Analyzing Healthcare

SummaryACA premiums, Obamacare subsidies, U.S. health insurance incentives, and healthcare cost inflation—WSJ economist Anthony LoSasso explains the real structural flaws.Massive subsidy expansion, weak pricing discipline, and a structurally misaligned insurance market are driving rapid cost escalation across the Affordable Care Act marketplace. Wall Street Journal author and economist Dr. Anthony LoSasso breaks down why premiums are rising, why insurers face almost no pressure to compete on price, and how the ACA’s “defined benefit” subsidy structure created a distorted market.In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Dr. LoSasso to explore what the ACA got right, what it unintentionally broke, and how shifting to a “defined contribution” model could introduce real competition, lower premiums, and restore market discipline.Title-What You’ll Learn✅ Why ACA premiums continue rising despite stagnant utilization✅ How the subsidy design shields consumers and removes insurer price pressure✅ Why 98% of marketplace enrollees being subsidized distorts competition✅ How defined-contribution subsidies could slow premium growth✅ What policymakers misunderstood when designing the ACA✅ Why ACA marketplaces became “happy times” for insurersSubscribeSubscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through strategy, investment, operations, and policy reform.Visit SCALE Community to access exclusive leadership insights and full member-only recordings.Timestamps(00:00) Introduction to Dr. Anthony LoSasso & the WSJ article(02:20) The original ACA design and how incentives went wrong(05:00) Gross vs. net premiums: who actually feels the cost?(08:00) Why insurers face little pressure to keep premiums down(11:00) Defined benefit vs. defined contribution subsidies(14:00) Political narratives vs. economic realities(18:00) What the ACA solved — and what it unintentionally distorted(22:00) U.S. healthcare as multiple systems operating at once(27:00) Closing thoughts: creating a more competitive insurance marketplaceKey Takeaways???? The ACA’s subsidy structure unintentionally removed consumer price sensitivity???? Insurers face almost zero competitive pressure to lower premiums???? Defined-contribution subsidies could reintroduce market discipline???? Structural design—not utilization—is driving premium inflation???? The ACA succeeded in coverage expansion but failed on cost containmentResource LinksGuest: Anthony LoSasso, PhD – https://www.anthonylosasso.com/Host: Roy Bejarano – linkedin.com/in/roy-bejarano-a5669ba8Organization: www.scale-community.comPodcast Hub: Analyzing Healthcare by SCALE CommunityGuest BioDr. Anthony LoSasso is a nationally recognized health economist, former Professor at DePaul University, and incoming faculty member at the University of Wisconsin–Madison’s La Follette School of Public Affairs. He is the author of the Wall Street Journal analysis “The Real Fix for Obamacare,” and his research focuses on health insurance design, incentives, premium growth, and labor-market dynamics. His expertise spans ACA marketplace behavior, public-sector program design, and the interplay between health policy and economic outcomes.SEO KeywordsObamacare, Affordable Care Act, ACA premiums, ACA subsidies, health insurance incentives, Anthony LoSasso, Wall Street Journal healthcare, healthcare inflation, U.S. healthcare reform, defined contribution, insurance marketplace, Roy Bejarano, SCALE Community, SCALE Healthcare, healthcare podcast, health economics, policy design, premium tax credits, managed competition

Summary AI, cloud technology, and open data ecosystems are redefining how healthcare operates. Oracle Health’s Seema Verma shares how innovation and interoperability can finally deliver the transformation policymakers have long promised.In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Seema Verma, Executive Vice President & General Manager of Oracle Health and Life Sciences and former CMS Administrator, to explore how Oracle is building the next generation of AI-enabled healthcare platforms. From Cerner’s acquisition to Oracle’s open-data vision, Verma details how the company is designing an EHR system built for AI, not one with AI “bolted on.” The discussion spans the future of ambient listening, automation in care delivery, interoperability mandates, and how AI can reduce administrative burden for both providers and patients.Verma also reflects on her time at CMS—why initiatives like Patients Over Paperwork were just the beginning—and how her current work at Oracle continues that mission through private-sector innovation.Title: Will Oracle’s AI Approach be the Catalyst for Technology Adoption in Healthcare? Seema Verma, Oracle x SCALE CommunityWhat You’ll Learn✅ How Oracle is building an AI-native EHR that transforms care delivery✅ Why interoperability is central to unlocking AI’s full potential✅ How Verma’s CMS experience informs her work at Oracle Health✅ Why open ecosystems and global AI adoption are critical for innovationSubscribe Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through technology, data, and strategy. Visit SCALE Community to access exclusive leadership insights and full member-only recordings.Timestamps(00:00) – Intro | Meet Seema Verma, EVP & GM, Oracle Health & Life Sciences(01:50) – The Vision Behind Oracle’s AI Transformation of Healthcare(04:49) – How Oracle’s EHR Differs from Epic, Athena & Others(09:51) – Cloud Platforms, AI Agents & Open Ecosystem Innovation(13:50) – From CMS to Oracle: Fixing Burnout with Technology(21:38) – The Fight for Interoperability & Patient Data Ownership(27:58) – Why Blocking Data Means Blocking Innovation(32:25) – Global Demand for AI-Driven Health Solutions(35:05) – How States and Systems Differ in AI Adoption(39:29) – Price Transparency, Private Equity & Health Policy Reform(43:03) – Future of Clinical Labor, Policy & Compliance(43:31) – Closing Reflections on Healthcare’s FutureKey Takeaways???? Oracle is reimagining EHRs as AI-native platforms, not retrofits.???? Interoperability is both a moral and technical imperative for healthcare.???? Verma believes open ecosystems are vital to accelerating innovation.???? The next wave of AI will serve patients and providers through automation and insight.Resource Links Guest: Seema Verma – LinkedIn Host: Roy Bejarano – LinkedIn Organization: ⁠www.scale-community.com⁠ Podcast Hub: Analyzing Healthcare by SCALE Community Oracle Health: ⁠https://www.oracle.com/health⁠Guest Bio Seema Verma serves as Executive Vice President and General Manager of Oracle Health and Life Sciences, where she leads the company’s mission to transform healthcare through data, AI, and technology integration. As the former Administrator of CMS, she oversaw one of the largest healthcare programs in the world, launching key initiatives like Patients Over Paperwork and Interoperability and Patient Access. At Oracle, she continues that mission—rebuilding healthcare’s digital infrastructure with innovation at the core.SEO Keywords Oracle Health, Seema Verma, Oracle Life Sciences, AI in Healthcare, Healthcare Interoperability, EHR Innovation, Healthcare Transformation, Digital Health Strategy, CMS Administrator, Value-Based Care, Healthcare Technology, Cloud Computing in Healthcare, Healthcare Policy Reform, Healthcare Podcast, Roy Bejarano, SCALE Community, SCALE Healthcare, Healthcare AI, Healthcare Innovation, Oracle Cerner

SummaryTelehealth, AI, and digital therapeutics are redefining American healthcare. The ATA leaders share insights on regulation, innovation, and the road ahead.In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Ann Mond Johnson, CEO of the American Telemedicine Association (ATA), and Kyle Zebley, ATA’s Senior VP of Public Policy, to discuss how digital health is reshaping care delivery across the U.S. They explore the evolution of telehealth from early remote care to today’s AI-driven, data-enhanced platforms. The conversation dives deep into barriers to adoption—from outdated state regulations and the 1997 Medicare law to CMS reimbursement models—and what it will take to achieve true parity for digital care. From state-by-state advocacy to the global future of telemedicine, this episode offers an unfiltered look at the policies, players, and promise of healthcare’s digital revolution.Title-Can AI and Telehealth Fix What Healthcare Policy Hasn’t? American Telemedicine Association x SCALE CommunityWhat You’ll Learn ✅ The ATA’s mission and its role as the voice of U.S. digital health ✅ The policy and regulatory challenges limiting telehealth adoption ✅ How COVID-era flexibilities changed the trajectory of virtual care ✅ Why global collaboration may define the next phase of healthcare innovationSubscribe to Analyzing Healthcare for more in-depth conversations with leaders transforming care delivery. Visit SCALE Community to join SCALE Community and access exclusive leadership insights.Timestamps • (00:00) – Intro | Meet Ann Mond Johnson & Kyle Zebley, ATA • (01:20) – Inside the ATA: Mission, Members & Market Influence • (03:30) – Evolution of Digital Health: From Telephones to AI • (06:50) – Advocacy & ATA Action: Policy Work Across 50 States • (09:20) – The Economics: Membership, Funding & Growth • (17:00) – Digital Care vs. In-Person Care: Why Adoption Lags • (21:00) – COVID’s Impact on Telehealth Expansion • (30:00) – The 1997 Law That Still Restrains Telemedicine • (34:00) – What Happens if the Waivers Expire? • (37:00) – State Licensing Barriers & Push for Uniformity • (42:00) – Global Digital Health: Opportunities & Challenges • (44:00) – Signs of Optimism for the Future of CareKey Takeaways • ???? The ATA leads U.S. advocacy for telehealth and digital therapeutics. • ???? Regulatory barriers—not technology—remain the greatest constraint. • ???? COVID accelerated digital adoption but left policy gaps unresolved. • ???? The next era of healthcare will merge local practice with global connectivity.Resource LinksGuest: LinkedIn – Ann Mond Johnson | LinkedIn- Kyle ZebleyHost: LinkedIn – Roy BejaranoOrganization: www.scale-healthcare.comPodcast Hub: Analyzing Healthcare by Scale CommunityAmerican Telemedicine Association – https://www.americantelemed.org | https://www.americantelemed.org/ata-action/Guest BioAnn Mond Johnson is CEO of the American Telemedicine Association, leading efforts to integrate digital health into the core of U.S. healthcare delivery. With decades of experience in innovation, policy, and healthcare transformation, Ann is recognized as one of the most influential advocates for accessible, technology-driven care.Kyle Zebley is SVP of Public Policy and Executive Director of ATA Action, where he drives the organization’s advocacy across all 50 states and on Capitol Hill. His work has helped modernize telehealth laws, protect digital access, and shape national debates on healthcare modernization.SEO KeywordsTelehealth policy, digital health innovation, ATA, Ann Mond Johnson, Kyle Zebley, telemedicine regulation, healthcare technology, virtual care adoption, CMS reimbursement, healthcare policy reform, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

SummaryAI in healthcare, data platforms, UC Irvine innovation, Dynatrace, and healthcare technology governance. Former UC Irvine CDO Tom Andriola reveals how data, AI governance, and cultural change are transforming healthcare systems. From building precision-health platforms to creating AI accountability frameworks at scale, Tom explains how technology leaders can integrate AI trust, transparency, and observability into clinical and administrative workflows. He shares lessons from UC Irvine’s COVID-era data success and his current work at Dynatrace to enable AI assurance across healthcare enterprises. A must-listen for CIOs, digital health executives, and leaders building the future of AI in medicine.What You’ll Learn✅ How UC Irvine Health built a comprehensive data and precision health platform.✅ Why AI governance and trust frameworks are essential for responsible AI use.✅ How AI augments clinical decision-making and reduces provider burden.✅ Where Dynatrace fits in the next wave of AI observability and accountability.Timestamps{00:00} Intro to AI in Healthcare{01:13} Tom’s Journey & UC Irvine Growth{06:51} Standardization & Integration{08:21} Innovation at UCI Health{11:43} Data-Driven Decisions & Precision Health{13:58} Culture Shift in Tech Adoption{18:12} Tech in Clinical Decision-Making{22:17} Governance & Trust in AI{25:10} Challenges & Opportunities{30:01} Building AI Governance{32:24} Leading AI Adoption{35:26} Future of EMRs & AI{37:45} Evolving Role of Tech Leaders{45:57} Dynatrace: AI Assurance in HealthcareKey TakeawaysAI and data platforms enable data-driven healthcare and precision medicine.Cultural shift and AI trust frameworks are critical for successful adoption.Ambient AI tools improve provider experience and patient communication.Observability and AI accountability will define the next wave of healthcare innovation.Resource LinksGuest: LinkedIn – Tom Andriola Host: LinkedIn – Jason SchifmanOrganization: www.scale-healthcare.comPodcast Hub: Analyzing Healthcare by Scale CommunityMentioned: UC Irvine Health, Institute for Precision Health, DynatraceGuest BioTom Andriola, a former Chief Information Officer now working at Dynatrace, leads the company’s global IT and digital innovation strategy. With extensive experience in healthcare technology, including leadership roles at UC Irvine and the University of California system, he has been a strong advocate for data-driven care, AI integration, and digital transformation across healthcare enterprises. Tom’s work bridges technology and clinical outcomes, advancing how health systems use data and automation to improve patient care and operational efficiency.SEO KeywordsAI, healthcare technology, UC Irvine, data platforms, precision health, pandemic response, clinical decision-making, AI governance, healthcare integration, Dynatrace, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

