Podcasts about healthcare disruption

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Best podcasts about healthcare disruption

Latest podcast episodes about healthcare disruption

LTC University Podcast
Specialty Care At Your Health

LTC University Podcast

Play Episode Listen Later Sep 14, 2026 35:22


Your primary care provider is doing their best. But there's something they may not be telling you — not because they're hiding it, but because they simply can't know everything.In this episode of Your Health University, Jamie Preston sits down with Scott Middleton — Founder and Chief Disruption Officer of Your Health — to talk about one of the most underutilized parts of the American healthcare system: specialty care. Scott shares real stories from the field that will make you rethink what you expect from your next appointment, including a patient who had been living in a nursing home for years without ever being offered a weight-loss medication that was available to her, and a lawsuit that turned on a single chest x-ray that no one thought to order.What you'll learn in this episode:Why your primary care provider legally cannot keep up with every new medication, treatment, and specialist recommendation — and what to do about itWhat GLP-1 medications are, who qualifies, and why so many eligible patients are never told they existThe standard of care around lung cancer screening for smokers — and why not knowing this can have life-altering consequencesHow to ask for a specialist referral (and what happens if your provider pushes back)Why behavioral health is one of the most under-accessed specialties in America — and how to change that for yourselfWhat "integrated care" actually looks like when it works — and what you deserve to expect from your healthcare teamYou are the CEO of your own health. This episode gives you tools to act like it. www.YourHealth.Org

The Disrupted Podcast
Specialty Care At Your Health, Use it!

The Disrupted Podcast

Play Episode Listen Later Sep 14, 2026 36:21


Most healthcare organizations know specialty care matters. Almost none of them are actually using it at the level their patients need.In this episode of The Disrupted Podcast, Jamie Preston sits down with Scott Middleton — Founder and Chief Disruption Officer of Your Health — for an unfiltered look at one of the most critical gaps in care delivery: specialty services. Your Health currently routes about 10% of its patient appointments through specialty providers. The national average is 20%. Scott makes the case — with real stories from nursing homes, lawsuits, and the road across South Georgia — that closing that gap isn't just a clinical priority, it's a survival strategy.What you'll hear in this episode:Why a 400-pound patient in a nursing home had never been offered a GLP-1 for weight loss — and what that reveals about how providers think about specialtyThe exact communication chain (DPH → EDCS → Care Manager → Provider) and precisely where it breaks downHow 80% of Your Health patients have behavioral health needs while psych providers sit with open schedules — and how to fix that paradoxWhy texts and emails don't cut it in care coordination — and why voice-to-voice is the only real standardThe lawsuit that should have been prevented with a single chest x-ray, and what it means for provider accountability going forwardWhy Scott banned the word "no" inside Your Health — and the mindset shift that comes with replacing itSpecialty is what separates Your Health from every other provider in the market. If you're a DPH, a care manager, or a provider inside this system — this episode is for you. If you're a healthcare leader watching specialty care fall through the cracks anywhere, it might be for you too. www.YourHealth.Org

The Disrupted Podcast
Wellness Wins

The Disrupted Podcast

Play Episode Listen Later Sep 7, 2026 38:24


A hundred million Americans don't have a primary care provider. For most healthcare systems, that's a problem. For Scott Middleton, it's proof that the whole model needs to change.Scott, founder and Chief Disruption Officer at Your Health, joins Jamie for an unfiltered conversation about what wellness actually is — and why it's not the same as primary care. Your Health's wellness program has exploded from zero to 4,100 patients in just two years, and Scott is just getting started. From GLP-1s and hormone replacement to peptides and the controversial South Carolina ruling that tried to silence physicians, Scott holds nothing back — and makes clear he's willing to take the fight to court.In this episode:Why wellness is a specialty — not an alternative to primary care — and why the distinction changes everything about how patients should seek careThe South Carolina Board of Medical Examiners' peptide ruling, why Scott believes it violates the First Amendment, and what he plans to do about itHow clinical pharmacists and nurse practitioners are filling the gaps physicians are being pressured to leaveScott's own transformation: from 425 pounds to 216, cholesterol from 280 to 189, and what specific peptides and protocols drove those resultsWhy employers like Bank of America — spending $2 billion a year on employee health — are the sleeper stakeholders in the wellness revolutionIf you've been told to "come back when something's wrong," this episode is the permission slip to demand something better. www.YourHealth.Org

Becker’s Healthcare Podcast
Anish Desai on AI, Healthcare Disruption and the Future of Physician Practice

Becker’s Healthcare Podcast

Play Episode Listen Later Sep 1, 2026 20:33 Transcription Available


In this episode, Anish Desai discusses healthcare innovation, AI-enabled care, physician shortages, emerging care models and how physicians can adapt to a rapidly changing healthcare landscape.Disclaimer: The views and opinions expressed by Anish Desai are his own and do not necessarily reflect the views or positions of any organization with which he is affiliated.

ai physicians desai anish healthcare disruption physician practice
LTC University Podcast
From Reactive to Proactive: What Integrated Therapy Actually Changes

LTC University Podcast

Play Episode Listen Later Aug 31, 2026 47:38


Most people think occupational therapy is what happens after something goes wrong. Tyler Broome is here to tell you that's exactly the framing that's costing patients their independence. In this episode of the Your Health University Podcast, Jamie sits down with Tyler Broome, a Certified Occupational Therapist Assistant at Your Health, to explore what OT actually is, how it fits into a truly integrated care model, and why the therapy team often sees the earliest signs of decline — before anyone else on the care team does. Tyler brings a uniquely grounded perspective, shaped by a baseball career, a grandmother's fall, and years of working inside the homes of real patients. He articulates something most healthcare systems have yet to fully grasp: that medical outcomes and functional outcomes are deeply connected, and that a care team working in silos is a care team leaving gaps. In this episode: Why occupational therapy is defined by daily function — bathing, dressing, meal prep, medication management — not just physical recovery How OT's presence in the home gives the care team "functional health intelligence" no clinic visit can replicate The difference between saying your system is integrated and actually delivering integrated care Two real patient stories where early cross-disciplinary communication prevented a crisis from becoming a catastrophe Why the shift to value-based care makes therapy's role not just important — but essential If you work inside the Your Health system — or if you've ever wondered what the therapy team actually contributes — this conversation will change how you think about the care happening around your patients every day. www.YourHealth.Org

The Disrupted Podcast
Log Your CCM

The Disrupted Podcast

Play Episode Listen Later Aug 31, 2026 40:53


What if the single biggest lever on your paycheck wasn't a raise, a promotion, or a new contract — but three minutes a day of logging? Scott Middleton returns to break down the real math behind Your Health's bonus structure, and why so many care managers, CNAs, and nurses are unknowingly walking away from serious money every month. Scott, Owner of Your Health and its Chief Disruption Officer, walks through a live coaching conversation he had with a team member confused about how hospice bonuses actually get calculated — and turns it into a masterclass on incentive design, healthcare economics, and why "showing your work" is the whole game. In this episode, you'll hear: How the hospice bonus pool is actually calculated, from raft scores to the $6,000-a-month billing baseline per patient A simple system for logging care management minutes in under five minutes a day — and why skipping it quietly shrinks every bonus check on the team Why 600+ patients on competitor hospices represent a multi-million-dollar opportunity Your Health is leaving on the table The uncomfortable truth about physician ego, referral economics, and why hospitals actually lose money in the ER Why some healthcare incentives are secretly built to keep patients sicker longer — and one patient's remarkable recovery story that exposes it If you've ever wondered why the system pays for what it pays for, or you're leaving money on the table because you're not tracking your own work, this conversation will change how you think about both. Press play — and then go log your hours. www.YourHealth.Org

Experiencing Healthcare Podcast

Every leader has a plan — until the road closes. The question isn't whether you'll hit a detour. It's whether you've been honest enough about which ones you could have seen coming. In this episode, Jamie sits down with Matt Stobb, CEO of Your Health, for a candid conversation on what detours really cost healthcare leaders — and what they can teach us. Drawing on real moments from the frontlines of healthcare leadership, Jamie and Matt explore the difference between detours we create and detours we inherit, and what we owe our teams when we hit either one. Key topics covered: The critical difference between avoidable and unavoidable detours — and how leaders confuse the two Why "there's no lesson in the second kick of a mule" is the most underrated leadership principle in healthcare A leader's real job when the detour hits: take responsibility, communicate openly, and run toward the fire — not away from it How navigating hard moments together is one of the most powerful team-building forces in healthcare Why the detour sometimes becomes a better route than the one you originally planned If you're in the middle of a detour right now — or just past one you're still processing — this episode will meet you there.

