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Analyzing Healthcare

Analyzing Healthcare

87 episodes — Page 2 of 2

Tech Series: Revolutionizing Brain Imaging: AI Innovations with Cortechs.ai CEO Kyle Frye

In this episode of the Scale Community Technology & Innovation in Healthcare Series, host Jason Schifman sits down with Kyle Frye, CEO of Cortechs.ai, to discuss healthcare leadership and groundbreaking healthcare innovations in AI-powered imaging technology. Kyle shares how Cortechs.ai is revolutionizing brain care and oncology by introducing quantitative imaging, giving neurologists and radiologists the ability to track and analyze patient conditions like never before. Tune in to explore the healthcare trends shaping neuroimaging, AI in diagnostics, and the future of brain health.Timestamps:[02:00] – The evolution of Cortechs.ai from neurology to oncology: How AI is transforming healthcare industry insights.[05:30] – From black-and-white imaging to AI-driven data: The rise of quantitative imaging in healthcare leadership.[14:00] – Overcoming barriers to adoption: How AI-driven imaging integrates seamlessly with existing workflows.[22:45] – Case study: Using AI to detect traumatic brain injuries missed by traditional imaging.[32:30] – The future of preventative healthcare: Can AI-driven brain scans become as routine as blood tests?[42:00] – Expanding globally: How Cortechs.ai is bringing healthcare innovations to new markets.Key Takeaways:AI Enhances, Not Replaces, Radiology – Cortechs.ai provides neurologists and radiologists quantitative imaging that complements existing workflows, improving speed and accuracy.Data-Driven Brain Health is the Future – AI-based brain scans help detect dementia, tumors, and brain injuries earlier, improving healthcare industry insights and patient outcomes.Preventative Imaging is on the Rise – The adoption of full-body and brain scans as preventative healthcare trends is growing, potentially making AI-driven diagnostics routine.Global Expansion & Healthcare Accessibility – Cortechs.ai is working to improve imaging access worldwide, especially in regions where wait times for scans are long.Resources:Website: https://www.cortechs.ai/LinkedIn: https://www.linkedin.com/in/kyle-frye-18843119/Kyle Frye, CEO of Cortechs.ai, a market leader, and innovator in medical technology solutions. Discover how the Company is transforming neurology, radiology, and oncology with state-of-the-art medical imaging, leveraging clinical data and machine learning to empower physicians in making more accurate and timely diagnostic decisions.

Jan 23, 2025

Tech Series: Healthcare Leadership & Innovation with Bruno Piquin of CEO of Ensure Data Solutions

In this episode of the Scale Community Technology & Innovation in Healthcare Series, host Jason Schifman sits down with Bruno Piquin, CEO of Ensure Data Solutions, to discuss healthcare leadership, value-based care, and healthcare innovations in data analytics. With over 30 years of experience in the payer market, including roles at UnitedHealthcare, Humana, and Amerigroup, Bruno shares insights into healthcare industry trends, payer-provider collaboration, and how healthcare data analytics is reshaping the value-based care landscape. Learn how Ensure Data Solutions is providing healthcare industry insights that drive healthcare innovations for payers, providers, and ACOs.Timestamps:[00:00] Introduction to the podcast and guest, Bruno Piquin, CEO of Ensure Data Solutions[02:00] How data analytics is driving healthcare innovations and improving patient care[06:30] The impact of value-based care and shifting reimbursement models in the healthcare industry[12:00] Regulatory changes and their influence on healthcare trends[18:00] The role of interoperability and technology in healthcare leadership[30:00] Looking ahead: The future of healthcare industry insights and healthcare innovations Key Takeaways:Data analytics is revolutionizing healthcare leadership: Bruno Piquin highlights how Ensure Data Solutions helps providers navigate data complexity, improving patient care and financial outcomes in the healthcare industry.Value-based care is reshaping healthcare trends: The transition from fee-for-service to value-based models is changing the way providers and payers approach healthcare innovations.Regulatory shifts impact healthcare industry insights: New risk-adjustment policies and CMS guidelines are driving major changes, influencing the financial sustainability of the healthcare industry.Interoperability is key to healthcare leadership: The future of healthcare innovations relies on seamless data exchange between payers, providers, and healthcare technology platforms.Resources:Website: https://www.ensuredatasolutions.com/LinkedIn: https://www.linkedin.com/in/bruno-piquin-3723741/Bruno Piquin, a 25+ year executive in the healthcare payer and value-based care markets, and the current CEO of Ensure Data Solutions, a company that specializes in value-based care analytics

Jan 22, 2025

Big Picture: Healthcare Leadership & Policy with Elizabeth Fowler in the U.S. Healthcare Trends

In this episode, Roy Bejarano speaks with Elizabeth Fowler, former Deputy Administrator of CMS and Director of CMMI (Innovation Center). We dive into the healthcare industry insights surrounding the evolution of value-based care, healthcare leadership, and how regulatory shifts impact healthcare innovations. Elizabeth shares her perspective on healthcare trends, including the successes and challenges of Medicare Advantage, coordinated care, and efforts to bend the cost curve. Elizabeth shares firsthand insights on healthcare innovations that have transformed healthcare industry insights and what must happen next to create a more equitable system.Timestamps:[00:00] Introduction to Elizabeth Fowler, her role in healthcare leadership, and her work with CMS and CMMI[04:00] The success and challenges of the Innovation Center in advancing value-based care[10:30] The impact of healthcare regulation on healthcare industry insights and provider incentives[18:00] Examining U.S. healthcare trends vs. global healthcare models[30:00] The role of data, analytics, and interoperability in healthcare innovations[45:00] Future outlook on value-based care, Medicare, and the policy roadmap aheadKey TakeawaysThe Innovation Center has driven major shifts in healthcare trends:Elizabeth Fowler explains how CMMI has reshaped value-based care, encouraging better patient outcomes and cost savings.Healthcare leadership must address equity and access: Despite healthcare innovations, disparities persist in access to care, requiring further policy efforts.Healthcare industry insights reveal evolving reimbursement models: Regulatory changes impact provider payments, requiring adaptation and strategic planning.U.S. healthcare is not broken, but requires continuous innovation: Data-driven solutions and policy shifts will shape the future of healthcare leadership and sustainability.Resources:Website: https://www.commonwealthfund.org/person/elizabeth-fowlerLinkedIn: linkedin.com/in/liz-f-b5612749About the Guest:Elizabeth Fowler, Ph.D., J.D., led the CMS Innovation Center, driving advancements in value-based care and innovative payment models for Medicare, Medicaid, and CHIP. She’s also a key figure behind landmark healthcare reforms, including the Affordable Care Act.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Medicare Advantage, Value-Based Care, Coordinated Care, Healthcare Disparities, Elizabeth Fowler, CMS, CMMI,

Jan 16, 2025

Big Picture: Policy & Innovation in U.S. Healthcare with Senator Richard Burr

In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Senator Richard Burr, former Chair of the HELP Committee and a senior member of the Senate Intelligence Committee, to explore healthcare policy, public health, and national security. With over 30 years in Congress, Senator Burr played a pivotal role in crafting the Pandemic and All-Hazards Preparedness Act (PAHPA) and led healthcare leadership efforts to strengthen U.S. biodefense and pandemic preparedness.The conversation covers the Affordable Care Act (ACA) and its impact on the healthcare industry, the financial sustainability of Medicare and Medicaid, and the rise of AI-driven medical innovation. Senator Burr also shares insights on public health strategies, intelligence policy, and national security concerns related to healthcare infrastructure, pandemic response, and medical advancements.Timestamps:[00:00] Introduction to the podcast and guest, Senator Richard Burr[03:30] The role of Congress in shaping healthcare leadership and healthcare trends[10:30] Pandemic preparedness: Lessons from COVID-19 and future healthcare innovations[24:30] The Affordable Care Act (ACA): Successes, failures, and the path forward[39:00] Medicare sustainability, Medicaid expansion, and healthcare industry insights[56:00] The rise of AI and healthcare data analytics in value-based careKey Takeaways:Healthcare needs investment, not just cost-cutting: Senator Burr emphasizes that funding healthcare innovations is essential for better patient outcomes and system efficiency.Medicare sustainability requires reform: While Medicare Advantage has seen growth, adjustments are needed to ensure financial stability for the healthcare industry.AI and healthcare data analytics will revolutionize patient care: Artificial intelligence and healthcare industry insights will shape the future of value-based care and coordinated care models.The ACA had mixed results: While healthcare disparities decreased, regulatory challenges still impact payer-provider relationships and reimbursement models.Resources:LinkedIn: linkedin.com/in/richard-burr-73b015272Senator Richard Burr, the longtime senator from North Carolina, is renowned for chairing the Senate Intelligence Committee, co-authoring the Pandemic and All-Hazards Preparedness Act (PAHPA), opposing the Affordable Care Act (ACA), advancing medical innovation, and strengthening U.S. biodefense, healthcare, and intelligence policies, leaving a significant legacy in public health and national security.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Medicare Advantage, Value-Based Care, Coordinated Care, Healthcare Disparities, Senator Richard Burr, HELP Committee, Affordable Care Act, enate Intelligence Committee, Pandemic and All-Hazards Preparedness Act, PAHPA, ACA, medical innovation, U.S. biodefense, healthcare policy, intelligence policy, public health, national security,

Jan 8, 20251h 22m

Big Picture-The Future of Nutrition, Preventive Medicine & Healthcare Policy with Dr. David Katz

Host Roy Bejarano welcomes Dr. David Katz, a globally recognized expert in preventive medicine, nutrition science, and public health. Dr. Katz shares his journey from traditional medicine to becoming a pioneer in lifestyle medicine, advocating for diet-based disease prevention and healthcare innovations that prioritize nutrition, exercise, and behavioral change over reactive treatments.The conversation covers healthcare industry insights on the obesity epidemic, processed foods, nutrition policy, healthcare leadership, and the economic sustainability of healthcare. They discuss the intersection of healthcare policy, intelligence policy, and public health, and how food industry regulation, AI in healthcare, and national security threats impact healthcare trends in the U.S.Timestamps:[00:00] Introduction to the podcast and guest, Dr. David Katz[02:00] How a cardiologist’s son became a global leader in preventive medicine and nutrition science[06:30] The obesity epidemic: How the U.S. food industry manipulates diet and public health[18:00] The science of food addiction and the role of ultra-processed foods in chronic disease[30:00] Public health vs. healthcare policy: Why the U.S. system focuses on disease care instead of prevention[45:00] The role of government and regulation in curbing the influence of Big Food and Big Tobacco[55:00] AI, medical innovation, and the future of healthcare leadership in preventing chronic disease[1:10:00] Addressing misinformation in healthcare: How distrust, AI, and media distort public health efforts[1:30:00] The biggest healthcare challenge of the future: Preventing disease through better knowledge, not just better medicineKey Takeaways:Healthcare needs to shift from disease care to prevention. Dr. Katz explains how the U.S. healthcare industry profits from treating chronic disease rather than preventing it. Nutrition, exercise, and behavioral health should be primary, not secondary, concerns in healthcare leadership.The food industry profits from poor health. Ultra-processed foods are scientifically engineered to be addictive, leading to obesity, diabetes, and heart disease. Better regulation and public health education are critical to reversing this trend.AI & technology could revolutionize healthcare – or make it worse. AI-driven healthcare innovations can personalize preventive care, but misinformation and commercial interests must be addressed to ensure true healthcare industry insights.Public health and national security are connected. The U.S. healthcare system is at risk of economic collapse due to rising chronic disease rates. Preventive healthcare isn’t just a medical issue—it’s a public health and intelligence policy issue.Resources:Website: https://davidkatzmd.com/Website: dietid.com/ Website: truehealthinitiative.org/ Instagram: https://www.instagram.com/drdavidlkatz/?hl=enLinkedIn- linkedin.com/in/david-l-katz-md-mph-4798667About the Guest:David L. Katz, MD, is a specialist in Internal Medicine, Preventive Medicine/Public Health, and Lifestyle Medicine – globally recognized for expertise in chronic disease prevention, health promotion, and nutrition. He has roughly 250 peer-reviewed publications and has authored 19 books.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Public Health, Preventive Medicine, Nutrition Science, Lifestyle Medicine, Healthcare Policy

Jan 7, 20251h 45m

Leadership Series: Transforming Plastic Surgery: Growth, Innovation & Aesthetic Leadership with Anthony Milonas

