Claims Denied: A Hospitalogy Podcast en Join one man’s quest to learn everything there is to know about the business of healthcare. Blake Madden and friends cut through the fluff to talk shop with influential healthcare leaders across innovation, strategy, finance, policy, and more. Learn about disruptive health tech startups, hear war stories, stay up to date on emerging health system transformation strategies, and listen in to scalding hot takes on pressing topics and the future of the industry. New episodes drop Mondays. Subscribe to get the latest! https://megaphone.imgix.net/podcasts/48e6fdaa-ca61-11f0-8107-7b4589cd3869/image/17b9034314e18461e344057536705af2.png?ixlib=rails-4.3.1&max-w=3000&max-h=3000&fit=crop&auto=format,compress Claims Denied: A Hospitalogy Podcast episodic Blake Madden Join one man’s quest to learn everything there is to know about the business of healthcare. Blake Madden and friends cut through the fluff to talk shop with influential healthcare leaders across innovation, strategy, finance, policy, and more. Learn about disruptive health tech startups, hear war stories, stay up to date on emerging health system transformation strategies, and listen in to scalding hot takes on pressing topics and the future of the industry. New episodes drop Mondays. Subscribe to get the latest! Join one man’s quest to learn everything there is to know about the business of healthcare.

Blake Madden and friends cut through the fluff to talk shop with influential healthcare leaders across innovation, strategy, finance, policy, and more.

Learn about disruptive health tech startups, hear war stories, stay up to date on emerging health system transformation strategies, and listen in to scalding hot takes on pressing topics and the future of the industry.

New episodes drop Mondays. Subscribe to get the latest!

]]> Blake Madden digitalteam@workweek.com The End of Managed Care? How Northwell Built a $2.5B Direct Contracting Machine (with Nick Stefanizzi, CEO Northwell Direct) Blake sits down with Nick Stefanizzi, CEO of Northwell Direct (https://northwelldirect.northwell.edu/) — the man running the most ambitious direct-to-employer play in the country. Since going live in 2022, his team has built a platform serving 70+ employers and unions, 300K members, and $2.5B in medical spend, with 97% retention. Then they landed 32BJ: 20% validated savings, $46M in year one, live as of April. Blake and Nick get into all of it — why Northwell runs Direct as a standalone company (Nick literally negotiates rates against his own parent system), what they rented instead of built, how the 32BJ deal came together in 10 weeks, and what happens to managed care when health systems stop asking permission. If you're a health system exec, benefits leader, or union fund trustee, this one's required listening. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠⁠https://navvishealthcare.com/vbc⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Nick on LinkedIn: https://www.linkedin.com/in/nickstefanizzi/ Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠ Tue, 18 Aug 2026 10:00:00 -0000 full Blake Madden Blake sits down with Nick Stefanizzi, CEO of Northwell Direct (https://northwelldirect.northwell.edu/) — the man running the most ambitious direct-to-employer play in the country. Since going live in 2022, his team has built a platform serving 70+ employers and unions, 300K members, and $2.5B in medical spend, with 97% retention. Then they landed 32BJ: 20% validated savings, $46M in year one, live as of April. Blake and Nick get into all of it — why Northwell runs Direct as a standalone company (Nick literally negotiates rates against his own parent system), what they rented instead of built, how the 32BJ deal came together in 10 weeks, and what happens to managed care when health systems stop asking permission. If you're a health system exec, benefits leader, or union fund trustee, this one's required listening. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠⁠https://navvishealthcare.com/vbc⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Nick on LinkedIn: https://www.linkedin.com/in/nickstefanizzi/ Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠ Blake sits down with Nick Stefanizzi, CEO of Northwell Direct (https://northwelldirect.northwell.edu/) — the man running the most ambitious direct-to-employer play in the country.

Since going live in 2022, his team has built a platform serving 70+ employers and unions, 300K members, and $2.5B in medical spend, with 97% retention. Then they landed 32BJ: 20% validated savings, $46M in year one, live as of April.

Blake and Nick get into all of it — why Northwell runs Direct as a standalone company (Nick literally negotiates rates against his own parent system), what they rented instead of built, how the 32BJ deal came together in 10 weeks, and what happens to managed care when health systems stop asking permission.

If you're a health system exec, benefits leader, or union fund trustee, this one's required listening.

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

⁠⁠https://navvishealthcare.com/vbc⁠⁠

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠

Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠

Be sure to leave us a review, and share our podcast with colleagues.

