthcare, encouraging providers, employers, patients, vendors, and other stakeholders to engage with standards communities and implementation efforts. She emphasizes that meaningful progress happens when stakeholders move beyond identifying problems and actively participate in building solutions. Throughout the discussion, Tony reinforces a central theme: the future of healthcare interoperability is not being shaped solely through regulation. It is shaped through the collaboration, testing, implementation, and problem-solving taking place every day within standards organizations, implementation accelerators, pilot programs, and stakeholder communities. Organizations that want to influence the future of healthcare should not wait for final rules to arrive. They should participate in the conversations that help create them.  

CMS continues to pull on the levers it has at its disposal to rein in national healthcare spend, including rulemaking around Medicare Advantage. In April, CMS announced the final rate for MA plans for CY2027, after a controversial proposed rule generated animated pushback — and a fair bit of panic — among payers. In this episode, host Abby Burns speaks with Alex Balmes, Vice President of Actuarial Services at Optum, to unpack what did — and didn't — end up in the final rate announcement, and what that signals for the future of the Medicare Advantage program. Together, they explore the components of the final rate that are most important for payers and providers to pay attention to, respectively, and why. Also in the 2027 final announcement, but not discussed in this episode: four measures are being added or updated in Star ratings calculations (Colorectal Cancer Screening; Care for Older Adults – Functional Status Assessment; Concurrent Use of Opioids and Benzodiazepines (COB); Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)) and three are being removed (Care for Older Adults – Pain Assessment, Medication Reconciliation Post-Discharge, Medication Therapy Management (MTM) Program Completion Rate for Comprehensive Medication Review (CMR)) We're here to help: Read the 2027 CMS Announcement | 2027 | CMS Episode | 286: A Medicare Advantage reset — and what comes next Ready-to-Use Slides | Medicare Advantage market outlook Stay informed | Healthcare policy updates Tool | Policy Scenario Impact Calculator Connect with an Optum Advisory expert | Optum Learn more about Advisory Board's 2026 summit series. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Health economics is not just about reimbursement. It is about proving how a technology reduces the total cost of care. In this episode, Betty Tsai, President of Cardiology Services International, explains why medtech companies must think beyond existing CPT or MS-DRG codes when shaping their commercialization strategies. Speaking with Saul at the MedTech Innovator event, she highlights how health economics reveals the true cost of a patient journey, from initial admission through readmissions and long-term care. Betty explores how value-based care and CMS performance metrics are reshaping hospital revenue and influencing adoption decisions. She also discusses alternative reimbursement pathways, such as the New Technology Add-on Payment, and emphasizes that companies demonstrating both clinical and economic value are more attractive to providers and investors. Tune in and learn why proving economic value may be one of the most important steps in driving medtech adoption. Resources: Connect with and follow Betty Tsai on LinkedIn.

CMS is reshaping DMEPOS accreditation. Learn what the shift to annual surveys means for ABC accredited facilities in 2026, what stays the same, and how to prepare for a year round, survey ready approach.

In this episode, Kate Heilpern, MD, President of Yale New Haven Hospital, and Dr. Deb Rhodes, Internist and Chief Quality Officer, Yale New Haven Health System, discuss the cultural transformation, leadership strategies, and systemwide approach that helped Yale New Haven Hospital achieve a five-star CMS rating.

This week I Share How Pivoting Isn't Failing [powerpress]

