Podnosis

The U.S. is facing a rapidly aging population alongside a dearth of primary care physicians, who play a crucial role in catching health issues early and keeping costs low. Everyone agrees technology should play a role in filling care gaps, but where its value truly lies is up for debate. Senior Writer Anastassia Gliadkovskaya talks to David Carmouche, M.D., chief medical and commercial officer of Lumeris, a health tech company that supports providers. Carmouche shares creative ways providers can use technology more effectively and the payment models needed to support those efforts long term. He also discusses lessons learned from leading Walmart Health centers, which shuttered in 2024, and his current work on a federal healthcare advisory committee to the Department of Health and Human Services. To learn more about the topics in this episode:  Walmart Health's shutdown underscores major challenges for retail health 'disruptors' Weekly Rundown: Lumeris adds symptom-checking tool to AI platform; DeepIntent rolls out agentic AI t…  Primary care is in trouble. So doctors band together to boost their market power  See omnystudio.com/listener for privacy information.

This podcast episode is sponsored by Johnson & Johnson and Legend Biotech. Dr. Paresh Patel and multiple myeloma patient Julia P. have been compensated by Johnson & Johnson and Legend Biotech for their time to participate in this podcast. In this episode of Podnosis: The Pulse of the Healthcare Industry, listeners hear a candid conversation about multiple myeloma from the patient and physician perspectives. A patient who underwent CAR-T therapy and her community oncologist, Dr. Paresh Patel, share how early education, trust and collaboration shaped her treatment journey. The patient walks through her experience from diagnosis to CAR-T, describing how informed decision-making and self-advocacy helped her navigate an evolving treatment landscape. She reflects on the emotional and practical challenges of multiple myeloma therapies, the importance of caregiver support and what the possibility of a treatment-free interval meant to her. Dr. Patel discusses the role of community oncologists in managing complex diseases like multiple myeloma, emphasizing why CAR-T should remain part of the treatment conversation early on. He explores timing, referral considerations and the value of clear communication as patients move between local care and specialized centers. At its core, this episode is about partnership and what is possible when patients and care teams navigate complexity together.See omnystudio.com/listener for privacy information.

Consumer wearables are popular for a reason. People like to have their health data on demand. These insights can encourage healthy habits and may flag early signals of an underlying illness. The problem is interpretability. Without a doctor’s input, many people are left to puzzle over their results and what they imply. Timely medical advice is important, yet often missing. Reperio Health aims to address that gap. It combines at-home health screenings, an app and virtual clinical visits to help patients make sense of it all. Senior Writer Anastassia Gliadkovskaya sits down with Reperio’s co-founder and CEO, Travis Rush, to explain. To learn more about the topics in this episode:  At-home testing company Reperio teams up with Amazon One Medical on preventive care Doctronic, Simple HealthKit partner to connect at-home screening with AI-powered clinical care Noom launches at-home biomarker test kit for metabolic health monitoring  See omnystudio.com/listener for privacy information.

Elevated medical costs and policy turmoil continued to affect the financial performance of payers and providers in the second quarter. Providers are still feeling the sting of fluctuations in ACA plan enrollment, while payers pointed to the No Surprises Act’s arbitration process as a major challenge. Fierce Healthcare editor Dave Muoio and senior writer Paige Minemyer sit down for another deep dive into the biggest trends emerging from second-quarter earnings calls. To learn more about the topics in this episode:  Insurers see positive results in managing health costs in Q2 Ardent Health offsets Q2 volume stumble by tightening costs, renegotiating contracts CVS enhances supports for patients taking GLP-1s Universal Health Services tops Q2 expectations, but dials back full-year earnings Tenet Healthcare shrugs off ACA headwinds with sweeping Q2 outperformance, boosts 2026 guidance HCA Healthcare's H1 ACA volume dropoffs 'almost one for one' shifted to uninsurance UnitedHealthcare exec says 'ineffective' No Surprises Act IDR process demands reform See omnystudio.com/listener for privacy information.

