Podcasts about value based care

Podcast Notes(Organized for learning & insight discovery)00:00 – Welcome: Rethinking everything we thought we knew about home care04:12 – Home Care vs. Home Health: Why this distinction matters09:30 – Crisis vs. Prevention: The real cost of waiting too long13:40 – The ROI of Proactive Support: Reducing ER visits, boosting length of stay18:25 – A Personal Story: When caregiving becomes invisible and unsustainable24:15 – Independent Living Meets a New Era: Why “forever homes” need partners31:00 – The Overlooked Value for Facility Operations & Team Culture38:00 – How to Build a Proactive Referral Culture that Actually Works44:50 – The Language of Trust: Why the words we use can empower or isolate50:00 – Good vs. Transformational Partners: A Chick-fil-A meets Disney approach56:10 – Looking Ahead: How Your Health is shaping the future of care www.YourHealth.Org

In this episode of the Health System CXO podcast, Robin Brand interviews Nick Bartz, co-founder and CEO of Kairon Health.  This conversation covers the importance of understanding the operational realities of healthcare, the role of technology in facilitating change, and the challenges of implementing value-based care.Welcome to the Health System CXO Podcast, sponsored by The Health Management Academy, featuring content designed for Health System Nurse Executives, Health Equity Officers and Strategy Executives provided by our company SME's - Anne Herleth, Jasmaine McClain, Ph.D. and Jackie Kimmell. Subscribe today and receive the latest insights from the country's leading Health System CXO experts regularly, helping you remain current and guide your health system strategy with thought leadership and success.The Health System CXO Podcast activates health system leaders towards outcomes and scalable solutions you can implement now.About The Health Management Academy:Since 1998, The Health Management Academy has cultivated the premier community of healthcare's most influential changemakers from the top U.S. health systems and innovative industry partners. We power more than 2,000 health system senior executives and 200 industry organizations through exceptional peer groups, original market insights, world-class leadership development programs and novel member alliances. Our industry-leading programs and solutions enable members to facilitate meaningful relationships, navigate strategic transformation and address critical industry issues. To learn more, visit hmacademy.com and follow The Health Management Academy on ...

Show NotesWhy traditional healthcare marketing has failed seniorsThe reemergence of Senior Solutions Advisors — and why they matter now more than everThe hidden costs behind "free" placement services like A Place for MomHow healthcare leaders can (and should) show up in the fieldReal stories about system failures — and how to fix themA peek into the future of Hospice, sitter services, and customized care at scaleHow title changes shift culture, mindset, and mission www.YourHealth.Org

Balancing Mission and Margin in Healthcare: A Candid Conversation with Dr. Ben Schwartz In this episode, host Stacey Richter engages in a deep dive with Dr. Ben Schwartz to explore the phrase 'No Margin, No Mission' and its practical implications in the healthcare industry.  They discuss the complex relationship between profitability and mission-driven care, the challenges of value-based care, and the role of dyad leadership. The episode emphasizes the importance of transparency, regulatory measures, and trust in fostering a balance between mission and margin. Along the way, Dr. Schwartz shares insights from his new role at Commons Clinic and addresses broader systemic issues like regulatory capture and the subjective nature of defining value in healthcare. === LINKS ===

“Very often, doctors try to suppress what they feel or don't even have the vocabulary to describe their emotions,” says Professor Alicja Galazka of the University of Silesia, an observation based on decades of work with physicians to enhance their emotional intelligence and resilience. Galazka, a psychotherapist, psychologist, lecturer and coach, believes this deficit is rooted in part in a lack of instruction in the internal and external psychological dimensions of being a medical provider. “There is not enough space created in medical school for teaching and training students about how to deal with their own stress and all of the skills connected to building relationships with patients,” she tells host Michael Carrese. Those same skills are also critical to working effectively as a member of a care team, which is an increasingly common arrangement in hospitals and clinics. Galazka employs simulations, dramatic role-playing, mindfulness, Acceptance and Commitment Therapy and other methods in her work with an eye on increasing the emotional agility and sensitivity of her trainees and clients. Tune in to this thoughtful episode of Raise the Line to hear Galazka's ideas on how to reshape medical training, why she is a proponent of narrative medicine, and the merits of embedding psychologists on care teams as a resource for both patients and providers. Mentioned in this episode:University of SilesiaInternational Association of Coaching Institutes 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/raisethelinepodcast

This week on Faisel and Friends, we are discussing Advanced Primary Care: Investing in Happier and Healthier Patients. Faisel and Dan are talking with Dr. Jon Leizman, Chief Medical Officer at Premise Health.Our conversation explores navigating access to primary care, shifting the focus within a model of onsite employer-based healthcare, and addressing the role of policy in the future of the healthcare workforce.

Episode NotesWhy Matt refuses to buy fireworks (and how that's weirdly related to healthcare spending) Proactive medicine: Why it saves lives and moneyThe evolving role of Community Health WorkersThe “Russian Doll” structure of care teams at Your Health Primary Care A real-world story of proactive, connected careTrust & empathy: What we can learn from Navy SEALs & surgery teamsSelf-care in high-stakes healthcare environmentsHow AI isn't a threat—it's your newest team member Why peptides and prevention are shaping the futureLeadership insight: Building resilient, compassionate healthcare teams

In this episode, Carey Ketelsen, President of Virtix Health, joins Becker's Healthcare to discuss how payers are navigating and accelerating value-based care (VBC) strategies in 2025. From increasing revenue projections to the role of AI and data analytics, Carey shares insights into the opportunities and challenges shaping payer-provider collaboration. Tune in to explore how health plans can align technology, readiness, and long-term strategy to thrive in a shifting care landscape.This episode is sponsored by Virtix Health.

