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Turning 65 opens the door to Medicare—but it also introduces a maze of choices that can have lasting financial and healthcare consequences. In this episode of Finishing Well, certified financial planner Hans Scheil and co-host Robbie Dilmore break down the critical decisions you'll face when enrolling in Medicare. Should you delay enrollment? What's the difference between Original Medicare with a supplement and a Medicare Advantage plan? How do provider networks, prior authorizations, premiums, and out-of-pocket costs affect your future care? Hans shares decades of experience helping retirees make informed Medicare decisions, explaining why the lowest upfront cost isn't always the best long-term value. Through real-life examples and practical guidance, you'll learn how to avoid common pitfalls and choose a path that fits your healthcare needs, financial goals, and peace of mind. Rooted in biblical wisdom and practical financial planning, this episode will help you approach one of retirement's biggest decisions with confidence instead of confusion. "Visit cardinalguide.com to access free retirement resources, browse our complete library of episodes, and connect with the Finishing Well ministry. Together, we're helping people honor God by finishing well."
America's Work Force Union Podcast brings together two conversations spanning American history, retirement security and a fight over who controls your Medicare coverage. American Legion Media and Communications Director Henry Howard opens with a recap of how the Legion marked America's 250th anniversary, including a reenactment of the first public reading of the Declaration of Independence in Lansing, Michigan on July 8, the date Colonel Nixon first read the document publicly in 1776. Howard also covers the conclusion of the USA 250 Challenge, which engaged more than 3,100 American Legion family members over the past year in fitness, wellness and community service, and a historic flag escort by American Legion riders from Pittsburgh to Arlington on July 4. He then previews the August edition of the American Legion magazine, which highlights ten notable American inventions that shaped the world and honors the late Diane Carlson Evans, the Vietnam combat nurse who led the decades-long fight to establish the Vietnam Women's Memorial on the National Mall. Then, Ohio Alliance for Retired Americans State Director Norm Wernet discusses two developments directly affecting retirees and disabled workers. The first is bipartisan momentum to scrap the Social Security earnings cap following a joint op-ed from Sen. Bernie Moreno and Sen. Elizabeth Warren, and what that step would do to address the 2032 Social Security funding cliff. The second is the WISeR program, a pilot AI prior authorization program now running in Ohio and six other states that is delaying and denying Medicare Advantage coverage with a financial incentive built into the algorithm to keep saying no. Visit legion.org for American Legion updates and retiredamericans.org for the full congressional voting record on retiree issues.
Major developments continue in the Nolan Wells case. As pressure mounts for answers, the governor is finally speaking out about the investigation and the growing public outcry. Tonight, Don breaks down the latest updates, what the governor had to say, and what it could mean for the search for accountability in one of the country's most closely watched cases. We are joined by Ashley Etienne and Monique Pressley to break it all down. This episode is brought to you by Shopify. Stop waiting for permission to build something. Your next revenue stream starts free at shopify.com/lemon This episode is brought to you by Upwork. Visit Upwork.com right now and post your job for free This episode is sponsored by FFRF. Visit https://ffrf.us/don or text DON 511511 to join or learn more. Because freedom belongs to all of us. Text Fees May Apply For free and unbiased Medicare help, dial 212-931-0855 to speak with my trusted partner, Chapter, or go to https://askchapter.org/don DISCLAIMER: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Fraud risks in Medicare Advantage, which now covers more than half of all Medicare beneficiaries, have been flagged as a top priority for government agencies. With that in mind, Rachel Rose, JD, MBA, joins the 1st Talk Compliance podcast to bring her expertise in False Claims Act litigation to the discussion on how best to avoid these risks, or run afoul of the DOJ or CMS. Listen now for firsthand insight into how these cases actually unfold and what providers can do to protect themselves and their practices.
Healthcare is one of the biggest expenses retirees face, yet few people understand how the system behind their care actually works. Jeremy Keil welcomes physician, hospice doctor, and author Dr. Jordan Grumet to discuss the ideas behind his new book, The Healthcare Heist. Discover how financial incentives have reshaped modern healthcare, the growing influence of private equity, and why patients and providers often feel caught in a system that prioritizes business interests over care. Dr. Grumet explains the differences between physician-owned practices and corporate healthcare systems, discusses direct primary care and concierge medicine, shares his perspective on Medicare Advantage versus traditional Medicare with supplemental coverage, and offers guidance for becoming a more informed healthcare consumer. Healthcare aside, hear why Dr. Grumet rejects the traditional definition of retirement and what he's learned since beginning the decumulation phase of his own financial life. For disclosures and conflicts visit keilfp.com/disclosures.
Got questions? Send Ericka a Text!Less than 1% of denied dental claims ever get appealed and insurance companies are counting on you to be in the other 99%. I walk you through the denial management mindset shift that changes everything: stop treating the third appeal like the edge of the map and start using the tools that actually hold payers accountable, including your state insurance commissioner for fully insured plans. We get practical and specific about what makes a denial “unreasonable” or “bad faith” and how to spot the pattern: benefits are active, eligibility is confirmed, documentation supports dental necessity, and the claim still comes back denied. I also explain why we start with state and federal laws before we obsess over codes, because language like prompt pay, network leasing, and silent PPO issues gives your conversations more weight. Then we clean up common risk areas by separating an honest mistake, a contract violation, and fraud, because mixing those up can put a practice in real trouble. From there, we talk tactics: why copy-and-paste appeal templates can work against you in a world where insurers use AI to review claims, and what to use instead. Think ICD-10 diagnosis codes, strong narratives, and patient-specific clinical details that make your claim defensible. Finally, I share documented enforcement examples, including a major fine tied to undisclosed “phantom” frequency limits, and why complaints to regulators compound over time. If you want a denial process that protects patients and stops leaving money on the table, listen all the way through, then subscribe, share this with your office team, and leave a review so more billers learn how to escalate the right way.Sources referenced in this episode:Appeal rate / upheld rate: KFF analysis of CMS data — fewer than 1% of denied ACA marketplace claims are appealed; insurers uphold ~56% of appeals (2023 data), 66% (2024 data). Medicare Advantage: ~57% of appealed denials overturned. (On air we used these instead of the "59% upheld because nobody appealed" framing, which conflated the appeal rate with the uphold-on-appeal rate.)Delta Dental of Washington: Washington State Office of the Insurance Commissioner fined Delta Dental + its health care benefits manager (Wyssta) $130,000 (Oct/Nov 2024) for, among other things, denying claims based on time/frequency limits not filed with or approved by the state; 7 service types and 50 billing codes had undisclosed limits. Triggered by consumer complaints. This is an actual regulatory fine.Self-funded vs. fully insured (the "federal path" mention): The commissioner regulates fully insured plans. Self-funded employer plans fall under federal ERISA law and route to the U.S. Department of Labor (EBSA) instead, not the state commissioner. This is covered in depth in the full denial management talk, not this episode. (Government and church plans are a further exception.)Cigna PxDx: 2023 class action (E.D. Cal.), citing ProPublica reporting — ~300,000 denials in two months, avg. 1.2 seconds per claim, "we literally click and submit." Court allowed the case to proceed March 2025 (abuse of discretion). This is litigation, not a fine — described on air as a lawsuit/court ruling.UnitedHealth nH Predict: Class action (D. Minn.) alleging a 90% error rate on the AI tool and that ~0.2% of policyholders appeal. Court ordered algorithm disclosure in 2026. Allegations in active litigation — stated as such on air.The "0.2% will appeal" motive appears in both the Cigna and UnitedHealth complaints as an allegation of intent. Interested in a Demo of Dentiq - The Billing Command Center? Get on the interest list here:https://4063-dentiq.systeme.io/waitlistGet your Dental Billing Toolkit Here:https://www.dentalbillingdoneright.com/the-dental-billing-toolkitDownload "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=headerSchedule a billing chat with Ericka:https://calendly.com/ericka-dentalbillingdoneright/30minEmail Ericka:ericka@dentalbillingdoneright.comEmail Jen:jen@dentalbillingdoneright.com
Learn the Top 10 Virtual Assistant roles that can help grow your agency—and claim 20 FREE hours with Hire Heroes for a limited time. https://hireheroes.com/ In this episode of the Seven Figures Or Bust Podcast, Christian Brindle and Glen Shelton break down why one of the nation's largest Medicare Advantage carriers is suing CMS over its star ratings—and why every Medicare agent should pay attention. They also discuss the real reason carriers push Home Risk Assessments (HRAs), how Medicare Advantage star ratings impact billions of dollars in funding, and what these behind-the-scenes battles mean for agents, carriers, and beneficiaries. Plus, they explain how carrier decisions, CMS regulations, and legal challenges continue to shape the future of the Medicare industry.