In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Anthony Milonas, CEO of Ascend Aesthetic Partners, to discuss the evolution of plastic surgery, medical aesthetics, and healthcare leadership in the private equity-backed MSO space. As one of the largest national plastic surgery and aesthetic medicine platforms, Ascend Aesthetic is transforming the industry through physician-led growth, data-driven decision-making, and patient-focused innovations.Anthony shares healthcare industry insights on operational excellence, patient acquisition strategies, digital marketing innovations, physician recruitment, and AI in healthcare. He also explores the synergy between Med Spa and plastic surgery services, the importance of patient engagement, and how Ascend is reshaping the future of aesthetic healthcare through strategic partnerships and technology.Timestamps:[00:00] Introduction to the podcast and guest, Anthony Milonas, CEO of Ascend Aesthetic Partners[02:00] The journey from healthcare distribution to leading a national plastic surgery MSO[06:30] Why private equity is fueling the transformation of plastic surgery and Med Spa practices[12:00] Patient demographics: Understanding the 35-65 age group and the rise of younger Med Spa clients[18:00] The role of data analytics, AI, and digital marketing in scaling aesthetic healthcare[24:30] Why traditional plastic surgery practices struggle with marketing and how Ascend is fixing it[30:00] Med Spa and Plastic Surgery: Are patient acquisition costs decreasing with integrated services?[40:00] Recruiting challenges in plastic surgery: How Ascend is attracting top surgeons with partnership models[50:00] AI, predictive analytics, and the future of patient experience and healthcare trends in aesthetics[1:00:00] Looking ahead: Where is the plastic surgery and Med Spa industry heading in the next 5 years?Key Takeaways:Plastic Surgery is Entering a New Era of Consolidation. With private equity investment and physician-led MSOs, the industry is shifting from independent practices to scalable, tech-enabled platforms.Data & AI Will Define the Future of Aesthetics. Advanced analytics, AI, and predictive modeling will drive marketing, patient engagement, and clinical decision-making for plastic surgery and Med Spa businesses.The Synergy Between Plastic Surgery & Med Spa is Powerful. While anecdotal evidence suggests cross-referrals reduce patient acquisition costs, Ascend Aesthetic is working on data-driven proof to quantify the impact.Recruitment & Retention in Plastic Surgery Requires a New Model. Competitive compensation, student loan support, and clear partnership pathways are key to attracting top talent in aesthetic medicine.Resources:Website: https://www.ascendaestheticpartners.com/LinkedIn: https://www.linkedin.com/in/anthony1care/About the Guest:Anthony Milonas is the CEO of Ascend Aesthetics Partners, a company involved in the aesthetics industry, particularly focusing on medical aesthetics and skincare. Ascend Aesthetics Partners partners with practices in the aesthetic sector to help them grow and optimize their operations. Under Milonas's leadership, the company seeks to leverage expertise and resources to enhance service offerings and operational efficiency for its network of medical aesthetic practices.Milonas has extensive experience in leadership roles, particularly in areas like healthcare and business development. His background includes working in senior positions in various healthcare-related companies, with a focus on driving growth, scaling businesses, and improving patient outcomes.Ascend Aesthetics Partners is part of a broader trend in the aesthetics industry, where private equity and strategic partnerships help smaller aesthetic practices thrive by providing access to resources, marketing, and operational support.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Plastic Surgery, Aesthetic Medicine, Med Spa, Patient Experience, Medical Marketing, Anthony Milonas, Ascend Aesthetic Partners,

Dec 27, 202455 min

Big Picture: Revolutionizing U.S. Healthcare: Innovations and Challenges with Mark Cuban

Host Roy Bejarano converses with Mark Cuban about the complexities and misconceptions surrounding the U.S. healthcare system. They discuss issues like the inefficiencies in patient care, the challenges with the current payment structures, and the scarcity of basic health data transparency. Cuban shares insights on the potential for innovation within the healthcare system, his work with Cost Plus Drugs, and the concept of single-payer systems. The discussion also touches on healthcare education, administrative costs, and the influence of economic incentives on health outcomes. Cuban emphasizes the need for transparent healthcare contracts and ownership of claims data to drive better health outcomes and foster efficient markets.IN THIS EPISODE:(00:00) Introduction to Analyzing Healthcare(00:34 )Meet the Host and Guest(01:26) Diving into U.S. Healthcare Issues(03:43) The Communication Problem in Healthcare(06:15) Comparing Global Healthcare Systems(08:05) Obesity and Food Regulations(12:42) Healthcare Costs and Spending(23:40) Transparency and Single Payer Systems(38:52) Simplifying Healthcare: Challenges and Opportunities(39:49) The Branding Race in Healthcare(40:41) Direct Contracts and Self-Insured Options(42:21) Transparency and Cost Management(44:56) Adoption of Healthcare Technology(51:28) Comparing Healthcare Systems: US vs. Canada(55:10) Innovative Solutions for Healthcare Deserts(01:04:22) The Role of Data in Healthcare(01:08:57) Mark Cuban's Healthcare VisionKEY TAKEAWAYS: Mark Cuban emphasizes the importance of price transparency in healthcare to create a more efficient and equitable system.While the U.S. offers the best care in certain specialties, systemic inefficiencies, such as delayed payments and pre-authorizations, hinder its effectiveness.Cuban discusses how self-insured employers can lead the charge in healthcare reform by promoting transparency and better care coordination.Cuban’s work with Cost Plus Drugs demonstrates how entrepreneurial solutions can challenge the status quo in the healthcare industry, promoting more affordable and accessible options for consumers.About the Guest:Mark Cuban, former Dallas Mavericks majority owner, former Shark, and more recently co-founder of Cost Plus Drugs, a company with a mission to transform the US drug market.U.S. healthcare, Healthcare reform, Transparency in healthcare, Mark Cuban, Cost Plus Drugs, Self-insured employers, Healthcare innovation, Health insurance, Health disparities, Healthcare economics Roy Bejarano, Mark Cuban,

Dec 20, 20241h 12m

Big Picture: Unpacking U.S. Healthcare: Profit, Policy & Innovation with Web Golinkin

In this compelling episode of Analyzing Healthcare, host Roy Bejarano sits down with Web Golinkin, a healthcare entrepreneur, thought leader, and author, to explore the myths, realities, and complexities of the U.S. healthcare system. They discuss whether U.S. healthcare is truly broken, the role of profit in healthcare, and how healthcare innovations and market forces are shaping the industry.The conversation dives into healthcare policy, corporate consolidation, hospital pricing, drug costs, and the blurred lines between payers and providers. Web Golinkin also shares insights from his book Here Be Dragons and his experience building healthcare delivery businesses that focus on accessibility, affordability, and consumer convenience.Timestamps:[00:00] Introduction to the podcast and guest, Web Golinkin[02:00] The U.S. healthcare system: Is it truly broken, or is that a media-driven narrative?[06:30] The role of profit in healthcare: Does capitalism drive innovation or inflate costs?[12:00] Retail medicine & urgent care: How healthcare delivery is evolving[18:00] Payers vs. Providers: The battle for control over healthcare economics[24:30] The real drivers of high healthcare costs: PBMs, hospital pricing, and pharmaceutical monopolies[30:00] How does the U.S. compare to other healthcare systems worldwide?[40:00] Medicare sustainability: Myth or reality?[50:00] The impact of AI, data, and technology on healthcare innovation[1:00:00] The assassination of UnitedHealthcare’s CEO: What does public reaction say about trust in the system?[1:15:00] The future of U.S. healthcare: What needs to change, and what is already improving?Key Takeaways:U.S. Healthcare is NOT broken, but it is evolving. The headlines paint an overly dramatic picture, but in reality, the system has bent the cost curve, leading to slower healthcare inflation and major innovations in care delivery.Market forces and competition drive innovation, but monopolies and inefficiencies create cost problems. The biggest pricing issues stem from pharmacy benefit managers (PBMs), hospital consolidation, and drug pricing strategies rather than capitalism itself.Medicare is not bankrupt, but it does require continuous reform. While Medicare Advantage, DRGs, and value-based care have helped improve efficiency, ongoing adjustments are needed to ensure long-term financial stability.Healthcare narratives in media and politics oversimplify complex issues. The conversation around U.S. healthcare spending, quality, and access is often distorted, leading to public distrust in the system and a misguided push for drastic reform.Resources:Website: https://webgolinkin.com/LinkedIn: https://www.linkedin.com/in/web-golinkin-19195b26/About the GuestWeb Golinkin has focused his career on making health information and care more accessible and affordable. He has done this as CEO of five companies over the past 35 years, including three he co-founded.These companies include the largest cable TV network devoted to health (America’s Health Network), one of the nation’s largest operators of retail-based clinics (RediClinic), a leading population health management company (Health Dialog), and one of the nation’s largest operators of urgent care clinics (FastMed). Web also co- founded the Convenient Care Association and served as its Chair for many years. He has been widely covered in the national media and has spoken at numerous healthcare conferences.A magna cum laude graduate of Harvard, Web grew up in New York City and Long Island but has lived in Houston since 1988, so he is almost a Texan. A longtime runner and fitness enthusiast, Web enjoys tennis and golf—as long as he can walk and carry his bag. Web has been married to the same extraordinary woman for 39 years, and they have two amazing sons who make him proud every day.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, U.S. Healthcare Policy, Public Health, Health System Reform, Medical Innovation, Healthcare Economics,

Dec 15, 20241h 33m

Tech Series: AI-Driven Cancer Detection & The Future of Preventive Imaging with Emi Gal, CEO of Ezra

Host Jason Schifman sits down with Emi Gal, CEO and founder of Ezra, a company pioneering AI-powered full-body MRI scans for early cancer detection. Emi shares his personal motivation behind founding Ezra, how AI-driven imaging innovations are reshaping preventive medicine, and why his company is expanding access to affordable cancer screening.The discussion explores healthcare industry insights around medical imaging, healthcare innovations, and the role of AI in streamlining cancer detection. Emi also shares the challenges of building strategic partnerships with imaging centers, scaling direct-to-consumer healthcare, and addressing false positives in full-body MRI scans.Timestamps:[00:00] Introduction to the podcast and guest, Emi Gal, CEO of Ezra[02:00] How personal experience led Emi to launch Ezra & revolutionize early cancer detection[06:30] The Ezra model: Direct-to-consumer AI-powered full-body MRIs[12:00] Partnering with imaging centers: How Ezra operates without owning facilities[18:00] AI’s role in making MRIs faster, more efficient, and more affordable[24:30] Scaling a direct-to-consumer health tech business: Challenges & successes[30:00] Addressing concerns over false positives, incidental findings, and patient anxiety[40:00] The future of AI-driven preventive imaging and healthcare innovation[50:00] What’s next for Ezra: Expanding affordability, increasing access, and AI advancementsKey Takeaways:AI-driven medical imaging is revolutionizing preventive healthcare. Ezra’s full-body MRI scans use AI to enhance speed, accuracy, and affordability, making early cancer detection more accessible.Strategic partnerships with imaging centers fuel Ezra’s rapid expansion. Rather than building facilities, Ezra leverages excess capacity in existing imaging centers, driving operational efficiency and scalability.False positives and incidental findings are a key challenge—but AI helps mitigate them. Ezra scores findings on a scale of 1-5, ensuring that only high-risk cases trigger follow-ups, reducing unnecessary procedures.Ezra’s long-term vision is a $600 AI-powered 15-minute scan. By continuing AI innovation, the goal is to make full-body cancer screening widely available, insurance-covered, and a standard preventive measure.Resources: Ezra Website LinkedIn Twitter/XAbout the Guest:Emi Gal is the founder and CEO of Ezra, an AI company pioneering the use of full-body MRI to detect cancer as early as possible. He is a software engineer and entrepreneur passionate about healthcare and longevity. Emi started his first company, Brainient, during his first year at university and spent the following 10 years building it into one of the leading ad-tech companies in Europe. Brainient (now called Teads Studio) was acquired by Teads in September 2016.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, AI in Healthcare, Medical Imaging, Cancer Screening, Preventive Medicine, Health Tech

Dec 12, 2024

Demystifying the Strategy, Opportunities, and Obstacles Driving Healthcare Payers with Mark Jamilkowski | Market Consolidation, Self-Insured Employers & Digital Health Innovations

