All Episodes
Health Tech Nerds Radio — 92 episodes
The Grand Roundup: Doximity's AI comeback, Bank of America's $250M GLP-1 bet, Clover and Oscar's blowout quarters, HCMC's $705M bailout, and more
The Grand Roundup: BetterHelp’s cash pay collapse, Centene-Molina ACA divergence, Function’s 450M debt raise, Iowa’s managed care debate, and more
The Grand Roundup: Payer Q2 earnings, HCA's ACA miss, OpenEvidence & Doximity's PR war, fee schedule backlash, Neko's $7B valuation, and more
Betting on regulatory tailwinds: how Evidenced picks its deals | Bryan Sivak & Sean Glass
CMS Bridge forecast, broker fraud, and the ACA numbers everyone's misreading | Sam Melamed (NCD)
The Grand Roundup: Debating the future of ESI, concierge medicine's $40K price tag, Elevance/SCAN sue over Stars, ACA rate hikes and death spiral fears, and more
A physician-turned-founder's take on making prior auth actually work | Jeremy Friese (Humata Health)
The Grand Roundup: Agentic voice AI wars, recent funding roundup, Cityblock acquires Homeward, UpDoc's FDA clearance, Humata's WISeR rollout, and more
The liability gap holding clinical AI back — and who should solve it | JD Friedland (Cleveland Clinic)
The Grand Roundup: Anti-tiering contracts and the OhioHealth ruling, Thoreau/Ensemble update, 340B and Eli Lilly, OpenLoop's D2C play, Cleveland Clinic on AI trust, and more
The tasks AI should take off doctors' plates — and the ones it shouldn't | Hashem Zikry (Counsel Health)
How Alignment Health gets health systems to come to them | John Kao (Alignment Health)
The Grand Roundup: $12B Matt Holt/Ensemble deal, Hawaii's payvider bet unravels, PwC's highest commercial trend in 18 years, Clover Stars win, clinical AI regulation, and more
The billing problem is actually an affordability problem | Seth Cohen (Cedar)
Why U.S. healthcare doesn't need more money—it needs a different system | Ezekiel Emanuel
The Grand Roundup: Finding the optimal amount of healthcare fraud, ACA premium churn, wealthy New Yorkers are buying "med-à-terres", Zeke Emanuel on where healthcare policy reform is headed, and more
Before, during, and after GLP-1s: the role of nutrition in metabolic care | Amit Shah (Virta Health)
Why foster-connected youth fall through healthcare's cracks—and how to fix it | Michelle Turner (Here Now Health)
The Grand Roundup: Elevance CMS update, healthcare AI bundling vs. the $100B benchmark, Clover Stars ruling, D-SNP upcoding, No Surprises Act, CVS/Tennessee PBM split, and more
How Gyde is enabling the shift from MA broker to trusted advisor | Will Johnson (Gyde)
How the No Surprises Act solved balance billing but created a pricing problem | Loren Adler (Brookings Institution)
The Grand Roundup: Mass General Brigham's AI PCP backlash, Hinge Health pushback on CMMI ACCESS, No Surprises Act increasing costs, US drug access & TAMs, AI market signals, and more
Why Photon Health is doubling down on the pharmacy patient experience | Otto Sipe (Photon Health)
The case for underwriting as the new defensible moat in healthcare | Sean Doolan & Emre Karatas (Virtue VC)
Why special needs plans are becoming strategically important in Medicare Advantage | Patrick Foley (Belong Health)
What's driving growth for the country's largest outpatient mental health provider | Dan Ferris (LifeStance Health)
The Grand Roundup: Strong Q1s driven by operational execution, hospital market power, MinuteClinic / Mass General Brigham, SNP growth, pharmacy patient experience, and more
The NC State Health Plan: a case study in managed care, benefit design, and healthcare affordability | Brian Miller (NC State Health Plan)
Healthcare affordability, declining trust, and the realities of reform | Natalie Davis (United States of Care)
What Kelonia's journey to exit could mean for cell & gene therapies | Bryan Roberts (Venrock)
Addressing revenue cycle's root problem, data fragmentation | Eliana Berger (Joyful Health)