Multiple sclerosis is a chronic autoimmune disease that requires proactive early intervention and treatment to achieve the best long-term outcomes. But recommendations for MS patients who are pregnant can be murky. Driven by knowledge gaps and concerns about the effects of disease-modifying therapies on the fetus, providers have often advised MS patients not to become pregnant. However, emerging research shows that patients can safely continue certain MS medications during pregnancy. Katrina Bawden, a family nurse practitioner and MS-certified nurse at Rocky Mountain MS Clinic, is working to fill the research gap by tracking pregnancies among women with MS. She discusses the outcomes she is seeing with Senior Writer Anastassia Gliadkovskaya. To learn more about the topics in this episode:  'We want to feel heard': Jamie-Lynn Sigler on how pharmas can better serve patients As Roche eyes busy 2026, Vabysmo undershoots targets and Tecentriq fails early lung cancer study  Fewer than 1% of clinical trials in the US include pregnant patients, study finds See omnystudio.com/listener for privacy information.

It’s no secret that healthcare is complicated. Patients face escalating costs and significant complexity as they try to navigate their own health journeys. That’s why CVS Health is making significant investments to improve the consumer experience and simplify patients’ interactions with the healthcare system. Amy Compton-Phillips, M.D., the company’s chief medical officer, joins senior writer Paige Minemyer to unpack initiatives such as CVS Health 100 and discuss what the ideal patient experience might look like. To learn more about the topics in this episode:  CVS unveils Health 100, its new Google-powered consumer engagement platform A look at how CVS is leaning on 'agentic twins' in developing consumer tech Inside Aetna's investments to build provider trust Consumers' satisfaction with health plan apps improves with familiarity: JD Power See omnystudio.com/listener for privacy information.

In this sponsored episode of Podnosis, host Irena Luo speaks with Patrick Velliky, chief external affairs officer at HaloMD, about the No Surprises Act and the ongoing challenges surrounding the independent dispute resolution process. Velliky reflects on the original expectations behind the legislation, including the goal of creating a fair arbitration framework where insurers and providers could resolve payment disputes in good faith. He discusses concerns that have emerged around arbitration award payments, highlighting how delayed or missing payments can affect providers despite favorable rulings. The conversation examines potential enforcement pathways, including regulatory oversight and bipartisan legislative proposals intended to address compliance gaps and establish clearer penalties. Velliky also shares his perspective on the financial pressures facing physician practices and how reimbursement challenges may influence healthcare consolidation trends. Listen in for an expert discussion on the evolving implementation of the No Surprises Act, the future of IDR enforcement and what these developments could mean for providers, payers and patients.See omnystudio.com/listener for privacy information.

Despite the importance of prenatal care, recent CDC data show that access is declining. Fewer women are beginning prenatal care in the first trimester, while the share starting later in pregnancy or receiving no prenatal care is rising. Unified Women’s Healthcare supports women’s health practices and provides fertility services, maternity analytics, care coordination and other technology-enabled services. The company is exploring how those tools can help patients enter care earlier and receive more tailored support throughout pregnancy. Unified Chief Medical Officer Elizabeth Cherot, M.D., joins Senior Writer Anastassia Gliadkovskaya to discuss the company’s approach, the barriers keeping patients from prenatal care and the role technology can play in expanding access. To learn more about the topics in this episode:  Family health provider Nest Health launches in-home prenatal services  Why UnitedHealth Group is betting big on doulas Wavelet Medical, Aegis Ventures partner on first AI non-invasive fetal EEG monitoring platform New Medicaid-focused doula provider Malama launches with $9.2M  See omnystudio.com/listener for privacy information.

As healthcare organizations look to ease clinician burden and improve care delivery, health IT is becoming a strategic lever, not just an operational tool. In this episode of Podnosis, Chad Dodd, vice president of product management at Athenahealth, shares a practical perspective on how technology can address some of the industry’s most persistent workflow challenges. Dodd explains how AI-powered documentation, automated insights and emerging agent-based tools can help reduce administrative friction while giving clinicians more time to focus on patients. He also outlines where technology has limits, including workforce shortages, reimbursement pressures and other systemic issues that require broader industry action. A central theme is the importance of clinician-led innovation. Athenahealth’s development model brings clinicians, engineers and data scientists together to build tools that reflect real workflows rather than adding complexity to them. The conversation also explores why trust, transparency and optionality are essential to AI adoption. For healthcare leaders, technology stakeholders and anyone shaping the future of care delivery, this episode offers a grounded look at how health IT can move from promise to practical impact. Click play to hear how clinician collaboration is redefining the next era of healthcare technology.See omnystudio.com/listener for privacy information.

