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Analyzing Healthcare
Roy Bejarano and Jason Schifman: SCALE Community and SCALE Healthcare
96 episodes
1 day ago
What’s next in healthcare? Analyzing Healthcare delivers expert insights, real-world case studies, and bold ideas shaping the future of U.S. & global health systems. Hosted by Roy Bejarano and Jason Schifman of SCALE Healthcare & SCALE Community, each episode explores medical innovation, healthcare leadership, value-based care, provider operations, health policy, artificial intelligence, & emerging health trends. Whether you're a provider, investor, operator, or simply healthcare curious—this podcast helps you stay informed, inspired, & ahead of the curve. More info at www.scale-community.com
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All content for Analyzing Healthcare is the property of Roy Bejarano and Jason Schifman: SCALE Community and SCALE Healthcare and is served directly from their servers with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.
What’s next in healthcare? Analyzing Healthcare delivers expert insights, real-world case studies, and bold ideas shaping the future of U.S. & global health systems. Hosted by Roy Bejarano and Jason Schifman of SCALE Healthcare & SCALE Community, each episode explores medical innovation, healthcare leadership, value-based care, provider operations, health policy, artificial intelligence, & emerging health trends. Whether you're a provider, investor, operator, or simply healthcare curious—this podcast helps you stay informed, inspired, & ahead of the curve. More info at www.scale-community.com
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Episodes (20/96)
Analyzing Healthcare
How is Technology Redefining Pediatric Care? Chris Johnson, CEO of Bluebirds Kids Health

Pediatric care in the U.S. is increasingly defined by fragmentation — especially for children with complex needs and those covered by Medicaid and CHIP. Access barriers, disconnected services, and lack of coordination often leave families navigating care on their own, with real consequences for outcomes.

In this episode of Analyzing Healthcare, host Jason Schifman speaks with Chris Johnson of Bluebird Kids Health about what actually drives pediatric outcomes and why traditional, encounter-based models fall short. Chris explains why most determinants of pediatric health exist outside the clinic, how integrating physical health, behavioral health, and social care is essential to improving outcomes, and why children play a central — but often misunderstood — role in Medicaid performance.

The conversation focuses on practical system design: aligning care teams, coordinating across community resources, and redefining success around impact — measured in healthier days at home, not just utilization.


What You’ll Learn

✅ How digital care platforms are improving access, efficiency, and outcomes
✅ Why data integration and interoperability remain foundational challenges
✅ How healthcare organizations can scale innovation without disrupting care delivery
✅ The role of partnerships in accelerating healthcare transformation
✅ What healthcare leaders must prioritize when adopting new technology
✅ How patient-centric design drives adoption and long-term impact

Subscribe

Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through strategy, technology, policy, and global innovation.

Visit SCALE Community to access exclusive leadership insights and full member-only recordings.

Timestamps

• (00:00) Why pediatric care is broken in the U.S.
• (03:12) The scale and complexity of caring for high-need children
• (07:45) Where fragmentation hurts families and outcomes most
• (12:30) How Bluebird Kids Health integrates care beyond the clinic
• (17:10) Aligning clinical teams, data, and family support
• (21:55) Technology’s role in coordinating pediatric care
• (26:40) Working with payers and health systems in the U.S.
• (31:20) Measuring outcomes in pediatric population health
• (36:05) What scalable pediatric care models must get right
• (40:30) Lessons for U.S. healthcare leaders and policymakers

Key Takeaways

• 💎 Digital platforms are becoming central to modern care delivery
• 💎 Interoperability is essential for scaling value-based models
• 💎 Technology must align with clinical workflows to drive adoption
• 💎 Partnerships accelerate innovation across fragmented systems
• 💎 Patient-centric design is critical to long-term success

Guest: Chris Johnson, Founder & CEO Bluebird Kids Health
Host: Jason Schifman, President & Co-Founder, SCALE Healthcare

Organization: https://www.scale-community.com
Podcast Hub: Analyzing Healthcare by SCALE Community

Guest Bio

Chris Johnson is a healthcare executive and innovator focused on advancing pediatric care through technology-enabled, family-centered models. As a leader at Bluebird Kids Health, Chris works at the intersection of clinical care, digital health, and care coordination to improve access and outcomes for children with complex and chronic needs. His work centers on building scalable pediatric care platforms that integrate primary care, specialty services, and social support—reducing fragmentation while supporting families beyond traditional clinical settings. Chris brings a practical, systems-level perspective on how pediatric healthcare can evolve to deliver higher-quality, more equitable care at scale.

Keywords

Digital healthcare, care delivery platforms, healthcare technology, interoperability, data-driven healthcare, population health, value-based care, healthcare challenges, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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2 days ago
40 minutes 32 seconds

Analyzing Healthcare
Why Medicare Pricing Still Controls U.S. Healthcare Economics featuring Medicare's Former Chief Transformation Officer, Douglas Jacobs

Inside Medicare Pricing and Policy: Douglas Jacobs on fee schedules, primary care, ACOs, and AI.

In this episode of Analyzing Healthcare, host Roy Bejarano speaks with Douglas Jacobs, former Chief Transformation Officer at Medicare, former Chief Medical Director at the Pennsylvania Department of Health, and a practicing primary care physician, to unpack how Medicare sets prices—and why those decisions shape the entire U.S. healthcare system.

Drawing on his experience inside CMS and on the front lines of care, Jacobs explains why Medicare pricing is constrained by statute, excludes demand, and has historically underpaid primary care and behavioral health. The conversation covers the latest physician fee schedule, advanced primary care payments, ACO performance, quality measures that improve outcomes, the limits of AI, and lessons from Pennsylvania’s managed care model.

What You’ll Learn

✅ How Medicare prices care — and why demand is excluded by law
✅ Why Medicare reimbursement anchors commercial insurance pricing
✅ How underpayment of primary care reshaped the physician workforce
✅ What changed in the latest Medicare physician fee schedule
✅ Why primary-care-led ACOs outperform large health-system ACOs
✅ Why AI cannot fix healthcare without structural access reform

Timestamps

  • (00:00) Introduction: Medicare leadership and practicing medicine

  • (01:14) Initial impressions of the new Medicare fee schedule

  • (02:30) Specialty winners, conversion factors, and efficiency adjustments

  • (04:20) Why Medicare pricing ignores market signals

  • (07:03) Demand, supply, and the broken market signal

  • (08:49) Primary care underpayment and workforce impact

  • (11:02) How commercial payers follow Medicare pricing

  • (13:33) Advanced primary care management payments

  • (16:15) Why primary-care-led ACOs save more

  • (22:35) Quality measures that reduce mortality

  • (24:54) AI skepticism and access limitations

  • (28:50) Pennsylvania’s managed care and cost controls

Key Takeaways

  • 💎 Medicare pricing is supply-driven and sets the reimbursement anchor for the market

  • 💎 Underpayment of primary care has lasting workforce and access consequences

  • 💎 Advanced primary care and primary-led ACOs deliver stronger savings and outcomes

  • 💎 Simple, focused quality measures can materially reduce mortality

  • 💎 AI cannot fix healthcare without addressing structural access and equity gaps

Resource Links

Guest: Douglas Jacobs – Former Chief Transformation Officer, Medicare
Host: Roy Bejarano – Analyzing Healthcare
Community: www.scale-community.com
Podcast Hub: Analyzing Healthcare by SCALE Community

Guest Bio

Douglas Jacobs is a practicing primary care physician and former Chief Transformation Officer at Medicare, where he spent nearly four years helping shape national payment, quality, and value-based care policy. He previously served as Chief Medical Director at the Pennsylvania Department of Health, overseeing large-scale managed care programs and quality oversight. His work spans physician payment reform, ACO strategy, primary care transformation, and national quality measurement, bringing together frontline clinical experience with federal and state health policy leadership.

SEO Keywords

Medicare Fee Schedule, Medicare Pricing, Primary Care Reimbursement, Value-Based Care, ACO Performance, Healthcare Economics, CMS Policy, Quality Measures in Healthcare, AI in Healthcare, Managed Care, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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1 week ago
35 minutes 22 seconds

Analyzing Healthcare
What Can the World Learn from Brazil’s Universal Healthcare System? Dr. Jefferson Fernandes, VP of Brazilian Medical Association x SCALE Community

Brazil’s universal healthcare system serves 210M+ people. Telehealth, digital health, and public-private models are reshaping access and equity nationwide.

In this episode of Analyzing Healthcare, host Jason Schifman sits down with Dr. Jefferson Fernandes to explore how Brazil’s Unified Health System delivers universal care at national scale, the critical role of community health workers, and how telehealth is transforming access across public and private sectors. The conversation also examines COVID-driven regulatory change, interoperability challenges, and why physician education and partnerships will define Brazil’s next phase of healthcare modernization.

Title

Inside Brazil’s Healthcare System: Universal Care, Telehealth & Digital Transformation with Dr. Jefferson Fernandes

What You’ll Learn

✅ How Brazil delivers universal, free healthcare to over 210 million people
✅ Why community health workers are critical to primary care and prevention
✅ How telehealth reduced specialist wait times from years to months
✅ Why telemedicine adoption accelerated post-COVID — and what changed legally
✅ How public and private systems coexist and reimburse one another
✅ Why interoperability and digital infrastructure are national priorities
✅ How physician culture, regulation, and financing shape digital adoption

Subscribe

Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through strategy, technology, policy, and global innovation.