Send us Fan MailWhy does the United States spend more on healthcare than any other nation—yet often achieve worse outcomes? In Part Two of this thought-provoking conversation, Dr. Don Berwick—former Administrator of the Centers for Medicare & Medicaid Services (CMS), internationally recognized healthcare quality expert, and founder of the Institute for Healthcare Improvement (IHI)—joins Chris Comeaux to explore the systemic challenges facing American healthcare and the leadership required to create meaningful reform. From the evolution of Medicare Advantage to the financial incentives shaping healthcare delivery, Dr. Berwick explains why administrative complexity, payment models, and profit-driven incentives continue to drive costs higher while often failing to improve patient outcomes. Together, they examine the future of healthcare policy, value-based care, healthcare leadership, healthcare reform, Medicare, health insurance, and the role employers may play in demanding a more sustainable healthcare system. The conversation also turns to one of healthcare's greatest success stories—hospice and palliative care. Dr. Berwick argues that compassionate, person-centered care isn't simply a better way to care for people nearing the end of life; it provides a blueprint for improving healthcare across every stage of life. The episode concludes with an inspiring challenge to healthcare leaders: speak up for what is right, lead with courage, and never lose sight of healthcare's true mission—to heal, serve, and care for people. Whether you're a healthcare executive, hospice leader, physician, nonprofit executive, health system administrator, board member, or business leader, this conversation offers strategic insights into the future of healthcare—and practical leadership lessons that extend far beyond medicine.⸻Episode Highlights✔ Why Medicare Advantage has drifted from its original mission✔ The hidden cost of healthcare bureaucracy and administrative waste✔ The $80 billion debate surrounding Medicare Advantage payments✔ Why employer-sponsored healthcare may be approaching a breaking point✔ Lessons the U.S. can learn from healthcare systems around the world✔ Why hospice and palliative care represent a model for all of healthcare✔ The moral responsibility of healthcare leaders to speak with courage⸻If you enjoyed this conversation, please Like, Subscribe, and Share this episode with your leadership team, colleagues, board members, and friends. Every conversation helps us build stronger leaders and healthier organizations.
The Friday Five for July 10, 2026: Halfway Through 2026 Ritter Insurance Marketing Summits Musings on Artificial Intelligence CDC High Heat & Medication Guidance Scam Targeting Insurance Agents
Why does the United States spend more on healthcare than any other nation—yet often achieve worse outcomes? In Part Two of this thought-provoking conversation, Dr. Don Berwick—former Administrator of the Centers for Medicare & Medicaid Services (CMS), internationally recognized healthcare quality expert, and founder of the Institute for Healthcare Improvement (IHI)—joins Chris Comeaux to explore the systemic challenges facing American healthcare and the leadership required to create meaningful reform. From the evolution of Medicare Advantage to the financial incentives shaping healthcare delivery, Dr. Berwick explains why administrative complexity, payment models, and profit-driven incentives continue to drive costs higher while often failing to improve patient outcomes. Together, they examine the future of healthcare policy, value-based care, healthcare leadership, healthcare reform, Medicare, health insurance, and the role employers may play in demanding a more sustainable healthcare system. The conversation also turns to one of healthcare's greatest success stories—hospice and palliative care. Dr. Berwick argues that compassionate, person-centered care isn't simply a better way to care for people nearing the end of life; it provides a blueprint for improving healthcare across every stage of life. The episode concludes with an inspiring challenge to healthcare leaders: speak up for what is right, lead with courage, and never lose sight of healthcare's true mission—to heal, serve, and care for people. Whether you're a healthcare executive, hospice leader, physician, nonprofit executive, health system administrator, board member, or business leader, this conversation offers strategic insights into the future of healthcare—and practical leadership lessons that extend far beyond medicine.⸻Episode Highlights✔ Why Medicare Advantage has drifted from its original mission✔ The hidden cost of healthcare bureaucracy and administrative waste✔ The $80 billion debate surrounding Medicare Advantage payments✔ Why employer-sponsored healthcare may be approaching a breaking point✔ Lessons the U.S. can learn from healthcare systems around the world✔ Why hospice and palliative care represent a model for all of healthcare✔ The moral responsibility of healthcare leaders to speak with courage⸻If you enjoyed this conversation, please Like, Subscribe, and Share this episode with your leadership team, colleagues, board members, and friends. Every conversation helps us build stronger leaders and healthier organizations.
About halfway through 2026 — and just a few months before the critical midterm elections — Democrats appear to be doubling down on healthcare as a campaign issue as costs rise and insurance coverage declines.Meanwhile, Congress is taking aim at nonprofit hospitals. Shefali Luthra of The 19th, Rachel Roubein of The Washington Post, and Victoria Knight of Bloomberg Government join KFF Health News' Julie Rovner to discuss these stories and more.Also this week, Rovner interviews KFF Health News' Samantha Liss, who wrote the latest “Bill of the Month” story, about a woman who changed Medicare Advantage plans and found herself at a disadvantage.Visit our website to read a transcript of this episode.Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: Axios' “Chinese Fentanyl Makers Find New U.S. Market in Peptides,” by Tina Reed. Shefali Luthra: Stat's “Online GLP-1 Prescriptions Are Often Fast, Easy — And Low on Clinical Oversight,” by Katie Palmer. Rachel Roubein: The New York Times' “Efforts To Help Smokers Quit Stall Under Trump,” by Chistina Jewett. Victoria Knight: Stat's “Booze Schmooze: The Alcohol Industry, Frazzled by Headwinds, Wields Its Power Behind the Scenes,” by Isabella Cueto and Lev Facher.
Corrie ten Boom once said, “If you look at the world, you'll be distressed. If you look within, you'll be depressed. But if you look at Christ, you'll be at rest.” That truth speaks directly to the way many people feel about money. When money becomes the place we look for peace, security, or identity, financial unrest is never far behind. And while it may seem like more money would solve that unrest, Scripture points us to something deeper. Elizabeth Brickman, a Certified Kingdom Advisor® (CKA®), longtime financial advisor, and author of Wealth Blessed and Wealth Confident, has spent more than 25 years helping people think biblically about money. Through her own financial challenges and her work with clients, she has seen that true peace does not begin with a larger bank account. It begins when we stop asking money to carry what only God can. Why Financial Life Feels So Restless Many people feel financially restless because life itself rarely slows down. News, markets, social media, and cultural pressure are constantly telling us that more is better, faster is necessary, and comparison is unavoidable. That message is very different from the wisdom of Scripture. The world encourages us to chase more. God calls us to trust Him. The world tells us to measure our worth by what we own. God reminds us that our identity is found in Christ. The world keeps us anxious about what might happen next. God invites us to seek first His Kingdom. That doesn't mean financial concerns are imaginary. Bills, debt, rising costs, and future needs are real. But unrest grows when those concerns become bigger in our hearts than the Lord's faithfulness. Elizabeth notes that this struggle is not limited to one income level. Financial unrest can affect both believers and unbelievers, the poor and the rich. That is because unrest is not ultimately about how much money we have. It is about the mindset and heart posture we bring to money. When You Feel Overwhelmed One common source of financial unrest is feeling overwhelmed. When bills pile up, debt grows, or expenses feel unclear, it can be tempting to avoid the numbers altogether. Some people stop opening the mail. Others avoid checking their accounts. But avoidance usually increases anxiety rather than relieving it. Proverbs 27:23 says, “Know well the condition of your flocks, and give attention to your herds.” In an ancient agricultural context, that meant understanding the condition of one's livelihood. Today, the principle still applies. Wise stewardship requires clarity. That first step can be uncomfortable. Looking honestly at income, expenses, debt, savings, and giving may feel painful at first. But clarity allows us to move from vague fear to faithful action. Once the numbers are known, a plan can begin. We can ask questions like: What do we owe? What do we need to prioritize? Where can we reduce spending? What habits need to change? How can we continue honoring the Lord with what He has entrusted to us? God is not a God of disorder, but of peace. Facing financial reality is not an act of fear. It can be an act of faith, trusting that the Lord meets us in the truth and gives wisdom for the next step. Building Restful Financial Rhythms Financial peace is often strengthened through simple, faithful rhythms. Elizabeth emphasizes the value of habits because habits reduce the weight of constant decision-making. When giving, saving, spending, and debt repayment are built into regular patterns, we do not have to start from scratch every time money comes in. A budget is not merely a restriction. It is a tool for aligning financial decisions with God-given priorities. When we establish rhythms around generosity, saving, and wise spending, we are better prepared to resist impulse, fear, and comparison. These habits do not replace trust in God. They help us practice it. When You Feel Overlooked by God Another source of financial unrest is feeling overlooked by God. This can happen when others seem to be getting ahead while we feel stuck. It can happen when our hard work does not produce the results we hoped for. It can happen when prayers seem unanswered or when financial progress feels painfully slow. In those moments, we need to remember what Scripture teaches about growth, provision, and timing. God's wisdom often works “little by little.” Proverbs 13:11 says, “Wealth gained hastily will dwindle, but whoever gathers little by little will increase it.” That principle stands against get-rich-quick thinking, gambling, and reckless financial shortcuts. The Lord's way is often patient, steady, and formative. He teaches us to work, give, save, wait, and trust. Financial delay may feel frustrating, but it can also become a place of discipleship. Sometimes the Lord uses seasons of limitation to prepare us for greater faithfulness later. Being overlooked by the world is not the same as being forgotten by God. He sees His children. He knows their needs. And His timing is never careless. When You Feel Overextended A third source of financial unrest is feeling overextended, especially through debt. Debt can weigh heavily on the heart. It limits flexibility, creates pressure, and can make people feel trapped. Elizabeth speaks with compassion here because she has