Episódios
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In this episode of Value-Based Care Insights, host Daniel Marino explores the newly introduced the CMS Transforming Episode Accountability Model (TEAM)—a mandatory five-year, episode-based pricing model, informed by earlier initiatives from the CMS Innovation Center. Designed to cover high-volume, high-cost surgical procedures, TEAM represents a significant shift in how hospitals and providers approach bundled payments. Join Daniel and special guest Lucy Zielinski, an expert in value-based programs and HCC coding , as they unpack what the TEAM model entails and what participating hospitals must do to prepare for the January 1, 2026 implementation. Gain insights how this model influences financial performance, drives care coordination redesign, and introduces new incentives and penalties. Whether you are a healthcare leader, provider, or payer, don’t miss this overview of one of CMS’s initiatives shaping the future of value-based care.
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As hospitals and health systems continue to evolve in value-based care, optimizing the post-acute recovery process has become a top priority. In this episode of Value-Based Care Insights, Diane Shifley, Assistant Vice President of Population Health and Post-Acute Services at a major Chicago health system joins us to discuss how robust transitions-in-care programs can drive better patient outcomes. She shares insights on the critical role of early patient evaluation—whether at hospital admission or pre-surgery—in shaping effective transitions. We explore how transitional care models that include post-acute facilities and home care can reduce readmission rates, improve patient satisfaction, and control post-acute costs. This episode offers actionable strategies to strengthen your transitions-in-care to support patients through successful recovery.
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In this episode of Value-Based Care Insights, host Daniel Marino explores one of the most pressing issues in healthcare today—workforce engagement and retention. Since the COVID-19 pandemic, healthcare organizations have faced unprecedented levels of burnout, turnover, and staffing shortages. Daniel is joined by Tanya Allee, Vice President of Patient Experience at Campbell County Health, a rural health system that is making meaningful strides in workforce development. Tanya shares practical strategies and initiatives to boost staff satisfaction, improve retention, and create a healthy culture of support and engagement. Tune in for valuable insights on how health systems can navigate workforce challenges and create a healthy organizational culture resulting in better patient care.
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In today’s episode of Value-Based Care Insights, host Daniel J. Marino sits down with Dr. Amit Jain, MD, MBA, Associate Professor of Orthopedic Surgery and Neurosurgery, Chief of Minimally Invasive Spine Surgery at Johns Hopkins, and Director of Value-Based Care for Johns Hopkins Health System. Together, they unpack how organizations can reduce costs while improving performance outcomes such as length of stay and readmission rates—ultimately advancing their value-based care strategy. Explore expert insights on aligning surgical services with cost-effective, high-quality care delivery.
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Artificial intelligence (AI) is making headlines everywhere—but how much of it is real, and how much is just hype? In this episode, host Daniel Marino is joined by Rick Howard, Chief Information and Data Officer at Brand Engagement Network, to unpack the growing role of AI in healthcare. Together, they separate fact from fiction, explore the opportunities and challenges AI presents, and discuss how healthcare organizations can responsibly integrate AI to improve operations and patient care. Whether you're excited, confused, or cautious about AI, this conversation offers clarity and insight for navigating the rapidly evolving digital landscape.
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In this special episode of Value-Based Care Insights, host Daniel Marino is joined by Fred Goldstein, President of Accountable Health and podcast host of PopHealth Week, to unpack key takeaways from HIMSS25. They share their experience at this year’s conference, focusing on artificial intelligence (AI), digital technology, and future trends. Already, AI is transforming care delivery and decision-making, while digital technology is revolutionizing patient engagement and operational efficiency. Join us for an insightful conversation on the evolving healthcare technology landscape and the trends shaping the future of care delivery, driving a more connected and efficient healthcare ecosystem.
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In this special episode of Value-Based Care Insights, host Daniel Marino brings you exclusive interviews recorded live at HIMSS25, where healthcare innovation took center stage. The first interview features Stephen Overman, CEO & Founder of Standpoint Solutions, who shares their groundbreaking technology aimed at improving communication within perioperative services. Next, Dr. Alan Young, Client Executive at Point B Solutions, dives into the transformative role of artificial intelligence in patient care. The future of AI-driven healthcare is explored, including the rise of intelligent agents and their potential to influence clinical decision-making. Tune in for an insightful discussion on the future of healthcare, technology, and how innovation is reshaping patient care.
