Medsolve Dynamics

Capital decisions in radiation oncology are not point-in-time decisions. The proforma that wins approval at signature is not the proforma that runs the program in year five. From 20 years on the vendor side and now on the program side, the math that protects margin through a full capital cycle. medsolvedynamics.com | [email protected]

A moment from the AMAC Spring Symposium 2026 talk on the day I told a room of oncology administrators that I have watched programs lose margin on contracts I helped sell them. Plus the 17-year ROI case study. medsolvedynamics.com | [email protected]

A short clip from the AMAC Spring Symposium 2026 talk on the discipline programs need to apply to every capital decision in the current environment. Forward-looking, not policy-blame. medsolvedynamics.com | [email protected]

The capital case in a vendor proforma is usually solid. The operating case is rarely modeled. From 20 years on the vendor side selling these programs, here is the operational reality that shows up in year two and never lives in the original proforma. Applies to LINAC purchases, theranostics expansions, and benign disease program builds. medsolvedynamics.com | [email protected]

Jeff Siupik, 35 years in oncology operations, on where volume responsibility actually belongs in a healthy program. The C-suite looks at P&L. The clinical team looks at compassionate care. Where leaders most often misallocate the volume expectation, and where it should sit instead.Full episode: https://youtu.be/9bPM8rjsv6Ymedsolvedynamics.com | [email protected]#RadiationOncology #OncologyLeadership #HealthcareExecutive #OncologyOperations

Yoel Bakas sits down with Jeff Siupik, a healthcare executive with 35 years in oncology operations and 25 years in oncology leadership. Jeff has put in eight to ten linear accelerators across his career, led oncology programs through every reimbursement shift since the early 1990s, and currently oversees operations across a multi-program system.The conversation walks through the actual job of an oncology administrator in 2026.The balance between growth and expense control. Why P&L looks worse before it looks better when a program is in growth mode, and what most administrators are explaining to finance committees right now.How to read your operation when the metrics look green. The stoplight framework Jeff uses for evaluating efficiency, and why a green department can still have staff running in the red line of mental capacity.The disconnect between the C-suite and the clinical team. Where volume responsibility actually belongs in a healthy program, and where leaders most often misallocate it.Capital decisions in radiation oncology. What separates the programs that get capital right from the ones that do not. Service contracts, software licensing, the ongoing-cost trap, and creative offsets like block leases.AI in oncology operations. A pragmatic take on what AI is actually doing in cancer programs right now versus what is being pitched. Where AI creates time, where it slows things down, and how to think about the patient-side implications.A worked example of how a leadership team handles competing capital requests across service lines, and why “every specialty feels their request is the highest priority” is the room every administrator is in.Yoel and Jeff have known each other for over a decade across the vendor and operator sides of radiation oncology. This is operator-thinking from someone who has lived the job.22 minutes. Worth the time for any administrator, medical director, or system executive running an oncology program in 2026.Medsolve Dynamics: medsolvedynamics.com Reach the team: [email protected]#RadiationOncology #OncologyLeadership #CapitalStrategy #HealthcareExecutive #OncologyOperations

Hiring and retention decisions are landing on the same desks as AI tool decisions, often in the same week. After 20 years on the vendor side, here is the discipline most programs are missing: the same questions you would ask of any capital line, applied to the people on the team and the tools being sold to replace them. medsolvedynamics.com | [email protected]#RadiationOncology #OncologyLeadership #StaffPlanning #FinancialStrategy

From the Medsolve Dynamics conversation with Heather Turner, radiation oncology operator with 14 years from therapist to director. The contracts are not the problem. The autopilot is. medsolvedynamics.com | [email protected]#RadiationOncology #ServiceContracts #VendorNegotiation #OncologyLeadership

The economic case for a LINAC purchase rarely fails at signature. It fails in years two through eight, when the bundled add-ons start collecting service contracts and software renewals. After 20 years on the vendor side, here is what the inside of that conversation looks like, and why bundles are designed exactly this way. medsolvedynamics.com | [email protected]#RadiationOncology #LINAC #CapitalStrategy #VendorNegotiation #OncologyLeadership