Continuing the NIC Chats series focused on value-based care, host Lisa McCracken welcomes Sarah Thomas — AgeTech advisor, and global innovator — for an illuminating deep dive into the transformative role of data and technology in senior living. Hear why value-based care demands a culture shift where data becomes a strategic asset, not just a compliance tool, and why embracing technology is an enabler for delivering personalized, predictive, and efficient care. Gain practical strategies for getting started with value-based care, such as focusing on one clinical area, building cross-functional teams, and choosing tech partners who understand both healthcare and senior living. Key takeaways include:The importance of integrating clinical, social, and engagement data for a 360-degree view of residentsHow predictive analytics and AI are shifting care from reactive to proactiveTips for vetting technology partners and aligning solutions with organizational goalsA vision for the future: smart rooms, digital biomarkers, and senior living communities as true clinical partners in the care continuumWhether you're a senior housing and care operator, investor, or tech innovator, this episode offers actionable advice and an inspiring roadmap for thriving in a rapidly evolving sector.Want to join the conversation? Follow NIC on LinkedIn.We want to hear from you! Let us know what you think of NIC Chats by giving us a review on Apple Podcasts, Spotify, or wherever you listen.

We keep saying we want value-based care. But why do most models still fall short?In this episode, I sat down with Hamad Husainy, a clinician-turned-HealthTech leader at PointClickCare, to explore the hidden reasons value-based systems collapse—and what it actually takes to build one that works.We unpacked why data timing, team collaboration, and cultural transformation—not just more tech—are essential to seamless care. Hamad brought real stories from the field and shared where most leaders miss the mark when scaling their care ecosystems.The question isn't: do you have the data? It's: are you using it at the right time, in the right hands, to prevent the wrong outcomes?If you've ever felt like your solution should drive better results but doesn't get traction, this is your inside look at what investors, payers, and care leaders want next.

Episode Highlights:Why the Fourth of July hits different for healthcare professionalsGrowing up in a military family and how it shaped Matt's valuesFireworks, peaches, and facility BBQs—holiday traditions in senior careReflections on government involvement in healthcare—what's working, what's notThe impact of Medicaid changes and how value-based care fits inWhy Disneyland ruined fireworks (and how to reframe your expectations)Key Takeaways:Celebrate your country and challenge the systems that need reformHealthcare professionals must have a seat at the policy-making tableValue-based care isn't perfect—but it's a step in the right directionReferenced:CMS Innovation CenterGilbert Peach FestivalFort Jackson fireworksKaty Perry's “Firework” (unfortunately, also now Matt's personal performance piece)

In this episode:Scott's thoughts from a recent trip to Key West and GeorgiaThe shocking gaps in primary care coverage in assisted living facilitiesReal examples of care breakdowns that led to avoidable hospitalizations—and even deathThe power of the Your Health model: 3 visits per week in facilities, 5 visits post-dischargeHow early, coordinated care reduces ER visits and saves millionsWhy United Healthcare is making a $122 million mistake—and how it could be avoidedThe role of respiratory therapy, PT/OT, and sleep studies in aging careWhy primary care should be the centerpiece of healthcare fundingKey takeaway:If it was your mom or dad, would once-a-month visits be enough? www.YourHealth.Org

In this episode of Quality Talks With Peggy O'Kane, NCQA President Peggy O'Kane has an energizing, constructive conversation with Dr. Will Shrank, a Venture Partner at Andreessen Horowitz.Will shares his vision for a more cohesive health care system that works based on aligned incentives, meaningful measurement of patient outcomes and savvy implementation of value-based care.Peggy and Will discuss:The ‘Systemness' Solution: Will emphasizes that while American health care has the right components—technology, talent and intent—it lacks the integration to make them work together. Systemness means aligning care delivery, data and incentives to function as a cohesive whole.Measurement Makeover: Current quality metrics often miss what matters most to patients and providers. Will calls for fewer measures that are focused on outcomes, not just process checks. Digital measurement can help, but fragmented data remains a challenge.Reimagined Reimbursement Prioritizes Primary Care: Will envisions a future where primary care providers take on meaningful financial risk for the cost and quality of care. This approach could help simplify incentives, foster collaboration with specialists and drive better outcomes.From Waste to Wellness: Health care wastes billions of dollars on administrative complexity. Meanwhile, prevention—arguably the most cost-effective strategy—struggles to gain traction due to delayed ROI. Will argues that aligning incentives around long-term health is essential to reducing waste and improving outcomes.Will concludes by assessing Medicare Advantage as a model of high-value care. Listen to the whole conversation for a warm, witty tour of quality's accomplishments and prospects.Key Quote:We just have to make this simpler. We've got to make it easy for doctors to do the right thing and to create the right relationships and to set the right paths.I think most people would agree a model where primary care docs have some meaningful accountability for the populations they serve would be better than what we have today.And if we as a system decided that's the direction we're going to go and make that the North Star, I think we in a much shorter time could get efficient, higher quality, and deliver better outcomes at lower cost, and deliver more equitable care for all Americans.”Will Shrank, MD Time Stamps:(01:06) A Systematic Approach to a Better Future(04:12) Challenges in Quality Measurement(09:24) Payment Models and Primary Care (13:55) Addressing Waste (24:49) Medicare Advantage and Value-Based Care(28:43) Peggy's Final Thoughts Links:Studies by Will Shrank (Google Scholar)Connect with Will

In this first episode in the NIC Chats series on value-based care, host Lisa McCracken, Head of Research & Analytics at NIC, sits down with Anne Tumlinson, CEO and founder of ATI Advisory, to demystify value-based care in the senior living sector. Together, they break down what value-based care really means and why it matters for operators and residents alike.  Tumlinson explains how senior living communities can leverage their unique environments to deliver better health outcomes and resident experiences, the importance of scale and partnerships, and the operational and financial considerations of implementing value-based care arrangements. The conversation also explores the evolving policy landscape, including new opportunities signaled by the latest federal strategies, and why the industry is at risk of falling behind.  Whether you're a senior living operator, care provider, or industry stakeholder, this episode offers timely guidance on embracing innovation and staying ahead in a rapidly changing healthcare environment. Want to join the conversation? Follow NIC on LinkedIn.We want to hear from you! Let us know what you think of NIC Chats by giving us a review on Apple Podcasts, Spotify, or wherever you listen.

