Podcasts about valuebased

In this Bright Spots in Healthcare episode, host Eric Glazer brings together an all-star panel of leaders who are reshaping the future of Medicaid and social care. Our guests include: Vanita Pindolia, Vice President, Medicare Star Ratings, Emergent Holdings (BlueCross BlueShield Michigan) Jason Merola, MD, Chief Medical Officer, MVP Health Care Charlotta Eriksson, Lead Director, National VBC Partnerships (Specialty), Aetna Mary O'Connor, MD, Chief Medical Officer & Co-Founder, Vori Together, they explore: How Medicare Advantage plans are embedding Stars, CAHPS, and adherence metrics directly into provider contracts to drive accountability, improve quality, and sustain year-over-year performance gains. How payers like Aetna are expanding value-based care into specialty domains—from CKD and oncology to musculoskeletal and cardiology—by partnering with specialty-aligned organizations rather than converting individual specialists to risk models. How MVP Health Care is designing hybrid incentive structures that reward specialists for closing quality gaps and improving outcomes, without requiring full downside risk. Why MSK care is becoming pivotal to Stars success, as physical and mental health measures grow in weight through 2027, and how holistic, physician-led models are improving activity, satisfaction, and cost savings simultaneously. How digital-first specialty networks are solving access challenges, reducing “ghost network” exposure, and creating new opportunities for plans to meet CMS adequacy standards while improving the member experience. How collaboration across utilization management, Stars, and member experience teams helps avoid trade-offs, ensuring that cost controls don't come at the expense of satisfaction or CAHPS performance. Panelist Bios: https://www.brightspotsinhealthcare.com/events/stars-savings-and-satisfaction-unlocking-msk-and-specialty-care-strategies-for-medicare-advantage-success/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://drive.google.com/file/d/1a_rX23Ev5VRrJKqb8_UwAYBd9tUBIfWA/view?usp=sharing Resources:  Maximizing 2026 Medicare Advantage Performance with Physician-Led MSK Care This report outlines how Vori's physician-led, virtual-first musculoskeletal (MSK) model helps Medicare Advantage plans:Improve up to 12 Star measures across preventive care, chronic condition management, and member experience Deliver faster access to care—appointments available within 48 hours Enhance outcomes for pain, fall prevention, and osteoporosis care while achieving an NPS of 87 Align with the new 2026 Star measures for Improving and Maintaining Physical and Mental Health To request your copy, email nroberts@brightspotsventures.com. Clinical Quality Performance of Value-Based and Fee-for-Service Models for Medicare Advantage: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2839238 This JAMA Health Forum article compares clinical quality outcomes for Medicare Advantage patients whose care is delivered under value-based payment (VBP) models versus traditional fee-for-service (FFS). It finds that VBP arrangements, especially those with two-sided financial risk—in general are associated with better performance on standardized clinical quality measures than FFS. Thank you to our Episode Partner, Vori: Vori partners with health plans and providers to improve musculoskeletal (MSK) care through data-driven, physician-led solutions. Their approach helps reduce unnecessary surgeries, improve recovery outcomes, and enhance patient satisfaction—supporting plans in achieving better Stars performance and overall member experience. To learn more, visit vorihealth.com. Schedule a meeting with Mary O'Connor Chief Medical Officer, Vori: To dive deeper into how Vori can help your plan improve outcomes, reduce costs, and strengthen Medicare Advantage Star Ratings,or to schedule a meeting with Mary O'Connor. Reach out to nroberts@brightspsotsventures.com  to schedule the meeting. About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.   We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.  