Most oncology capital and service negotiations are decided before anyone sits down. Vendor teams map your budget range, rehearse responses to your objections, and identify pricing flexibility they never surface unless you ask the right way.Yoel Bakas spent 20+ years on the vendor side of those conversations at Varian, GE HealthCare, ViewRay, and Mevion before founding Medsolve Dynamics. In this short, he lays out what actually happens in the prep call two days before your meeting, and why harder negotiating rarely changes the outcome.Medsolve Dynamics is a vendor-neutral oncology consulting firm built for programs navigating margin pressure, capital scrutiny, and AI overload.medsolvedynamics.com [email protected]#RadiationOncology #CapitalStrategy #VendorNegotiation #LINAC #OncologyLeadership

After 20 years on the vendor side of oncology at GE HealthCare, ViewRay, and Varian, Yoel Bakas launched Medsolve Dynamics to work from your program side. In this episode, he walks through what Medsolve actually does: capital strategy on LINAC and theranostics purchases, service contract renegotiation before escalator clauses compound, financial case building for theranostics and benign disease service lines before capital is committed, and AI and software evaluation on clinical value and ROI rather than vendor claims. If you have a capital decision, a service contract renewal, a new service line, or an AI evaluation in front of you right now, this is who Medsolve was built for. LINAC capital strategy, oncology vendor negotiation, radiation oncology service contracts, theranostics service line, benign disease radiation therapy, AI in oncology, hospital operations. medsolvedynamics.com | [email protected]

Most oncology service contracts renew automatically unless a specific window is used to renegotiate. Yoel Bakas, founder of Medsolve Dynamics, walks through the specific mechanics of a renewal clock that most program administrators miss until it has already closed — and what a single overlooked provision on page 7 cost one cancer program. Twenty years on the vendor side of oncology means knowing where the escalators, auto-renewals, and quiet cost increases are written into the fine print, and where the leverage lives before the next signature. LINAC service contracts, oncology service renewal, radiation oncology operations, capital strategy. medsolvedynamics.com | [email protected]

The conversation highlights the pitfalls of AI procurement, the consequences of procurement failure, misleading claims in AI sales, and key questions for procurement. It emphasizes the importance of considering adoption requirements and the impact on workflow when purchasing AI solutions.TakeawaysProcurement failureAdoption [email protected]

The conversation explores the critical question of whether decisions hold up at 80% of the current reimbursement, emphasizing the importance of considering this in every capital decision and service renewal.TakeawaysFinancial decisions must consider sustainability at 80% reimbursementEvery purchase decision should be evaluated based on sustainability at 80% [email protected]

A physicist's excitement about a new tool without a clear problem to solve.TakeawaysTool adoption without a clear problemThe allure of new [email protected]

Preparation and Anticipation in NegotiationsTakeawaysPreparation is keyAnticipate [email protected]

The conversation explores the impact of contracts on margins and highlights the importance of paying attention to contract details, especially key provisions that can have a significant financial impact.TakeawaysContract provisions can have significant financial impactImportance of paying attention to contract detailsmedsolvedynamics.com [email protected]

The conversation emphasizes the importance of answering key questions before requesting a quote from a vendor, highlighting the vendor's influence on unanswered questions and the significance of defining the problem before pricing. It also mentions an upcoming presentation at the AMAC® Spring Symposium.TakeawaysAnswer key questions before engaging with vendorsDefining the problem before pricing is [email protected]

Heather Turner has 14 years of experience in radiation oncology. Radiation therapist, operations manager for a new cancer center build, director. In this conversation she and Yoel Bakas talk about the real challenges programs are navigating in 2026. Staffing shortages across therapists, dosimetrists, physicists, and physicians. Workflow breakdowns between radiation oncology, medical oncology, and imaging. The administrative burden of prior authorization. AI tools being purchased before the problem is defined. Service contracts that have not been reviewed since signature. And the pressure of buying equipment when reimbursement just changed the math. [email protected] #RadiationOncology #OncologyOperations #OncologyLeadership #HealthcareStrategy #VendorNegotiation #CapitalStrategy #Theranostics #HospitalOperations

In the context of radiation oncology capital conversations, the focus on price often overshadows other critical factors such as service coverage, software license terms, training, and delivery timelines. Vendors have already modeled the price negotiation and have a floor in mind, leading to a conversation that stays within their designed model.TakeawaysPrice conversation overshadows critical factorsVendors have already modeled price negotiation

Understanding the key provisions in a service contract is crucial to avoid financial losses and unexpected escalations. Four common provisions, including the Evergreen Clause, CPI escalator, bundled software license, and Uptime SLA Definition, can have significant financial implications if not carefully reviewed and understood.TakeawaysKey provisions in service contracts can have significant financial implications.Reading and understanding the entire contract before renewal conversations is crucial.