"Older adults have this special clarity about who they are and what they want, which is incredibly inspiring," says Dr. Julia Hiner, explaining, in part, why she loves her work as a geriatrician in Houston, Texas. She also enjoys the challenge of the medical complexity these patients present and the opportunity it creates to see the patient as a whole person. In fact, as you'll hear in this upbeat conversation with Raise the Line host Lindsey Smith, there's almost nothing about geriatrics that Dr. Hiner does not enjoy, which explains her passion for teaching the subject at McGovern Medical School at the University of Texas Health Science Center in Houston and trying to convince more students to pursue it as their specialty.  The need is great, given that there are only 8,000 geriatricians in the US despite a rapidly growing senior population. Tune in to learn why Dr. Hiner thinks clinicians avoid the field and the steps that can be taken to improve the situation, including requiring courses in geriatrics. You'll also learn about the importance of capacity assessments, the troubling, and under-reported, problem of elder mistreatment, ageism among health professionals and much more in this super informative episode. Mentioned in this episode:University of Texas Health Science Center at Houston McGovern Medical School  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/raisethelinepodcast

Send us a textIs America's Healthcare System Beyond Repair?  Rita Numerof Doesn't Think So.In this powerful crossover episode of Anatomy of Leadership and TCNTalks, Chris Comeaux sits down with healthcare strategist and thought leader Rita Numerof, Co-founder and President of Numerof & Associates.  Together, they pull back the curtain on one of today's most urgent crises: the deeply flawed business model driving healthcare in America.Rita offers a bold diagnosis, explaining how misaligned incentives, opaque pricing, and outdated payment systems have derailed care.  But she doesn't stop there.  With clarity and conviction, she lays out a path forward: a market-based model that ties payment to performance, empowers consumers, and demands transparency and accountability from every player—from providers to payers to policymakers.The episode dives into:Why the current system resists change—and how to break throughThe role of technology in reshaping care deliveryHow insurance companies contribute to the dysfunctionWhat real consumer responsibility in healthcare could look likeRather than offering quick fixes, Rita champions systemic reform with optimism and urgency. 

Is America's Healthcare System Beyond Repair?  Rita Numerof Doesn't Think So.In this powerful crossover episode of TCNTalks and Anatomy of Leadership, Chris Comeaux sits down with healthcare strategist and thought leader Rita Numerof, Co-founder and President of Numerof & Associates.  Together, they pull back the curtain on one of today's most urgent crises: the deeply flawed business model driving healthcare in America.Rita offers a bold diagnosis, explaining how misaligned incentives, opaque pricing, and outdated payment systems have derailed care.  But she doesn't stop there.  With clarity and conviction, she lays out a path forward: a market-based model that ties payment to performance, empowers consumers, and demands transparency and accountability from every player—from providers to payers to policymakers.The episode dives into:Why the current system resists change—and how to break throughThe role of technology in reshaping care deliveryHow insurance companies contribute to the dysfunctionWhat real consumer responsibility in healthcare could look likeRather than offering quick fixes, Rita champions systemic reform with optimism and urgency. 

We're discussing Relationships and Community: the Fabric of Rural Health! Faisel and Dan are joined by Dr. Sonya Bruton: CEO and President of CCI Health Services, Clinical Psychologist, and Author.Our conversation revolves around the inherent link between physical and behavioral health, the necessity of physicians staying engaged with their passion for care, and the hesitancy of patients around AI in healthcare.

Dr. Brad Diephuis, COO & President of Thyme Care, joins Kellogg MBA student Joy Basinger to unpack how wraparound, value-based oncology care is transforming the cancer experience—especially for high-risk, MA populations. They explore how Thyme Care is going beyond the doctor's office to deliver proactive, tech-enabled symptom monitoring and reduce avoidable ER visits and hospitalizations.From standardizing care team workflows through the Thyme Box platform to deepening integration with partners like Oak Street Health, this episode dives into the value of structured, longitudinal support in oncology. Timestamps:00:00 Introduction to Thyme Care and Dr. Brad Diephuis04:57 The Thyme Care Model: Supporting Cancer Patients12:41 Technology Integration in Care Delivery20:15 Thyme Care's Business Model and Revenue Generation22:57 Measuring Outcomes and Quality of Care27:42 Focus on Medicare Advantage Population30:35 Partnerships and Collaborations in Value-Based Care (e.g., Oak Street)34:48 Future Growth and Service Expansion LinkedIn: Dr. Brad Diephuis, COO & President of Thyme Care⁠Joy Basinger, Kellogg MBA ('25)⁠ 

In this episode of the Move to Value Podcast, we take a deep dive into one of the most impactful updates in healthcare risk adjustment: the transition from CMS-HCC Version 24 to Version 28. Our guest, TaSonya Hughes, CHESS Health Solutions' Manager of Coding and Documentation Education, explains what the shift means for providers, coding teams, and care managers—and why now is the critical time to prepare.CMS-HCC Version 28 introduces new disease classification categories, retires thousands of existing diagnosis codes, and emphasizes greater specificity in clinical documentation. TaSonya walks us through how these changes affect Medicare risk adjustment, the financial sustainability of value-based care, and ultimately, the ability to deliver accurate, coordinated care for patients with complex chronic conditions.

NOTES00:01:08 – 00:04:30 Why continuous learning fuels credible leadership00:04:30 – 00:08:00 Emotional intelligence as the “second bottom line” in care00:08:00 – 00:11:30 The payer paradox: collaboration vs. competition00:11:30 – 00:14:45 Staying mission-driven when policies keep shifting00:14:45 – 00:18:40 Adaptability, AI, and the future of primary care00:18:40 – 00:22:10 Data as a conversation, not a conclusion00:22:10 – 00:27:30 Mentoring, apprenticeship, and building leadership pipelines00:27:30 – 00:33:00 Managing vs. leading: the rowboat and the horizon00:33:00 – 00:34:11 The leadership qualities that will matter most in the next decadeKey TakeawaysEmpathy and analytics aren't opposites—they're partners in better outcomes.True collaboration starts when incentives align around patient health, not billable units.Wearables and AI expand what we can measure; curiosity and compassion determine what we do with the data.Mentoring isn't a nice-to-have; it's the supply chain of future leadership.The next decade of value-based care will belong to leaders who balance curiosity, courage, and care. www.YourHealth.Org