The Disrupted Podcast
The Bundled Payment Bomb: CMS Is About to Blow Up Orthopedic Care

The Disrupted Podcast

Play Episode Listen Later Aug 24, 2026 45:20


What if your hospital billed $90,000 for your surgery — and no one on the surgical team had any idea what it cost, or whether you were okay after you went home? That's not a hypothetical. That's the system Scott Middleton walked into at a Boston conference of hospital administrators and orthopedic surgeons — and what he found will change how you understand every hip replacement, every knee surgery, and every nursing home stay on Medicare. In this episode, Scott unpacks the incoming CJX bundled payment program — the sweeping CMS policy set to take effect January 1, 2028, that will hold hospitals financially accountable for everything that happens to a Medicare surgical patient from 30 days before the OR to 90 days after they go home. And the hidden detail that changes everything: the risk score that determines how much a hospital gets paid is captured 180 days before the surgery even happens. Why the 180-day risk score window means proactive patient management isn't just good medicine — it's now a financial imperative How orthopedic surgeons will be incentivized to cherry-pick healthy patients and avoid complex ones under the new bundled model Why excluding social determinants of health from the risk score formula is a disaster waiting to happen — and who pays for it The "studies" hospitals are using to eliminate physical therapy after hip and knee surgery — and why they're comparing apples to 88-year-olds How Your Health is already positioning itself as the value-based care partner that orthopedic surgeons and hospitals are going to desperately need The system that's coming will reward the organizations that have been doing the right thing all along — and penalize everyone who's been gaming fee-for-service. Press play to find out which side you're on. www.YourHealth.Org

The Disrupted Podcast
Presence vs. Popping In: Why Most Facility Relationships Are Failing Patients

The Disrupted Podcast

Play Episode Listen Later Aug 17, 2026 41:22


Most nursing homes think they're measuring success by how many patients move through their building. What they're not measuring is how many of those same patients end up right back in the hospital — and who pays the price when they do. In this episode of The Disrupted Podcast, Scott Middleton — Owner of Your Health and Chief Disruption Officer — pulls back the curtain on the facility partnership model Your Health is rolling out across the Southeast. It's a model that doesn't just serve patients in skilled nursing facilities; it pays those facilities for the care coordination work their staff is already doing, while creating the kind of presence that actually moves the needle on outcomes. Scott and Jamie cover the mechanics, the competitive landscape, and the cultural shift required to make it all work: Why Your Health is contracting with nursing homes to pay up to $20,000 a month for care coordination — and what that's worth annually to a facility with 200 Medicare patients The difference between "popping in" and genuine presence — and why only one of them drives real cost savings and keeps patients from bouncing back to the hospital Why physicians working in isolation are the biggest liability in a team-based care model, and how a September 1st bonus restructure is designed to change that culture How 80% of what used to require an in-person visit can now happen via telehealth — and the one thing technology will never replace: the relationship that makes a patient actually follow through Scott's 10-year urgency: why Your Health is already three steps ahead of the competition — and why that lead only matters if the model scales fast enough If you work in a nursing facility, lead a care team, run a healthcare organization, or believe the system needs a fundamentally better architecture — this is what building it actually looks like. Press play. www.YourHealth.Org

The Disrupted Podcast
Medicare Is Already Paying for This — Your Facility Just Isn't Collecting It

The Disrupted Podcast

Play Episode Listen Later Aug 10, 2026 41:12


Most nursing home administrators don't realize they're sitting on one of the most underutilized revenue streams in all of Medicare — and until someone shows up and tells them what it's worth, they never will. In this episode, Scott Middleton — founder and Chief Disruption Officer of Your Health — calls in from the road as he travels across rural Georgia on a multi-day facility tour, fresh off completing a major merger with TCPA. What follows is an unfiltered, on-the-ground breakdown of two transformational opportunities Scott is actively building: chronic care management (CCM) reimbursement and ACO cost savings — and the very specific reasons most of the industry is getting both wrong. In this episode, you'll hear: Why Medicare already pays $65/hour for care management performed by nurses, community health workers, and social workers — and how Your Health is now contracting with nursing home facilities to perform it, paying them up to $100 per patient per month The "Fuse" platform — a communication and documentation tool that routes care management notes directly into billing-ready buckets, syncing with point-of-care software so the minutes get captured and billed automatically How ACO risk scores work, why Your Health's scores have grown 30% under their current plan, and what failing to see hospice patients could cost the organization — up to $22 million in a single year The $4,800 per patient per year problem: how one physician in their network was quietly rated one of the worst under the ACO model simply because his patients were going home without any follow-up Scott's announcement that SSAs and TCPs are being restructured to report directly to peer group administrators — and why the confusion about their roles has cost the company If you lead a nursing home, an assisted living facility, a physician group, or any organization inside the long-term care ecosystem, this episode will change how you look at what you're already doing — and what you're leaving behind. www.YourHealth.Org

The Disrupted Podcast
Closing The Merger

The Disrupted Podcast

Play Episode Listen Later Aug 3, 2026 30:26


What does it look like the day a healthcare merger closes — not in a press release, but in real life? Scott Middleton was still signing DocuSign documents from his car when Jamie Preston hit record, and what followed is one of the most honest conversations yet about what it takes to grow a healthcare organization without losing the soul of why you started. Scott Middleton, Owner of Your Health and Chief Disruption Officer, joins the show to break down the just-completed acquisition of TCPA and Providence Care — and what it means to suddenly be responsible for 32 nursing home buildings, 900 new patients, and the enormous operational lift of pulling it all together under one roof. In this episode, Scott and Jamie cover: Why Your Health is immediately deploying two nurses and two community health workers per building — and how the revenue model makes them essentially self-funding from day one The continuous care hospice strategy: how night nurses on call can simultaneously generate $67/hour in Medicare reimbursement and ensure no patient dies alone The critical failure Scott discovered — hospice patients who haven't been seen by a provider since January, and the financial and human cost of letting that slide Why strategic planning lives in the field, not the boardroom — and what happens when leaders stop getting out from behind their desks The 30-day integration sprint: switching all providers to Athena, connecting hospice nurses to nurse practitioners, and getting risk scores captured before it's too late This is what disruption actually sounds like — not a keynote, not a case study, but a leader in motion, making decisions in real time, building something the healthcare system has never seen. If you're in healthcare, business, or just believe the way things have always been done is not good enough — this one's for you. www.YourHealth.Org

The Disrupted Podcast
Presence & Consistency

The Disrupted Podcast

Play Episode Listen Later Jul 27, 2026 37:52


What if the most powerful growth strategy in hospice and primary care had nothing to do with your clinical protocols, your technology stack, or your marketing budget — and everything to do with who shows up, and how often? In this episode of The Disrupted Podcast, Scott Middleton — founder and Chief Disruption Officer of Your Health — unpacks the real-world lessons shaping how your Health is staffing, growing, and rebuilding trust as it integrates the newly merged TCPA and Providence Care organizations. Scott spent the week in the field — Monroe, Georgia; Beaufort, South Carolina; Atlanta and beyond — sitting in care team meetings, talking to nurses, watching exercise classes, and rethinking everything from staffing ratios to personality matching. What he found is both a warning and a blueprint. In this episode: Why minor service failures — a nurse who didn't show up once — can cost you an entire facility relationship, and what it actually takes to earn it back The strategic case for pulling a nurse off a shared caseload and planting her full-time in a single building — even when the numbers don't fully justify it yet The story of a nurse so embedded in one facility that an administrator told Your Health: "I will cut you if you move her" How DISC personality profiles should determine which staff member walks into which building — and why getting it wrong creates friction that kills referrals Why the best talent you'll ever hire is already living in the community you serve — and why your recruiters will never find them on Indeed The centralize-then-decentralize model Your Health deploys every time it launches something new — and why it's the only way to scale without losing quality If you lead a care team, run a hospice program, manage a building, or are trying to grow in any direction in healthcare right now — this episode is your field guide. www.YourHealth.Org

Experiencing Healthcare Podcast
Are You A Healthcare Advocate?

Experiencing Healthcare Podcast

Play Episode Listen Later Jul 21, 2026 47:20


An ER nurse who spent 15 years on the night shift says she can predict which patients heal fastest — and it has nothing to do with diet or exercise. It's whether someone showed up for them and refused to stay quiet. In this episode, Matt Staub, CEO of Your Health, sits down with Jamie Preston to unpack that idea from every angle: as a son who once filled a hospital waiting room with 20 advocates for his mother's liver transplant, as a nursing home administrator who sat with a dying patient who had no one else, and as a cancer patient who carried a notebook into every appointment so he wouldn't forget the questions that mattered. Together they explore: Why family advocates get prioritized in the ER — and it isn't about fear of being sued The data behind advocacy: a 65% drop in 30-day hospital readmissions and a 98% staff satisfaction rate when patients have someone in their corner How to ask a "dumb" question without ever sounding dumb — and why staff want you to ask it What to do when a well-meaning advocate crosses the line into disrespect, and how healthcare workers can hold the line with empathy intact The "teach-back" method that helps patients actually retain what they were told Why the best advocates aren't the loudest in the room — they're the most present This is a conversation about the most overlooked job in healthcare: the one nobody's officially hired for, but everybody eventually needs. Whether you're a caregiver, a patient, or the clinician on the other side of the exam table, you'll walk away knowing exactly what to do differently at your next appointment.