By Adam Turteltaub With a rising focus on value-based care, and a new program seeking to make the approach mandatory, we spoke with Ed White (LinkedIn), Partner at Nelson Mullins. Previous efforts to move toward value-based models, such as Accountable Care Organizations (ACOs), faced significant barriers due to regulatory frameworks like the Stark Law and Anti-Kickback Statute. These laws were designed to prevent financial incentives from influencing medical decisions, but they also limited the ability of hospitals and physicians to collaborate in ways necessary for effective value-based care implementation. Recognizing these constraints, CMS and the Office of Inspector General (OIG) collaborated in 2020 to issue new regulations aimed at facilitating the transition to value-based care. The next step in the transition is the new Transforming Episode Accountability Model or TEAM program, which will become mandatory in 2026. This program includes 740 hospitals across the country and targets five specific surgical procedures. Participating hospitals must coordinate care with a range of providers—including specialists, primary care physicians, labs, durable medical equipment (DME) providers, hospice agencies, and others. The TEAM program is designed to last for five years, during which time hospitals are responsible for ensuring that patients are connected to appropriate post-discharge care, including follow-up with primary care providers. The goal is to reduce complications, avoid emergency room readmissions, and promote better health outcomes—all while keeping costs below a CMS-established target price. To drive efficiency, the TEAM program introduces three financial risk “tracks”: Upside-only track – Hospitals can earn shared savings if costs come in below the target price. Moderate risk (upside/downside) track – Hospitals can either earn savings or incur penalties depending on performance. Full-risk track – This track will offer both greater risks and rewards. According to industry consultants, two-thirds of participating hospitals are expected to lose money in the early phases of the TEAM program. Hospitals must rethink their compliance, care coordination, and partnership strategies in the wake of these changes. Listen in to learn more about what this all means for your compliance program both today and in the future.

The Max Price Formula: Jonathan Stark on Value-Based Pricing That Creates Outrageous Profits>> Get the newest LFG episodes delivered to your inbox when you Sign Up for our Newsletter.>> Get the new book beyondintakebook.comResource Links:Fast track your marketing efforts while avoiding common marketing mistakes in our new trainingEstate planning attorney? Stop guessing how to get results from online ads and grow your firm with our client-generating Seminar 3.0 Hosted on Acast. See acast.com/privacy for more information.

Cancer care in the U.S. costs over $250 billion each year, and nearly 2 million Americans receive a new diagnosis annually, yet too often the journey begins with silence: no call, no plan, no guide.In this episode, a16z's Vineeta Agarwala and Jay Rughani talk with Thyme Care leaders Robin Shah (cofounder and CEO), Bobby Green, MD (president and CMO), and Brad Diephuis, MD (president and COO) about rebuilding oncology around the patient. They cover where the system breaks, how navigation plus value-based contracts align incentives, how AI can extend clinicians, and what scale looks like today, more than 83,000 active patients. A concise blueprint for truly patient-centered cancer care. Timecodes: 0:00  Introduction 1:47 Personal Stories & Early Days of Time Care5:27 Building the Team & Mission7:07 The Patient Journey: Where the System Fails9:58 Why Tech Hasn't Solved Cancer Care (Yet)15:45 Scaling Impact: Growth & Partnerships17:45 How Time Care Works: Value-Based Care Explained23:15 Technology, AI, and the Human Touch37:06 Building for the Future: Generational Impact Resources: Find Robin on LinkedIn: https://www.linkedin.com/in/robin-shah-8072bb35Find Bobby on LinkedIn: https://www.linkedin.com/in/drbobbygreen/FInd Brad on LinkedIn: https://www.linkedin.com/in/bdiephuis/Find Vineeta on X: https://x.com/vintweetaFind Jay on X: https://x.com/JayRughani Stay Updated: If you enjoyed this episode, be sure to like, subscribe, and share with your friends!Find a16z on X: https://x.com/a16zFind a16z on LinkedIn: https://www.linkedin.com/company/a16zListen to the Raising Health on Spotify: https://open.spotify.com/show/4fjb8YTzHDuPBgDXc3ElkRListen to Raising Health on Apple Podcasts: https://podcasts.apple.com/us/podcast/raising-health/id1529318900Please note that the content here is for informational purposes only; should NOT be taken as legal, business, tax, or investment advice or be used to evaluate any investment or security; and is not directed at any investors or potential investors in any a16z fund. a16z and its affiliates may maintain investments in the companies discussed. For more details please see a16z.com/disclosures. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