---

Follow Nick on LinkedIn: https://www.linkedin.com/in/nickstefanizzi/


Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠

]]> 3392 Insurance Is the Inflation: Your Health Plan Costs the Same as a Tesla Model Y, and What Collective Health is Doing to Fix it This episode hits the affordability crisis head-on, as Blake sits down with Ali Diab, CEO and co-founder of Collective Health (https://collectivehealth.com/). Ali started the company after his own hospital claim got denied, and has spent the decade since building what he calls the “Stripe” of healthcare benefits — for employers today, and potentially insurers and health systems tomorrow. In this episode, Ali makes the case that health insurance itself is the real inflationary catalyst in American healthcare.  Ali doesn't do the polite version. He calls the MLR a cost-plus contract, compares network "discounts" to markdowns off the Neiman Marcus price, and told me about the time he was charged $340 in coinsurance for a $125 knee brace on his own company's plan.  We dig into why self-insurance and direct contracting are eating the fully-insured market alive, why small employers are legally boxed out of self-funding, and why he thinks healthcare pricing needs an SEC. Also: World Cup takes. Ali's a winger-turned-number-nine and I broke two leg bones playing this sport, so we earned the tangent. Follow Ali Diab on LinkedIn: https://www.linkedin.com/in/alidiab/ Follows Collective Health on LinkedIn: https://www.linkedin.com/company/collectivehealth/home/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠https://navvishealthcare.com/vbc⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠ Tue, 11 Aug 2026 10:00:00 -0000 full Blake Madden This episode hits the affordability crisis head-on, as Blake sits down with Ali Diab, CEO and co-founder of Collective Health (https://collectivehealth.com/). Ali started the company after his own hospital claim got denied, and has spent the decade since building what he calls the “Stripe” of healthcare benefits — for employers today, and potentially insurers and health systems tomorrow. In this episode, Ali makes the case that health insurance itself is the real inflationary catalyst in American healthcare.  Ali doesn't do the polite version. He calls the MLR a cost-plus contract, compares network "discounts" to markdowns off the Neiman Marcus price, and told me about the time he was charged $340 in coinsurance for a $125 knee brace on his own company's plan.  We dig into why self-insurance and direct contracting are eating the fully-insured market alive, why small employers are legally boxed out of self-funding, and why he thinks healthcare pricing needs an SEC. Also: World Cup takes. Ali's a winger-turned-number-nine and I broke two leg bones playing this sport, so we earned the tangent. Follow Ali Diab on LinkedIn: https://www.linkedin.com/in/alidiab/ Follows Collective Health on LinkedIn: https://www.linkedin.com/company/collectivehealth/home/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠https://navvishealthcare.com/vbc⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠ This episode hits the affordability crisis head-on, as Blake sits down with Ali Diab, CEO and co-founder of Collective Health (https://collectivehealth.com/).

Ali started the company after his own hospital claim got denied, and has spent the decade since building what he calls the “Stripe” of healthcare benefits — for employers today, and potentially insurers and health systems tomorrow.

In this episode, Ali makes the case that health insurance itself is the real inflationary catalyst in American healthcare. 

Ali doesn't do the polite version. He calls the MLR a cost-plus contract, compares network "discounts" to markdowns off the Neiman Marcus price, and told me about the time he was charged $340 in coinsurance for a $125 knee brace on his own company's plan. 

We dig into why self-insurance and direct contracting are eating the fully-insured market alive, why small employers are legally boxed out of self-funding, and why he thinks healthcare pricing needs an SEC.

Also: World Cup takes. Ali's a winger-turned-number-nine and I broke two leg bones playing this sport, so we earned the tangent.


Follow Ali Diab on LinkedIn: https://www.linkedin.com/in/alidiab/

Follows Collective Health on LinkedIn: https://www.linkedin.com/company/collectivehealth/home/

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

⁠https://navvishealthcare.com/vbc⁠

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠

Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠

Be sure to leave us a review, and share our podcast with colleagues.