SummaryValue-based care models, CMS Innovation Center strategy, AI in healthcare delivery and primary care reimbursement — health equity meets policy innovation.In this Healthcare Podcast from Scale Community’s Analyzing Healthcare series, Roy Bejarano, Co-Founder & CEO of Scale Healthcare, hosts Dr. Purva Rawal, former Chief Strategy Officer at the CMS Innovation Center (CMMI). Together they explore how value-based care models, AI in healthcare delivery, and CMS initiatives are redefining the future of U.S. healthcare.Dr. Rawal shares insights from her time shaping Medicare and Medicaid innovation — explaining how primary care reimbursement models and payment reform can drive health equity and efficiency. She and Roy discuss the realities of implementing CMS strategy, the role of AI in care coordination, and lessons from COVID-19 that transformed virtual care and policy.A must-listen for Leading Healthcare Stakeholders, Thought Leaders in Healthcare, and executives tracking Healthcare Trends and Innovations, this episode delivers actionable Healthcare Strategy insights from two of the industry’s most trusted voices — Roy Bejarano and Jason Schifman’s Scale Healthcare team.Title Is CMS Doing Enough to Make Value-Based Care Sustainable? | Purva Rawal × SCALE CommunityWhat You’ll Learn ✅ How value-based care and primary care reimbursement models advance health equity. ✅ The role of the CMS Innovation Center in modern healthcare reform. ✅ How AI in healthcare delivery enhances outcomes and reduces inefficiency. ✅ Policy insights for leaders navigating the latest trends in healthcare innovation.If you enjoy forward-thinking Healthcare Podcasts, subscribe to Analyzing Healthcare for weekly Healthcare Industry Insights and Healthcare Strategies from top leaders. ???? Visit www.scale-healthcare.com to join Scale Community and explore the latest Healthcare Thought Leadership and Innovation initiatives.Timestamps • (00:00) – Intro | Meet Dr. Purva Rawal of CMS Innovation Center • (01:30) – Defining “Value” in Healthcare & Human-Centered Care Design • (04:20) – Top Gaps in U.S. Healthcare & Primary Care Infrastructure • (10:44) – Primary Care Reimbursement Models & Political Challenges • (15:30) – Evaluating Value-Based Care Models and Provider Satisfaction • (21:15) – CMS Initiatives for Reducing Health Disparities • (34:00) – Medicare Spending, Inflation, and System Sustainability • (40:00) – AI in Healthcare Delivery & the Future of CMS Innovation • (46:00) – COVID-19 Lessons for Healthcare Strategy and Equity • (53:00) – Closing Insights on Public Trust and Institutional IntegrityKey Takeaways • Value-based care models are the foundation of sustainable health equity. • AI in healthcare delivery is reshaping care coordination and data-driven policy. • Primary care reimbursement models must align financing with outcomes. • CMS initiatives prove that innovation and policy can work together to improve access.Resource LinksGuest: LinkedIn – Purva RawalHost: LinkedIn – Roy BejaranoOrganization: www.scale-healthcare.comSCALE Community: https://www.scale-community.com/Podcast Hub: Analyzing Healthcare by Scale CommunityMentioned: CMS Innovation Center (CMMI)Guest BioPurva Rawal, former Chief Strategy Officer at the CMS Innovation Center, is a clinical psychologist and policy strategist recognized for advancing value-based care models, primary care reimbursement innovation, and health equity initiatives across Medicare and Medicaid. She has led national CMS initiatives connecting AI in healthcare delivery with policy reform to build a system “wrapped around people and their needs.”Hashtags #HealthcarePodcast #ValueBasedCare #CMSInnovationCenter #AIinHealthcare #HealthEquity #HealthcareStrategy #HealthcareInnovation #ScaleHealthcare #ScaleCommunity #RoyBejaranoSEO Keywordsvalue-based care, CMS Innovation Center, AI in healthcare delivery, value-based care models, primary care reimbursement models, health equity, CMS initiatives, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Discover how Prenuvo and CEO Andrew Lacy are revolutionizing preventive healthcare with full-body MRI, AI-powered imaging, and early disease detection insights. In this SCALE Community: Healthcare Technology & Innovation episode, Andrew Lacy, Founder & CEO of Prenuvo, shares how his company is transforming preventive healthcare through advanced full-body MRI and AI-assisted diagnostics. He discusses balancing technology with human expertise in radiology, enhancing the patient experience, and addressing challenges around insurance coverage and integration into traditional care systems. Andrew also highlights Prenuvo’s global expansion, physician referral growth, and mission to make early detection and proactive health screening the new standard in modern healthcare.Title - Can Advanced Imaging and AI Redefine Preventive Medicine? | Andrew Lacy, Prenuvo x SCALE CommunityKey Timestamps:{00:00} Introduction to Prenuvo and Proactive Screening{03:17} The Role of AI in Radiology{06:11} Patient Experience and Clinic Environment{08:55} Recruiting and Retaining Radiologists{11:46} Expansion and Growth of Prenuvo{14:33} Overcoming Skepticism in Preventative Imaging{16:58} Insurance and Pricing Challenges{19:53} Integrating Prenuvo into Healthcare Ecosystem{22:38} Understanding Scan Results and Patient Guidance{26:36} Empowering Patients Through Innovative Healthcare{28:13} Reimagining the Healthcare Landscape{28:41} The Financial Burden of Healthcare{30:06} Preventative Care vs. Reactive Care{31:30} Economic Models and ROI in Healthcare{32:54} Employer Engagement in Preventative Health{34:19} Safety and Efficacy of Whole Body Scans{35:59} The Future of Whole Body Scans{37:03} Prenuvo's Market Position and Expansion{38:11} Integrating Technology in Healthcare{45:27} International Expansion and Market AdaptationKey Takeaways:Prenuvo offers proactive health screening through advanced full-body MRI technology.AI in radiology is used judiciously, with a focus on human clinical expertise.A patient-first experience drives engagement and trust in preventive health.Whole-body scans can detect early-stage cancers and chronic conditions, saving lives.Recruiting and retaining top radiologists ensures diagnostic precision.Public awareness of proactive healthcare and preventive scans remains low.Physician referrals are growing as confidence in Prenuvo’s technology increases.Insurance coverage for preventive imaging remains limited but is evolving.Prenuvo aims to integrate into traditional healthcare systems through data-driven evidence.Patient empowerment is central — reports include actionable, personalized insights.About the Guest:Andrew Lacy is the Founder and CEO of Prenuvo, a pioneering health technology company offering full-body MRI scans to detect disease early and promote proactive healthcare. A seasoned entrepreneur and technologist, Andrew is redefining preventive medicine by combining advanced imaging, AI-assisted diagnostics, and clinical precision. Under his leadership, Prenuvo has grown to 23 clinics across North America and internationally, empowering thousands of patients to take control of their health before symptoms appear.linkedin.com/in/andrewllacylinkedin.com/in/jasonschifmanKeywords:Prenuvo, proactive screening, radiology, AI in healthcare, patient experience, whole body scans, insurance coverage, early detection, health technology, healthcare innovation, SCALE Community, Analyzing Healthcare, Healthcare Innovation, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Priya Basu, Executive Head of the Pandemic Fund, discusses lessons from COVID-19 and the urgent need to strengthen pandemic preparedness worldwide. She highlights the Fund’s mission to support over 75 countries with investments in surveillance, laboratories, and workforce training, particularly in low- and middle-income nations. Basu underscores the importance of the One Health approach, recognizing the links between human, animal, and environmental health. She shares success stories from projects in India, Rwanda, and the Caribbean, and emphasizes how technology, digital tools, and international collaboration are reshaping public health. Her call to action: sustained investment to build resilient health systems.Title – Can the World Ever Be Truly Ready for the Next Pandemic? Priya Basu, Executive at The Pandemic FundKey Timestamps:{00:00} Introduction to the Pandemic Fund and Priya Basu{02:57} The Need for Pandemic Preparedness{06:14} Operational Challenges in Pandemic Response{11:47} Country-Driven Approaches to Health Security{14:29} Lessons from COVID-19 and Future Preparedness{17:14} Successful Projects and Challenges Faced{23:59} The Role of Technology in Future Pandemics{27:00} Public Health Awareness and Community EngagementKey Takeaways:COVID-19 exposed the world's lack of preparedness for pandemics.The Pandemic Fund aims to strengthen health systems in low-income countries.Surge capacity is essential for effective pandemic response.Countries must take ownership of their health security plans.Collaboration across countries is vital for pandemic preparedness.Investments in health security are cost-effective compared to the costs of pandemics.A multi-sectoral approach is necessary for effective health interventions.AI and technology can enhance data gathering and response coordination.Successful projects demonstrate the impact of the Pandemic Fund's investments.Building resilient public health systems is crucial for future preparedness.Guest Bio – Priya Basu, Executive Head of the Pandemic FundPriya Basu is a global health and development finance leader with nearly 30 years of experience driving pandemic preparedness, health systems strengthening, and innovative finance. As the founding Executive Head of the Pandemic Fund at the World Bank, she mobilized $3B in seed capital and catalyzed over $6B in co-financing for 75+ countries. Previously, she led global initiatives at the World Bank, IMF, ADB, and UN, shaping landmark health financing mechanisms and advancing inclusive growth across regions.???? Connect with Priya Basu on LinkedInAbout the Host – Roy Bejarano, Co-founder & CEO at SCALE HealthcareRoy Bejarano is Co-Founder & CEO of SCALE Healthcare, the nation’s top healthcare consulting firm. As host of Analyzing Healthcare, Roy interviews leading executives, policymakers, and innovators shaping the future of healthcare strategy, MSO leadership, and system transformation.???? Connect with Roy Bejarano on LinkedInKeywords:Pandemic Fund, Priya Basu, COVID-19, pandemic preparedness, health security, global health, surveillance, workforce training, international collaboration, One Health, healthcare innovation, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care, Healthcare Trends and Innovations, Leading Healthcare Stakeholders, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Richard Zane of UC Health shares healthcare innovation strategies, tech adoption, patient care frameworks, and building a culture of collaboration.In this episode, Richard Zane, Chief Medical and Chief Innovation Officer at UC Health, discusses the innovative strategies and frameworks that drive the healthcare system's approach to patient care and technology. He emphasizes the importance of understanding problem statements, the duality of his roles, and the collaborative nature of innovation at UC Health. The conversation explores successful initiatives, challenges in technology adoption, and the cultural aspects that foster a spirit of innovation within the organization. Zane also shares insights on measuring success and the future direction of UC Health's innovation efforts.Title- Inside UCHealth: How Pragmatic Innovation Scales Across a $9B Health SystemKey Timestamps:{00:00} Introduction to UC Health and Innovation{04:28} The Role of Technology in Healthcare Innovation{07:12} Dual Role of Chief Medical and Innovation Officer{12:27} Structure and Focus of the Innovation Office{13:54} Case Study: The Haystack Project{20:09} Challenges in Third-Party Technology Integration{24:00} Criteria for Evaluating Innovation Initiatives{27:48} Fostering a Culture of Innovation{31:53} Measuring Success in Innovation Projects{35:11} The Evolution of UC Health's Innovation Program{38:32} Future Directions for UC Health{40:22} Partnerships Beyond Hospital ProvidersKey Takeaways:Innovation is a strategic pillar for UC Health.The role of Chief Innovation Officer is crucial for integrating technology and patient care.Understanding problem statements is key to effective innovation.UC Health's approach is hyper pragmatic and data-driven.The organization values partnerships with technology companies for co-development.Cultural transformation is essential for fostering innovation.Measuring success involves identifying clear metrics and outcomes.Phased deployments are preferred over pilot programs to avoid 'pilotitis'.The future of healthcare will involve more outpatient and home care solutions.UC Health aims to be a leader in innovative healthcare delivery.About the Guest:Richard Zane, Chief Innovation Officer at UCHealth and Professor of Emergency Medicine, shares how he is transforming healthcare delivery through digital innovation, AI, and data-driven care models. From emergency medicine leadership to pioneering virtual care strategies, Zane highlights UCHealth’s role in advancing patient outcomes, clinical efficiency, and system-wide innovation. This conversation offers critical insights for healthcare executives, providers, and innovators navigating the future of health systems.linkedin.com/in/richard-zane-md-9b87b5alinkedin.com/in/jasonschifmanKeywordsUC Health, innovation, healthcare technology, patient care, healthcare system, Chief Innovation Officer, healthcare delivery, technology adoption, healthcare partnerships, quality improvement, healthcare technology, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

David Lubarsky on safety net hospitals, trauma care, AI, value-based care, and leading large healthcare systems.In this episode, David Lubarsky, President and CEO of Westchester Medical Center Health Network, discusses the complexities and challenges of managing a large healthcare system. He highlights the unique aspects of Westchester Medical Center, including its role as a major trauma center and safety net hospital. The conversation delves into operational challenges, financial pressures, and the importance of community care. Lubarsky also emphasizes the need for integration and synergy within healthcare systems, the impact of technology, and the significance of strategic partnerships in enhancing patient care.Title- AI, Medicaid Cuts & Safety Net Hospitals: How Health Systems Survive and Innovate | Dr. David LubarskyKey Timestamps:{00:00} Introduction to Westchester Medical Center Health Network{02:38} Comparative Analysis of Healthcare Systems{05:13} The Complexity of Healthcare Integration{08:20} Operational Challenges in a Safety Net System{10:56} The Role of Trauma Centers in Community Health{13:41} Navigating Medicaid and Unfunded Patients{16:35} Contrasts in Safety Net Access Across States{19:22} The Future of Healthcare: Technology and PartnershipsKey Takeaways:Westchester Medical Center serves as a critical healthcare hub in New York.The center handles a significant number of inbound patient transfers, indicating its importance in the region.Operational efficiency and standardization are key goals for healthcare systems.Financial sustainability is a major concern for safety net hospitals.AI and technology can enhance healthcare delivery and efficiency.Community care and access to services are essential for underserved populations.The healthcare landscape is evolving with new partnerships and care models.State variations impact healthcare access and safety net responsibilities.Healthcare is a complex system with many interdependent parts.The future of healthcare will rely on innovative solutions and strategic collaborations.Guest Bio – Dr. David Lubarsky, President and Chief Executive Officer Westchester Medical Center Health NetworkDavid Lubarsky, MD, MBA, is the President and CEO of Westchester Medical Center Health Network, a vital safety-net health system serving millions across New York’s Hudson Valley. With prior leadership at UC Davis, Miami, and Duke, Dr. Lubarsky has spent his career expanding access for underserved populations while pioneering system integration and value-based care. In this conversation, he shares candid insights on Medicaid disenrollment, payer disruption, AI as “augmented intelligence,” and the growing role of retail health partnerships. His perspective offers MSO leaders, providers, and payers a real-world look at how healthcare can adapt and transform under pressure.Connect with Dr. David Lubarsky on LinkedInAbout the Host – Roy Bejarano, Co-founder & CEO at SCALE HealthcareRoy Bejarano is Co-Founder & CEO of SCALE Healthcare, the nation’s top healthcare consulting firm. As host of Analyzing Healthcare, Roy interviews leading executives, policymakers, and innovators shaping the future of healthcare strategy, MSO leadership, and system transformation.Connect with Roy Bejarano on LinkedInKeywords: Westchester Medical Center, healthcare system, trauma care, operational challenges, safety net hospitals, healthcare technology, strategic partnerships, community health, financial pressures, healthcare access, healthcare innovation, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care, Healthcare Trends and Innovations, Leading Healthcare Stakeholders, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Transforming Pakistani healthcare with 7,500+ female doctors & 3M+ teleconsults—Sehat Kahani is closing access gaps through tech & cultural insight. In this episode, Dr. Sara Saeed Khurram, CEO of Sehat Kahani, unpacks how her tech-enabled platform tackles the country’s doctor-patient mismatch, leverages 7,500+ female doctors, and delivers over 3 million teleconsults. From cultural constraints to nationwide growth, hear how Sehat Kahani blends virtual clinics, corporate partnerships, and community care to improve outcomes. Dr. Khurram highlights the resilience of providers and the vital role of cultural values in healthcare delivery.Title- Scaling Primary Care: Inside Sehat Kahani’s 60+ Clinics Across Pakistan | Dr. Sara Saeed Khurram x SCALE CommunityKey Timestamps:{00:00} Overview of the Pakistani Healthcare System{12:53} The Birth of Sehat Kahani{23:40} Sehat Kahani's Growth and Impact{28:31} Healthcare Accessibility in Pakistan{29:45} Corporate Partnerships and Patient Utilization{31:28} Community Clinics and Rural Healthcare{32:56} Innovative Clinic Models and Mental Health Services{34:19} Corporate Healthcare Solutions and Cost Savings{36:11} Financial Models and Payment Structures{40:23} Provider Recruitment and Quality Assurance{45:29} Data Analytics and Outcome Tracking{49:44} Future Expansion and Technological Advancements{53:06} Cultural Resilience in Healthcare DeliveryKey Takeaways:Pakistan has a significant doctor-patient mismatch.Cultural barriers prevent many female doctors from practicing.Sehat Kahani was founded to address healthcare access issues.Telehealth can bridge gaps in primary care.The company has grown to include over 7,600 doctors.Corporate partnerships have expanded Sehat Kahani's reach.The app connects patients to doctors within 60 seconds.Sehat Kahani is exploring expansion into the GCC and Kenya.Resilience and hospitality are key strengths in Pakistani healthcare.The future includes enhancing technology and AI solutions.About the Guest: Dr. Sara Saeed Khurram, CEO and Co-founder of Sehat Kahani, is transforming Pakistan’s healthcare landscape. Her platform has delivered over 3.1 million telemedicine consultations, reactivated 8,000+ female doctors, and served 10 million+ lives—all while bridging primary care gaps in underserved areas. In this episode, she unpacks what’s broken in women’s health, how her full-spectrum model works, and why it’s yielding a 4:1 ROI for employers. A must-listen on innovation, inclusion, and the power of women-led healthcare reform.linkedin.com/in/dr-sara-saeed-khurram-9a8873aalinkedin.com/in/jasonschifman KeywordsSehat Kahani, telehealth, Pakistani healthcare, Dr. Sara Saeed Khurram, healthcare innovation, doctor-patient mismatch, corporate telemedicine, healthcare access, women in healthcare, healthcare technology, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Medicaid cuts, drug pricing, rural hospital challenges, AI in healthcare, and why prevention is key to the future of U.S. healthcare. In this episode, Kristi Martin, former Chief of Staff at the Center for Medicare, examines the implications of recent Medicaid cuts, their impact on long-term care, and the ripple effects on private insurance and rural hospitals. She discusses the challenges of Medicare drug pricing negotiations, rising healthcare inflation, and the critical role of nonprofit hospitals in care delivery. The conversation highlights the need to rethink healthcare financing models, especially in rural communities, while exploring the opportunities and risks of AI in healthcare. Kristi also underscores the importance of preventative care, health equity, and value-based care in shaping better outcomes.Title- Inside the Healthcare Policy Crossroads: Medicaid, Medicare, and Reform with Kristi Martin, Former CMS LeaderKey Timestamps:{00:00} Introduction to Kristi Martin and Healthcare Landscape{01:05} Impact of Recent Medicaid Changes{04:56} Long-Term Care and Medicaid's Role{09:12} State Variations in Medicaid Coverage{11:54} The Dichotomy of Healthcare Systems{15:45} Medicare Drug Pricing Negotiations{18:51} Challenges in Drug Pricing and Healthcare Spending{23:10} The Frustrations of Medical Education and Debt{26:02} The Role of Nonprofits in Healthcare{28:47} Diversity in Nonprofit Hospitals{34:09} Rethinking Financing for Community Hospitals{37:01} AI and the Future of Healthcare{42:22} The Importance of Preventative CareKey Takeaways:Medicaid cuts will significantly impact long-term care services.The ripple effect of Medicaid disqualification will affect all insurance types.State variability in Medicaid coverage leads to unequal access to care.Drug pricing negotiations are a crucial step towards more equitable healthcare costs.Nonprofits play a vital role in providing affordable healthcare solutions.AI in healthcare presents both opportunities and risks that need careful regulation.Preventative care is essential for improving overall health outcomes.The healthcare system needs to be restructured to better serve rural populations.Healthcare spending growth is driven by various factors, including drug prices.There is a critical need for a public health focus beyond just healthcare services.Guest Bio –Kristi MartinKristi Martin, Director at Canberra Collective and former Chief of Staff at the Center for Medicare, brings decades of experience shaping U.S. health policy. In this conversation, she unpacks the implications of recent Medicaid cuts, the strain on long-term care and rural hospitals, and the ripple effects across the healthcare system. Kristi also explores Medicare drug pricing negotiations, the role of nonprofits, and the need to rethink healthcare financing. She closes by examining AI’s risks in care delivery and emphasizing preventative care as essential to improving outcomes and advancing value-based care.Connect with Kristi Martin on LinkedInAbout the Host – Roy Bejarano, Co-founder & CEO at SCALE HealthcareRoy Bejarano is Co-Founder & CEO of SCALE Healthcare, the nation’s top healthcare consulting firm. As host of Analyzing Healthcare, Roy interviews leading executives, policymakers, and innovators shaping the future of healthcare strategy, MSO leadership, and system transformation.Connect with Roy Bejarano on LinkedInKeywords:healthcare policy, Medicaid, drug pricing, long-term care, ACA, healthcare spending, nonprofit healthcare, AI in healthcare, preventative care, community hospitals, healthcare technology, healthcare innovation, Healthcare System, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care

