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Value Based Care Advisory (VBCA) Podcast
by Carenodes
The VBCA Podcast is a solution-focused platform dedicated to advancing the transformation of healthcare through value-based care (VBC) models. Our mission is to break down complex healthcare topics into accessible, actionable insights for leaders, entrepreneurs, engaged consumers, and anyone passionate about meaningful change in healthcare. By challenging the healthcare industrial complex, we provide tools, strategies, and expert perspectives that empower our listeners to navigate and accelerate the shift toward better outcomes, lower costs, and improved patient experiences.Each episode delivers thought-provoking discussions and practical advice from industry experts, spotlighting innovative approaches to healthcare reform and highlighting voices that are often overlooked in traditional dialogues. Whether you're a healthcare executive, provider, payer, policy influencer, entrepreneur, or informed patient, we aim to inspire new ideas and support you in driving transformation in the hea
Episodes
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She Built a Peer Mentorship Program to End Youth Loneliness
Youth Loneliness & Chronic Conditions: The Shared Strength Project Guest: Esha Mittal, Founder, The Shared Strength Project Expert Words: Todd May, MD, Vice President & Medical Director, Health Net Host: Alex Yarijanian Episode Summary One in three young people in the U.S. live with a chronic...
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Bonus: 5 Contract Clauses Killing Your Reimbursement
This bonus episode is the full recording of Alex Yarijanian's HBMA continuing-education webinar. It runs longer than a standard VBCA episode — treat it as a resource, not a highlight reel. Most revenue cycle teams treat denials and underpayments as billing problems. A meaningful share of them are...
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Lindsay Clancy: Examining the Healthcare System's Failures
17 minutes. That's how long Lindsay Clancy's last psychiatric visit lasted — the day before her three children died. Nine prescribers. Two hospitals. A suicide hotline called twice. And allegedly, not one person connecting the dots. Before you listen: This episode discusses allegations from a…
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The Ghost Network Behind Pediatric Home Nursing: When Authorized Hours Go Unfilled
Episode Summary A pediatric patient in a New Jersey hospital is medically ready for discharge — equipment arranged, family ready, nursing hours authorized by the health plan. The only missing piece: an actual nurse. This episode uses that scenario to examine the structural gap between authorized...
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Your Billing Problem Started in the Contract
Most revenue cycle teams are chasing the wrong fire. Persistent underpayment, denials that don't respond to appeals, patterns nobody can explain — these are often contract problems wearing a billing problem's disguise. In this episode, Alex breaks down the structural gap between contracting and…
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How to Decide to Contract with a Payer: Should You be Joining "the Network"?
You've built the operation — clinicians credentialed, tech stack running, compliance buttoned up. Then a regional Medicaid managed care plan wants to talk about contracting. Your first instinct: great, let's do it. Then someone pulls up the 40-page contract with a 43-code prior authorization…
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LEAD Model: The ACO Test Most Organizations Will Fail — Before They Apply
CMS has posted the LEAD (Long-Term Enhanced ACO Design) model application materials. Preliminary scoring is due April 27, 2026. Full applications are due May 17, 2026. LEAD replaces ACO REACH in 2027 and runs as a 10-year demonstration with enhanced payments and care coordination flexibility.…
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The Definitive Playbook for Choosing Behavioral Health Markets
Rate sheets don't tell the whole story. In this episode, Alex Yarijanian breaks down the 8-indicator playbook he uses to evaluate any tele-behavioral health market before committing capital — and names the specific states he'd enter today and why. Most operators default to the biggest states:...
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Medicare Negotiates Like an Owner. Commercial Doesn’t.
In this episode of the VBCA Podcast, Alex Yarijanian sits down with Dr. Kumar Dharmarajan — co-founder and Chief Medical Officer of World Class Health and former Chief Scientific and Medical Officer at Clover Health — to unpack one of the most important structural differences in U.S. healthcare:...
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The Rural Health Transformation Fund: What States Are Funding in 2026
CMS is moving tens of billions of dollars into every state to stabilize rural healthcare heading into 2026—not through across-the-board rate increases, but through targeted investments in workforce, technology, care coordination, and alternative payment models. In this episode, Alex Yarijanian...
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Medicare Advantage 2026: How Payers Are Choosing Partners
While most providers are waiting on CMS, payers are already narrowing networks and rewriting delegation terms. Payers are quietly narrowing networks and rewriting delegation expectations. This playbook explains how to do business with MA business for 2026. If you’re waiting, you’re already...
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Digital Health at a Crossroads: The Fallout from a $100M Adderall Fraud Scheme
A federal jury has convicted the founders of Done, one of the fastest-growing telehealth companies in the stimulant-prescribing space, for orchestrating one of the largest Adderall distribution and fraud schemes in U.S. history. More than 40 million stimulant pills, over $100 million in revenue,...
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2026 Medicare Fee Schedule: 5 Big Opportunities for Providers & Startups
Medicare’s 2026 physician fee schedule is packed with change — but change means opportunity. In this episode of the VBCA Podcast, Alex Yarijanian breaks down the five biggest updates every provider and startup should know: Shorter, billable windows for remote monitoring New behavioral health...
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How to Win in Medicare Advantage 2026
Welcome back to the Value-Based Care Advisory podcast! In this episode, host Alex Yarijanian delves into the significant updates and strategies for 2026 in the Medicare Advantage space. He covers essential news and policy changes, including a 5% increase in Medicare payment rates, the scaling…
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Behind the Scenes of Power: Emotional Labor in Negotiation
In this episode of the VBCA podcast, host Alex Yarijanian delves into the often overlooked yet crucial aspect of leadership: emotional labor. Discover how managing emotions plays a pivotal role in negotiations and leadership effectiveness. Alex shares personal experiences and insights on how...