Visit SCALE Community to access exclusive leadership insights and full member-only recordings.

Timestamps

  • (00:00) Introduction to Brazilian Healthcare

  • (17:57) Telehealth as a Strategic Direction

  • (27:43) The Role of the Brazilian Medical Association

  • (36:57) Brazil's Contribution to Global Healthcare

Key Takeaways

  • 💎 Brazil guarantees healthcare as a constitutional right for all citizens

  • 💎 SUS delivers free, nationwide care to over 210 million people

  • 💎 Community health workers bring primary care directly into homes

  • 💎 Telehealth has become a core care delivery method post-COVID

  • 💎 Public–private partnerships are critical to sustaining access and scale

  • 💎 Brazil serves as a model for universal care in middle-income countries

Guest: Dr. Jefferson Fernandes – Vice President, Digital Health Commission, Brazilian Medical Association

Host: Jason Schifman, President & Co-founder at SCALE Healthcare

Organization- https://www.scale-community.com

Podcast Hub- Analyzing Healthcare by SCALE Community

Guest Bio

Dr. Jefferson Fernandes is a neurologist and leading digital health expert with more than 15 years of experience advancing telemedicine and health system transformation in Brazil. He serves as Vice President of the Digital Health Commission at the Brazilian Medical Association and Director of Education for the International Society for Telemedicine & eHealth. Dr. Fernandes has played a key role in physician education, telehealth adoption, and regulatory advocacy, including nationwide teleconsultation approval during COVID. His work focuses on universal healthcare access, digital infrastructure, interoperability, and scaling telehealth across public and private systems.

Keywords

Brazilian healthcare, telehealth, telemedicine, public health system, community health workers, digital health, healthcare access, health policy, chronic diseases, healthcare challenges, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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2 weeks ago
43 minutes

Analyzing Healthcare
Is Global Healthcare Actually Improving? With Kumanan Rasanathan, Executive Director, World Health Organization

Inside the World Health Organization: Dr. Kumanan Rasanathan explains global health systems, primary care, inequality, conflict, and AI-driven transformation.

In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Dr. Kumanan Rasanathan, Executive Director at the Alliance for Health Policy & Systems Research at WHO, to explore the realities behind global health governance, primary care, conflict-driven health crises, and the coming disruption from digital infrastructure and AI.

Drawing on two decades inside WHO, UNICEF, and ministries of health worldwide, Dr. Rasanathan explains why health outcomes diverge within countries more than between them, why primary care remains the most underfunded lever in healthcare, and how nations like Estonia, Thailand, and Rwanda are quietly redefining what modern health systems can look like.

What You’ll Learn

  • ✅ How the World Health Organization actually operates — beyond headlines

  • ✅ Why primary healthcare remains the most powerful (and neglected) investment

  • ✅ How conflict now defines the worst global health outcomes

  • ✅ Why inequality within countries is growing faster than inequality between countries

  • ✅ How digital public infrastructure can reshape healthcare delivery

  • ✅ Why Estonia, Thailand, Rwanda, and Singapore matter as health system case studies

  • ✅ The real limits — and necessity — of public-private healthcare models

  • ✅ Why AI may finally disrupt healthcare’s 30-year stagnation

Timestamps

  • (00:00) Introduction to Global Health and WHO

  • (11:10) The State of Global Health: Progress and Challenges

  • (23:41) Key Determinants of Effective Health Systems

  • (26:09) The Alma Ata Declaration and Primary Health Care

  • (31:54) Challenges and Innovations in Universal Health Coverage

  • (34:52) The Role of Tax Funding in Health Systems

  • (40:21) Digital Health Innovations: The Case of Estonia

  • (45:55) Public-Private Partnerships in Healthcare

Key Takeaways

  • 💎 Health outcomes vary more by policy choice than by national wealth

  • 💎 Conflict zones now represent the worst global health environments

  • 💎 Primary care remains the most underutilized lever in healthcare

  • 💎 Universal coverage succeeds when community-based systems lead

  • 💎 Digital public infrastructure enables true care coordination

  • 💎 AI may finally modernize healthcare delivery at scale

  • 💎 Public-private systems only work with strong stewardship

Resource Links

Guest: Dr. Kumanan Rasanathan – World Health Organization
Host: Roy Bejarano – Analyzing Healthcare
Community: www.scale-community.com
Podcast Hub: Analyzing Healthcare by SCALE Community

Guest Bio

Dr. Kumanan Rasanathan is Executive Director of the Alliance for Health Policy and Systems Research at the World Health Organization. A public health physician with nearly 25 years of experience across WHO, UNICEF, and the UN system, his work spans global health policy, health systems research, and implementation. Career highlights include serving as WHO Incident Manager for the COVID-19 response in Cambodia, helping shape the health-related Sustainable Development Goals at UNICEF, contributing to the WHO Commission on Social Determinants of Health, co-authoring the 2008 World Health Report on primary health care, and leading meningococcal vaccine trials in New Zealand.

SEO Keywords

World Health Organization, WHO, Global Health Systems, Primary Care, Health Equity, Public Health Policy, Universal Health Coverage, AI in Healthcare, Digital Health Infrastructure, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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3 weeks ago
50 minutes 17 seconds

Analyzing Healthcare
Inside India’s Healthcare Transformation: Digital IDs, Telemedicine & More with Dr. Rajendra Pratap Gupta, Public Policy Expert

India’s digital health transformation is one of the most ambitious anywhere in the world. National health IDs, population-scale telemedicine, redesigned primary care, and AI-enabled care delivery are reshaping how healthcare is accessed and delivered across 36 states and union territories.

In this episode of Analyzing Healthcare, host Jason Schifman sits down with Dr. Rajendra Pratap Gupta, one of India’s foremost health policy architects and a global digital health leader, to unpack how India is building a next-generation model of healthcare at national scale.

Dr. Gupta explains how 825 million digital health IDs, telemedicine platforms providing 300,000+ consults per day, and insurance-driven private sector growth are accelerating India’s transformation. He also explores global lessons from Sri Lanka, Saudi Arabia, and why emerging markets under resource pressure may leapfrog legacy systems with AI-enabled care.

Title- Inside India’s Healthcare Transformation: Digital IDs, Telemedicine & More with Dr. Rajendra Pratap Gupta, Public Policy Expert

What You’ll Learn

✅ How India is building one of the largest digital health infrastructures on the planet
✅ Why national health IDs and telemedicine platforms are redefining care access
✅ How public and private systems interact across India’s 36 states
✅ Why private investment and consolidation are accelerating — and the risks ahead
✅ What global markets can learn from India, Sri Lanka, and Saudi Arabia
✅ Why AI-driven disruption may outpace traditional healthcare modernization

Subscribe

Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through strategy, technology, policy, and global innovation.

Visit SCALE Community to access exclusive leadership insights and full member-only recordings.

Timestamps

(00:00) Introduction to Dr. Gupta's Expertise
(01:05) Overview of India's Healthcare Market
(04:14) Traditional Medicine and Its Role
(06:14) Public vs. Private Healthcare Dynamics
(09:48) Consolidation and Private Equity in Healthcare
(11:34) Government Initiatives and Digital Health
(18:57) Global Perspectives on Healthcare Systems
(26:29) Future of Healthcare: Innovation and Disruption

Key Takeaways

💎 India is creating the world’s largest digital health identity system
💎 Telemedicine platforms like eSanjeevani deliver 300k+ consults/day
💎 Private sector growth remains strong despite public expansion
💎 Consolidation introduces both opportunity and systemic risk
💎 Sri Lanka’s hospital-based model and Saudi Arabia’s virtual hospital offer global prototypes
💎 AI will disrupt healthcare faster than legacy systems can adapt
💎 Future winners will be countries with limited resources and high innovation pressure

Guest: Dr. Rajendra Pratap Gupta – linkedin.com/in/rajendragupta
Host: Jason Schifman – https://linkedin.com/in/jason-schifman-536bb8106
Organization: https://www.scale-community.com
Podcast Hub: Analyzing Healthcare by SCALE Community

Guest Bio

Dr. Rajendra Pratap Gupta, PhD, is a globally recognized health policy leader, former advisor to the Government of India, and Chair of the Dynamic Coalition on Digital Health for the United Nations Internet Governance Forum. He has shaped major national reforms including the National Health Policy and the National Digital Health Mission, and advises global governments and multilateral institutions including the WHO.

He is also a leading thinker on AI-enabled health system redesign, virtual care models, and scalable digital health infrastructure for emerging and developed markets.