LTC University Podcast
Data Driven Outcomes Part 2 with Brodie Wall

LTC University Podcast

Play Episode Listen Later Jul 20, 2026 36:00


A scale. A phone call at the end of the week. A data alert at 6 a.m. Monday morning. These aren't high-tech fantasies — they're the tools that are quietly keeping people out of hospitals and in their homes. In Part 2 of this two-part conversation, Jamie and Brody Wall, Division President of Operations at Your Health, go inside what data-driven care actually looks like on the ground — for the staff delivering it and the patients whose lives depend on it. This episode is less about the architecture of the system and more about what happens when you turn it on. Jamie and Brody cover: The Monday and Tuesday ER spike — and what the data revealed about a weekend coverage gap that was hiding in plain sight How remote patient monitoring caught a CHF patient's five-pound weight gain before it became a Monday emergency room visit — and what that prevented What staff data reveals about burnout, scheduling, and where care quietly falls through the cracks The math that should change how every healthcare organization operates: $800,000 in proactive primary care versus $16 million in hospitalizations for the same 800 patients A hip fracture story — and the 80% mortality statistic behind it — that captures everything Your Health is trying to prevent before it ever becomes a catastrophe This episode is about what it looks like when an organization decides that data isn't there to watch over people — it's there to protect them. If you have a parent, a patient, or a neighbor who deserves this kind of care, share this episode with them. www.YourHealth.Org

The Disrupted Podcast
Lost In Misinterpretation

The Disrupted Podcast

Play Episode Listen Later Jul 20, 2026 40:42


What if the reason your boss wants you in the office has nothing to do with your productivity — and everything to do with their ego? Scott Middleton admits it: he walked around his 30,000-square-foot corporate office on a Friday afternoon, found nobody, and got irritated. Then he caught himself. The data said his team was productive. The irritation was his ego talking. That moment of self-awareness opens a much bigger conversation about what happens when leaders — in business and in healthcare — stop reading the evidence and start acting on assumption. In this episode of The Disrupted Podcast, Scott and Jamie dig into: Why most CEOs pushing return-to-office mandates are solving for ego, not outcomes — and the New York Times data that proves it How Your Health is shifting from counting patients to measuring risk scores — and why that changes everything about how care teams are built The "legs grow back on January 1st" problem: how the Medicare system loses patient diagnoses every year and why hospice patients often appear healthier right before they die Why misinterpreting hospice rules is putting patients on the wrong track — and costing providers in ways they don't see coming The role of chaplains in advanced care planning, and why getting that right could reduce hospitalizations and change end-of-life outcomes South Carolina's jump from 49th to 26th in healthcare quality rankings — and what it means for the rest of the country Scott closes with a mission statement that's hard to argue with: at 67, he could have retired. He didn't. If this conversation lights something up in you, share it with someone who needs to hear it. www.YourHealth.Org

LTC University Podcast
Data Driven Outcomes with Brodie Wall

LTC University Podcast

Play Episode Listen Later Jul 13, 2026 21:26


The American healthcare system is built around a simple idea: get sick, get treated. But what if the problem isn't how we treat illness — it's that we've never seriously tried to prevent it? In this first installment of a two-part conversation, Jamie sits down with Brody Wall, Division President of Operations at Your Health, to trace the arc from a broken, reactive healthcare system to one where data tells you what's coming before the patient even knows something is wrong. Brody's path to healthcare wasn't through a textbook — it was through a father who was a Methodist minister and a mother who spent her career caring for underprivileged children. The mission was always there. The data just became the most honest way to fulfill it. In Part 1, Jamie and Brody cover: Why fee-for-service healthcare financially rewards volume of sick visits — not health — and how that one incentive structure explains why 17-20% of America's GDP goes to healthcare costs with outcomes that still lag behind other developed nations What Your Health was flying blind on before it committed to building a real data infrastructure — and what gut-feeling decisions look like when data finally proves them wrong How social determinants of health (Z codes) and behavioral health conditions (F codes) reveal which patients are actually at the highest risk of hospitalization The finding that changed everything: patients with four or more behavioral health conditions were ten times more likely to have multiple ER visits — and the clinical response that followed This isn't just a conversation about numbers. It's about what happens when an organization decides that preventing the crisis matters more than reacting to it. Part 2 drops next week. www.YourHealth.Org

The Disrupted Podcast
Stop Making Up Rules Already!

The Disrupted Podcast

Play Episode Listen Later Jul 13, 2026 34:50


What happens when the rules everyone follows weren't actually rules to begin with? In this episode, Scott Middleton — Owner of Your Health and Chief Disruption Officer — shares what he's seeing on the ground as the TCPA and Providence Care merger moves toward its final close. But the real conversation goes deeper: the quiet, dangerous habit of staff making up policies, enforcing phantom restrictions, and defaulting to "no" when the answer should have been "let's figure it out." Key topics covered: Why fabricated rules (like requiring a psych NP referral for talk therapy) become embedded in organizations — and how to stop it How Scott is approaching the merger with radical transparency, and why "don't tell until it's done" has no place in his culture The one thing that will get you fired fast: "don't tell Scott" What TCPA's nursing home model is teaching Your Health about patient frequency, hospitalizations, and what actually works Why the chaplain conversation changed Scott's entire philosophy — and how advanced care planning pays for it The system doesn't need more rules. It needs more people willing to ask. Listen now and ask yourself: what rule in your organization did somebody just make up? www.YourHealth.Org

LTC University Podcast
Building Interns Who Build the Company with Heather Bower

LTC University Podcast

Play Episode Listen Later Jul 6, 2026 31:44


Most companies recruit interns to take work off someone's plate. Your Health does the opposite — and it's why several of its current executives, including a Chief Information Officer, first walked in the door as interns. In this episode, Jamie sits down with Heather Bower, Director of Experiential Learning, who has taken the reins of Your Health's internship, mentorship, preceptorship, and apprenticeship programs. Heather shares how a long-standing program is being rebuilt with structure, data, and intention — organized into semester cohorts, anchored by a four-day all-company orientation, and designed so every intern owns a project with genuine stakes. In this conversation, you'll hear: Why "get interns because they're cheap" is exactly the wrong spirit — and what replaces it How one MBA intern's shadowing experience redirected him toward nursing school The "spreadsheet whisperer" intern who taught regional leadership to pull data faster What surprises interns most once they're inside healthcare: the human complexity How Your Health uses feedback loops to move interns toward roles where they'll actually shine If you're early in your career and unsure where you fit, this episode is a map to possibilities you may not know exist. Press play and rethink what an internship can really be. www.YourHealth.Org

Disruption / Interruption
Disrupting the UK's Healthcare Journey: Why It's Easier to Book a Flight Than a Surgery, with Andrew Archibald

Disruption / Interruption

Play Episode Listen Later Jul 2, 2026 37:37


Andrew Archibald, CEO of MEDMIN, breaks down why the UK's private healthcare sector has been stuck in operational chaos — and what he's doing to fix it. Built on a model where NHS consultants moonlight as private practitioners with zero business infrastructure, the system has forced brilliant surgeons to spend Sunday mornings writing their own invoices. MEDMIN steps in as a total practice management partner, handling admin, billing, marketing, and patient relations so doctors can focus on medicine. The results speak for themselves: new-to-practice consultants see 300% income growth within three years. Andrew also makes the case for embracing AI tools as a non-negotiable business move, and shares how MEDMIN is scaling toward a UK-wide brand that serves both doctors and patients. Key Takeaways: 3:34 — Curiosity is a professional strategy: Andrew attributes his entire career trajectory to a compulsion to understand how systems work and why they break, which drives him toward roles others avoid. 6:08 — COVID exposed a healthcare system already running on empty: the UK's waiting lists doubled during the pandemic and have never fully recovered because the NHS was underfunded through the 2010s before the crisis hit. 15:17 — The problem is personal: top-tier surgeons are spending Sunday mornings reconciling invoices instead of recovering, and that hidden administrative tax is the core inefficiency MEDMIN was built to eliminate. 24:42 — The ROI of removing friction is measurable: consultants who join MEDMIN as new-to-practice doctors grow their earnings by 300% between year one and year three. Quote of the Show (19:21):"People have just learnt to put up with inadequate systems. The healthcare system in the UK is very poor at investing in technology, in the administrative things that make the whole thing get better. And it's about time to say: stop accepting it." — Andrew Archibald Join our Anti-PR newsletter where we’re keeping a watchful and clever eye on PR trends, PR fails, and interesting news in tech so you don't have to. You're welcome. Want PR that actually matters? Get 30 minutes of expert advice in a fast-paced, zero-nonsense session from Karla Jo Helms, a veteran Crisis PR and Anti-PR Strategist who knows how to tell your story in the best possible light and get the exposure you need to disrupt your industry. Click here to book your call: https://info.jotopr.com/free-anti-pr-eval Ways to connect with Andrew Archibald:LinkedIn: http://www.linkedin.com/in/andrew-archibald-363050aCompany Website: https://medmin.co.uk How to get more Disruption/Interruption: Amazon Music - https://music.amazon.com/podcasts/eccda84d-4d5b-4c52-ba54-7fd8af3cbe87/disruption-interruption Apple Podcast - https://podcasts.apple.com/us/podcast/disruption-interruption/id1581985755 Spotify - https://open.spotify.com/show/6yGSwcSp8J354awJkCmJlD YouTube: https://www.youtube.com/results?search_query=disruption+%2F+interuuptionSee omnystudio.com/listener for privacy information.