"It was pretty apparent to me that something was going on with him," says Kristi Levine, describing the realization that, based on her experience as a Montessori teacher, her infant son, Trey, was missing developmental milestones. Unfortunately, Kristi's hunch turned out to be correct and Trey was later diagnosed with a rare genetic mutation called CACNA1A which is impacting his motor skills, balance, coordination and speech. Kristi and her husband, Eric, join host Michael Carrese on this installment in our Year of the Zebraseries to help us understand the disorder and its implications for Trey and their family, which includes Trey's older sister Stella.  “There's a lot of guilt involved in being a parent of a child who has a disability because you never feel like you're doing enough,” shares Eric, even though they both work full time and have becoming experts at juggling work, caregiving, advocating, and volunteering with the CACNA1A Foundation. In this candid interview, Eric and Kristi discuss the challenges of parenting a child with complex medical needs, the importance of community support, the ongoing search for treatment options, and share some advice for clinicians caring for patients and families living with rare disorders. “We just want medical professionals to respect and understand what we're dealing with on a day-to-day basis and to see our kids holistically, and not just try to fix the problem medically. Understand that for us, the biggest thing that we want for our kids is just their quality of life.”Mentioned in this episode:CACNA1A Foundation 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/raisethelinepodcast

Send us a textIn this episode we sit down with Alon Joffe, CEO of Israeli AI startup Eleos, for a fascinating deep dive into how behavioral health documentation is being revolutionized. What makes this conversation compelling is learning why Israel has become such a health tech powerhouse - with $1.2 billion in funding in 2024 alone and digital medical records dating back to the 1970s.Alon breaks down how his AI technology reduces clinical documentation time by over 70% for mental health workers dealing with 60-90 minute therapy sessions. The company now serves 20,000 clinicians across 34 states, focusing on the most underserved populations in behavioral health. They explore the stark differences between acute care and behavioral health tech needs, why companies like Epic struggle to cross that divide, and how AI agents are about to transform EMR integration. Plus, Alon shares the dramatic shift from pre-ChatGPT skepticism to today's reality where a quarter of US physicians are already using ambient AI tools.Timestamps:00:00:08 - Introduction and Welcome00:01:02 - Israeli Health Tech Ecosystem and Innovation Culture00:03:51 - Government Healthcare Systems and Innovation Frameworks00:06:09 - Value-Based Care vs Fee-for-Service Risk Models00:09:14 - Introduction to Eleos: Mission and Market Focus00:11:42 - Technology Differentiation and Competitive Landscape00:15:19 - Behavioral Health vs Acute Care System Differences00:16:01 - AI Agents and Job Automation in Healthcare00:18:03 - EMR Integration and the Future of Healthcare Interfaces00:20:12 - Epic's Market Evolution and Platform Strategy00:25:04 - Fundraising Experience and Series C Journey00:27:17 - Technology Evolution: Pre vs Post-ChatGPT Era00:33:53 - Future Plans and Expansion Strategy00:34:57 - Closing Remarks and Final Thoughts

Key Topics Discussed:The philosophy of care behind RPM How RPM empowers patients and improves outcomes Common barriers for providers and patients—and how to overcome them The emotional and human impact of being “seen” through RPM Why RPM is essential for proactive care and value-based models How RPM strengthens patient-provider partnershipsWho Should Listen:Providers looking to elevate their standard of care Patients managing chronic conditionsCaregivers advocating for loved onesHealthcare leaders navigating the shift to proactive careTune in to hear why Jennifer believes every Your Health patient should be on RPM—and why the time to act is now. www.YourHealth.Org

In this episode of Voices of Otolaryngology, Rahul K. Shah, MD, MBA, AAO-HNS/F Executive Vice President and CEO, talks with Willard C. Harrill, MD, and David E. Melon, MD, in a conversation exploring succession planning and private practice evolution in otolaryngology. They share insights on leadership transition, building sustainable practice models, and navigating the shift to value-based care. The discussion covers recruitment strategies, practice diversification, and the unique challenges facing medium-sized ENT groups. They offer valuable guidance on dynamic scheduling, community engagement, and maintaining competitive advantage while transitioning from traditional fee-for-service models to comprehensive, coordinated patient care approaches.  Helpful Resources: Get Involved with OPPS: https://www.entnet.org/opps  Collaborate on ENT Connect: https://entconnect.entnet.org/home  Learn more about our Annual Meeting & OTO EXPO: https://www.entnet.org/events/annual-meeting/  AAO-HNS Business of Medicine: https://www.entnet.org/business-of-medicine/  More Ways to Listen: Spotify: https://open.spotify.com/show/3UeVLtFdLHDnWnULUPoiin  Apple Podcasts: https://podcasts.apple.com/us/podcast/voice-of-otolaryngology/id1506655333   Connect the AAO-HNS: Instagram: https://www.instagram.com/aaohns  X (Twitter): https://x.com/AAOHNS  Facebook: https://www.facebook.com/AAOHNS  LinkedIn: https://www.linkedin.com/company/american-academy-of-otolaryngology/  Website: https://www.entnet.org  Shop AAO-HNS Merchandise: https://www.otostore.org  Help Us Improve Future Episodes: Share your feedback and topic suggestions at https://forms.office.com/r/0XpA83XNBQ  Subscribe to Voices of Otolaryngology for more insights from leading voices in ENT. New episodes released every Tuesday.

This week on Faisel and Friends, we are discussing Innovations in Primary Care: Independent & Rural Practices. Dan moderates a panel discussion with Dr. Jim Lancaster, Sonya J. Bruton, Psy.D, Tim Gronniger, and Carrie Cochran-McClain, DrPH.Our conversation explores providing important care for small communities, solving the workforce shortage in rural practices, and addressing the financial barriers that independent practices face.This conversation was recorded live at Primary Care for America's annual event PrimaryCare25.