How do we demonstrate the value of what we do in healthcare simulation?  This question prompted Lisa Barker and a stellar author team to develop a new model for thinking about value in simulation. They present that model - and the thinking behind it - in Value-based simulation in healthcare: a new model for metrics reporting, recently published in Advances in Simulation. They authors describe their article as “.. designed to support simulation teams and organizational leaders in selecting relevant measurement strategies, aligning simulation work with institutional goals, and co-creating metrics that are operationally meaningful.”  In this Simulcast/ Advances episode, Vic speaks with Lisa Barker and two of her co-authors; Ben Symon and Katie Walker. Our conversation started with a look back at the challenge of measuring and demonstrating value from simulation activities, and a timeline summary of how this issue has been approached over the last 25 years.  We then parse the value-based simulation in healthcare (VBSH) model, comprising six distinct but interdependent categories: Service Products, Program Perceptions, Acquired Expertise, Workplace Performance, System Benefit, and Value Analyses. Lisa, Ben and Katie leave us with some final thoughts as to how this might be applied in practice and offer some speculation about future work on value in healthcare simulation.  Some of the many references to background literature in our conversation included:  Barsuk JH, McGaghie WC, Cohen ER, Balachandran JS, Wayne DB. Use of simulation-based mastery learning to improve the quality of central venous catheter placement in a medical intensive care unit. J Hosp Med. 2009 Sep;4(7):397-403.  Nestel D, Brazil V, Hay M. You can't put a value on that… Or can you? Economic evaluation in simulation-based medical education. Med Educ. 2018 Feb;52(2):139-141.  Varpio L, Sherbino J. Demonstrating causality, bestowing honours, and contributing to the arms race: threats to the sustainability of HPE research. Med Educ. 2023;58(1):1–7  Barker L. et al, Simulation-Debriefing Enhanced Needs Assessment to Address Quality Markers in Health Care: An Innovation for Prospective Hazard Analysis, The Joint Commission Journal on Quality and Patient Safety, Volume 51, Issue 2, 2025,  Happy listening 

Today, we're hear a conversation between Rebecca Grandy, Director of Pharmacy at CHESS and Debi Hueter, Executive Director of WakeMed Key Community Care, a clinically integrated network focused solely on primary care. Discover how integrating pharmacy services is transforming provider workflows, reducing emergency visits, and improving patient outcomes.

As fee-for-service models become less sustainable and reimbursement grows increasingly tied to quality outcomes, more long-term care operators are turning to value-based care as a path to financial stability and improved performance. In this episode of the McKnight's Reimagining Senior Living and Long-Term Care podcast, Jim Berklan sits down with Curana Health Vice President of Operations, Tasha Janssen, NP-C, and Care Initiatives' Vice President of Clinical Services, Johanna Volm, RN, BSN, to explore how skilled nursing facilities can lay the groundwork for success before diving into value-based care arrangements. You won't want to miss this insightful discussion, which breaks down the essential steps operators can take to avoid common pitfalls and maximize impact. Sponsored by Curana Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

Children make up nearly half of all Medicaid enrollees—37 million nationwide—yet their unique needs are too often overlooked in value-based care models. In this episode, Michael sits down with Taylor Beery, Chief Innovation & Administrative Officer and Co-Founder at Imagine Pediatrics, to explore why pediatric value-based care requires its own distinct strategy. From addressing the needs of 14.5 million children with special health care needs to building trust with families and caregivers, Taylor makes the case that centering children in healthcare reform not only improves outcomes for vulnerable populations but also strengthens the foundation for broader Medicaid and commercial models.

In this episode of The Nonprofit Exchange, I had the pleasure of welcoming back Noel Massie for part two of our discussion on "Terms and Conditions of Value-Based Leadership." Noah, a retired vice president of U.S. delivery operations for UPS and an experienced leader in the nonprofit sector, shared invaluable insights that are applicable not only in corporate settings but also for nonprofit and faith leaders. We explored the concept of being "promoted" into leadership roles, emphasizing that every time we enter a new environment, we take on the responsibility of leadership. Noah highlighted the importance of establishing clear values and conditions that foster a positive organizational culture. He introduced his B.E.S.T. acronym, which stands for Be Clear, Expect the Best, Stick to the Objective, and Test Commitment, as a framework for effective leadership communication. We also tackled the myth that lower standards are acceptable when working with volunteers, asserting that excellence should always be the goal, regardless of the context. Noah provided practical tools, including the Four by Five Method and the Seven Steps of Effective Training, to help leaders engage their teams effectively and ensure that everyone is on the same page. Throughout our conversation, we emphasized the significance of daily messaging and the need for leaders to communicate clearly and consistently with their teams. Noah reminded us that leadership is about influence, not coercion, and that we must invest in our people to achieve the best outcomes. As we wrapped up, Noah shared a powerful closing thought: "You can't hope to get more than you give." This principle serves as a reminder that investing in our teams is essential for fostering a thriving organizational culture. I encourage all listeners to check out Noah's book, "You've Been Promoted," as it offers practical insights and strategies that every leader should have in their toolkit. Thank you for joining us, and I look forward to our next conversation! Learn more about your ad choices. Visit megaphone.fm/adchoices