We hosted an exceptional roundtable with former CMS and CMMI leaders—Kristy Martin, Doug Jacobs, Liz Fowler, and Purva O’Rourke—who pulled back the curtain on how CMS operates, what drives policy, and how providers can productively engage the agency.Highlights & TakeawaysCMS culture = mission-first, non-partisan, expert-driven. Career staff see themselves as stewards of Medicare/Medicaid and keep the “trains running” regardless of administration.Playbook to engage CMS (no lobbyist required):Use public comment periodsRequest meetingsAttend site visitsEmail program leads directly (staff will often route you to the right person)Don’t wait until there’s a compliance issue—build relationships early“Listening mode” is normal. During rulemaking windows CMS may not respond in the moment—but silence can mean your input landed and is being weighed.Accountable care remains the north star. CMS wants beneficiaries in models where a “quarterback” is accountable for cost and quality, with on-ramps for smaller/rural providers and emphasis on provider-led governance.Primary care signals are positive. Recent PFS proposals maintain/expand advanced primary care, CCM/remote monitoring, and navigation codes—an encouraging sign for longitudinal, team-based care.Site-of-service migration will continue. CMS is actively evaluating procedures moving from inpatient to outpatient/ASC when safe and cost-effective—stakeholder comments matter here.Transparency is advancing. Price-posting requirements and NSA data are maturing; expect a more navigable market over the next few years as datasets standardize and tools improve.Behavioral health is moving from “supplemental” to integrated. New codes, broader provider definitions, and ACO/primary-care integration are building blocks—further progress may require Congressional authority.AI + burden reduction are live priorities. CMS is exploring AI for fraud detection and administrative simplification; proposals that reduce provider burden are welcome.Practical “Do / Don’t” from the PanelDO:Comment on proposed rulesShare data, outcomes, and real-world constraintsIntroduce innovative models earlyFollow up even if CMS can’t discuss specificsDON’T:Assume only large systems get heardWait until there’s a problemRead “quiet” meetings as failures Why it matters for MSOs & Health SystemsStrategy: Align roadmaps with accountable care, primary-care enablement, and behavioral integration.Operations: Build capabilities around care management, RPM/RTM, and documentation to capture value under evolving codes.Advocacy: Engage both CMS and Congress—some levers (e.g., broader BH coverage, physician payment reform) are statutory.

Mark Frank, SonderMind CEO, explores mental health MSO scaling, virtual care integration, AI-driven outcomes, value-based care models, and healthcare technology innovation. This episode examines how SonderMind built a 13,000-provider network delivering measurable patient outcomes through hybrid virtual-physical care delivery across all 50 states. Frank discusses mental health access barriers, cost optimization strategies, EHR integration, provider network management, and strategic health system partnerships. Key topics include telehealth adoption post-COVID, clinical outcome measurement, fee-for-service to value-based care transition, inpatient facility collaborations, and the role of AI in treatment planning. The conversation addresses MSO operational challenges, Medicaid population considerations, emergency department cost reduction, and technology's impact on mental healthcare scalability and quality.Title- Scaling 13,000 Providers: The AI-Driven Evolution of Mental Health Care with Mark Frank, SonderMind x SCALE CommunityKey Timestamps:{00:00} Introduction to Sondermind{02:10} Sondermind's Service Model and Geographic Reach{04:40} Spectrum of Mental Health Care Provided{06:36} Sondermind's Position in the Virtual Care Landscape{10:44} The Evolution of Virtual Care Post-COVID{13:43} Quality Measurement in Mental Health Care{17:39} The Role of Virtual Care in Patient Management{20:35} Integration of Virtual and In-Person Care{23:21} Sondermind's Scale and Technological Advantages{28:45} Frictionless Patient-Provider Matching{31:55} Collaboration with Health Systems{35:17} Inpatient Care and Virtual Health{39:22} Value-Based Care Models{46:09} Access and Cost in Behavioral Health{54:05} Serving Underserved PopulationsKey Takeaways:SonderMind is a leading mental health provider offering both virtual therapy and in-person counseling.The company operates in all 50 states and accepts a wide range of insurance plans for broader accessibility.SonderMind focuses on a comprehensive spectrum of mental health issues, from low-acuity conditions to severe psychiatric cases.The integration of technology in mental health care is central to improving outcomes and enhancing patient engagement.Virtual care expansion post-COVID has significantly increased access to behavioral health services nationwide.Quality measurement in mental health remains complex, requiring innovative approaches and outcome-driven metrics.SonderMind provides a seamless transition between virtual and in-person care, ensuring better continuity for patients.The company leverages its scale and advanced technology to improve care delivery and enable efficient patient-provider matching.Collaboration with inpatient facilities is essential for effective patient discharge, follow-up care, and recovery support.Value-based care models in behavioral health are being explored to incentivize improved patient outcomes and cost savings.About the Guest:Mark Frank leads SonderMind, the nation's largest scaled mental health provider organization delivering hybrid virtual and in-person care across all 50 states. Under his leadership since 2015, SonderMind has built proprietary technology integrating EHR systems, patient applications, and AI-powered clinical tools that demonstrate superior outcomes—achieving subclinical improvement in severe depression and anxiety cases within 6-8 sessions. Frank's strategic vision combines MSO operational efficiency with full-stack technology development, establishing strategic partnerships with health systems while pioneering value-based care models that prioritize patient outcomes over session volume in behavioral health delivery.linkedin.com/in/markdfrank1 linkedin.com/in/jasonschifman KeywordsSondermind, mental health, virtual care, outpatient care, behavioral health, technology in healthcare, access to care, value-based care, mental health outcomes, healthcare innovation, SCALE Community, Analyzing Healthcare, Healthcare Innovation, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Lee Shapiro, Seven Wire Ventures Managing Partner & former Livongo CFO, drives healthcare innovation and venture capital investment across Allscripts, Transcarent & Jasper Health.In this conversation, Lee Shapiro, Managing Partner of Seven Wire Ventures, discusses the evolving landscape of the healthcare system and healthcare investment, emphasizing the importance of consumer behavior, preventative care, and the challenges faced by startups in healthcare technology. He highlights the need for technology-enabled services, stronger patient engagement, and the role of employers in driving healthcare innovation. Shapiro also addresses the complexities of navigating cash vs. payer models and the regulatory challenges that impact the industry.Throughout the discussion, he shares industry insights on evaluating founders, leadership, and the risks associated with early-stage venture capital investments, ultimately advocating for a more consumer-centric approach to healthcare strategies, value-based care, and MSO strategy.Title- Can B2B2C Work in Healthcare or Is Employer & Payer Buy-In the Only Way to Scale? Lee Saphiro, 7wire Ventures x SCALE CommunityKey Timestamps{00:00} Introduction to Healthcare Investment{02:38} The Shift from Healthcare to Health{05:25} Consumer Behavior in Healthcare{08:26} Understanding Consumer Needs{11:22} The Importance of Preventative Care{13:51} Engaging Consumers Effectively{16:36} Navigating the Cash vs. Payer Dilemma{19:23} The Role of Employers in Healthcare{22:14} Challenges in Venture Capital{24:49} Evaluating Founders and Business Models{27:41} Risks in Early-Stage Investments{30:16} Regulatory Challenges in Healthcare{32:57} The Future of Healthcare Technology{35:52} The Innovator's Dilemma in Healthcare{38:36} Conclusion and Final ThoughtsKey TakeawaysSeven Wire Ventures focuses on supporting companies that help consumers navigate health challenges.The distinction between healthcare and health is crucial; consumers prefer to be healthy rather than just receiving healthcare services.Engaging consumers effectively is essential for driving patient engagement and long-term behavior change.Preventative care is often overlooked but is vital for improving overall health outcomes.Understanding consumer behavior and mapping their journey is key to developing effective healthcare strategies.The cash versus payer dilemma presents challenges for startups in the healthcare system.Employers play a significant role in healthcare governance, leadership, and adoption of new solutions.Evaluating founders, market fit, and strong leadership is critical for successful venture capital investments.Regulatory challenges can slow down the adoption of new healthcare technology.The future of healthcare innovation will increasingly rely on technology, value-based care, and sustainable MSO strategy to improve access and affordabilityGuest Bio –Lee Saphiro, Managing Partner at 7wire VenturesLee Shapiro, Managing Partner at Seven Wire Ventures, is a leading voice in digital health innovation. As former CFO of Livongo, he helped scale one of the industry’s most successful chronic care platforms, ultimately acquired by Teladoc Health for $18.5 billion. Earlier, as President of Allscripts, he guided the company through significant growth in electronic health records. Shapiro also serves on the boards of companies including Transcarent, MedArrive, and Jasper Health, where he continues to champion technology-driven solutions improving access, affordability, and patient outcomes across healthcare. ⁠

Virtual women’s healthcare redefined: Joe Connolly, CEO of Visana Health, shares how his national clinic addresses menopause, PCOS, fibroids & more with a comprehensive, tech-enabled model. He discusses the mission behind Visana, women’s unique care needs, patient acquisition strategies, regulatory hurdles, quality benchmarks, and partnerships with in-person providers. The episode explores how Visana is closing gaps in access, driving better outcomes, and shaping the future of women’s health delivery.Title-How Is Visana Health Redefining Access, Equity, and Value in Women’s Care? | Joe Connolly x SCALE CommunityKey Timestamps:{00:00} Introduction to Visana Health{00:49} The Founding Story and Mission of Visana Health{02:45} Provider Scope and Comprehensive Care Model{05:42} Patient Acquisition Strategies{08:42} Overcoming Barriers to Patient Engagement{10:21} Navigating Regulations and Provider Licensing{12:22} Quality of Care in Virtual Health{14:29} Cost Efficiency and Payment Models{19:13} Collaboration with In-Person Clinics{22:06} Measuring Outcomes and Patient Satisfaction{23:01} Challenges and Resistance in the Market{25:39} Future of Visana Health and Expansion Plans{30:29} Addressing Underserved Populations{33:29} Provider Experience and Satisfaction{35:07} Conclusion and Future OutlookKey Takeaways:Visana Health was founded to address women's health issues beyond fertility and maternity.The clinic operates with a 50-state medical group to provide comprehensive care.Many women seeking care have multiple comorbidities, highlighting the need for integrated services.Patient acquisition involves partnerships with health plans and employers to raise awareness.Trust is essential for patient engagement and overcoming barriers to care.Visana Health has a high Net Promoter Score (NPS) of 91, indicating patient satisfaction.The clinic measures clinical outcomes, with 93% of patients experiencing symptom improvement.Challenges include educating health plans about the importance of women's health conditions.Visana aims to expand access to underserved populations, particularly women of color.The provider experience at Visana is positive, with a focus on whole-person care.About the Guest: Joe Connolly, Founder and CEO of Visana Health, is redefining women’s healthcare through a national virtual-first model. Inspired by his family’s struggles with complex gynecological conditions, Joe built Visana to close critical gaps in care beyond fertility and maternity. Under his leadership, Visana has scaled across all 50 states, caring for more than 30,000 patients, many in rural and underserved communities. By integrating OB-GYNs, primary care providers, endocrinologists, and nurse practitioners, Visana delivers whole-person care with measurable results—93% of patients report symptom improvement within months, alongside average annual cost savings of $2,400 per patient.About the Host: Jason Schifman is Co-Founder & President of SCALE Healthcare and host of the Analyzing Healthcare podcast’s Healthcare Technology & Innovation series. A leading voice in healthcare transformation, he blends strategic, operational, and financial expertise to help multi-site systems scale efficiently, adopt value-based care, and deliver measurable improvements in patient outcomes and organizational performance.⁠Connect with Joe Connolly on LinkedIn⁠ ⁠Connect with Jason Schifman on LinkedIn⁠Keywords Visana Health, women's health, telehealth, virtual care, healthcare innovation, patient acquisition, healthcare access, provider collaboration, health outcomes, healthcare regulations, SCALE Community, Analyzing Healthcare, Healthcare Innovation, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Latest Trends in Healthcare, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Opioid crisis solutions, AI in drug discovery, precision medicine, healthcare innovation, and policy insights from Dr. Rahul Gupta.In this episode, Dr. Rahul Gupta, former White House Director of National Drug Control Policy, shares lessons from leading America’s fight against the opioid crisis. He discusses strategies that reversed decades of rising overdose deaths, highlighting the need for accessible treatment and equitable care. Dr. Gupta also introduces his current work with GATC Health, where AI-driven platforms are transforming drug discovery and precision medicine. From predictive analytics to reducing the cost and timeline of clinical trials, his insights reveal how innovation can improve outcomes, lower healthcare costs, and close systemic gaps in care delivery across the U.S.Title – Can AI Redefine the Economics of Drug Discovery and Healthcare? Rahul Gupta, President, GATC Health x SCALE Community Key Timestamps:{00:00} Introduction to Dr. Raul Gupta and GATC Health{01:24} The Opioid Epidemic and National Drug Control Policy{08:15} Repositioning Opioids and Alternative Pain Management{14:49} Understanding Healthcare Disparities in America{21:00} Transition to GATC Health and AI in Drug Discovery{34:38} The Future of Precision Medicine and Drug Development Key Takeaways:Dr. Gupta has experience across city, state, and federal healthcare systems.The opioid crisis has led to over 112,000 deaths annually in the U.S.Predictive analytics can help reduce overdose deaths significantly.Access to naloxone is critical in combating the opioid crisis.Healthcare disparities exist significantly across different states in the U.S.The transition from state to national healthcare perspectives is crucial for addressing addiction.AI can streamline drug discovery and reduce costs.Precision medicine will lead to more effective and personalized treatments.Democratizing drug discovery can increase access to new treatments.Collaboration between law enforcement and healthcare providers is essential. Guest Bio – Rahul Gupta, President at GATC HealthDr. Rahul Gupta, one of the nation’s most respected physician-leaders, with a career spanning frontline care, state leadership, and the White House. As Director of National Drug Control Policy, he reversed decades of rising overdose deaths and drove groundbreaking addiction and public health strategies that saved tens of thousands of lives. Today, as Chief Medical Officer at GATC Health, Dr. Gupta is pioneering AI-driven drug discovery and precision medicine, reshaping the economics and future of healthcare.⁠