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National healthcare organizations like the Healthcare Financial Management Association (HFMA), American Hospital Association (AHA), and Medical Group Management Association (MGMA) offer valuable industry-wide insights and legislative guidance. However, state associations provide a more tailored, in-depth understanding of the specific challenges healthcare providers face in their local markets. In this episode of Value-Based Care Insights, host Daniel Marino sits down with fellow Illinois MGMA board members, Meghan Heiy and Jenny Kovich, and explores the growing importance of state healthcare associations in effectively navigating today’s rapidly evolving healthcare landscape.
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The healthcare industry is grappling with a growing shortage of providers in every specialty, with primary care being hit the hardest. In this episode, host Daniel Marino is joined by primary care physician, Dr. Leila Obeid, to discuss how physician shortages and rising patient demands are forcing many primary care physicians to seek better work-life balance through alternative practice models. One solution? Concierge medicine. Tune in as we discuss how this model helps physicians regain control, improve patient care, and create a sustainable future in healthcare.
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In 2025, the continued growth of Medicare Advantage underscores the increasing importance of specialists in value-based care, as healthcare models shift toward more integrated, patient-centered approaches. In this episode of Value-Based Care Insights, host Dan Marino sits down with Lynn Carroll, COO and Head of Strategy at HSblox, to explore how specialists can successfully engage in value-based care models. Tune in to explore current value-based programs that incorporate specialty providers, key challenges encountered, and the critical infrastructure required for success in this evolving healthcare landscape.
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The Physician Fee Schedule (PFS) Final Rule for Calendar Year (CY) 2025 introduces several key updates to Medicare payment policies, aiming to enhance care delivery and reduce administrative burdens. In this episode, Daniel Marino is joined by Managing Partner, Lucy Zielinski, as well as Sarah Hartley, to explore the implications of the PFS Final on physicians and other billing professionals. Together, they discuss the key changes and opportunities for physician services furnished in a variety of settings including physician offices, hospitals, ambulatory surgery centers (ASCs), and others. Tune in to stay informed and gain valuable perspectives on navigating these critical regulatory updates.
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Healthcare providers will continue to move toward value-based care, fostering a more equitable healthcare system that enhances accessibility, quality, affordability, and innovation. In this episode of Value-Based Care Insights, I sit down with Lumina’s Managing Partner, Lucy Zielinski, to explore the healthcare trends of 2025, the effects of new regulatory changes, and the pressures these developments place on providers. Tune in to learn about the top five trends that health systems should include in their strategic planning.
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Based on your feedback, our listeners, we've selected the top three episodes for 2024. We dive into the key challenges and opportunities defining healthcare trends this past year through three captivating Value-Based Care Insights episodes. In Episode 102, Sarah Hartley discusses the unique demands of managing Medicare Advantage contracts, offering creative strategies to align providers and patients. Episode 98 features Dr. Riya Pulicharam and Kevin Zhao exploring how integrating clinical data and fostering cultural change within care management transforms patient outcomes. In Episode 106, Tim Hanners and Dr. Dave Lebec tackle the anesthesia provider shortage and delve into tactics to boost financial performance, optimize staffing models, and improve payer reimbursement.
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Accountable Care Organizations (ACOs) have made great strides in enhancing patient care and reducing costs, saving $3.1 billion in 2023. The recently released report based on ACO performance in 2023 (PY2023) provides valuable insights into where ACOs are excelling. In this episode of Value-Based Care Insights, Dan Marino sits down with Sarah Kachur PharmD, MBA, BCACP, Executive Director of Strategy and Solutions at Johns Hopkins Population Health Analytics, to discuss the key findings of the report and what they reveal about the future of ACOs. Gain insights into the priorities of the most successful ACOs (in PY 2023) and their predictions for changes and challenges in 2025 and beyond.
