Podcasts about value based care

With decades of experience in senior living, Greg Roderick, CEO of Frontier Senior Living, joins the show to discuss the industry's comeback from COVID-19 and the future benefits of value-based care. From repurposing buildings to new development, this episode is packed with valuable insights.Sponsored by Aline, NIC MAP, Procare HR, Sage, Hamilton CapTel, Service Master, The Bridge Group Construction and Solinity. Produced by Solinity Marketing.Become a sponsor of the Bridge the Gap Network.Connect with BTG on social media:YouTubeInstagramFacebookTwitterLinkedInTikTokMeet the Hosts:Lucas McCurdy, @SeniorLivingFan Owner, The Bridge Group Construction; Senior Living Construction Renovation, CapEx, and Reposition. Joshua Crisp, Founder and CEO, Solinity; Senior Living Development, Management, Marketing and Consulting.

Ryan Daniels, William Blair's group head of healthcare technology and services, returns to discuss the accelerating transformation of specialty care in the face of rising acuity, delayed diagnoses, and regulatory shifts. From bundled payments to AI-driven coordination, this episode explores how providers and investors are reshaping oncology, cardiology, and other high-impact disease states.

In this episode, Robin Roberts of PointClickCare and Dr. Jennifer Brady of Advocate Health discuss the evolving landscape of value-based care, the role of technology in creating meaningful patient moments, and strategies to make care delivery more efficient and impactful for providers and patients alikeThis episode is sponsored by PointClickCare.

“We've been able to show that even by 30 days of age, we can predict with some accuracy if a child is going to have a diagnosis of autism,” says Dr. Geraldine Dawson, sharing one of the recent advancements in early diagnosis being aided by artificial intelligence.  Dr. Dawson -- a leading scholar in the field and founding director of the Duke Center for Autism and Brain Development – explains that an AI examination of a child's pattern of visits to medical specialists in its very early life is an objective diagnostic tool that can supplement the current subjective reports from parents which vary in reliability. Another objective diagnostic tool in development uses a smartphone app developed at Duke that takes video of babies watching images and applies AI-aided Computer Vision Analysis to measure for signs of autism. This enlightening Raise the Line conversation with host Lindsey Smith is loaded with the latest understandings about Autism Spectrum Disorder including advancements in early therapeutic interventions, the interplay of genetic and environmental factors, and the role of the mother's health and exposures during pregnancy. You'll learn as well about what Dawson sees as necessary societal shifts in how autism is perceived, the numerous factors contributing to a near tripling of diagnoses over the past two decades, and how early intervention and informed advocacy can make a meaningful difference in the lives of countless families.Mentioned in this episode:Duke Center for Autism and Brain Development 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

We're discussing Direct Primary Care: a Rising Tide for American Healthcare! Faisel and Dan are joined by Dr. Jeffrey Davenport, from One Focus Medical and Direct Primary Care Alliance.Our conversation revolves around recent policy changes in favor of DPC, timely momentum in the alternative care model movement, and finding physician satisfaction after burnout.This episode was recorded live at FUTURE, the AAFP's annual conference! Learn more about FUTURE here: https://www.aafp.org/events/future-conference/2026.html

"Burnout and trauma are not mental illnesses. They live in your physiology. They live in your biology. They live very specifically in your nervous system,” Dr. Rola Hallam says with a conviction rooted in her own successful journey to overcome the effects of chronic stress she accumulated during many years on the frontlines of humanitarian crises in Syria and other conflict zones. Out of concern for the multitudes of health professionals who, like herself, spend years carrying the weight of their traumatic experiences without seeking help, or who pursue ineffective remedies for relieving it, Dr. Rola -- as she's known – has shifted her focus to being a trauma and burnout coach. Among her offerings is Beyond Burnout, a twelve-week program that includes multimedia content as well as live coaching and teaching about developing nervous system awareness and regulation. “Most wellness initiatives fail because they're not rewiring the nervous system to come out of survival mode and back into what is called the ventral-vagal state, which is our state of social connection and of healing and repair.” She also stresses that healing is not an individual pursuit, especially for providers who work in a relational field, and teaches about the benefits of borrowing from a colleagues' state of calm and offering them the same. Don't miss this insightful and giving conversation with host Lindsey Smith that covers Dr. Rola's wrenching experiences providing care in desperate conditions, the critically important distinction between empathy and compassion, and how empowering frontline workers to heal their trauma can uplift individuals and empower entire communities. Mentioned in this episode:Dr. Rola CoachingBeyond Burnout AssessmentCanDo - Humanitarian Aid 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