experienced that burden herself. After being caught in a devastating financial situation involving a trusted person who disappeared with borrowed money, she became morally obligated to repay a debt equal to about $200,000 in today's dollars. That season required daily trust, humility, and perseverance. But by God's grace, she paid the debt in full. For those who feel buried by debt, the way forward usually begins with humility and a plan. That may mean living more simply for a season, seeking wise counsel, cutting expenses, increasing income, or pursuing a structured debt-repayment strategy. Debt may be painful, but it does not have to define the rest of your story. God gives wisdom. He gives endurance. And He often uses the process of getting out of debt to reshape our desires, priorities, and dependence on Him. True Peace Begins With Christ Financial unrest often grows when we look to money for what only Christ can give. Money can pay bills, reduce certain pressures, and provide practical options. But it cannot give lasting peace. It cannot secure our identity. It cannot satisfy the soul. It cannot carry the weight of our ultimate hope. That is why biblical financial wisdom begins with worship. Before we ask, “How much do I have?” we need to ask, “Who am I trusting?” When we look at the world, there will always be reasons for distress. When we look only within, we may find fear, worry, or discouragement. But when we look to Christ, we are reminded that our lives are held by the One who is faithful. Financial peace is not found in pretending problems do not exist. It is found in bringing those problems honestly before the Lord and taking the next wise step with Him. So if you feel overwhelmed, seek clarity. If you feel overlooked, remember God's timing. If you feel overextended, humble yourself and begin taking faithful steps toward freedom. More money alone will not solve financial unrest. But Christ can reorder our hearts, renew our minds, and teach us to handle money with wisdom, contentment, and trust. On Today's Program, Rob Answers Listener Questions: I bought a home computer from a rent-to-own company right before COVID, but when work slowed down, I couldn't keep up with the payments. I tried to return it, but they said it would still count as a repossession and told me to keep it. Now the company has gone bankrupt, and a collection agency is offering a discounted payoff I can't afford yet. What legal action could they take if I miss the deadline, and could I go to jail over this? I'm 64 and turning 65 in November. I'm a retired educator with a strong pension and widow's benefit, and I may eventually switch to my own Social Security. I'm receiving lots of Medicare mail and dinner invitations from insurance companies. Where can I get reliable guidance, and how should I decide between Medicare Advantage and a Medigap plan? Resources Mentioned: Faithful Steward: FaithFi's Quarterly Magazine (Become a FaithFi Partner) Our Ultimate Treasure: A 21-Day Journey to Faithful Stewardship by Rob West Wisdom Over Wealth: 12 Lessons from Ecclesiastes on Money Look At The Sparrows: A 21-Day Devotional on Financial Fear and Anxiety Rich Toward God: A Study on the Parable of the Rich Fool Find a Certified Kingdom Advisor® (CKA) FaithFi App Remember, you can call in to ask your questions every weekday at (800) 525-7000. Faith & Finance is also available on Moody Radio Network and American Family Radio. You can also visit FaithFi.com to connect with our online community and partner with us as we help more people live as faithful stewards of God's resources. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
In this episode, Dr. Ken Cohen, Chief Medical Officer at Optum Health, discusses new research on Medicare Advantage, social vulnerability, and how full-risk care models can improve quality, efficiency, and patient outcomes. He also shares insights on the infrastructure, technology, and strategies needed to advance value-based care.
This is the WFHB Local News for Thursday, July 9th, 2026. In today's newscast, Gloria Bent joins us on Prescription for Healthcare to discuss denial from United Healthcare's Medicare Advantage coverage while trying to save her husband's life. That's coming up in today's feature report. Also coming up in the next half hour, Correspondent Elena …
In this episode,Jakob Emerson, Associate News Director, Becker's Healthcare, examines the growing litigation over Medicare Advantage star ratings and the billions of dollars tied to quality bonuses. He also explores how AI is intensifying the coding and claims battle between health systems and insurers, creating new operational and financial challenges across the industry.
In this episode, Dr. Ken Cohen, Chief Medical Officer at Optum Health, discusses new research on Medicare Advantage, social vulnerability, and how full-risk care models can improve quality, efficiency, and patient outcomes. He also shares insights on the infrastructure, technology, and strategies needed to advance value-based care.
We're delighted today to sit down with MDVIP Chief Medical Officer, Dr. Jeffrey Lin to talk about so building a sustainable practice, finding joy in the practice of medicine, and what's happening what the next chapter of Primary Care looks like. Dr. Jeffrey Lin is a board-certified cardiologist, internist, and the newly appointed Chief Medical Officer of MDVIP, the nation's leading network supporting physicians in personalized, preventive, and relationship-driven primary care. A Harvard Medical School graduate and Yale summa cum laude, Dr. Lin completed advanced fellowship training at Massachusetts General Hospital and Columbia University before building a distinguished career that spans academic medicine, elite sports cardiology as a consultant to the NFL Players Association, and executive leadership at Devoted Health, where he was the company's first physician hire and helped build a patient-centered care model serving over 400,000 members across 29 states. He joins MDVIP at a pivotal moment in the organization's growth, bringing with him a career-long conviction that prevention is a long game, that physician joy is inseparable from patient outcomes, and that the future of primary care depends on giving doctors the time and the tools to actually know their patients. --- MDVIP Appoints Jeffrey Lin, MD, FACC, as Chief Medical Officer BOCA RATON, Fla. – April 22, 2026 – MDVIP, the national leader in supporting physicians to provide personalized, preventive, and primary care, today announced the appointment of Dr. Jeffrey Lin as Chief Medical Officer. A board-certified cardiologist and accomplished healthcare executive, Dr. Lin will lead MDVIP's clinical strategy and delivery as the company continues to expand its preventive and relationship-driven primary care model nationwide. Dr. Lin will also collaborate with the network's Medical Advisory Board on MDVIP's current and future offerings. The appointment reflects MDVIP's investment in physician leadership that deeply understands both the patient and provider experience, reinforcing the company's commitment to long-term health outcomes, proactive prevention, and a care model that gives doctors the time and tools to deliver truly personalized care. A cardiologist and internist by training, Dr. Lin has a longstanding commitment to prevention and optimizing health through data-driven, lifestyle-oriented approaches. He joins MDVIP from Devoted Health, where he served as National Medical Director and was the company's first physician hire, responsible for building its clinical care platform from the ground up. Since 2019, he helped lead the development and scaling of a comprehensive, patient-centered care model integrating preventive care, chronic disease management, and longitudinal wellness for primary care patients across the country, growing the clinical team to serve over 400,000 members across 29 states. As Chief Medical Officer, Dr. Lin will work closely with affiliated physicians and the MDVIP team to enhance the MDVIP experience for patients and providers alike. His priorities include strengthening MDVIP's preventive and wellness programs, supporting physicians transitioning into more manageable practice sizes, and expanding the MDVIP model to new physician segments and patient populations across different life stages. "MDVIP was built on the belief that primary care should be proactive, personal and sustainable for physicians," said Larry Kutscher, CEO and Board Chairman of MDVIP. "Dr. Lin has devoted his career to those same principles, designing care models that prioritize prevention, meaningful time with patients and better long-term health. He will be a powerful advocate for our physician community and a key partner in shaping the future of MDVIP." Dr. Lin's passion for MDVIP's mission is rooted in his early years in practice, when he saw firsthand how fragmented, specialist-heavy care consumed patients' lives and made it difficult to focus on prevention and long-term health. "As a cardiologist, I've always viewed health as a long game," said Dr. Jeffrey Lin, Chief Medical Officer of MDVIP. "The choices we make in our 40s and 60s shape the next 30 years of our lives. MDVIP has spent more than 25 years building a model that gives physicians the time and tools to focus on prevention and real relationships with patients. I'm excited to help bring that kind of care to more doctors and patients across the country." Dr. Lin also emphasized the importance of elevating the physician experience. "You can't deliver great long-term outcomes if the people providing care are burnt out," he added. "I'm looking forward to partnering with our affiliated clinicians to bring more joy back into their practice and help patients live longer, healthier lives." With the appointment of Dr. Lin, MDVIP is beginning a new chapter in its growth story, doubling down on personalized, relationship-centered care and expanding its influence among patients and physicians nationwide. About Dr. Jeffrey Lin Dr. Jeffrey Lin is a board-certified cardiologist, internist, and an accomplished physician executive dedicated to advancing personalized, preventive, and relationship-driven care. He previously served as National Medical Director at Devoted Health, a tech-enabled Medicare Advantage organization, where he's helped lead the development and scaling of a comprehensive, patient-centered care model nationwide since 2019. A cardiologist by training, Dr. Lin has a longstanding commitment to prevention and optimizing cardiovascular health through data-driven, lifestyle-oriented approaches. Earlier in his career, he served as Assistant Professor of Medicine at Mount Sinai Medical Center in Miami Beach and Co-Director of Cardiac Rehabilitation, where he built a thriving ambulatory cardiology practice and developed programs that enabled patients to achieve meaningful, sustained improvements in heart health. Dr. Lin's experience also includes caring for elite and professional athletes as a cardiology consultant to the National Football League Players Association, as well as leading clinical research on cardiovascular performance and endurance. His work has been published in leading medical journals, including the Journal of the American College of Cardiology and Circulation. He is also a Fellow of the American College of Cardiology. Dr. Lin earned his medical degree from Harvard Medical School and graduated summa cum laude from Yale University. He completed his residency in internal medicine at Columbia University Medical Center, followed by advanced fellowship training in cardiovascular medicine, sports cardiology, and cardiac imaging at Massachusetts General Hospital and Columbia University.