For millions of people, AI chatbots have become a new front door to health information. More than 230 million people use ChatGPT each week for health and wellness questions. With healthcare now OpenAI’s biggest and fastest-growing use case, the company is making a major push into the sector, rolling out enterprise tools for hospitals and personal health assistants for consumers. OpenAI has set a bold goal of ensuring that AI “improves health for all humanity,” and Karan Singhal is driving that work. A leading artificial intelligence researcher who previously worked at Google, Singhal joined OpenAI two years ago as head of Health AI and Artificial General Intelligence. His team is focused on improving the quality of ChatGPT’s health-related responses. In a wide-ranging interview with Executive Editor Heather Landi, Singhal shared his perspective on why healthcare is a strategic priority for OpenAI and how the company is rapidly improving its health capabilities. He makes the case for AI becoming a “silent background companion” for clinicians and patients and explains how it can serve as a bridge in a fragmented healthcare system. To learn more about the topics in this episode:  OpenAI launches ChatGPT for Clinicians, a free AI tool for physicians, NPs and pharmacists OpenAI acquires healthcare startup Torch to build out ChatGPT Health OpenAI launches ChatGPT Health to connect data from health apps, medical records AI chatbot use for health information up 16% from 2024: Rock Health survey 40M people use ChatGPT to get answers to healthcare questions, OpenAI says See omnystudio.com/listener for privacy information.

Artificial intelligence is here to stay, and physicians should be learning how to use it thoughtfully. That’s the argument Shawn Martin, CEO of the American Academy of Family Physicians, makes in a conversation with Senior Writer Anastassia Gliadkovskaya. Martin discusses the findings of a recent AAFP survey on clinician AI use, why primary care is especially ripe for tech disruption and what physicians should be doing now to understand and responsibly deploy AI. To learn more about the topics in this episode:  Primary care doctors say AI saves time and helps them provide better care: survey AI playing a major role in consumers' healthcare decision-making, survey finds  Perplexity rolls out AI-powered medical records search; Doximity survey examines how docs use AI See omnystudio.com/listener for privacy information.

A new value-based care program for chronic condition management begins July 5. The Advancing Chronic Care with Effective Scalable Solutions Model, or ACCESS, offers vendors outcome-aligned payments for managing qualifying chronic conditions. In total, 150 digital health companies are participating, including some in the behavioral health track. How does behavioral health fit into ACCESS, and what types of services are participants offering? Senior Writer Anastassia Gliadkovskaya talks with two behavioral health companies about the elements needed for success and what the model signals about where payments for these services could be headed. First, you’ll hear her conversation with Wes Knepper, vice president of clinical excellence at SonderMind. Then, you’ll hear her conversation with Jenna Glover, Ph.D., chief clinical officer at Headspace. To learn more about the topics in this episode:  A deeper dive into the ACCESS Model—Who’s participating, potential headwinds and how it could spur h…  CMS taps 150 digital health companies, providers for ACCESS Model  See omnystudio.com/listener for privacy information.

Cybersecurity has long been a priority for hospitals, but the risks are shifting as AI, biometrics and digital identity tools become more deeply embedded in care delivery. For health systems, the challenge is not just keeping hackers out. It is making sure clinicians can quickly access the tools they need while guarding against new threats, including AI agents that can move through systems at machine speed. Senior Writer Anastassia Gliadkovskaya talks with Sean Kelly, M.D., chief medical officer of Imprivata, a digital identity security company, about why hospitals need to rethink access management, treat AI as a high-risk third party and build stronger guardrails around the vendors and tools connecting to their systems.  To learn more about the topics in this episode:  An emerging cyberthreat: vishing  ECRI flags misuse of AI chatbots as a top health tech hazard in 2026 How healthcare ransomware attacks shifted in 2025  See omnystudio.com/listener for privacy information.

Life insurance may not be the first thing that comes to mind when thinking about healthcare. But some life insurers are increasingly interested in incentivizing healthy habits. John Hancock has invested in its health and wellness program for more than a decade. The program’s goal is to reward policyholders for things like exercise and preventive health screenings. There’s actually a simple business rationale behind this approach. To explain, Senior Writer Anastassia Gliadkovskaya talks with John Hancock CEO Brooks Tingle. To learn more about the topics in this episode:  Mercer survey: Employers eye cost-shifting strategies as health benefit spend rises Only 1 in 4 employers able to ‘absorb’ increasing health benefit costs without impacting business  See omnystudio.com/listener for privacy information.