In this episode, Laura Dyrda, Vice President and Editor-in-Chief at Becker's Healthcare, shares insights on the financial trends shaping hospitals, the growing role of AI in health systems, and strategies for advancing value-based care amid ongoing industry challenges.

In this episode of Healthcare Americana, host Christopher Habig talks with Dr. Shannon Decker, CEO of VBC One, about what value-based care (VBC) really means and how it differs from traditional fee-for-service models. Dr. Decker explains that VBC focuses on prevention, quality measures, total cost of care, and accurate risk adjustment. She discusses payment approaches like capitation with quality bonuses and highlights the practical needs for success, including strong EMR documentation, risk coding, clinician and patient engagement, interoperable data, and effective workflows. The conversation also covers pitfalls such as underreported chronic conditions, challenges with global risk contracts like ACO REACH, and the importance of contract protections and ongoing education. Dr. Decker emphasizes that with the right systems and trust between clinicians and patients, value-based care can improve outcomes and reduce costs, but it requires careful planning and implementation.More on Freedom Healthworks & FreedomDoc HealthSubscribe at https://healthcareamericana.com/More on Dr. Shannon Decker & VBC OneFollow Healthcare Americana: Instagram & LinkedIN

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Senior Editor Leslie Erdelack back to the pod to discuss the proposed rule change to the Medicare Physician Fee Schedule for 2026, which includes payment conversion factors for doctors, alternative payment models, add-on codes for Advanced Primary Care Management services, a new mandatory value-based payment model, and more.Order the August 2025 issue of Health Affairs.Join us for a live taping of A Health Podyssey on Tuesday August 12 where Rob Lott will discuss recent findings about changes in clinician's participation across Medicare value-based payment models with Kenton Johnston.Upcoming Events include:8/20: 340B w/ Sayeh Nikpay (INSIDER EXCLUSIVE)8/26: Provider Prices in the Commercial Sector: Independent Dispute Resolution (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)View all Upcoming Events.Become an Insider today to get access to exclusive events like the ones highlighted above.Related Articles:PRESS RELEASE: Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule (CMS-1832-P)CMS proposes rule aligning Medicare physician payment with ‘Big Beautiful Bill,' MACRA (Healthcare Dive)CMS proposes 3.6% pay bump for docs, takes aim at chronic conditions in physician fee schedule (Fierce Healthcare)Physicians will see Medicare payments rise in 2026 (AMA)Medicare proposes ‘efficiency' pay cuts that would hit highly paid specialists the most (STAT News) Subscribe to UnitedHealthcare's Community & State newsletter.

“Seeing that you can get through the most difficult times in life, succeed, and then also return to your community and work in service to your community was a lesson that has stuck with me,” says Dr. Uche Blackstock, the Founder and CEO of Advancing Health Equity and our guest on this inspiring episode of Raise the Line with Osmosis from Elsevier. It was a lesson the Harvard-trained physician learned from her own mother – also a Harvard trained physician – who overcame poverty, sexism and racial bias to forge an inspiring path.  In her bestselling book, Legacy: A Black Physician Reckons with Racism in Medicine, Dr. Blackstock weaves her mother's remarkable story with her own and argues for systemic change in a healthcare system riddled with racially-biased practices and policies that impact patient outcomes. As she explains to host Lindsey Smith, Advancing Health Equity's work to drive measurable and sustainable change is focused on embedding equity as a core value in the leadership, strategy, and organizational practice of health systems. “We exist to challenge inequities, empower underrepresented communities, and help build a healthcare system where everyone can thrive.” Don't miss a thought-provoking conversation with a nationally respected voice that also addresses race correction factors that impact the care of Black patients, and the work required of health institutions to build trust in effected communities.Mentioned in this episode:Advancing Health EquityLegacy: A Black Physician Reckons with Racism in 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/raisethelinepodcast