Nephrologist Timothy Pflederer discusses his article "How value-based care transforms chronic kidney disease management," highlighting how value-based care (VBC) is reshaping the treatment of chronic kidney disease and end-stage kidney disease. Timothy explains how VBC encourages continuity of care through interdisciplinary teamwork, empowers long-term patient engagement, and addresses health inequities that disproportionately affect minority populations. He emphasizes that shifting from a volume-based to a value-based approach supports prevention, improves outcomes, and enhances patient experiences. Listeners will walk away with actionable takeaways on how VBC supports whole person care, integrates support services, and builds a sustainable future for chronic disease management. Our presenting sponsor is Microsoft Dragon Copilot. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click. Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise—and it's built on a foundation of trust. It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Modivcare provides 15,000 personal care aides to 13,000 patients in seven states, said Bekah Corns, VP of quality and clinical, home, Modivcare. The company also provides nonmedical emergency transportation and remote patient monitoring. Medicaid is a major payer for Modivcare's personal care program, and the vast majority of the company's personal care workforce is nonskilled home care aides, she noted. There is nursing oversight of aides in several states, she pointed out. While the One Big Beautiful Bill Act will significantly cut Medicaid funding, the impact on Modivcare's personal care patients and workers is not yet clear, Corns said. Going forward, it will be important to advocate how personal care provides value for patients and to larger communities and how it is less expensive to care for someone in their home than to send them to a nursing home. The workforce shortage presents another obstacle for personal care. Modivcare's strategy is to offer the most competitive rates based on reimbursement, and investing in learning platforms to provide education for aides and a rewards platform to recognize deserving aides. Many family caregivers work for Modivcare, Corns said.Follow us on social media:X: @McKHomeCareFacebook: McKnight's Home CareLinkedIn: McKnight's Home CareInstagram: mcknights_homecareFollow Modivcare on social media:X: @ModivcareFacebook: ModivcareLinkedIn: ModivCareShow contributors:McKnight's Home Care Editor Liza Berger; Bekah Corns, VP of quality and clinical, home, Modivcare

Subscribe to UnitedHealthcare's Community & State newsletter.On August 12, A Health Podyssey's Rob Lott chatted with Kenton Johnston of Washington University about his paper in the August 2025 edition of Health Affairs that explores changes in clinician's participation across Medicare value-based payment models.Order the August 2025 issue of Health Affairs. Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Subscribe to UnitedHealthcare's Community & State newsletter.

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.

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

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/

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.

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  

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

EP 154. Why feelings drive sales. Most marketers focus on data—but people buy based on emotion. Guest Emily Lyman, the Founder & CEO of Branch & Bramble agency, breaks down value-based marketing, the 4 core human values, and how to tweak your messaging to connect and convert with more moms and other customer segments.   SHOWNOTES:   https://www.podpage.com/marketing-with-empathy/blog/why-feelings-drive-sales-value-based-marketing-that-connects-and-converts-with-emily-lyman-episode-154/     LEARN MORE ABOUT SARAH'S STORYBRAND WORKSHOPS: https://www.kindredspeak.com/storybrand    SCHEDULE FREE 30-MIN. DISCOVERY CALL WITH SARAH PANUS FOR HELP CREATING CONTENT PLANS THAT ATTRACT MORE MOM CUSTOMERS (and other audiences): ⁠https://app.squarespacescheduling.com/schedule/a0d08759/?appointmentTypeIds[]=25950382⁠    WATCH ON YOUTUBE: https://www.youtube.com/@iamsarahpanus   FREE QUIZ: Which of These Content Makeovers is Right for Your Brand?  Discover which content makeover will boost your brand's success! Take this 40-second QUIZ to find your "home" makeover show match and get a content makeover plan to help you attract customers & drive better business results.  ⁠https://www.tryinteract.com/share/quiz/65c650923a654f0015bbd704⁠  Learn more about your ad choices. Visit megaphone.fm/adchoices