Keywords

India healthcare, digital health, public health, private equity, insurance, telemedicine, healthcare consolidation, national health policy, healthcare technology, global health systems, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Roy Bejarano, Scale Community, Jason Schifman

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1 month ago
34 minutes 57 seconds

Analyzing Healthcare
How is Oscar Health Reinventing Insurance? Mark Bertolini, CEO of Oscar Health & Former CEO of Aetna

Summary
Oscar Health’s CEO — and former Aetna Chairman & CEO — Mark Bertolini breaks down how incentives, technology, and market design are reshaping the future of U.S. healthcare. From reengineering Oscar’s operating model to exposing structural flaws across payer economics, Bertolini unpacks why consumers lack meaningful choice, how ACA marketplaces actually function, and why AI-native platforms are redefining what an insurer can be.
In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Mark Bertolini, CEO of Oscar Health, to explore the transformation of payer strategy, the economics behind insurance competition, and how Oscar’s platform leverages AI and unified data to reduce operating costs and build personalized member experiences.The conversation spans payer incentives, ACA dynamics, organizational redesign, network strategy, consumer choice, and why AI-driven infrastructure will define the next decade of healthcare modernization.


Title
Can Oscar Health Redefine the Future of U.S. Insurance? — Mark Bertolini, CEO Oscar Health x SCALE Community


What You’ll Learn
✅ Why legacy healthcare incentives block true competition and cost control
✅ How Oscar rebuilt its cost structure through AI and unified data architecture
✅ Why individualized plans outperform employer-designed insurance
✅ How ACA marketplaces create real consumer choice — and what still needs fixing
✅ Why value-based care often fails to change clinician behavior
✅ What the future of payers looks like in an AI-driven environment


Subscribe
Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through strategy, investment, operations, and technology innovation.
Visit SCALE Community to access exclusive leadership insights and full member-only recordings.


Timestamps

  • (00:00) Introduction to Mark Bertolini & Oscar Health

  • (01:40) Mark’s engineering mindset & leadership approach

  • (03:20) Why healthcare hasn’t improved in 30+ years

  • (06:00) Culture lessons from Aetna, Cigna & Oscar

  • (07:20) Trust, leadership, and organizational change

  • (12:20) How payer competition really works

  • (16:00) Why U.S. healthcare incentives collide

  • (18:20) Why Mark joined Oscar & the turnaround thesis

  • (21:50) Rebuilding Oscar’s operations & cost structure

  • (23:30) Why personalized networks outperform broad networks

  • (27:40) ACA trend reality vs. public perception

  • (31:30) Consumer choice & individual plan selection

  • (36:00) AI, LLMs & the future of payer infrastructure

  • (39:50) Why value-based care rarely changes behavior

  • (41:15) The future: account-based insurance for all

Key Takeaways

  • 💎 The ACA’s per-capita trend is stable — contrary to public perception

  • 💎 Consumers make better insurance decisions when choosing for themselves

  • 💎 Oscar’s AI-native infrastructure reduces admin costs and improves accuracy

  • 💎 Narrow networks work best when built around individual preferences

  • 💎 The U.S. system struggles because economic incentives collide

  • 💎 Value-based care only works when excellence exists before contracting

  • 💎 The future is account-based coverage where every American selects their own plan

Resource Links
Guest: Mark Bertolini – linkedin.com/in/markbertolini
Host: Roy Bejarano – linkedin.com/in/roy-bejarano-a5669ba8
Organization: www.scale-community.com
Podcast Hub: Analyzing Healthcare by SCALE Community


Guest Bio
Mark T. Bertolini, CEO of Oscar Health and former Chairman & CEO of Aetna, is widely regarded as one of the most influential leaders in U.S. healthcare. He is known for redesigning payer models, elevating consumer choice, and steering Aetna’s transformation into a technology-enabled, integrated care organization. A former Co-CEO of Bridgewater Associates, he brings deep operational and strategic expertise. At Oscar, he is leading a focused turnaround centered on AI-native systems, personalized networks, and modern operating infrastructure.


SEO Keywords
Mark Bertolini, Oscar Health, Aetna, ACA marketplace

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1 month ago
43 minutes 42 seconds

Analyzing Healthcare
Did the ACA Create a Market Where Insurers No Longer Need to Compete on Price? – Anthony LoSasso, Wall Street Journal Health Economist & ACA Expert x SCALE Community

Summary

ACA premiums, Obamacare subsidies, U.S. health insurance incentives, and healthcare cost inflation—WSJ economist Anthony LoSasso explains the real structural flaws.


Massive subsidy expansion, weak pricing discipline, and a structurally misaligned insurance market are driving rapid cost escalation across the Affordable Care Act marketplace. Wall Street Journal author and economist Dr. Anthony LoSasso breaks down why premiums are rising, why insurers face almost no pressure to compete on price, and how the ACA’s “defined benefit” subsidy structure created a distorted market.


In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Dr. LoSasso to explore what the ACA got right, what it unintentionally broke, and how shifting to a “defined contribution” model could introduce real competition, lower premiums, and restore market discipline.


Title-

What You’ll Learn

  • ✅ Why ACA premiums continue rising despite stagnant utilization
  • ✅ How the subsidy design shields consumers and removes insurer price pressure
  • ✅ Why 98% of marketplace enrollees being subsidized distorts competition
  • ✅ How defined-contribution subsidies could slow premium growth
  • ✅ What policymakers misunderstood when designing the ACA
  • ✅ Why ACA marketplaces became “happy times” for insurers


Subscribe

Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through strategy, investment, operations, and policy reform.


Visit SCALE Community to access exclusive leadership insights and full member-only recordings.


Timestamps

  • (00:00) Introduction to Dr. Anthony LoSasso & the WSJ article
  • (02:20) The original ACA design and how incentives went wrong
  • (05:00) Gross vs. net premiums: who actually feels the cost?
  • (08:00) Why insurers face little pressure to keep premiums down
  • (11:00) Defined benefit vs. defined contribution subsidies
  • (14:00) Political narratives vs. economic realities
  • (18:00) What the ACA solved — and what it unintentionally distorted
  • (22:00) U.S. healthcare as multiple systems operating at once
  • (27:00) Closing thoughts: creating a more competitive insurance marketplace


Key Takeaways

  • 💎 The ACA’s subsidy structure unintentionally removed consumer price sensitivity
  • 💎 Insurers face almost zero competitive pressure to lower premiums
  • 💎 Defined-contribution subsidies could reintroduce market discipline
  • 💎 Structural design—not utilization—is driving premium inflation
  • 💎 The ACA succeeded in coverage expansion but failed on cost containment


Resource Links

Guest: Anthony LoSasso, PhD – https://www.anthonylosasso.com/

Host: Roy Bejarano – linkedin.com/in/roy-bejarano-a5669ba8

Organization: www.scale-community.com

Podcast Hub: Analyzing Healthcare by SCALE Community


Guest Bio

Dr. Anthony LoSasso is a nationally recognized health economist, former Professor at DePaul University, and incoming faculty member at the University of Wisconsin–Madison’s La Follette School of Public Affairs. He is the author of the Wall Street Journal analysis “The Real Fix for Obamacare,” and his research focuses on health insurance design, incentives, premium growth, and labor-market dynamics. His expertise spans ACA marketplace behavior, public-sector program design, and the interplay between health policy and economic outcomes.


SEO Keywords

Obamacare, Affordable Care Act, ACA premiums, ACA subsidies, health insurance incentives, Anthony LoSasso, Wall Street Journal healthcare, healthcare inflation, U.S. healthcare reform, defined contribution, insurance marketplace, Roy Bejarano, SCALE Community, SCALE Healthcare, healthcare podcast, health economics, policy design, premium tax credits, managed competition

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1 month ago
29 minutes 25 seconds

Analyzing Healthcare
Can AI Fix Clinical Workflows? Ali Parsa, Founder & CEO, Quadrivia AI x SCALE Community

Summary
Healthcare’s biggest challenge isn’t technology—it’s the fundamental imbalance between elastic demand for care and a fixed global supply of clinicians. In this episode of Analyzing Healthcare, host Jason Schifman sits down with Ali Parsa, Founder & CEO of Quadrivia AI and previously the founder of both Circle Health and Babylon Health, to examine how AI can finally shift this equation.
Parsa describes how Quadrivia is building real-time, autonomous clinical agents capable of handling 20–30% of repetitive clinical tasks—from pre-op readiness calls to post-op follow-ups, symptom discussions, lab result explanations, and wide-ranging clinical conversations. These agents operate under strict guardrails, oversight layers, and configurable clinical boundaries—supporting clinicians rather than replacing them.
The discussion also explores global deployment across the U.S., UK, Europe, and Asia, why thoughtful scientific iteration matters more than Silicon Valley hyper-growth, and how lessons from Babylon’s rapid scale and SPAC collapse shaped Quadrivia’s disciplined approach. Parsa closes by articulating his belief that AI will finally make essential healthcare accessible and affordable for every person on earth by expanding the supply of clinical labor.

What You’ll Learn
✅ How AI can automate 20–30% of routine clinical tasks
✅ Why “elastic clinical supply” may redefine global healthcare
✅ Where AI safely supports clinicians—and where it must stop
✅ How autonomous agents manage real-time clinical conversations
✅ Why Quadrivia rejects hype-driven growth in favor of scientific rigor
✅ How global pilots across continents accelerate model reliability
✅ Lessons from scaling Circle and Babylon into billion-dollar businesses

SubscribeSubscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through AI, technology, data, and operational strategy. Visit SCALE Community to access exclusive leadership insights and full member-only recordings.

