PAC & Forth

Why does your premium keep climbing even in a clean year?In this episode of PAC & Forth, we sit down with Vincent Catalano, Founder and CEO of Clear Healthcare Solutions. Vincent brings decades of experience in employee benefits and insurance brokerage and now helps organizations manage cost and strategy across health care.We unpack:How brokers actually get paid, and why flat percentage commissions give them a raise when premiums rise.Why small practices under 20 employees have almost no negotiating power in the ACA risk pool.PEOs, level-funded plans, and the tools small practices can use to take back control.The rise of direct primary care and why employers are routing around traditional insurance.A no-nonsense look at the misaligned incentives baked into how benefits are bought and sold.For any physician who pays for benefits and wonders where the money actually goes, this is a must-listen.Tune in to hear how a longtime insider thinks physicians can start winning the benefits conversation.

What does it take for a physician to finally say enough?In this episode of PAC & Forth, we sit down with Dr. Todd Otten, board-certified family physician, former U.S. Navy flight surgeon, co-author of Ripple of Change, and executive producer of the documentary Suck It Up, Buttercup. After two decades in practice and his own experience with burnout, Dr. Otten is one of the most candid voices on what is breaking the people who deliver care.Dr. Otten shares:The moment he walked away from a 13-year practice and what it taught him about moral injury.Why the "quadruple aim" must include the well-being of those providing care.Physician suicide, the stigma around getting help, and why speaking up feels risky.Direct primary care, Mark Cuban Cost Plus Drugs, and the workarounds physicians are building.A raw, honest look at what corporate medicine costs the people inside it. If you've ever wondered why so many physicians are quietly stepping back from medicine, or what it would take to bring them back, this conversation is for you.Tune in to hear why change starts with physicians willing to draw a line in the sand.

What if staying independent didn't have to mean going it alone?In this episode of PAC & Forth, we sit down with Tyler Tracewski, President of Astrana Care Partners, to unpack PAC's new collaboration with Astrana and what it means for independent primary care physicians navigating Medicare's shift to value-based care.This episode dives into:What an Accountable Care Organization (ACO) is, how shared savings work in traditional Medicare, and why Astrana's model carries no downside risk for participating physiciansThe real financial picture: in 2024, participating providers supplemented their fee-for-service income by an average of 50%, with top performers more than doubling itWhy independence is protected in this model, with no changes to clinical workflows, networks, or patient choiceHow prior authorization, reporting, and administrative burdens get absorbed by the ACO so the practice doesn't carry themHow independent physicians can join Medicare's value-based future without giving up autonomy, taking on risk, or adding to their administrative load. Tyler shares Astrana's track record of shared savings and why its wraparound model is built to keep small practices independent.For any primary care physician trying to stay independent in a consolidating system, this is essential listening.Tune in to hear what value-based care looks like when it's built around the physician, not the payer.

What happens when TikTok becomes your second opinion?In this episode of PAC & Forth, we sit down with Dr. Hailey MacNear, OB-GYN and partner at Sacramento Women's Health, for an honest conversation about health misinformation, patient trust, and the growing challenge of navigating medicine in the age of social media, from menopause advice on Instagram to "doctor versus Google" debates in the exam room.This episode dives into:Why patient research can be helpful and when it becomes a barrier to careThe biggest myths she wishes patients would stop believingHow social media has fueled anxiety around perimenopause and menopauseWhy so much online "health advice" is really just marketing in disguiseHow private practice creates stronger physician-patient trustThe balance between patient autonomy and good medical careThis episode explores how physicians can build relationships with their patients strong enough to cut through noise, fear, and bad advice. It's about getting back to what medicine should be: trust, expertise, and real conversation.If you care about women's health, private practice, and how physicians can navigate a world where everyone has "done their own research," this episode is a must-listen.

In this episode of PAC & Forth, we go inside the Capitol with John Latimer, founder and managing partner of Capital Advocacy — one of Sacramento’s most influential lobbying firms — for a no-nonsense look at how decisions really get made.This conversation pulls back the curtain on:Why health care policy is dominated by big institutions — and how smaller voices can still break throughThe real meaning of “affordability” in Sacramento (and why it’s more complicated than it sounds)How California’s budget deficit is already reshaping health care debatesWhat the next governor’s race could mean for single-payer, access, and qualityWhy grassroots physician voices matter more now than everA candid, insider’s view of power, politics, and persuasion and how independent physicians can stop being spectators and start being heard.If you’ve ever wondered why common-sense health care fixes are so hard to pass or how PAC turned a brand-new association into a legislative win, this episode is essential listening.