Inside the $60B voluntary benefits market—Amy Hollis on transparency, utilization, and rethinking how employers & carriers deliver value.In this episode of the Analyzing Healthcare podcast’s Healthcare Technology & Innovation series, host Jason Schifman, Co-Founder & President of SCALE Healthcare, sits down with Amy Hollis, Founder & CEO of Employees First, to pull back the curtain on the $60B voluntary benefits market.They explore how employers, employees, and insurance carriers interact in this space—and why the product structure is sound, but the ecosystem is flawed. Hollis shares insights from 20+ years in healthcare and benefits consulting, covering market size, employee participation rates, utilization challenges, carrier strategies, and the role of transparency in driving better outcomes.From self-funding models to claims data visibility and integrated supplemental–core benefit strategies, this conversation is packed with actionable intelligence for healthcare leaders, benefits consultants, and employer decision-makers.Title - Is the Voluntary Benefits Market Built to Serve… or to Profit? | Amy Hollis x SCALE CommunityKey Timestamps:{00:00} Understanding the Voluntary Benefits Market{02:56} Market Size and Employee Participation{05:52} Drivers of Employee Adoption{08:51} Utilization Challenges in Voluntary Benefits{11:46} Evaluating the Product Fit{14:53} The Ecosystem of Voluntary Benefits{17:58} The Role of Insurance Carriers{21:01} Future of Integrated Benefits{29:34} Understanding the Challenges in Healthcare Benefits{32:24} Innovative Approaches to Self-Funding{34:55} Transparency in Claims and Costs{40:57} Client Engagement and Market Dynamics{46:24} Addressing Employer Concerns and Risks{51:14} Comparing Voluntary and Medical BenefitsKey Takeaways:Understanding the $60B voluntary benefits market and its misunderstood valueWhy employee participation ranges from 2% to 35%The growing role of insurance carriers in supplemental benefitsLow utilization rates and the awareness gapRisks of transparency and employer liability in today’s environmentHow integration with core medical benefits could unlock valueInnovative self-funding approaches and market dynamicsEducating employers on options and shifting incentivesAbout the Guest:Amy Hollis, Founder & CEO of Employees First, is a 20+ year healthcare and benefits consulting veteran. She specializes in bringing transparency, accountability, and value to the voluntary benefits market. Amy’s innovative model realigns incentives, exposes inefficiencies, and returns dollars to benefit plans—empowering employers with informed choices and employees with better coverage.About the Host:Jason Schifman is Co-Founder & President of SCALE Healthcare and host of the Analyzing Healthcare podcast’s Healthcare Technology & Innovation series. A leading voice in healthcare transformation, he blends strategic, operational, and financial expertise to help multi-site systems scale efficiently, adopt value-based care, and deliver measurable improvements in patient outcomes and organizational performance.Connect with Amy Hollis on LinkedInConnect with Jason Schifman on LinkedInKeywordsVoluntary benefits, healthcare, employee benefits, insurance, market trends, employee participation, utilization, insurance carriers, healthcare costs, supplemental insurance, healthcare benefits, self-funding, transparency, employer engagement, risk management, voluntary benefits, claims data, insurance models, employee benefits, market dynamics, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Healthcare data transparency, provider benchmarking, and value-based analytics are transforming patient outcomes and network optimization in the U.S.On Analyzing Healthcare, Keith Somers—CEO of Health Corum—explores how risk-adjusted claims and outcomes data from Medicare and commercial payers drive smarter decisions for payers, employers, and patients. Health Corum benchmarks over 1.5 million providers, enabling fair, data-driven comparisons by adjusting for patient complexity and demographics. The discussion reveals why price doesn’t equal quality, showcases regional variations, and highlights how data-driven transparency empowers stakeholders to build higher-performing networks and advance value-based care nationwide. Title- How Can Data-Driven Insights Transform Healthcare Delivery? Keith Somers, Health Corum x SCALE Community Key Timestamps {00:00} Introduction to Health Corum{01:14} The Unique Approach of Health Corum{04:21} Understanding the End Users{06:47} Provider Engagement and Transparency{08:32} Data Coverage and Analytics{10:14} Data Sources and Partnerships{12:39} Clinician Involvement and Data Integrity{13:41} Market Position and Competitors{15:16} Use Cases and KPIs for Payers{20:50} Value-Based Care Evaluation{23:01} Consumerization of Healthcare{24:01} Strategic Partnerships and Price Transparency{26:59} Insights from Data Analysis in Healthcare{34:47} Regional Variations in Healthcare Quality and Costs{40:02} Impact of COVID-19 on Healthcare Utilization Key TakeawaysHealth Corum delivers granular, transparent analytics to support smarter healthcare decisions.Founded out of frustration with healthcare’s lack of actionable data.Benchmarks 1.5 million providers nationwide using claims data from Medicare and commercial payers.Focuses on care effectiveness, quality outcomes, and provider performance within specialties.Empowers patients, payers, and employers to make data-driven choices.Health plans use insights for network optimization and improved patient care.Providers use benchmarking to identify areas for improvement.Strategic partnerships advance price transparency, aligning quality scores with costs.Data analysis shows that high healthcare prices do not always equal high quality.Healthcare quality and costs vary widely by region.Texas stands out for strong outcomes despite less medical education recognition.COVID-19 delayed care and changed patient utilization habits.Healthcare prices don’t reliably reflect demand or quality.Innovation often thrives in the Midwest and South, where competition and tight budgets drive adoption.Understanding local healthcare dynamics is essential for lasting solutions. Guest Bio – Keith Somers Keith Somers is CEO & Co-Founder of Health Corum, pioneering healthcare transparency and value-based analytics. By leveraging advanced data science to benchmark provider performance, Keith empowers payers, employers, and health systems to achieve superior clinical and financial outcomes—setting new standards for quality and accountability in healthcare.

Joe Corkery, CEO of Jaide Health, is revolutionizing healthcare communication with AI-driven solutions that enhance translation accuracy, equity, and patient access to care.In this enlightening episode, Joe Corkery, CEO of Jaide Health, delves into the critical issue of language barriers in healthcare and how they hinder access to care. He shares Jaide Health's innovative AI-driven platform designed to provide real-time medical interpretation and translation. The conversation covers the profound impact of language gaps on patient outcomes, the limitations of current solutions, and the cutting-edge approach Jaide Health is taking to bridge these divides. This episode includes a live demo of Jaide Health's technology, exploring its capabilities, security, and regulatory challenges. Tune in to discover the future of AI in healthcare communication and how it can transform patient care.Title: Bridging the Healthcare Language Divide: AI for Equitable Patient Care | Joe Corkery x SCALE CommunityKey Timestamps:{00:00} – Introduction to Jaide Health and Its Mission{02:12} – Understanding Language Barriers in Healthcare{04:39} – Current Solutions for Language Interpretation{09:54} – Jaide Health's Innovative Approach{13:30} – Live Demo of Jaide Health's Technology{17:12} – Quality and Security in AI Translation{24:26} – The Future of AI in Healthcare Communication{28:14} – Recommendations for Healthcare Providers{32:00} – Regulatory Considerations and Future OutlookKey Takeaways:Jaide Health is pioneering an AI-driven platform for healthcare translation.8% of the U.S. population faces limited English proficiency, exacerbating language barriers in healthcare.Traditional solutions like bilingual staff and Language Line have significant limitations.AI can enable fast, unscheduled interactions between patients and providers, ensuring better communication.Jaide Health supports 35 languages for real-time spoken translation and 80–90 languages for written medical translations.AI translation quality varies by language and digital footprint, but it can provide a consistent patient experience.Healthcare organizations are encouraged to experiment with AI-driven solutions through pilot programs.Regulatory clarity around AI language services is essential to support widespread adoption in healthcare.Jaide Health aims to enhance health equity by breaking down language barriers in patient care.About the Guest:Joe Corkery, CEO of Jaide Health, is leading groundbreaking work to address language disparities in healthcare. His innovative use of AI technology is transforming how healthcare systems provide inclusive care, improving patient-provider communication and access to care. Joe's mission is to ensure health equity for all patients, regardless of their language proficiency. With his leadership, Jaide Health is at the forefront of AI-powered healthcare innovation, reshaping how healthcare communicates globally.⁠linkedin.com/in/joecorkery⁠ ⁠linkedin.com/in/jasonschifman⁠Keywords:Healthcare, language barriers, AI translation, patient care, Jaide Health, health equity, medical interpretation, technology innovation, healthcare access, patient communication, SCALE Community, Analyzing Healthcare, Healthcare Innovation, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Explore how the World Health Summit drives global health innovation, pandemic preparedness, and cross-sector healthcare collaboration worldwide.In this compelling episode, Carsten Schicker, CEO of the World Health Summit, joins Roy Bejarano for a high-level discussion on global health strategy, healthcare governance, and the collaborative dynamics shaping the future of international health systems.From the World Health Summit's role in setting the global health agenda to the urgent need for pandemic preparedness and resilient health systems, this episode provides actionable insights for healthcare executives, policymakers, and private-sector stakeholders. Carsten unpacks how cross-sector collaboration, innovative public-private models, and lessons from COVID-19 can inform smarter investments and more equitable global health delivery.Title: Leading Global Health: Insights from the CEO, World Health Summit x SCALE CommunityKey Timestamps:{00:00} Introduction to the World Health Summit{02:24} The Role of the World Health Summit in Global Health{04:56} Measuring Success in Global Health Initiatives{07:07} Learning from Diverse Health Systems{09:46} The Importance of Cross-Sector Collaboration{12:23} Innovative Solutions from Resource-Constrained Settings{14:45} The Shift in Global Health Investment Perspectives{17:25} Challenges in Global Health Delivery{19:55} The Need for Holistic Health Approaches{25:59} Contradictions in Healthcare Management{28:40} The Complexity of Healthcare Funding{29:28} Global Perspectives on US Healthcare{32:53} Disparities in Access to Care{35:04} The Erosion of Trust in Institutions{38:20} Lessons from the COVID-19 Pandemic{42:09} The Global Pandemic Agreement{48:07} Preparing for Future PandemicsKey Takeaways:The World Health Summit aims to set the agenda for a healthier future.Collaboration among stakeholders is essential for better health outcomes.Learning from diverse health systems can lead to innovative solutions.The private sector plays a crucial role in healthcare delivery.Funding for global health needs to be viewed as an investment.Resilient health systems are necessary to respond to future pandemics.Trust in health institutions has been eroded due to the pandemic.Effective communication is vital for public health initiatives.Health outcomes are influenced by factors beyond healthcare delivery.Future pandemic preparedness requires a holistic approach.Guest Bio – Carsten Schickar Carsten Schickar is the CEO of the World Health Summit, a leading global platform for health policy, innovation, and cross-sector collaboration. With a background from INSEAD and extensive international experience, he has elevated the Summit’s influence on global health diplomacy. Carsten is a strong advocate for pandemic preparedness, resilient health systems, and strategic investment in healthcare. Under his leadership, the Summit drives partnerships between governments, academia, and the private sector to shape a more equitable and sustainable global health future.⁠

Value-based care, cancer treatment innovation, and integrated oncology platforms take center stage in this episode featuring Daniel Virnich, CEO of The Oncology Institute.In this powerful conversation on the Analyzing Healthcare Podcast, Dr. Daniel Virnich joins host Jason Schifman to explore how the Oncology Institute is redefining cancer care through a value-based, integrated delivery model. As the largest value-based oncology platform in the U.S., TOI operates over 80 care sites and is leading efforts to transform outcomes, improve adherence, and manage costs in underserved communities. Title: Redesigning Oncology at Scale: How TOI Is Leading the Value-Based Revolution | Daniel Virnich x SCALE Community Key Timestamps:{00:00} Introduction to the Oncology Institute{01:51} Value-Based Care in Oncology{06:35} Integrated Care Models in Oncology{11:22} Managing Drug Spend and Innovation{13:06} Measuring Success in Oncology Care{14:38} Differentiation in Oncology Services{17:52} The Three-Party Relationship in Oncology Care{21:41} Building a Value-Based Network{27:26} The Role of Florida Oncology Network{33:23} Navigating Growth as a Public Company{35:42} Leveraging Technology for Efficiency{39:42} Future Growth and Market Expansion Key Takeaways:What value-based oncology care truly entails—and why it mattersManaging misaligned incentives in oncology’s drug reimbursement modelThe role of technology, telemedicine, and home-based careHow TOI achieves over 30% cost savings while improving clinical outcomesStrategic growth through partnerships with payers and primary care networksNavigating public company growth and expanding regional oncology networksUtilizing AI and operational efficiencies to scale integrated oncology models About the Guest:Dr. Daniel Virnich is CEO of The Oncology Institute, the largest value-based oncology platform in the U.S., with over 80 care sites across five states. Board-certified and a seasoned leader, Dr. Virnich is pioneering scalable, risk-bearing oncology care models that align financial incentives with clinical outcomes—delivering 30%+ cost savings, improved adherence, and elevated community-based cancer care for underserved populations. ⁠linkedin.com/in/danielvirnich⁠⁠linkedin.com/in/jasonschifman ⁠ Keywords: Oncology Institute, value-based care, cancer treatment, healthcare innovation, integrated care, cost management, healthcare partnerships, technology in healthcare, oncology network, patient care, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

U.S. healthcare performance is under the microscope. From Medicaid expansion and ACOs to spending trends and racial disparities, Dr. Elizabeth Fowler joins SCALE Community to break it down.In this episode of Analyzing Healthcare, Dr. Elizabeth Fowler—healthcare policy leader and former Director of the CMS Innovation Center—sits down with host Roy Bejarano to explore the real state of U.S. healthcare. They dive deep into how state-level performance varies dramatically, where Medicaid expansion made a difference, and how accountable care organizations (ACOs) are shifting care delivery.Expect insightful commentary on technology's role in improving healthcare data, the challenge of public vs. private systems, and the real-world impact of rising obesity and overdose rates. Together, they assess how the U.S. stacks up internationally and the ongoing policy efforts needed to drive better outcomes.This episode is a must-listen for healthcare leaders, policymakers, and anyone seeking to understand where U.S. healthcare is headed—and what it’ll take to get there.Title: Healthcare in Crisis or Transition? ACOs, Access, and State Disparities with Elizabeth Fowler | SCALE CommunityKey Timestamps{00:00} Exploring State-by-State Healthcare Performance{02:37} The Role of Technology in Healthcare Data{05:14} Accountable Care Organizations: A Deep Dive{07:48} Understanding Medicaid Expansion and Coverage{10:35} Mandatory Coverage: State Approaches and Impacts{13:10} Comparative Analysis of Healthcare Systems{15:59} Private Insurance vs. Public Systems{18:36} Healthcare Spending Trends Across States{21:24} Obesity and Its Impact on Healthcare{24:05} Drug Overdose Rates and Healthcare Strain{26:41} Access to Care: Disparities and Solutions{29:07} Healthcare Infrastructure: Beds and Admissions{31:42} The Role of Public Health Data{34:29} Disparities in Access to Primary Care{37:00} Comparing State Performance to International Standards{39:38} The Complexity of Healthcare Policy Solutions{42:08} Final Thoughts on Healthcare Data and AnalysisKey TakeawaysChatGPT's limitations in providing accurate healthcare dataThe evolving role of ACOs in improving care quality and cost controlStark disparities in coverage—from Massachusetts’ leadership to Texas’ uninsured challengeCalifornia's infrastructure strain amid demand]Persistent racial and ethnic disparities in care accessObesity and overdose rates’ burden on state healthcare systemsThe need for public health data transparency and cross-state comparisonsWhy healthcare policy requires nuanced, localized approachesGuest Bio – Elizabeth Fowler Elizabeth Fowler is a leading healthcare policy expert and former director of the CMS Innovation Center. She played a key role in drafting the Affordable Care Act and has championed value-based care models to improve quality and reduce costs. Her work has shaped national healthcare reform, with a focus on equity, innovation, and patient-centered delivery systems.

In this high-impact episode of the Analyzing Healthcare podcast, we sit down with Robbie Allen, CEO of US Heart and Vascular (USHV), to explore how he scaled the cardiology platform from 40 to 400+ providers across six states in just 3.5 years. Robbie shares a behind-the-scenes look at building one of the fastest-growing cardiovascular care organizations in the country.This episode dives into key themes shaping the future of cardiology and multi-site specialty care—value-based care models, digital health, health equity, access expansion, provider network growth, and legislative challenges. We also examine how technology, AI, and strategic MSO models are reshaping patient experience and healthcare delivery at scale.Whether you're a healthcare executive, MSO operator, cardiologist, policy expert, or investor, this conversation offers essential insights on how to scale care delivery models, navigate regulatory hurdles, and position for national and global healthcare transformation. Title: How Robbie Allen Scaled US Heart & Vascular 10x — Inside the Future of Cardiology | SCALE Community Key Timestamps:{00:00} Introduction to US Heart and Vascular{02:47} Growth and Expansion of USHV’s Platform{05:49} Innovations in Patient Care and Technology{09:03} Building Value-Based Care and Risk Models{11:47} Expanding Access & Health Equity Focus{17:42} Strategic Partnerships and MSO Opportunities{24:18} Leveraging Technology for Scalable Care{27:15} Shaping the Future of Cardiology{32:31} Collaboration vs. Competition in the MSO Space{34:38} Legislative and Regulatory Considerations{41:42} Global Healthcare Trends & Expansion Potential Key Takeaways:US Heart and Vascular grew from 40 to 400+ providers in 3.5 years.Focused on expanding care access in underserved markets.Uses technology and AI to improve patient experience and operations.Developing value-based care and risk-sharing models.Health equity is a core organizational priority.Promotes collaboration among cardiology providers.Shift underway as providers move out of traditional health systems.Legislative changes impact MSO operations and strategy.Exploring global models to inform U.S. care delivery.Emphasizes scalable, sustainable healthcare practices. About the Guest: Robbie Allen, CEO of US Heart and Vascular, has scaled the platform from 40 to 400+ providers across six states in just 3.5 years. A seasoned healthcare leader, he champions access, value-based care, and tech-driven innovation. Robbie’s impact spans cardiology, AI health startups, and executive leadership—reshaping the future of specialty care through strategic growth and patient-centric solutions.