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠

]]> 3494 25K Patients Deep and Zero Physician Equity: Inside MGB and Regent's Site-of-Service Bet, and their New ASC Ownership Playbook For this week's episode, Hospitalogy's Blake Madden puts two people on opposite ends of the same handshake into one virtual room: Travis Messina, CEO of Regent Surgical, and Niyum Gandhi, CFO of Mass General Brigham (MGB), who runs one of the most-watched integrated systems in the country. Nominally, this episode is about ASCs. Really, it's about what a system does when it could build anything itself — and chooses to partner instead. Blake walked in carrying a grudge from his valuation days, when every ASC cap table he cracked open had physician ownership baked in like it was law. Niyum spent 20 minutes calmly arguing the opposite. They also get into MGB's $3B insurance arm (don't call it a provider-sponsored plan to his face), a 25,000-patient endoscopy wait list, robots doing oncology, and the best AI adoption framework Blake's heard a CFO articulate. Travis also reminded Blake that his Geogia Bulldogs bounced Blake's Texas Longhorns during the College World Series — which Blake is choosing to forgive. Follow Travis Messina on LinkedIn: https://www.linkedin.com/in/travis-messina-4460565/ Follow Niyum Gandhi on LinkedIn: https://www.linkedin.com/in/niyum-gandhi/ Follow Mass General Brigham on LinkedIn: https://www.linkedin.com/company/mass-general-brigham/ Follow Regent Surgical on LinkedIn: https://www.linkedin.com/company/regent-surgical/ Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠https://navvishealthcare.com/vbc⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠ Tue, 04 Aug 2026 10:00:00 -0000 full Blake Madden For this week's episode, Hospitalogy's Blake Madden puts two people on opposite ends of the same handshake into one virtual room: Travis Messina, CEO of Regent Surgical, and Niyum Gandhi, CFO of Mass General Brigham (MGB), who runs one of the most-watched integrated systems in the country. Nominally, this episode is about ASCs. Really, it's about what a system does when it could build anything itself — and chooses to partner instead. Blake walked in carrying a grudge from his valuation days, when every ASC cap table he cracked open had physician ownership baked in like it was law. Niyum spent 20 minutes calmly arguing the opposite. They also get into MGB's $3B insurance arm (don't call it a provider-sponsored plan to his face), a 25,000-patient endoscopy wait list, robots doing oncology, and the best AI adoption framework Blake's heard a CFO articulate. Travis also reminded Blake that his Geogia Bulldogs bounced Blake's Texas Longhorns during the College World Series — which Blake is choosing to forgive. Follow Travis Messina on LinkedIn: https://www.linkedin.com/in/travis-messina-4460565/ Follow Niyum Gandhi on LinkedIn: https://www.linkedin.com/in/niyum-gandhi/ Follow Mass General Brigham on LinkedIn: https://www.linkedin.com/company/mass-general-brigham/ Follow Regent Surgical on LinkedIn: https://www.linkedin.com/company/regent-surgical/ Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠https://navvishealthcare.com/vbc⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠ For this week's episode, Hospitalogy's Blake Madden puts two people on opposite ends of the same handshake into one virtual room: Travis Messina, CEO of Regent Surgical, and Niyum Gandhi, CFO of Mass General Brigham (MGB), who runs one of the most-watched integrated systems in the country.

Nominally, this episode is about ASCs. Really, it's about what a system does when it could build anything itself — and chooses to partner instead.

Blake walked in carrying a grudge from his valuation days, when every ASC cap table he cracked open had physician ownership baked in like it was law. Niyum spent 20 minutes calmly arguing the opposite.

They also get into MGB's $3B insurance arm (don't call it a provider-sponsored plan to his face), a 25,000-patient endoscopy wait list, robots doing oncology, and the best AI adoption framework Blake's heard a CFO articulate.

Travis also reminded Blake that his Geogia Bulldogs bounced Blake's Texas Longhorns during the College World Series — which Blake is choosing to forgive.


Follow Travis Messina on LinkedIn: https://www.linkedin.com/in/travis-messina-4460565/

Follow Niyum Gandhi on LinkedIn: https://www.linkedin.com/in/niyum-gandhi/

Follow Mass General Brigham on LinkedIn: https://www.linkedin.com/company/mass-general-brigham/

Follow Regent Surgical on LinkedIn: https://www.linkedin.com/company/regent-surgical/


Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

⁠https://navvishealthcare.com/vbc⁠

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠

Be sure to leave us a review, and share our podcast with colleagues.

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠

]]> 4327 Addiction Treatment and Why Your Claims Data Is Lying About Gambling Disorder Featuring: Elliott Rapaport (Founder of Birches Health) and Dr. Doug Nemecek (Senior advisor with Birches Health and former Cigna/Evernorth CMO) --- This episode with two experts in the mental health space (Elliott Rapaport, Founder of Birches Health, and Dr. Doug Nemecek, a senior advisor with Birches Health and former Cigna/Evernorth CMO for behavioral health) was one of the more eye-opening conversations Hospitalogy’s Blake Madden has had on payor behavioral spend. Think about this: 39 states + DC have legalized online gambling, FanDuel and DraftKings are sponsoring everything that moves, and yet payors will tell you they don't "see" the gambling disorder volume in their claims data. That's because it's getting coded as depression or anxiety. F63.0 never makes it to the bill. Blake, Doug, and Elliott get into the real prevalence numbers (a recent Pennsylvania study puts roughly a third of the state somewhere on the gambling-risk spectrum), why specialty networks for behavioral process addictions are about to follow the same pattern Equip ran in eating disorders, and what AI actually does in this model (spoiler: it's not replacing the therapist). Blake also pushed Elliott on the "anti-capitalism" of building a clinical model that explicitly wants patients to use you less over time. Elliott’s answer was sharp. Follow Birches Health on LinkedIn: ⁠https://www.linkedin.com/company/bircheshealth/⁠ Follow Doug on LinkedIn: https://www.linkedin.com/in/douglasnemecek/ Follow Elliott on LinkedIn: https://www.linkedin.com/in/er1/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ Tue, 28 Jul 2026 10:00:00 -0000 full Blake Madden Featuring: Elliott Rapaport (Founder of Birches Health) and Dr. Doug Nemecek (Senior advisor with Birches Health and former Cigna/Evernorth CMO) --- This episode with two experts in the mental health space (Elliott Rapaport, Founder of Birches Health, and Dr. Doug Nemecek, a senior advisor with Birches Health and former Cigna/Evernorth CMO for behavioral health) was one of the more eye-opening conversations Hospitalogy’s Blake Madden has had on payor behavioral spend. Think about this: 39 states + DC have legalized online gambling, FanDuel and DraftKings are sponsoring everything that moves, and yet payors will tell you they don't "see" the gambling disorder volume in their claims data. That's because it's getting coded as depression or anxiety. F63.0 never makes it to the bill. Blake, Doug, and Elliott get into the real prevalence numbers (a recent Pennsylvania study puts roughly a third of the state somewhere on the gambling-risk spectrum), why specialty networks for behavioral process addictions are about to follow the same pattern Equip ran in eating disorders, and what AI actually does in this model (spoiler: it's not replacing the therapist). Blake also pushed Elliott on the "anti-capitalism" of building a clinical model that explicitly wants patients to use you less over time. Elliott’s answer was sharp. Follow Birches Health on LinkedIn: ⁠https://www.linkedin.com/company/bircheshealth/⁠ Follow Doug on LinkedIn: https://www.linkedin.com/in/douglasnemecek/ Follow Elliott on LinkedIn: https://www.linkedin.com/in/er1/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ Featuring: Elliott Rapaport (Founder of Birches Health) and Dr. Doug Nemecek (Senior advisor with Birches Health and former Cigna/Evernorth CMO)