As healthcare costs rise and access challenges persist, health plans face growing pressure to engage members more effectively. Employers and plan sponsors expect their plans to play a critical role in that effort. In this episode of “Podnosis,” Senior Writer Paige Minemyer talks with Dan Kueter, CEO of UnitedHealthcare Employer & Individual, about what employers are asking for in today’s commercial insurance market and how UnitedHealthcare is using digital tools, AI and more personalized benefit design to support member engagement. Kueter also discusses the push for greater affordability, the role of consumer choice and where he sees the employer-sponsored insurance market heading as health plans look to bring more customization into the member experience. To learn more about the topics in this episode:  UnitedHealth Group spotlights AI investments as part of operational turnaround A look at how UnitedHealthcare is developing, deploying AI solutions UnitedHealthcare unveils direct-to-consumer tool to shop for health and wellness programs Claims for younger adults are on the rise: UnitedHealthcare, HAC study See omnystudio.com/listener for privacy information.

What does the Department of Health & Human Services’ Office of Inspector General do? Today, Senior Writer Anastassia Gliadkovskaya sits down with Assistant Regional Inspector General Scott Perry to find out. They dive into the agency’s work, the findings of a few recent audits and what providers can do to ensure they are in compliance. The latest inpatient rehab facilities report discussed in this episode can be found here. The hospital compliance report can be found here. A general compliance guide is also available. To learn more about the topics in this episode:  OIG: Jury still out on impacts of vertical consolidation in Part D More than half of patient harm events missed by hospital surveillance systems: HHS OIG OIG: Medicare Advantage, Medicaid managed care plans often offer limited behavioral health networks See omnystudio.com/listener for privacy information.

It’s been more than two years since Eli Lilly announced LillyDirect, a platform that combines telehealth and pharmacy services to provide access to Lilly’s portfolio of diabetes, migraine and obesity medications. The goal is to offer a more transparent and affordable way to access certain drugs. The platform has quickly drawn attention from both consumers and lawmakers. To understand LillyDirect’s growth and where it’s headed, Senior Writer Anastassia Gliadkovskaya spoke with Jen Mazur, senior vice president and general manager of U.S. LillyDirect and Consumer Services. To learn more about the topics in this episode:  Eli Lilly launches oral GLP-1 drug across US through Lilly Direct, telehealth providers Lilly makes website to simplify access to obesity drug Zepbound, plus diabetes and migraine meds 'Abuse of power': Senators call out 'shady tactics' after investigating Pfizer, Lilly DTC platforms  See omnystudio.com/listener for privacy information.

Is AI in health care overhyped — or underutilized? In this sponsored episode of Podnosis, host Irena speaks with Sanjay Subramanian, SVP & Head of Healthcare Payer Business at Cognizant at Cognizant, about where artificial intelligence is delivering measurable ROI today and why many organizations struggle to scale adoption. Sanjay explains that back‑office functions such as claims processing, prior authorization and revenue cycle management are seeing the strongest results, thanks to data‑rich workflows and clear operational metrics. He also outlines why more complex use cases, including autonomous clinical decision‑making, remain constrained by fragmented data, regulatory requirements and trust challenges. The discussion explores common mistakes leaders make when funding AI initiatives, including chasing disconnected use cases, underestimating data readiness and focusing on pilots instead of enterprise outcomes. Looking ahead, Sanjay describes how connected intelligence, responsible AI governance and human‑in‑the‑loop models will shape the next phase of health care transformation — and why AI’s future lies in augmenting decision‑making, not replacing it.   Guest Bio Sanjay Subramanian is a transformational leader with over 29 years of expertise in profit and loss management, sales and delivery across management consulting, systems integration and outsourcing. He is recognized for guiding CXO clients through strategic business decisions and digital transformation, consistently delivering measurable outcomes in challenging environments. Sanjay has led successful turnarounds, managed large teams exceeding 5000 members and originated transformative outsourcing contracts totaling over $8 billion with Fortune 100 clients. His experience spans Asia Pacific, the UK and North America, across industries including healthcare, life sciences, automotive, manufacturing, retail, energy, utilities, transportation and logistics. He has built and scaled businesses, launched new consulting capabilities and enabled cross-functional collaboration among diverse stakeholders. Sanjay brings a strong focus on client relationships and long-term value creation, supporting sustained growth across major global accounts.See omnystudio.com/listener for privacy information.