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Meditate Like a CEO: Real ROI from Mindful Leadership
This podcast episode delves into the intricate relationship between mindfulness meditation and its profound implications for healthcare leadership. We explore how mindfulness practices not only enhance emotional well-being but also significantly improve the quality and effectiveness of leadership...
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Managed Care Contracting for Health Tech Startups
How Health Tech Startups Can Win at Managed Care Contracting: Insider Strategies for Scalable Payer Partnerships. This episode dives deep into the essentials of navigating managed care contracts as a health tech startup. Whether you're a founder, operator, or policy strategist, you'll walk away...
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Doulas and Value-Based Maternity Care: Driving Cost Reduction and Improved Outcomes
This conversation explores the historical context of childbirth, the current state of maternal mortality in the U.S., and the emerging role of doulas in modern maternity care. It highlights the paradox of high maternal mortality rates despite advanced medical technology and discusses how doulas…
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Uncovering the Hidden Influencers of Our Health System
The podcast delves into the complexities and challenges of the American healthcare system, arguing that it often prioritizes profit over patient care. Through the lens of investigative journalism from More Perfect Union, the hosts explore how companies like CVS Caremark and pharmaceutical giants...
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2025 Opportunities in Healthcare: Navigating the Perfect Storm
What Every Provider and Innovator Must Know Going into 2025: The health insurance industry is facing a perfect storm characterized by rising healthcare costs, increased patient demand, and intense scrutiny from lawmakers. As we move into 2025, the challenges confronting Medicare Advantage plans,...
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EXPOSED: The MultiPlan Healthcare Cartel Costing Providers and Patients Billions
Welcome to this eye-opening episode of the VBCA Podcast, where we tackle one of the most pressing yet underreported issues in healthcare: hidden fees, surprise bills, and the alleged cartel controlling out-of-network reimbursements. In this episode, host Alex Yarijanian breaks down the…
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Startup Pitfalls and Healthcare Horror Stories: Introduction to Value-Based Care
This episode explores the rising tide of healthcare startups pursuing value-based care (VBC) with ambitious visions to improve patient outcomes and lower costs. However, without a robust patient acquisition strategy, many founders find themselves struggling to meet volume requirements, maintain...
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Understanding the Mental Health Parity Act: A Guide for Providers (From Payer Executives)
This podcast episode dives deep into the complexities of mental health parity and the implications of the Mental Health Parity Act. The conversation emphasizes the necessity for behavioral health services to be treated with the same level of care and coverage as physical health services…
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Changing Demographics & Value-Based Care
This episode is also available as a blog post: https://healthcare-wiki.com/2022/03/12/changing-demographics-value-based-care/
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Paying for Biopsychosocial Care
The system used to pay for health care today does not encourage the integration of health care and social care, nor can it adequately adapt to the trending shift toward value-based payments for care — paying for better quality and better health outcomes. New financing approaches are needed to...
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Telehealth Landscape Overview 50 States + DC
No two states are alike in how telehealth is defined and regulated. While there are some similarities in language, perhaps indicating states may have utilized existing verbiage from other states, noticeable differences exist. These differences are to be expected, given that each state defines its...
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Florida Market Telehealth Rule & Controlled Substances
During the 2019 legislative session, Florida passed Chapter 2019-137, Laws of Florida, which establishes standards of practice for telehealth services, including patient evaluations, record-keeping, and controlled substances prescribing. The law also authorizes out-of-state health care...
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How to Talk to Health Plans for Mental Health Coverage.
California Governor Gavin Newsom on September 25 signed Senate Bill 855, Health coverage: mental health or substance use disorders, into law. The law increases health and disability insurers' coverage obligations for mental health and addiction diagnosis, prevention, and treatment in the state.
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ABOUT THIS SHOW
The VBCA Podcast is a solution-focused platform dedicated to advancing the transformation of healthcare through value-based care (VBC) models. Our mission is to break down complex healthcare topics into accessible, actionable insights for leaders, entrepreneurs, engaged consumers, and anyone passionate about meaningful change in healthcare. By challenging the healthcare industrial complex, we provide tools, strategies, and expert perspectives that empower our listeners to navigate and accelerate the shift toward better outcomes, lower costs, and improved patient experiences.Each episode delivers thought-provoking discussions and practical advice from industry experts, spotlighting innovative approaches to healthcare reform and highlighting voices that are often overlooked in traditional dialogues. Whether you're a healthcare executive, provider, payer, policy influencer, entrepreneur, or informed patient, we aim to inspire new ideas and support you in driving transformation in the hea
HOSTED BY
Carenodes
CATEGORIES
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Frequently Asked Questions
How many episodes does Value Based Care Advisory (VBCA) Podcast have?
Value Based Care Advisory (VBCA) Podcast currently has 28 episodes available on PodParley. New episodes are automatically indexed when they're published to the podcast feed.
What is Value Based Care Advisory (VBCA) Podcast about?
The VBCA Podcast is a solution-focused platform dedicated to advancing the transformation of healthcare through value-based care (VBC) models. Our mission is to break down complex healthcare topics into accessible, actionable insights for leaders, entrepreneurs, engaged consumers, and anyone...
How often does Value Based Care Advisory (VBCA) Podcast release new episodes?
Value Based Care Advisory (VBCA) Podcast has 28 episodes. Check the episode list to see recent publication dates and frequency.
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You can listen to Value Based Care Advisory (VBCA) Podcast on PodParley by clicking any episode. We provide an embedded audio player for direct listening, and you can also subscribe via your preferred podcast app using the RSS feed.
Who hosts Value Based Care Advisory (VBCA) Podcast?
Value Based Care Advisory (VBCA) Podcast is created and hosted by Carenodes.
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