EPISODE · Apr 25, 2026 · 26 MIN
The Nurse Case Manager
from The Disrupted Podcast · host Scott Middleton, Jamie Preston
What if the people case-managing your care had a financial reason to keep you sicker? That's the uncomfortable question Scott Middleton puts on the table in this episode — recorded live from the American Case Managers Conference in Orlando, where Scott went to learn, and ended up being told Your Health didn't "fit" because they weren't a hospital. Jamie and Scott unpack what the nurse case manager role actually looks like at Your Health — and why moving case management out of hospitals and into patients' homes isn't just better care, it's better economics. Scott shares the research proving the model works: 50% reduction in Medicare spend when patients are seen at the right frequency by the right people. In this episode: Why hospitalists may be "the demise of the American healthcare system" The difference between nurse practitioners (diagnose and treat) and nurse case managers (assess and guide) — and why blurring them costs patients The 16.05-visits-per-risk-point model David Clemens' research validated How coding departments are quietly diagnosing patients with diseases they don't have Why Medicare's 6-year insolvency window may be the disruption we need Head-to-toe assessments, delegation rights, and the real job of an RN in the home If you've ever suspected the system is working exactly as designed — just not for the patient — press play. www.YourHealth.Org
What this episode covers
Live from the American Case Managers Conference in Orlando, Scott pulls back the curtain on why hospital-run case management is quietly costing Medicare billions — and why the nurse case manager, done right, may be the single most underused role in modern healthcare. He breaks down Your Health's home-based model, the 16.05-visits-per-risk-point ratio that's cutting Medicare spending in half, and why the future of care won't happen inside a hospital at all.
NOW PLAYING
The Nurse Case Manager
No transcript for this episode yet
Similar Episodes
Mar 26, 2026 ·1m
Mar 19, 2026 ·34m
Feb 18, 2026 ·11m
Feb 11, 2026 ·45m