We have a special guest on today's episode whose voice will be familiar to regular listeners. Last year at this time, Dr. Raven Baxter occupied the Raise the Line host chair for a special ten-part series we produced in collaboration with the Cohen Center for Recovery from Complex Chronic Illness (CoRe) at Mount Sinai in New York City, where she serves as the Director of Science Communication. The series explored the latest understandings of post-acute infection syndromes -- such as Chronic Lyme and Long COVID -- with an array of experts from the Center and other researchers and providers. In this episode, we check-in with Dr. Baxter to get an update on the work of the Cohen Center, especially with regard to its mission to educate providers. “We're building programs so that clinicians can earn credit for learning about chronic illnesses that are infection associated, and we've also developed a 200-page provider manual. I really think that we will be able to shift the narrative that currently exists,” Dr. Baxter tells host Michael Carrese. That narrative includes lingering skepticism among providers of some infection-associated illnesses, which Dr. Baxter witnessed herself as a Long COVID patient, an experience that has added meaningful perspective to her work. Dr. Baxter is also working on her own time to advance knowledge and combat misinformation through a robust social media presence as “The Science Maven” and helps other scientists and clinicians to do the same. "If we're not there to fill in that void, other people will fill it for us and the narrative may not be consistent with the truth or facts." This is a great opportunity to learn about the art and science of communications that can reach clinicians and patients alike.Mentioned in this episode:Cohen Center for Recovery from Complex Chronic IllnessThe Science Maven 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/raisethelinepodcast

Both CMS and value-based healthcare systems are increasingly leveraging data and enhanced communication to transition patients out of acute care more efficiently, support successful post-acute recovery, and reduce readmissions. In this video, Phyllis Wojtusik, RN, Executive Vice President of Value-Based Care at Real Time Medical Systems (Real Time), outlines the key components of an effective care transition process – and how Real Time's data-driven solution and interventional analytics help enable smoother transitions and improved outcomes.Check out our interview with Phyllis Wojtusik from Real Time to learn more about the CMS TEAM model – and how acute and post-acute providers can better coordinate care for improved patient outcomes.Learn more about Real Time Medical Systems: https://realtimemed.com/Health IT Community: https://www.healthcareittoday.com/

In this episode of the Becker's Healthcare Podcast, Erika Spicer Mason is joined by Linda Bedwell of Powder River Surgery Center and Dana Jacoby of Vector Medical Group to discuss the evolving role of ambulatory surgery centers (ASCs) in value-based care. The conversation explores how physician alignment, data-driven strategies, and innovative care models are enabling ASCs to deliver longitudinal, patient-centered care—despite challenges like staffing shortages and low reimbursement rates. Tune in for insights on building sustainable, risk-aware strategies that move beyond fee-for-service and deliver measurable outcomes.This episode is sponsored by Vector Medical Group.

Flashback episode in honor of Hinge Health's IPO this week. In the episode, Jacob and Nikhil sit down with Daniel Perez, the Co-Founder and CEO of Hinge Health, a digital clinic for patients with joint and muscle pain. They discuss Hinge Health's strategy for selling to employers, how digital health solutions can reach and retain users, the role of software x hardware in disrupting healthcare, and more. (0:00) Intro(2:34) The Evolution of Employer Health Solutions(4:03) Challenges and Strategies in Digital Health(7:07) Focus on Musculoskeletal Care(9:51) Engaging and Retaining Patients(16:17) Marketing and Awareness Strategies(19:31) The Role of Independent Validators(22:27) Clinical Validation and R&D Excellence(23:04) Healthy Competition and Market Differentiation(23:59) Product Superiority and Customer Validation(26:05) Team Dynamics and Tough Decisions(29:49) Future of Hinge Health and Healthcare Automation(31:44) AI and Technology Integration(36:18) Hardware Innovations and Market Impact(39:19) Value-Based Care and Outcome Guarantees(41:14) Regulatory Challenges and Innovation Constraints(43:38) Closing Thoughts and Entrepreneurial Advice Out-Of-Pocket: https://www.outofpocket.health/

We're discussing Addressing the Chronic Disease Crisis: The Foundation of Making America Healthy! Faisel moderates a panel discussion with Dr. Wayne Jonas, Dr. Kate Goodrich, Dr. Joseph B. Brodine, and Peter Shin, PhD.Our conversation revolves around incentivizing primary care as a viable career for physicians, optimizing processes to unburden patients, and collaborating on multidisciplinary teams for whole-person care.This conversation was recorded live at Primary Care for America's annual event PrimaryCare25. 

CMS Changes and the Future of Value-Based CareJennifer Houlihan and Jennifer Gasperini of Advocate Health discuss the impact of new CMS and CMMI leadership, current challenges in value-based care, and the future of ACOs, ECQMs, and Medicare Advantage. A timely conversation for anyone navigating the evolving policy landscape.Welcome to the Move to Value Podcast, powered by CHESS Health Solutions.In this episode, we're joined by Jennifer Houlihan, Vice President, and Jennifer Gasparini, Director of Policy, from Advocate Health's Population Health Team. Together, we unpack the implications of the recent administration change, explore what new leadership at CMS could mean for value-based care, and hear their perspectives on the legislative priorities they hope to see take shape.Thomas Royal Jennifer Houlihan, Jennifer Gasparini, welcome to the move to Value podcast.Jennifer GasperiniThanks for having us.Jennifer Houlihan Happy to be here.Thomas Royal So you both just attended the NAACOS conference?Can you tell us what are some of the hot topics that folks were talking about?Jennifer GasperiniI can get us started.I think it's always great to see colleagues at the NAACOs conference and was also great to see Kim Brandt, who is the deputy administrator and COO at CMS, come and share some of Doctor Oz's priorities. For CMS and I think a lot of those priorities align really well with value based care. So they they really spoke a lot about tackling fraud and abuse. And as you know, ACOs are really the early identifiers of fraud.And so really was pleased to see them talking about that and also using technology and better data really for beneficiaries and providers to advance care. And I think ACOs obviously are very focused on that goal as well.Jennifer, do you have anything else to add there?Jennifer Houlihan Yeah. There, in addition, there were some really good sessions on the new team model, the transferring Episode Accountability model as well as guide and a lot of thoughtful conversation around how to integrate these models into the ACO and a clearer path for outcomes there. So I think there was a great discussion and got to give kudos to Jennifer. She was part of a really well attended and fantastic panel on how ACOs are adapting ECQMs and MIPCQMs and some of the kind of demands and multiple issues that are impacting ACOs on how to do all payer adjustments leveraging some of these requirements. So a lot of really timely topics and I think then the kind of final was Specialty Care integration, I think continued to be a recurring topic that we need to think more deeply about that and and how those get nested within cost, so hopefully we'll see more about that in the future.Thomas Royal So there is new leadership in place at HHS, CMS and CMMI.What does NAACOS think this might signal for the future of value-based care?Jennifer HoulihanSure, I I can. I can jump in on that one first, so I think you know, looking at Abe Sutton, you know, as as Jennifer mentioned, Kim Brandt was there from CMS. But we've also seen with Abe Sutton's appointment, who's been a strong supporter of value-based care. I think the mood was mostly positive, that there has been sort of a lot of statements, whether it's in some of the confirmation hearings, or direct statements that value-based care and the need to achieve savings is is one of the priorities. I think there's gonna be some different thinking about more aggressive requirements for more savings and as as as we've seen already, some of the model review that's already taking place. The ability to kind of end models early if they're not achieving the outcomes and the savings. So I think the mood in...