---

This episode with two experts in the mental health space (Elliott Rapaport, Founder of Birches Health, and Dr. Doug Nemecek, a senior advisor with Birches Health and former Cigna/Evernorth CMO for behavioral health) was one of the more eye-opening conversations Hospitalogy’s Blake Madden has had on payor behavioral spend.

Think about this: 39 states + DC have legalized online gambling, FanDuel and DraftKings are sponsoring everything that moves, and yet payors will tell you they don't "see" the gambling disorder volume in their claims data. That's because it's getting coded as depression or anxiety. F63.0 never makes it to the bill.

Blake, Doug, and Elliott get into the real prevalence numbers (a recent Pennsylvania study puts roughly a third of the state somewhere on the gambling-risk spectrum), why specialty networks for behavioral process addictions are about to follow the same pattern Equip ran in eating disorders, and what AI actually does in this model (spoiler: it's not replacing the therapist).

Blake also pushed Elliott on the "anti-capitalism" of building a clinical model that explicitly wants patients to use you less over time. Elliott’s answer was sharp.


Follow Birches Health on LinkedIn: ⁠https://www.linkedin.com/company/bircheshealth/⁠

Follow Doug on LinkedIn: https://www.linkedin.com/in/douglasnemecek/

Follow Elliott on LinkedIn: https://www.linkedin.com/in/er1/

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

https://navvishealthcare.com/vbc

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠

Be sure to leave us a review, and share our podcast with colleagues.

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

]]> 3676 AvoMD’s Series A and the Bet That Epic Doesn't Eat Everything (with Yair Saperstein, MD MPH) Hospitalogy's Blake Madden sits down with Yair Saperstein, MD MPH — co-founder and CEO of AvoMD — fresh off the company's Series A close in Q1. Yair makes the case that the real prize in clinical AI isn't the AI scribe, it's the operating system living inside the EHR itself, and why he thinks most of primary care ultimately gets replaced by AI voice chatbots, at-home labs, and wearables. Blake also pushes Yair on the Open Evidence valuation question (politely sidestepped), how AvoMD sells differently to academic systems versus rural hospitals, and the "avoid the 800-pound gorilla" go-to-market strategy against Epic. Plus: what Dr. Oz told a ViVE crowd about agentic AI being in front of every patient by 2028 — and a closing piece of life advice that somehow involves Frogger. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ Tue, 21 Jul 2026 10:00:00 -0000 full Blake Madden Hospitalogy's Blake Madden sits down with Yair Saperstein, MD MPH — co-founder and CEO of AvoMD — fresh off the company's Series A close in Q1. Yair makes the case that the real prize in clinical AI isn't the AI scribe, it's the operating system living inside the EHR itself, and why he thinks most of primary care ultimately gets replaced by AI voice chatbots, at-home labs, and wearables. Blake also pushes Yair on the Open Evidence valuation question (politely sidestepped), how AvoMD sells differently to academic systems versus rural hospitals, and the "avoid the 800-pound gorilla" go-to-market strategy against Epic. Plus: what Dr. Oz told a ViVE crowd about agentic AI being in front of every patient by 2028 — and a closing piece of life advice that somehow involves Frogger. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ Hospitalogy's Blake Madden sits down with Yair Saperstein, MD MPH — co-founder and CEO of AvoMD — fresh off the company's Series A close in Q1.