Board governance, scaling companies, and healthcare strategy with Jan Babiak, former EY leader and Walgreens Boots Alliance board member.In this compelling episode of the Analyzing Healthcare podcast, Jan Babiak—board leader and former Global Managing Partner at EY—joins Roy Bejarano, Co-Founder of SCALE Healthcare, to explore how governance must evolve as companies grow from startups to $250B+ giants.Jan breaks down what makes a board high-functioning versus dysfunctional, why diverse skill sets matter, and how board members shape corporate culture and long-term outcomes. With a focus on healthcare, she addresses the unique challenges boards face in this highly regulated and rapidly evolving industry.From transitioning private companies to public boards, to modernizing consulting and aligning board oversight with mission and innovation—this conversation is a must-listen for leaders at every stage of growth. Key Timestamps{00:00} Introduction to Board Dynamics{02:49} Scaling Companies: From Startups to Uber Caps{05:45} High Functioning vs. Dysfunctional Boards{08:23} The Role of Board Members{11:13} Navigating Change in Large Organizations{14:05} The Importance of Diverse Skill Sets{17:02} The Impact of Governance on Company Culture{19:39} Transitioning from Private to Public Boards{22:08} Healthcare vs. Other Industries{25:00} Consulting in the Modern EraTop TakeawaysBoard composition evolves significantly as companies scale.High-functioning boards foster open dialogue and diverse thinking.Dysfunctional boards are often dominated by CEO-driven agendas.Effective governance demands understanding organizational complexity.Diverse expertise on boards improves innovation and risk management.Navigating large-scale change requires adaptability and strategic foresight.Healthcare boards face unique pressures due to regulation and patient impact.Consulting firms must modernize to stay relevant in dynamic markets.Strong governance encourages a transparent and accountable culture.Transitioning from private to public boards requires significant shifts in oversight. Guest Bio – Jan BabiakJan Babiak is a globally respected board director and governance expert. Formerly Global Managing Partner at EY, she now serves on the boards of companies such as Walgreens Boots Alliance. Her work spans digital innovation, risk management, cybersecurity, ESG, and ethics—with a strong lens on the healthcare industry and how effective governance can drive patient-centered, resilient organizations.

Patient Prism uses AI, healthcare analytics, and call center optimization to drive patient engagement, data-driven decisions, and revenue recovery in healthcare.In this episode of the SCALE Community's Healthcare Podcast, hosted by Roy Bejarano and Jason Schifman, we dive deep into how Patient Prism leverages AI and healthcare analytics to optimize call center operations, drive patient engagement, and unlock real revenue recovery for providers.Guest Amol Nirgudkar, Founder & CEO of Patient Prism, breaks down the operational barriers in healthcare that prevent converting inquiries into appointments. He shares how real-time call analysis, actionable marketing insights, and sales conversion strategies enable better data-driven decisions, improve lead quality, and enhance the overall patient experience.The conversation explores the intersection of automation and human touch, measuring ROI and patient lifetime value, and the importance of tech consolidation in modern healthcare environments.Title:Operationalizing AI to Boost Patient Engagement & ROI | Amol Nirgudkar, CEO of Patient Prism | SCALE CommunityKey Timestamps:{00:00} Introduction to Patient Prism and Its Mission{05:14} Implementation and Client Engagement with Patient Prism{09:54} Marketing Insights and Lead Quality Analysis{12:45} Sales Optimization and Conversion Strategies{17:55} Operational Challenges and Solutions in Healthcare{21:01} Data-Driven Recommendations and Strategic Insights{24:09} Maximizing Revenue Potential{25:16} Understanding Patient Lifetime Value{26:43} Real-Time Insights and Call Analysis{28:04} The Future of AI in Healthcare{30:45} Balancing Automation and Human Touch{34:44} The Importance of Product vs. Feature{38:45} Consolidation of Tech Solutions{41:12} Expanding Beyond Dental: A Broader Vision{44:26} Attribution and Measuring ROIKey Takeaways:Patient Prism applies AI and healthcare analytics to unlock call center optimization and higher sales conversion.Understanding lead quality is vital to boosting patient engagement and appointment rates.Real-time call analysis and automation drive significant revenue recovery and data-driven decisions.Clear insights into patient lifetime value guide better resource allocation.Effective marketing insights improve ad spend and ROI attribution across functions.Operational inefficiencies—not just poor leads—are major culprits in lost revenue.Healthcare organizations benefit from ongoing reporting, strategy, and tech consolidation.Balancing AI with human touch is crucial to enhancing the patient experience.Scaling solutions beyond DSOs opens new growth in healthcare.About the Guest: Amol is the Founder & CEO of Patient Prism, a pioneering AI-powered healthcare analytics platform helping providers turn calls into care. With a focus on patient engagement, automation, and data-driven decisions, Amol has driven measurable outcomes like 20× ROI and 80% sales conversion rates. He advocates for scalable AI that enhances—rather than replaces—human interaction.⁠linkedin.com/in/amolnirgudkar⁠⁠linkedin.com/in/jasonschifman⁠Keywords: Patient Prism, AI, healthcare analytics, call center optimization, patient experience, marketing insights, sales conversion, operational efficiency, lead quality, data-driven decisions, healthcare, patient engagement, AI, automation, revenue recovery, patient lifetime value, call analysis, tech consolidation, DSO, marketing attribution, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Description:In this episode of the SCALE Community Healthcare Podcast, presented by SCALE Healthcare, host Roy Bejarano is joined by award-winning journalist Noam Levey (KFF Health News) for a bold, data-packed discussion on healthcare challenges in the U.S. They dissect how the Affordable Care Act reshaped coverage, why private equity is transforming care delivery, and how predatory patient financing leads to devastating medical debt. They also unpack systemic healthcare costs, the call for transparency, and the role Scale Community can play in advancing sustainable change. This is must-listen content for health policy experts, providers, and change agents committed to a stronger, smarter healthcare system.Key Timestamps:(00:00) Welcome to Scale Community with Roy Bejarano & Healthcare Journalism Journey(02:49) Affordable Care Act: Reform Wins & Policy Pitfalls(05:55) Why ACA Didn’t Lower Overall Healthcare Costs(08:48) Transparency & Systemic Barriers in U.S. Healthcare(11:55) Outpatient Growth, Patient Financing & Financial Stress(15:01) The Patient Experience & Out-of-Pocket Costs(20:52) Private Equity in Healthcare: Ownership Trends(25:26) Can Private Equity Enhance Healthcare Transparency?(28:03) Patient Financing & Rising Medical Debt Crisis(34:01) Demystifying Patient Balances & the Need for Regulation(40:28) Healthcare Costs & the Emotional Toll of Medical Debt(48:19) A Call from Scale Community: Transparency as a SolutionKey Takeaways:The Affordable Care Act increased insurance access but didn’t control rising healthcare costs, especially in outpatient settings.Private equity firms now play a dominant role in healthcare, often reducing transparency and increasing system complexity.Rising medical debt is fueled by exploitative patient financing schemes and unexpected billing practices.Healthcare journalism like Levey’s brings clarity to these trends—offering evidence-based perspectives on reform.Roy Bejarano and Scale Community spotlight the need for industry-wide accountability and improved transparency.Guest Bio:Noam Levey, senior correspondent at KFF Health News, is one of the most trusted voices in healthcare journalism. With over 15 years at the LA Times, he’s led award-winning investigations on medical debt, the Affordable Care Act, healthcare costs, and transparency. His work continues to shape how Americans and stakeholders understand the modern healthcare landscape. ⁠

In this episode of Analyzing Healthcare, brought to you by Scale Community, we sit down with Dr. William Briggs, CEO of Naitive, to explore the frontier of bone health innovation, with a sharp focus on osteoporosis diagnosis, musculoskeletal health, and healthcare technology. Dr. Briggs shares how Naitive is addressing critical gaps in orthopaedic care through a turnkey solution—“Bone Health Service in a Box”—powered by cutting-edge AI. From FDA approval of OsteoSight™ to piloting with leading orthopaedic groups, this conversation delivers actionable healthcare strategies, deep industry insights, and real-world applications for providers, payers, and innovators alike. Title: Reinventing Musculoskeletal Care with AI - William Briggs, CEO at Naitive x Analyzing Healthcare Key Timestamps:(00:00) Introduction to Naitive & the Future of Bone Health(04:27) The Silent Threat: Diagnosing Osteoporosis(06:03) Native’s Turnkey Solution for Orthopaedic Practices(10:52) Implementing Osteocyte: Integration & Usability(20:13) Go-to-Market Strategy & Commercial Potential(38:01) Vision Beyond Bones: Joint & Muscle Health Expansion Key Takeaways:Naitive is building scalable solutions in musculoskeletal care, with a specific focus on osteoporosis—a condition that often goes undiagnosed.Their AI-powered platform, OsteoSight™, leverages routine imaging data to proactively detect bone loss.The company has received FDA Breakthrough Device Designation, reinforcing its potential clinical impact.Currently in pilot with leading orthopaedic groups, the implementation process is designed to be seamless and minimally disruptive.Dr. Briggs shares insights on whether Naitive will stay purely tech-focused or expand into human-led patient care services.The conversation covers market readiness, payer strategy, and what it takes to drive adoption among healthcare stakeholders. About the Guest:Dr. William Briggs is a Cambridge-trained physician and biochemist who transitioned from clinical practice in London to healthcare innovation. At Naitive, he developed OsteoSight™, an AI-powered tool that analyzes routine X-rays to detect early signs of osteoporosis, addressing the widespread underdiagnosis of this condition. Under his leadership, OsteoSight™ received FDA Breakthrough Device Designation, marking a significant advancement in proactive bone health management. ⁠linkedin.com/in/will-briggs-76585990⁠⁠linkedin.com/in/jasonschifman ⁠ Keywords:Bone Health, Osteoporosis, Naitive, Healthcare Innovation, Orthopaedics, Technology, Diagnosis, Patient Care, FDA Approval, Musculoskeletal Health, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

In this episode of Analyzing Healthcare by SCALE Community proudly supported by SCALE Healthcare x JPMorgan, we dive deep with John McDonough, professor at the Harvard T.H. Chan School of Public Health, to explore the growing public health crisis driven by federal research funding cuts. McDonough dissects the Harvard funding crisis, the erosion of grant-supported research institutions, and the challenges facing academic medical research under the Trump administration and beyond. We examine how shifts in healthcare policy research, NIH funding threats, and the impact of political funding decisions are reshaping public health, particularly in health disparities research, environmental health studies, and population health innovation. The conversation also contrasts the U.S. and European healthcare systems, highlights the limitations of value-based care, and emphasizes the importance of state-level healthcare policy experimentation in advancing more equitable, sustainable solutions. Title: John McDonough on Population Health, Research Disruption & the Harvard Funding Crisis | Analyzing Healthcare | SCALE Community Key Timestamps:(00:00) Introduction to Harvard T.H. Chan School of Public Health(03:00) The Role of Research in Public Health(06:10) Nutrition and Public Health Research(09:05) Population Health vs. Public Policy(11:56) Healthcare Spending and Health Outcomes(14:51) The Obesity Crisis in America(18:01) Environmental Health Determinants(22:54) EU vs. US Healthcare System: A Comparative View(27:06) Structural Challenges in the U.S. Healthcare System(31:58) Value-Based Care: Insights & Limitations(40:41) Why State-Level Policy Variations Matter Key Takeaways: The academic funding crisis threatens long-term innovation in public health education and healthcare research.Nutrition research and environmental health studies remain critically underfunded.The U.S. prioritizes reactive care over preventive population health initiatives.Obesity and environmental factors drive poor health outcomes.State-level experimentation could be a catalyst for nationwide policy change.Despite challenges, opportunities exist to refocus research investment on health equity, health system innovation, and population-level outcomes. ⁠linkedin.com/in/john-mcdonough-2bb49825⁠⁠linkedin.com/in/roy-bejarano-a5669ba8⁠⁠www.scale-community.com ⁠ About the Guest:John McDonough is a renowned health policy expert and Harvard professor whose work has shaped U.S. healthcare reform, including key roles in the Affordable Care Act. With decades of experience in government, academia, and advocacy, he brings unmatched insight into health systems, policy analysis, and public health—making him a leading voice in the national healthcare conversation. KeywordsHarvard TH Chan, Public Health, Nutrition, Healthcare Policy, Population Health, Obesity, Environmental Health, Research Funding, Health Outcomes, Healthcare Spending, Healthcare Systems, Europe, US Healthcare, Value-Based Care, State Policy, Healthcare Outcomes, Investment, Patient Care, Medical Care, Population Health, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

In this episode, Dr. David Jacofsky, founder and CEO of HOPCo, discusses how the company is transforming musculoskeletal care through value-based models, tech-driven services, and integrated operations. He shares insights on preventative care, global risk, custom EMRs, analytics, and HOPCo’s support for practices across 34 states. The conversation also covers partnerships, tech strategy, governance, and global expansion plans.Title: Integrating Data and Care to Lead MSK Transformation with David Jacofsky, CEO at HOPCoKey Timestamps:(00:00) Introduction to Hopco and Its Mission(02:53) Understanding Hopco's Business Model and Growth(05:47) Achieving Better Outcomes in Value-Based Care(08:59) Preventative Care and Comprehensive Services(12:01) Global Risk Management in Orthopedic Care(14:50) Operational Programs and Infrastructure Investments(18:08) Market Transformation and Integration in Healthcare(21:00) Service Line Offerings and Management Strategies(23:57) The Future of Orthopedic Care and Industry Trends(25:04) Building Value in Healthcare Partnerships(28:39) Navigating Market Entry Strategies(29:08) Technology Strategy: Build vs. Buy(34:43) Governance and Long-Term Vision(39:38) Strategic Partnerships in Value-Based Care(43:23) Direct Relationships with Employers(46:35) Future of Hopco and the MSK Market(49:21) Global Expansion OpportunitiesKey Takeaways: HOPCo is the only fully integrated musculoskeletal platform leading orthopedic care transformation in the U.S.Built on four pillars: physician practice management, hospital partnerships, value-based care, and digital health.Its fast-growing digital division enhances patient engagement and care delivery.Focused on improving health outcomes and financial performance through value-based care.Emphasizes preventative care to lower costs and avoid unnecessary procedures.Takes on global risk and per-member, per-month models for long-term sustainability.Offers tech-driven services to boost efficiency and reduce admin burden.Developing a unified platform for better patient engagement and care coordination.Integrates services across providers to ensure continuity and market improvement.A model for non-MSO specialty practices looking to consolidate and scale.Prioritizes delivering more value than it consumes to strengthen partnerships.Proven track record makes HOPCo a trusted partner in value-based care.Grows through strategic partnerships with providers, payers, and employers.Uses flexible entry models that scale through deeper integration.Tech-forward from the start, with robust infrastructure supporting growth.Pursues acquisitions aligned with long-term goals and seamless integration.Offers a full suite of tools to improve practice efficiency and care quality.Partners with risk-bearing organizations to excel in population health models.Exploring international markets to expand its orthopedic care platform.⁠linkedin.com/in/david-jacofsky-md-4204419⁠⁠linkedin.com/in/jasonschifman⁠⁠www.scale-community.com ⁠About the Guest: David Jacofsky is the founder and CEO of HOPCo and The CORE Institute. A pioneer in value-based musculoskeletal care, he has grown HOPCo into a $1B national platform across 34 states. With 30+ patents and 85+ publications, his innovations have reshaped orthopedic care in the U.S.Keywords:#ValueBasedCare #HealthcareOperations #TechEnabledHealthcare #HealthTech #DavidJacofsky #HOPCo #MedicalPracticeSupport #HealthcareInnovation #RevenueCycleManagement #CustomEMR #HealthcareAnalytics #PracticeEfficiency #HealthcareTransformation #OutsourcedHealthcare #MSOvsNonMSO #CloudHealthcare #DigitalHealthSolutions #OrthopedicLeadership #HealthcareIT #HealthSystemPerformance #SpecialtyCareTransformation #GroupPurchasingOrganization #PhysicianGroupEfficiency

In this episode, Ty Wang, CEO of Angle Health, joins Jason Schifman to share how their AI-native health plan is transforming healthcare marketing solutions for small and mid-sized businesses (SMBs). Discover how tech-driven healthcare lead generation, C-level healthcare engagement, and risk management innovations are shaping the future of healthcare access. A must-listen for those in MSO marketing strategy, healthcare sponsorship opportunities, and healthcare conferences 2025.Title: How Angle Health Is Redefining Healthcare Marketing Solutions for SMBs | Featuring CEO Ty WangKey Timestamps:(00:00) – Introduction to Angle Health and Its Mission(03:02) – Focus on Small and Medium-Sized Businesses(06:04) – Angle Health's Unique Value Proposition(08:49) – Navigating Healthcare Costs and Employee Experience(11:56) – Operational Efficiency and Technology Integration(14:51) – Strategic Partnerships and Service Offerings(18:01) – Addressing the Needs of SMBs(21:02) – Customization and Plan Design Flexibility(23:53) – Risk Management and Underwriting Practices(26:49) – Future Outlook for Angle Health(30:03) – Market Trends and Disruptors in HealthcareKey Takeaways:Angle Health delivers full-service, AI-powered health plans tailored for SMBs.The company champions healthcare sponsorship opportunities and healthcare brand awareness through digital-first solutions.Focuses on improving care through healthcare advertising platforms and tech-integrated operations.Offers plan customization and robust risk management practices.Builds strategic partnerships that support medical group marketing and physician group branding.Poised for growth amid shifts toward alternative funding models and healthcare innovation events.About the Guest:Ty Wang is the Co-Founder and CEO of Angle Health, a digital-first health insurance company focused on modernizing access to healthcare for small and mid-sized businesses. With a background in engineering and data strategy, he brings a tech-driven approach to streamlining insurance, improving care delivery, and addressing gaps in affordability, access, and patient experience across the U.S. healthcare system.linkedin.com/in/tywlinkedin.com/in/jasonschifmanKeywords:Healthcare, Angle Health, AI, Small Businesses, Insurance, Employee Benefits, Cost Savings, Healthcare Services, Market Trends, Technology Integration, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