The Grand Roundup: Devoted's long-term bet, Anthropic's AI services firm, Q1 earnings, healthcare financial infrastructure, gene therapy exit, public trust in healthcare, NC state health plan turnaround, and more
How ACCESS unlocks innovative digital care models for original Medicare | Amanda Rees (Bold)
The evolution of MA brokerages: from volume to retention—and what’s next | Patrick Keavy & Rebecca Springer (Bailey & Company)
AI and ACCESS: how Pair Team is scaling whole-person care to a broader population | Neil Batlivala
The state of behavioral health: demand, supply, direct-to-consumer, and emerging treatments | Alli Oakes (Trilliant Health)
The Grand Roundup: Q1 earnings, behavioral health market, Pair Team and Bold on ACCESS, future of MA brokers, Epic AI vs startups, AI prescribing, and more
Why so few patients access palliative care, and how Empassion is addressing that | Robin Heffernan (Empassion)
From building an alternative health plan to powering them: what Yuzu learned and why they pivoted | Russell Pekala & Will Gillach
Why a connected device company is well positioned for CMMI's ACCESS model | Patrick Sheehan (Withings)
From AI scribing to clinical intelligence: how Abridge is expanding its role across the clinical encounter | Shiv Rao
Maternity care unbundling: why the global payment bundle is ending and what it means for innovation, costs, and access | Neel Shah (Maven Clinic)
The Grand Roundup: Digital vs consumer health participation in ACCESS, maternity care unbundling, Abridge and clinical intelligence, Yuzu's pivot to power alternative plans, peptide market, price transparency, AI-driven risk adjustment funding, and more
Inside alternative plan design: the mechanics and behavior change driving employer cost savings | Craig Allen & Nancy Wang (Sidecar Health)
How CMS Administered Risk Arrangements (CARA) bridge the gap between ACOs and specialists | Will Gordon (Manatt Health)
An investor’s view of the private market, and navigating AI-driven uncertainty | Conor Green (Truehelm)
The case for investing in maternity care and the driving forces behind SimpliFed's $10.8M Series A | Andrea Ippolito (SimpliFed)
CMMI LEAD and three key changes from ACO REACH: incorporating specialists, using AI-inferred risk, and simplifying tracks | Gabe Drapos (Pearl Health)
The Grand Roundup: CMMI's LEAD program and engaging specialists via CARA, MA final rates and benefit cuts, Teladoc's valuation conundrum, AI creating confusion in private markets, and SimpliFed's $10.8M Series A to extend OB care
Making GLP-1s work for patients and payers | Evan Richardson (Form Health)
Improving pediatric care access and outcomes through value-based Medicaid contracting, technology, and a prevention-first model | Chris Johnson & Michael Glazier, MD (Bluebird Kids Health)
Chris Klomp on the 2027 MA final rate notice, accountable relationships, and why there’s never been a better time to build in Medicare
Medicare Advantage under pressure: why Greenbrook Medical is leaning in with full-risk primary care | Neil Machhar
The Grand Roundup: CMMI's LEAD Model, Medicaid cuts, Medicare Advantage care models that are working, and the latest health tech funding
How Oshi builds trust, drives adoption, and improves outcomes with their virtual GI care model | Sam Holliday
More effective depression treatments exist—so why aren’t they used? Everbright on TMS, esketamine, and the barriers to prescribing | Ben Kuhn
What it takes to achieve value-based oncology care: how Thyme Care's model aligns incentives, reduces spend, and improves outcomes at scale | Bradford Diephuis, MD
Building better Opioid Use Disorder care: Ophelia’s approach and why the system falls short | Zach Gray + Dr. Arthur Robin Williams
Stedi's $50M round and the future of clearinghouses with Zack Kanter, Founder & CEO