Yair makes the case that the real prize in clinical AI isn't the AI scribe, it's the operating system living inside the EHR itself, and why he thinks most of primary care ultimately gets replaced by AI voice chatbots, at-home labs, and wearables.

Blake also pushes Yair on the Open Evidence valuation question (politely sidestepped), how AvoMD sells differently to academic systems versus rural hospitals, and the "avoid the 800-pound gorilla" go-to-market strategy against Epic.

Plus: what Dr. Oz told a ViVE crowd about agentic AI being in front of every patient by 2028 — and a closing piece of life advice that somehow involves Frogger.

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

https://navvishealthcare.com/vbc

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠

Be sure to leave us a review, and share our podcast with colleagues.

---

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

]]> 3163 Inside US Heart and Vascular: Cardiology's Independent Integration Play and When Private Equity Works Featuring: Emily Rash (COO) and Dr. Neil Gheewala (CMO of Value-Based Care), US Heart and Vascular --- Is 3-6 weeks really how long patients should have to wait to see a cardiologist? That's the national average — and it's the exact inefficiency Emily Rash (COO) and Dr. Neil Gheewala (CMO of Value-Based Care) at US Heart and Vascular are betting they can fix. Blake Madden sat down with them for a refreshingly candid conversation about what actually separates an integrated cardiology platform from a bunch of practices bolted onto a cap table. In this episode: The Ares + Rubicon Founders dual capital structure — arguably the sharpest specialty-VBC sponsor pairing out there The "AIR" framework (autonomy, independence, representative governance), and why the third leg is the one most rollups get wrong Why cardiology might be the cleanest specialty fit for value-based care, full stop (no structural fee-for-service conflict the way a hospital has) Neil's actual pitch to RFK Jr. for a "Level 6" reimbursement category for ambulatory IV diuretics (CMMI, this one's free) Where cardiology bifurcates in the next five years: outpatient access groups vs. hospital-based acute care If specialty VBC, physician governance, or the cardiology rollup wave are anywhere on your radar, this one's worth the listen. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ Tue, 14 Jul 2026 10:00:00 -0000 full Blake Madden Featuring: Emily Rash (COO) and Dr. Neil Gheewala (CMO of Value-Based Care), US Heart and Vascular --- Is 3-6 weeks really how long patients should have to wait to see a cardiologist? That's the national average — and it's the exact inefficiency Emily Rash (COO) and Dr. Neil Gheewala (CMO of Value-Based Care) at US Heart and Vascular are betting they can fix. Blake Madden sat down with them for a refreshingly candid conversation about what actually separates an integrated cardiology platform from a bunch of practices bolted onto a cap table. In this episode: The Ares + Rubicon Founders dual capital structure — arguably the sharpest specialty-VBC sponsor pairing out there The "AIR" framework (autonomy, independence, representative governance), and why the third leg is the one most rollups get wrong Why cardiology might be the cleanest specialty fit for value-based care, full stop (no structural fee-for-service conflict the way a hospital has) Neil's actual pitch to RFK Jr. for a "Level 6" reimbursement category for ambulatory IV diuretics (CMMI, this one's free) Where cardiology bifurcates in the next five years: outpatient access groups vs. hospital-based acute care If specialty VBC, physician governance, or the cardiology rollup wave are anywhere on your radar, this one's worth the listen. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ Featuring: Emily Rash (COO) and Dr. Neil Gheewala (CMO of Value-Based Care), US Heart and Vascular

---

Is 3-6 weeks really how long patients should have to wait to see a cardiologist?

That's the national average — and it's the exact inefficiency Emily Rash (COO) and Dr. Neil Gheewala (CMO of Value-Based Care) at US Heart and Vascular are betting they can fix. Blake Madden sat down with them for a refreshingly candid conversation about what actually separates an integrated cardiology platform from a bunch of practices bolted onto a cap table.

In this episode:

  • The Ares + Rubicon Founders dual capital structure — arguably the sharpest specialty-VBC sponsor pairing out there
  • The "AIR" framework (autonomy, independence, representative governance), and why the third leg is the one most rollups get wrong
  • Why cardiology might be the cleanest specialty fit for value-based care, full stop (no structural fee-for-service conflict the way a hospital has)
  • Neil's actual pitch to RFK Jr. for a "Level 6" reimbursement category for ambulatory IV diuretics (CMMI, this one's free)
  • Where cardiology bifurcates in the next five years: outpatient access groups vs. hospital-based acute care

If specialty VBC, physician governance, or the cardiology rollup wave are anywhere on your radar, this one's worth the listen.

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

https://navvishealthcare.com/vbc

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠

Be sure to leave us a review, and share our podcast with colleagues.