Host Roy Bejarano sits down with Mark Jamilkowski, a seasoned actuary and healthcare executive, to explore the dynamics of the healthcare payer industry, the challenges facing self-insured employers, and barriers to entry for new insurance providers.In this episode, Mark shares insights into how government regulations, Medicare Advantage, and payer-provider relationships shape the industry. He also discusses his experience launching Every Health, a new insurance model focused on digital health integration and care coordination. This conversation is a must-listen for healthcare leaders, investors, and innovators navigating the ever-evolving payer landscape.Timestamps:[00:01] Introduction to Mark Jamilkowski and his 30-year career in the healthcare industry[02:09] Understanding the payer landscape: Medicare, Medicaid, and employer-based insurance[05:55] The economics of Medicare Advantage and why insurers focus on this market[12:28] Myths vs. realities of the self-insured employer market[22:33] –you Launching Every Health: How to break into the insurance industry[40:47] The role of digital health, value-based care, and provider partnerships in the future of healthcareKey Takeaways:Market Segmentation Defines Success – Large payers like UnitedHealth, Humana, and Centene approach different market segments strategically, favoring high-margin Medicare Advantage plans.Government Influence is Unavoidable – Over 65% of U.S. healthcare spending is government-funded, shaping the priorities and strategies of insurers.Self-Insured Employers Are Not Taking Over – Contrary to industry narratives, the percentage of self-insured employers has remained stable for decades, despite broker-driven hype.Technology & Value-Based Care Will Drive the Future – Innovations in digital health, data analytics, and care coordination are reshaping how payers and providers interact, with companies like Every Health leading the charge.Connect with the Guest: Website: Evry Health LinkedIn: Mark JamilkowskiAbout Mark Jamilkowski:Mark Jamilkowski is a healthcare industry veteran with over 30 years of experience as an actuary, investment banker, and entrepreneur. He has held leadership positions at Aetna, Big Four consulting firms, and venture-backed insurance startups. As co-founder of Every Health, he is pioneering digital-first insurance solutions that integrate value-based care and provider partnerships to enhance patient outcomes. Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Health Insurance Market, Medicare Advantage, Self-Insured Employers, Digital Health Solutions, Value-Based Care, Payer Market Strategy, Healthcare Consolidation, Insurance Industry Disruption, Mark Jamilkowski,

Nov 26, 202456 min

Growth & Innovation in Dental Care | CEO Insights with David Drzewiecki of Absolute Dental

Roy Bejarano sits down with David Drzewiecki, CEO of Absolute Dental, to explore the growth, challenges, and innovations shaping the dental service industry (DSOs). The discussion covers healthcare trends, technology advancements in dentistry, the expansion of value-based care, and how Medicaid dental programs are evolving.David shares insights on healthcare leadership, the future of patient experience, and how Absolute Dental has built a successful all-in-one model for specialty and general dentistry. The conversation is essential for healthcare executives, investors, and dental professionals looking to understand the next phase of dental care consolidation and innovation.Timestamps:[00:00] Introduction to Roy Bejarano & David Drzewiecki – The Evolution of Absolute Dental[03:00] Growth of DSOs Over the Last 10 Years – Market Consolidation & Industry Shifts[07:15] The Role of Medicaid & Medicare in Dental Care – Expanding Access & Reimbursement Challenges[12:30] Technology’s Impact on Patient Experience – AI, Teledentistry & Standardization[18:00] Value-Based Care in Dentistry – The Path to Greater Payor Engagement[24:45] Strategic Partnerships & Growth Opportunities – ACOs, Medicare Advantage & Direct Contracting[30:30] Specialty Dental Services – The Role of Oral Surgery, Orthodontics & Pediatric Dentistry[38:15] The Future of Dentistry – Innovation, Expansion & Workforce ChallengesKey Takeaways:DSOs continue to grow, but misconceptions persist. Many believe the market is already consolidated, yet dental care still has significant room for expansion.Technology is transforming patient experience. Innovations like AI-driven x-ray analysis, teledentistry, and automated scheduling are improving patient access and clinical outcomes.Value-based care in dentistry is still developing. As Medicaid and Medicare Advantage expand, DSOs must engage with payers to drive cost-effective, outcomes-focused care.All-in-one dental care models enhance patient retention. Offering general, specialty, and surgical dental services in one location prevents patient leakage and improves continuity of care.About David Drzewiecki:David Drzewiecki is the CEO of Absolute Dental, Nevada’s largest Medicaid dental provider with nearly 40 practices. With a background in healthcare IT, revenue cycle management, and dental practice operations, he has led Absolute Dental through expansion, innovation, and strategic payer engagement. His expertise offers valuable insights for DSO leaders, healthcare investors, and technology innovators in the dental industry. Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Dental Service Organizations (DSOs), Medicaid Dental Care, Patient Experience in Dentistry, Value-Based Care, Specialty Dental Services, Oral Surgery, Teledentistry, Dental Technology,

Nov 26, 202439 min

Exploring the Mechanics of a Value-Based Care Platform with Yates Lennon | ACOs, Risk Models & Operational Execution

Host Roy Bejarano sits down with Dr. Yates Lennon, President of CHESS Health Solutions, to discuss the operational execution of value-based care (VBC) models, the complexities of ACO REACH, MSSP tracks, and risk-based agreements, and how health systems and provider groups can maximize performance in value-based contracts.In this episode, Dr. Lennon breaks down how CHESS supports 220,000 lives, builds efficient care coordination teams, and negotiates value-based contracts with major payers. He also explores the challenges of aligning incentives, leveraging predictive analytics, and maintaining provider engagement. This is a must-listen for healthcare leaders, providers, and payers navigating the future of population health and risk-sharing agreements.Timestamps:[00:01] Introduction to Dr. Yates Lennon and CHESS Health Solutions’ role in value-based care[02:25] The scope of CHESS: 220,000 covered lives, ACO models, and payer agreements[12:28] The role of care coordination, clinical pharmacists, and social workers in reducing hospital readmissions[22:33] How value-based contracts are negotiated and why aligning clinical and financial performance is crucial[40:47] The rise of super practices vs. hospital systems – Who will win the future of physician market power?[50:16] Specialty care integration & predictive analytics – What’s next for cost containment and clinical efficiency?Key Takeaways:Value-Based Care Requires Significant Infrastructure Investment – Managing 220,000+ lives demands a highly coordinated network of nurses, pharmacists, social workers, and analysts.Payer-Provider Collaboration is Critical – CHESS negotiates Medicare Advantage, MSSP, and commercial value-based agreements with major payers, ensuring contracts align with clinical capabilities.Super Practices Are Reshaping Physician Market Power – The rise of Privia, Oak Street, and Agilon is shifting influence away from hospital-owned physician groups, creating competition for high-risk patient populations.The Future Lies in Data-Driven Healthcare – Predictive and prescriptive analytics will define the next phase of value-based care, helping organizations prioritize patient outreach and interventions for maximum impact.Connect with the Guest:Website: CHESS Health SolutionsLinkedIn: Dr. Yates LennonAbout Dr. Yates Lennon:Dr. Yates Lennon is the President of CHESS Health Solutions, a physician-led value-based care organization that partners with health systems, ACOs, and independent providers to implement risk-based care models. With a background in family medicine and health system leadership, he has helped CHESS become a turnkey provider of value-based care solutions, supporting operational transformation, clinical integration, and payer strategy. Healthcare, Value-Based Care, Healthcare Trends, Roy Bejarano, Healthcare Innovations, ACOs, Risk-Based Contracts, Population Health, Care Coordination, Medicare Advantage, Payer-Provider Collaboration, Healthcare Leadership, Data-Driven Healthcare, Healthcare Economics, CHESS Health Solutions, Yates Lennon,

Nov 26, 202453 min

Healthcare Innovations & Data-Driven Leadership | Business Intelligence in Healthcare with Lancer Seaman

Roy Bejarano sits down with Lancer Seaman, an expert in healthcare IT and business intelligence, to discuss the transformative role of data analytics in healthcare leadership. The conversation explores healthcare trends, healthcare innovations, and the importance of business intelligence in medical service organizations (MSOs) and physician management services.Lancer shares his experience in optimizing healthcare IT systems, addressing physician burnout, and how healthcare industry insights can drive patient care improvements. This discussion is essential for healthcare executives, IT professionals, and medical providers looking to harness business intelligence in healthcare for operational success and strategic growth.Timestamps:[00:00] Introduction to Roy Bejarano & Lancer Seaman – The Role of Healthcare IT & Business Intelligence[05:02] Physician Burnout & Technology – How Healthcare Innovations Improve Physician Efficiency[10:51] Due Diligence in Healthcare Mergers & Acquisitions – Key IT Risk Assessments in MSOs[19:47] The Impact of Data Analytics on Patient Outcomes – Improving Clinical & Surgical Efficiencies[27:46] Standardizing Healthcare IT Systems for Scalability & Cost Savings[50:54] Proof of Concept in Healthcare IT Investments – Reducing Risk & Cost of ImplementationKey Takeaways:Data Analytics is Reshaping Healthcare Leadership: Healthcare trends are shifting towards business intelligence, driving operational efficiency and patient outcomes.Physician-Centric IT Systems Reduce Burnout: Healthcare innovations in AI, automation, and data standardization help reduce administrative burden and optimize physician workflows.Standardization is Key to Scaling Healthcare Organizations: Effective healthcare IT integration ensures seamless data sharing, compliance, and organizational efficiency.Business Intelligence in Healthcare is a Profit Driver: Healthcare industry insights reveal that data analytics can lead to cost savings, optimized patient care, and new revenue opportunities.Connect with the Guest:Website: Scale HealthcareLinkedIn: Lancer Seaman About Lancer Seaman:Lancer Seaman is a healthcare IT & business intelligence expert with over 30 years of experience in healthcare leadership, data analytics, and operational optimization. Having served as CIO for multiple MSOs and healthcare organizations, he has helped healthcare leaders leverage data-driven strategies to improve efficiency, patient outcomes, and cost reduction.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Business Intelligence in Healthcare, Data Analytics in Healthcare, Healthcare IT Strategy, Medical Service Organizations (MSOs), Physician Burnout, Patient Outcomes, Healthcare Mergers & Acquisitions, Value-Based Care,

Nov 26, 202456 min

Strategic HR & Talent Recruiting | Healthcare Leadership with Alan Cooper

Roy Bejarano sits down with Alan Cooper, an expert in healthcare leadership and talent recruiting, to discuss the evolving role of HR strategy in the healthcare industry. The conversation explores healthcare trends, healthcare innovations, and the critical differences between transactional and strategic HR.Alan shares insights on talent acquisition, performance evaluation, and employee development, emphasizing the importance of creating a strong organizational culture in healthcare leadership. This discussion is essential for healthcare executives, HR professionals, and medical organizations seeking to optimize talent retention and improve workforce engagement.Timestamps:[00:00] Introduction to Roy Bejarano & Alan Cooper – The Role of HR in Healthcare Leadership[04:30] Transactional vs. Strategic HR – Shaping Healthcare Industry Insights[09:45] Sourcing & Talent Acquisition – Building a Proactive Healthcare Workforce[16:00] Performance Evaluations – The Shift from Annual Reviews to Continuous Feedback[27:30] Employee Development & Career Planning – Creating Growth Opportunities in Healthcare[45:30] HR Structure & Integration – Implementing a Hub-and-Spoke Model for Multi-Site OrganizationsKey Takeaways:HR Must Be a Strategic Partner: Healthcare industry insights show that HR strategy should move beyond compliance to focus on workforce development, retention, and engagement.Performance Reviews Should Be Continuous: Annual reviews are outdated—frequent feedback and career planning create better employee satisfaction and efficiency in healthcare leadership.Sourcing & Hiring Require a Long-Term Approach: Healthcare trends highlight that maintaining a talent pipeline is more effective than reactive hiring.Organizational Culture Defines Success: Healthcare innovations in HR should focus on fostering a positive work environment, particularly in physician engagement and employee satisfaction.Connect with the Guest:Website: Scale HealthcareLinkedIn: Alan CooperAbout Alan Cooper: Alan’s has over 25 years of experience in the area of strategic organizational transformation, with a specific focus on organization development (OD), leadership development, customer experience, change management, teambuilding/collaboration, organizational capacity, and human capital/HR. Dr. Cooper has had extensive experience working with numerous healthcare organizations ranging in size from single practitioner offices to large health systems providing consulting services. His work is consistently aligned with an overarching emphasis on the achievement of an organization’s strategic mission.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Talent Acquisition, Employee Development, Performance Evaluation, HR Strategy, Physician Engagement, Organizational Culture, Workforce Planning, Alan Cooper,

Nov 26, 202455 min

US vs. UK/European Healthcare: Key Market Differences & Business Opportunities | Jonathan Kron