AI in healthcare: the case for starting in Medicaid with Cityblock's CEO, Toyin Ajayi
The Grand Roundup: Peptide boom, payer pressures, AI and Medicaid, clearinghouse innovation, and nearly $600M in health tech funding
AI & organizational realities, rising labor costs, and specialty care as the next wave of virtual care and VBC: insights from 150 payer & provider execs | Ezra Mehlman (HEP) and Tom Cassels (Manatt)
Meeting the pressing need for mental health in America’s public schools | Jake Sussman (CEO, Marble Health)
Building virtual care models that help health systems scale care | Ashul Govil (Story Health by Innovaccer)
The Grand Roundup: Sutter–Allina merger, Lantern's $30M raise & model, WISeR prior auth backlash, Medicare Advantage vs FFS, state directed payments, health tech funding, and more
Medicaid is an under appreciated innovation lab | Dr. Chris Cogle (Florida Medicaid)
Why CMMI needs simpler models and better measurement | Ankit Patel (Percepta, ex-CMMI)
How North Carolina is fixing its $5.5B state employee health plan | Tom Friedman (NC State Health Plan)
The Grand Roundup: Devoted Health’s strategy, Doctronic & AI regulation, DC MA spending debate, and more
The evolution of value-based kidney care: policy, treatment, and payment | Tim Fitzpatrick (Signals Group)
Caring for medically complex children: the case for PPEC | Jeffrey Soffen (Spark Pediatrics)
The Grand Roundup: Novo-Hims partnership, UHS buys Talkspace, OpenEvidence's "Spotify of healthcare" strategy & Wiley partnership, and Idaho Microhospitals
Why medically integrated dispensing is gaining traction amid PBM reform | Denali Cahoon & Tamiko Yamatani (House Rx)
How state Medicaid programs are preparing for cell and gene therapies | Bruce Greenstein (Louisiana DoH) and Will Shrank (Aradigm)
Why preventative care is hard to finance and how Truemed is trying to fix it | Justin Mares (Truemed)
The Grand Roundup: A busy for publicly traded healthcare company stocks, Allina partnership with Story Health, and a bit on the 340B program
The clinical model behind Alignment Healthcare’s success in Medicare Advantage | John Kao (Alignment Health)
Reengineering ACOs for competition and better outcomes | Liz Fowler and Purva Rawal (ex-CMMI)
Designing and delivering home-based care for dual-eligible populations | Oren Shatken + Romanos Fessas (Jukebox Health)
The Grand Roundup: How to spend less money on healthcare, a few more healthcare earnings calls, whether it’s possible to make money in Medicare Advantage and more
Omada on ACCESS, reimbursement rates, and its new cholesterol program | Wei-Li Shao
Unpacking the ACCESS Model | Jacob Shiff (CMMI)
The state of the Medicaid tech stack and readiness for upcoming eligibility changes | Nikita Singareddy (Fortuna Health) and Luke Farrell (Better Government Lab)
The Grand Roundup: ACCESS, Humana makes a big acquisition, what costs more original Medicare or Medicare Advantage, and a quick healthcare earnings review
Introducing Nest Origin: Transforming prenatal and postpartum care for Medicaid families | Kelsie Brandt (Nest Health)
Humana's Q4 Earnings Call Recap: Membership Growth and Strategy Insights
Rethinking medication affordability with a two-sided marketplace | Anurati Mathur (Sempre Health)
The Grand Roundup: Carbon Health's bankruptcy, AI and primary care, funding trends, payer earnings (Molina, Centene, DaVita), and the outlook of PACE & vertically integrated models
The Grand Roundup: Medicare Advantage Advance Notice, healthcare earnings calls, and a big Annual Enrollment Period for Devoted Health
Building and scaling an in-home care model for Medicaid populations | Dr. Rebekah Gee and Rebecca Kavoussi (Nest Health)
What it takes to deliver rural primary care | Dr. Aditi Malik and Tim Gronniger (Hopscotch)
Automating prescription renewals with AI: Lessons from a Utah pilot | Adam Oskowitz (Doctronic)