Don and D.L. Hughley are back together, and absolutely nothing is off limits. From Clarence Thomas and the birthright citizenship ruling to Megyn Kelly's latest racist rant, Trump's failing "Great American State Fair," and the future of MAGA, the laughs come fast and the takes hit even harder. Plus, Don and D.L. announce their brand-new DL + DL: Anything Goes Tour, and trust us, if this conversation is any indication, you won't want to miss what's coming. This episode is sponsored by FFRF. Visit https://ffrf.us/don or text DON 511511 to join or learn more. Because freedom belongs to all of us. Text Fees May Apply This episode is brought to you by Lean. Visit https://TAKELEAN.com and enter LEMON for your 20% discount and free rush shipping For free and unbiased Medicare help, dial 212-931-0855 to speak with my trusted partner, Chapter, or go to https://askchapter.org/don DISCLAIMER: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors. Learn more about your ad choices. Visit podcastchoices.com/adchoices
SUMMARY Arundhati Parmar speaks with Jill Schwartz-Chevlin, Chief Medical Officer at Vinca, about the evolution of palliative care from a hospital-based, end-of-life service to a community and home-based model for patients living with serious illness. Jill explains how Vinca grew from an advanced care planning platform into a value-based palliative care company serving patients across five states, primarily through Medicaid and Medicare Advantage plans. The conversation covers the critical distinction between palliative care and hospice, the cost savings data that health plans are paying attention to, and what it will take for Medicare to finally build a sustainable reimbursement model for the specialty. KEY TAKEAWAYS Palliative care is not hospice. It is symptom management and whole-person support for patients still pursuing active treatment for serious illness, including cancer, COPD, and advanced heart failure. More than 75% of hospitals now have palliative care teams, but their positioning around end-of-life discussions has created a widespread misconception that palliative care equals dying. Home-based palliative care through Vinca produces a 42% reduction in ER admissions and a 53% reduction in hospitalizations. Only three states (California, Hawaii, and New Jersey) have established a Medicaid benefit specifically for palliative care. Traditional Medicare offers no such benefit. The current fee-for-service model for palliative care is not sustainable. Most palliative care programs linked to hospices survive only because the hospice subsidizes them. KEYWORDS palliative care at home, home-based palliative care, serious illness management, palliative care vs hospice, Vinca health, value-based palliative care, Medicaid palliative care benefit, Medicare Advantage palliative care, community palliative care, advanced care planning, hospice length of stay, ER reduction palliative care, whole-person care, serious illness, home health palliative care, CMO interview healthcare, palliative care reimbursement, MedCity Pivot podcast Links and resources Connect with Arundhati Parmar aparmar@medcitynews.com Arundhati Parmar (@aparmarbb) on X MedCity News EPISODE HIGHLIGHTS [00:02:04 – 00:02:36] Jill defines palliative care: symptom relief, patient wishes, team-based approach [00:03:11 – 00:03:46] Why hospital palliative care teams created the end-of-life association [00:06:13 – 00:07:06] Vinca's 15-year journey from advanced care planning to full palliative care services [00:11:43 – 00:12:07] The data: 42% ER reduction, 53% hospitalization reduction [00:12:52 – 00:13:31] Patient story: metastatic pancreatic cancer, golf one month ago, ER the next [00:18:47 – 00:19:29] Jill clarifies the hospice misconception: 90% of hospice care happens at home [00:22:50 – 00:24:10] Why Medicare's fee-for-service model for palliative care is failing and what should replace it
MEDICARE ADVANTAGE MINUTE: ARE THE TRADEOFFS FROM PRIOR AUTHORIZATIONS WORTH IT? THIS IS THE SINGLE BIGGEST BURDEN FOR PATIENTS WITH CHRONIC CONDITIONS ONE COMPANY'S MEDICARE SUPPLEMENT RATE INCREASE IN THE STATE OF UTAH IS A WHOPPER A PROSPECTIVE CLIENT CHECKS IN WITH SEVERAL PITHY QUESTIONS Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2026; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE ENROLLMENT GUIDE" - DOWNLOAD FREE "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" ....AND A PODCAST! @ DBJ@M4TLM.com W medicareforthelazyman.com T (630) 878-5055 Review Us On Google For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to help future readers. Official website: https://www.MedicareForTheLazyMan.com.
In the latest episode of the Leadership in Insurance Podcast, host Dan Briselden sits down with Stan Smith, CEO and founder of Gradient AI — one of the fastest-growing AI platforms in the insurance industry — for a wide-ranging conversation on data, decisioning, and what it actually takes to build something that sticks in this market.Stan is a six-time startup veteran who came to insurance not from the industry itself, but from a deep belief that machine learning could solve problems most insurers didn't yet know how to articulate. His route in — through Milliman's franchise model and a patient, trust-first approach to data partnerships — is one of the most instructive origin stories in InsurTech.In this episode, Stan and Dan explore:
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While Elsevier's most recent Clinician of the Future Report shows increasing adoption of artificial intelligence tools among physicians and nurses, and optimism that they will improve quality of care in the future, a majority raised concerns about trust and reliability. To increase the level of trust, 60% said transparent citations of evidence-based and peer-reviewed research will be key. How to provide that transparency is our focus today as Raise the Line host Lindsey Smith welcomes Elsevier colleagues Rhett Alden and Raman Kaur to guide us through the complexities involved, including the concept of traceability and what role it plays in how AI tools such as Elsevier's ClinicalKey AI are built and deployed. “Traceability changes the confidence that a clinician has in an AI tool so that they aren't trusting the AI, they're trusting the underlying evidence they're consuming from the AI-assisted platform,” says Raman, who brings years of experience as a primary care practitioner to her work. It's also important, Rhett adds, to provide additional information, pulled from both the clinician's query and the patient's medical record, to inform clinical thinking. “ClinicalKey AI can be more than a response engine by establishing a larger context to provide a more precise answer for that individual patient.” In this thought-provoking discussion, these experts also provide insights on: Mitigating bias in AI results; Using AI responsibly with sustainability in mind; What type of clinician will benefit most from AI Mentioned in this episode: ClinicalKey AI Clinician of the Future Report If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
What happens when two of the Republican Party's top former strategists start spilling the tea? Rick Wilson and Stuart Stevens pull back the curtain on the GOP like never before, exposing decades of hypocrisy, the party's obsession with LGBTQ+ issues, and the shocking stories they witnessed from the inside. From the so-called "Pink Mafia" to MAGA's culture wars, nothing is off limits. It's funny, jaw-dropping, and guaranteed to have Republicans clutching their pearls. And after years of hearing Donald Trump gush about men's physiques, Arnold Palmer's anatomy, and a seemingly endless parade of very gay-adjacent comments, one question inevitably comes up: Could Trump be gay? (We're kidding... mostly.) This episode is sponsored by Incogni. Go to https://incogni.com/donlemon and use code donlemon for 60% off. Incogni HELPS wipe yourself from the Internet — they can't harm you if they can't find you. Click the link below to claim your 60% off and get your personal data off the market! Erase yourself from the internet This episode is brought to you by Shopify. See less carts go abandoned and more sales go with Shopify and their Shop Pay button.Sign up for your one-dollar-per-month trial today at https://SHOPIFY.COM/lemon This episode is sponsored by FFRF. Visit https://ffrf.us/don or text DON 511511 to join or learn more. Because freedom belongs to all of us. Text Fees May Apply This episode is brought to you by Helix. Go to https://helixsleep.com/don for 20% off Sitewide and 25% off Luxe Mattresses and 30% off Elite Mattresses For free and unbiased Medicare help, dial 212-931-0855 to speak with my trusted partner, Chapter, or go to https://askchapter.org/don DISCLAIMER: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this episode of Sg2 Perspectives, host Trevor DaRin is joined by Sg2 experts Brian Esser and Jayme Zage, PhD, for a discussion of recent health care headlines and what they may signal for health systems. The conversation explores affordability and AI, hospital rankings, Medicare Advantage tensions, workforce pressures, and GoodRx's subscription strategy. Together, they separate signal from noise and highlight how leaders can think about technology, payer dynamics, labor supply and consumer engagement in the years ahead. We are always excited to get ideas and feedback from our listeners. You can reach us at sg2perspectives@sg2.com, or visit the Sg2 company page on LinkedIn.