Roy Bejarano sits down with Jonathan Kron, a healthcare IT and business intelligence expert, to explore the differences between the US and UK/European healthcare markets. This discussion delves into healthcare industry insights, the role of healthcare IT strategy, and the challenges faced by medical service organizations (MSOs) when expanding into international markets.Jonathan shares his experience in healthcare leadership, highlighting the opportunities and risks associated with global healthcare trends, market expansion, and healthcare innovations that drive strategic decision-making. The conversation is crucial for healthcare executives, investors, and policy-makers looking to navigate the complexities of cross-border healthcare operations.Timestamps:[00:00] Introduction to Roy Bejarano & Jonathan Kron – Understanding Healthcare Market Differences[05:30] US vs. UK/European Healthcare Models – Key Structural and Financial Differences[11:45] Market Opportunities & Challenges – Expanding Healthcare Businesses Internationally[18:20] Role of Healthcare IT Strategy – Leveraging Data Analytics for Market Expansion[26:50] Physician Engagement & Operational Efficiency – Lessons from Different Healthcare Systems[39:15] Healthcare Mergers & Acquisitions – Best Practices for Cross-Border IntegrationsKey Takeaways:Healthcare markets vary significantly between the US and UK/Europe. Understanding financial models, government involvement, and patient expectations is crucial for successful expansion.Healthcare IT strategy is key to market entry. Leveraging data analytics and business intelligence helps organizations optimize operations across global healthcare markets.Physician engagement is critical in different regulatory environments. Organizations must align compensation structures, performance metrics, and workflow efficiencies to fit local standards.Healthcare mergers & acquisitions require strategic alignment. Successful cross-border deals depend on operational integration, cultural adaptation, and compliance with local regulations.About Jonathan Kron:Jonathan Kron is a healthcare IT & business intelligence expert with over 30 years of experience in healthcare leadership, IT strategy, and operational optimization. Having worked with global healthcare markets, he specializes in data-driven decision-making, cross-border healthcare expansion, and market entry strategies for medical organizations looking to scale internationally.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Global Healthcare Markets, UK Healthcare System, European Healthcare Trends, Healthcare IT Strategy, Market Expansion, Physician Engagement, Medical Service Organizations (MSOs), Healthcare Mergers & Acquisitions, Jonathan Kron,

Nov 26, 202456 min

Scaling Fertility Care | CEO Insights with Andrew Mintz of Pinnacle Fertility

Roy Bejarano sits down with Andrew Mintz, CEO of Pinnacle Fertility, to explore the growth, challenges, and strategic vision behind one of the fastest-growing fertility care platforms in the U.S. The discussion covers healthcare trends, the impact of private equity in fertility care, and the operational challenges of scaling fertility services.Andrew shares insights on healthcare leadership, patient experience optimization, and creating a culture-driven organization. The conversation highlights Pinnacle Fertility’s approach to physician engagement, embryology training, and fertility innovation. This episode is essential for healthcare executives, investors, and fertility professionals seeking insights on the business of reproductive medicine.Timestamps:[00:00] Introduction to Roy Bejarano & Andrew Mintz – The Growth of Pinnacle Fertility[03:15] The Evolution of Physician Practice Management in Fertility Care[07:30] Scaling a Fertility Platform – From the First Practice to National Expansion[12:45] The Role of Private Equity in Fertility Healthcare – Investment & Growth Strategies[18:15] Physician & Employee Engagement – Creating a Strong Culture & Leadership Model[24:00] Technology & Innovation in Fertility Clinics – The Role of Data & Standardization[30:30] Addressing the Physician Shortage in Fertility – Training Programs & Workforce Solutions[37:15] The Future of Fertility Care – Market Trends, Growth Challenges & Emerging OpportunitiesKey Takeaways:Fertility care is growing, but physician shortages remain a challenge. With only 1,400 reproductive endocrinologists nationwide, top-of-license models and embryology training programs are crucial for scaling care.Private equity-backed healthcare must be patient-centered. Pinnacle Fertility focuses on patient experience, quality outcomes, and employee engagement, ensuring long-term success beyond financial returns.A strong leadership culture drives performance. Pinnacle Fertility invests in physician leadership training, standardization of clinical protocols, and data-driven decision-making to enhance patient outcomes.Technology is key to improving fertility outcomes. Centralized electronic medical records (EMRs), AI-driven diagnostics, and process automation are improving clinical efficiency and success rates.About Andrew Mintz:Andrew Mintz is the CEO of Pinnacle Fertility, a rapidly expanding fertility care platform backed by private equity. With decades of experience in physician practice management, women's health, and fertility operations, he has led Pinnacle’s growth strategy, employee engagement initiatives, and innovation efforts. His insights provide a roadmap for healthcare executives, investors, and fertility professionals navigating the future of reproductive medicine. Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Fertility Clinics, Pinnacle Fertility, Physician Practice Management, Value-Based Care, Employee Engagement, Embryology Training, Private Equity in Healthcare, Andrew Mintz,

Nov 26, 202441 min

Growth & Challenges in Vascular Healthcare | CEO Insights with Eric Rogers of Palm Vascular

Roy Bejarano sits down with Eric Rogers, CEO of Palm Vascular, to explore the growth, challenges, and opportunities in the vascular healthcare market. The discussion covers healthcare trends, the expansion of outpatient vascular centers (OBLs & ASCs), and the strategic integration of podiatry and vascular care.Eric shares insights on healthcare leadership, navigating healthcare industry challenges, and how healthcare innovations are shaping vascular care, cardiac expansion, and value-based care models. This conversation is critical for healthcare executives, investors, and physicians looking to scale and optimize their practice in a rapidly evolving market.Timestamps:[00:00] Introduction to Roy Bejarano & Eric Rogers – The Growth of Palm Vascular[02:15] Understanding the Vascular Market – Services, Procedures & Expansion Trends[05:00] The Role of OBLs vs. ASCs – Business Model & Growth Strategy[09:15] Adapting to Market Shifts – Rate Cuts, New Service Lines & Expansion Strategies[14:30] Podiatry & Vascular Synergies – The Impact of Mergers on Referral Networks[20:00] Competition in Vascular Healthcare – Navigating Hospitals, Independent Physicians & Payers[28:00] Future of Vascular Healthcare – Cardiac Expansion, Value-Based Care & New TechnologiesKey Takeaways:Vascular healthcare has significant growth potential. With OBLs & ASCs expanding, there is a large untapped market opportunity to move procedures out of hospital settings.Podiatry & Vascular Synergies are Real – But Complex. While podiatry and vascular care have natural referral synergies, operational and cultural integration remains a challenge.Healthcare innovation is shaping the vascular space. New diagnostic technologies, AI in radiology, and hyperbaric oxygen therapy (HBO) are exciting frontiers.Value-Based Care presents both challenges and opportunities. While vascular care is inherently cost-effective for payers, Palm Vascular continues to develop a refined strategy to maximize value-based contracts.Connect with the Guest:Website: Palm Vascular https://www.palmvascular.com/LinkedIn: Eric Rogers https://www.linkedin.com/in/eric-rogers-a49b2539/ About Eric Rogers:Eric Rogers is the CEO of Palm Vascular, the largest peripheral vascular group in Florida. With expertise in OBLs, ASCs, podiatry-vascular integration, and healthcare leadership, he has led Palm Vascular's rapid growth while adapting to market shifts and healthcare innovations. His insights provide a roadmap for healthcare executives and investors looking to scale in the vascular healthcare market.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Vascular Healthcare, Outpatient Vascular Centers, OBLs & ASCs, Podiatry & Vascular Synergies, Healthcare Mergers & Acquisitions, Value-Based Care, Cardiac Care Expansion, Healthcare Technology, Eric Rogers,

Nov 26, 202437 min

Tech Series: AI, Value-Based Care & Healthcare Innovation: A Holistic Approach with Amir Dan Rubin

Host Roy Bejarano sits down with Amir Dan Rubin, an industry veteran and former CEO of One Medical, Stanford Health, UCLA Medical, and United Healthcare’s Optum. Now leading Healthier Capital, a venture fund dedicated to AI-driven healthcare innovations, Amir shares a holistic perspective on the intersection of technology, business strategy, and healthcare transformation.This conversation explores how AI, value-based care, payer models, and care coordination must work together to drive sustainable innovation. Amir explains how AI can improve patient engagement and operational efficiency, but only when aligned with existing healthcare systems and incentives. He also delves into the challenges of scaling risk-based care models, the evolving role of health systems, and why execution is just as critical as strategy.Timestamps:[00:00] Introduction to the podcast and guest, Amir Dan Rubin[02:00] Managing for-profit vs. non-profit healthcare: How leadership, funding, and decision-making differ[06:30] The impact of private equity and venture capital on healthcare leadership[12:00] The One Medical playbook: How strategic primary care innovation led to its acquisition by Amazon[18:00] AI in healthcare: The biggest opportunities and risks for AI-driven healthcare innovations[24:30] A holistic approach to healthcare transformation—aligning AI, patient engagement, and care coordination[30:00] The challenge of coordinating care across specialties and health systems[40:00] Value-based care: Is it working? Lessons from Medicare Advantage and risk-based models[50:00] AI in action: How Healthier Capital is funding the next wave of AI healthcare startups[1:00:00] What’s next: Amir’s vision for AI, digital health, and healthcare transformationKey Takeaways:For-profit and non-profit healthcare models each have strengths—but focus and execution matter most. Nonprofits benefit from tax advantages and academic affiliations, while for-profits have greater agility in decision-making and innovation.One Medical’s success stemmed from a hybrid model that improved access and efficiency. By offering tech-enabled primary care with a membership model and employer partnerships, One Medical bridged gaps in value-based care and traditional fee-for-service models.AI is a game-changer for patient care and operational efficiency. AI-driven tools can automate administrative tasks, enhance clinical decision-making, and improve patient engagement, but they must be secure, compliant, and seamlessly integrated into existing workflows.Value-based care is complex, but risk is risky. Many healthcare groups struggle with financial sustainability in global capitation models, but data-driven care coordination and AI-driven risk stratification can help reduce costs while improving patient outcomes.Health systems will increasingly partner with AI startups to modernize care delivery. Large tech firms like Amazon, Google, and Optum are investing in AI healthcare solutions, but the most impactful innovations often come from specialized startups solving specific industry challenges.Resources:Healthier Capital WebsiteLinkedInAmir Dan Rubinis a distinguished healthcare executive renowned for his transformative leadership in innovative healthcare delivery. As the former CEO of One Medical, a membership-based primary care practice, Rubin spearheaded its national expansion, increased its membership base, and successfully led the company to a public offering in January 2020.Rubin’s impressive career includes pivotal roles in leading healthcare organizations. He served as President and COO of UnitedHealth Group’s Optum and as CEO of Stanford Health Care, where he championed the integration of advanced technology and patient-centered care. His expertise lies in healthcare transformation, innovation, and leveraging digital tools to enhance patient experiences.Rubin holds an MBA from Stanford University, an MHA from the University of Michigan, and a Bachelor’s degree in Economics from the University of California, Berkeley. His contributions have significantly impacted how healthcare organizations utilize technology to provide more accessible and patient-focused care.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, AI in Healthcare, Value-Based Care, Digital Health, Venture Capital in Healthcare, Health System Strategy, Amir Dan Rubin, One Medical, Stanford Health, UCLA Medical, United Healthcare’s Optum, Holistic Healthcare,

Nov 12, 202459 min

The Future of Life Sciences, Clinical Research & Healthcare Investment with Steven Meehan & Dr. Ya-El Mandel

Steven Meehan, Managing Director of Scale Life Sciences and Dr. Ya-El Mandel, Senior Vice President of Clinical Operations at Équilibre Biopharmaceuticals Corp., and the founder and CEO of Cardea Sciences, sit down to discuss the future of life sciences, clinical research, and healthcare investment. With a background in investment banking, clinical trials, and biotechnology operations, Steven shares insights into biotech funding trends, AI in life sciences, and private equity investment strategies in healthcare innovation.The discussion takes a holistic approach to how the political and economic landscape impacts clinical research, why provider groups should enter the clinical trial space, and how private equity investors can optimize their life sciences investments.Timestamps:[00:00] Introduction to the podcast and guests, Steven Meehan & Dr. Ya-El Mandel[02:00] Steven’s background: From Wall Street to biotech investments and life sciences strategy[05:30] How private equity in healthcare is adapting to economic and political shifts[08:15] The impact of AI in healthcare and its role in clinical research & biotech advancements[11:00] The challenge of securing funding for small to mid-sized biotech firms[14:30] Why clinical trials are struggling with patient diversity and site participation[18:00] The opportunities for healthcare providers to integrate clinical research infrastructure[21:00] Final thoughts: The future of healthcare leadership, biotech investments, and AI in healthcareKey Takeaways:Private equity in healthcare is shifting toward strategic biotech investments. Investors are focusing on scalability, clinical research efficiency, and healthcare innovations.AI in healthcare is a transformative force. AI-driven healthcare trends are improving diagnostic accuracy, patient engagement, and operational efficiency.Diversity in clinical research is critical. Expanding patient recruitment beyond major institutions is essential for better healthcare industry insights and improved treatment outcomes.Healthcare leadership must integrate clinical research. Life sciences advancements depend on stronger partnerships between healthcare providers and biotech firms.About the Guests:Steven Meehan is an expert in biotech investments, private equity in healthcare, and life sciences advisory, with a background in investment banking and clinical research strategy.Dr. Ya-El Mandel specializes in clinical trial design, regulatory strategy, and healthcare innovations. She helps healthcare leadership and private equity navigate the complexities of clinical research.Resources:Scale Life Sciences WebsiteSteven MeehanWebsite: [email protected] Steven’s Profilelinkedin.com/in/steven-meehan-776530Dr. Ya-El Mandel Website: cardeasciences.com Linkedin: https://www.linkedin.com/in/yaelmp/overlay/contact-info/Steven Meehan is a seasoned professional with over 25 years of expertise in financial and operational leadership, excelling in corporate strategy, mergers and acquisitions, capital raising, and financial planning and analysis. His extensive background demonstrates a strong focus on navigating organizations through complex financial and strategic challenges, with a keen emphasis on value creation and growth acceleration.Ya-El Mandel, PhD, MSc, is a distinguished leader in biopharmaceuticals and medical innovation. As a founding member and Senior Vice President of Clinical Operations at Équilibre Biopharmaceuticals Corp., and the founder and CEO of Cardea Sciences, she spearheads advancements in non-invasive platforms for Atrial Fibrillation risk assessment. A PhD alumna of the Icahn School of Medicine at Mount Sinai, she also contributes as an adjunct professor. With over a decade of expertise in clinical trials and emergency medical leadership, Dr. Mandel’s work seamlessly integrates academia, industry, and healthcare innovation, driving transformative progress in the field.: Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Life Sciences, Clinical Research, AI in Healthcare, Private Equity in Healthcare, Biotech Investment, Steven Meehan, Scale Life Sciences, Dr. Ya-El Mandel, Équilibre Biopharmaceuticals Corp, Cardea Sciences,