The conversation delves into the asymmetry in sales conversations, the structural information asymmetry, and the need for program leaders to have support when navigating major capital decisions or service contract renewals.TakeawaysSales conversations are characterized by asymmetryProgram leaders need support in major decisions

Customer experience drives 53% of purchase decisions, not clinical superiority. This is particularly relevant for radiation oncology programs. Programs that document performance gaps can negotiate from a position of strength.TakeawaysCustomer experience is a key factor in purchase decisionsDocumented performance gaps empower negotiation

The conversation delves into the misconceptions and limitations of requesting a quote from a vendor, highlighting the importance of defining success and the problem before engaging in pricing discussions.TakeawaysVendor PerspectiveImportance of Defining Success

Understanding the margin structure of LINAC service contracts and its impact on negotiations.TakeawaysService contracts are highly profitable for vendors.Knowing the margin structure can impact negotiation outcomes.

Oncology programs often have service contracts with major vendors, but lack active tracking of vendor performance. Key performance indicators (KPIs) such as uptime guarantees, response times, maintenance windows, and parts availability are critical levers for negotiation. Documented performance gaps lead to better outcomes than frustration-driven interactions. Leveraging contracts and KPI tracking is essential for program success.TakeawaysVendor performance tracking is crucialDocumented performance gaps lead to better outcomes

The conversation highlights the significant impact of budget cuts on oncology programs, particularly on capital decisions, pre-approved purchases, and service line expansion. It emphasizes the need for reevaluating assumptions and conducting a rigorous review of budget numbers in response to budget cuts.TakeawaysBudget cuts impact capital decisionsReevaluation of assumptions is crucial

The conversation explores the challenges of using AI tools developed by vendors and the importance of understanding support mechanisms. It emphasizes the need to evaluate support gaps before signing up for AI or software solutions.TakeawaysVendor support for AI toolsUnderstanding support mechanisms

The conversation delves into the misconceptions and limitations of requesting a quote from a vendor, highlighting the importance of defining success before engaging in pricing discussions.TakeawaysVendor PerspectiveImportance of Defining Success

The challenges of operationalizing clinical plans and the impact of supply chain disruptions on service lines. The importance of ownership and preparation in the successful launch of new initiatives.TakeawaysOperational challenges impact service linesPreparation and ownership are crucial for successful launches

The conversation covers the importance of starting AI adoption with math, validating model accuracy, challenges with benchmarks, the review and sign-off process, and the impact of AI on business. It emphasizes the need to ask questions before signing AI paperwork to ensure it drives positive change.TakeawaysAI adoption starts with mathValidate model accuracy on relevant dataBenchmarks may not reflect your practiceConsider who needs to review and sign offAI should drive change, not just add costAsk questions before signing AI paperwork

Preparing for a capital meeting involves understanding the negotiation structure and being aware of vendor flexibility. Medsolve can assist in navigating this process effectively.TakeawaysNegotiating within a structured frameworkVendor flexibility and pricing tiers

The conversation covers the importance of understanding and defining constraints, negotiating leverage, and the role of Medsolve in providing a second set of eyes on constraints.TakeawaysDefine your constraintsLeverage comes from understanding and defining your constraints

The conversation covers the preparation for a capital meeting, understanding likely objections, rehearsed responses, negotiating within a pre-mapped structure, negotiating blind, and the value of Medsolve in negotiations.TakeawaysPreparation is key to successful negotiationsUnderstanding the structure of negotiations is crucial for effective outcomes.