Dhrooti Vyas, Co-founder at a value-based care startup and expert in healthcare incubations at Primary VC, joins the podcast to share her perspective on what makes a healthcare startup truly impactful. She discusses foundational best practices for early-stage companies and emphasizes the importance of delivering real value to communities, specifically through her work with Crosswalk. Dhrooti also reflects on her personal experiences with the emergency department and how they revealed major issues in primary care—sparking efforts to connect EMS systems more directly with health insurance providers to close care gaps.

In this episode of the Becker's Healthcare Podcast, Erika Spicer Mason speaks with Brian Workinger and Lauree Handlon of The Craneware Group about how AI and data-driven insights are helping providers navigate increasingly complex payer contracting and reimbursement environments. The conversation covers predictive modeling, payer transparency, and preparing for shifts in Medicare Advantage participation, all within the broader context of value-based care. Tune in to hear how hospitals can leverage advanced analytics to drive smarter financial strategies and improve long-term sustainability.This episode is sponsored by Craneware.

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

Show Notes: Ami Parekh discusses the business model and services of Included Health, a company that provides personalized healthcare. Included Health partners with self-insured employers and health plans to improve the way working Americans and their families receive healthcare.  Included Health Services  About a third of Fortune, 100 companies, and 10 million Americans have access to Included Health's services. The company focuses on providing access answers and advocacy as people engage in the healthcare system. The company has nearly 3000 people, including 1000 clinicians across the country, including primary care doctors, specialists, nurse practitioners, and therapists. Additionally, hundreds of care advocates help patients understand the ins and outs of the healthcare system. Many patients come to Included Health because they can't get access to primary care and behavioral health, which can take one to two months across most of the country. The company aims to address this supply problem. Navigating the Healthcare System Ami talks about the role of Included Health in helping patients navigate the healthcare system, focusing on personalized and best-for-the-patient approach. She explains how it can help patients navigate their insurance and coverage options. She also covers the use of data and data science to match patients with the highest quality healthcare professionals for specific requirements, such as orthopedic surgeons or specialists. Ami emphasizes that Included Health are not plans or payers, but providers who work with a wide field of providers, and their job is to help patients achieve the best outcomes within the current healthcare system. Accessing Quality Data in Healthcare The conversation turns to the concept of quality data in healthcare, how it is crucial to consider the quality of care and the likelihood of repeat surgeries, and the issue of inappropriate prescribing behavior, such as the use of opiates and benzodiazepines, which can be addictive. Ami explains how Included Health accesses and uses data, and how collected sanctioned data can help determine if a provider is safe for family members to see. Ami emphasizes that data is never perfect, and in the worst case scenario, patients can consult with clinicians to find the right doctor. The data can help inform conversations about who to see, and Included Health offers support in finding publicly available data sources and the right practitioner. She highlights the need for better data and collaboration between healthcare providers and patients to improve patient outcomes and overall healthcare quality. Improving Healthcare Pricing and Cost Employers typically pay for Included Health as a layer on top of their health plan, as they want their employees to be healthy, productive, and engaged members of their workforce. They also want healthcare costs to remain low so that they can pay their employees a living wage and invest in other benefits. Healthcare is often the number two cost after supplies in America, and employers want their employees to be healthy, productive, and engaged. Included Health offers a way to give healthy days back to employees by reducing the number of days they are unable to be healthy due to mental or physical health reasons. This results in increased productivity, better work performance, and overall cost savings. There are two dimensions to using included health services: first-time care and saving time. First, employees get the right care the first time, which can lead to cost savings. Second, health plans are incentivized to offer support to their patient population, as they are paying for it. Third, Included Health helps find providers quickly, saving employees time and freeing them up to focus on the healing process and family. Furthermore, Included Health provides access to primary care doctors, which is crucial for long-term cost savings and better health. How Included Health Works Included Health has about 1500 clinicians available for virtual appointments, including behavioral health providers. The app allows users to schedule appointments within a week, ensuring choice and quick access to healthcare services. Technology has brought about broader trends in the industry, such as value-based care and making things easier to access. The cost of healthcare is increasing by seven to 10% year over year, making it unsustainable for the American population. Employers, who are often the purchasers of healthcare, are seeking better solutions to control healthcare costs. They are trying to do this through products and services, creating new networks, and focusing on wellness. The trend is driven by employers and the government, as well as insurance companies. Included Health fits into this trend by reducing total care costs and prioritizing the member experience. By being a one-stop shop for patients and members, employers can experiment with different services without disrupting the member experience. This allows them to work with the growing trend of cost-cutting and value-based care in the healthcare industry. Included Health's Clients and Pricing Structure  The pricing structure for the company is custom, client-by-client, and depends on the population being served. The company does not have a per-head pricing structure, but rather on a population level. Performance guarantees are part of the pricing model, which includes up-operation and delivery of savings.The company has started participating in shared savings models with CalPERS, which allows California employees and their dependents access to their services. Payers see the company as a provider for their members, and they believe that these models are helping them achieve better outcomes for patients. Included Health mostly focuses on larger enterprise and jumbo clients, with 33 of the Fortune 100 companies being clients. Smaller clients also receive good results from the company. The Role of AI in Healthcare Ami discusses the use of Telehealth in healthcare. She mentions her parents as an example of how they could do more virtually than they are today. Ami also discusses the role of AI in healthcare, stating that, by providing tools that can help healthcare workers it is a beneficial tool.  AI has been used in healthcare for therapy, diagnosis, and diagnosis, with 20% of conversations being healthcare-related. She is excited about the potential of AI in healthcare. Member-facing AI can answer basic health insurance questions and provide guidance on insurance deductibles and costs. Included Health ensures all of their AI services are supported by humans, whether on the clinical side or on the care team side, to ensure a human is available to the customer when needed.  Ami believes that AI will be a tool that supports the human workforce in healthcare, making their jobs easier and allowing them to do more for the members. Over the next year or two, AI will play a significant role in healthcare, with AI helping navigate systems, schedule calls, and provide better access to care for patients. Timestamps: 01:22 Included Health's Services and Impact 03:22: Navigating the Healthcare System  07:20: Challenges and Solutions in Healthcare Data  14:29: Employer and Health Plan Perspectives  21:33: Value-Based Care and Pricing Structure  27:21: Health Plan and TPA Relationships  32:41: Role of AI in Healthcare  Link:  https://includedhealth.com/   Unleashed is produced by Umbrex, which has a mission of connecting independent management consultants with one another, creating opportunities for members to meet, build relationships, and share lessons learned. Learn more at www.umbrex.com.