Minnesota is right in the thick of summer sports, with the Twins and the Lynx both wrapping up the first halves of their seasons. On his bobblehead night on Saturday, Twins star Byron Buxton completed the first cycle in Target Field history. In the WNBA, Hopkins native Paige Bueckers of the Dallas Wings faced off against Caitlin Clark and the Fever in Indiana on Sunday. Minnesota Now sports contributors Wally Langfellow and Eric Nelson joined Minnesota Now with the latest sport news.

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 ...

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.

In this episode of theNonprofit Exchange, I had the pleasure of speaking with Noah Massey, a seasoned leader with over 42 years of experience at UPS. Noah shared his journey from a college student working to pay for his education to becoming a high-level executive, emphasizing the importance of value-based leadership throughout his career. We discussed the concept of leadership as the ability to influence individuals or groups towards positive outcomes, highlighting the significance of coaching and development in leadership roles. Noah's insights on the "terms and conditions" of leadership were particularly enlightening, as he explained how every individual has their own set of expectations that must be acknowledged for effective team dynamics. Noah also introduced his book, "Been Promoted: Your Guide for New Leaders and Their Teams," which aims to support newly promoted leaders, especially in the nonprofit sector. He emphasized the need for intentional leadership, where leaders articulate their values and establish a congruence within their teams. Throughout our conversation, Noah shared powerful anecdotes and practical techniques, such as the "four by five method" for handling challenging situations and the importance of listening as both a skill and a value. He underscored that leadership is not just about achieving results but about investing in the development of others. As we wrapped up, Noah left us with a profound reminder: "You can't hope to get more than you give." This principle serves as a guiding light for leaders who aspire to foster high-performing teams. I encourage our listeners to reflect on their own leadership journeys and consider how they can invest in the people they lead. For more insights and resources, be sure to check out Noah's website at noelmassey.com, where you can find his book and a masterclass that expands on the topics we discussed. Thank you for joining us on this episode of the Nonprofit Exchange! Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of Value-Based Care Insights, host Daniel Marino explores the newly introduced the CMS Transforming Episode Accountability Model (TEAM)—a mandatory five-year, episode-based pricing model, informed by earlier initiatives from the CMS Innovation Center. Designed to cover high-volume, high-cost surgical procedures, TEAM represents a significant shift in how hospitals and providers approach bundled payments. Join Daniel and special guest Lucy Zielinski, an expert in value-based programs and HCC coding , as they unpack what the TEAM model entails and what participating hospitals must do to prepare for the January 1, 2026 implementation. Gain insights how this model influences financial performance, drives care coordination redesign, and introduces new incentives and penalties. Whether you are a healthcare leader, provider, or payer, don't miss this overview of one of CMS's initiatives shaping the future of value-based care.

Ep 130- Value-Based Shift: Inside the CMS TEAM Transformation On this episode Dan explores the newly introduced the CMS Transforming Episode Accountability Model (TEAM)—a mandatory five-year, episode-based pricing model, informed by earlier initiatives from the CMS Innovation Center. Designed to cover high-volume, high-cost surgical procedures, TEAM represents a significant shift in how hospitals and providers approach bundled payments. Join Dan and special guest Lucy Zielinski, an expert in value-based programs and HCC coding, as they unpack what the TEAM model entails and what participating hospitals must do to prepare for the January 1, 2026 implementation. Gain insights how this model influences financial performance, drives care coordination redesign, and introduces new incentives and penalties. Whether you are a healthcare leader, provider, or payer, don't miss this overview of one of CMS's initiatives shaping the future of value-based care. 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

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. 

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Rob Lott interviews Robert Burke of the University of Pennsylvania about his recent paper which evaluates outcomes for skilled nursing facilities value-based purchasing programs. Order the June 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

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.

Discussion between NCOs, SNCOs and CGOs about leadership topics and leader responsibilities.