Nov 11, 2024

The Future of Physician Consolidation & Healthcare Investment with Wyatt Ritchie, Managing Director at Cain Brothers

Host Roy Bejarano speaks with Wyatt Ritchie, Managing Director at Cain Brothers, one of the leading investment banks specializing in healthcare transactions. Wyatt has overseen over 150 healthcare deals in the past five years and shares his expert insights on physician consolidation, private equity investment, and the changing healthcare services landscape.This discussion takes a holistic approach to the future of healthcare investment, covering what works in MSOs, why physician practices must adapt, how AI will drive efficiencies, and how health systems and private equity are reshaping the landscape. Wyatt also addresses the evolution of capital markets, value-based care adoption, and the role of employer-sponsored healthcare innovation.Timestamps:[00:00] Introduction to the podcast and guest, Wyatt Ritchie, Managing Director at Cain Brothers[02:00] Wyatt’s journey in healthcare investment banking: From Jeffries to Cain Brothers[06:30] The state of physician consolidation: Why private equity remains interested despite headwinds[12:00] Key investment trends: Which healthcare specialties are thriving, and which are struggling?[18:00] The rise of AI in healthcare and how it will drive operational efficiencies[24:30] Why health systems struggle with ambulatory care and what can be done[30:00] Multi-specialty vs. single-specialty MSOs: Which model is more sustainable?[40:00] Health system & MSO partnerships: A new wave of strategic alliances in healthcare[50:00] How private equity is adapting to a shifting capital environment[1:00:00] The future of employer-sponsored healthcare: Why companies are taking healthcare into their own hands[1:15:00] Wyatt’s final thoughts on where healthcare investment is headed nextKey Takeaways:Healthcare is entering a new phase of consolidation and efficiency. Physician groups must scale smarter by aligning with either health systems, private equity, or employer-driven healthcare innovations.Private equity investment in MSOs remains strong but is evolving. Investors are becoming more selective, prioritizing scalability, operational efficiency, and value-based care capabilities.AI will transform MSOs, health systems, and payer-provider relationships. AI is poised to drive efficiencies, reduce administrative waste, and enhance patient engagement, making it a key differentiator for future healthcare investment.Multi-specialty MSOs are gaining traction—but execution remains difficult. While multi-specialty models offer care coordination advantages, scaling them is far more complex than single-specialty roll-ups.Health system partnerships with MSOs are the next big wave. As hospitals face financial pressure, they are increasingly looking to partner with MSOs for ambulatory expansion, rather than owning all assets outright.Employer-driven healthcare is a growing force. Large corporations are moving away from traditional payer models, creating custom networks and engaging directly with provider groups to control costs and improve outcomes.Connect with Wyatt Ritchie: Cain Brothers Website LinkedInAbout Wyatt Ritchie:Wyatt Ritchie is a healthcare investment banking leader with over 20 years of experience in M&A, private equity transactions, and strategic advisory for healthcare services. As Managing Director at Cain Brothers, Wyatt has played a pivotal role in helping healthcare organizations navigate consolidation, investment, and strategic growth.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Physician Consolidation, Private Equity in Healthcare, MSO Growth, AI in Healthcare, Health System Partnerships, Wyatt Ritchie, Cain Brothers,

Nov 7, 20241h 0m

The Future of the DSO Market & Dental Investments with Jeff Staser, CFO of Straine Dental

Host Roy Bejarano sits down with Jeff Staser, CFO of Straine Dental, to explore the evolving DSO market, the impact of private equity in healthcare, and the future of dental investments. As a dental industry veteran with decades of experience in scaling DSOs, optimizing financial models, and practice management, Jeff shares key insights on what makes Straine Dental’s ownership model unique, how hygiene departments drive revenue, and why data-driven decision-making is crucial for DSOs.This episode covers the differences between Straine Dental and traditional DSOs, common mistakes dental practices make, and how AI in healthcare and DSOs will shape the future of the industry.Timestamps:[00:00] Introduction to the podcast and guest, Jeff Staser, CFO of Straine Dental[02:00] Jeff’s background: From Heartland Dental to Straine Dental’s growth strategy[06:30] The origin of Straine Dental and its unique ownership structure[10:00] Why hygiene departments are a key driver of revenue for DSOs[14:30] How most independent dental practices fail to optimize operational efficiency[18:00] The role of private equity in shaping the future of DSOs[22:30] The importance of KPIs and analytics in DSO success[26:00] How AI and technology are changing the DSO landscape[30:30] The biggest challenges and resistance dentists face when scaling their practices[35:00] Jeff’s predictions for the future of DSOs and dental consolidation trends[40:00] Final thoughts and closing remarksKey Takeaways:Straine Dental prioritizes dentist ownership in its DSO model. Unlike traditional private equity-backed DSOs, Straine ensures that clinicians maintain majority ownership, aligning incentives for long-term practice growth.Hygiene departments are a hidden driver of DSO success. Many dental practices underinvest in hygiene, missing out on significant revenue opportunities that could improve patient care and practice performance.Private equity in healthcare is accelerating DSO consolidation. Large DSOs are focusing on de novo growth instead of acquisitions, leading to fewer opportunities for individual dentists to sell their practices in the future.The future of the DSO market will resemble healthcare systems. Larger dental groups will increasingly adopt medical-like structures, integrating technology, data-driven management, and operational efficiencies.Resources:Website- https://dykemadso.com/LinkedIn- https://www.linkedin.com/in/jeff-staser-0530a71a/About Jeff Staser:Jeff Staser is a dental industry expert with extensive experience in DSO financial strategy, private equity investment, and dental practice management. As the CFO of Straine Dental, he has played a pivotal role in scaling DSOs, optimizing financial models, and ensuring long-term growth for dentist-owned organizations. Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Private Equity in Healthcare, Dental Support Organizations (DSOs), Dental Investments, AI in Healthcare, Jeff Staser, Straine Dental,

Sep 8, 202443 min

Overcoming Healthcare Marketing & IT Challenges with Jason Tushman, CEO of Red Spot Interactive

Host Roy Bejarano sits down with Jason Tushman, CEO of Red Spot Interactive, to discuss the challenges of healthcare IT adoption, patient acquisition, and digital marketing. With over 15 years of experience in healthcare marketing, CRM, and practice management solutions, Jason shares insights into why healthcare IT lags behind other industries, how data integration can improve patient retention, and why AI and predictive analytics are the future of healthcare marketing.This episode explores why most healthcare practices struggle with digital transformation, the biggest inefficiencies in patient communication, and how CRM technology is reshaping practice operations. Jason also reveals the most cost-effective digital marketing strategies for healthcare providers and how AI in healthcare will drive automation and operational efficiencies.Timestamps:[00:00] Introduction to the podcast and guest, Jason Tushman, CEO of Red Spot Interactive[02:00] Jason’s background: How his experience in automotive finance led to healthcare IT[06:00] The early challenges of Red Spot Interactive and the pivot into patient acquisition[10:00] The biggest reasons healthcare IT adoption lags behind other industries[14:30] How data fragmentation is slowing down digital transformation in healthcare[18:00] Why healthcare marketing remains inefficient and how CRM can fix it[22:00] How AI in healthcare will change patient acquisition & operational workflows[26:30] The importance of integrating call centers with practice management systems[30:00] Why standardized data is essential for healthcare system-wide efficiency[35:00] The future of patient engagement: AI, predictive analytics, and automation[40:00] Final thoughts and predictions for the next five years in healthcare ITKey Takeaways:Healthcare IT adoption lags due to fragmented data and misaligned decision-makers. Most practices fail to integrate data across phone systems, practice management software, and marketing platforms, creating inefficiencies.AI in healthcare will drive automation and improve patient retention. AI-powered patient engagement, automated scheduling, and predictive analytics will increase efficiency and reduce administrative burdens.CRM is the missing link between patient acquisition, retention, and revenue tracking. A properly integrated CRM allows practices to connect marketing efforts to real patient outcomes and revenue performance.Organic video content is the most cost-effective healthcare marketing strategy. Practices that invest in educational video content on social media, YouTube, and their websites see the highest ROI on marketing efforts.Resources:Red Spot Interactive Website https://www.redspotinteractive.com/LinkedIn: Jason Tushman https://www.linkedin.com/in/jason-tuschman/About Jason Tushman:Jason Tushman is the CEO and Founder of Red Spot Interactive, a leading healthcare CRM and patient acquisition platform. With over 15 years of experience in healthcare IT and marketing, Jason specializes in helping multi-location practices streamline patient engagement, optimize digital marketing, and improve operational efficiency through AI and data integration.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Private Equity in Healthcare, AI in Healthcare, Patient Acquisition, Digital Marketing in Healthcare, CRM for Healthcare, Jason Tushman, Red Spot Interactive,

Aug 13, 202444 min

Establishing Competitive Advantage in Home Health with Scott Herman, CEO of New Day Healthcare

Host Roy Bejarano sits down with Scott Herman, CEO of New Day Healthcare, to discuss how home healthcare is evolving, the challenges of scaling a home care platform, and how AI is transforming care delivery. New Day Healthcare, founded in 2020, has rapidly grown to 120,000 patients, 7,000 team members, and 29 locations across five states, making it one of the fastest-growing home health providers in the industry.In this episode, Scott shares insights into the importance of technology-driven home care models, how New Day differentiates itself from traditional home care providers, and why AI-driven analytics are crucial for improving patient outcomes. He also explains how Medicare Advantage is reshaping home care, why avoiding the acquisition "value trap" is essential, and how his company is pioneering a virtual-first home healthcare model.Timestamps:[00:00] Introduction to the podcast and guest, Scott Herman, CEO of New Day Healthcare[02:00] Scott’s background: From paramedic and nurse to leading major home health platforms[06:00] How New Day Healthcare differs from traditional home care providers[10:00] Why a virtual-first corporate model reduces overhead and improves patient care[14:30] How New Day avoids the acquisition "value trap" when scaling[18:00] The role of AI in healthcare: How New Day uses predictive analytics to manage patient care[22:00] Why Medicare Advantage is driving major change in home healthcare[26:30] The challenges of integrating different EMRs and billing systems[30:00] How AI-driven automation is streamlining patient referrals and intake[35:00] The future of home healthcare: AI, predictive analytics, and strategic partnerships[40:00] Final thoughts and Scott’s predictions for the future of the home care industryKey Takeaways:New Day Healthcare is revolutionizing home care with a virtual-first model. By eliminating corporate overhead and using AI-powered automation, New Day is able to deliver more resources to bedside care.AI in healthcare is transforming home health operations. Predictive analytics, AI-driven patient tracking, and automated referral processing are helping New Day reduce hospitalizations and improve patient engagement.Avoiding the "value trap" in acquisitions is key to sustainable growth. Unlike other home care providers, New Day focuses on middle-tier acquisitions and leverages AI to optimize operations instead of overpaying for premium assets.Medicare Advantage is forcing home health providers to rethink their business models. With 53% of Medicare patients now enrolled in MA plans, New Day is adapting to lower-margin, high-volume care models.Strategic partnerships must be carefully structured. Scott explains why many home care providers fall into inefficient strategic alliances and how New Day selectively engages in payer and provider partnerships.Resources:New Day Healthcare Website https://www.newdayhealthcare.com/LinkedIn: Scott Herman https://www.linkedin.com/in/g-scott-herman-10a9a1178/About Scott Herman:Scott Herman is a home healthcare industry leader with over 30 years of experience in scaling home health, hospice, and personal care platforms. As the CEO of New Day Healthcare, Scott has built one of the fastest-growing tech-enabled home care companies in the U.S., focused on AI-driven care delivery and operational efficiency.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Private Equity in Healthcare, Home Healthcare, AI in Healthcare, Medicare Advantage, Patient Acquisition, Scott Herman, New Day Healthcare,