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

]]> 3219 Whoop for Your Poop: Inside Throne Science's Bet on the Smart Toilet (with Scott Hickle, Co-Founder, Throne Science) This episode covers something Claims Denied hasn't touched before: the world's first passive gut health monitoring device. Blake sits down with Scott Hickle, co-founder of Throne Science, for a deep dive into the tech behind hands-free gut health, hydration, and urinary health monitoring — and yes, that means talking about poop for an hour. It turns out to be one of the most fascinating conversations on the pod yet, covering real technology, wild behavior-change data, and a long-term vision for cancer screening. Listen to hear: How Throne's monitor clips onto your toilet, identifies users via Bluetooth, and runs entirely in the background with no sample collection and no manual logging How Whoop's former CTO ended up joining the team after a hospital stay with ulcerative colitis What three years of obsessive product development looks like when building a camera for the most intimate room in someone's home What longitudinal gut health data reveals that elimination diets and manual stool logs can't How Oura Ring's decade-long arc — from 2,400 Kickstarter units to an $11 billion valuation — shapes Throne's own go-to-market patience The roadmap toward detecting microscopic blood in stool, and why that could make Throne a smoke detector for colon cancer, bladder cancer, and more Follow Scott Hickle on LinkedIn: https://www.linkedin.com/in/scotthickle/ Follow Throne Science on LinkedIn: https://www.linkedin.com/company/thronescience/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ Tue, 07 Jul 2026 10:00:00 -0000 full Blake Madden This episode covers something Claims Denied hasn't touched before: the world's first passive gut health monitoring device. Blake sits down with Scott Hickle, co-founder of Throne Science, for a deep dive into the tech behind hands-free gut health, hydration, and urinary health monitoring — and yes, that means talking about poop for an hour. It turns out to be one of the most fascinating conversations on the pod yet, covering real technology, wild behavior-change data, and a long-term vision for cancer screening. Listen to hear: How Throne's monitor clips onto your toilet, identifies users via Bluetooth, and runs entirely in the background with no sample collection and no manual logging How Whoop's former CTO ended up joining the team after a hospital stay with ulcerative colitis What three years of obsessive product development looks like when building a camera for the most intimate room in someone's home What longitudinal gut health data reveals that elimination diets and manual stool logs can't How Oura Ring's decade-long arc — from 2,400 Kickstarter units to an $11 billion valuation — shapes Throne's own go-to-market patience The roadmap toward detecting microscopic blood in stool, and why that could make Throne a smoke detector for colon cancer, bladder cancer, and more Follow Scott Hickle on LinkedIn: https://www.linkedin.com/in/scotthickle/ Follow Throne Science on LinkedIn: https://www.linkedin.com/company/thronescience/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ This episode covers something Claims Denied hasn't touched before: the world's first passive gut health monitoring device.

Blake sits down with Scott Hickle, co-founder of Throne Science, for a deep dive into the tech behind hands-free gut health, hydration, and urinary health monitoring — and yes, that means talking about poop for an hour. It turns out to be one of the most fascinating conversations on the pod yet, covering real technology, wild behavior-change data, and a long-term vision for cancer screening.

Listen to hear:

  • How Throne's monitor clips onto your toilet, identifies users via Bluetooth, and runs entirely in the background with no sample collection and no manual logging
  • How Whoop's former CTO ended up joining the team after a hospital stay with ulcerative colitis
  • What three years of obsessive product development looks like when building a camera for the most intimate room in someone's home
  • What longitudinal gut health data reveals that elimination diets and manual stool logs can't
  • How Oura Ring's decade-long arc — from 2,400 Kickstarter units to an $11 billion valuation — shapes Throne's own go-to-market patience
  • The roadmap toward detecting microscopic blood in stool, and why that could make Throne a smoke detector for colon cancer, bladder cancer, and more

Follow Scott Hickle on LinkedIn: https://www.linkedin.com/in/scotthickle/

Follow Throne Science on LinkedIn: https://www.linkedin.com/company/thronescience/

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

https://navvishealthcare.com/vbc


For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠

Be sure to leave us a review, and share our podcast with colleagues.