This week on Faisel and Friends, we are discussing Beyond the Copay: DPC, HSAs, and the Politics of Change. Faisel and Dan are talking with Jay Keese: CEO of Capitol Advocates and Executive Director of the Direct Primary Care Coalition (DPCC).Our conversation explores meaningful changes to healthcare delivery, groundbreaking achievements in IRS policy, and advice for leveraging law to provide more personal patient experience and better outcomes.Learn more at www.dpcare.org

Mansoor Khan, like other health care transformers, wants AI to help clinicians “do the job better, faster, cheaper.” As CEO at Persivia, he recognizes that different types of AI are needed for different parts of the workflow. This is particularly true if you really want to address the challenge that Persivia is taking on, value based care in all its varieties.For instance, a physician's workflow probably begins with data intake, either from a patient interview or from incoming records. Natural language processing can be employed to structure the information.Next perhaps is risk stratification, for which predictive AI is appropriate.Data aggregation management, care management, quality management, cost utilization management, and risk management are all crucial tasks that require their own digital solutions.Learn more about Persivia: https://persivia.com/Health IT Community: https://www.healthcareittoday.com/

Episode Notes (Key Takeaways)Why "customer satisfaction" can be the wrong metric in healthcareWhat Scott learned from a meeting with JPMorgan Chase CEO Jamie DimonThe difference between perceived value and actual healthcare needsA candid story about overprescribing pain meds and the cultural shift requiredWhy the healthcare "customer" is more complicated than we thinkBreaking down Your Health's value-based care results: $75M savedThe danger of over-collaboration and inefficiency in care coordinationRealigning roles: Why community health workers need to drive proactive careYour Health's shift toward specialty divisions and wellness clinicsThe staggering ROI of early interventions: $1.1 million in bonuses justifiedWhy United Healthcare and others may be falling behind on data access www.YourHealth.Org

“Pandemics are a political choice. We will not be able to prevent every disease outbreak or epidemic but we can prevent an epidemic from becoming a pandemic,” says Dr. Joanne Liu, the former International President of Médecins Sans Frontières/Doctors Without Borders and a professor in the School of Population and Global Health at McGill University. You are in for a lot of that sort of frank and clear-eyed analysis in this episode of Raise the Line from Dr. Liu, whose perspective is rooted in decades of experience providing medical care on the frontlines of major humanitarian and health crises across the globe, as well as wrangling with world leaders to produce more effective responses to those crises and to stop attacks on medical facilities and aid workers in conflict zones. Firsthand accounts from the bedside to the halls of power are captured in her new book Ebola, Bombs and Migrants, which focuses on the most significant issues during her tenure leading MSF from 2013-2019.  The book also contains insights about the geopolitical realities that hamper this work, including lax enforcement of international humanitarian law, and a focus on national security that erodes global solidarity. Join host Lindsey Smith as she interviews this leading voice on our preparedness to meet the needs of those impacted by violent conflict, forced migration, natural disasters, disease outbreaks and other grave challenges. 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

In this episode, Dr. Rob Fields and Rebecca Grandy continue their conversation and focus on data. What's useful and what's a waste of time? What data truly drives value and why do so many predictive tools fall flat? You'll also hear practical strategies such as where to direct focus when resources are tight, how to build an ideal care team, and how to make your value-based programs sustainable—even in a broken fee-for-service world.

“As parents dedicated to getting a treatment for our children in their lifetimes, we have turned the rare disease drug development landscape upside down and created a new model,” says Nicole Johnson, co-founder and executive director of the FOXG1 Research Foundation.  That's not an exaggeration, as the foundation is on track to make history as it begins patient clinical trials on a gene replacement therapy next year. The former TV news producer and media executive unexpectedly entered the world of patient advocacy and drug research after her daughter, Josie, was born with FOXG1, a genetic disorder which causes severe seizures and impedes normal movement, speech, and sleep among other problems. Johnson is also making an impact in another important dimension of the rare disease space in her efforts to educate parents, teachers, and students about disability inclusion through her Joyfully Josie book series and “Live Joyfully” education programs. Tune-in to this fascinating Year of the Zebra conversation with host Lindsey Smith to find out how the foundation is aiming to bring a drug to market in less than half the time and at a fraction of the cost than the industry standard, and how this model might impact research on other rare disorders. Mentioned in this episode:FOXG1 Research FoundationJoyfully Josie Book 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