The Disrupted Podcast
A Value-Based Merger

The Disrupted Podcast

Play Episode Listen Later Jun 29, 2026 46:00


What if the patient you discharged three years ago is still costing you money today? In this episode of The Disrupted Podcast, Scott Middleton pulls back the curtain on the mechanics of value-based care most providers never see — and the merger bringing it all into focus. With the July 15th closing date approaching, Scott walks through what the merger of Your Health with TCPA and Providence Care actually means on the ground: new contracts, new provider numbers, a reimbursement model built on RAF scores and revenue rather than guesswork, and a technology stack — from the Clini app to QR-coded patient wristbands — designed to capture what was previously left on the table. In this episode: Why patient attribution under value-based contracts follows you for years — and what hospice discharges are really costing the organization How the new bonus structure ties pay to billing, RAF scores, and quality measures (and why you can never be paid to put someone on hospice) The difference between care management, facilitated visits, and what providers have been under-billing all along How skilled nursing facilities became the highest-leverage opportunity in the entire model Why advanced care plans aren't just clinical — they're a 30% income increase hiding in plain sight If you've ever wondered why the "why" behind a process matters more than the process itself, this episode is the answer. Press play. www.YourHealth.Org

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Experiencing Healthcare Podcast
The Merger with Matt Staub

Experiencing Healthcare Podcast

Play Episode Listen Later Jun 23, 2026 44:34


What if the patient never noticed the merger at all? For Matt Staub, that's not a failure — it's the goal. In this episode, Your Health CEO Matt Staub sits down with Jamie to talk through the company's merger with TCPA and Providence Care — a move that brings together similar footprints in primary care, palliative, hospice, skilled nursing, and assisted living across South Carolina and Georgia. As a 23-year healthcare veteran going through his first merger, Matt is candid about the tedious due-diligence "earnest money" phase, the EMR transitions ahead, and why he refuses to let "what could go wrong" crowd out "what could go right." You'll hear: Why "mass moves mass" — and what scale actually buys patients in care management and data analytics How Your Health breaks 50,000 patients into groups, teams, and "hubs" so no one falls through the cracks The "change is hard" philosophy and the discipline of productive (not just effective) communication How the spirit of agape — godly love — still threads through a company that's evolved far past its original name What success looks like in six months: patient retention, mission and margin If you lead through change — or live through it — this one will reframe how you think about getting bigger without losing what made you matter.

The Disrupted Podcast
We NOT Them

The Disrupted Podcast

Play Episode Listen Later Jun 22, 2026 40:46


What if the fastest way to grow your healthcare organization is to slow down? In this episode of The Disrupted Podcast, Scott Middleton returns from Scotland straight into the thick of a merger — and what he's learning is reshaping how he thinks about change itself. Scott takes us inside the integration of TCPA and Providence Care into Your Health, where two very different models are colliding. One organization built 640 billing codes last year; the other built 40. One puts a single nurse practitioner in a building with no support; the other surrounds providers with nurses and community health workers. The opportunity is enormous — but so is the risk of moving too fast and scaring everyone away. What if the fastest way to grow your healthcare organization is to slow down? In this episode of The Disrupted Podcast, Scott Middleton returns from Scotland straight into the thick of a merger — and what he's learning is reshaping how he thinks about change itself. Scott takes us inside the integration of TCPA and Providence Care into Your Health, where two very different models are colliding. One organization built 640 billing codes last year; the other built 40. One puts a single nurse practitioner in a building with no support; the other surrounds providers with nurses and community health workers. The opportunity is enormous — but so is the risk of moving too fast and scaring everyone away. In this conversation, Jamie and Scott explore: Why a nurse practitioner alone is a "single source of failure" — and how staffing changes everything How to enter a building without threatening the provider they already love Why billing isn't bureaucracy — it's how Medicare knows you made a difference The art of giving people what they think they need now, and the rest over time Advanced care planning, DNRs, and why the right message sometimes needs a different voice This is a masterclass in change management disguised as a healthcare conversation. Listen now — and rethink what "disruption" really requires. Why a nurse practitioner alone is a "single source of failure" — and how staffing changes everything How to enter a building without threatening the provider they already love Why billing isn't bureaucracy — it's how Medicare knows you made a difference The art of giving people what they think they need now, and the rest over time Advanced care planning, DNRs, and why the right message sometimes needs a different voice This is a masterclass in change management disguised as a healthcare conversation. Listen now — and rethink what "disruption" really requires. www.YourHealth.Org

scotland visits medicare building trust building relationships change management social workers telehealth win win nurse practitioners palliative care primary care behavioral health long term care patient care home care social services your health endocrinology sustainable growth medicare advantage elder care assisted living senior living healthcare costs dnr organizational change operational excellence end of life care health care reform senior care healthcare innovation wellness programs hospice care home health patient outcomes trust building value based care aco aging populations care team case management primary care physicians slow growth healthcare technology customer needs healthcare leadership health care delivery access to care organizational communication patient centered care healthcare marketing care coordination community health workers polypharmacy medication management end of life planning healthcare business healthcare quality senior health revenue cycle healthcare leaders wellness director tcpa quality of care healthcare podcast healthcare transformation specialty care home visits accountable care organizations skilled nursing facilities skilled nursing psychiatric care family conversations dnrs healthcare strategy geriatric care do not resuscitate medical podcast advanced care planning healthcare operations healthcare entrepreneur nursing home care chronic care management healthcare sales healthcare disruption home based care chief disruption officer patient recruitment
Experiencing Healthcare Podcast
Matt Goes To The Capital

Experiencing Healthcare Podcast

Play Episode Listen Later Jun 16, 2026 42:14


What if the most important care in the entire healthcare system is also the most underfunded? While hospitals and inpatient reimbursements rise with inflation, the physician fee schedule has quietly declined roughly 33% in real terms over 25 years — and this year it's facing another cut. In this episode, Jamie Preston sits down with Your Health CEO Matt Staub, just back from Capitol Hill, where he spent a record-setting 95-degree day meeting with seven legislative offices to advocate for physicians, providers, and the patients they serve across rural South Carolina, Georgia, and beyond. What follows is part field report, part reflection on why preventive primary care saves money and lives — and why we plan meticulously for weddings, retirement, and vacations, but treat our own health with a "call us if something happens" approach. In this conversation: Why a 2.5–5% physician fee cut hits frontline rural practices hardest The bipartisan doctors' caucus and the real appetite for reform Why winning can come from a loss — the Kobe Bryant mindset on process over outcome How a Disney ride (Spaceship Earth) reframes humanity's whole story around communication The case for proactive, team-based primary care over reactive sick visits Press play for a conversation about advocacy, communication, and a simple, powerful idea: the change you need to make starts with you.

LTC University Podcast
What If Your Company Trained You to Outgrow Your Job?

LTC University Podcast

Play Episode Listen Later Jun 15, 2026 36:10


What if educating your people so well that they could leave was exactly the point? At Your Health, that's not a risk to manage — it's the philosophy that built an entire learning ecosystem. In this episode, Jamie talks with Aubrey Wall, who came to Your Health from a background in education and now leads Your Health University, the organization's learning management system and continuous-development engine. Aubrey brings an educator's eye to a fast-evolving healthcare environment, where best practice changes by the day and meeting patients where they are demands that staff never stop learning. Here's what you'll hear: Why a healthcare company runs 12-month, Department of Labor–registered apprenticeships — including programs in management, value-based care, population health, and hospice aide preparation How gamification is being built into nurse instruction (straight from Aubrey's dissertation research) The difference between Your Health University (your classroom) and the Hub (your resource library) How LinkedIn Learning delivered roughly $4.2 million in CEUs to staff last year Meeting Leah — the new AI assistant that helps employees find exactly the right course If you've ever believed growing your people is a cost rather than the whole point, this conversation will change how you think. Press play, then go ask Leah a question. www.YourHealth.Org

ai press adhd accountability labor nurses curiosity reporting creative directors trained health and wellness leadership development professional development protocols hub dyslexia registered nurses edtech gamification special education employee engagement lifelong learning palliative care behavioral health workflows microsoft teams patient care continuing education workforce development medical education professional growth talent development continuous learning upskilling leadership training your health clinical practice patient experience health care professionals organizational culture peer support population health healthcare providers lms end of life care health care reform leadership insights ceu subject matter experts healthcare innovation career advancement hospice care mentorship program outgrow patient outcomes wellness podcast adobe photoshop ceus reskilling healthcare management value based care career pathways ai in education case management licensure nursing students healthcare technology healthcare leadership learning technologies employee development skill building technical college evidence based practice learning culture care management knowledge sharing learning management systems learning differences business training adobe illustrator community health workers nursing education virtual classrooms self directed learning preceptor education innovation quality of care healthcare podcast medical assistant staff retention resource library educational innovation clinical coordinator employee growth peer coaching healthcare disruption it training continuing education credits healthcare careers proprietary software just in time learning
LTC University Podcast
Christopher Laffey, NP: What Happens When Healthcare Follows You Home