In this episode of PAC & Forth, we’re joined by Dr. Lamia Gabal, board-certified urologist, founder of Prestige Medical Group, and PAC board member, for one of our most honest and human conversations yet.Dr. Gabal shares:Her family’s immigrant journey and how it shaped her drive as a physician and entrepreneurWhy she chose private practice and why so many doctors no longer canThe hidden administrative and financial pressures squeezing independent physiciansHow insurance practices like downcoding and prior authorization delay care and raise costsWhy autonomy in medicine is about doing what’s right for patientsWhat it’s really like being a woman building a business in a male-dominated specialtyThis episode blends policy, practice, and personal experience, from the exam room to the Capitol, and makes clear what’s at stake if independent medicine disappears.If you care about patient choice, physician leadership, and preserving a healthcare system that values relationships over volume, this is a must-listen.Tune in to hear why independence still matters.

In this episode of PAC & Forth, we sit down with Assemblymember Damon Connolly, author of AB 2457, PAC-sponsored legislation that builds on last year’s credentialing reform by extending it to Medi-Cal managed care plans.This conversation gets into:Why AB 2457 is the logical next step after AB 1041How credentialing delays create real barriers to care in rural and underserved communitiesWhy physician shortages and reimbursement challenges hit Medi-Cal patients especially hardHow Sacramento is thinking about health care access amid federal funding threatsWhat lawmakers need to hear from physicians to move policy across the finish lineWhy fixing administrative bottlenecks can be one of the most practical ways to improve careTune in to hear a broader conversation about access, affordability, and whether California can keep moving forward on health care at a moment of real uncertainty.

In this episode of PAC & Forth, we break down AB 1041, PAC’s first sponsored legislation, and the real-world problem it was designed to solve: broken, slow, and inconsistent provider credentialing that delays patient access to care.Joining us are Dr. Join Luh, radiation oncologist in Eureka, and Flo Di Benedetto, PAC’s General Counsel and former Chief Legal Officer at Sutter Health. Together, they unpack how credentialing delays were impacting independent physicians and why reform was long overdue.This conversation explores:How credentialing delays of 6–12 months kept physicians from seeing patientsWhy independent doctors were disproportionately burdenedWhat AB 1041 changes, including clear timelines and provisional approvalsWhat physicians must do now to stay compliant and take full advantage of the reformLearn about access to care, workforce shortages, and making sure red tape doesn’t stand between patients and treatment.

In this episode of PAC & Forth, we’re joined by two veterans of California politics — Andrew Acosta and Rob Stutzman — who have shaped some of the state’s biggest campaigns, from the historic 2003 recall to statewide ballot fights and major policy battles.This conversation pulls back the curtain on:Why the 2026 governor’s race has no clear frontrunner and why that mattersHow California’s open primary could produce unexpected outcomesThe real political power of affordability, homelessness, and crimeWhether single payer and health care expansion still have political momentumWhy structural budget deficits make big promises harder to keepWhat independent physicians and small businesses should be watching closelyIf you want to understand where Sacramento is headed and how that direction will affect access to care, reimbursement rates, and the future of private practice, this episode is essential listening.

PAC & Forth is a podcast about the forces shaping health care in California and the people working to change it.Produced by the Physician Association of California and hosted by PAC CEO, Matthew Robinson, PAC & Forth brings together physicians, policy insiders, advocates, and industry leaders for candid conversations about independent medicine, health care policy, and the real-world impact of decisions made in Sacramento.A practical, grounded discussion from people on the front lines, in exam rooms, boardrooms, and the Capitol.Whether you’re a physician, policymaker, health care professional, or someone who simply cares about the future of patient-centered care, PAC & Forth offers insight, perspective, and a seat at the table.

What happens when doctors lose the freedom to treat patients the way they believe is right?In our very first episode of PAC & Forth, we sit down with Dr. Omer Deen, nationally recognized clinical nutrition expert, private practice physician, and Chair of the Physician Association of California, for a candid conversation about healthcare in California.We unpack:Why private practice physicians are vanishing and what’s driving them outHow declining reimbursements and growing bureaucracy are impacting patient careWhy “more efficiency” in healthcare often means less time with your doctorHow policy decisions in Sacramento directly affect access, quality, and trustWhat real advocacy looks like and why physicians can’t stay on the sidelinesAutonomy, access, and the future of the doctor-patient relationship, told by someone living it every day.If you care about healthcare that’s personal, accountable, and centered on patients, this conversation is for you.Listen now and join the conversation!