Timestamps

  • (00:00) – Intro | Meet Ali Parsa, Founder & CEO, Quadrivia AI

  • (01:04) – The Global Supply–Demand Crisis in Healthcare

  • (05:33) – Quadrivia’s AI: Automating Key Clinical Processes

  • (07:46) – Handling Structured Workflows & Free-Form Clinical Conversations

  • (09:35) – Clinical Boundaries: What AI Can & Cannot Do

  • (11:53) – Telehealth vs. AI: Access vs. Affordability

  • (14:25) – Will AI Move Closer to Diagnosis?

  • (18:09) – Global Footprint: U.S., UK, Europe & Asia

  • (19:32) – Accuracy, Guardrails & Real-Time Oversight

  • (25:44) – Rejecting the Silicon Valley Growth Playbook

  • (29:13) – Why Global Pilots Accelerate Learning

  • (33:25) – Deploying Across Countries: What Translates & What Doesn’t

  • (35:57) – Go-to-Market: Choosing the Right Partners

  • (37:45) – Live Demo: AI Handling a Real-Time Patient Call

  • (46:50) – Human Error vs. AI Error: The Risk Conversation

  • (51:35) – Lessons from Circle & Babylon

  • (55:20) – Closing Vision: Universal Healthcare Access Through AI

Key Takeaways

  • 💎 AI can safely automate a meaningful slice of clinical workloads

  • 💎 Elastic clinical supply is the real unlock for global access & affordability

  • 💎 Guardrails, oversight agents & real-time monitoring are essential for safety

  • 💎 Telehealth expands access; AI finally addresses cost and scalability

  • 💎 Global deployments expand the learning dataset dramatically

  • 💎 Thoughtful, slow, scientific iteration outperforms hype-driven growth

Resource Links
Guest: Ali Parsa – linkedin.com/in/ali-parsa-qu
Host: Jason Schifman – linkedin.com/in/jasonschifman
Organization: www.scale-healthcare.com
Podcast Hub: Analyzing Healthcare by SCALE Community


Guest Bio
Ali Parsa is the Founder & CEO of Quadrivia AI, pioneering autonomous clinical process automation to expand global healthcare capacity. He previously founded Circle Health & Babylon Health, and has focused his career on solving healthcare’s supply–demand imbalance by using AI to automate routine clinical tasks and greatly expand clinician reach.

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1 month ago
47 minutes 39 seconds

Analyzing Healthcare
Can Saudi Arabia Lead the Next Wave of Healthcare Transformation? — Youssef Haidar, CEO of Nexus Gulf x SCALE Community

Summary

Massive investment, national reform, and a rapidly expanding private sector are reshaping how healthcare is delivered across the Middle East. Nexus Gulf’s Youssef Haidar breaks down why Saudi Arabia is becoming one of the most compelling healthcare transformation stories in the world — and what global operators, MSOs, and investors should understand about the region’s extraordinary momentum.

In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Youssef Haidar, Founder of Nexus Gulf, to explore how Saudi Arabia and the UAE are building a next-generation healthcare services ecosystem. Haidar discusses the investment thesis behind the region’s growth, Nexus Gulf’s role in enabling service-line expansion, and how the group’s partnership with the global Cephanad Group is powering new models of care. The conversation spans private-sector enablement, system redesign, infrastructure gaps, and why the Gulf is increasingly seen as a global case study for healthcare modernization.


Title

Can Saudi Arabia Lead the Next Wave of Healthcare Transformation?- Youssef Haider, Nexus Gulf x SCALE Community


What You’ll Learn

  • ✅ Why Saudi Arabia is undergoing one of the world’s most ambitious healthcare transformations
  • ✅ How Nexus Gulf is driving private-sector healthcare expansion in the region
  • ✅ How investment, reform, and national strategy are reshaping care delivery
  • ✅ Why global MSOs, operators, and investors should watch the Gulf closely


Subscribe

Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through strategy, investment, operations, and global expansion. Visit SCALE Community to access exclusive leadership insights and full member-only recordings.


Timestamps

  • (00:00) Introduction to Youssef Haidar and Nexus Gulf
  • (01:45) The Transformation of Healthcare in Saudi Arabia
  • (05:15) Public-Private Partnerships and Market Dynamics
  • (11:03) Global Perspectives on Healthcare Models
  • (16:34) The Future of Healthcare Globalization
  • (19:28) Partnerships and Collaborations in Healthcare
  • (20:39) Transforming Healthcare in Saudi Arabia
  • (24:05) Innovative Partnerships and Localized Solutions
  • (26:57) Navigating the Outpatient Healthcare Landscape
  • (29:47) The Ideal Healthcare Partner
  • (33:38) Building Sustainable Healthcare Models
  • (37:02) Future of Global Healthcare Collaboration


Key Takeaways

  • 💎 Saudi Arabia is rapidly building a modern, scalable healthcare services ecosystem
  • 💎 Investment and national reform are enabling service-line development at unprecedented speed
  • 💎 The Gulf’s transformation offers lessons for global MSOs and health-system operators
  • 💎 Private-sector participation is central to the region’s long-term healthcare strategy


Resource Links

Guest: Youssef Haidar – linkedin.com/in/youssefhaidar

Host: Roy Bejarano – linkedin.com/in/roy-bejarano-a5669ba8

Organization: www.scale-community.com

Podcast Hub: Analyzing Healthcare by SCALE Community


Guest Bio

Youssef Haidar has 25+ years in private equity, principal investing, and advisory, with 22 years in the MENA region. He led investments and regional growth for eight international healthcare companies, achieving multiple high-profile exits in healthcare and education. Founder of StonePine Capital Partners and Nexus Gulf Healthcare, he also chairs ACE&Company’s Investment Committee and has held board roles at Taaleem/NUB, Nexus Gulf, Orpea AlGihaz, Nerhadou Pharmaceuticals, Cerba Nexus, ProVita, Cambridge Medical, Manzil Healthcare, Bourn Hall, and Ameco Medical.


SEO Keywords

Saudi Arabia, Healthcare, Middle East Healthcare, Nexus Gulf, Youssef Haidar, Healthcare Investment, Saudi Vision 2030, Gulf Healthcare Transformation, MSO Growth, Healthcare Strategy, Healthcare Modernization, Private-Sector Healthcare, Global Health Systems, Roy Bejarano, SCALE Community, SCALE Healthcare, Healthcare Podcast, UAE Healthcare, Cephanad Group, Healthcare Infrastructure, International Healthcare Expansion, Healthcare Podcast

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1 month ago
40 minutes 17 seconds

Analyzing Healthcare
How Is Healthcare Data Driving Smarter Decisions Across Canada? — Anne Forsyth, Executive Director at Women College Hospital x SCALE Community

Summary

Canada’s healthcare system operates through 14 independent health plans—with no single national digital health strategy. Yet, that very fragmentation may be what’s driving some of the most innovative thinking in healthcare data and digital transformation.

In this episode of Analyzing Healthcare, host Jason Schifman sits down with Anne Forsyth, Director of Clinical Applications at Women’s College Hospital and former Manager of Data Standards at the Canadian Institute for Health Information (CIHI). Together, they explore how Canada’s decentralized model shapes digital health strategy, the critical role of CIHI in national data collection, and the growing movement toward interoperability and standardization.

Forsyth also shares case studies from her work at Women’s College Hospital, including how workflow redesign and patient engagement tools are reducing no-show rates and improving data quality. She closes by emphasizing the need for digital literacy and collaboration across government, providers, and technology partners to achieve better healthcare outcomes.


What You’ll Learn

✅ Why Canada operates 14 separate healthcare systems—and how that impacts digital innovation

✅ How CIHI collects and analyzes healthcare data to inform national policy decisions

✅ Why real-time data and interoperability are the next frontiers for Canadian healthcare

✅ How Women’s College Hospital is driving digital transformation in ambulatory care

✅ Why data literacy and standardization are essential to improving care delivery


Subscribe

Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through data, technology, and strategy.


Visit SCALE Community to access exclusive leadership insights and full member-only recordings.


Timestamps

  • (00:00) – Intro | Meet Anne Forsyth, Director of Clinical Applications, Women’s College Hospital
  • (01:21) – Why Canada Has No National Digital Health Strategy
  • (04:56) – Inside the Canadian Institute for Health Information (CIHI)
  • (09:21) – Data Collection, Usage & Policy Applications
  • (11:46) – Case Study: Real-Time Data & the Opioid Crisis
  • (16:33) – How Canada Compares Globally in Healthcare Outcomes
  • (19:14) – Women’s College Hospital: Digital Innovation in Ambulatory Care
  • (22:00) – Standardizing Workflows & Reducing No-Show Rates
  • (27:13) – Bridging Gaps Between Government, Providers & Tech
  • (29:25) – The Urgent Need for Digital & Data Literacy in Healthcare
  • (31:09) – Closing Thoughts on Canada’s Digital Health Future


Key Takeaways

  • 💎 Canada’s decentralized system creates challenges—but also sparks regional innovation.
  • 💎 CIHI is one of Canada’s greatest assets, centralizing healthcare data for national use.
  • 💎 Workflow standardization and patient engagement can drive measurable outcomes.
  • 💎 Real-time, interoperable data is the next leap for healthcare improvement.
  • 💎 Digital literacy across clinicians and administrators is essential for progress.