LTC University Podcast

Play Episode Listen Later Jun 8, 2026 37:48


What if your healthcare team already knew what happened during your hospital stay — before you even explained it? What if someone on your care team noticed you were struggling on a Saturday and simply showed up? In this episode, Jamie sits down with Christopher Laffey, Nurse Practitioner at Your Health, to break down what a truly connected, proactive model of care actually looks like when it's working. Christopher practices in North Charleston, SC, where his team — nurses, therapists, social workers, community health workers, and more — functions less like a traditional office practice and more like a living, breathing safety net woven around each patient's real life. What you'll hear in this episode: Why most patients are failing not because nobody cares, but because the system itself is fragmented — and what doing it differently actually looks like on a Tuesday morning The real difference between "patient-centered" as a marketing phrase and patient-centered as a daily practice (hint: it involves seeing the medication bottles on the kitchen table) A powerful real-life story of a bedbound patient whose caregiver suddenly disappeared — and how the team mobilized over a weekend, on their own time, to prevent a hospitalization The single mindset shift every clinician needs to make the transition from visit-based thinking to longitudinal care Why "value-based care" doesn't mean discounted care — it means the organization is accountable for your outcomes, not just your appointments If you've ever left a doctor's appointment feeling more confused than when you walked in, this episode will show you what healthcare can feel like when it's actually designed around you. www.YourHealth.Org

The Disrupted Podcast
If You Didn't Document It, Medicare Thinks It Never Happened

The Disrupted Podcast

Play Episode Listen Later Jun 8, 2026 32:39


It was 3 o'clock in the morning when Scott Middleton finally signed the papers. The merger was official. And within days, he was already on the road — visiting facilities, riding along with providers, and spotting the same gap everywhere he went: brilliant clinicians doing real work that was completely invisible to the system. In this episode of The Disrupted Podcast, Jamie sits down with Scott Middleton, calling in from Boston, to unpack what he's discovering on the ground in the newly merged Your Health organization — and why tracking your time isn't about paperwork. It's about protection, proof, and getting paid for every minute of care you're already delivering. What you'll hear in this episode: The Dr. Jeeve story: a high-producing doc who managed a nursing home crisis by phone, saved a patient from an unnecessary ER visit — and never billed for it, leaving Medicare with no record of his intervention Why not documenting a visit before a hospitalization doesn't just cost you revenue — it makes you look like a bad provider, even when you did everything right How insurance companies like United Healthcare boldly take 15% off the top of every healthcare dollar — and why that math means providers can't afford to give their time away for free The TCPA pattern Scott keeps seeing: 15,000–18,000 visits a month, almost entirely in nursing homes, with zero follow-up once patients go home The new post-discharge standard: every patient leaving a nursing home gets a telehealth visit within 48 hours, then weekly follow-up for four weeks — no one gets left in the gap This episode is a masterclass in understanding that documentation isn't bureaucracy — it's how you tell your story, protect your reputation, and keep the care you've already given from disappearing. www.YourHealth.Org

Michigan's Big Show
* Dr. Marschall Runge, Longtime CEO of Michigan Medicine and Author of “The Great Healthcare Disruption”

Michigan's Big Show

Play Episode Listen Later Jun 4, 2026 9:01 Transcription Available


The Disrupted Podcast

What does it actually cost when a doctor writes a verbal order over the phone instead of seeing the patient? Scott Middleton has the receipts — and the answer is going to make you rethink everything about how American healthcare spends its money. In this episode of The Disrupted Podcast, Scott announces a landmark three-way merger bringing Your Health together with Transitional Care Professionals of America (TCPA) out of Georgia and Providence Care, a hospice organization in South Carolina. The combined organization will serve approximately 55,000 active patients — not patients on a list, but people being seen regularly — and Scott lays out exactly how he's going to run it. What you'll hear in this episode: Why Scott's family owning 80% of the merged company changes everything about how decisions get made — and who they get made for The difference between fee-for-service and value-based care, and why the ACO model means every unnecessary hospitalization literally comes out of Your Health's pocket How Your Health's risk-adjustment-based visit model (16 visits per year per risk point) was independently validated by a new government study — and why it works The three things Scott is asking every new employee to do in the first weeks: align with a nurse practitioner, track every minute of care management, and recruit like their livelihood depends on it — because it does Why Scott's new management philosophy is six words: "Keep them out of the hospital and see your damn patients" This isn't a corporate announcement. It's a playbook for how healthcare can actually work when operators run the company, providers see their patients, and every minute of care gets counted. www.YourHealth.Org

Price of Business Show
John Baxter- The Greatest Healthcare Disruption in History Is Happening Now

Price of Business Show

Play Episode Listen Later May 18, 2026 8:43


05-18-2026 John Baxter Learn more about the interview and get additional links here: https://usdailyreview.com/the-greatest-healthcare-disruption-in-history-is-happening-now/ Subscribe to the best of our content here: https://priceofbusiness.substack.com/ Subscribe to our YouTube channel here: https://www.youtube.com/channel/UCywgbHv7dpiBG2Qswr_ceEQ

history john baxter healthcare disruption
LTC University Podcast
A Nurse Practitioner's Field Guide to Whole-Person Care — with Jaclyn Taylor, PART 1

LTC University Podcast

Play Episode Listen Later May 15, 2026 26:42


What if every "non-compliant" patient was actually a signal that the system isn't working for them? In this episode, Jamie sits down with Jaclyn Taylor, Clinical Strategy Director at Your Health and a nurse practitioner who started her career as a home-based provider in 2020 — thrown straight into the fire of COVID, isolated patients, and a healthcare world rewriting itself in real time. What she saw inside patients' homes — medications scattered on tables, food insecurity, missing transportation — changed how she thinks about every chart she's ever read. You'll hear: Why a nurse-first pathway gives nurse practitioners a fundamentally different lens than a medical school pathway — and why patients feel it What working across home care, telehealth, trauma, and wellness teaches you about treating the whole human, not just the diagnosis Why trauma surgery turned Jacqueline into a believer in proactive, longitudinal care — and what gets missed when we only meet patients after something has already gone wrong The two words she uses to describe what's most broken in traditional healthcare: fragmentation and misalignment How empathy stops being a poster and starts being operational — built into the design of care itself If you've ever felt invisible inside the healthcare system, or if you're the one trying to fix it, this conversation reframes the whole game. Press play. www.YourHealth.Org

The Disrupted Podcast
The Administrator Role Part 1

The Disrupted Podcast

Play Episode Listen Later May 2, 2026 28:52


Most healthcare organizations wait until they're drowning to add administrative support. Your Health is doing the opposite — and it's changing the math on what a primary care practice can actually deliver. In Part 1 of this two-part conversation, Scott Middleton — owner of Your Health, founder, and Chief Disruption Officer — sits down with Jamie Preston to unpack why a dedicated administrator is now sitting beside the executive director of clinical services at every care group. With hospice added to the model, a single care group can now be responsible for more than 80 staff members across four care teams — bigger than most medical organizations in the country. Asking a nurse to run that alone was breaking people and burying clinical judgment under scheduling concerns. In this episode: Why the care group exploded overnight — and what hospice changed about staffing ratios What the administrator does on Monday morning before the clinical team even looks at the dashboard The Bridget story: how a "we're not allowed to do one-on-ones" response nearly cost a dementia patient her home Why "what could we have done today" is the wrong question — and what to ask instead How fee-for-service quietly incentivizes the wrong decisions at the hospital level The team structure every administrator now sits inside: nurse, HR, marketing, engagement If you've ever wondered what's actually supposed to stand between a great clinician and burnout, this is it. www.YourHealth.Org

The Disrupted Podcast
The Nurse Case Manager

The Disrupted Podcast

Play Episode Listen Later Apr 25, 2026 26:14


What if the people case-managing your care had a financial reason to keep you sicker? That's the uncomfortable question Scott Middleton puts on the table in this episode — recorded live from the American Case Managers Conference in Orlando, where Scott went to learn, and ended up being told Your Health didn't "fit" because they weren't a hospital. Jamie and Scott unpack what the nurse case manager role actually looks like at Your Health — and why moving case management out of hospitals and into patients' homes isn't just better care, it's better economics. Scott shares the research proving the model works: 50% reduction in Medicare spend when patients are seen at the right frequency by the right people. In this episode: Why hospitalists may be "the demise of the American healthcare system" The difference between nurse practitioners (diagnose and treat) and nurse case managers (assess and guide) — and why blurring them costs patients The 16.05-visits-per-risk-point model David Clemens' research validated How coding departments are quietly diagnosing patients with diseases they don't have Why Medicare's 6-year insolvency window may be the disruption we need Head-to-toe assessments, delegation rights, and the real job of an RN in the home If you've ever suspected the system is working exactly as designed — just not for the patient — press play. www.YourHealth.Org

Experiencing Healthcare Podcast
What If You Don't Train Them — and They Stay?

