Episodes

It’s not a secret, the broken healthcare system is exquisitely tuned to react after patients get sick. For the most part, profits are made after we FAIL patients. And it hurts all of the caregivers who face the daily internal conflict of doing what is right for the patient or doing what is right for the business. But there are a few who are positioned differently. When the strategy and business are unconflicted they’re not worried about demand destruction and leakage but are instead focused on p...

Race to Value listeners — April is National Minority Health Month, and this year, the HHS Office of Minority Health is focusing on the disproportionate impact the COVID-19 pandemic is having on racial and ethnic minority communities. This Bonus Episode is a compilation of viewpoints on health equity and racial disparities of care from some of our former guests in the past year. We hope you take the time to listen intently to their message. Certainly over the last many year we have been exposed ...

Fixing the behavioral health crisis is an absolute imperative in the movement to value-based care. Currently, 1 out of 5 Americans (over 51 million) are living with a behavioral health condition, there are approximately 20 million individuals in the US with a substance use disorder, and 9 million people have had suicidal thoughts in the past year. The onset of a global pandemic has only exacerbated the behavioral health challenges in our country. The solution is the integration of behavioral hea...

Achieving health value demands the formation of a new social construct, one that puts aside self-interest and builds systems of care for the common good. One that prioritizes health and equity for all, including the underserved and most vulnerable among us. This effort requires stronger leaders and better leadership than ever before. Getting Medicaid right, transforming addiction and substance use disorder treatment, reframing behavioral health, and removing silos – these are a few of the effort...

When Thomas Edison created the electric light bulb, he didn’t stop with that one incredible invention. He took the next step and created the industry that would maximize the benefit of that light bulb, the infrastructure needed to make that light bulb become a permeating and permanent piece of society. This is the type of vision needed for the health care system as a whole, and the type of vision that is occurring in Dallas Texas. Catalyst Health Network’s physicians are intent on the vision of...

Decades of poor outcomes in terms of cost, quality, and access have not created societal commitment to confronting the issue of low-value care in hospitals. Despite medical errors serving as the #3 cause of death, unpaid hospital bills leading as the #1 reason for personal bankruptcy in our country, vast disparities in care prevalent across racial and sociodemographic lines, and a general sense of pricing opaqueness, we have not yet seen a community-led movement towards hospital accountability f...

Chronic kidney disease kills more people than breast or prostate cancer each year – it’s the 9th leading cause of death but you won’t see NFL players wearing socks and gloves to increase awareness. Thirty-seven million people in the U.S., or 15 percent of adults, are impacted by CKD, and around 90 percent of those with the disease don’t even know they have it! Treating kidney disease costs the Medicare program $130B and although patients with kidney failure account for only one percent of the Me...

Last year, research at Johns Hopkins showed that healthcare consumes nearly half of all federal spending, which includes funding for Medicare, Medicaid, Social Security, military health benefits, health benefits for federal employees and their dependents, plus interest. Our federal government spends 48% of its money on health care and still healthcare devastates state budgets all across this country, with serious consequences in public health, education and other national priorities. This week’...

Stephen Nuckolls grew up listening to his physician father talk about how healthcare could save money for Medicare if it was accountable for outcomes. It was with this intent that he built Coastal Carolina Health Care (CCHC) in 1998, a multi-specialty practice managing 36,000 patients with 60 providers across 16 sites of care in Eastern North Carolina. CCHC serves in both urban and rural communities, with a mission is to promote the health of its patients by providing high quality, compassionate...

In this episode, reflect on the importance of Black History Month, an important time to recognize and honor the contributions and achievements of the millions of African Americans who have helped build our nation and enrich our culture. We also address racial disparities in care, which have become increasingly evident during the pandemic and vaccine distribution response. And we consider how value-based care can work to ensure true population health and parity in health outcomes for all. This w...

Our health care industry excels at rescue care – when a patient needs to be saved, our system has answers. However, we are not well suited to address the challenges associated with serious illness, death and dying. Evidence shows that palliative care and advanced care planning improve health value. These tools lead to better management of pain and symptoms and improve both the quality and length of life. The preferences of patients and their families and caregivers are better accounted for, and ...

An industry inflection point is coming in the transition to value: federal and state governments are feeling an insurmountable level of pressure as public debt and spending increase, large employers are reeling from high healthcare costs, and provider organizations are being crushed by the current environment as they realize that FFS is perilous in the middle of a pandemic. Health system executives not leading with a strategy in health value are increasingly facing significant financial uncertai...