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

As hospitals and health systems continue to evolve in value-based care, optimizing the post-acute recovery process has become a top priority. In this episode of Value-Based Care Insights, Diane Shifley, Assistant Vice President of Population Health and Post-Acute Services at a major Chicago health system joins us to discuss how robust transitions-in-care programs can drive better patient outcomes. She shares insights on the critical role of early patient evaluation—whether at hospital admission or pre-surgery—in shaping effective transitions. We explore how transitional care models that include post-acute facilities and home care can reduce readmission rates, improve patient satisfaction, and control post-acute costs. This episode offers actionable strategies to strengthen your transitions-in-care to support patients through successful recovery.

As hospitals and health systems continue to evolve in value-based care, optimizing the post-acute recovery process has become a top priority. On this episode Dan is joined by Diane Shifley, Assistant Vice President of Population Health and Post-Acute Services at a major Chicago health system to discuss how robust transitions-in-care programs can drive better patient outcomes. She shares insights on the critical role of early patient evaluation—whether at hospital admission or pre-surgery—in shaping effective transitions. They explore how transitional care models that include post-acute facilities and home care can reduce readmission rates, improve patient satisfaction, and control post-acute costs. This episode offers actionable strategies to strengthen your transitions-in-care to support patients through successful recovery. 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

The Home Health Value-Based Purchasing (HHVBP) model seeks to achieve four key objectives. 1) Improve the quality and efficiency of home health care 2) Improve the patient's experience with care 3) Strengthen the patient's physical function 4) Address the patient's health issues before they require an ED visit. In 2025, CMS is launching an expanded Home Health Value-Based program to better compare provider quality and streamline the reporting process. To view accreditation information and access completion requirements to receive a certificate for completing this course, please click here. The content of this Summit podcast is provided only for educational and training purposes for licensed physical therapists and occupational therapists. This content should not be used as medical advice to treat any medical condition in either yourself or others.

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.

Thriving Business Finances with Value-Based Pricing Strategies and the Profit First Model Running a successful business today requires more than just hard work—it takes strategy, clarity, and a sustainable approach to finances. Adopt value-based pricing strategies and implement the Profit First model to avoid burnout. Together, these two approaches enable business owners to set prices based on the value they provide, ensuring that profit is prioritized from the outset. Rethinking Your Worth with Value-Based Pricing Strategies: What Are You Providing? One of the most common pitfalls in business is undervaluing your work, particularly when pricing is based solely on the time spent. Instead of asking, "How long did this take me?" with value-based pricing strategies, we ask, "What difference is this making for the person I serve?" When you price based on value, you recognize the real impact of your work: peace of mind, business growth, clarity, and confidence. These things go far beyond time spent and deserve to be reflected in how you charge. Clients aren't just paying for your time—they're investing in meaningful change. And that change has measurable value. You deliver an ROI when you help a client increase their revenue, streamline operations, or reduce stress that leads to better decision-making. This return on investment (ROI) often exceeds the cost of your services. By clearly communicating that ROI—whether it's financial growth, time saved, or long-term stability—you make it easier for clients to see your services as an investment, not an expense. When you price according to the outcomes you create, you simplify your pricing, establish clear expectations, and reinforce the true worth of your services. Read the full show notes and access all links. Website for Kristin Gravitt Additional Resources Download the free eBook: A guide for alleviating anxiety and developing healthy habits for a healthy mind Why every entrepreneur needs systems and processes to scale their business

Send us a textIf you're a freelancer, self-employed, or working without traditional benefits, the idea of long term planning can feel overwhelming. If you're just starting out, navigating a major transition professionally, or feeling like you're just trying to survive financially, how are you ever supposed to plan for retirement? In this episode of Women & Money: The Shit We Don't Talk About, we sit down with Allie Beckmann, the founder of Beckmann Financial, where mission-driven individuals and business owners are empowered to use money as a tool to turn their dreams into reality- one that reflects their values and vision for impact.Allie knows what it takes to save for retirement and she shares the exact tools women can use to build wealth, even with an unpredictable income. During our conversation, she explains why financial planning should be about your life first and the numbers, second. What do you care about most? What are your values? Your money should help you live in alignment with what really matters most to you!This episode is a must-listen for creatives, side-hustlers, or anyone feeling like they're behind or don't belong in “the financial world.” Because you're not behind, you do belong, and Allie's here to show you exactly how to walk your path towards financial freedom!Are you ready to take the next step? Join our weekly Money Talks series every Thursday at 11am CT! Register for FREE to gain access to our weekly sessions where Purse Strings-approved professionals discuss various financial topics. Click here to register now and bring your questions!Got a unique financial story to share? Whether it's about crushing debt, building wealth, an unexpected windfall, or just a wild money moment, we want to hear it!  Or are you a professional who helps women with money? If you're a financial coach, attorney, CPA, or work in any area that empowers women financially, we'd love to hear from you too! Your story could inspire our community of women. Fill out our intake form here!Follow & Connect with Allie:Website LinkedInNewsletterConnect with us! Facebook Page Facebook group Instagram TikTok LinkedIn YouTube Resources Have questions? Click this to check out our expert Q&A for tips from industry experts, tailored to help women address their most common financial concerns. Subscribe to our newsletter to receive financial tips delivered weekly here! Explore our free guides to help you on your financial journey