Experiencing Healthcare Podcast

Play Episode Listen Later Apr 24, 2026 44:24


"What if you train them and they leave?" It's the fear that quietly keeps most healthcare leaders from investing in their people. Matt Staub — CEO of Your Health — wants you to sit with the question his mentor once asked in return: What if you don't train them, and they stay? In this episode, Matt joins Jamie Preston for a conversation about why workforce education isn't a perk at Your Health — it's the culture. From nationally accredited apprenticeships, to a training pipeline built out of a licensing crisis, to the real people behind the success stories, this is a blueprint for leaders who want to grow something that lasts. Key topics covered: The lumberjack story: why sharpening your axe beats swinging harder every time How a shortage of licensed administrators became the catalyst for Your Health's training engine The shift from "education happens on your own time" to "this is how we behave" Real success stories — Olivia, Kristin, Taylor, McKinsey, Rebecca — and what they share Matt's three challenges for anyone ready to grow: show up, find your who, take your shot If you've ever wondered whether developing your people is worth the cost, this episode will change the math. Press play — then look around, and ask yourself who's looking at you.

Experiencing Healthcare Podcast
Quarter 1 at Your Health

Experiencing Healthcare Podcast

Play Episode Listen Later Apr 8, 2026 42:18


What if the healthcare system your loved one relies on doesn't even know they need help until it's too late — and what would it look like if it did? In this Q1 2026 episode, Jamie Preston sits down with Matt Staub, CEO of Your Health, for a candid and wide-ranging look at how one of the country's largest home-based care providers is navigating the evolving landscape of value-based care, population health, and the human experience at the center of it all. Matt brings his characteristic clarity and heart to a conversation that is equal parts strategy, story, and honest reckoning with what the system still gets wrong. Key topics covered: Why 11% of patients account for 67% of all healthcare spending — and why most of them don't know they're in an ACO The evolution of value-based care: from quality-over-cost to outcomes + patient experience over total costs How Your Health is becoming proactive — not reactive — about falls, readmissions, and high-needs patients The quiet crisis of patient trust: down from 71% in 2020 to just 33% today, and what the correlation means for hospitalizations Real stories: a 79-year-old patient who went from barely existing to living fully — and Matt's own mom, who hasn't fallen since leaving the hospital after her stroke If you work in healthcare, advocate for someone in the system, or simply believe that better is possible — this episode will change the way you see what care can be.

Experiencing Healthcare Podcast
People Serving People

Experiencing Healthcare Podcast

Play Episode Listen Later Mar 27, 2026 40:34


What if the greatest threat to healthcare isn't a broken system — it's a dehumanized one? In this episode of Experiencing Healthcare, Jamie Preston and Your Health CEO Matt Staub wrestle with a deceptively simple idea from Harvard Business School Professor Ryan Buell: service is the business of people helping people. Sparked by Matt's experience at an Athena Health executive leadership forum, this is a conversation about what it truly means to serve — in a world where technology promises to do it faster, cheaper, and at scale. Key topics covered: Why you can never fully take people out of a service industry — and what happens to care quality when you try How ambient listening technology like Mobius is using AI to restore human connection in the exam room, not replace it The ICU nurses who used tough love to get a post-heart-surgery patient walking — and what that story reveals about what genuine service really looks like The "can vs. should" question every healthcare leader must ask before deploying new technology How to show up and serve others with excellence, even on your hardest personal days Healthcare will always evolve — but Matt and Jamie make a compelling case that the human at the center of care is the one thing worth protecting above all else. This one's worth the listen.

Experiencing Healthcare Podcast
Is American Healthcare a Commodity?

Experiencing Healthcare Podcast

Play Episode Listen Later Mar 14, 2026 50:59


America spends nearly double what the fourth-ranked country spends on healthcare per capita — and still ranks among the worst in outcomes. So what exactly are we paying for? In this episode of the Experiencing Healthcare Podcast, Jamie Preston and Your Health CEO Matt Staub examine what happens when healthcare gets treated like gasoline: something people expect to be available, can't easily compare on quality, and ultimately choose based on price or convenience. When brand and price stop mattering, the only differentiator left is how patients are made to feel — and whether they trust the person across from them enough to actually change. What you'll hear in this episode: Why Matt ranks service above outcomes and access — and the patient story that changed how he thinks about both The "Chick-fil-A problem": how your healthcare experience is now being compared to your best service experience anywhere, not just the clinic down the street What provider burnout really looks like when a clinician closes their notes at 11pm wondering if their patient listened How insurance billing creates distrust that bleeds directly into the patient-provider relationship — and what healthcare organizations can do about it Why the most caring thing a doctor can do sometimes feels like the worst customer service in the room If you've ever felt like a number in a waiting room — or if you've ever been the one trying to help someone who wouldn't listen — this conversation will stay with you. Press play.

Self-Funded With Spencer
Building The TPA Of The Future

Self-Funded With Spencer

Play Episode Listen Later Mar 10, 2026 57:08


"We don't view ourselves as a TPA, we view ourselves more as a platform... our goal is to simplify and reduce the barriers of entry into the TPA space."The role of the Third-Party Administrator is undergoing a massive evolution. No longer just a back-office claims processor, the modern TPA is being asked to serve as the high-tech, high-touch "nucleus" of the entire health plan.My guest this week is Vinny Esposito, CEO of Reflect Health (formerly S&S Health). Drawing on a decade of experience in the hedge fund world, Vinny recognized a massive opportunity to bring scalable, asset-light infrastructure to the self-funded market. Today, Reflect Health acts almost like the "Intel Inside" of the industry, licensing its proprietary claims technology to other TPAs and health plans.In this episode, we explore exactly what it takes to build the TPA of the future. We discuss how to solve "point solution fatigue" through a centralized marketplace, the mechanics behind infusion drug carve-outs, and how to successfully deploy dynamic deductibles to incentivize better care routing. Vinny also shares his bold vision for "frictionless claims" paid instantly at the point of service, moving us closer to an Amazon-style shopping experience for healthcare.If you want to understand the technological and administrative innovations driving the self-funded market forward, this episode provides the blueprint.Thank you to our 2026 sponsors!ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit ParetoHealth.com to learn more.Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.Chapters:(00:00:00) Intro: Competing on Service in the TPA Market (00:01:56) Meet Vinny Esposito & Reflect Health (00:03:35) Rebranding from S&S Health (00:07:32) From Hedge Funds to Healthcare Disruption (00:11:05) The Platform Model: Licensing Tech to Other TPAs (00:15:05) The Marketplace & Infusion Drug Carve-Outs (00:19:14) How the TPA Role is Expanding (The "Nucleus") (00:24:12) Direct Contracting, RBP, and DPC Integration (00:29:15) Dynamic Deductibles & Tiered Networks (00:33:25) Curing "Point Solution Fatigue" (00:41:09) The Future of Stop-Loss and Preventative Care (00:45:44) The Fiduciary Breaking Point & 80% Renewals (00:50:26) Frictionless Claims & Amazon-Style HealthcareKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Self-Funded With Spencer
Building The TPA Of The Future

Self-Funded With Spencer

Play Episode Listen Later Mar 10, 2026 57:08


"We don't view ourselves as a TPA, we view ourselves more as a platform... our goal is to simplify and reduce the barriers of entry into the TPA space."The role of the Third-Party Administrator is undergoing a massive evolution. No longer just a back-office claims processor, the modern TPA is being asked to serve as the high-tech, high-touch "nucleus" of the entire health plan.My guest this week is Vinny Esposito, CEO of Reflect Health (formerly S&S Health). Drawing on a decade of experience in the hedge fund world, Vinny recognized a massive opportunity to bring scalable, asset-light infrastructure to the self-funded market. Today, Reflect Health acts almost like the "Intel Inside" of the industry, licensing its proprietary claims technology to other TPAs and health plans.In this episode, we explore exactly what it takes to build the TPA of the future. We discuss how to solve "point solution fatigue" through a centralized marketplace, the mechanics behind infusion drug carve-outs, and how to successfully deploy dynamic deductibles to incentivize better care routing. Vinny also shares his bold vision for "frictionless claims" paid instantly at the point of service, moving us closer to an Amazon-style shopping experience for healthcare.If you want to understand the technological and administrative innovations driving the self-funded market forward, this episode provides the blueprint.Thank you to our 2026 sponsors!ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit ParetoHealth.com to learn more.Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.Chapters:(00:00:00) Intro: Competing on Service in the TPA Market (00:01:56) Meet Vinny Esposito & Reflect Health (00:03:35) Rebranding from S&S Health (00:07:32) From Hedge Funds to Healthcare Disruption (00:11:05) The Platform Model: Licensing Tech to Other TPAs (00:15:05) The Marketplace & Infusion Drug Carve-Outs (00:19:14) How the TPA Role is Expanding (The "Nucleus") (00:24:12) Direct Contracting, RBP, and DPC Integration (00:29:15) Dynamic Deductibles & Tiered Networks (00:33:25) Curing "Point Solution Fatigue" (00:41:09) The Future of Stop-Loss and Preventative Care (00:45:44) The Fiduciary Breaking Point & 80% Renewals (00:50:26) Frictionless Claims & Amazon-Style HealthcareKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Disruption / Interruption
Disrupting HealthTech for Women: Hacking Hormonal Health with Oleg Kovalev

