The Value Shift by Protera Health

What happens when an Actuary and a Surgeon look at the same claims data?In our latest episode of The Value Shift, we’re joined by Clem Foltz, FSA, an expert in specialty value-based care. While doctors see patients, actuaries see the "sequences" and "intensity" of care journeys—and that’s where the opportunity for true value lies.

Welcome to the Season 2 premiere of The Value Shift. We’re kicking off the new season with a deep dive into one of the biggest hurdles in modern medicine: aligning surgical incentives with patient outcomes.In this episode, host Eric sits down with neurosurgeon Dr. Ahilan Sivaganesan to tackle the fundamental question: How can we get surgeons to value value-based care? The current fee-for-service model often rewards volume over value, leading to "CPT Envy" and misaligned incentives. Dr. Sivaganesan shares his firsthand experience navigating these hurdles—from his viral advocacy on LinkedIn to resolve insurance denials to his work with Mishe Health and Mark Cuban’s Cost Plus Wellness to build a direct, transparent healthcare ecosystem.

In Episode 11 of the Value Shift Podcast, we sit down with Dr. Aaron Chamberlain & Casey Leavitt of Intermountain Health to discuss payor/provider speciality collaboration.

Ever wondered how AI is changing orthopedic care? We sat down with Dr. Christian Pean of Revel AI Health and Duke University to talk:Scaling high-quality care without breaking the systemMaking healthcare more equitable and accessibleValue-based care and longitudinal bundles for joint healthA must-listen for anyone curious about the future of clinical technology and population health.

In this episode of our podcast, Dr. Makhni sits down with Kelton Burbank, MD, a nationally recognized orthopedic shoulder surgeon and value-based care expert.Kelton shares how his unique path from family medicine to orthopedics shaped his passion for high-value, patient-centered care and how his team built an Integrated Practice Unit (IPU) model that:Coordinates orthopedics, behavioral health, nutrition, and PTReduces unnecessary procedures and costsBoosts PROM scores and patient engagementIf you’re a healthcare leader or innovator looking to replicate a proven value-based care model, this episode is a must-listen.

How do you scale value-based musculoskeletal care inside a competitive market? Dr. Joe Kucksdorf of Bellin Health (now Emplify) shares how embedding physical therapists in primary care, offering free PT for employees, and layering in virtual care creates measurable ROI. From reducing unnecessary surgeries to boosting retention and patient satisfaction, this episode is a blueprint for payers and providers looking to bend the MSK cost curve.

What happens when a frontline clinician turns into a policy leader? Dr. Dana Strauss, PT, shares her journey from inpatient rehab to shaping national value-based care policy. We dive into bundled payments, CMS’s new TEAM model, and how aligning incentives can transform musculoskeletal care — for patients, providers, and payers alike.

In the fifth episode of The Value Shift podcast, we are excited to welcome Dr. Charles Bloom, Chief Medical Officer of Health Alliance Plan (HAP) of Michigan.Dr. Bloom discusses his career transition from an emergency department physician to a health plan executive and his passion for value-based care. He explains how HAP, a regional health plan owned by Henry Ford Health, is working to align incentives between payers, providers, and patients to improve quality of care and patient outcomes while managing costs.

In the fourth episode of The Value Shift podcast, we are excited to welcome Dave Thomas, a seasoned health plan executive with 25 years of experience at Fidelis and Centene.Thomas details his career, rising from director to CEO of Fidelis, growing it from under 70,000 members to 1.7 million by 2018, and ultimately overseeing 32 health plans across 31 states as CEO of Medicaid and Markets for Centene.

In the third episode of The Value Shift podcast, we are excited to welcome Dr. David Lee.Dr. Lee is the President of OhioHealthy, a value-driven health plan operated in partnership with OhioHealth, Ohio’s largest not-for-profit healthcare system.From medical school to coffee entrepreneur to health plan president - Dr David Lee has established himself as a leading health plan executive. Lee sits down with Dr. Eric Makhni of Protera Health to discuss his fascinating professional development journey and what he is most excited about in the days ahead.

On our second episode of The Value Shift podcast, we were excited to welcome Charles S. Day, MD MBA. Dr. Day is an orthopedic hand surgeon and Medical Director for Value-Based Specialty Care at Henry Ford Health.During the episode, we focused on a topic that’s becoming increasingly urgent for specialty care providers:How do we define and actually measure value in healthcare?We unpacked why the Porter value equation—while foundational—is more of a framework than a practical tool for real-world decision-making. If we want value-based care to work, we need better ways to quantify outcomes that matter to patients and link them to cost.We also talked about:📉 The decline of fee-for-service surgical revenue📈 The rising momentum for specialists to engage in value-based care🤝 Why orthopedic surgeons and other specialists should consider joining clinically integrated networks (CINs) to access emerging value-based opportunities

📢 Subscribe to our newsletter for exclusive insights, event invitations, and future podcast episodes: https://protera-health-46386493.hubspotpagebuilder.com/subscribe-to-protera-health?utm_source=youtube&utm_medium=video&utm_campaign=podcast&utm_content=bozic_interview Or follow our LinkedIn newsletter for more impactful value-based care advice like in this video: https://www.linkedin.com/build-relation/newsletter-follow?entityUrn=7266172896786415616🎓 Learn more about the Dell Medical School Immersion Program in Value-Based Health Care: https://dellmed.utexas.edu/units/department-of-surgery-and-perioperative-care/immersion-program-in-value-based-health-care-musculoskeletal-instituteIn the premiere episode of The Value Shift podcast, Dr. Eric Makhni and Dr. Melvin Makhni sit down with the legendary Dr. Kevin Bozic — a pioneer in orthopedic value-based care and Chair of Surgery and Perioperative Care at Dell Medical School at UT Austin.Dr. Bozic shares how his journey into value-based care began, what orthopedic value truly means, and why integrated, multidisciplinary care models are the future of musculoskeletal health. From his mentorship roots to launching a nationally recognized immersion program, he breaks down what’s needed to implement real change — and why culture and leadership are at the heart of it.💡 Topics Covered:Defining value in orthopedic careBuilding integrated practice unitsCondition-based longitudinal payment modelsOvercoming barriers to value-based care adoptionMentorship and the next generation of clinical leadersThe Dell Med musculoskeletal immersion program🎧 Whether you're a clinician, policymaker, payer, or health innovator, this episode offers invaluable insights into the current state — and future promise — of value-based specialty care.🔔 Like, subscribe, and stay tuned for more conversations that drive the shift toward better care at lower cost.#ValueBasedCare #Orthopedics #HealthcareInnovation #MSKcare #IntegratedCare #HealthLeadership #ProteraHealth #DellMedicalSchool #KevinBozic #HealthcareTransformation