In this episode, Jason Schifman interviews Michael Liebman, co-founder of IPQ Analytics, to discuss the importance of understanding diseases, particularly in women's health. They explore the flaws in current medical approaches, the need for a holistic view of health conditions, and the role of data analytics in improving patient outcomes. Michael shares insights on various women's health issues, including breast cancer, maternal health, and menopause, and emphasizes the importance of collaboration in healthcare research. Title: The Hidden Data Gaps Crippling Healthcare Innovation – with Michael Liebman, Co-founder of IPQ Analytic Key Timestamps:(00:00) Introduction to IPQ Analytics and Michael Liebman(04:01) Understanding Disease: The Flaws in Current Approaches(11:50) Exploring Women's Health: Conditions and Challenges(17:56) Data Collection and Analysis: The Role of IPQ Analytics(23:49) The Journey of Women: From Menarche to Menopause(30:00) International Perspectives on Healthcare Data(36:05) Collaborative Approaches in Healthcare Research Key Takeaways: IPQ Analytics focuses on understanding diseases from multiple perspectives.Current medical practices often lack a holistic view of health conditions.There is a need to move from correlation to causality in healthcare research.Women's health issues, such as menopause, require more comprehensive data.The age of menarche is decreasing, impacting women's health.Collaboration with international healthcare networks is essential for data collection.The Nordic countries excel in healthcare data collection and organization.Clinicians need better tools to ask the right questions about patient health.Understanding the journey of women from menarche to menopause is crucial for personalized medicine.Healthcare innovation should focus on problem-solving rather than just technology application. ⁠linkedin.com/in/michael-n-liebman-4b55b25 ⁠⁠linkedin.com/in/jasonschifman⁠⁠www.scale-community.com ⁠ About the Guest:Michael Liebman is a renowned biomedical scientist and thought leader in healthcare innovation. He is the Executive Director of IPQ Analytics and has pioneered approaches in disease understanding, personalized medicine, and data-driven healthcare. With a focus on women’s health and system-level change, his work bridges clinical research and real-world outcomes to drive more effective, patient-centered care. Keywords:Ipq Analytics, Women's Health, Breast Cancer, Data Analytics, Healthcare Innovation, Disease Understanding, Preventative Care, Clinical Research, Healthcare Collaboration, Patient Outcomes, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

In this episode of Analyzing Healthcare, Dr. Meena Seshamani, director of the Center for Medicare, discusses managing Medicare and Medicaid complexities in US Healthcare, initiatives to improve patient care, and the importance of transparency and engagement in healthcare policy. She elaborates on care transformation, Medicare Advantage challenges, and significant prescription drug pricing changes, emphasizing teamwork and collaboration. Dr. Meena Seshamani and Roy Bejarano discuss the complexities of drug pricing in America, Medicare's role in negotiating drug prices, and the impact of pharmacy benefit managers on healthcare costs. They explore the need for transparency in drug pricing and the potential benefits of new market entrants. The discussion also highlights state-level healthcare innovations, particularly Maryland's unique payment model, and the importance of focusing on prevention and chronic disease management. Meena shares her vision for the future of healthcare in Maryland, emphasizing a system that cares for individuals throughout their lives.Title: She Transformed Medicare for 68 Million Americans—Now She Reveals What’s Next: A Discussion with Former Medicare Director, Dr. Meena SeshamaniKey Timestamps:(00:00) Introduction To Medicare Leadership(03:02) Understanding Medicare And Medicaid(06:10) Transforming Care In Medicare(09:06) Medicare Advantage And Transparency(12:00) Prescription Drug Affordability Initiatives(15:02) Engagement And Team Dynamics In Medicare(18:01) Comparing Medicare With Other Payers(20:46) Pricing Mechanisms In Medicare(28:24) The Story Of Drug Pricing In America(32:01) Medicare's Role In Drug Negotiation(37:03) The Impact Of Drug Pricing On Healthcare Costs(40:27) New Entrants In The Drug Market(47:38) State-Level Innovations In Healthcare(54:06) Future Goals For Maryland's Health SystemKey Takeaways:Medicare serves 68M+ Americans (65+), a federal program unlike state-run Medicaid.Transforming care integrates behavioral health and community services.Medicare Advantage needs transparency and better navigation.The Inflation Reduction Act changed Medicare drug pricing.Stakeholder engagement is key for policy.Medicare pricing is statutory and budget-neutral.The Medicare Shared Savings Program promotes value-based care.Auditing and oversight are essential.Collaboration enhances Medicare effectiveness.US drug pricing is complex.Pharmacy Benefit Managers (PBMs) significantly control drug purchasing.Medicare negotiation can yield major savings.Drug pricing transparency is vital for trust.Healthcare markets differ from traditional ones.State-level innovations can model reform.Maryland's payment model enables healthcare innovation.Preventative care improves health outcomes.Life expectancy needs context.A holistic healthcare approach is necessary.⁠linkedin.com/in/meena-seshamani-0679424 ⁠⁠linkedin.com/in/roy-bejarano-a5669ba8⁠⁠www.scale-community.com ⁠About the Guest:Dr. Meena Seshamani, former Director of the Center for Medicare at CMS, led transformative efforts in U.S. healthcare. A physician and health economist, she championed equitable access, prescription drug affordability, Medicare Advantage transparency, and community-based care. Her leadership helped implement the Inflation Reduction Act and drove Medicare’s shift toward value-based, patient-centered models, impacting over 68 million Americans.Keywords:Medicare, Medicaid, Healthcare, Prescription Drugs, Medicare Advantage, Healthcare Policy, Health Equity, Pricing, Healthcare Transformation, Patient Care, Drug Pricing, Medicare, Healthcare Costs, Pharmacy Benefit Managers, Health Economics, Drug Negotiation, Healthcare Innovation, Maryland Health System, Healthcare Transparency, Prescription Drugs, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

In this episode, Jason Schifman interviews Mark Paradis, VP of Data Strategy for Northwell Holdings, on the intersection of AI, technology, and healthcare. They discuss Northwell’s role in innovation, investment strategies, and new technologies improving patient care and operations. Paradis shares insights on AI implementation challenges, data integration, and governance. He highlights Northwell’s approach to prioritizing ideas, evaluating tech opportunities, and driving adoption. The conversation also explores healthcare disparities and AI’s role in bridging these gaps while addressing the complexities of clinical integration. Tune in for a deep dive into the future of AI-powered healthcare transformation. Title: What Northwell Learned After Deploying AI in the Real World - with Marc Paradis, VP of Data Strategy at Northwell Holdings. Key Timestamps:(00:00) Introduction to Northwell Holdings and Its Role(03:08) The Role of Technology and AI in Healthcare(06:05) Investment Focus and Strategic Partnerships(08:50) Innovations in Back Office Operations(11:57) Clinical Innovations and AI Applications(18:00) Development Timelines and Regulatory Challenges(23:55) Future of Data Integration and AI in Healthcare(28:46) Reimagining Healthcare with AI(30:20) Innovative Governance and Idea Prioritization(33:03) Evaluating Opportunities in Healthcare Technology(36:27) The Future of Healthcare Technology(41:43) Adoption Challenges in Healthcare(46:12) Scaling Innovation Across Healthcare Systems Key Takeaways: Northwell Holdings is a for-profit arm of Northwell Health focused on innovation.Technology and data are essential for effective patient care.AI can enhance both clinical and operational efficiencies in healthcare.Investments are made in areas of care that are under-resourced.Partnerships with startup studios help align incentives for better patient outcomes.Innovations like Acertain automate back-office processes to reduce burdens.Optane integrates AI for clinical applications in primary care settings.Regulatory challenges can lengthen the timeline for clinical innovations.Data integration is crucial for improving healthcare delivery.AI can unlock insights from vast healthcare datasets. AI can analyze in thousands of dimensions.Northwell Health separates experimental ideas from clinical practice.Innovation comes from both internal and external sources.AI was incorporated into the innovation challenge process.Soft ROI is often lost in the complexity of healthcare.Healthcare is moving from linear to exponential technology adoption.Technology will be ready for adoption in three to five years.Non-clinical applications of AI will see faster adoption.Regulation and societal conversations around AI are crucial.AI can improve care quality beyond the average clinician's performance. ⁠linkedin.com/in/marcdparadis⁠⁠linkedin.com/in/jasonschifman⁠⁠www.scale-community.com ⁠ About the Guest:Marc Paradis, VP of Data Strategy at Northwell Holdings, is a leading voice in harnessing data and AI to drive real-world impact in healthcare. With deep expertise in analytics and a mission-driven mindset, he’s shaping how health systems leverage technology for better outcomes, smarter decisions, and scalable value-based care. In this episode, he shares bold insights on healthcare’s AI-powered future. KeywordsNorthwell Holdings, Healthcare Technology, AI In Healthcare, Data Strategy, Clinical Innovations, Investment In Healthcare, Healthcare Efficiency, Patient Care, Healthcare Systems, Healthcare Data Integration, AI In Healthcare, Innovation, Technology Adoption, Healthcare Governance, Patient Care, Healthcare Systems, Northwell Health, Healthcare Technology, Healthcare Transformation, Healthcare Efficiency, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

In this episode, Jason Schifman interviews Itzik Cohen, co-founder and CEO of PayZen, a company focused on AI-powered patient financing solutions in healthcare. They discuss the challenges of patient balances, the evolution of healthcare financing, and how PayZen aims to improve affordability for patients while enhancing collection rates for providers. The conversation highlights the importance of data-driven solutions, operational integration, and the future growth potential of PayZen in the healthcare market.Title: Can AI Solve the Patient Payment Crisis? A Deep Dive with PayZen’s CEO, Itzik CohenKey Timestamps:(00:00) Introduction to PayZen and Its Mission(08:54) Understanding Patient Financing Challenges(17:58) Innovative Solutions for Patient Affordability(26:57) Operational Integration and Challenges(35:58) Future Growth and Market OpportunitiesKey Takeaways:PayZen offers AI-powered patient financing solutions in healthcare.The shift in payment responsibility from payers to patients has increased collection challenges.Providers are seeing a 30-35% increase in collection rates with PayZen.PayZen focuses on affordability, not just payment plans.The company uses predictive analytics to assess patient financial needs.High NPS scores indicate patient satisfaction with PayZen's services.Operational complexity is a significant challenge for scaling the business.PayZen aims to automate processes to improve efficiency and patient experience.The healthcare market presents a significant opportunity for patient financing solutions.PayZen is committed to treating patients with respect and understanding their financial situations. linkedin.com/in/itzikcohlinkedin.com/in/jasonschifmanwww.scale-community.comAbout the Guest:Itzik Cohen, founder and CEO of PayZen, is dedicated to making healthcare affordable. Leveraging his fintech background from companies like Beyond Finance and Prosper Marketplace, Cohen's PayZen offers interest-free, AI-powered payment plans for medical bills. His vision addresses the growing issue of medical debt, providing accessible and manageable solutions for patients while improving financial health in healthcare.Keywords:PayZen, Patient Financing, Healthcare Innovation, Affordability Solutions, Healthcare Payments, Fintech In Healthcare, Patient Experience, Collection Rates, Healthcare Providers, Financial Assistance, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

In this podcast episode, Rivka Friedman, Managing Director at Morgan Health, discusses the mission and focus of Morgan Health, a unit within JPMorgan Chase dedicated to improving quality, equity, and affordability in employer-sponsored insurance. The conversation explores the dynamics of employer-sponsored insurance, the importance of innovation in primary and specialty care, and the challenges of implementing value-based care models. Rivka emphasizes the role of data and technology in empowering employees to make informed healthcare decisions and addresses the need for collaboration between employers and providers to enhance healthcare strategies. The discussion also highlights the unique challenges faced by small and medium-sized businesses in accessing quality healthcare options and the importance of managing expectations in healthcare innovation. Title: Is Employer-Sponsored Healthcare Broken? Rivka Friedman, Managing Director of Morgan Health on Fixing the System Key Timestamps:(00:00) Introduction to Morgan Health and Its Mission(03:06) Understanding Employer-Sponsored Insurance (ESI) Dynamics(05:52) Innovations in Primary and Specialty Care(09:13) Testing Comprehensive Care Models(12:11) Challenges in Value-Based Care Models(14:53) The Role of Data and Technology in Healthcare(17:56) Empowering Employees in Healthcare Decisions(20:49) Addressing Affordability and Quality in Healthcare(24:00) Collaboration Between Employers and Providers(26:48) The Future of Employer Health Strategies(29:58) Innovations for Small and Medium-Sized Businesses(33:11) Managing Expectations in Healthcare Innovation(36:14) The Role of Carriers in Healthcare Solutions(39:00) Final Thoughts on Healthcare Innovation Key Takeaways:Morgan Health aims to improve quality, equity, and affordability in healthcare.Employer-sponsored insurance (ESI) presents unique challenges and opportunities.Primary care access remains a significant issue in healthcare.Testing comprehensive care models is essential for improving outcomes.Value-based care models are slow to gain traction in the employer space.Data management and technology are crucial for employers to understand healthcare utilization.Empowering employees with actionable data can improve healthcare decisions.Affordability remains a pressing challenge for employers and employees alike.Collaboration between employers and providers is key to healthcare innovation.Small and medium-sized businesses need tailored healthcare solutions.⁠linkedin.com/in/rivka-friedman⁠ ⁠linkedin.com/in/jasonschifman⁠ ⁠www.scale-community.com⁠ About the Guest: Rivka Friedman, Managing Director at Morgan Health, leads healthcare innovation through pilots, data analytics, and payment reforms. She previously shaped Medicare and Medicaid policy at CMMI and led health system strategy at the Advisory Board Company. With expertise in value-based care and employer-provider collaboration, she offers deep insights into improving healthcare quality, equity, and affordability. Keywords Morgan Health, Employer-Sponsored Insurance, Healthcare Innovation, Primary Care, Specialty Care, Value-Based Care, Healthcare Affordability, Employee Empowerment, Healthcare Technology, Small Business Healthcare, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

In this conversation, Dr. David Shulkin, former Secretary of the US Department of Veterans Affairs, discusses the current state of the VA, the challenges it faces, and the opportunities for modernization. He emphasizes the need for clear objectives in reforming the VA, the importance of technology in improving efficiency, and the complexities of the relationship between the VA and TRICARE. Shulkin also reflects on the impact of the Mission Act, the necessity for rationalizing the healthcare system, and the political dynamics surrounding veteran care. Title: Is the VA in Crisis? Dr. David Shulkin, Former Secretary of the VA, on DOGE’s Plan and the Politics of the Veterans’ Healthcare Key Timestamps:(00:00) Understanding the Current State of the VA (03:06) Challenges and Opportunities in VA Modernization (05:55) Comparing VA and TRICARE: A Dual System (09:06) The Impact of the Mission Act (12:06) Navigating the Complexities of VA and DOD (15:00) The Need for System Rationalization (17:55) The Role of Private Sector in VA Care (21:06) The Importance of Clear Communication in Change (24:00) The Political Landscape and Veteran Care (27:10) Reflections on Leadership and Accountability Key Takeaways: The VA is facing confusion due to multiple stakeholders with different objectives.Modernization of the VA is crucial for improving veteran care.The VA's technology systems are outdated and need significant upgrades.TRICARE and VA serve similar populations but operate differently.The Mission Act allows veterans to seek care outside the VA system.The VA has a large integrated delivery system to serve veterans.There is a need for rationalization between the VA and community care systems.The presence of both VA and community care systems can lead to inefficiencies.Clear communication is essential for successful change initiatives in the VA.Political polarization can hinder progress in veteran care.⁠linkedin.com/in/davidshulkin⁠⁠linkedin.com/in/roy-bejarano-a5669ba8⁠⁠www.scale-community.com ⁠ About the Guest:Dr. David Shulkin is the former U.S. Secretary of Veterans Affairs and a respected healthcare leader. He has driven major reforms in veteran care, expanded private sector partnerships, and championed modernization efforts within the VA. With decades of experience in both public and private healthcare, he continues to advocate for policies that improve access, efficiency, and quality in U.S. healthcare. KeywordsVA, Department Of Veterans Affairs, David Shulkin, Healthcare, Veteran Care, Modernization, TRICARE, Mission Act, Healthcare System, Government Efficiency, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