Disruption / Interruption

Play Episode Listen Later Mar 5, 2026 26:02


In this episode of Disruption/Interruption, KJ sits down with Oleg Kovalev, Chief Marketing Officer at Aspect Health, revealing how his company became the #1 women's hormonal health startup in the USA by disrupting traditional PCOS treatment. Discover how continuous glucose monitoring and lifestyle coaching are helping one in five women manage a condition that doctors have been treating wrong for decades—and how this medical innovation is driving explosive business growth. Four Key Takeaways: [4:21] PCOS affects 20% of women and is the #1 cause of infertility - Traditional medicine has underdiagnosed and undertreated PCOS for decades, leaving millions of women without proper answers or solutions beyond pills that mask symptoms. [8:33] Managing glucose levels can dramatically reduce PCOS symptoms - Simple lifestyle changes combined with continuous glucose monitoring help women see real-time correlations between their food choices and symptom improvement, leading to exceptional product retention. [17:24] Data-driven positioning beats gut feeling every time - Aspect Health grew 12x in nine months by systematically testing positioning through paid ads and user behavior metrics rather than relying on intuition or assumptions. [24:11] Ask what you should NOT be doing - Focus and intentionality come from eliminating tasks rather than adding them—the critical question every founder and marketer must answer to achieve breakthrough success. Quote of the Show (8:00):"When women go to doctor and they ask questions about PCOS, in most cases they don't get answers to their questions. Often they are given some standard protocol of taking some kind of pills." - Oleg Kovalev Join our Anti-PR newsletter where we’re keeping a watchful and clever eye on PR trends, PR fails, and interesting news in tech so you don't have to. You're welcome. Want PR that actually matters? Get 30 minutes of expert advice in a fast-paced, zero-nonsense session from Karla Jo Helms, a veteran Crisis PR and Anti-PR Strategist who knows how to tell your story in the best possible light and get the exposure you need to disrupt your industry. Click here to book your call: https://info.jotopr.com/free-anti-pr-eval Ways to connect with Oleg Kovalev LinkedIn: https://www.linkedin.com/in/alecko/Company Website: www.aspect-health.com How to get more Disruption/Interruption: Amazon Music - https://music.amazon.com/podcasts/eccda84d-4d5b-4c52-ba54-7fd8af3cbe87/disruption-interruption Apple Podcast - https://podcasts.apple.com/us/podcast/disruption-interruption/id1581985755 Spotify - https://open.spotify.com/show/6yGSwcSp8J354awJkCmJlDSee omnystudio.com/listener for privacy information.

Impact Quantum: A Podcast for Engineers
Quantum Computing in LATAM - Financial and Healthcare Disruption from QNOW

Impact Quantum: A Podcast for Engineers

Play Episode Listen Later Mar 2, 2026 51:26 Transcription Available


In this episode, your hosts Frank La Vigne and Candace Gillhoolley dive deep into the rapidly evolving quantum tech landscape of Latin America, with a special spotlight on Argentina. Joined by Daniel Ruiz, founder of QNOW, the conversation explores why Argentina and the broader LATAM region are emerging as surprising global leaders in quantum research, development, and application—particularly in the financial and healthcare sectors.Daniel Ruiz shares insight into the unique challenges and opportunities for quantum startups in Argentina, from the abundance of technical talent to the barriers around funding, infrastructure, and brain drain. The discussion touches on the entrepreneurial spirit of the region, the role of government and academia, and how LATAM innovators are bringing fresh perspectives to a field often dominated by the US, China, and Europe.Whether you're a quantum enthusiast, a tech founder, or simply curious about the global impact of quantum computing, this episode offers an energetic and honest look at the paths, pitfalls, and potential in LATAM. Stay tuned for practical lessons, misconceptions worth busting, and why the next quantum breakthrough might just come from south of the equator!Linkshttps://www.linkedin.com/in/luisdanielruiz-in/https://www.linkedin.com/company/qnow-tech/Time Stamps00:00 Argentina's Quantum and AI Landscape03:52 "LATAM's Quantum Innovation Potential"07:20 Tech Applications: Finance & Healthcare13:09 Quantum Computing: Awareness and Investment18:30 "Unlocking LATAM's Research Potential"20:52 "Latin America's Growing Tech Potential"26:36 Quantum-Driven Drug Discovery Process28:32 "Argentina's Quantum Potential Explored"32:51 "Quantum Complements Classical Data"37:41 "Embrace Unique Innovation Identity"43:14 Quantum Innovation Challenges in Latin America46:56 "The Right Team Drives Success"49:15 Global Perspectives on Quantum Tech

TechNation Radio Podcast
Episode 664: Episode 26-07 The Great Healthcare Disruption

TechNation Radio Podcast

Play Episode Listen Later Feb 17, 2026 59:00


On this week's Tech Nation, Moira speaks with Dr. Marschall Runge, University of Michigan Medical School Professor and author of “The Great Healthcare Disruption: Big Tech, Bold Policy, and the Future of American Medicine,” about the ways the American Healthcare system is changing - and needs to change - for the future. Then, Tech Nation Health Chief Correspondent Dr. Daniel Kraft discusses some of the latest developments for early cancer screening.

Shingo Principles Podcast
Episode 56: Leading Through Healthcare Disruption

Shingo Principles Podcast

Play Episode Listen Later Jan 29, 2026 26:14


Health care organizations are entering a period of significant disruption following the passage of H.R. 1, with deep Medicaid cuts, tighter eligibility requirements, and growing administrative complexity reshaping the care landscape—especially for safety-net providers. This moment raises a critical leadership challenge: how to continue delivering high-quality, safe, and accessible care while doing more with fewer resources.This webinar explores why Lean thinking is no longer optional, but essential, in navigating today's turbulence and building long-term resilience. Drawing on lessons from past disruptions and real-world examples from leading health systems, we will examine how principle-based Lean frameworks help organizations improve cost, quality, access, and patient experience—even under intense pressure.Participants will learn how forward-thinking health care leaders use Lean to strengthen culture and engagement, align strategy with daily operations, redesign care delivery to improve access, reduce administrative burden, and thoughtfully integrate technology and AI. The session emphasizes Lean not as a set of tools, but as a leadership mindset that enables clarity, adaptability, and sustained performance in uncertain times.To learn more, please visit https://shingo.org/articles. 

health ai drawing medicaid healthcare disruption
Disruption / Interruption
Disrupting Biotech: How DNA Nanorobots Are Rewriting the Rules of Drug Discovery with Jurek Kozyra

Disruption / Interruption

Play Episode Listen Later Jan 8, 2026 30:35


In this episode of Disruption/Interruption, host KJ sits down with Jurek Kozyra, founder and CEO of Nanovery, to explore how DNA nanotechnology and AI are revolutionizing molecular medicine. Discover how tiny nanorobots made from DNA could dramatically accelerate drug development, make diagnostics faster and more affordable, and potentially cure diseases that were previously untreatable. From detecting diseases in hours instead of days to cutting years off the drug development process, this conversation reveals the cutting-edge science that's transforming healthcare. Four Key Takeaways: The Promise of Oligonucleotide Therapeutics (9:06) Traditional medicine targets defective proteins, but many diseases can't be cured because we can't find the right molecule. Oligonucleotide therapeutics target mRNA—the underlying mechanism of disease—meaning you could potentially cure all diseases since all proteins come from mRNA. DNA Nanorobots for Rapid Detection (14:12) Nanovery's DNA nanorobots can detect diseases in blood samples within 2-4 hours compared to traditional lab tests that take two days. These self-assembling machines produce fluorescent signals when they find specific DNA or RNA molecules, enabling point-of-care diagnostics. Accelerating Drug Development (17:13) Pharmaceutical companies race against 20-year patents while drugs take 10+ years to develop. Nanovery's technology provides more accurate data at lower cost and time, potentially shaving years off the development process and helping more drugs successfully reach the market. Real-World Clinical Validation (20:26) In a hospital study with 170 patient samples, Nanovery's technology delivered same or better results than traditional tests in just two hours instead of two days—a game-changer for emergency situations like drug overdoses where immediate answers are critical. Quote of the Show (9:05):"If you can target mRNA very specifically, that means that in theory you could potentially cure all diseases. That's why this area is so exciting right now." – Jurek Kozyra Join our Anti-PR newsletter where we’re keeping a watchful and clever eye on PR trends, PR fails, and interesting news in tech so you don't have to. You're welcome. Want PR that actually matters? Get 30 minutes of expert advice in a fast-paced, zero-nonsense session from Karla Jo Helms, a veteran Crisis PR and Anti-PR Strategist who knows how to tell your story in the best possible light and get the exposure you need to disrupt your industry. Click here to book your call: https://info.jotopr.com/free-anti-pr-eval Ways to connect with Jurek Kozyra: LinkedIn: https://www.linkedin.com/in/j3ny/ Company Website: https://nanovery.co.uk How to get more Disruption/Interruption: Amazon Music - https://music.amazon.com/podcasts/eccda84d-4d5b-4c52-ba54-7fd8af3cbe87/disruption-interruption Apple Podcast - https://podcasts.apple.com/us/podcast/disruption-interruption/id1581985755 Spotify - https://open.spotify.com/show/6yGSwcSp8J354awJkCmJlDSee omnystudio.com/listener for privacy information.