We're discussing Taking Care: of Ourselves, Each Other, and Our System! Faisel and Dan are joined by Dr. Asaf Bitton, executive director of Ariadne Labs and Associate Professor of Medicine and Health Care Policy at Harvard Medical School and Harvard T.H. Chan School of Public Health.Our conversation revolves around innovating payment models beyond units, taking responsibility for patient needs beyond clinic visits, and efficiently connecting with patients and colleagues beyond bare necessity.

Episode Description: In this episode, Atlantic Health System, Intermountain Health, and Navina explore how AI is transforming value-based care by boosting financial resilience and improving outcomes. Learn how these organizations are: Enhancing risk adjustment and closing care gaps Reducing administrative burden through AI-augmented workflows Equipping teams with real-time insights to drive performance under VBC models From virtual medical assistants to smarter financial planning, this discussion offers actionable strategies for leaders across clinical, operational, and financial roles. Download the Episode Guide: Summarizing key insights and speaker highlights, this guide is your companion to the discussion. Download it to follow along and take away actionable strategies. Thank you to Navina for supporting this episode. Navina helps physicians thrive in value-based care with an AI-powered platform that turns data into actionable clinical insights. Learn how they're enabling smarter decisions, better care, and less burnout at www.navina.ai. How to Engage: Chat with Us: Share your thoughts with Producer Vekonda Luangaphay at vluangaphay@brightspotsventures.com  

In this second take on episode host Stacey Richter speaks with Dr. Tom Lee, founder of One Medical and Galileo. The discussion centers on the survival of independent primary care practices in the current healthcare economy, the associated challenges, and the paradox of primary care.  Topics include reducing ER visits, managing downstream specialty spend, and the imbalance between CMS and commercial carrier payments to primary care practices.  Dr. Lee highlights the importance of 'enlightened leadership' and a 'value-focused mindset' in balancing efficient service operations with quality care. He also touches on the complexities of integrating technology and human-centered care, the importance of operational efficiency, and the challenges posed by current reimbursement models. For a bonus sidebar conversation with Dr. Lee, click here. === LINKS ===

Today on Raise the Line, we bring you the unlikely and inspiring story of a woman who was afraid of blood as a child but became an accomplished nurse; who struggled with learning disabilities but became an effective educator; and who, despite lacking business experience or knowledge of graphics, built a successful company that produces visually rich educational materials for nurses and other providers. “I think the theme of my life has been I have struggled with learning, and I didn't want other people to struggle,” says Jennifer Zahourek, RN, the founder and CEO of RekMed which has developed a sequential, interactive learning system that includes illustrated planners, books, and videos used by millions of students and providers. The initial focus was to provide nurses with everything they needed to know from “the basics to the bedside” but RekMed now offers content for medics, respiratory therapists, medical assistants, and veterinarians as well. Driven by her belief in the power of visual learning and her “just freakin' do it” attitude, Jennifer overcame her fear of launching a business and quickly realized just how well nursing had prepared her for the hard work and unpredictability of entrepreneurship. “Nursing teaches you how to just be resilient, to pivot, to delegate, to work on a team and to handle high stress. I think nurses could literally be some of the best entrepreneurs on the planet,” she tells host Lindsey Smith. Tune in to this lively and valuable conversation as Jennifer shares lessons from bootstrapping a publishing company, insights on the evolving landscape of healthcare education, and advice on embracing change in nursing, especially with the expanding role of AI. Mentioned in this episode:RekMed 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

Host Keri Boyce continues a compelling conversation with Dr. Eric Weaver. Dr. Weaver, the newly appointed Executive Director of Bellin Health Partners, shares insights on the evolving role of case managers in value-based care. Building on his recent CM Learning Network webinar, this discussion dives deeper into how case management intersects with population health, health equity, and the future of accountable care. 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

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 ...

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.

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 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

"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

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.

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. 

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.

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.