Jason Schifman interviews Pelu Tran, CEO of Ferrum Health, on the challenges and opportunities in clinical AI adoption. They explore AI governance, security, and Ferrum’s role in helping hospitals select, implement, and monitor AI solutions. The discussion covers AI’s impact on patient care, the need for customization, white glove support, buy vs. build decisions, pricing models, vendor consolidation, and expanding AI applications. They also highlight the importance of governance frameworks, data security, and measuring AI’s impact on clinical outcomes. Title: Is AI the Answer to Better Patient Care? Ferrum Health CEO, Pelu Tran, on the Race to Modernize Healthcare Key Timestamps:(00:00) Introduction to Ferrum Health and AI in Healthcare(01:44) Challenges in AI Adoption in Healthcare(04:53) Ferrum's Role in AI Governance(06:15) Selection of AI Solutions for Hospitals(11:42) Implementation of AI Solutions(15:47) The Importance of Security in AI Deployments(19:48) Market Adoption of AI Solutions(23:07) Oversight and Monitoring of AI Applications(25:04) Integrating AI into Patient Care(28:30) Customization in Clinical Analytics(30:03) White Glove Support for AI Governance(32:46) Buy vs. Build: The AI Dilemma(35:51) Pricing Models and Client Engagement(37:51) Future Predictions for AI Adoption(40:23) Consolidation in the Vendor Landscape(41:06) Expanding into Non-Clinical Applications(44:21) Data Security in AI Applications(46:11) Governance as a Foundation for AI Adoption(49:55) Measuring AI Impact on Clinical OutcomesKey Takeaways: Ferrum Health enhances AI adoption by providing a curated ecosystem of AI applications and governance platforms for hospitals.Security and governance are key challenges, as hospitals struggle with deployment complexity and ensuring AI aligns with patient care pathways.AI evolves rapidly, requiring ongoing monitoring, customization for specialties, and white glove support for effective integration.Healthcare AI adoption is accelerating, driven by generative models, vendor consolidation, and expanding non-clinical applications.Data security and impact measurement remain critical, highlighting the need for strong governance frameworks and oversight. linkedin.com/in/pelutranlinkedin.com/in/jasonschifmanwww.scale-community.com About the Guest:Pelu Tran, CEO of Ferrum Health, is a healthcare innovator dedicated to improving patient outcomes through AI-driven technology. A Stanford-trained engineer and former co-founder of Augmedix, he has led groundbreaking advancements in clinical AI adoption. Recognized by Forbes and the World Economic Forum, Tran is committed to reducing medical errors and expanding healthcare accessibility worldwide. Keywords:Ferrum Health, AI In Healthcare, Clinical AI, Healthcare Technology, AI Governance, Patient Data Security, AI Adoption Challenges, Healthcare Innovation, AI Solutions, Healthcare Provider Landscape, AI In Healthcare, Patient Care, Clinical Analytics, AI Governance, Healthcare Technology, Data Security, AI Adoption, Healthcare Systems, Customization, Vendor Landscape, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

In this conversation, Dr. Robert Fields, an expert in population health, shares his journey from being a family doctor to a leader in healthcare. He discusses the complexities of population health, the differences between ACOs and traditional healthcare systems, and the challenges faced by Medicare Advantage. The conversation delves into the role of consumerism in healthcare and the future of value-based care, highlighting the need for a shift in how healthcare is delivered and financed. In this conversation, the speakers delve into the complexities of Accountable Care Organizations (ACOs) and their value in the healthcare system. They discuss the evolution of care coordination, the challenges faced in population health management, and the importance of addressing social determinants of health. The conversation highlights innovative approaches to social care and the need for a more integrated healthcare system that prioritizes patient outcomes and community well-being. Title: Understanding Population Health: Challenges and Opportunities with Dr. Robert Fields Key Timestamps:(00:00) Introduction to Population Health and Dr. Robert Fields(04:51) Dr. Fields' Journey in Healthcare Leadership(09:58) Understanding Population Health: Definitions and Perspectives(15:04) The Role of ACOs in Population Health(20:08) Challenges in Medicare Advantage vs. Traditional Medicare(25:12) Consumerism and the Healthcare System(29:58) The Future of Value-Based Care and ACOs(34:19) Evaluating the Value of ACOs(39:22) The Evolution of Care Coordination(45:00) Challenges in Population Health Management(52:25) Addressing Social Determinants of Health(01:00:01) Innovative Approaches to Social Care Key Takeaways: Dr. Fields stresses the importance of viewing population health beyond individual care.His journey highlights the challenge of aligning healthcare economics with patient care.ACOs are essential for managing population health effectively.Medicare Advantage presents unique challenges compared to traditional Medicare.Consumerism influences healthcare decisions, but the system often misaligns with patient needs.Value-based care is still evolving, and its success depends on system adaptation.Transparency in healthcare costs and outcomes is crucial.The effectiveness of ACOs varies, with Medicare Shared Savings ACOs being more trusted.Care coordination is critical but remains a complex, evolving aspect of healthcare.Social determinants significantly impact patient outcomes.Innovative approaches and nonprofit collaboration can enhance community health.The healthcare industry must address its moral responsibilities to patients.Economic incentives can drive improvements in social care. ⁠linkedin.com/in/robfieldsmd⁠⁠linkedin.com/in/roy-bejarano-a5669ba8⁠⁠www.scale-community.com ⁠ About the Guest:Dr. Robert Fields is a leader in healthcare quality, population health, and value-based care. As EVP and Chief Clinical Officer at Beth Israel Lahey Health, he oversees key clinical services. Previously, at Mount Sinai, he advanced care delivery and health equity. Co-founder of Vista Family Health, he champions linking social care to healthcare for better outcomes. Keywords:Population Health, Healthcare Leadership, ACOs, Medicare Advantage, Value-Based Care, Healthcare Economics, Chronic Disease Management, Healthcare Policy, Consumerism in Healthcare, Healthcare System Challenges, ACOs, Healthcare, Value-Based Care, Care Coordination, Population Health, Social Determinants of Health, Medicare, Medicaid, Healthcare Innovation, Health Systems, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

In this podcast episode, Jason Schifman interviews Suzanne Steinbaum, founder and CEO of Adesso, a company dedicated to improving cardiovascular care for women. They discuss the alarming statistics surrounding women's heart health, the unique challenges faced by female patients, and how Adesso's tailored care management platform aims to address these issues. The conversation covers the importance of prevention, the differences in treatment between men and women, and the innovative approach Adesso takes to engage patients and improve outcomes. Suzanne shares insights on the company's growth strategy, partnerships, and future developments in their platform. Title: The Future of Cardiovascular Care Tech Tailored for Women with Dr. Suzanne Steinbaum Key Timestamps: (00:00) Introduction to Cardiovascular Care for Women(02:53) Understanding the Statistics: Women's Heart Health(05:57) The Unique Challenges of Women's Cardiovascular Disease(09:07) Introducing Adesso: A Tailored Care Management Platform(11:47) Patient Experience: Standard Care vs. Adesso's Approach(15:09) Ongoing Care and Patient Engagement with Adesso(17:54) Adesso's Market Footprint and Growth Strategy(21:07) Partnerships and Coordination in Cardiovascular Care(23:52) Data-Driven Care: Algorithms and Outcomes(27:00) Future Directions and Product Development for Adesso(30:10) Challenges in Scaling and Replicating Success Key Takeaways: One in three women die of heart disease, more than all cancers combined.80% of heart disease is preventable, highlighting the need for prevention strategies.Women experience heart disease differently than men, often with worse outcomes.Adesso focuses on a tailored approach to cardiovascular care for women.The platform integrates with primary care to manage heart health proactively.Patient engagement is crucial; Adesso uses an app for ongoing communication.The company has seen a significant re-engagement of patients through its platform.Adesso is expanding its reach through partnerships with ACOs and other healthcare providers.Data-driven algorithms are used to assess patient risk and guide treatment.Future developments include a men's version of the platform and integration of various health management solutions. About the Guest:Dr. Suzanne Steinbaum, a leading cardiologist, entrepreneur, and advocate for women's heart health. With decades of experience at top hospitals, she pioneers technology-driven solutions to prevent heart disease. Through Adesso she is reshaping cardiac care and empowering women to take control of their heart health. Keywords:Cardiovascular Care, Women's Health, Heart Disease Prevention, Adesso, Healthcare Technology, Patient Engagement, Care Management, Health Statistics, Women's Heart Health, Preventive Care, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

Roy Bejarano hosts Brendan Ballou on Analyzing Healthcare to discuss his book Plunder and private equity’s impact on the U.S. economy. Ballou explores its dual nature—value creation vs. short-term risks—along with legal and regulatory challenges. The conversation covers ownership dynamics, risk management, and transaction implications. It highlights private equity’s conservative approach, healthcare investments, and the need for greater transparency and accountability. Title: Private Equity Under the Microscope: Incentives, Liability, and the Transactional Truth with Brendan Ballou Key Timestamps: (00:00) Introduction to Private Equity and Brendan Ballou(03:05) The Research Behind 'Plunder' and Private Equity's Impact(06:12) The Dual Nature of Private Equity: Pillaging vs. Building(08:54) Regulatory Challenges and Public Perception of Private Equity(11:51) Incentives and Fee Structures in Private Equity(14:55) Long-term vs. Short-term Perspectives in Private Equity(18:12) The Role of Legal Incentives in Private Equity(21:01) Conclusion: Balancing Perspectives on Private Equity(27:37) Understanding Private Equity Ownership Dynamics(30:01) The Risk Landscape in Private Equity(33:57) Transaction Risks and Their Implications(40:18) Private Equity's Focus on Healthcare Investments(52:23) Regulatory Considerations and Industry AccountabilityKey Takeaways: Plunder critiques private equity’s impact on America.Private equity firms often shield themselves from legal consequences.Fee structures incentivize short-term gains.Many private equity portfolios have a 90% success rate.Legal incentives can misalign firm interests.Public perception is often negative due to anecdotal cases.Long-term investment approaches yield better results.Private equity professionals are not inherently malicious.Regulatory challenges remain significant.A balanced view is needed for informed discussions.Ownership can be majority or minority, affecting control.Transaction risks outweigh litigation risks.Ownership changes introduce governance challenges.Private equity firms tend to be conservative and risk-averse.Investment bankers shape transaction risk landscapes.Healthcare investments are often misrepresented.Regulatory frameworks need updates for accountability.Transparency is key to building public trust.Inflated valuations pose systemic risks.Risk management is often reactive, not proactive.⁠⁠linkedin.com/in/brendan-ballou-2546801b7⁠⁠⁠⁠www.scale-community.com ⁠⁠ About the Guest: Brendan Ballou, author of "Plunder," critically examines private equity's influence on America. As a former federal prosecutor, including Special Counsel for Private Equity at the Justice Department, he brings unique legal insight. Ballou exposes risks like excessive debt and limited liability, driving vital discussions on industry regulation and its societal impact. His work sparks debate on accountability and economic fairness. Keywords: Private Equity, Brendan Ballou, Plunder, Legal Incentives, Short-term Thinking, Long-term Investment, Regulatory Challenges, Fee Structures, Public Perception, Healthcare, private equity, ownership dynamics, risk management, healthcare investments, regulatory accountability, transaction risks, investment strategies, legal insulation, corporate governance, financial incentives, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare Leadership, Healthcare Trends

In this episode, Tim Atterbury, CEO of Cardiovascular Associates of America (CVA USA), discusses the innovative approaches and structural changes being implemented in the cardiovascular care sector. He emphasizes the importance of empowering entrepreneurial cardiologists, integrating various aspects of care delivery, and navigating the complexities of risk-based reimbursement models. The conversation highlights the need for innovation, experimentation, and collaboration within the healthcare ecosystem to improve patient outcomes and reduce costs. This conversation delves into the evolving landscape of cardiology, focusing on patient management, collaborative care models, and the importance of risk-based contracting. The speakers discuss the challenges and opportunities presented by technology, strategic partnerships, and the role of private equity in shaping the future of healthcare. Emphasis is placed on the need for transparency and sustainability in operations, as well as the importance of adapting to geographic constraints and market dynamics.Title: How CVAUSA is Transforming Cardiology with Innovation, Risk-Based Models, and Patient-Centric Solutions with Tim Attebery Key Timestamps: (00:00) Introduction to CVA USA and Its Mission(02:49) The Evolution of Cardiovascular Care(05:46) Building a Comprehensive Care Model(09:09) Innovative Approaches to Patient Care(12:07) Risk-Based Reimbursement in Cardiology(15:02) Fostering Innovation and Experimentation(18:13) Navigating the Future of Cardiovascular Care(28:41) Understanding Patient Management in Cardiology(30:01) Collaborative Care Models with Primary Care(32:45) Risk-Based Contracting in Cardiology(34:40) Geographic Constraints in Risk Models(35:42) Exploring Strategic Partnerships(37:27) Impact of Technology in Cardiology(41:43) Building a Modern MSO(46:02) Future Challenges in Cardiology(49:19) The Role of Private Equity in HealthcareKey Takeaways: CVA USA has 160+ locations and 550+ providers.The mission is to empower specialists to improve care.Clinical, operational, and financial integration is key.Data analytics and advanced practice providers are vital.Risk-based contracting helps control patient care costs.Home-based cardiac rehab improves accessibility.Innovation and transparency are encouraged.CVA USA manages the full spectrum of cardiovascular care.The goal is quality care while reducing avoidable costs.10% of patients don’t respond to primary care.Collaborative models are crucial for complex cases.Geography affects risk model implementation.Partnerships with primary care improve patient management.Technology is essential in modern cardiology.A modern MSO must prioritize quality and compliance.Medicare policies shape cardiology’s future.Private equity drives healthcare innovation.Long-term success requires sustainability and execution.linkedin.com/in/jasonschifman linkedin.com/in/timothy-attebery-dsc-mba-fache-b06442b6www.scale-community.com About the Guest:Dr. Tim Attebery is a leader in cardiovascular care, driving innovation and technology. As CEO of CVAUSA and former CEO of the American College of Cardiology, he has advanced physician-led healthcare, improved cardiac imaging, and optimized hospital systems. His work continues to drive innovation in cardiovascular medicine and patient care.KeywordsCVA USA, cardiovascular care, risk-based reimbursement, healthcare innovation, patient care, MSO, healthcare technology, entrepreneurial cardiology, value-based care, healthcare ecosystem, cardiology, patient management, primary care, risk-based contracting, healthcare technology, strategic partnerships, MSO, private equity, healthcare innovation, collaborative care, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare, Healthcare Leadership, Healthcare Trends

Roy Bejarano sits down with Dr. Robin Smith and Dr. Andrew Von Eschenbach as they delve into the evolving field of regenerative medicine, focusing on stem cell therapy and its applications. In this episode, they discuss the history, current trends, and future potential of regenerative medicine, emphasizing the importance of exosomes and the challenges faced in clinical trials and FDA approval processes. They highlight the promise of regenerative therapies in restoring health and the need for continued innovation in healthcare. Title: Pioneering Innovation in Regenerative Medicine and Stem Cell Therapy with Dr. Robin Smith Guests: Dr. Robin Smith & Dr. Andrew Von Eschenbach Key Timestamps: (00:00) Introduction to Regenerative Medicine (03:11) The Evolution of Stem Cell Therapy (05:50) Understanding Regenerative Medicine(09:10) Applications and Public Interest in Stem Cell Therapy (11:51) The Role of Exosomes in Regenerative Medicine (14:46) Current Trends and Companies in Regenerative Medicine (17:57) Promise vs. Peril in Regenerative Medicine (21:04) Challenges in Clinical Trials and FDA Approval (24:02) The Future of Regenerative Medicine (26:57) Global Perspectives on Stem Cell Therapy (30:01) The Role of Innovation in US Healthcare (32:47) Conclusion and Future Directions Key Takeaways: Regenerative medicine aims to restore health, not just eliminate disease. Stem cells have been used in clinical settings for decades, primarily in oncology. Exosomes play a crucial role in cell communication and regenerative therapies. The public is increasingly interested in the applications of stem cell therapy. Clinical trials are essential for proving the safety and efficacy of new treatments. Innovation and funding are critical for advancing regenerative medicine. The FDA plays a significant role in regulating stem cell therapies. Different sources of stem cells can lead to different therapeutic outcomes. The complexity of creating new organs presents challenges in regenerative medicine. Global perspectives on stem cell therapy vary, with some countries advancing faster than others. ⁠ ⁠linkedin.com/in/robinlsmith-mdmba⁠⁠linkedin.com/in/andrew-von-eschenbach-m-d-9439ab10⁠⁠www.scale-community.com⁠ About the Guests: Dr. Robin L. Smith, doctor, author, and entrepreneur, is transforming healthcare through stem cell therapy, regenerative medicine, and predictive analytics. With expertise in M&A, FDA regulatory advancements, and industry turnarounds, she drives innovation and shapes the future of patient care. Dr. Andrew Von Eschenbach, M.D., former FDA Commissioner and NCI Director, advanced regulatory science, streamlined drug approvals, and prioritized innovation in medical products. His leadership focused on cancer research, prevention, and improving public health outcomes. Keywords: regenerative medicine, stem cell therapy, exosomes, FDA approval, clinical trials, healthcare innovation, oncology, musculoskeletal disease, tissue engineering, health restoration, Analyzing Healthcare, Roy Bejarano, Jason Schifman, Healthcare Leadership, Healthcare Trends