Resource Links

Guest: Anne Forsyth –linkedin.com/in/akankshaforsyth

Host: Jason Schifman – linkedin.com/in/jasonschifman

Organization: www.scale-healthcare.com

Podcast Hub: Analyzing Healthcare by SCALE Community


Guest Bio

Anne Forsyth serves as Director of Clinical Applications at Women’s College Hospital, leading digital transformation and data standardization initiatives. Previously, she spent nearly a decade at the Canadian Institute for Health Information (CIHI), where she helped define data standards across Canada’s healthcare system. Her work bridges government, providers, and technology to create a more connected and data-driven future for Canadian healthcare.


SEO Keywords

Canadian Healthcare System, Digital Health Strategy, CIHI, Healthcare Data, Interoperability, Women’s College Hospital, Healthcare Innovation, Value-Based Care, Data Standardization, Roy Bejarano, SCALE Community, Digital Transformation, Public Health Policy, Health Information Systems, Data-Driven Healthcare, Canada Health

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1 month ago
32 minutes 50 seconds

Analyzing Healthcare
Will Oracle’s AI Strategy Accelerate Tech Adoption in Healthcare? — Seema Verma, SVP & General Manager at Oracle Health x SCALE Community

Summary
AI, cloud technology, and open data ecosystems are redefining how healthcare operates. Oracle Health’s Seema Verma shares how innovation and interoperability can finally deliver the transformation policymakers have long promised.

In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Seema Verma, Executive Vice President & General Manager of Oracle Health and Life Sciences and former CMS Administrator, to explore how Oracle is building the next generation of AI-enabled healthcare platforms. From Cerner’s acquisition to Oracle’s open-data vision, Verma details how the company is designing an EHR system built for AI, not one with AI “bolted on.” The discussion spans the future of ambient listening, automation in care delivery, interoperability mandates, and how AI can reduce administrative burden for both providers and patients.

Verma also reflects on her time at CMS—why initiatives like Patients Over Paperwork were just the beginning—and how her current work at Oracle continues that mission through private-sector innovation.

Title: Will Oracle’s AI Approach be the Catalyst for Technology Adoption in Healthcare? Seema Verma, Oracle x SCALE Community

What You’ll Learn

  • ✅ How Oracle is building an AI-native EHR that transforms care delivery

  • ✅ Why interoperability is central to unlocking AI’s full potential

  • ✅ How Verma’s CMS experience informs her work at Oracle Health

  • ✅ Why open ecosystems and global AI adoption are critical for innovation

Subscribe
Subscribe to Analyzing Healthcare for in-depth conversations with leaders transforming healthcare through technology, data, and strategy.
Visit SCALE Community to access exclusive leadership insights and full member-only recordings.

Timestamps

  • (00:00) – Intro | Meet Seema Verma, EVP & GM, Oracle Health & Life Sciences

  • (01:50) – The Vision Behind Oracle’s AI Transformation of Healthcare

  • (04:49) – How Oracle’s EHR Differs from Epic, Athena & Others

  • (09:51) – Cloud Platforms, AI Agents & Open Ecosystem Innovation

  • (13:50) – From CMS to Oracle: Fixing Burnout with Technology

  • (21:38) – The Fight for Interoperability & Patient Data Ownership

  • (27:58) – Why Blocking Data Means Blocking Innovation

  • (32:25) – Global Demand for AI-Driven Health Solutions

  • (35:05) – How States and Systems Differ in AI Adoption

  • (39:29) – Price Transparency, Private Equity & Health Policy Reform

  • (43:03) – Future of Clinical Labor, Policy & Compliance

  • (43:31) – Closing Reflections on Healthcare’s Future

Key Takeaways

  • 💎 Oracle is reimagining EHRs as AI-native platforms, not retrofits.

  • 💎 Interoperability is both a moral and technical imperative for healthcare.

  • 💎 Verma believes open ecosystems are vital to accelerating innovation.

  • 💎 The next wave of AI will serve patients and providers through automation and insight.

Resource Links
Guest: Seema Verma – LinkedIn
Host: Roy Bejarano – LinkedIn
Organization: www.scale-community.com
Podcast Hub: Analyzing Healthcare by SCALE Community
Oracle Health: https://www.oracle.com/health

Guest Bio
Seema Verma serves as Executive Vice President and General Manager of Oracle Health and Life Sciences, where she leads the company’s mission to transform healthcare through data, AI, and technology integration. As the former Administrator of CMS, she oversaw one of the largest healthcare programs in the world, launching key initiatives like Patients Over Paperwork and Interoperability and Patient Access. At Oracle, she continues that mission—rebuilding healthcare’s digital infrastructure with innovation at the core.

SEO Keywords
Oracle Health, Seema Verma, Oracle Life Sciences, AI in Healthcare, Healthcare Interoperability, EHR Innovation, Healthcare Transformation, Digital Health Strategy, CMS Administrator, Value-Based Care, Healthcare Technology, Cloud Computing in Healthcare, Healthcare Policy Reform, Healthcare Podcast, Roy Bejarano, SCALE Community, SCALE Healthcare, Healthcare AI, Healthcare Innovation, Oracle Cerner

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2 months ago
43 minutes 34 seconds

Analyzing Healthcare
Can AI and Telehealth Fix What Healthcare Policy Hasn’t? — Ann Mond Johnson, CEO of the American Telemedicine Association x SCALE Community

Summary

Telehealth, AI, and digital therapeutics are redefining American healthcare. The ATA leaders share insights on regulation, innovation, and the road ahead.

In this episode of Analyzing Healthcare, host Roy Bejarano sits down with Ann Mond Johnson, CEO of the American Telemedicine Association (ATA), and Kyle Zebley, ATA’s Senior VP of Public Policy, to discuss how digital health is reshaping care delivery across the U.S. They explore the evolution of telehealth from early remote care to today’s AI-driven, data-enhanced platforms. The conversation dives deep into barriers to adoption—from outdated state regulations and the 1997 Medicare law to CMS reimbursement models—and what it will take to achieve true parity for digital care. From state-by-state advocacy to the global future of telemedicine, this episode offers an unfiltered look at the policies, players, and promise of healthcare’s digital revolution.


Title-Can AI and Telehealth Fix What Healthcare Policy Hasn’t? American Telemedicine Association x SCALE Community


What You’ll Learn

✅ The ATA’s mission and its role as the voice of U.S. digital health

✅ The policy and regulatory challenges limiting telehealth adoption

✅ How COVID-era flexibilities changed the trajectory of virtual care

✅ Why global collaboration may define the next phase of healthcare innovation

Subscribe to Analyzing Healthcare for more in-depth conversations with leaders transforming care delivery. Visit SCALE Community to join SCALE Community and access exclusive leadership insights.


Timestamps

• (00:00) – Intro | Meet Ann Mond Johnson & Kyle Zebley, ATA

• (01:20) – Inside the ATA: Mission, Members & Market Influence

• (03:30) – Evolution of Digital Health: From Telephones to AI

• (06:50) – Advocacy & ATA Action: Policy Work Across 50 States

• (09:20) – The Economics: Membership, Funding & Growth

• (17:00) – Digital Care vs. In-Person Care: Why Adoption Lags

• (21:00) – COVID’s Impact on Telehealth Expansion

• (30:00) – The 1997 Law That Still Restrains Telemedicine

• (34:00) – What Happens if the Waivers Expire?

• (37:00) – State Licensing Barriers & Push for Uniformity

• (42:00) – Global Digital Health: Opportunities & Challenges

• (44:00) – Signs of Optimism for the Future of Care


Key Takeaways

• 💎 The ATA leads U.S. advocacy for telehealth and digital therapeutics.

• 💎 Regulatory barriers—not technology—remain the greatest constraint.

• 💎 COVID accelerated digital adoption but left policy gaps unresolved.

• 💎 The next era of healthcare will merge local practice with global connectivity.


Resource Links

Guest: LinkedIn –  Ann Mond Johnson | LinkedIn-  Kyle Zebley

Host: LinkedIn – Roy Bejarano

Organization: www.scale-healthcare.com

Podcast Hub: Analyzing Healthcare by Scale Community

American Telemedicine Association – https://www.americantelemed.org | https://www.americantelemed.org/ata-action/


Guest Bio

Ann Mond Johnson is CEO of the American Telemedicine Association, leading efforts to integrate digital health into the core of U.S. healthcare delivery. With decades of experience in innovation, policy, and healthcare transformation, Ann is recognized as one of the most influential advocates for accessible, technology-driven care.


Kyle Zebley is SVP of Public Policy and Executive Director of ATA Action, where he drives the organization’s advocacy across all 50 states and on Capitol Hill. His work has helped modernize telehealth laws, protect digital access, and shape national debates on healthcare modernization.