Aug 2, 202441 min

Healthcare Innovations & Value-Based Care with Soran Health Leaders- Jason Conger and Dr. Marlow Hernandez

Host Roy Bejarano sits down with Jason Conger and Dr. Marlow Hernandez, co-founders of Soran Health, to discuss how healthcare innovations are reshaping value-based care. They explore the challenges of public ownership in healthcare, the importance of payer-provider partnerships, and how data-driven insights can improve patient outcomes.In this episode, Jason and Marlow share their healthcare industry insights from their time at Cano Health to launching Soran Health, explaining how their experiences in healthcare leadership shaped their mission to transform specialty care services at home.Timestamps:[00:01] Introduction to the podcast and guests, Jason Conger & Dr. Marlow Hernandez[04:15] Public ownership in healthcare: Pros, cons, and lessons from Cano Health[09:45] How provider incentives impact healthcare industry performance[15:30] The power of payer-provider partnerships in healthcare leadership[22:00] Geographic expansion in healthcare: Lessons from scaling Cano Health[30:00] The foundation of Soran Health: A new approach to value-based care[38:30] How predictive analytics & real-time healthcare insights drive better patient care[45:00] The future of healthcare: Innovations, partnerships, and technology-driven solutionsKey Takeaways:Public Ownership in Healthcare Requires Strategic Planning: Healthcare leadership teams must have a strong capital base and operational infrastructure before considering an IPO.Payer-Provider Partnerships Are Essential for Value-Based Care: Collaborations like those with Humana have proven that healthcare innovations can drive better patient outcomes while managing costs.Soran Health is Pioneering a New Model in Specialty Care: By leveraging healthcare data analytics, Soran Health is improving care delivery without relying on traditional claims data.Predictive Analytics is the Future of Healthcare Trends: Instead of waiting for claims or medical deterioration, real-time risk stratification can proactively improve patient outcomes.Resources:Soran Health Website: https://www.soranhealth.org/LinkedIn: Dr. Marlow Hernandez: linkedin.com/in/marlowhernandezAbout the Guests:Jason CongerJason R. R. Conger is an American attorney and Republican politician from the U.S. state of Oregon. He served in the Oregon House of Representatives representing District 54 in Bend, Oregon, from 2011 to 2015.Marlow HernandezMarlow Hernandez, D.O. is a board-certified physician and experienced venous specialist who has been serving the South Florida community for more than a decade.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Payer-Provider Partnerships, Value-Based Care, Public Healthcare Ownership, Healthcare Data Analytics, Public Ownership, Payer-Provider Partnership Models, and the Evolution of Value-Based Care, Jason Conger, Dr. Marlow Hernandez, Soran Health,

Jul 10, 20241h 38m

Healthcare Innovations & Leadership in ENT and Allergy Care with Drew Franklin & Dr. Gavin Setzen | ENT Urgent Care, MSO Growth & Value-Based Care

Host Roy Bejarano sits down with Drew Franklin and Dr. Gavin Setzen, leaders in ENT and allergy care, to discuss the evolution of specialty healthcare, MSO development, and scaling a multi-site practice. They explore how healthcare leadership, patient access models, and value-based care innovations are reshaping the industry.In this episode, Drew and Gavin share healthcare industry insights on private equity vs. independent growth, optimizing clinical operations, and integrating ancillary services like allergy, audiology, and imaging. They also unveil an ENT urgent care model designed to improve patient access and cost efficiency.Timestamps:[00:01] Introduction to the podcast and guests, Drew Franklin & Dr. Gavin Setzen[04:00] The role of healthcare leadership in ENT & allergy care growth[12:00] Expanding an ENT practice: From a regional leader to a national brand[19:45] Private Equity vs. Independent Growth: Strategic decisions in healthcare business models[26:30] ENT Urgent Care & Ancillary Services: How innovations drive better patient outcomes[41:00] The Referral Challenge: Balancing specialty collaboration & in-house services[50:00] Value-Based Care & Healthcare Trends: Navigating new payer models & cost-efficient careKey Takeaways:ENT & Allergy Care Innovations Are Expanding: Urgent care, allergy services, and audiology offer new revenue streams and better patient care.Private Equity vs. Physician-Owned Models: Retaining clinical control and culture is crucial for long-term success.Value-Based Care & Payer Models Are Evolving: ENT groups must adapt to healthcare industry shifts for sustainable growth.Healthcare Leadership & MSOs Create Scalable Success: A dyad leadership approach (clinical + business expertise) is key to building efficient multi-site practices.Drew Franklin, MBA, FACMPE – Medical Practice Executive, ENT Administrator at ENT Specialty PartnersI’m a strategic advisor for Albany ENT and Allergy Services. I’ve been with the practice for four years. I’ve been in ENT for 18 years, having previously worked with ENT and Allergy Associates, which is the largest Ear, Nose and Throat practice in the country. I have my MBA from NYU Stern. I’m a fellow of the American College of Medical Practice Executives, and I’m very happy to be here.Gavin Setzen – CEO & President at Albany ENT & Allergy ServicesMy journey’s a little circuitous to Albany, having grown up in South Africa. I went to medical school in South Africa, did a short stint at a family practice, 60 miles north of North Dakota, waiting for my green card. I completed a partial general surgery residency in New York City. Before coming up to Albany, I completed my ENT Head and Neck surgery residency here and loved the Adirondacks, the upstate New York area. I had a great opportunity to take over the practice of a solo practitioner and have lived in upstate New York since that time. We developed a great platform in comprehensive otolaryngology here, growing the practice to now our 10th physician and onboarding our 20th physician assistant. We have a very diverse, broadbased, comprehensive type of practice and we can certainly talk more about the offerings and ancillaries and other care services that we provide. It’s been a very rewarding, important journey, and we’re glad to be providing care to upstate New York and contiguous communities in southern Vermont, Western Massachusetts, and the like.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, ENT Urgent Care, Value-Based Care, Medical Practice Growth, Private Equity in Healthcare, Drew Franklin, Dr. Gavin Setzen, specialty healthcare, MSO development, allergy care growth,

Jun 9, 202456 min

Healthcare Innovations & Life Sciences Leadership with Suzy Engwall & David Reese | MedTech, Pharma, and MSO Growth

Host Roy Bejarano sits down with Suzy Engwall and David Reese to explore the intersection of MedTech, pharma, and healthcare services, focusing on how MSOs (Management Services Organizations) can play a larger role in healthcare innovation, clinical research, and early adoption of new medical technologies.In this episode, Suzy and David discuss the commercialization of medical devices and pharmaceuticals, how healthcare providers can integrate life sciences into their business models, and whether MSOs should build their own GPOs and venture capital arms. They also address the challenges and opportunities in MedTech and pharma adoption for outpatient settings.Timestamps:[00:01] Introduction to the podcast and guests, Suzy Engwall & David Reese[04:00] Why MSOs should take an active role in MedTech and Pharma innovation[12:00] Commercialization strategies: How medical devices and drugs enter the market[19:45] Private Equity vs. MSO-Owned GPOs: The business of healthcare innovation[26:30] The role of clinical research in MSO expansion and physician engagement[41:00] Venture Capital in Healthcare: Should MSOs fund life sciences innovations?[50:00] AI, Regulatory Trends, and the Future of MedTech & Pharma in HealthcareKey Takeaways:MSOs Can Play a Larger Role in Healthcare Innovation: From GPOs to early adoption programs, outpatient providers should engage with MedTech and pharma earlier in the commercialization process.Building a Clinical Research Infrastructure is a Competitive Advantage: MSOs that develop in-house research capabilities can improve patient outcomes and attract top clinical talent.Healthcare Venture Capital is Growing: Health systems have led the way—now MSOs should explore funding innovation to support new medical technologies and revenue diversification.Regulatory & Technological Shifts Are Reshaping Healthcare: AI, cost pressures, and regulatory frameworks are changing how new treatments are developed and adopted.Resources:Suzy Engwall: LinkedIn Profile linkedin.com/in/sengwallDavid Reese: https://www.scale-healthcare.com/employees/david-reese/Clinician Exchange: Websitehttps://healthtechstrategies.com/https://alirahealth.com/About the Guests:Suzy Engwall is the CEO and Founder of HealthTech Strategies, LLC, a boutique consulting firmShe is a healthcare innovation leader, speaker, startup advisor and mentor that has been working to make change in healthcare for almost 2 decades.David Reese is the Executive Partner, Infusion & Pharma Services at SCALE HealthcareDavid is a seasoned and proven healthcare management professional whose career spans more than thirty years of experience in physician-office infusion services, new service-line start-ups, operational management, and business strategy and development settings.David Reese, PhD Dr. Reese has a proven track record of leading and growing molecular diagnostics companies, raising funds, developing products, and building partnerships. He was the founder, CEO, and CSO of Provista Diagnostics, Inc., where he oversaw two CLIA/CAP laboratories and the commercialization of Videssa Breast, a novel blood-based test for breast cancer detection. He also served as the CEO and Lab Manager of Accurex Diagnostic Services, a COVID-19 and flu testing service provider, where he implemented the sales and marketing strategy and developed business development opportunities. Dr. Reese is passionate about advancing healthcare innovation and improving patient outcomes through his scientific and commercial expertise.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, MedTech, Pharma, MSO Growth, Life Sciences, Clinical Research, Venture Capital in Healthcare, Suzy Engwall, David Reese, MedTech, pharma, healthcare services, MSOs,

Jun 7, 202455 min

Redefining Pain Management & MSK Care with Dr. Ira Kornbluth | Clearway Pain Solutions, ASCs, and the Future of Interventional Pain

Host Roy Bejarano sits down with Dr. Ira Kornbluth, a leading figure in pain management and musculoskeletal (MSK) care, to discuss the evolution of Clearway Pain Solutions, its growth into the largest pain management practice in the U.S., and how interventional pain treatments are reshaping the industry.In this episode, Dr. Kornbluth shares his journey from independent practice to private equity-backed national leader, his strategic approach to ASC (ambulatory surgery center) expansion, and how Clearway Pain Solutions maintains clinical compliance while driving innovation in pain treatment. The conversation also tackles opioid prescribing trends, risk management in pain medicine, and the future of MSK practice growth.Timestamps:[00:01] Introduction to the podcast and guest, Dr. Ira Kornbluth[03:30] The evolution of pain management & interventional pain medicine[10:45] Private Equity vs. Independent Practice: What works best for growth?[17:30] Compliance in Pain Medicine: How Clearway Pain Solutions mitigates risk[24:15] Acquisition Strategy & Due Diligence: What Clearway looks for in partnerships[30:00] ASCs & Procedure Expansion: Why surgery centers are the future of pain care[37:00] Pain Management & Opioids: How the industry is adapting post-crisis[45:00] The Future of MSK Care: Growth opportunities in value-based care, partnerships, and technologyKey Takeaways:Pain Management is Evolving: Interventional treatments, ASCs, and new procedures are shifting the focus from chronic opioid management to minimally invasive pain relief solutions.Private Equity Helps Scale Operations: With the right partner, MSK and pain practices can gain financial discipline, accelerate growth, and maintain clinical quality.Surgery Centers are the Next Big Growth Area: Clearway Pain Solutions is investing heavily in ASC development as pain procedures move into outpatient settings.Opioid Prescribing is Declining: The medical community is shifting to earlier interventional pain management and reducing reliance on opioids.Acquisitions Require Strict Due Diligence: Not all pain practices meet Clearway’s compliance and cultural standards—choosing the right partners is key to long-term success.Resources:Clearway Pain Solutions: Website: https://clearwaypain.com/Dr. Ira Kornbluth: LinkedIn Profile linkedin.com/in/ira-kornbluth-1b70a31bAbout the Guest:Dr. Ira Kornbluth is a pain management physician, entrepreneur, and national leader in interventional pain care. He has led Clearway Pain Solutions to become the largest pain practice in the U.S., focusing on scalable growth, compliance, and high-quality patient outcomes.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Pain Management, MSK Care, Interventional Pain, Surgery Centers, Value-Based Care, Private Equity in Healthcare, Dr. Ira Kornbluth, pain management , musculoskeletal care, Clearway Pain Solutions,