LinkedIn https://www.linkedin.com/in/sarahgracekachur/
Hopkins ACGs: https://www.hopkinsacg.org/
Illustra Health from Johns Hopkins: https://illustra.health/
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Care management is critical, especially for individuals with chronic conditions like dementia, because it ensures coordinated, comprehensive, and individualized care. Currently, more than 6.7 million Americans are living with dementia and Alzheimer’s disease, and this number is projected to continue rising. While the impact of the disease on individuals is widely recognized, the personal and financial burden it places on caregivers is less often highlighted. Today, on Values-Based Care Insights, Dan Marino sits down with JVS Health’s CEO Vanessa Guzman and Co-founder Seth Hyman to discuss the GUIDE Model, a Centers for Medicare & Medicaid Services (CMS) supplement for caregivers of patients with dementia and Alzheimer’s disease. Gain insights into the valuable services within the GUIDE model that can support and benefit individuals living with dementia and their unpaid caregivers.
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This year, 2024, presented significant challenges for clinically integrated networks (CINs) delivering value-based care, with the disruption from Medicare Advantage reaching widespread levels. As we look toward 2025, it is crucial for CINs to reflect and gear up for success in the coming year by focusing on risk-based contracting, engaging specialists, and investing in care management. In this episode of Value-Based Care Insights, Dan Marino sits down with Dr. Will Faber, to tackle several challenges, including the lack of structure among commercial payers to effectively handle value-based contracts and obstacles in negotiating such contracts with specialty providers. Gain insights into strategies and data utilization that will position your provider organization for success in 2025.
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Success in the operating room is critical to the financial health of many healthcare organizations, with perioperative services contributing up to 75% of primary revenue streams. Effective perioperative care relies on skilled nurses who balance patient care while collaborating with other teams. In this episode of Value-Based Care Insights, Dan Marino sits down with Cindy Mahal, Chief Administrative Officer of Providence Saint Joseph Medical Center, to explore the challenges nurses face in achieving alignment and how to overcome them. We’ll uncover insights into key strategies administrators can implement to empower nurses, giving them a voice and enabling them to not only align but also lead.
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A coherent and consistent approach to evaluating and optimizing surgical patients not only minimizes avoidable harm and complications but also impacts inefficiencies such as case cancellation, delayed case starts and turnover. Furthermore, avoidable complications are increasingly costly through post-acute care utilization, readmissions and never events. Facilities, surgeons, anesthesiologists, patients and families share an interest in doing better from the very beginning of the surgical journey. On today’s episode of Value-Based Care Insights, Daniel Marino explores how to identify and capture opportunities to streamline care and is joined by Alex Hannenberg, former President of the American Society of Anesthesiologists and Adjunct Clinical Professor of Anesthesiology at Tufts School of Medicine, and Art Boudreaux, Professor of Anesthesiology and Perioperative Medicine at the University of Alabama, Birmingham. Gain insights into the importance of aligning and standardizing perioperative processes, and how leveraging data can help reduce inefficiencies, reduce costs, and improve patient outcomes.
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Care management is crucial for adding value to value-based care, but gaining stakeholder buy-in on its significance can be challenging. While the return on investment for care management strategies is undeniable, the delayed realization of these returns can be daunting for financial leaders. In this episode of Value-Based Care Insights, Dan Marino sits down with Lisa Stockdale, the Director of Value-Based Care at Silver Cross Health Systems, to look at challenges, as well as the benefits, in implementing successful care management programs. Gain insights into the importance of leadership buy-in, technology, and reinvestment in effective and cost-saving care management programs.
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Certain specialties, such as primary care, are generally better positioned to shift to value-based care. Specialists, particularly cardiologists, encounter challenges when transitioning from fee-for-service to fee-for-value. To succeed in this shift, they must rethink their approach to patient care. In this episode of Value-Based Care Insights, Dan Marino sits down with Dr. Sameer Sheth, a board-certified cardiologist who helps specialists transition to value-based care by focusing on a patient-centric approach to medicine. Gain insight into the healthcare provider ecosystem and how data and tools, patient engagement, and communication support the shift from volume-based to value-based care.
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