In today's episode of Value-Based Care Insights, host Daniel J. Marino sits down with Dr. Amit Jain, MD, MBA, Associate Professor of Orthopedic Surgery and Neurosurgery, Chief of Minimally Invasive Spine Surgery at Johns Hopkins, and Director of Value-Based Care for Johns Hopkins Health System. Together, they unpack how organizations can reduce costs while improving performance outcomes such as length of stay and readmission rates—ultimately advancing their value-based care strategy. Explore expert insights on aligning surgical services with cost-effective, high-quality care delivery.

On this episode of “Raise the Line” we welcome Dr. Sheldon Fields, a trailblazer in the nursing field and the president of the National Black Nurses Association. In a candid conversation, Dr. Fields shares his inspiring journey from the bedside to becoming a prominent figure in nursing, HIV/AIDS prevention and academia and also shares the challenges he faced as a Black man in a predominantly white and female field. "I fell in love with a profession that has not always loved me back," he tells host Kelsey Lafayette. Dr. Fields brings over thirty years of experience as an educator, researcher, clinician, administrator, consultant, health policy specialist, and entrepreneur to his current role at NBNA, and as the inaugural associate dean for equity and inclusion at the College of Nursing at Penn State University, where he also serves as a research professor. Listeners will find Dr. Fields' insights on navigating a career in healthcare particularly valuable, as he stresses the importance of resilience, continuing education, and mentorship. It's a compelling listen for anyone interested in the intersection of health, policy, and social justice.Mentioned in this episode:National Black Nurses Association 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/raisethelinepodcast

Nurses aren't just at the bedside—they're in boardrooms, legislatures, and labs. In this episode, Ajay Mody and Asher Perzigian sit down with Dr. Allison Norful of Columbia University and Summer Davis of the Ohio Association of Advanced Practice Nurses to unpack how nurses are reshaping healthcare. From navigating towards full practice authority to driving policy and tackling mental health, this conversation reveals the untapped power of nursing leadership in a rapidly evolving system. Part of The Heart of Healthcare series—where the future of medicine gets personal.

Ep 127 - Dr. Jain- Improving Perioperative Services to Enhance Value-Based Care Exploring one of the most significant drivers of total cost of care: surgical and perioperative services. With surgical services accounting for up to 70% of a hospital's revenue, inefficiencies in the OR can have a profound impact on both financial and clinical outcomes. On this episode Dan sits down with Dr. Amit Jain, Associate Professor of Orthopedic Surgery and Neurosurgery and Chief of Minimally Invasive Spine Surgery at Johns Hopkins. Dr. Jain also serves as Director of Value-Based Care for Johns Hopkins Health System. Together, they unpack how organizations can reduce costs while improving performance outcomes such as length of stay and readmission rates—ultimately advancing their value-based care strategy. Tune in for expert insights on aligning surgical services with cost-effective, high-quality care delivery. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Farzad Mostashari, founder & CEO of Aledade and the former National Coordinator for Health IT, to the pod to break down insights in the latest MedPAC report, quality measurement reform, and areas of opportunity for value-based care.Health Affairs is hosting an Insider exclusive event on May 29 focusing on the FDA's first 100 days under the second Trump administration featuring moderator Rachel Sachs alongside panelists Richard Hughes IV and Arti Rai.Related Links:Crossing the Chasm: How to Expand Adoption of Value-Based Care (The New England Journal of Medicine)2025 MedPAC Report Subscribe to UnitedHealthcare's Community & State newsletter.

This episode of the Astonishing Healthcare podcast with Dr. Sunil Budhrani (Chief Innovation & Medical Officer) highlights the transformative potential of Judi Health™, the first Unified Claims Processing™ platform offering a combined medical and pharmacy benefit experience (with vision and dental soon to follow)! Why is unifying claim administration necessary to reach a value-based world? Well, everyone has been talking about VBC for years, and it's proved to be an elusive target. On Episode 7, Dr. Budhrani explained why pharmacy must be included in the equation along with providers, patients, and payers, and today we go a level deeper, explaining why "everything" - all the patient's data - must be in one system to be able to achieve better health outcomes at a lower cost. On AH054 - Judi Health™: Going Beyond Pharmacy and into Medical Claims, with AJ Loiacono and Dr. Sunil Budhrani, we revealed what we're doing and why.Today, Sunil discusses our experience thus far - 5 months into our unified claims experience - and the importance of flexibility in plan design to achieve a plan's goals. He also explains how Judi Health helps to empower providers and the provider-patient relationship via a "transparent architecture." What should the experience be like for patients? How about the plan sponsor/HR team side of the equation? Tune in to find out and hear why Judi Health represents an "opportunity to see - and achieve - what many people in healthcare say cannot exist" (hint: it's a win for all stakeholders). Related Content:Judi Health™ Earns Best Healthcare InsurTech Solution in the 9th Annual MedTech Breakthrough Awards ProgramCapital Rx Unveils Healthcare's First Unified Pharmacy and Medical Claims Processing PlatformAH058 - Building Judi®, the Healthcare Infrastructure of the Future, with Liya LomsadzeReplay - Build a Lasting Pharmacy Benefit Strategy with Never Move Again™Setting a New Standard for the Future of Pharmacy Benefit AdministrationFor more information about Capital Rx and this episode, please visit Capital Rx Insights.