In this episode, Scott Becker reviews 8 key healthcare developments, including telehealth expansion, Medicare Advantage challenges, CEO turnover, AI governance, and more.
Revenue cycle metrics can reveal far more than days in A/R, cash collections, or cost to collect. In this episode, Jon Vitiello, SVP & CFO at St. Luke's Health, joins Stuart Newsome to discuss how CFOs interpret RCM signals, separate operational noise from financial risk, and use revenue cycle insight to guide strategy, investment, Medicare Advantage response, and patient access performance.Brought to you by www.infinx.com
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:
The Knicks are NBA champions, but should they head to the White House? After James Dolan announced the team plans to visit, questions are already swirling: Is the entire team on board, and what does that visit mean in today's political climate? Tonight, Don breaks it all down, along with the powerful message of hope, democracy, and unity from today's opening ceremony at the new Obama Presidential Center. Michelle Obama had some words for Donald Trump! This episode is brought to you by BetterHelp. BetterHelp makes it easy to get matched online with a qualified therapist. Sign up and get 10% off at https://BetterHelp.com/donlemon This episode is sponsored by Byron Publishing. Get your copy of “Bullies, Parasites and Slaves” at https://www.BPS.online or text the word, “BULLY” to 511511 and receive an immediate link to get the book – paperback, E-book or audio. Text Fees may apply. This episode is sponsored by Lean. Visit https://TAKELEAN.com and enter LEMON for your discount. For free and unbiased Medicare help, dial 212-931-0855 to speak with my trusted partner, Chapter, or go to https://askchapter.org/don DISCLAIMER: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options. Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors. Learn more about your ad choices. Visit megaphone.fm/adchoices
It's been one year since the U.S. Centers for Disease Control and Prevention, in an unprecedented move, dismissed all the members of its Advisory Committee on Immunization Practices (ACIP), kicking off what would turn out to be a very concerning and busy year for infectious disease specialists. We're going to recap this turbulent period – which includes a resurgence of measles, an unusually rough flu season, the emergence of a new COVID strain and outbreaks of hantavirus and Ebola – with Dr. William Schaffner, one of the country's most frequently quoted medical experts on infectious disease, vaccination, and public health. As a member of ACIP for decades, Dr. Schaffner brings unique insight into the dismantling of the committee and the distrust of vaccines that lies at the root of the changes. As he explains to Raise the Line host Lindsey Smith, while many vaccine critics are beyond reach, there are those he describes as vaccine hesitant that may be persuadable if the right approach is taken. “Beyond providing facts, we have to listen to them and respond to their concerns and make them feel comfortable. Information is fundamental, but behavior change only comes with a change in attitude.” Tune in for a wealth of wisdom and context that includes observations on: What's complicating containment of the Ebola outbreak; Challenges in public health communication in the current social media environment; What grade health authorities should get on their response to the hantavirus outbreak. Mentioned in this episode:Vanderbilt University School of Medicine If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
State Treasurer Brad Briner joins the SEANC View podcast to explain how the pension reached a record $148.3 billion, discuss recent investment moves, including AI stakes like Anthropic, and explain why the office passed on buying part of the Carolina Hurricanes. He also covers portfolio changes, timber holdings, and efforts to improve returns for retirees and taxpayers. The conversation addresses health plan challenges, recent Medicare Advantage cost adjustments for retirees, transparency around fees and holdings, and broader initiatives—from power affordability to America 250 outreach—that affect state employees and retirees.
Rural healthcare is facing one of its most pivotal moments in decades. With major Medicaid changes, a historic $50 billion Rural Health Transformation Fund, workforce shortages, and growing pressure on hospitals and providers, the decisions being made in Washington today will shape the future of rural communities for years to come.In this episode, we sit down with a leading policy expert from the National Rural Health Association (NRHA) to unpack the rapidly evolving healthcare landscape and what it means for rural providers, patients, and community leaders across the country.From Capitol Hill politics to federal funding opportunities, our guest breaks down the key healthcare issues dominating the national conversation, including Medicaid reform, Medicare Advantage challenges, workforce shortages, telehealth expansion, AI in healthcare, pharmacy benefit manager (PBM) reform, and the long-awaited Farm Bill. We also explore the Rural Health Transformation Program—one of the largest federal investments in rural healthcare in generations—and what states must do to secure and sustain funding.The conversation dives into the realities facing rural hospitals and clinics, the impact of federal policy changes on healthcare access, and the innovative solutions emerging across the country to strengthen rural health infrastructure and improve outcomes.Whether you're a healthcare executive, policymaker, provider, educator, or advocate, this episode offers valuable insight into the opportunities and challenges shaping the future of rural health.If you care about the future of healthcare access in rural America, this is a conversation you won't want to miss. Tune in for an inside look at the policies, funding, and innovations that could redefine rural healthcare for the next generation.The CSRHA has been a go-to resource for rural healthcare and community leaders since 1995. The CSRHA brings an accumulation of actionable insights to the next generation of rural healthcare leaders. For more behind the scenes of this podcast follow @CSRHApodcast on Twitter or @csrha.advocate on Facebook.If you enjoy This Is Rural Health, we could use your support! Please consider leaving a 5-star rating and review, and share it with someone who needs to hear this!Learn more about the CSRHA at csrha.org.