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

]]> 3664 VBC’s shift to performance, AI agents on the org chart, LEAD is a no-go, and why health systems should prep for mandatory risk models (with Tim Elliott, CEO of Navvis) In this latest episode of Claims Denied, Blake sits down with Tim Elliott, CEO of Navvis, for one of the most clear-eyed conversations he's had on where value-based models are actually headed. Tim doesn't deal in buzzwords or wishful thinking. He deals in what's actually working, what operators are getting wrong, and where the puck is going — whether you're ready for it or not. Here were some gems from the discussion which makes the broader convo worth your time: Payment innovation will always come out of the government. Tim's conviction is that DRGs came from CMS, and the next durable models, commercial and governmental alike, will too. Not the private market. Tim is a fan of moving more into mandatory risk models. While most operators are bracing against mandatory, Tim thinks the mandatory direction is exactly where we need to go and would tell CMMI to keep pushing. LEAD is a no-go right now for most systems. Navvis' analysis with their partners anticipates very few of them will move to LEAD as it stands today. Benchmarking and settlement math doesn't pencil yet, so it's enhanced-track MSSP until they get a few more reps. Stop leading with the comp model. Popular belief (that Blake asked Tim about) is that nothing changes in healthcare until physician comp changes. Tim pushed back on this notion hard. At SSM Health, he led with culture first and comp later, and argued you can get pretty darn far before you ever touch the RVU. FTEs are becoming FTAs, meaning full-time equivalent agents. His advice was to start drawing your org chart with agents on it. Pretty interesting mental model and paradigm shift. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Tim Elliott on LinkedIn: https://www.linkedin.com/in/tim-elliott-b246aa151/  Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ Tue, 23 Jun 2026 11:00:00 -0000 full Blake Madden In this latest episode of Claims Denied, Blake sits down with Tim Elliott, CEO of Navvis, for one of the most clear-eyed conversations he's had on where value-based models are actually headed. Tim doesn't deal in buzzwords or wishful thinking. He deals in what's actually working, what operators are getting wrong, and where the puck is going — whether you're ready for it or not. Here were some gems from the discussion which makes the broader convo worth your time: Payment innovation will always come out of the government. Tim's conviction is that DRGs came from CMS, and the next durable models, commercial and governmental alike, will too. Not the private market. Tim is a fan of moving more into mandatory risk models. While most operators are bracing against mandatory, Tim thinks the mandatory direction is exactly where we need to go and would tell CMMI to keep pushing. LEAD is a no-go right now for most systems. Navvis' analysis with their partners anticipates very few of them will move to LEAD as it stands today. Benchmarking and settlement math doesn't pencil yet, so it's enhanced-track MSSP until they get a few more reps. Stop leading with the comp model. Popular belief (that Blake asked Tim about) is that nothing changes in healthcare until physician comp changes. Tim pushed back on this notion hard. At SSM Health, he led with culture first and comp later, and argued you can get pretty darn far before you ever touch the RVU. FTEs are becoming FTAs, meaning full-time equivalent agents. His advice was to start drawing your org chart with agents on it. Pretty interesting mental model and paradigm shift. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Tim Elliott on LinkedIn: https://www.linkedin.com/in/tim-elliott-b246aa151/  Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ In this latest episode of Claims Denied, Blake sits down with Tim Elliott, CEO of Navvis, for one of the most clear-eyed conversations he's had on where value-based models are actually headed.

Tim doesn't deal in buzzwords or wishful thinking. He deals in what's actually working, what operators are getting wrong, and where the puck is going — whether you're ready for it or not.

Here were some gems from the discussion which makes the broader convo worth your time:

  • Payment innovation will always come out of the government. Tim's conviction is that DRGs came from CMS, and the next durable models, commercial and governmental alike, will too. Not the private market.
  • Tim is a fan of moving more into mandatory risk models. While most operators are bracing against mandatory, Tim thinks the mandatory direction is exactly where we need to go and would tell CMMI to keep pushing.
  • LEAD is a no-go right now for most systems. Navvis' analysis with their partners anticipates very few of them will move to LEAD as it stands today. Benchmarking and settlement math doesn't pencil yet, so it's enhanced-track MSSP until they get a few more reps.
  • Stop leading with the comp model. Popular belief (that Blake asked Tim about) is that nothing changes in healthcare until physician comp changes. Tim pushed back on this notion hard. At SSM Health, he led with culture first and comp later, and argued you can get pretty darn far before you ever touch the RVU.
  • FTEs are becoming FTAs, meaning full-time equivalent agents. His advice was to start drawing your org chart with agents on it. Pretty interesting mental model and paradigm shift.

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

https://navvishealthcare.com/vbc

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠

Be sure to leave us a review, and share our podcast with colleagues.

Follow Tim Elliott on LinkedIn: https://www.linkedin.com/in/tim-elliott-b246aa151/ 