SEO Keywords

Telehealth policy, digital health innovation, ATA, Ann Mond Johnson, Kyle Zebley, telemedicine regulation, healthcare technology, virtual care adoption, CMS reimbursement, healthcare policy reform, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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2 months ago
48 minutes 25 seconds

Analyzing Healthcare
Can Data and AI Finally Deliver on Healthcare’s Digital Promise? — Tom Andriola, CIO at UC Irvine Health x SCALE Community

Summary

AI in healthcare, data platforms, UC Irvine innovation, Dynatrace, and healthcare technology governance. Former UC Irvine CDO Tom Andriola reveals how data, AI governance, and cultural change are transforming healthcare systems. From building precision-health platforms to creating AI accountability frameworks at scale, Tom explains how technology leaders can integrate AI trust, transparency, and observability into clinical and administrative workflows. He shares lessons from UC Irvine’s COVID-era data success and his current work at Dynatrace to enable AI assurance across healthcare enterprises. A must-listen for CIOs, digital health executives, and leaders building the future of AI in medicine.


What You’ll Learn

✅ How UC Irvine Health built a comprehensive data and precision health platform.

✅ Why AI governance and trust frameworks are essential for responsible AI use.

✅ How AI augments clinical decision-making and reduces provider burden.

✅ Where Dynatrace fits in the next wave of AI observability and accountability.


Timestamps

  • {00:00} Intro to AI in Healthcare
  • {01:13} Tom’s Journey & UC Irvine Growth
  • {06:51} Standardization & Integration
  • {08:21} Innovation at UCI Health
  • {11:43} Data-Driven Decisions & Precision Health
  • {13:58} Culture Shift in Tech Adoption
  • {18:12} Tech in Clinical Decision-Making
  • {22:17} Governance & Trust in AI
  • {25:10} Challenges & Opportunities
  • {30:01} Building AI Governance
  • {32:24} Leading AI Adoption
  • {35:26} Future of EMRs & AI
  • {37:45} Evolving Role of Tech Leaders
  • {45:57} Dynatrace: AI Assurance in Healthcare


Key Takeaways

  • 💎 AI and data platforms enable data-driven healthcare and precision medicine.
  • 💎 Cultural shift and AI trust frameworks are critical for successful adoption.
  • 💎 Ambient AI tools improve provider experience and patient communication.
  • 💎 Observability and AI accountability will define the next wave of healthcare innovation.


Resource Links

Guest: LinkedIn –  Tom Andriola

Host: LinkedIn – Jason Schifman

Organization: www.scale-healthcare.com

Podcast Hub: Analyzing Healthcare by Scale Community

Mentioned: UC Irvine Health, Institute for Precision Health, Dynatrace


Guest Bio

Tom Andriola, a former Chief Information Officer now working at Dynatrace, leads the company’s global IT and digital innovation strategy. With extensive experience in healthcare technology, including leadership roles at UC Irvine and the University of California system, he has been a strong advocate for data-driven care, AI integration, and digital transformation across healthcare enterprises. Tom’s work bridges technology and clinical outcomes, advancing how health systems use data and automation to improve patient care and operational efficiency.


SEO Keywords

AI, healthcare technology, UC Irvine, data platforms, precision health, pandemic response, clinical decision-making, AI governance, healthcare integration, Dynatrace, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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2 months ago
41 minutes 50 seconds

Analyzing Healthcare
Is CMS Doing Enough to Make Value-Based Care Sustainable? — Purva Rawal, Former Chief Strategy Officer at CMS x SCALE Community

Summary

Value-based care, CMS Innovation strategy, AI in healthcare delivery, and primary care reimbursement — where health equity meets policy innovation.

In this episode of Analyzing Healthcare by Scale Community, Roy Bejarano, Co-Founder & CEO of Scale Healthcare, speaks with Dr. Purva Rawal, former Chief Strategy Officer at the CMS Innovation Center (CMMI). They discuss how value-based care models, AI, and CMS initiatives are reshaping U.S. healthcare.

Dr. Rawal shares lessons from leading Medicare and Medicaid innovation, highlighting how payment reform and primary care reimbursement drive equity and efficiency. The conversation explores CMS strategy, the role of AI in care coordination, and key takeaways from COVID-19 that continue to shape policy and virtual care.

Title
Is CMS Doing Enough to Make Value-Based Care Sustainable? | Purva Rawal × SCALE Community


What You’ll Learn
✅ How value-based care and primary care reimbursement models advance health equity.
✅ The role of the CMS Innovation Center in modern healthcare reform.
✅ How AI in healthcare delivery enhances outcomes and reduces inefficiency.
✅ Policy insights for leaders navigating the latest trends in healthcare innovation.

If you enjoy forward-thinking Healthcare Podcasts, subscribe to Analyzing Healthcare for weekly Healthcare Industry Insights and Healthcare Strategies from top leaders.
👉 Visit www.scale-healthcare.com to join Scale Community and explore the latest Healthcare Thought Leadership and Innovation initiatives.

Timestamps
• (00:00) – Intro | Meet Dr. Purva Rawal of CMS Innovation Center
• (01:30) – Defining “Value” in Healthcare & Human-Centered Care Design
• (04:20) – Top Gaps in U.S. Healthcare & Primary Care Infrastructure
• (10:44) – Primary Care Reimbursement Models & Political Challenges
• (15:30) – Evaluating Value-Based Care Models and Provider Satisfaction
• (21:15) – CMS Initiatives for Reducing Health Disparities
• (34:00) – Medicare Spending, Inflation, and System Sustainability
• (40:00) – AI in Healthcare Delivery & the Future of CMS Innovation
• (46:00) – COVID-19 Lessons for Healthcare Strategy and Equity
• (53:00) – Closing Insights on Public Trust and Institutional Integrity

Key Takeaways
• Value-based care models are the foundation of sustainable health equity.
• AI in healthcare delivery is reshaping care coordination and data-driven policy.
• Primary care reimbursement models must align financing with outcomes.
• CMS initiatives prove that innovation and policy can work together to improve access.

Resource Links
Guest: LinkedIn – Purva Rawal
Host: LinkedIn – Roy Bejarano
Organization: www.scale-healthcare.com
SCALE Community: https://www.scale-community.com/
Podcast Hub: Analyzing Healthcare by Scale Community
Mentioned: CMS Innovation Center (CMMI)

Guest Bio
Purva Rawal, former Chief Strategy Officer at the CMS Innovation Center, is a clinical psychologist and policy strategist recognized for advancing value-based care models, primary care reimbursement innovation, and health equity initiatives across Medicare and Medicaid. She has led national CMS initiatives connecting AI in healthcare delivery with policy reform to build a system “wrapped around people and their needs.”

Hashtags
#HealthcarePodcast #ValueBasedCare #CMSInnovationCenter #AIinHealthcare #HealthEquity #HealthcareStrategy #HealthcareInnovation #ScaleHealthcare #ScaleCommunity #RoyBejarano

SEO Keywords
value-based care, CMS Innovation Center, AI in healthcare delivery, value-based care models, primary care reimbursement models, health equity, CMS initiatives, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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2 months ago
48 minutes 54 seconds

Analyzing Healthcare
Can Advanced Imaging & AI Redefine Preventive Medicine? — Andrew Lacy, Founder & CEO of Prenuvo x SCALE Community

Discover how Prenuvo and CEO Andrew Lacy are revolutionizing preventive healthcare with full-body MRI, AI-powered imaging, and early disease detection insights. In this SCALE Community: Healthcare Technology & Innovation episode, Andrew Lacy, Founder & CEO of Prenuvo, shares how his company is transforming preventive healthcare through advanced full-body MRI and AI-assisted diagnostics. He discusses balancing technology with human expertise in radiology, enhancing the patient experience, and addressing challenges around insurance coverage and integration into traditional care systems. Andrew also highlights Prenuvo’s global expansion, physician referral growth, and mission to make early detection and proactive health screening the new standard in modern healthcare.


Title - Can Advanced Imaging and AI Redefine Preventive Medicine? | Andrew Lacy, Prenuvo x SCALE Community


Key Timestamps:

  • {00:00} Introduction to Prenuvo and Proactive Screening
  • {03:17} The Role of AI in Radiology
  • {06:11} Patient Experience and Clinic Environment
  • {08:55} Recruiting and Retaining Radiologists
  • {11:46} Expansion and Growth of Prenuvo
  • {14:33} Overcoming Skepticism in Preventative Imaging
  • {16:58} Insurance and Pricing Challenges
  • {19:53} Integrating Prenuvo into Healthcare Ecosystem
  • {22:38} Understanding Scan Results and Patient Guidance
  • {26:36} Empowering Patients Through Innovative Healthcare
  • {28:13} Reimagining the Healthcare Landscape
  • {28:41} The Financial Burden of Healthcare
  • {30:06} Preventative Care vs. Reactive Care
  • {31:30} Economic Models and ROI in Healthcare
  • {32:54} Employer Engagement in Preventative Health
  • {34:19} Safety and Efficacy of Whole Body Scans
  • {35:59} The Future of Whole Body Scans
  • {37:03} Prenuvo's Market Position and Expansion
  • {38:11} Integrating Technology in Healthcare
  • {45:27} International Expansion and Market Adaptation


Key Takeaways:

  • Prenuvo offers proactive health screening through advanced full-body MRI technology.
  • AI in radiology is used judiciously, with a focus on human clinical expertise.
  • A patient-first experience drives engagement and trust in preventive health.
  • Whole-body scans can detect early-stage cancers and chronic conditions, saving lives.
  • Recruiting and retaining top radiologists ensures diagnostic precision.
  • Public awareness of proactive healthcare and preventive scans remains low.
  • Physician referrals are growing as confidence in Prenuvo’s technology increases.
  • Insurance coverage for preventive imaging remains limited but is evolving.
  • Prenuvo aims to integrate into traditional healthcare systems through data-driven evidence.
  • Patient empowerment is central — reports include actionable, personalized insights.