Would you like access to our advanced agency training for FREE? https://www.agencymastery360.com/training Have you ever hired your way into a problem? Have you promoted your best people into management roles and watched them struggle, not because they lacked talent, but because nobody asked whether that was actually the job they wanted? Today's featured guest grew her agency team to nearly 200 people before making the deliberate decision to scale back to around 75. She did it not because the business was failing, but because she had learned the hard way that headcount is not leverage. In this episode, she walks through what each stage of that growth actually cost, how she thinks about the difference between a manager and an executive, and why going all in on one service in 2017 was the scariest and most important decision she made for her agency. Hope Horner is the co-founder and CEO of Lemonlight, a video content agency based in California that produces commercials and primarily works with enterprise clients. She started the company in 2014 in her bedroom with two co-founders, betting that affordable, accessible video content would become essential for brands who had been priced out of the market. She was right. Lemonlight grew to nearly 200 employees before a deliberate rightsizing brought the team to around 75. In this episode, we'll discuss: The difference that going all in on one niche made The mistake fast-growing agencies make Distinction between manager and executive Subscribe Apple | Spotify | iHeart Radio Sponsors and Resources This episode is brought to you by Wix Studio: If you're leveling up your team and your client experience, your site builder should keep up too. That's why successful agencies use Wix Studio — built to adapt the way your agency does: AI-powered site mapping, responsive design, flexible workflows, and scalable CMS tools so you spend less on plugins and more on growth. Ready to design faster and smarter? Go to wix.com/studio to get started. Why Going All In on One Thing Was the Decision That Changed Everything In 2017, Lemonlight was doing what a lot of agencies do: offering paid advertising, web design, social media, and video production, because saying yes to everything felt safer than narrowing down. Hope and her co-founders made the call to turn all of that off almost overnight and go all in on video. This decision cost hundreds of thousands of dollars in revenue at the time. It also removed every piece of ambiguity about what the agency was, what it was building toward, and who it should be talking to. The downstream effects of that decision compounded over years. As the agency focused exclusively on video, the quality of the work got sharper. The quality of the work attracted better clients. Better clients required more sophisticated production. More sophisticated production required higher-end talent and systems. By the time COVID hit and enterprise clients started investing heavily in video, Lemonlight had the positioning, the craft, and the infrastructure to capture that demand at a level a generalist agency never could have. The decision that felt like contraction was the one that made real scale possible. What 200 Employees Actually Taught Her About Headcount The path to nearly 200 people was not a strategic choice. It was a response to demand. When clients flooded in during 2021 and 2022, they did what fast-growing agencies do: they threw bodies at the problem. The result was a team where tasks were fragmented across too many people, ownership was unclear, and productivity per person was low precisely because the work was so divided. It looked like growth, but operationally, it was expensive redundancy. The rightsizing that followed was a correction with a clear-eyed read on what actually produces leverage. Technology replaced a significant portion of the work that had been distributed across dozens of roles. Many employees who had been promoted into management discovered they preferred the individual contributor track and, given the option to step back, they performed better in it. Some of what felt like a painful downturn was actually the agency becoming the shape it should have been earlier. As Hope says: not better, just different. The problems at 75 people are real. They are just different problems than the ones at 200. The Manager Versus Executive Distinction Most Founders Miss Until Too Late Hope has a framework for telling a manager apart from an executive. A manager is built for evolution: improving existing processes incrementally, guiding people through what already works, making the current system run better. An executive is built for revolution: seeing where a fundamentally different process or product line needs to exist and building the case for it before anyone else has named the problem. Most founders who hire senior people for the first time discover, sometimes expensively, that a great manager at a large company is not the same as an executive who can function in a resource-constrained environment. The person who ran a function at a hundred-million-dollar company and wants a team of fifteen behind them to make them look good is not the same as the resourceful operator a growing agency actually needs. Recognizing the difference before the hire, not six months after, is the thing that separates founders who build strong leadership teams from founders who cycle through senior hires and wonder why nothing sticks. The Support Group Nobody Told You That You Needed Every agency owner knows that the loneliness of building an agency is real, it is underreported, and most founders make it worse by surrounding themselves with other founders who are performing confidence rather than telling the truth. The bravado of how many employees, how much revenue, how many awards is not just useless. It actively misleads founders into thinking their own internal chaos is unique to them when it is almost universally shared. What actually helps is a room where the performance stops. Where a founder who is eight figures and structurally broken can say that out loud and find that everyone in the room recognizes the pattern. That kind of peer truth-telling is not therapy. It is the fastest way to close the gap between where a founder is and where they need to be, because the person across the table has already lived through the version of the problem that is still invisible to the person describing it. Do You Want to Transform Your Agency from a Liability to an Asset? Looking to dig deeper into your agency's potential? Check out our Agency Blueprint. Designed for agency owners like you, our Agency Blueprint helps you uncover growth opportunities, tackle obstacles, and craft a customized blueprint for your agency's success.

Health Affairs Publishing's Jeff Byers welcomes Sarah Jane Tribble of KFF Health News to the pod to discuss the Rural Health Transformation Fund, highlighting how it aims to improve infrastructure and access in rural communities amid ongoing challenges like hospital closures, workforce shortages, and Medicaid cuts. To learn more about the Rural Health Transformation Fund, join us on June 8 for a free event featuring Kate Sapra and Katherine Ornstein highlighting state initiatives focusing on improving care for older adults.Join us on June 23 for an exclusive Insider virtual event examining how antitrust policy in health care is evolving at both the federal and state levels, featuring insights from Katherine Gudiksen, Leemore Dafny, and Nathan Hostert.Related Links:Rural Health Payout Series (KFF Health News)Rural America at a Glance (U.S. Department of Agriculture)Federal Budget Cuts Won't Hit All Hospitals Equally: How States Can Better Analyze Hospital And Health System Financial Data (Health Affairs Forefront)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

Are you secretly running on empty, wondering if burnout is targeting you next?In this episode, Alen Voskanian, COO of Cedars-Sinai Medical Network and author, pulls back the curtain on the raw realities beneath operations leadership. From the constant grind of clinical environments to the personal toll of endless firefighting, Voskanian exposes why burnout hits high performers hardest and how ignoring your creative side can quietly sabotage your impact. This isn't just about wellness platitudes. It's a real-world look at chasing fulfillment, designing systems that beat chaos, and the unexpected arts that make leaders resilient.If you're a COO (or run with one), you can't afford to miss these insights. The game has changed. Listen now or risk staying stuck in cycles that will bury both your team and your spirit. This is the side of leadership nobody else is showing you.Sponsored byGenius Network - An exclusive community for highly successful entrepreneurs, connecting you with top-tier leaders, strategic insights, and powerful relationships to help you grow your business faster and smarter.Learn more: https://www.geniusnetwork.com/Timestamped Highlights00:25 – The real reason burnout is rampant among COOs and physicians04:12 – The under-the-radar roles that secretly prepared him for operations07:29 – Three unconventional ways to master leadership fast12:18 – Why stand-up comedy became his secret tool for resilience15:57 – The hidden danger in neglecting your creative life as a leader19:53 – Brutal realities of burnout nobody is willing to admit29:55 – How lean principles are quietly transforming healthcare operations39:09 – What people on their deathbeds taught him about fulfillment and regretAbout the GuestAlen Voskanian, MD, MBA, is the Vice President and COO of Cedars-Sinai Medical Network. A board-certified physician in Family Medicine and Hospice & Palliative Medicine, he's also an author and sought-after keynote speaker. Alen is known for transforming healthcare to improve access and quality. He holds degrees from UC Berkeley, UC Irvine, and an MBA from Indiana University. He's a former innovation advisor for CMS, a Cunniff-Dixon/Hastings Center Physician Award winner, and a Health Innovators Fellow with the Aspen Global Leadership Network.