Episodes

We’re excited to share this special edition episode with Dr. Tony Dale, an “Old World” doctor from England who has since become a successful healthcare entrepreneur in the United States. Despite practicing socialized medicine early in his medical career, Dr. Dale has become a champion for free market reforms to our nation’s healthcare system. As the founder and Chairman of The Karis Group and Sedera, he has brought cost transparency and consumerism to the forefront. Dr. Dale’s entrepreneurial vi...

Historically, health systems in low- and middle-income countries (LMICs) have taken a volume-based approach to health rather than a value-based one. The public sector has focused on coverage rates or access, and the private sector profits when it drives quantity of expensive, hospital-based care. Adhering to this path will create long-lasting structural flaws that increase costs without delivering desired results, similar to what we see in the US and many other developed economies. Our guest th...

The traditional definition of post-acute care (PAC) represents the legacy of a fragmented approach to healthcare that segments care into “silos” and finances institutions to care for a “slice” of the patient instead of incentivizing whole-person, coordinated care. As post-acute care is the largest driver of overall Medicare spending variation, establishing a coordinated, whole-person care network across the PAC continuum is essential for organizations to successfully operate under value-based pa...

We are pleased to release a special bonus episode and do our part to address the nation’s concerns around the pandemic and the COVID vaccine. As it stands right now, around 164 million people, or 50% of the total U.S. population, have now been fully vaccinated. Ultimately, with a large portion of the U.S. population still unvaccinated, it seems that COVID-19 is not going to disappear soon. The U.S. will continue to see outbreaks of the virus in communities with low vaccine uptake. Our guest is ...

Employers are on the frontlines in the battle against rising healthcare costs. Legendary investor Warren Buffett said that rising health care costs, not the tax system, are the number one problem that American businesses face. “If you go back to 1960, or thereabouts, corporate taxes were about 4% of GDP. And now, they’re about 2% of GDP,” “At that time, health care was 5% of GDP, and now it’s about 17% of GDP.” In Buffett’s view, this says a lot of what’s playing a bigger role in hindering busin...

Our guest this week is Dr. Jim Walton, President and CEO of Genesis Physicians Group. Dr. Walton was drawn into medicine at an early age – he followed his dad making house calls, going to nursing homes, and forging deep ties in the community. His clinical work throughout his medical career was focused in poor communities, coordinating care for complex patients from diverse backgrounds. As an experienced and innovative physician leader, Dr. Walton provides executive leadership to more than 1,700...

This is one of the most health challenging times in modern history. Healthcare systems and practitioners face dire circumstances in delivery of care to scores of citizens. A reverential ethic in healthcare leadership that promotes an informed and respectful approach towards life is key to health system success in population health. This core value is how Trinity Health, one of the largest integrated care delivery systems in the nation that serves more than 30 million people across 22 states, app...

Our guest this week, Matt Miclette, is military veteran and a psychiatric and mental health board certified registered nurse. He is the Senior Director of Clinical Operations at NeuroFlow – a digital health company that provides an industry-leading solution for Technology-Enabled Psychiatric Collaborative Care. Matt is also the Co-Founder and Executive Director of a nonprofit organization called Action Tank. As a recipient of the prestigious Pat Tillman military scholarship, Matt is living with ...

Our guest this week is driven by an inner purpose to alleviate suffering for those in the poorest of communities, recognizing that health care can only truly be transformative in providing superior health outcomes if it advances health equity. Over the years, he has used his voice to advocate for underserved communities in the belief that the equitable attainment to health is a human right. Dr. Derek J. Robinson is Vice President and Chief Medical Officer for Blue Cross and Blue Shield of Illin...

While the health care system has been gradually transitioning to a more tech-enabled industry for several years, in a matter of months, the global pandemic has fast-tracked digital health care trends that have been primed and ready for greater investment and implementation. The increased investment in and use of technology-enabled care protocols like telehealth and remote patient monitoring during the crisis has accelerated the acceptance and adoption of digital solutions for both health care pr...

Only 25% of health is in the control of the healthcare system. So why does our country continue to pump the majority of its health care spending into a deficit-based health care model that focuses solely on the science of doing something to the individual? Aspirational Healthcare is a better answer, spending 75% on supporting the individual in the ownership and management of their own health. And employer-driven reform is the key that will unlock aspirational healthcare for millions nationwide. ...

There is an immediate opportunity for value-minded medical practices and health systems in joining a Direct Contracting Entity (DCE) that is already established. Many of these DCEs (typically existing health care delivery organizations or newly-organized physician aggregators) are now seeking formal partnerships with providers in their area. These partnerships may facilitate an entry point for organizations who have not participated in prior CMMI models or those organizations more advanced in ri...

Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region or community. In 2009, Congress attempted to modernize HIE processes by passing the HITECH Act, offering grants and incentives to states and municipalities for developing regional HIE initiatives. Although there has been some progress toward effective mechanisms for data exchange, in many regions of the country it is no easier to share medical information than it w...

We are discussing “Price Transparency and Free Market Healthcare” with Dr. Keith Smith, co-founder of Surgery Center of Oklahoma and Sean Kelley, Founder & Managing Partner of Texas Medical Management. Keith and Sean are the forefathers of price transparency as they have been providing upfront, transparent prices to patients for decades. This is one of our more controversial episodes to date, as we cover with brutal honesty, the systemically broken healthcare system that allows patient fleecing,...

The movement to value-based care will necessitate a major paradigm shift in how physicians practice medicine. They can no longer be “cowboys” in the wild west of fragmented, uncoordinated care delivery where information technology is focused on fee-for-service. Instead of cowboys, we need “quarterbacks”, communicating with an interdisciplinary care team and facilitating hand offs across the care ecosystem. In this environment, information technology is like the offensive line, protecting the phy...

When Billy Beane decided to employ a recent Harvard graduate to use advanced statistical analysis to build a championship major league baseball team, he changed the game forever. While Beane’s famous early 2000s team never won a World Series, multiple 100-win seasons and a new record for the longest winning streak got the attention of teams across the MLB, all while on one of the league’s lowest payrolls. Most people know Beane’s story as it was popularized in the book—and later in the movie—Mon...

Sixty years ago, May 1961, President John F. Kennedy challenged the American nation in a speech to Congress, asking them to commit to “landing a man on the Moon and returning him safely to the Earth.” Eight years later, that bold goal was realized – in July 1969 Apollo 11 landed and returned safely with a crew. President Kennedy’s moonshot goal is an important reminder of courageous leadership that sets an inspiring goal that pushes us to think and achieve boldly. That is not unlike the 10-year ...

The difference between average people and achieving people is their perception of and response to failure. “Failing Forward” was a concept defined by John C. Maxwell several years ago, and that axiomatic truth could not be more readily apparent than in value-based care. Transforming healthcare to lower costs and improve patient outcomes is tough work. PERIOD. It requires many years of experimentation and “trial and error” innovation. The suffering index in the value movement can be immense, but ...

Former President of South Africa, Nelson Mandela, made an important observation when he said, “There can be no keener revelation of a society’s soul than the way in which it treats its children.” Our children are wholly dependent upon us, their parents, teachers, and society for their education, their safety and their health. It is with this mindset that we proclaim, high-value pediatric care is critical for winning the race to value. Our guests this week are Ginger Hines, Executive Director, S...

The all-too-common visualization of balancing between the two canoes of fee-for-service (FFS) and value-based care (VBC) is an appropriate illustration of the pressure that providers feel, but maintaining balance is clearly focused on staying upright, on survival. The challenge is that the FFS canoe has a motor, and the paddle for the VBC canoe is not enough to change direction – clearly the tools used to optimize reimbursement in the two worlds are oftentimes diametrically opposed. The mission ...

This month is National Military Appreciation Month and with this week’s episode we take opportunity to offer our solemn regard and deep gratitude to the brave men, women, and their families who have served our nation with selflessness, gallantry, and sacrifice in upholding our foremost ideals of liberty. We are grateful for their nobility, for their duty, and for their sacrifice and that they “loved country more than self” so that we may live in a nation that is free. We are grateful that our li...

Nurses have been rightly recognized as heroes during the pandemic – on top of their consistently tireless effort, providing sustained caring and empathy over long hours, nurses stepped up to do more, to meet their patients’ needs despite risk to themselves. For example, they innovated to find solutions that would allow families to stay connected despite the barriers of quarantine. Building on a tradition that has been evident since they first began, nurses have always innovated solutions to impr...

This week’s episode is the second part of our conversation with Dr. Robert Pearl. In his book, Uncaring: How the Culture of Medicine Kills Doctors & Patients, Dr. Pearl asserts that doctors are taught how to cure people, but they don’t always know how to care for them. There are many contributing factors, ranging from how doctors are trained, to increasing workloads and lack of resources, a widening disconnect between patients’ and doctors’ values and expectations, and increased risk and death d...

In a year of great need, during the pandemic, Americans saw and celebrated an army of physician heroes. In doing so, they overlooked an uncomfortable reality. Doctors are humans who share a culture that produces both remarkable successes and abysmal failures. As in Robert Louis Stevenson’s gothic novella The Strange Case of Dr. Jekyll and Mr. Hyde, it is possible that one person — or this case, one culture — can be both a virtuous force and a destructive influence. Until now, the negative aspect...