The Better Life with Dr. Pinkston Podcast
The Great Healthcare Disruption: A Path to Better Health

The Better Life with Dr. Pinkston Podcast

Play Episode Listen Later Jan 3, 2026 50:01


In this episode of The Better Life, Dr. Pinkston sits down with Dr. Marschall Runge, Dean of the University of Michigan Medical School and CEO of Michigan Medicine. Together, they explore the systemic challenges facing the American healthcare system and discuss the optimistic future outlined in Dr. Runge’s new book, The Great Healthcare Disruption. The conversation dives deep into the "corporatization" of medicine, where insurance companies and administrative costs often take precedence over the doctor-patient relationship. Dr. Runge highlights a startling statistic: while the U.S. spends the most on healthcare globally, it ranks roughly 60th in "healthy average life expectancy." They discuss potential solutions, including shifting focus toward prevention, learning from international models like Singapore and Denmark, and restoring the fundamental trust between physicians and their patients. Key Topics Covered: The Efficiency Gap: Comparing the 16% administrative costs of private insurance to the 2% cost of Medicare. The Preventive Approach: How lifestyle factors, nutrition, and social policy impact long-term health outcomes. AI in Healthcare: The double-edged sword of AI being used by insurance companies to drive high denial rates. The Primary Care Shortage: Why the U.S. has fewer primary care doctors per capita than almost any other developed nation and how "medical homes" can bridge the gap. Restoring Trust: Moving away from "Reddit-based" medical advice and back to evidence-based care provided by trusted professionals. See omnystudio.com/listener for privacy information.

TrueLife
Health Reform 2025

TrueLife

Play Episode Listen Later Dec 6, 2025 84:56


One on One Video Call W/George https://tidycal.com/georgepmonty/60-minute-meetingSupport the show:https://www.paypal.me/Truelifepodcast?locale.x=en_USThe Lila Code: https://orcid.org/0009-0008-4612-3942

Disruption / Interruption
Disrupting Healthcare: How One Practitioner is Using AI and Behavioral Science to Transform Patient Care

Disruption / Interruption

Play Episode Listen Later Oct 23, 2025 28:46


In this episode of Disruption/Interruption, host KJ interviews Dr. Jay Greenstein, CEO of Embodi Health, about disrupting the status quo in healthcare. Dr. Greenstein shares his journey from chiropractor to tech entrepreneur, discusses the challenges of patient adherence, and reveals how his company is using AI, behavioral science, and gamification to transform musculoskeletal care and improve patient outcomes. Key Takeaways: The Healthcare System is Broken [4:12]Dr. Greenstein explains how the U.S. healthcare system is plagued by barriers and value extractors, making it difficult for patients to access the right care. Evidence-Based, Non-Pharmacologic Care is Essential [7:14]He emphasizes the importance of following clinical practice guidelines that prioritize non-pharmacologic interventions like spinal manipulation and exercise. Gamification Improves Patient Adherence [16:27]Dr. Greenstein describes how his team built a gamified app to reward patients for adhering to care plans, leading to measurable improvements in outcomes. AI and Remote Monitoring Drive Better Outcomes [18:17]The Embody platform uses AI-driven, evidence-based home exercise programs and remote therapeutic monitoring to keep patients and providers connected and engaged. Quote of the Show (4:12):"I want justice for humanity. I want justice for patients. I want justice for the healthcare system. Our system in the US is broken, and it can be fixed." – Dr. Jay Greenstein Join our Anti-PR newsletter where we’re keeping a watchful and clever eye on PR trends, PR fails, and interesting news in tech so you don't have to. You're welcome. Want PR that actually matters? Get 30 minutes of expert advice in a fast-paced, zero-nonsense session from Karla Jo Helms, a veteran Crisis PR and Anti-PR Strategist who knows how to tell your story in the best possible light and get the exposure you need to disrupt your industry. Click here to book your call: https://info.jotopr.com/free-anti-pr-eval Ways to connect with Dr. Jay Greenstein: LinkedIn: https://www.linkedin.com/in/drjaygreenstein/ Company Website: https://embodihealth.com How to get more Disruption/Interruption: Amazon Music - https://music.amazon.com/podcasts/eccda84d-4d5b-4c52-ba54-7fd8af3cbe87/disruption-interruption Apple Podcast - https://podcasts.apple.com/us/podcast/disruption-interruption/id1581985755 Spotify - https://open.spotify.com/show/6yGSwcSp8J354awJkCmJlDSee omnystudio.com/listener for privacy information.

AI Briefing Room
EP-355 Commonwealth Fusion's $863m Boost

AI Briefing Room

Play Episode Listen Later Aug 29, 2025 2:53


i'm wall-e, welcoming you to today's tech briefing for friday, august 29. here's what's making headlines: commonwealth fusion systems' major funding: the massachusetts-based startup secures $863 million from big names like nvidia and google, pushing total funding to nearly $3 billion. the focus is to accelerate its prototype reactor, sparc, aiming for scientific breakeven by 2027, with plans for a commercial reactor by 2028. transunion data breach: a breach affecting 4.4 million customers via a third-party application. personal data including names, birthdates, and social security numbers were accessed, though no credit information was compromised. mark cuban's healthcare disruption: cuban's cost plus drugs initiative aims to tackle the $5 trillion industry with transparent pricing and a new robotic manufacturing plant to address drug shortages and reduce costs. anthropic's ai data policy update: users have until september 28 to opt in or out of having their chat data used for ai training. data retention could last up to five years, reflecting industry trends for improving ai models. expansion of mathgpt.ai: the 'cheat-proof' tutor is expanding to over 50 colleges, enhancing learning through inquiry-based methods with plans for more features and a potential mobile app launch. that's all for today. we'll see you back here tomorrow!

HMA Vital Viewpoints on Healthcare
Ready or Not: Implementing Strategy Amid Massive Healthcare Disruption

HMA Vital Viewpoints on Healthcare

Play Episode Listen Later Jul 23, 2025 30:31


Rebecca Nielsen and Alex Rich, co-leaders of HMA's Strategy and Transformation practice, have been supporting healthcare strategies in an ever-changing environment defined by constant disruption from AI, shifting regulatory policies, and financial strain. With so much change in the air now, many strategic plans are outdated before they ever get implemented. In this episode of Vital Viewpoints on Healthcare, they expose the blind spots that sabotage even the most well-crafted strategies and offer a grounded look at what actually works when change is the only constant. They unpack the challenge of the 5-year strategic plan and the risk of trying to do everything at once, explaining why real-time information sharing may be your most overlooked leadership tool. If your organization is struggling to turn strategy into action, this is the clarity you've been waiting for.

The Revitalizing Doctor
What If Our Patients Didn't Have to Choose Between Food and Medicine?

The Revitalizing Doctor

Play Episode Listen Later Jul 8, 2025 37:20


You shouldn't need a PhD in insurance billing to understand why your medication costs $600 this month and $60 the next. But for millions of Americans, that's the reality.In this episode of Heartline: Changemaking in Healthcare, I talk to pharmacist and startup founder Vinay Patel, whose decade-long career spans high-volume pharmacy operations, clinical program design, and now, drug pricing reform.Vinay's origin story begins with a moral injury: watching patients forced to choose between rent and medications. Instead of accepting the system as-is, he built one that works better. From negotiating fair reimbursement rates to empowering local pharmacies and cutting out predatory Pharmacy Benefit Managers (PBMs), his work is restoring agency—one prescription at a time.You'll hear how he:Turned failure and scarcity into a superpower as a founderBuilt a mission-driven team by prioritizing soft skills over perfect résumésDesigned cost-plus drug programs that serve patients firstProtects independent pharmacies while keeping GLP-1s accessible About the Guest:"Failure means you're learning. And in healthcare innovation, learning fast is everything.” – Vinay PatelVinay Patel is a pharmacist, entrepreneur, and healthcare reformer. After years running a home delivery pharmacy for 15,000+ patients a month, he founded MakoRx, a company that bypasses traditional pharmacy benefit managers to lower costs for employers and improve access for patients.Vinay's mission is deeply personal—and systemic. His company's cost-plus model strengthens local pharmacies, bypasses industry bloat, and brings transparency to one of healthcare's most broken sectors.

Becker’s Healthcare Podcast
The Great Healthcare Disruption: Dr. Marschall Runge on Innovation, Access, and the Future of Medicine

Becker’s Healthcare Podcast

Play Episode Listen Later Jun 9, 2025 22:13


In this episode, Dr. Marschall Runge, CEO of Michigan Medicine and Dean of the University of Michigan Medical School, joins the podcast to discuss his new book The Great Healthcare Disruption: Big Tech, Bold Policy, and the Future of American Medicine. He shares insights on transformative trends in healthcare, from AI and GLP-1 drugs to the urgent need for primary care investment and systemwide cost reform.