About the Guest:

Andrew Lacy is the Founder and CEO of Prenuvo, a pioneering health technology company offering full-body MRI scans to detect disease early and promote proactive healthcare. A seasoned entrepreneur and technologist, Andrew is redefining preventive medicine by combining advanced imaging, AI-assisted diagnostics, and clinical precision. Under his leadership, Prenuvo has grown to 23 clinics across North America and internationally, empowering thousands of patients to take control of their health before symptoms appear.


linkedin.com/in/andrewllacy


linkedin.com/in/jasonschifman


Keywords:

Prenuvo, proactive screening, radiology, AI in healthcare, patient experience, whole body scans, insurance coverage, early detection, health technology, healthcare innovation, SCALE Community, Analyzing Healthcare, Healthcare Innovation, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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3 months ago
51 minutes 59 seconds

Analyzing Healthcare
Can the World Ever Be Ready for the Next Pandemic? — Priya Basu, Executive Head of The Pandemic Fund x SCALE Community

Priya Basu, Executive Head of the Pandemic Fund, discusses lessons from COVID-19 and the urgent need to strengthen pandemic preparedness worldwide. She highlights the Fund’s mission to support over 75 countries with investments in surveillance, laboratories, and workforce training, particularly in low- and middle-income nations. Basu underscores the importance of the One Health approach, recognizing the links between human, animal, and environmental health. She shares success stories from projects in India, Rwanda, and the Caribbean, and emphasizes how technology, digital tools, and international collaboration are reshaping public health. Her call to action: sustained investment to build resilient health systems.


Title – Can the World Ever Be Truly Ready for the Next Pandemic? Priya Basu, Executive at The Pandemic Fund


Key Timestamps:

  • {00:00} Introduction to the Pandemic Fund and Priya Basu
  • {02:57} The Need for Pandemic Preparedness
  • {06:14} Operational Challenges in Pandemic Response
  • {11:47} Country-Driven Approaches to Health Security
  • {14:29} Lessons from COVID-19 and Future Preparedness
  • {17:14} Successful Projects and Challenges Faced
  • {23:59} The Role of Technology in Future Pandemics
  • {27:00} Public Health Awareness and Community Engagement


Key Takeaways:

  • COVID-19 exposed the world's lack of preparedness for pandemics.
  • The Pandemic Fund aims to strengthen health systems in low-income countries.
  • Surge capacity is essential for effective pandemic response.
  • Countries must take ownership of their health security plans.
  • Collaboration across countries is vital for pandemic preparedness.
  • Investments in health security are cost-effective compared to the costs of pandemics.
  • A multi-sectoral approach is necessary for effective health interventions.
  • AI and technology can enhance data gathering and response coordination.
  • Successful projects demonstrate the impact of the Pandemic Fund's investments.
  • Building resilient public health systems is crucial for future preparedness.


Guest Bio – Priya Basu, Executive Head of the Pandemic Fund

Priya Basu is a global health and development finance leader with nearly 30 years of experience driving pandemic preparedness, health systems strengthening, and innovative finance. As the founding Executive Head of the Pandemic Fund at the World Bank, she mobilized $3B in seed capital and catalyzed over $6B in co-financing for 75+ countries. Previously, she led global initiatives at the World Bank, IMF, ADB, and UN, shaping landmark health financing mechanisms and advancing inclusive growth across regions.

🔗 Connect with Priya Basu on LinkedIn


About the Host – Roy Bejarano, Co-founder & CEO at SCALE Healthcare

Roy Bejarano is Co-Founder & CEO of SCALE Healthcare, the nation’s top healthcare consulting firm. As host of Analyzing Healthcare, Roy interviews leading executives, policymakers, and innovators shaping the future of healthcare strategy, MSO leadership, and system transformation.

🔗 Connect with Roy Bejarano on LinkedIn


Keywords:

Pandemic Fund, Priya Basu, COVID-19, pandemic preparedness, health security, global health, surveillance, workforce training, international collaboration, One Health, healthcare innovation, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care, Healthcare Trends and Innovations, Leading Healthcare Stakeholders, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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3 months ago
30 minutes 51 seconds

Analyzing Healthcare
How Does Pragmatic Innovation Scale Across a $9B Health System? — Dr. Richard Zane, Chief Medical Information Officer at UCHealth x SCALE Community

Richard Zane of UC Health shares healthcare innovation strategies, tech adoption, patient care frameworks, and building a culture of collaboration.


In this episode, Richard Zane, Chief Medical and Chief Innovation Officer at UC Health, discusses the innovative strategies and frameworks that drive the healthcare system's approach to patient care and technology. He emphasizes the importance of understanding problem statements, the duality of his roles, and the collaborative nature of innovation at UC Health. The conversation explores successful initiatives, challenges in technology adoption, and the cultural aspects that foster a spirit of innovation within the organization. Zane also shares insights on measuring success and the future direction of UC Health's innovation efforts.


Title- Inside UCHealth: How Pragmatic Innovation Scales Across a $9B Health System


Key Timestamps:

  • {00:00} Introduction to UC Health and Innovation
  • {04:28} The Role of Technology in Healthcare Innovation
  • {07:12} Dual Role of Chief Medical and Innovation Officer
  • {12:27} Structure and Focus of the Innovation Office
  • {13:54} Case Study: The Haystack Project
  • {20:09} Challenges in Third-Party Technology Integration
  • {24:00} Criteria for Evaluating Innovation Initiatives
  • {27:48} Fostering a Culture of Innovation
  • {31:53} Measuring Success in Innovation Projects
  • {35:11} The Evolution of UC Health's Innovation Program
  • {38:32} Future Directions for UC Health
  • {40:22} Partnerships Beyond Hospital Providers


Key Takeaways:

  • Innovation is a strategic pillar for UC Health.
  • The role of Chief Innovation Officer is crucial for integrating technology and patient care.
  • Understanding problem statements is key to effective innovation.
  • UC Health's approach is hyper pragmatic and data-driven.
  • The organization values partnerships with technology companies for co-development.
  • Cultural transformation is essential for fostering innovation.
  • Measuring success involves identifying clear metrics and outcomes.
  • Phased deployments are preferred over pilot programs to avoid 'pilotitis'.
  • The future of healthcare will involve more outpatient and home care solutions.
  • UC Health aims to be a leader in innovative healthcare delivery.


About the Guest:

Richard Zane, Chief Innovation Officer at UCHealth and Professor of Emergency Medicine, shares how he is transforming healthcare delivery through digital innovation, AI, and data-driven care models. From emergency medicine leadership to pioneering virtual care strategies, Zane highlights UCHealth’s role in advancing patient outcomes, clinical efficiency, and system-wide innovation. This conversation offers critical insights for healthcare executives, providers, and innovators navigating the future of health systems.


linkedin.com/in/richard-zane-md-9b87b5a


linkedin.com/in/jasonschifman


Keywords

UC Health, innovation, healthcare technology, patient care, healthcare system, Chief Innovation Officer, healthcare delivery, technology adoption, healthcare partnerships, quality improvement, healthcare technology, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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3 months ago
39 minutes 50 seconds

Analyzing Healthcare
How Can Safety-Net Health Systems Innovate Under Cost Pressure? — Dr. David Lubarsky, CEO of UC Davis Health x SCALE Community

David Lubarsky on safety net hospitals, trauma care, AI, value-based care, and leading large healthcare systems.


In this episode, David Lubarsky, President and CEO of Westchester Medical Center Health Network, discusses the complexities and challenges of managing a large healthcare system. He highlights the unique aspects of Westchester Medical Center, including its role as a major trauma center and safety net hospital. The conversation delves into operational challenges, financial pressures, and the importance of community care. Lubarsky also emphasizes the need for integration and synergy within healthcare systems, the impact of technology, and the significance of strategic partnerships in enhancing patient care.


Title- AI, Medicaid Cuts & Safety Net Hospitals: How Health Systems Survive and Innovate | Dr. David Lubarsky


Key Timestamps:

  • {00:00} Introduction to Westchester Medical Center Health Network
  • {02:38} Comparative Analysis of Healthcare Systems
  • {05:13} The Complexity of Healthcare Integration
  • {08:20} Operational Challenges in a Safety Net System
  • {10:56} The Role of Trauma Centers in Community Health
  • {13:41} Navigating Medicaid and Unfunded Patients
  • {16:35} Contrasts in Safety Net Access Across States
  • {19:22} The Future of Healthcare: Technology and Partnerships


Key Takeaways:

  • Westchester Medical Center serves as a critical healthcare hub in New York.
  • The center handles a significant number of inbound patient transfers, indicating its importance in the region.
  • Operational efficiency and standardization are key goals for healthcare systems.
  • Financial sustainability is a major concern for safety net hospitals.
  • AI and technology can enhance healthcare delivery and efficiency.
  • Community care and access to services are essential for underserved populations.
  • The healthcare landscape is evolving with new partnerships and care models.
  • State variations impact healthcare access and safety net responsibilities.
  • Healthcare is a complex system with many interdependent parts.
  • The future of healthcare will rely on innovative solutions and strategic collaborations.