As almost 1 in 4 American teens identify as LGBTQ, affirming therapy can be life-saving. Yet availability is shrinking. Access to mental healthcare for LGBTQ youth dropped from 80% to 60% from late 2023 to late 2024, according to The Trevor Project. In 2025, though 84% of LGBTQ youth wanted mental healthcare, 44% could not get it.   In a recent collaboration between Fierce Healthcare and Uncloseted Media, Anastassia Gliadkovskaya and Sam Donndelinger dive into the barriers to mental health access for queer youth. In this week’s episode of “Podnosis,” they discuss their reporting process and introduce listeners to trans teens and the experts featured in the project. Read the full story at FierceHealthcare.com or UnclosetedMedia.com. To learn more about the topics in this episode:  The broken pipeline of mental healthcare for LGBTQ teenagers NYU Langone Health says it received grand jury subpoena over gender-affirming care Texas Children's Hospital agrees to launch nation's first 'detransition clinic' to settle state, DOJ investigation Executives examine the benefit of DEI practices for building trust in healthcare See omnystudio.com/listener for privacy information.

Payers and providers felt the upheaval and instability on the Affordable Care Act exchanges in the first quarter of this year. Marketplace plans saw significant enrollment declines alongside tier shifts, while providers felt the impact in both volumes and payer mix. Fierce Healthcare's Dave Muoio and Paige Minemyer sit down this week on “Podnosis” to break down those trends and other first-quarter throughlines, including the effect of winter storms on provider finances and signs of a rebound in Medicare Advantage. To learn more about the topics in this episode:  The ACA exchanges dominated Q1 earnings calls. Here's what payer, health system execs had to say Tenet Healthcare met Q1's volume curveballs with 'old-fashioned discipline' Cigna to exit ACA market, pursue strategic alternatives for eviCore unit Universal Health Services' Q1 2026 earnings growth dampened by volume hits Centene swings to $1.5B profit as Medicaid business improves even as ACA membership falls by 2 million HCA Healthcare executives shrug off Q1 volumes disruptions, reaffirm FY2026 guidance See omnystudio.com/listener for privacy information.

Fertility services—and conversations about them—are expanding across the U.S. But the sector remains underregulated, expensive and, in some cases, outdated. These factors are reshaping how Americans seek care, sometimes in ways that may put quality and safety at risk. Where are the biggest gaps? And what would make the system safer? Senior Writer Anastassia Gliadkovskaya breaks it down with Brian Levine, M.D., founding partner and practice director of CCRM Fertility of New York and founder of Nodal, a platform connecting surrogates and intended parents. To learn more about the topics in this episode:  Trump admin takes aim at the cost of IVF with new coverage guidance Women's health sector could grow to $600B industry by 2030: PwC report Emotional support crucial in addition to financial support for fertility journey, Maven finds See omnystudio.com/listener for privacy information.

In this sponsored episode of Podnosis, experts examine how molecular residual disease testing is transforming how clinicians assess recurrence risk in triple-negative breast cancer. Drawing on new data from the NSABP B-59 substudy presented at SABCS and AACR, the discussion highlights how circulating tumor DNA is providing earlier and more precise insight into patient outcomes.Dr. Priya Rastogi, chief medical officer of the NSABP Foundation, explains how MRD testing can detect residual disease that standard tools may miss, often months or years before clinical recurrence. The conversation explores key findings, including the strong correlation between post-surgical ctDNA positivity and recurrence risk, as well as the prognostic value of ctDNA status earlier in the treatment pathway.See omnystudio.com/listener for privacy information.

Condoms can be purchased almost anywhere, from big retailers to small convenience stores. The same can’t be said for female birth control. One company is trying to change that. Cadence OTC sells the morning-after pill, a cheaper alternative to Plan B. Recognizing that many communities in the U.S. are pharmacy deserts, the company is pursuing atypical distribution channels such as convenience stores and gas stations to get emergency contraceptives into the hands of more Americans. Cadence is also advocating for a daily birth control pill to be made available over the counter. Senior Writer Anastassia Gliadkovskaya sits down with Cadence OTC co-founder and CEO Samantha Miller to discuss how this approach could reshape reproductive healthcare and what policy and awareness challenges remain. To learn more about the topics in this episode:  Insurers not covering 12-month contraception supply as required: study The quiet collapse of America's reproductive health safety net Perrigo's over-the-counter birth control launch takes flight in the US Amid Trump victory, women's health providers see flood of orders for contraception, abortion pills See omnystudio.com/listener for privacy information.