Welcome to the Pat Iyer Podcast! In this special episode, we celebrate the launch of an insightful new book on traumatic brain injury (TBI) by Mary Ann, a seasoned legal nurse consultant and founder of Cyborg and Associates. Drawing on her deep clinical experience in critical care, med-surg, forensic nursing, and legal consulting, Mary Ann brings fresh perspective and practical guidance for legal nurse consultants, attorneys, and case reviewers navigating complex TBI cases. Join us as Mary Ann breaks down why traumatic brain injuries are uniquely challenging to diagnose, assess, and litigate. She shares real-world examples, including cases that seemed invisible at first glance but carried devastating, lifelong impacts for victims. Discover her structured approach for analyzing medical records, building timelines, and explaining the nuanced interplay between the location of a brain injury and a patient's specific deficits critical knowledge for anyone dealing with legal cases involving brain trauma. Whether you're a legal nurse consultant searching for a systematic evaluation framework, an attorney seeking to strengthen your TBI cases, or a healthcare professional aiming to understand the full scope of this “invisible injury,” this episode equips you with actionable strategies and expert insight to make a meaningful difference for clients and patients alike. What You'll Learn in This Episode on Unveiling the Invisible Injury: TBI Case Strategies for Legal Nurse Consultants Here are 5 discussion questions answered in the podcast: Based on the stories shared in the podcast, how can subtle or “invisible” brain injuries have long-term, life-altering consequences for patients? What strategies did Mary Ann recommend for constructing a systematic approach to reviewing complex medical records in TBI cases? How does Mary Ann's book specifically address the needs of legal professionals and legal nurse consultants, distinguishing it from books written for clinicians or patients? What types of red flags did Mary Ann advise legal nurse consultants to look for when reviewing TBI records, and why are these significant? How can legal nurse consultants support attorneys or insurance companies in ensuring TBI patients receive appropriate treatment or compensation? Get the free transcripts and also learn about other ways to subscribe. Go to Legal Nurse Podcasts subscribe options by using this short link: http://LNC.tips/subscribepodcast. Your Presenter for Unveiling the Invisible Injury: TBI Case Strategies for Legal Nurse Consultants Pat Iyer Pat Iyer is a seasoned legal nurse consultant and business coach, renowned for her expertise in guiding new legal nurse consultants to successfully break into the field. As the host of the Legal Nurse Podcast, Pat addresses critical challenges that legal nurse consultants face, such as difficulty in landing clients and a lack of response from attorneys. Through her insightful episodes, she emphasizes the importance of effectively communicating one's value to potential clients. With a wealth of experience, Pat has empowered countless consultants to overcome these hurdles and thrive in their careers. Connect with Pat Iyer by email at patiyer@legalnusebusiness.com Mary Ann Mary Ann Seibold is a registered nurse with over 12 years of experience in the healthcare field both clinically and administratively. After graduating with a BSN in nursing; she went to work as a medical-surgical and critical care nurse. After a few years MaryAnn went back to earn an MBA in Healthcare Administration; education she took to the insurance side of healthcare to review cases for the Medicare Advantage population. Currently, she owns and operates her own legal nurse consulting business Seibold and Associates Consulting Agency. Here she uses all her various experiences providing focused, insightful reviews for attorney clients. Connect with Mary Ann by email at seiboldandassociatesclnc@gmail.com
In this episode of The Broker Link Podcast, Leigha Hayes and Aleshia Holliday sit down to discuss the growing impact of Medicare Advantage network disruptions and what agents can do to help clients navigate these unexpected changes. Aleshia explains that provider network shifts have reached unprecedented levels, affecting more than 2.9 million Medicare beneficiaries in 2026. Unfortunately, agents often learn about these changes from concerned clients before receiving official communication, creating confusion and urgency for everyone involved. The conversation explores the chaos that follows major network announcements, from providers managing operational challenges to agents working quickly to find solutions for impacted members. Aleshia shares practical strategies for success, including proactive outreach, providing compliant communication materials, and serving as a trusted resource for both clients and healthcare providers. Most importantly, she emphasizes that moments of disruption create opportunities for agents to strengthen relationships. By stepping in with guidance, education, and solutions, agents can reduce stress for clients and provider offices while building long-term trust and loyalty. Learn more about partnering with The Brokerage Inc. by visiting our website, www.thebrokerageinc.com. Remember to like, share, and subscribe to our show! New episodes are available every Tuesday. Join our Community! LinkedIn: https://www.linkedin.com/company/the-brokerage-inc-/ Facebook: https://www.facebook.com/thebrokerageinc/ Instagram: https://www.instagram.com/thebrokerageinc/ YouTube: https://www.youtube.com/@TheBrokerageIncTexas Website: https://thebrokerageinc.com/
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:
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:
"Do nothing for us without us." According to today's guest Robyn Bussey, that operating principle is the basis for effective community health work. "You don't go into a community and dictate. You go and listen and trust and be a partner," she adds. As you'll learn in this enlightening conversation, Bussey is following that approach in her current work as Just Health Director at the Partnership for Southern Equity, an Atlanta-based nonprofit advancing racial equity and shared prosperity across the South. On this episode of Raise the Line from Elsevier, Bussey provides illuminating examples of community-rooted work in South Fulton County and rural Georgia, and explains why community health workers may be the most underutilized asset in addressing health disparities. This wide-ranging interview with host Michael Carrese also explores: Bussey's candid perspective on what happened to the surge of interest in health equity that occurred during COVID; Why life expectancy gains in many Southern states have lagged behind the rest of the country; Her advice to students and early-career clinicians about where they're needed most. Mentioned in this episode: Partnership for Southern Equity If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Tonight, Don is back on the streets of New York to check in with Knicks fans ahead of the next big game. Is the energy different now that Trump isn't in attendance? And after the last loss, do New Yorkers really think he jinxed the team?
Social determinants of health, including housing, food access, insurance status, and structural inequities, significantly influence stroke prevention, recovery, and long term outcomes. These factors affect biological risk, treatment adherence, and disparities in care, even when traditional clinical measures are addressed. This episode highlights practical strategies for integrating screening, leveraging multidisciplinary teams, and identifying opportunities for advocacy to improve patient outcomes. In this episode, Teshamae Monteith, MD, FAAN, speaks with Nneka L. Ifejika, MD, MPH, author of the article "Social Determinants of Health and Their Impacts on Stroke Prevention and Outcomes" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Ifejika is an adjunct professor of physical medicine and rehabilitation at UT Southwestern Medical Center in Dallas, Texas, and the chief scientific officer of the Division of Academics at Ochsner Health System in New Orleans, Louisiana. Additional Resources Read the article: Social Determinants of Health and Their Impacts on Stroke Prevention and Outcomes Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Full episode transcript available here Dr Monteith: Two patients have the same stroke, but when they return, they have very different outcomes. We can look into some of their comorbidities, but something we don't spend enough time talking about is the social determinants of health. Stay tuned to this discussion. I promise you, you'll become a better neurologist. Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: This is Dr. Teshamae Monteith. Today I'm interviewing Dr. Nneka Ifejika about her article on social determinants of health and their impacts on stroke prevention and outcomes. This article appears in the June 2026 Continuum issue on cerebrovascular disease. How are you? Welcome to our podcast. Dr Ifejika: Thanks for having me. I'm doing great. Dr Monteith: Great. So, can you introduce yourself to our audience? Dr Ifejika: Sure. I'm Dr. Nneka Ifejika. I am the Chief Scientific Officer of Ochsner Health System in New Orleans, Louisiana. But I'm also a cerebrovascular rehabilitation doctor. I've been practicing for about nineteen years, and am happy and honored to be a contributor to this Continuum Neurology article. It's a really important topic. Dr Monteith: Great. So, what got you into this field, first of all? Dr Ifejika: Well, I was deciding between PM&R and neurology, and I was putting in both match lists. And I thought about it and I leaned toward PM&R, but stroke still had a grasp on my heart and my mind. And so, after I finished my residency, I joined the UT Houston stroke team, and I did a, thankfully did a two-year fellowship and became cross-trained in stroke as well as physical medicine rehab. So, I am a jack of both trades. Dr Monteith: So, you got your way in a way. Dr Ifejika: I did. Dr Monteith: You know, we have a lot of learners that are listening, so it's always, uh, nice for them to be inspired, I think, by people's career paths. So why don't we talk about the objectives of your article? Dr Ifejika: Sure. So, one of the most important things that we wanted to do was make sure that medical students, residents, faculty, and fellows understood the impact of social determinants of health on stroke recovery and stroke rehabilitation. It's not as simple as you have hypertension, hyperlipidemia, we're going to manage your stroke risk factors. Oh, you had an ischemic stroke. You presented in time for the window. We're going to give you endovascular therapy and then modified Rankin scale at hospital discharge in ninety days. No, no, no. The stroke survivor and their caregivers and their family have a lot more to deal with outside of what we look at during the acute stroke hospitalization and post-acute rehabilitation. Things like, can they afford the medication that we're prescribing? Antiplatelet agents or anticoagulation can be extremely expensive. Do they have housing insecurity? Is there food insecurity? What's going on behind the scenes that we are not addressing that can directly impact the admission rate and the readmission rate after we take care of a stroke survivor? Dr Monteith: I love the article because you took a real deep dive into social determinants of health, what they are, why they matter, and what we can do about them. And so why don't we talk a little bit about the NINDS framework for social determinants of health? I think many of us might not be familiar with the framework per se. Dr Ifejika: So, the framework consists of multiple domains specifically that relate to social determinants of health that were published in Neurology a couple of years ago. So, I do hope that people who are hearing this recording actually read them. There are interpersonal domains, there are classic medical domains, there are indeterminate domains, and there are six total domains. And health domains are the last domain. So, things like when it comes to housing insecurity, food insecurity, that's a domain of social determinants of health. When it comes to chronic racism, when it comes to biases that patients experience, those actually impact outcomes. So, there are six separate indices that we're going to get into in