Jun 6, 202449 min

MSO Strategies & Healthcare Leadership with Chris Kane, CEO of Allergy Partners

In this insightful episode of the Scale Leadership Series, host Roy Bejarano sits down with Chris Kane, CEO of Allergy Partners, to discuss healthcare leadership, MSO strategies, and the evolving healthcare industry. Chris shares his extensive experience navigating healthcare trends, investment models, and the impact of healthcare innovations on patient care. From private equity dynamics to healthcare industry insights, this episode is packed with invaluable takeaways for leaders and investors in the field.Timestamps:[02:00] – Chris Kane’s journey in healthcare leadership: from West Dermatology to Allergy Partners.[05:30] – The impact of ownership models on healthcare industry insights and business outcomes.[14:30] – Healthcare consolidation: Does size in healthcare lead to better or worse patient outcomes?[26:00] – Comparing healthcare trends in Dermatology and Allergy: Business models & operational challenges.[39:00] – The role of AI, healthcare innovations, and data analytics in improving patient care.[52:30] – The importance of public discourse and regulatory engagement in healthcare leadership.Key Takeaways:Ownership Structures Shape Outcomes – Whether private equity, family offices, or multinational corporations, the ownership model of a healthcare entity directly affects strategy and patient care.Healthcare Consolidation Has Pros and Cons – While some fear monopolization, healthcare trends show that consolidation can drive efficiencies if executed correctly.Data and AI are Transforming Healthcare – Emerging healthcare innovations in analytics and artificial intelligence are shaping the future of patient care and operations.Payvider Models Pose a Competitive Threat – The integration of payers and providers (e.g., Optum) is one of the biggest disruptors in the healthcare industry today.'RESOURCES:https://chrismkane.com/https://www.linkedin.com/in/chris-m-kane/About Guest: Chris Kane As a CEO and consultant, Chris has led companies through game-changing evolutions including rapid, sustainable and profitable growth, complex operations management, strategic planning, shifting leadership dynamics at all levels of the organization, and highly successful exits. Chris draws on these experiences – the wins, the setbacks, the deep commitment to learning – in service of his coaching and facilitation work with individuals, teams, and companies. Leaders turn to Chris to broker a better relationship between the C-suite, board members, and private equity companies. They trust him to provide incisive and objective advice on growth strategies, team development and market position. They are persuaded by Chris’ conviction that healthy cultures and strong business outcomes are inextricably linked. That psychological safety and performance-oriented cultures matter now more than ever. That, at the end of the day, your people, and how they learn to work well together, makes all the difference.Tags: Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, MSO Strategies, Allergy Partners, Private Equity in Healthcare, Healthcare Consolidation

Jun 5, 202456 min

Expanding Veteran Healthcare & Federal Partnerships with Dr. Scott C. Wise | Valor Healthcare’s Growth in Primary & Behavioral Care

Host Jason Schifman sits down with Dr. Scott C. Wise, President of Valor Healthcare, to explore how his organization is expanding federal healthcare services, winning complex government contracts, and scaling veteran-focused primary and behavioral healthcare.In this episode, Dr. Wise shares insights on federal healthcare partnerships, navigating complex RFP processes, and how Valor Healthcare is leading in remote patient monitoring and outpatient primary care. He also discusses strategic growth plans, private equity involvement, and the future of veteran healthcare innovation.Timestamps:[00:01] Introduction to the podcast and guest, Dr. Scott C. Wise[03:00] The Valor Healthcare Mission: Serving veterans and government agencies[09:00] Winning Federal Healthcare Contracts: Strategies for securing large-scale projects[14:30] Scaling Primary & Behavioral Care for Veterans: How Valor Healthcare grew from 12 to 50+ locations[20:00] Strategic Partnerships in Federal Healthcare: Building the right teams for success[27:00] Remote Patient Monitoring & Digital Health: The future of tech-driven veteran care[34:00] Challenges in Government Healthcare: Decentralization, funding, and policy barriers[41:00] The Future of Veteran & Government Healthcare: AI, data analytics, and private sector collaborationKey Takeaways:Federal Healthcare Contracts are Expanding: Valor Healthcare has successfully scaled by securing contracts for primary care, behavioral health, and remote patient monitoring for veterans and government agencies.Government Healthcare Requires Strategic Partnerships: Winning and executing large-scale government contracts requires assembling teams across IT, clinical care, and infrastructure development.Digital & Remote Care is the Future: Valor Healthcare’s $250M contract in remote patient monitoring highlights the growing role of tech-driven solutions for veteran care.Behavioral Health is a Priority for Veterans: Government agencies are increasing funding and resources for mental health and PTSD care, creating opportunities for innovative care models.Private Equity is Driving Growth in Government Healthcare: With the backing of Trive Capital, Valor Healthcare aims to triple its size in the coming years.Resources:Valor Healthcare: Website https://valorhealthcare.com/Dr. Scott C. Wise: LinkedIn Profile https://www.linkedin.com/in/scott-wise-md-mba/About the Guest:Dr. Scott C. Wise is a physician, business leader, and President of Valor Healthcare, overseeing one of the largest veteran-focused primary and behavioral care networks. With decades of experience in healthcare leadership, federal healthcare contracts, and private equity-backed growth, he is shaping the future of government-funded healthcare services.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Valor Healthcare, Veteran Healthcare, Government Healthcare Contracts, Behavioral Health, Primary Care Expansion, Remote Patient Monitoring, Public-Private Partnerships, Federal Healthcare Policy, Health IT Security, Population Health, Military Healthcare, Dr. Scott C. Wise,

Jun 4, 202453 min

Cybersecurity Risks in Healthcare with Jon Moore | Protecting Patient Data, AI Threats & Risk Mitigation Strategies

Host Roy Bejarano sits down with Jon Moore, Chief Risk Officer at Clearwater, to discuss the evolving landscape of cybersecurity in healthcare, how AI is changing cyber threats, and what organizations can do to strengthen their risk management strategies.In this episode, Jon Moore shares insights on ransomware attacks, regulatory compliance challenges, and the rise of AI-driven cyber threats. He also explores how healthcare providers, MSOs, and health systems can proactively protect patient data, simulate security breaches, and implement enterprise risk management programs.Timestamps:[00:01] Introduction to the podcast and guest, Jon Moore[04:00] The Role of a Chief Risk Officer: Why cybersecurity is critical for healthcare[10:00] AI & Cyber Threats: How hackers are using AI to create sophisticated attacks[17:30] Ransomware & Data Breaches: The biggest cyber risks facing healthcare organizations[24:00] Best Practices for Risk Management: How to develop a cybersecurity strategy[30:00] Tabletop Exercises & Simulated Attacks: Preparing healthcare leaders for cyber threats[37:30] Regulatory & Compliance Changes: HIPAA, SEC rules, and third-party security risks[42:00] The Future of Cybersecurity in Healthcare: What organizations should focus on nextKey Takeaways:Cyber Threats are Evolving Rapidly: Hackers are using AI to create realistic phishing scams, deepfake voicemails, and ransomware attacks targeting healthcare organizations.Ransomware is an Existential Threat: Healthcare breaches cost up to $11 million per incident, making cybersecurity a top priority for protecting patient data.Risk Management Programs are Essential: Every healthcare organization should have a cybersecurity strategy, conduct risk assessments, and simulate attacks to test system resilience.Regulatory Compliance is Increasing: New HIPAA and SEC regulations are placing greater accountability on healthcare organizations to secure patient data and mitigate cyber risks.Proactive Cybersecurity Measures Can Reduce Liability: Demonstrating a strong cybersecurity program can help mitigate legal risks, including class action lawsuits after a breach.Resources:Clearwater Security & Risk Solutions: Website https://clearwatersecurity.com/Jon Moore: LinkedIn Profile https://www.linkedin.com/in/jonamoore/About the Guest:Jon Moore is the Chief Risk Officer at Clearwater, a leading provider of cyber risk management solutions for healthcare. With expertise in privacy, security, and compliance, he helps healthcare organizations strengthen their IT security and mitigate risks against cyber threats.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Cybersecurity in Healthcare, Patient Data Protection, AI and Cybersecurity, Healthcare Risk Management, Ransomware Protection, Cyber Threats in Healthcare, Regulatory Compliance, IT Security, HIPAA Compliance, Jon Moore,

Sep 13, 202345 min

Financial Strategies & Healthcare Trends with Saurabh Tripathi | Payer-Provider Economics, Value-Based Care & Market Consolidation

Host Roy Bejarano sits down with Saurabh Tripathi, former CFO of Highmark, Fresenius, and GE Healthcare, to discuss the financial landscape of healthcare, the payer-provider relationship, and the ongoing shift toward value-based care.In this episode, Saurabh Tripathi shares insights on healthcare economics, payer negotiations, and the financial pressures on providers. He also discusses strategic partnerships, digital transformation, and the challenges of balancing cost efficiency with high-quality patient care.Timestamps:[00:01] Introduction to the podcast and guest, Saurabh Tripathi[05:00] The Solar System of Healthcare: How medical devices, providers, and payers interact[12:00] Misconceptions Between Stakeholders: What providers and payers get wrong about each other[19:30] Fixing a Broken Healthcare System: Policy changes that could drive meaningful reform[26:00] Value-Based Care in Action: How Highmark transitioned to a VBC-heavy model[33:00] Narrow vs. Broad Networks: Payer-provider alignment for cost-efficient care[40:00] Digital Transformation in Healthcare: How telemedicine and AI are reshaping patient care[47:00] Market Consolidation & The Future of Specialty Care: The impact of M&A on small practicesKey Takeaways:Payer-Provider Relationships Need Better Alignment: Providers argue that payers don’t reimburse enough, while payers believe providers are inefficient—both need to meet in the middle to improve outcomes.Value-Based Care is the Future: Highmark successfully flipped its model to prioritize value-based reimbursement, proving that financial incentives can align with better patient outcomes.Market Consolidation is Accelerating: Independent specialty practices will need to join larger groups or risk struggling in a value-based care environment.Digital Health & AI Will Drive Cost Reductions: Telemedicine, AI-driven care coordination, and digital documentation can help healthcare organizations lower costs while maintaining high-quality care.Retail & Big Tech Are Entering Healthcare Aggressively: Companies like CVS, Amazon, and United Optum are reshaping healthcare by integrating payer and provider models in new ways.About the Guest:Saurabh Tripathi is a former CFO of Highmark, Fresenius, and GE Healthcare, with extensive experience in healthcare finance, insurance reimbursement, and value-based care models. He has played a key role in shaping financial strategies for some of the largest healthcare organizations in the U.S.Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Financial Strategies in Healthcare, Value-Based Care, Payer-Provider Partnerships, Healthcare Market Consolidation, Insurance Reimbursement, Digital Health, Healthcare Economics, Private Equity in Healthcare, Healthcare Cost Reduction, Saurabh Tripathi,

Aug 7, 202352 min

The Future of Physician Independence is Now with Dr. Jim Weber

Dr. Jim Weber Chief Executive Officer and Founder of GI AllianceDr. Weber leads the nation’s largest independent gastroenterology (GI) provider network. His vision of creating a premier GI network by being Patient-First, Quality-Centric, and Physician-Led drives the organization’s success.

Jul 7, 202352 min

Navigating Healthcare Leadership & Innovation with Dr. Mark Rubino | Payer-Provider Integration, Value-Based Care & Workforce Challenges

Host Roy Bejarano welcomes Dr. Mark Rubino, President of two hospitals within Allegheny Health Network (AHN), for an in-depth discussion on healthcare leadership, payer-provider integration, workforce challenges, and the transition to value-based care.In this episode, Dr. Rubino shares insights into how hospitals compete with large MSOs, the role of AI in healthcare, and the financial and operational pressures facing hospital systems today. They discuss payer-provider partnerships, the impact of healthcare consolidation, and how hospitals must adapt to changing physician workforce dynamics and new reimbursement models.Timestamps:[00:01] – Introduction to the podcast and guest, Dr. Mark Rubino[05:00] – How AHN integrates payer-provider models like Kaiser and United Health[12:00] – The shift from fee-for-service to value-based care in an open network system[19:30] – Competition with MSOs & Private Equity-backed groups – How hospitals can stay relevant[26:00] – Workforce shortages & physician burnout – Strategies for recruitment and retention[33:00] – The Role of AI & Digital Transformation in Healthcare – Efficiency, patient care & automation[40:00] – Telemedicine & Rural Healthcare Expansion – How digital tools improve accessibility[47:00] – Market Consolidation & The Future of Specialty Care – What’s next for independent practices?Key Takeaways:Payer-Provider Integration Creates Stability: AHN’s integrated payer-provider model provides financial flexibility, allowing them to balance cost containment with quality care.Value-Based Care Needs a Phased Approach: Transitioning from RVU-based compensation to value-based reimbursement requires gradual, incentive-driven adjustments.AI & Digital Health Will Reshape Healthcare Delivery: AI-driven care coordination, telemedicine, and digital documentation can lower costs and improve patient access.Physician Workforce Challenges Are Reshaping Specialties: With changing physician demographics, hospitals must adapt by offering flexible employment models and expanding residency programs in high-demand fields.Market Consolidation Is Accelerating: Independent specialty practices will need to align with health systems or larger groups to survive in a value-based care environment.About the Guest:Dr. Mark Rubino is the President of two hospitals within the Allegheny Health Network (AHN). With a background in obstetrics, gynecology, and healthcare administration, Dr. Rubino has played a key role in hospital leadership, payer-provider integration, and workforce management strategies. Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Value-Based Care, Payer-Provider Partnerships, Telemedicine in Healthcare, Healthcare Market Consolidation, Physician Workforce Challenges, Digital Health, Private Equity in Healthcare, Hospital Management, Healthcare Cost Reduction, Dr. Mark Rubino