The health care industry is experiencing a digital transformation that has been decades in the making. In this era of COVID-19 disruption and heightened consumer expectations for care delivery, the industry needs trusted leaders like Ed Marx. As one of the leading experts on artificial intelligence, machine learning, and other disruptive technology innovations in healthcare, Ed Marx is the trusted advisor that healthcare organizations seek for advice on successfully navigating this digital trans...

ACOs are increasingly moving into two-sided risk options with MSSP BASIC E and ENHANCED. The Direct Contracting model (with both Professional and Global options) introduces new opportunities and flexibilities that are not included in other CMMI models or through the MSSP. Prospective participants must act now to evaluate their model options in preparation for the 2022 performance year, with both MSSP and DC application cycles quickly approaching. CMS will soon reopen the MSSP for the 2022 perfor...

The American Dream is the hallowed ideology that any individual can advance his or her state of being through ambition and hard work. It defines the American psyche. Historian James Truslow Adams wrote, “The American Dream is that dream of a land in which life should be better and richer and fuller for everyone, with opportunity for each according to ability or achievement.” In today’s episode we explore a Dream Plan in health care – one that is based on consumerism accountability for health ou...

As we prepare for a new era in our government with President-Elect Biden’s administration and a Democratic-controlled Congress, we must be steadfast in our commitment to value-based care. Can soon-to-be President Biden capitalize on this historical moment of unrest to unite our country with a value-based care policy agenda? Is COVID-19 truly a silver-lining moment for the value movement? How will providers, payers, policy-makers, public health, and patients leverage increased regulatory flexibil...

ChenMed was created with a mission to provide care in such a way that it could alleviate suffering for those seniors in the poorest of communities, recognizing that full-risk primary care can truly be transformative in providing superior health outcomes. This strong sense of purpose is what guides the physicians at ChenMed and serves as a moral compass in caring for patients. It is born out of an idea that ChenMed is a ministry that allows those in the organization to glorify God by spreading mo...

In this episode, we interview Ken Terry, author of one of the best-researched books we’ve ever seen! The new book, Physician-Led Healthcare Reform: A New Approach to Medicare For All, explores why we must, and how we can, get doctors to change how they practice. Most employed physicians and independent physicians alike feel powerless. Hospital-employed doctors feel like cogs in a machine, and community doctors are increasingly threatened by forces beyond their control. The biggest problems of p...

Dr. Kevin Spencer, Medical Director, Texas at Agilon Health, is passionate about improving the health care delivery system. He believes that by enabling physician-led organizations with technology, proven processes, and human capital under global risk capitation models, we can transform care for patients and physicians alike. With a deep understanding of the local market, combined with extensive health care experience, Kevin Spencer, MD oversees the strategy, operations, and growth for the Conne...

Our nation has lost more than 300,000 people from COVID-19. It is the latest sign of a generational tragedy – one still unfolding in every corner of the country. As we head into the Christmas holiday, refusal to acknowledge the severity of the pandemic by acting irresponsibly will result in countless more deaths from the virus. Our nation is at stake, and this week’s Race to Value guest, Dr. Brent Staton wants to share a personal message of love and hope for a brighter tomorrow. His featured po...

A guiding principle of Cumberland Center for Healthcare Innovation, CCHI, is that communities and the state benefit from healthier families, and it’s not just about cost savings or longer lives. Better health means a more productive workforce and greater opportunity for economic development. CCHI is focused on a structured approach to build economic strength in the community. And their approach is working – since being established in 2012, CCHI has saved CMS over $43 million and achieved a 98.48...

Join us in this episode as we speak with Dr. Mark McClellan, former CMS Administrator and former FDA Commissioner during SARS – his understanding of the COVID-19 pandemic and options for our national response is nearly unmatched. His unique insights into our health care system provide clarity around the new administration’s position on value-based care as well as offer understanding regarding what the presidential transition will mean for COVID-19 response efforts, including vaccine distribution...

Dr. Elizabeth Teisberg is a leading figure in the value-based health care strategy movement and is the executive director of the Value Institute for Health and Care as well as a Professor at the Dell Medical School at the University of Texas at Austin. With her deep background in strategy and innovation, and with special attention to the health care sector, she collaborates closely with Michael Porter, renowned authority on competitive strategy. Together they co-authored “Redefining Health Care:...

It was Thanksgiving 2016 and Sugandan (Su) Barathy was a normal college student in Texas, with finals and graduation in the weeks ahead. His future was bright with a comfortable job already secured, but a car accident changed his life. Though seriously injured, the medical professionals sent him home twice as a result of negligent care. Consequently, Su experienced avoidable complications and needless pain – but the blatant errors and deficiencies of the health care system are distant followers ...