detail and how we address them as clinicians, whether it be at the medical student level, resident level, faculty level, to integrate the social determinants of health in our care plans, because we could be doing a much better job. And I think it'll be really important from the interpersonal perspective when we really relate to our patients and their families that we ask these questions. For example, if we're prescribing someone to have treatment for their diabetes mellitus and ha- and, and be taking insulin, if they have housing insecurity and they're in a homeless shelter, they have to leave the homeless shelter during the day. So, what happens to the insulin that we prescribe? These are variables that we are not considering on a regular basis, but they directly relate to compliance. Dr Monteith: Great. So that was one thing I wanted to bring up. We're very good at measuring blood pressure and trying to determine, uh, the association between stroke outcomes and things that we can measure, glucose, lipids, blood pressure. What is the evidence for social determinants of health and stroke outcome? Dr Ifejika: The evidence is growing, and there have been many publications that have come out that are, are going to be highlighted in this article related to structural determinants of health inequities, like structural racism, as well as disparities related to ethnicity and race. There's geographical disparities. For example, a lot of patients are, are primarily concerned about rural versus urban, whether you have access to different post-acute rehabilitation, whether you have access to secondary stroke prevention because you simply don't have the transportation from a, a rural area to get to a drugstore to get things available to you. Social status. There are actually publication related to socioeconomic status and the concerns when it comes to air pollution. So particulate matter 2.5, we know that that has a direct impact on stroke outcomes and health overall, but we don't really think about it as a structural determinant of health inequity. There's several multiple layers of research that have gone on specifically that have been cited in the literature that relate directly to social determinants of health and how we can address them moving forward. Dr Monteith: And what I found interesting in your article in that you gave at least a few examples where social factors like income, education were controlled for, and maybe in large part it is, but even when you control for some of these very obvious social risk factors, you still have inequities. Dr Ifejika: Absolutely. And I think it was really important to show that we had strong peer review evidence behind this, as it wasn't just something that we were creating or hypothesizing about. There have been studies that have been done over this over decades of time, showing the impacts of social determinants of health on outcomes. But the question and concern that we have is we know this growing body of literature continues to expand. What are we doing about it when it comes to education of the future generations of providers who will be caring for this population? Dr Monteith: Before we get into how, you know, what we're going to do about that, let's just kind of put that link, cause the evidence is there. How does it drive biology? Dr Ifejika: It's a great question. So, for example, particulate matter 2.5 in air pollution has been shown to have an existing impact on hypertension, raising your blood pressure. So that's a direct effect of a social determinant of health related to socioeconomic status because people who live in areas with higher air pollution are... They're not green spaces. They live near highways. Those are areas that unfortunately are also impacted by food deserts. Food deserts, if you're not able to get fresh fruits, vegetables, whole foods, increases your risk of developing diabetes, hyperlipidemia, also increases your sodium intake, again, increasing hypertension. These things are all connected to biological determinants. It's just that we're not asking about them necessarily within the social history when we're taking people into the hospital, but they have direct effects. Dr Monteith: Great. Neurologists tend to be busy and, you know, we're... have all of these things that we're being asked to do and chart and click and all of that stuff. And so how can we more readily integrate screening for social determinants of health and that conversation into the work we do? We recognize it's important. We recognize it's an important risk factor. There's a lot of these determinants. So, what is a good way to do so? And I, I know that in the paper you've, you've given different roles to different team players, so I want you to talk about that too, but just kind of even a regular routine office visit. Walk us through a way we can more easily integrate that kind of conversation. Dr Ifejika: It's an excellent question, and what I've recommended that we do in a standard office visit is utilize the time before the visit to send out screeners. So, for example, usually with an electronic medical record, you can send documents before the visit even starts, where people can check off whether they have any concerns regarding housing, food insecurity. They can check out their location of where they live, whether they live near a highway or not near a highway. It's specifically related to socioeconomic status. We can ask about insurance status, whether they have insurance, insured versus uninsured, but then also types of insurance, whether they have Medicaid insurance versus Medicare insurance. Then even drilling even further, type of Medicare insurance, Medicare Advantage versus traditional Medicare, cause all of those things actually play a role in this. Dr Ifejika: And evaluate these things and don't take time during your office visit. Send these screeners out beforehand. Have them be assimilated by your medical staff. Make sure you're utilizing every resource that you have at your disposal to help streamline things, so by the time the person comes in for the visit, you've primed the pump. You have this information already in your hands at your fingertips cause it was sent out in advance, and you have your medical staff already have an understanding of. If they didn't fill it out electronically, give it to them in the lobby. Make sure they have a handwritten copy in the lobby so that when they come into the office visit, you have the information at your fingertips. Dr Monteith: Are there any particular resources that you recommend for those types of screeners? Dr Ifejika: What I've used in the past, if you have patient-reported outcomes, so the PROMIS instruments, that's a good start. It doesn't get into the details of housing insecurity, food insecurity, but it's a good start to help prime questions and to start the conversation during your office visit. In my clinics, I do a PROMIS 27 on every patient, as well as a PHQ-9 for depression on everyone. And then I collect data longitudinally, and I can always drill down on factors that I noticed that could become a problem moving forward. Dr Monteith: Yeah. And then also in your article, you spoke a bit about this impact from the acute presentation in the hospital to rehab. Dr Ifejika: Yeah. Dr Monteith: So why don't you talk about these different entry points where we can really engage our patients and try and help reduce their burden? Dr Ifejika: Sure. So, healthcare can be quite fragmented, and the stroke patient, stroke survivor, and their family member have no grasp of that. They've had a stroke, and they may be going from the ER to the ICU to the stroke unit to the floor to the rehab unit, and we see it as multiple levels of care, multiple types of providers. They see it as one hospital. And the concern that we have is, at those branch points, things get dropped, and we have the opportunity to pick things up at those branch points. So, during the acute care hospitalization-Primarily, that's the establishment of what has happened, how we're gonna treat it, what are the variables that we can control for right now to address those determinants of health moving forward, and to specifically looking at whether they were taking medications before, whether they could afford medications before, what that looks like at hospital discharge. Is there any duplication of medications? If a person is taking Coreg and you prescribe metoprolol, but they still have the Coreg at home, should we have really prescribed the metoprolol? We're just spending money that they may have concerns when it comes to access to care and the cost of these prescriptions. So, it's the responsibility of the acute care physician to kind of look at that. Those are subtle things that we think are subtle, but they add up quickly for the family when it comes to having one group of medications that's the same class and having to buy another type. When it comes to post-acute rehabilitation, it's really an important time to screen for whether the caregiver can handle what's occurring. So specifically, if the caregiver is already burning out and the average length of stay for a stroke patient is five days and they've come to rehab for two weeks, what's gonna happen in the next two years or the next four years? So, during the post-acute rehabilitation phase, it's time to kind of look at that and drill down on those kind of questions. Also, the levels of care, Dr Ifejika: it's really important to look at other levels of rehabilitation, so skilled nursing facilities, making sure people have access to that if they need to, if the caregiver is burned out and they don't have the ability to go straight home. Because acute inpatient rehab, the goal of it afterwards, is to go straight home. It's not to go to another facility. So, you need to have that screener in place when it comes to whether the family can take care of this person, and whether the family can do it in an effective way to prevent them being readmitted. Dr Monteith: Great. I also like that you spoke about kind of the team approach and different roles, both for screening and for intervention, both being very important, especially the intervention. And so why don't you give us a few examples how the team could break up the responsibility and how also for the intervention component that can be done. Dr Ifejika: Sure. So, I broke up the team into several levels. So, the team medically is the medical student, resident, and faculty physician. However, the team also includes the support staff, so your case manager, your social worker, the therapist, physical therapy, occupational therapy, speech therapy, the pastoral services, all these members of the team. You know, sometimes as physicians, we don't read those notes. There's a lot of information in the notes from social work, care coordination, and the therapist. They get down to subtleties cause they're asking questions, for example, "What kind of equipment do you have at home? How many stairs do you have at home? What level of house do you have, one story, two story? If you live in an apartment, do you have an elevator access?" That's important for someone with hemiparesis. When it comes to medications, when it comes to insurance status, when it comes to your ability to have the mechanisms to pay for care as an outpatient, social workers are required to ask these questions cause they have to figure out resources for the patient and their family to help facilitate improved outcomes. So, they have to ask questions regarding these tasks. The concerns are, do we read what they're saying? So, it's really important to interact with them, and if it's not something that you're looking at in the chart, cause we're all so tied to our computers, find where they are in the hospital. Walk by their office and have a chat. Run your list with them, especially for people who you're concerned have vulnerabilities, and make sure that you're setting an example for your medical students with your faculty doing so. If you're looking at it from the medical student, resident, faculty perspective, medical students, listen. This is your opportunity to really contribute to the team as well as learn about social determinants of health and research in their fields. You are the boots on the ground for the medical team. You are the ones who should be priming the pump and asking these questions of the family members. We're sending you into the rooms to do a history and