Roy Bejarano sits down with Dan Greenleaf, CEO of Duly Health, to discuss the innovative strategies driving success in the healthcare industry. Dan shares his journey from the pharmaceutical and infusion industries to leading one of the largest independent multispecialty groups in the country. They dive into the importance of team alignment, improving patient experience, and the value of value-based care in driving cost efficiency and better patient outcomes. Dan also shares insights on how technology, including AI and ambient listening, is revolutionizing patient care and physician experiences. Tune in to learn how Duly is paving the way for the future of healthcare through innovation, patient-centered care, and cost-effective solutions.Key Timestamps:(00:00) Introduction to Dan Greenleaf and Duly Health.(01:21) Dan shares his unexpected journey to becoming the CEO of Duly Health.(04:02) Discussing the importance of team alignment and the "right people in the right seats."(07:06) The focus on patient experience, reducing friction, and achieving world-class Net Promoter Scores.(12:30) Addressing access to care, cost efficiency, and patient convenience at Duly.(18:21) Value-based care and its integration into Duly's operations.(22:45) The transition from single specialty to multi-specialty practice and the challenge of balancing fee-for-service with value-based care.(25:02) How technology and AI, such as ambient listening, are improving patient and physician experiences.(30:30) Dan’s vision for the future of Duly, including the potential for direct-to-employer healthcare models.(35:01) The importance of reducing healthcare system inefficiencies and monopolistic behavior.(40:54) Global healthcare perspectives and what the U.S. can teach the world about cost efficiency and patient outcomes.Key Takeaways:Team Alignment is Crucial: The key to improving any healthcare organization is ensuring the right people are in the right roles, fostering a high-performing team that is aligned with the organization’s goals.Patient Experience Drives Success: Achieving high patient satisfaction and focusing on improving the patient journey are central to Duly's success, with world-class Net Promoter Scores.Cost Efficiency through Value-Based Care: Duly’s focus on value-based care allows for significant cost savings and better patient outcomes, with a strong emphasis on patient access and convenience.AI and Technology as Game-Changers: Technologies like ambient listening and AI-driven automation are transforming the clinical experience, improving efficiency, and reducing administrative burdens on physicians.Resources:Duly Health: Learn more about Duly Health’s patient-centered care model⁠ here⁠.SCALE-Community Website: https://www.scale-community.com/About the Guest:Dan Greenleaf is the CEO of Duly Health, the country’s largest independent multispecialty group, with over 1,000 primary and specialty care physicians. With extensive experience in both healthcare and pharmaceuticals, Dan has held multiple CEO positions across various sectors and is a strong advocate for improving patient care, reducing healthcare costs, and integrating value-based care. Under his leadership, Duly Health has become a model for healthcare innovation and patient-centered care.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Jason Schifman, Healthcare Innovations, Healthcare Industry Insights,patient care, value-based care, healthcare innovation, health systems, cost efficiency, primary care, multi-specialty group, patient experience, healthcare analytics

In this episode, Jason Schifman sits down with Andrew Ritter, CEO of Cairns Health, to discuss innovative solutions in senior care and patient engagement. Andrew shares his journey from founding Ritter Pharmaceuticals to leading Cairns Health, a company dedicated to enhancing care through digital tools like Luna, a proactive health companion. Tune in to learn about the role of technology in home health care, the challenges of patient engagement, and how Luna is transforming the patient-caregiver relationship. Timestamps:(00:00) Introduction to the podcast and guest(00:29) Andrew Ritter’s background in healthcare and technology(02:20) Transition from biotech to digital healthcare(05:01) Introduction to Luna: The digital care companion(08:03) Real-time monitoring and assessments with Luna(10:09) Reducing healthcare risks through predictive data(13:03) How Luna fits into home care and senior care models(15:52) Case studies: Vitality and Alzheimer's patient focus(19:36) Challenges in scaling digital solutions for healthcare(22:29) The future of healthcare technology and Luna’s impact(27:02) The potential for AI and voice recognition in senior care(29:47) Competitive landscape and Cairns Health's unique approach(32:05) The vision for the next 3-5 years in digital health Key Takeaways:Proactive Patient Engagement: Luna serves as a digital companion that provides proactive health monitoring and communication between patients, caregivers, and providers, improving care and reducing caregiver burden.Predictive Healthcare: By using advanced radar technology and AI, Luna helps predict potential health issues before they become critical, allowing for timely intervention.Empowering Patients: Luna enables patients, particularly seniors, to take an active role in managing their healthcare through easy-to-use digital tools that enhance communication and care plan adherence.Future of Healthcare Tech: The vision for digital healthcare is expanding beyond basic monitoring, aiming to create a comprehensive system where all health data is integrated to predict and prevent potential issues.About the Guest:Andrew Ritter, CEO of Cairns Health, shared his journey from biotech to digital healthcare. Through Luna, an autonomous radar system for non-intrusive patient monitoring, improving patient outcomes, and reducing the burden on caregivers, reshaping the future of healthcare.Resources:Scale Community⁠ https://www.scale-community.com/⁠Andrew Ritter ⁠linkedin.com/in/andrewritter⁠Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Jason Schifman, Healthcare Innovations, Healthcare Industry Insights, , Senior Care, Patient Engagement, Remote Monitoring, Digital Health, Healthcare Technology, Luna, AI in Healthcare, Senior Living, Home Care Technology

Barbara E. Wachsman is a healthcare leader with 25+ years of experience driving innovation in employer-sponsored healthcare. Formerly leading Disney’s healthcare strategy, she has shaped quality metrics, primary care access, and strategic partnerships. She advises startups, private equity firms, and healthcare organizations, championing affordability, accessibility, and improved care delivery.

In this episode of the Scale CEO Leadership Series, we sit down with Dr. Scott Hayworth, the former CEO of CareMount Medical, to discuss innovation, growth, and the future of medicine. With his wealth of experience in the healthcare industry, Dr. Hayworth shares valuable insights on leadership strategies, navigating healthcare transformation, and what the future holds for healthcare providers. Tune in to hear about the evolution of CareMount and how healthcare leaders are shaping the future of medicine.Timestamps:[00:00] Introduction to the Scale CEO Leadership Series[01:03] Dr. Hayworth’s background and CareMount acquisition by Optum[04:26] Transition from fee-for-service to value-based care[06:54] Managing multiple payment structures and supporting physicians[08:31] Managing healthcare costs and ensuring better patient care[12:15] Negotiating with Medicare and Medicare Advantage[15:45] Data and analytics in healthcare negotiations[18:11] Moving to Optum: Insights into the transition[23:31] Differences between managing CareMount and Optum[49:34] Addressing healthcare's rising costs and personal responsibilityKey Takeaways:Leadership in Healthcare: Dr. Hayworth emphasizes the importance of visionary leadership in driving healthcare transformation and innovation.Technology’s Impact: The integration of new technologies is essential for scaling healthcare organizations and enhancing patient care.Creating a Culture of Innovation: Building a culture that encourages continuous improvement and innovation is key to thriving in the healthcare sector.The Future of Healthcare: The future of medicine is centered around technology, personalized care, and a focus on preventive healthcare to improve overall patient outcomes.Guest Bio:Dr. Scott Hayworth, a distinguished OB-GYN and healthcare executive, has played a pivotal role in reshaping the U.S. healthcare system. As the former CEO of CareMount Medical, he expanded it into one of the largest independent medical groups. Under his leadership, CareMount transitioned to Optum, where he spearheaded major healthcare initiatives. His expertise spans clinical excellence, strategic growth, and healthcare innovation, making him a key voice in the industry's evolution.Resources:Scale Community https://www.scale-community.com/Dr. Scott Hayworth's LinkedIn Dr. Scott Hayworth LinkedInHealthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, CEO Insights, CareMount, Growth Strategies, Future of Medicine, Healthcare Transformation, Dr. Scott Hayworth

In this episode of Analyzing Healthcare, Roy Bejarano speaks with Dr. Neil Smith, CEO of Family First Medical, about the evolution of primary care in China. With firsthand experience as a UK-trained physician building a healthcare network in China, Dr. Smith offers a unique perspective on bridging gaps in patient access, overcoming regulatory challenges, and implementing global best practices. They discuss how China’s healthcare system, once hospital-centric, is shifting towards family medicine, the role of technology in patient care, and the government's evolving stance on private healthcare. This conversation provides crucial insights for healthcare entrepreneurs, policymakers, and global health professionals. Timestamps:(00:00:00) Introduction to the episode & guest Dr. Neil Smith(00:02:30) How Dr. Neil Smith’s background led him to work in China’s healthcare system(00:08:45) Challenges of implementing primary care in a hospital-dominated system(00:14:20) The role of government regulations in shaping China’s private healthcare sector(00:20:10) Lessons from the UK’s NHS and how they apply to China(00:26:30) How COVID-19 reshaped China’s approach to telemedicine and patient care(00:34:15) Why China is embracing family medicine and long-term patient management(00:41:50) The shift from hospital-based care to community clinics and digital health(00:49:00) Overcoming regulatory hurdles and licensing challenges in China(00:56:30) Addressing the shortage of trained family medicine doctors in China(01:03:15) How private healthcare providers are gaining more government support(01:10:45) Final thoughts and what’s next for Family First Medical Key Takeaways:China’s healthcare system is undergoing a major transformation, moving away from hospital-dominated care to family medicine and community clinics.Government policies are shifting in favor of private healthcare providers, making it easier for non-Chinese operators to contribute to healthcare reform.Technology is playing a crucial role in expanding access, with telemedicine and digital health tools becoming widely accepted post-COVID.Lessons from global healthcare models, like the UK’s NHS, are influencing China’s approach to primary care, with an emphasis on long-term patient management. Dr. Neil Smith, is a UK board-certified Family Medicine Doctor with extensive experience in London and Shanghai. As CEO of Family First Medical, he has led primary care innovation in China, integrating UK and US healthcare expertise. A clinical lecturer and published author, he actively advances global healthcare accessibility, mental health, and chronic disease care. Healthcare Innovation, Primary Care, China Healthcare, Dr. Neil Smith, Patient Access, Global Health, Family Medicine, Healthcare Podcast, HealthTech, Public Health, Healthcare Policy, Telemedicine, Medical Training, Digital Health, Hospital Systems, Private Healthcare, Government Regulations, COVID-19 Impact, Healthcare Investment, Healthcare Leadership,

In this episode of Analyzing Healthcare, Roy Bejarano sits down with Dr. Andrew von Eschenbach, former commissioner of the FDA, to discuss the evolution of healthcare, the challenges of regulation, and the future of medical innovation. They explore topics such as the FDA’s role in drug approvals, the integration of nutrition into healthcare policy, and how AI can revolutionize medical research. This is a must-listen for anyone interested in the intersection of healthcare, policy, and technology.Timestamps:[00:00] - Introduction to Dr. Andrew von Eschenbach and his journey to becoming FDA Commissioner[03:30] - The role of former commissioners in shaping healthcare policy[06:45] - Why the FDA remains the global gold standard for drug approvals[10:15] - The transformation of medicine through molecular research[19:00] - The FDA’s hidden vault of drug research and how AI can unlock its potential[25:00] - Food regulation and the role of nutrition in disease prevention[38:00] - Speed vs. safety: How the FDA can improve drug approval timelines[45:15] - The need for structural reforms at the FDAKey Takeaways:The FDA plays a crucial role in balancing innovation and safety, ensuring new drugs and medical devices reach the market efficiently without compromising public health.Food is a powerful medicine, and regulatory agencies must integrate nutritional science into healthcare policy to combat chronic diseases.AI and data analytics can revolutionize medical research, unlocking past studies and accelerating drug development.The FDA’s structure needs reform to eliminate inefficiencies and adapt to the rapid pace of scientific advancements.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, U.S. Healthcare Policy, Dr. Andrew von Eschenbach, Analyzing Healthare the Podcast,Andrew von Eschenbach, M.D., former FDA Commissioner and NCI Director, advanced regulatory science, streamlined drug approvals, and prioritized innovation in medical products. His leadership focused on cancer research, prevention, and improving public health outcome.

Roy Bejarano sits down with Rachel Winokur, CEO and Founder of TailorCare, to discuss how her risk-based musculoskeletal care model is reshaping patient-centered care. With a background in healthcare investment, payer strategy, and care delivery, Rachel shares her journey from Aetna and Bright Health to launching TailorCare, a company dedicated to optimizing MSK treatment pathways for better patient outcomes and lower costs.This conversation dives into how care coordination, data-driven decision-making, and provider-patient engagement are essential for success in risk-based healthcare. Rachel also highlights the limitations of existing value-based models, the role of predictive analytics, and the future of innovative therapies like GLP-1s and stem cells.Timestamps:[00:01] Introduction to Rachel Winokur and her career spanning Aetna, Bright Health, and TailorCare[04:47] The evolution of risk-based musculoskeletal care and why it remains an untapped opportunity[08:12] Challenges in Medicare Advantage and value-based models – misaligned financial incentives and fragmented care[14:36] The importance of real-time data access and claims transparency in patient management[22:57] How TailorCare’s risk-based navigation model improves patient outcomes and reduces unnecessary procedures[33:18] The role of predictive analytics and provider quality data in care coordination[39:09] How musculoskeletal care impacts patient mobility, function, and behavioral health[45:32] The potential impact of GLP-1s and stem cell therapies in orthopedic careKey Takeaways:Risk-Based Care Requires Smarter Coordination – TailorCare bridges payer incentives and provider decision-making to create cost-effective, high-quality MSK care pathways.Predictive Analytics is a Game Changer – Using claims data, patient history, and utilization patterns, TailorCare proactively navigates patients toward optimal treatment options.Care Fragmentation Leads to Poor Outcomes – Without structured guidance, MSK patients often go through unnecessary imaging, procedures, or delayed interventions, increasing costs and worsening health.Patients Need More Engagement & Support – TailorCare’s licensed physical therapists act as navigators, providing evidence-based guidance to ensure better outcomes and patient satisfaction.Connect with the Guest:Website: TailorCareLinkedIn: Rachel WinokurAbout Rachel Winokur:Rachel Winokur is a healthcare entrepreneur and executive with deep expertise in payer strategy, risk-based care models, and healthcare investment. She has led major initiatives at Aetna and Bright Health, driving value-based care adoption and primary care integration. As the Founder & CEO of TailorCare, she is revolutionizing musculoskeletal care by optimizing treatment pathways, improving patient engagement, and reducing unnecessary medical spend.Healthcare, Patient-Centered Care, Healthcare Leadership, Roy Bejarano, Healthcare Innovations, Value-Based Care, Musculoskeletal Health, Risk-Based Models, Medicare Advantage, Care Coordination, Population Health, Digital Health, TailorCare, Healthcare Economics, Rachel Winokur

Roy Bejarano sits down with Victor Schmerbeck, CEO of Emerus, to discuss the evolution of neighborhood hospitals, how health systems are shifting their care models, and the role of private equity in modernizing healthcare delivery.In this episode, Victor explains how Emerus has partnered with 12 major health systems, developing 40+ neighborhood hospitals to improve patient access, care coordination, and efficiency. He shares insights on why hospitals are decentralizing, the financial structure of these partnerships, and why smaller hospitals reduce costs while improving outcomes. This discussion is essential for healthcare executives, payers, and investors looking to understand the future of hospital-at-home models, outpatient expansion, and MSO partnerships.Timestamps:[00:02] Introduction to Victor Schmerbeck and his leadership journey at Emerus[01:53] The evolution of Emerus – from emergency care to health system partnerships[05:02] Neighborhood hospitals vs. micro-hospitals – the shift to community-based care[12:56] How neighborhood hospitals act as hubs, improving patient flow and referrals[18:17] Why only 150+ neighborhood hospitals exist today and the case for expansion[24:46] Hospitals are shifting towards performance-focused, cost-effective care[33:13] The role of payers & value-based care in small-format hospital success[44:10] How private equity supports hospital MSO partnerships and future growthKey Takeaways:Health Systems Are Decentralizing – Large hospitals are shifting to smaller, community-based neighborhood hospitals to increase access, lower costs, and improve care coordination.MSO-Hospital Partnerships Drive Efficiency – Through white-label partnerships, Emerus helps health systems operate efficient, high-quality neighborhood hospitals, reducing readmissions and length of stay.Neighborhood Hospitals Fill a Critical Gap – Positioned between urgent care and tertiary hospitals, these facilities reduce ER overcrowding and streamline specialty referrals.Private Equity Is Fueling Healthcare Innovation – Investors like Welsh Carson play a key role in funding operational improvements, driving focus, and expanding care models.Connect with the Guest:Website: Emerus About Victor Schmerbeck:Victor Schmerbeck is the CEO of Emerus, the nation’s largest operator of neighborhood hospitals. With extensive experience in healthcare investment, operations, and system partnerships, he has led Emerus’ expansion to 40+ hospitals in collaboration with 12 major health systems. Under his leadership, Emerus has helped health systems increase access, reduce costs, and modernize acute care delivery.