This week on Faisel and Friends, we are discussing Connecting Back to Care: Reimagining Maternal Health. Faisel and Dan are talking with Dr. Esa Davis: Associate Vice President for Community Health at University of Maryland School of MedicineOur conversation explores navigating challenging medical situations, creating an environment where patient voices matter, and looking towards a psychologically safe future in healthcare.Dr. Esa Davis is a Vice Chair of the US Preventive Services Task Force (USPSTF) and the materials expressed in this podcast reflect her individual views only and do not represent the views or recommendations of the USPSTF.  The overall presentation should not be attributed to the USPSTF.

Elligint Health provides a toolset outside of the electronic medical record to help organizations perform value-based care arrangements. In this episode, Chris Caramanico, CEO of Elligint Health, discusses how his organization is helping drive change in healthcare delivery. He shares insights into how their solution creates proactive workflows to affect patient outcomes, emphasizing the importance of data-driven decision-making and patient activation. Chris also shares that their platform provides analytics, care management tools, and communication solutions to improve patient outcomes and drive efficiency. Finally, he touches on emerging trends in healthcare technology, particularly the role of AI and interoperability, and how Elligint Health is addressing these needs. Tune in and learn how Elligint Health is transforming healthcare with its integrated approach to value-based care, analytics, and patient activation! Resources: Connect with and follow Chris Caramanico on LinkedIn. Learn more about Elligint Health on their LinkedIn and website.

Join hosts Asher Perzigian and Ajay Mody as they welcome Carolyn Jones, a renowned filmmaker and advocate for healthcare workers, to discuss the vital, yet often unrecognized, contributions of nurses. In this episode, Carolyn shares powerful stories from her film "American Delivery," highlighting the impact of the wholistic care nurses offer their patients. Carolyn, a brilliant storyteller, offers a unique perspective on the daily challenges and triumphs of these healthcare heroes, showcasing their technical expertise and unwavering compassion. Kicking off our Nurses Month mini series, The Heart of Healthcare, this episode is a timely reminder of the expertise and compassion that nurses bring to our communities each day. Tune in to explore the incredible work of these dedicated professionals and their crucial role in shaping the future of healthcare.

We're honored to continue our global tour of medical education today with Professor Katarzyna Taran, MD, PhD, a pioneering interdisciplinary researcher of tumor cell biology, an award winning educator noted for her focus on student engagement, and -- in a first for a Raise the Line guest -- a shooting sports certified coach and referee. As Professor Taran explains to host Michael Carrese, these seemingly disparate professional activities require the same underlying attributes: patience, the ability to overcome barriers, openness and adaptation. She believes those last qualities are especially important for today's medical students to acquire given the accelerated pace of change in healthcare. “They need to be equipped with the ability for critical thinking, to analyze and synthesize, and to search for unconventional solutions.” Professor Taran tries to impart these skills, in addition to the medical and scientific knowledge students must know, through a high level of engagement. “Teaching is relational, so try to be familiar with students' concerns. Talk to them, listen to them and you will become someone they trust.” In this wide-ranging and engaging conversation, Professor Taran also discusses her work as the head of the Laboratory of Isotopic Fractionation in Pathological Processes in Chair of Oncology, the use of neurodidactics in teaching, and the connection between the science of pathology and the future of humans in space. Mentioned in this episode:Medical University of Lodz 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/raisethelinepodcast

As major healthcare payers, employers can drive value-based care, health equity, and innovative models to improve outcomes and cut costs. In this episode, Dan Mendelson, CEO of Morgan Health, discusses how employers, as significant healthcare payers, can play a pivotal role in demanding and implementing quality care models. He dives into the impact of primary care innovations, tackling health equity. Dan talks about the critical need for actionable data in transforming healthcare delivery. Dan also mentions how Morgan Health helps close the gaps by putting primary healthcare services close to their employees.  Tune in and uncover how employers can revolutionize healthcare delivery through value-based care, health equity initiatives, and innovative small business solutions!  Resources: Connect with and follow Dan Mendelson on LinkedIn. Follow Morgan Health on LinkedIn and visit their website.

This episode of Relentless Health Value features Dr. Kenny Cole from Ochsner Health System. The discussion emphasizes the critical role of trusted relationships and excellent primary care teams in keeping patients out of the emergency room, thus reducing healthcare costs. Stacey Richter revisits this conversation to highlight the importance of care teams building trust with patients and the concept of primary care as an investment in health and wellness. The episode outlines four key points for delivering great primary care, including accountability for outcomes, belief in clinical goals, standardized care flows, and building patient trust. Dr. Cole also discusses the real-world challenges and strategies for achieving clinical and financial success in primary care. The episode serves as a guide for plan sponsors, clinicians, and healthcare executives looking to improve primary care delivery and align it with financial viability. The discussion is further enriched with insights on digitizing care pathways and the importance of measuring and sharing best practices to achieve high standards of care.I Stacey revisits, in a take two, this episode with Dr. Kenny Cole because she's listening to it this time with a new focus. That focus is the theme that keeps coming up over and over and over again on Relentless Health Value these past few months. === LINKS ===

We're discussing From Pain to Purpose: Transforming Trauma into Healing! Faisel and Dan are joined by Dr. Jeff Brenner: CEO at The Jewish Board.Our conversation revolves around the unexpected findings regarding coordinated care, the reality of medicalizing social issues, and the importance of timely empathy in mental and behavioral health.