physical. Social determinants of health should be a part of your history and physical, and you should be taking what we're saying in this article and asking these questions and tying it into your resident. Now, the resident is the work person of the hospital. We all know this. Things run through the resident. Things run through the fellow. It's really important that they have this information in a manner that is negotiable. The list keeps getting longer, and a resident doesn't need to be overburdened. It needs to be synthesized in a manner that can help facilitate the resident being able to act as well as communicate any concerns to the faculty. And at the faculty level, we are the voices that can affect change. So, if there's any concerns when it comes to advocacy, research, making sure that people are accessing care in a way that makes sense, particularly when it comes to the ability for us to galvanize change on a national level, that's kind of our job. Dr Monteith: Great, and so let's talk about intervention. What are things that, let's say, the neurologist can do to deal with some of these social factors? Dr Ifejika: From the neurology perspective, I think it's really important to identify missed opportunities and making sure that we address them. For example, the conversations around the ability to have access to care related to insurance versus no insurance. There are many, many ways that neurologists are able to advocate for a person being able to get to Medicare insurance, particularly in the outpatient setting. When we see patients in clinic, it takes two years, them, to qualify for Medicare, two years at a minimum. But there's a gap there that can be filled by us making sure that we document what's happened, contact their providers, facilitate communication with their employers, if they're employees, they can get some short-term disability benefits to help bridge that gap prior to receiving Medicare insurance. It behooves us to do this because if we do not, they fall into the gap and they get readmitted and they're back on service anyway. So, what's important is the outpatient that we really kind of focus on things that we can impact and things like insurance and getting people transitioned from having employer-based insurance versus getting to Medicare is a really important way that we can effect change in a, in a way that's viable and, and replicable. So, in the outpatient setting, neurologists have a wonderful opportunity to effect change in social determinants of health. When it comes to employed persons, who had a stroke transitioning to Medicare, it takes two years to do so. So, in the outpatient clinic, if you have an employed person, make sure that you fill out their short-term disability benefits forms, their long-term disability benefits form. Bridge the gap. Get that information to their employer so they can maintain constant coverage. Because if they do not, if they have to choose between refilling medications and putting food on the table, they're going to choose putting food on the table, and that's going to directly impact their outcomes if they're not taking the medication that we recommend. Dr Monteith: I think that's a great point. I mean, there's a lot that we can do, and in some ways, it may not take that much to document and to be able to ask the questions and to include some of that information into the assessment and plan is really a, a great idea. Dr Ifejika: And you know, if we don't bring these things up and have these conversations, it doesn't get addressed. And that's why I'm very, very thankful that I had the opportunity to do so, cause this is a part of what I do all day. I think that if I wasn't integrating these kind of conversations into my practice, I wouldn't have the ability to share these tips and these abilities to move things forward in a manner that will be constructive for our field overall and for our patients. Dr Monteith: And towards the end of the article, you brought up something I think we don't see in many articles, and that's the role of advocacy and getting involved in health policy. So, can you talk a little bit about that? Dr Ifejika: You know, it's really important to facilitate change when you see that there are things that need to be changed. And the best way to do that is through advocacy at the local or state or federal level. A lot of these variables that we're dealing with can be addressed through legal changes. I'll give you an example. End-stage renal disease, if you have immediate hemodialysis and you have that requirement upon hospital discharge, you qualify for Medicare immediately. Immediately. Before you even leave the hospital. Why wouldn't something be similar for a stroke? Well, the reason why is because there was a level of advocacy that came around end-stage renal disease and a member of Congress's wife had hemodialysis requirements. And so, a law was passed to make sure Medicare covered it immediately after hospital discharge. So, it requires advocacy in some significant ways to get things done, but we have the bandwidth to do this. We take care of a population that has some of the highest rates of preventable disability. That's not going away. We need to make sure that we're effecting change for this group to make sure that they have the best possible outcomes they can experience. Dr Monteith: So, any final messages for our listeners? Dr Ifejika: I look forward to hearing everyone's feedback about our issue. I am thankful for the opportunity to talk about, address, and write about this important topic, and look forward to everyone's feedback. Dr Monteith: Well, thank you so much for being on our podcast. It was a really wonderful summary and we had a very thorough conversation, but you didn't give away too much, so I think they're going to have to read the article. Dr Ifejika: You're going to have to read the article. And we want medical students, residents, fellows, faculty, all of our ancillary staff within the hospitals, please read this article. We really appreciate it. Dr Monteith: Again today, I've been interviewing Dr. Nneka Ifejika about her article on social determinants of health and their impacts on stroke prevention and outcomes. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
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.
Medicare Advantage covers more than half of seniors, and the debate over what it really costs is stuck in two camps. Timothy Bulat, a senior consulting actuary who spent nearly two decades leading Medicare Advantage analytics inside a major insurer, raises a question the loudest voices keep avoiding: who actually pays for the program, and is the value being shared fairly? This episode is based on his article "The truth about Medicare Advantage funding and costs," published on KevinMD. You will hear how plans simultaneously manage costs well and extract excess taxpayer dollars through coding intensity and favorable selection, why headlines about Medicare Advantage being "in retreat" are overblown, and which specific policy levers (risk adjustment reform, benchmarking, slowing annual payment growth) the Biden and Trump administrations have already started using. Listen for the distinction Timothy draws between a funding cut and a smaller increase, and why that distinction matters for every clinician dealing with prior auth. 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
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
Turning 65 opens a new season of life—and with it comes some of the most important financial and healthcare decisions you'll ever make. In this episode of Finishing Well, Certified Financial Planner Hans Scheil and co-host Robbie Dilmore continue their Financial Plan Series by exploring Medicare, IRMAA (Income-Related Monthly Adjustment Amount), and how these choices fit into a comprehensive retirement strategy. Hans walks through the key Medicare decisions every retiree faces, including the differences between Original Medicare and Medicare Advantage plans, the importance of Medicare Supplement coverage, and why your initial enrollment period can create opportunities that may never come again. Using the real-life financial planning case of Tom and Susan, listeners will learn how Medicare decisions affect healthcare costs, retirement income planning, tax strategies, and long-term financial security. The discussion also covers Medicare Part D prescription drug plans, common enrollment mistakes, and strategies for managing or potentially reducing costly IRMAA surcharges. Through personal experiences and practical examples, Hans and Robbie highlight how choosing the right Medicare coverage can protect both your health and your retirement savings. Whether you're approaching age 65, already enrolled in Medicare, or helping a loved one navigate retirement healthcare decisions, this episode provides valuable insights to help you make informed choices and avoid costly mistakes. Topics Covered: Original Medicare vs. Medicare Advantage Medicare Supplement (Plan G) coverage Open enrollment opportunities and deadlines Medicare Part D prescription drug plans Understanding IRMAA and Medicare premiums Healthcare planning as part of a complete retirement strategy Real-world retirement planning case study Learn how thoughtful Medicare planning can help you finish well in retirement.
The fallout continues after the firing of CBS icon Scott Pelley, with many questioning what it means for the future of 60 Minutes and the credibility of CBS itself. Is this the beginning of the end for one of journalism's most respected institutions?
As concerns escalate about the deadly Ebola virus outbreak in Africa, we bring you the unique insights of Dr. Peter Piot, a renowned microbiologist who co-discovered the virus 50 years ago during the first recorded outbreak of the disease. His on-the-ground account of that crisis was provided to us in April before the current outbreak was declared, but it contains valuable historical perspective and shares lessons learned that he carried forward in his consequential career. “What I saw from the beginning is the most important thing is to listen to people and that you need to act fast to save lives, before you have the evidence you would like to have.” He followed his contributions on Ebola by diving into the fight against HIV/AIDS, eventually reshaping global response in leadership roles at the World Health Organization and United Nations. As he shares with host Lindsey Smith, the learnings in that case were more pragmatic than scientific. “We had to redefine HIV/AIDS not as a medical problem but as an economic and security problem in order to get it on the political agenda.” Tune in for a fascinating episode that takes you from the gritty frontlines of public health crises to the battles for funding and attention in the halls of power as Dr. Piot shares what it actually takes to move the world to respond effectively to health threats. Mentioned in this episode: London School of Hygiene & Tropical Medicine If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
SummaryThis episode features a detailed discussion on recent healthcare compliance issues, focusing on Medicare Advantage overpayments, the importance of proactive audits, and the evolving role of data analytics in fraud detection. Experts Terry Fletcher and Sean Weiss share insights on regulatory updates, best practices, and the need for strategic compliance in healthcare organizations.Key TopicsMedicare Advantage overpayment risksThe role of OIG alerts in complianceData analytics in fraud detectionBest practices for healthcare audits
The Tenpenny Files – Twila Brase warns that Medicare Advantage is becoming a controlled healthcare system shaped by automatic enrollment, restricted networks, prior authorization, AI decision-making, and corporate cost containment. Her conversation with Dr. Sherri Tenpenny examines how seniors may lose access to doctors, specialists, cancer centers, and medical independence when it matters most...
The Tenpenny Files – Twila Brase joins Dr. Sherri Tenpenny to expose how Medicare Advantage, prior authorization, AI-driven denials, and administrative controls reshape healthcare access. The discussion reveals how delays, appeals barriers, and corporate incentives ration care while doctors lose authority and patients face a system increasingly built on surveillance, dependency, and nationwide control...
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