Guest Bio – Dr. David Lubarsky, President and Chief Executive Officer Westchester Medical Center Health Network


David Lubarsky, MD, MBA, is the President and CEO of Westchester Medical Center Health Network, a vital safety-net health system serving millions across New York’s Hudson Valley. With prior leadership at UC Davis, Miami, and Duke, Dr. Lubarsky has spent his career expanding access for underserved populations while pioneering system integration and value-based care. In this conversation, he shares candid insights on Medicaid disenrollment, payer disruption, AI as “augmented intelligence,” and the growing role of retail health partnerships. His perspective offers MSO leaders, providers, and payers a real-world look at how healthcare can adapt and transform under pressure.


 Connect with Dr. David Lubarsky on LinkedIn


About the Host – Roy Bejarano, Co-founder & CEO at SCALE Healthcare

Roy Bejarano is Co-Founder & CEO of SCALE Healthcare, the nation’s top healthcare consulting firm. As host of Analyzing Healthcare, Roy interviews leading executives, policymakers, and innovators shaping the future of healthcare strategy, MSO leadership, and system transformation.


Connect with Roy Bejarano on LinkedIn


Keywords: Westchester Medical Center, healthcare system, trauma care, operational challenges, safety net hospitals, healthcare technology, strategic partnerships, community health, financial pressures, healthcare access, healthcare innovation, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care, Healthcare Trends and Innovations, Leading Healthcare Stakeholders, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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3 months ago
29 minutes 55 seconds

Analyzing Healthcare
How Is Sehat Kahani Scaling 60+ Clinics Across Pakistan? — Dr. Sara Saeed Khurram, Co-Founder & CEO x SCALE Community

Transforming Pakistani healthcare with 7,500+ female doctors & 3M+ teleconsults—Sehat Kahani is closing access gaps through tech & cultural insight. In this episode, Dr. Sara Saeed Khurram, CEO of Sehat Kahani, unpacks how her tech-enabled platform tackles the country’s doctor-patient mismatch, leverages 7,500+ female doctors, and delivers over 3 million teleconsults. From cultural constraints to nationwide growth, hear how Sehat Kahani blends virtual clinics, corporate partnerships, and community care to improve outcomes. Dr. Khurram highlights the resilience of providers and the vital role of cultural values in healthcare delivery.


Title- Scaling Primary Care: Inside Sehat Kahani’s 60+ Clinics Across Pakistan | Dr. Sara Saeed Khurram x SCALE Community


Key Timestamps:

  • {00:00} Overview of the Pakistani Healthcare System
  • {12:53} The Birth of Sehat Kahani
  • {23:40} Sehat Kahani's Growth and Impact
  • {28:31} Healthcare Accessibility in Pakistan
  • {29:45} Corporate Partnerships and Patient Utilization
  • {31:28} Community Clinics and Rural Healthcare
  • {32:56} Innovative Clinic Models and Mental Health Services
  • {34:19} Corporate Healthcare Solutions and Cost Savings
  • {36:11} Financial Models and Payment Structures
  • {40:23} Provider Recruitment and Quality Assurance
  • {45:29} Data Analytics and Outcome Tracking
  • {49:44} Future Expansion and Technological Advancements
  • {53:06} Cultural Resilience in Healthcare Delivery


Key Takeaways:

  • Pakistan has a significant doctor-patient mismatch.
  • Cultural barriers prevent many female doctors from practicing.
  • Sehat Kahani was founded to address healthcare access issues.
  • Telehealth can bridge gaps in primary care.
  • The company has grown to include over 7,600 doctors.
  • Corporate partnerships have expanded Sehat Kahani's reach.
  • The app connects patients to doctors within 60 seconds.
  • Sehat Kahani is exploring expansion into the GCC and Kenya.
  • Resilience and hospitality are key strengths in Pakistani healthcare.
  • The future includes enhancing technology and AI solutions.


About the Guest:

Dr. Sara Saeed Khurram, CEO and Co-founder of Sehat Kahani, is transforming Pakistan’s healthcare landscape. Her platform has delivered over 3.1 million telemedicine consultations, reactivated 8,000+ female doctors, and served 10 million+ lives—all while bridging primary care gaps in underserved areas. In this episode, she unpacks what’s broken in women’s health, how her full-spectrum model works, and why it’s yielding a 4:1 ROI for employers. A must-listen on innovation, inclusion, and the power of women-led healthcare reform.


linkedin.com/in/dr-sara-saeed-khurram-9a8873aa


linkedin.com/in/jasonschifman


Keywords

Sehat Kahani, telehealth, Pakistani healthcare, Dr. Sara Saeed Khurram, healthcare innovation, doctor-patient mismatch, corporate telemedicine, healthcare access, women in healthcare, healthcare technology, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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4 months ago
52 minutes 33 seconds

Analyzing Healthcare
Inside the Healthcare Policy Crossroads: Medicaid, Medicare & Reform — Kristi Martin, Former Senior Advisor at CMS x SCALE Community

Medicaid cuts, drug pricing, rural hospital challenges, AI in healthcare, and why prevention is key to the future of U.S. healthcare. In this episode, Kristi Martin, former Chief of Staff at the Center for Medicare, examines the implications of recent Medicaid cuts, their impact on long-term care, and the ripple effects on private insurance and rural hospitals. She discusses the challenges of Medicare drug pricing negotiations, rising healthcare inflation, and the critical role of nonprofit hospitals in care delivery. The conversation highlights the need to rethink healthcare financing models, especially in rural communities, while exploring the opportunities and risks of AI in healthcare. Kristi also underscores the importance of preventative care, health equity, and value-based care in shaping better outcomes.


Title- Inside the Healthcare Policy Crossroads: Medicaid, Medicare, and Reform with Kristi Martin, Former CMS Leader


Key Timestamps:

  • {00:00} Introduction to Kristi Martin and Healthcare Landscape
  • {01:05} Impact of Recent Medicaid Changes
  • {04:56} Long-Term Care and Medicaid's Role
  • {09:12} State Variations in Medicaid Coverage
  • {11:54} The Dichotomy of Healthcare Systems
  • {15:45} Medicare Drug Pricing Negotiations
  • {18:51} Challenges in Drug Pricing and Healthcare Spending
  • {23:10} The Frustrations of Medical Education and Debt
  • {26:02} The Role of Nonprofits in Healthcare
  • {28:47} Diversity in Nonprofit Hospitals
  • {34:09} Rethinking Financing for Community Hospitals
  • {37:01} AI and the Future of Healthcare
  • {42:22} The Importance of Preventative Care


Key Takeaways:

  • Medicaid cuts will significantly impact long-term care services.
  • The ripple effect of Medicaid disqualification will affect all insurance types.
  • State variability in Medicaid coverage leads to unequal access to care.
  • Drug pricing negotiations are a crucial step towards more equitable healthcare costs.
  • Nonprofits play a vital role in providing affordable healthcare solutions.
  • AI in healthcare presents both opportunities and risks that need careful regulation.
  • Preventative care is essential for improving overall health outcomes.
  • The healthcare system needs to be restructured to better serve rural populations.
  • Healthcare spending growth is driven by various factors, including drug prices.
  • There is a critical need for a public health focus beyond just healthcare services.


Guest Bio –Kristi Martin

Kristi Martin, Director at Canberra Collective and former Chief of Staff at the Center for Medicare, brings decades of experience shaping U.S. health policy. In this conversation, she unpacks the implications of recent Medicaid cuts, the strain on long-term care and rural hospitals, and the ripple effects across the healthcare system. Kristi also explores Medicare drug pricing negotiations, the role of nonprofits, and the need to rethink healthcare financing. She closes by examining AI’s risks in care delivery and emphasizing preventative care as essential to improving outcomes and advancing value-based care.


Connect with Kristi Martin on LinkedIn


About the Host – Roy Bejarano, Co-founder & CEO at SCALE Healthcare

Roy Bejarano is Co-Founder & CEO of SCALE Healthcare, the nation’s top healthcare consulting firm. As host of Analyzing Healthcare, Roy interviews leading executives, policymakers, and innovators shaping the future of healthcare strategy, MSO leadership, and system transformation.


Connect with Roy Bejarano on LinkedIn


Keywords:

healthcare policy, Medicaid, drug pricing, long-term care, ACA, healthcare spending, nonprofit healthcare, AI in healthcare, preventative care, community hospitals, healthcare technology, healthcare innovation, Healthcare System, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care

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4 months ago
45 minutes 36 seconds

Analyzing Healthcare
What’s next in healthcare? Analyzing Healthcare delivers expert insights, real-world case studies, and bold ideas shaping the future of U.S. & global health systems. Hosted by Roy Bejarano and Jason Schifman of SCALE Healthcare & SCALE Community, each episode explores medical innovation, healthcare leadership, value-based care, provider operations, health policy, artificial intelligence, & emerging health trends. Whether you're a provider, investor, operator, or simply healthcare curious—this podcast helps you stay informed, inspired, & ahead of the curve. More info at www.scale-community.com