In this episode, I'm dropping a real-world, no-fluff blueprint that'll help you break free from outdated sales tactics and start closing deals by solving real problems. You'll learn how to shift from the typical “pitch” mindset and become the trusted guide your clients actually need. I walk you through my 4-Step Value-Based Sales Blueprint—the exact system I use to build trust, increase conversions, and create long-term client relationships that drive repeat business and referrals. If you're in real estate, entrepreneurship, or any service-based business, this episode is for you.

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.

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

Modern law practice needs a modern billing approach. Learn tactics for the successful transition from hourly billing to flat and alternative fees with Scott Leigh of AltFee, the 2024 ABA Techshow Startup Alley winner. Mathew Kerbis talked with Scott at Techshow 2025 about the evolution of fee structures alongside technology advances and what lawyers should be thinking about to align their services with competitive pricing. They discuss how modernized fees can increase efficiency and profitability while offering transparent pricing for your clients.  Scott Leigh is co-founder and CEO at AltFee.

“It's being proactive rather than reactive, which physicians or others didn't get compensated for previously. It's doing the things that keep people healthy such that they are on the right path to get better, rather than this endless cycle of treatment and temporary relief.” In this episode, we sit down with Rob Cohen, CEO of Livara Health, to explore how a tech-enabled, value-based approach to musculoskeletal (MSK) care is driving better patient outcomes while reducing costs. Key insights include: Improving access to MSK care, even for underserved populations Boosting quality while reducing cost through holistic solutions The power of combining machine learning and traditional analytics How predictive models help steer patients to the right care Find Rob's work at: livarahealth.com Subscribe and stay at the forefront of the digital healthcare revolution. Watch the full video on YouTube @TheDigitalHealthcareExperience The Digital Healthcare Experience is a hub to connect healthcare leaders and tech enthusiasts. Powered by Taylor Healthcare, this podcast is your gateway to the latest trends and breakthroughs in digital health. Learn more at taylor.com/digital-healthcare About Us: Taylor Healthcare empowers healthcare organizations to thrive in the digital world. Our technology streamlines critical workflows such as procedural & surgical informed consent with patented mobile signature capture, ransomware downtime mitigation, patient engagement and more. For more information, please visit imedhealth.com   The Digital Healthcare Experience Podcast: Powered by Taylor Healthcare Produced by Naomi Schwimmer  Hosted by Chris Civitarese Edited by Eli Banks Music by Nicholas Bach  

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.

SpectraMedix helps health plans and systems navigate value-based contracts with technology that enhances administration, provider support, and data-driven decisions. In this episode, Rahul Lakhanpal, Chief of Staff, and Sean Kelly, Senior Vice President of Growth and Business Development at SpectraMedix, discuss how their organization is driving change in healthcare by focusing on value-based contract administration and management. They share insights into how SpectraMedix's platform helps health plans and health systems administer contracts, track performance, and translate contract terms into actionable insights for providers. Rahul and Sean also highlight how their technology differentiates itself by filtering information through the prism of the value-based contract, enabling better decision-making and improved outcomes in the evolving landscape of value-based care. Tune in and learn how SpectraMedix is transforming value-based care through contract administration, provider enablement, and data-driven insights! Resources: Connect with and follow Rahul Lakhanpal on LinkedIn. Follow and connect with Sean Kelly on LinkedIn. Learn more about SpectraMedix on their LinkedIn and website.

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.