Negotiating with vendors requires a deep understanding of business assumptions and leverage points. Preparation is key to successful negotiation.TakeawaysBusiness assumptions are crucialPreparation is key

The conversation discusses the importance of maximizing LINAC capacity and optimizing referral flow, scheduling blocks, and protocol discipline for revenue generation in disease treatments like osteoarthritis and plantar fasciitis.TakeawaysEfficient use of LINAC capacity is crucial for revenue generationReferral flow, scheduling blocks, and protocol discipline are key for revenue generation

The conversation explores the challenges and considerations related to the implementation of AI tools in programs. It delves into the evaluation framework, task automation, liability, KPIs for success, workflow changes, and the impact on schedule and review processes.TakeawaysAI tools require a clear evaluation frameworkWorkflow changes are essential for AI implementation

The conversation delves into the complexities of oncology capital deals, highlighting the root causes of failed negotiations and the importance of alignment between deal structure and program needs. It also explores the impact of incorrect assumptions on costs and the significance of vendor relationships in this environment.TakeawaysCapital negotiations root causesAlignment between deal structure and program needsOptimistic utilization projectionsVague service expectationsKPIs not tied to patient flowImpact of incorrect assumptions on costsImportance of vendor relationships

Yoel Bakas has experience on the vendor side, helping oncology program structure capital and service agreements. He emphasizes the importance of validating and aligning assumptions before committing capital, as fixing issues after Go Live is expensive.TakeawaysCapital and service agreements require multi-year operating commitmentsValidating and aligning assumptions before committing capital is crucial

The 2026 reimbursement change in radiation oncology has led to a focus on AI to protect margins and rebuild workflows. However, the trap lies in addressing downstream processes and avoiding bottlenecks.Takeaways2026 reimbursement changeAI to protect margins

The conversation discusses the positioning of benign disease as a stabilizer and the impact of referral behavior on machine utilization.TakeawaysBenign disease as a stabilizerReferral behavior impacts machine utilization

Theranostics in radiation oncology requires a deliberate design of operational infrastructure to ensure ownership, growth, and clinical opportunity. The alignment of theranostics with radiation oncology impacts scheduling, flow, waste protocols, and coordination across departments.TakeawaysOperational infrastructure is crucial for the success of theranostics in radiation oncologyTheranostics requires deliberate design and coordination across departments

The impact of thoughtful sequencing on technology success and failure.TakeawaysSequencing is crucial for technology successOperating model readiness is key for technology implementation

Capital decisions often fail due to unvalidated assumptions and lack of reflection of reality. The fix is to validate reality before locking decisions.TakeawaysUnvalidated assumptions lead to capital decision failuresValidate reality before locking decisions

Physicians are increasingly involved in capital decisions, impacting clinic autonomy and program success. Clinical decisions now affect workflows, coverage models, and daily possibilities. Physicians need to translate clinical intent into operational and financial implications to ensure program sustainability.TakeawaysPhysicians' involvement in capital decisions impacts clinic autonomy and program success.Physicians need to translate clinical intent into operational and financial implications for program sustainability.

Yoel Bakas discusses his focus on the conversations at ACRO and the challenges in healthcare administration, including capital plans, AI investments, and margin pressure.TakeawaysACRO conversationsChallenges in healthcare administration

The conversation delves into the multifaceted nature of margin target challenges in oncology programs, highlighting the various factors that contribute to missed targets. It also emphasizes the importance of recognizing that growth failure is often a result of execution issues rather than the failure of the growth strategy.TakeawaysMultiple factors contribute to missed margin targets in oncology programs.Growth failure is often a result of execution issues, not the failure of the growth strategy.

The conversation delves into the impact of the reimbursement change on capital plans and the hidden strategy gap in growth plans. It also explores the need for a sanity check in response to the changing landscape of healthcare delivery.TakeawaysReimbursement change impactHidden strategy gap

Yoel Bakas has spent 20 years in the medtech industry, focusing on structuring complex medtech deals and ensuring technology investments are mathematically successful. He shares a success story of unlocking $3 million in capital savings for a client and emphasizes the importance of preserving vendor relationships while ensuring hospital solvency. He expresses gratitude to his network and invites introductions for those navigating clinical ambition and financial pressure. The next chapter for Medsolve Dynamics is just beginning.TakeawaysMedtech deal structuringClosing the gap between ROI and P&LPreserving vendor relationships