Jun 5, 202354 min

Scaling Health System Networks with Kathleen Kinslow | Hospital Mergers, MSOs & Physician Integration

Kathleen Kinslow, a seasoned healthcare executive with experience leading hospital networks, physician MSOs, and large-scale healthcare integrations. As the former CEO of Pennsylvania Hospital, Chief Integration Officer at Jefferson Health, and East Coast leader for Prospect Health, Kathleen has firsthand experience navigating hospital mergers, payer-provider partnerships, and the evolving role of private equity in healthcare.In this episode, Kathleen shares insights on the realities of health system expansion, the complexities of integrating multiple hospitals, and why cultural alignment is critical to successful mergers. She also discusses the growing role of AI and automation in healthcare, how physician MSOs are changing hospital dynamics, and what hospital leaders must do to stay competitive in a rapidly evolving industry.Timestamps:[00:01] Introduction to the podcast and guest, Kathleen Kinslow[05:00] Managing 17 hospitals – The day-to-day challenges of system-wide leadership[12:00] Health system expansion vs. FTC regulations – The fine line between scaling and monopolization[18:30] Why most hospital mergers fail – Overcoming integration challenges and cultural resistance[24:45] The rise of Physician MSOs – How independent practices navigate a consolidating healthcare market[30:00] AI & Automation in Healthcare – How digital transformation is reshaping operations and staffing models[34:15] Private Equity’s growing influence in healthcare – Risks and opportunities for hospitals and physician groups[38:00] The role of strategic partnerships in health system success – Why selective collaborations matter[41:00] Future of healthcare leadership – Key trends and how hospital executives must adaptKey Takeaways:Mergers alone don’t create efficiency – Scaling a health system is about operational streamlining and cultural alignment, not just acquiring hospitals.Physicians are the key to hospital success – Health systems must engage physicians as strategic partners, or risk losing them to MSOs, retail healthcare, and payer-backed provider groups.AI & automation are reshaping healthcare operations – Staffing models and administrative workflows are being overhauled to reduce costs and improve efficiency.FTC regulations will increase scrutiny on hospital consolidation – Large health systems must rethink expansion strategies to avoid monopolistic concerns.Private Equity & Big Tech are reshaping healthcare – Companies like UnitedHealth, Amazon, and CVS are rapidly disrupting traditional hospital models, forcing health systems to adapt or be outcompeted.Resources:LinkedIn: Kathleen Kinslow https://www.linkedin.com/in/kathleen-kinslow-94a20a154/About Kathleen Kinslow:Kathleen Kinslow is a healthcare executive with extensive experience in hospital leadership, mergers, and payer-provider integrations. As the former CEO of Pennsylvania Hospital and Chief Integration Officer at Jefferson Health, she played a pivotal role in hospital system expansion, workforce management, and healthcare innovation. Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Hospital Mergers, Physician MSOs, Health System Integration, Healthcare Cost Reduction, Value-Based Care, Digital Health, Healthcare Consolidation, Payer-Provider Partnerships, Workforce Challenges, Kathleen Kinslow,

Jun 3, 202346 min

The Future of Healthcare Real Estate with Jon Boyajian | Medical Office Trends, Site Selection & Private Equity Insights

Jon Boyajian, Co-Founder of Echo Real Estate Capital, for an in-depth discussion on healthcare real estate, medical office building (MOB) trends, and site selection strategies for healthcare providers.In this episode, Jon shares insights into how healthcare real estate is evolving in a rising interest rate environment, how provider groups can optimize their leased and owned assets, and why real estate strategy is critical to long-term healthcare growth.The conversation dives into the impact of private equity in healthcare real estate, how healthcare groups can leverage location analytics for patient acquisition, and why site selection mistakes can be costly.Timestamps:[00:01] Introduction to the podcast and guest, Jon Boyajian, Co-Founder of Echo Real Estate Capital[05:00] Understanding healthcare real estate investment models – value-add properties, ground-up development, and private equity partnerships[10:00] Site selection strategy for provider groups – What most groups overlook when choosing locations[16:00] Optimizing existing real estate portfolios – How to maximize lease agreements and negotiate better terms[24:00] Hidden costs in real estate leases – How providers can recover thousands in overpaid expenses[30:00] How healthcare landlords take advantage of tenants – Understanding lease audits, CAM charges & rent renegotiations[38:00] Private equity & market consolidation in healthcare real estate – What investors and providers need to know[44:00] The future of healthcare real estate – The impact of telemedicine, home healthcare, and AI-driven real estate analyticsKey Takeaways:Healthcare real estate is not a commodity—it’s a business. Success in medical office real estate depends on site optimization, patient traffic analytics, and real estate flexibility.Most provider groups overlook lease optimization. Hidden overcharges in lease agreements can cost healthcare groups thousands per year, making lease audits essential.Location selection is critical for patient acquisition. Real estate visibility, signage, traffic patterns, and nearby amenities can significantly impact patient volume and referral traffic.Private equity is reshaping healthcare real estate. The rise of private equity-backed provider groups has increased demand for MOBs, driving investment in healthcare real estate.Medical office trends are shifting toward high-efficiency properties. Rising costs have made existing properties more attractive than ground-up development, pushing providers to optimize their current portfolios.Connect with the Guest:Website: Echo Real Estate Capital https://www.echorecap.com/LinkedIn: Jon Boyajian https://www.linkedin.com/in/jonboyajian/About Jon Boyajian:Jon Boyajian is the Co-Founder of Echo Real Estate Capital, specializing in healthcare real estate investment, site selection, and medical office development. With extensive experience in retail and healthcare real estate, Jon has helped provider groups, private equity firms, and health systems optimize their real estate strategies for long-term success. Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Healthcare Real Estate, Medical Office Buildings, Private Equity in Healthcare, Site Selection, Payer-Provider Partnerships, Healthcare Facility Expansion, AI in Real Estate, Healthcare Market Consolidation, Physician Practice Growth, Jon Boyajian,

Apr 12, 202356 min

Navigating Payer Strategy & Value-Based Care with Margaret Braxton | Health Equity, Risk Contracts & Market Trends

Margaret Braxton, a seasoned healthcare executive leading payer strategy and research at Scale Healthcare. With over 35 years of experience spanning provider operations, health systems, and payer negotiations at UnitedHealthcare and Cigna, Margaret offers deep insights into value-based care, payer-provider partnerships, and the evolution of health equity in healthcare.In this episode, Margaret shares her expertise on the shifting landscape of payer contracts, the challenges of implementing risk-based models, and how health systems are adapting to value-based initiatives. She also explores why Florida has become a hotspot for Medicare Advantage and direct primary care contracting, and how government programs are shaping the next wave of healthcare funding and innovation.Timestamps:[00:01] Introduction to the podcast and guest, Margaret Braxton[05:00] Understanding Value-Based Care Programs – Shared savings, risk-based contracts & payer alignment[12:00] Why Value-Based Care Adoption Varies by State – Health system influence & regulatory differences[18:30] Florida’s Unique Role in Primary Care Expansion – Why major brands like Oak Street, Cano, and others scaled rapidly[24:45] Private Equity & Payer Partnerships – The rise of Optum, Evernorth, and vertically integrated care models[30:00] Health Equity & Government Incentives – How CMS, Medicaid, and federal programs are driving new funding[36:00] The Impact of Medicare Advantage on Value-Based Care – Understanding risk thresholds and member attribution[41:00] The Role of Hospitals in Value-Based Care – How health systems are shifting toward performance-based contracts[47:00] Future of Healthcare Funding & Policy Trends – What to expect in payer strategy, Medicaid expansion & hybrid modelsKey Takeaways:Value-Based Care is Expanding, But Slowly. While risk-based contracting and total cost of care models are growing, fee-for-service still plays a dominant role, especially in smaller practices.Florida is the Epicenter of Medicare Advantage Growth. With high enrollment numbers and payer flexibility, Florida has attracted major primary care groups and risk-based provider models.Health Equity is Becoming a Payer Priority. Government and CMS initiatives are now tying funding to health equity efforts, requiring payers and providers to address social determinants of health (SDOH).Large Payers Are Diversifying Their Business Models. Optum, Evernorth, and Aetna are leveraging provider ownership, PBMs, and analytics platforms to dominate the market.Hospitals Are Being Pulled Into Value-Based Care. Health systems are under increasing pressure to shift reimbursement models and integrate value-based contracts into their long-term strategies.Connect with the Guest:LinkedIn: Margaret BraxtonAbout Margaret Braxton:Margaret Braxton is a healthcare strategy expert with extensive experience in payer negotiations, value-based contracting, and provider network development. Having worked at UnitedHealthcare and Cigna, she now leads payer strategy and research at Scale Healthcare, advising healthcare organizations on market trends, risk-based models, and payer-provider partnerships. Healthcare, Healthcare Leadership, Healthcare Trends, Roy Bejarano, Healthcare Innovations, Healthcare Industry Insights, Value-Based Care, Payer-Provider Partnerships, Health Equity, Risk-Based Contracting, Medicare Advantage, Medicaid Expansion, Healthcare Market Consolidation, Digital Health, Healthcare Economics, Margaret Braxton,

Apr 8, 202356 min

Understanding Market Dynamics & Strategy in Veterinary Care with Brett Holloway | Industry Consolidation, De Novo Growth & Payer Challenges

Host Roy Bejarano sits down with Brett Holloway, CFO of Veterinary Emergency Group (VEG), to discuss the rapid transformation of the veterinary industry, private equity consolidation, de novo expansion, and the challenges of veterinary payer models.In this episode, Brett shares insights on how the veterinary care sector differs from human healthcare, why emergency veterinary services resemble urgent care, and the impact of rising costs on pet healthcare access. The discussion also covers market consolidation trends, challenges in staffing and workforce development, and how insurance—or the lack of it—is shaping the industry’s future.Timestamps:[00:01] – Introduction to Brett Holloway, CFO of Veterinary Emergency Group (VEG)[04:30] – Veterinary Industry Evolution – Private equity’s role in consolidation[12:00] – Innovation Gaps in Veterinary Care – Why the sector lags behind human healthcare[18:30] – The Veterinary Investment Boom & Bust – How acquisitions created a bubble[24:00] – Pet Insurance & Fee-for-Service Challenges – Why insurance hasn’t taken off[30:00] – Rising Costs & Workforce Shortages – The impact of supply-demand imbalances[36:00] – Payer Market & Subscription Models – Can veterinary care adopt a sustainable structure?[42:00] – De Novo Growth Strategies – Why some groups are shifting away from acquisitions[47:00] – International Expansion in Veterinary Care – Is the U.S. market ready for global growth?Key Takeaways:Private Equity Has Reshaped Veterinary Care. Over the past decade, massive consolidation has taken place, leading to higher acquisition multiples, a fragmented workforce, and concerns over sustainable growth.Veterinary Care Lacks a Strong Payer Model. Unlike human healthcare, insurance penetration is low (2-5%), leaving veterinary practices to rely on out-of-pocket payments and fee-for-service models.Inflation & Workforce Shortages Are Driving Costs Up. A shortage of veterinarians and rising costs of care have led to consistent price inflation, making pet healthcare less affordable for consumers.De Novo Growth is Becoming More Attractive. As acquisition prices have skyrocketed, some veterinary groups are shifting to organic growth strategies, opening new locations instead of acquiring practices.The Future of Veterinary Care is Uncertain. With rising costs, slowing demand, and no unifying payer system, the industry must find innovative ways to structure care delivery and pricing models.Connect with the Guest:Website: Veterinary Emergency Group (VEG) https://www.veterinaryemergencygroup.com/Email: [email protected]: Brett Holloway https://www.linkedin.com/in/brett-holloway-89483414/About Brett Holloway:Brett Holloway is the Chief Financial Officer of Veterinary Emergency Group (VEG). With a background in investment banking and private equity, he has helped scale one of the fastest-growing veterinary emergency care companies in the U.S.. Brett has played a pivotal role in de novo expansion, financial strategy, and operational development in the veterinary healthcare sector. Veterinary Care, Veterinary Industry Trends, Roy Bejarano, Healthcare Innovations, Market Consolidation, Private Equity in Veterinary Care, De Novo Veterinary Growth, Veterinary Insurance, Veterinary Economics, Healthcare Real Estate, Veterinary Workforce Challenges, Pet Healthcare, Payer Strategy, Veterinary Practice Management, Brett Holloway,

Feb 8, 202353 min