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

]]> 3485 How Lantern and Morgan Health Are Re-Wiring Employer Healthcare, And Why Narrow Networks Are Suddenly Worth a Second Look (with Dan Mendelson, CEO Morgan Health and John Zutter, CEO Lantern) Blake Madden sits down with two of the people most responsible for re-wiring the employer side of healthcare right now: Dan Mendelson, CEO of Morgan Health — JPMorgan Chase's $280M healthcare investment arm — and John Zutter, CEO of Lantern, a specialty care navigation platform now covering 12 million member lives. The conversation covers serious ground: How Lantern cracked the code on surgeons of excellence at a community level Why Dan thinks traditional payer networks are failing The $10M cell & gene therapy math nobody at the employer level wants to run Whether AI finally makes narrow networks work this time around Why specialty care, oncology, infusions, and specialty drugs represent ~60% of total employer healthcare spend — and are growing 1.5x to 3x faster than overall trend If you sell into employers, sit on a benefits committee, run a self-funded plan, or invest in this corner of the market, this one's worth blocking off the time for. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠⁠https://navvishealthcare.com/vbc⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠  Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠  --- Follow Dan Mendelson on LinkedIn: https://www.linkedin.com/in/dnmendelson/  Follow John Zutter on LinkedIn: https://www.linkedin.com/in/john-zutter-687000a/  Tue, 16 Jun 2026 11:00:00 -0000 full Blake Madden Blake Madden sits down with two of the people most responsible for re-wiring the employer side of healthcare right now: Dan Mendelson, CEO of Morgan Health — JPMorgan Chase's $280M healthcare investment arm — and John Zutter, CEO of Lantern, a specialty care navigation platform now covering 12 million member lives. The conversation covers serious ground: How Lantern cracked the code on surgeons of excellence at a community level Why Dan thinks traditional payer networks are failing The $10M cell & gene therapy math nobody at the employer level wants to run Whether AI finally makes narrow networks work this time around Why specialty care, oncology, infusions, and specialty drugs represent ~60% of total employer healthcare spend — and are growing 1.5x to 3x faster than overall trend If you sell into employers, sit on a benefits committee, run a self-funded plan, or invest in this corner of the market, this one's worth blocking off the time for. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠⁠https://navvishealthcare.com/vbc⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠  Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠  --- Follow Dan Mendelson on LinkedIn: https://www.linkedin.com/in/dnmendelson/  Follow John Zutter on LinkedIn: https://www.linkedin.com/in/john-zutter-687000a/  Blake Madden sits down with two of the people most responsible for re-wiring the employer side of healthcare right now: Dan Mendelson, CEO of Morgan Health — JPMorgan Chase's $280M healthcare investment arm — and John Zutter, CEO of Lantern, a specialty care navigation platform now covering 12 million member lives.

The conversation covers serious ground:

  • How Lantern cracked the code on surgeons of excellence at a community level
  • Why Dan thinks traditional payer networks are failing
  • The $10M cell & gene therapy math nobody at the employer level wants to run
  • Whether AI finally makes narrow networks work this time around
  • Why specialty care, oncology, infusions, and specialty drugs represent ~60% of total employer healthcare spend — and are growing 1.5x to 3x faster than overall trend

If you sell into employers, sit on a benefits committee, run a self-funded plan, or invest in this corner of the market, this one's worth blocking off the time for.

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

⁠⁠https://navvishealthcare.com/vbc⁠⁠

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠ 

Be sure to leave us a review, and share our podcast with colleagues.

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠ 

---

Follow Dan Mendelson on LinkedIn: https://www.linkedin.com/in/dnmendelson/ 

Follow John Zutter on LinkedIn: https://www.linkedin.com/in/john-zutter-687000a/ 

]]> 3366 From Multiplan Insider to Multiplan Disruptor: The Daffodil Health Story (with Navin Nagiah, CEO of Daffodil Health) In this latest episode of Claims Denied, Blake Madden sits down with Navin Nagiah, co-founder and CEO of Daffodil Health. Navin spent nearly two years inside Multiplan trying to modernize their repricing model from the inside — went to the board three times, couldn't get alignment, and left to build the AI-native version himself. Blake and Navin get into the No Surprises Act arbitration imbalance (88% provider win rate), why the "percent of savings" model is built on a fake pricing anchor, and Daffodil's vision to evolve from OON repricing into a full smart plan platform. Plus, Navin shares why a 10-day silent meditation retreat is a founder development hack. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠https://navvishealthcare.com/vbc⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠  Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠  --- To learn more about Daffodil Health, check out their website: https://daffodilhealth.com/ Follow Navin Nagiah on LinkedIn: ⁠https://www.linkedin.com/in/navin-nagiah-8ab16⁠ Tue, 09 Jun 2026 10:00:00 -0000 full Blake Madden In this latest episode of Claims Denied, Blake Madden sits down with Navin Nagiah, co-founder and CEO of Daffodil Health. Navin spent nearly two years inside Multiplan trying to modernize their repricing model from the inside — went to the board three times, couldn't get alignment, and left to build the AI-native version himself. Blake and Navin get into the No Surprises Act arbitration imbalance (88% provider win rate), why the "percent of savings" model is built on a fake pricing anchor, and Daffodil's vision to evolve from OON repricing into a full smart plan platform. Plus, Navin shares why a 10-day silent meditation retreat is a founder development hack. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠https://navvishealthcare.com/vbc⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠  Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠  --- To learn more about Daffodil Health, check out their website: https://daffodilhealth.com/ Follow Navin Nagiah on LinkedIn: ⁠https://www.linkedin.com/in/navin-nagiah-8ab16⁠ In this latest episode of Claims Denied, Blake Madden sits down with Navin Nagiah, co-founder and CEO of Daffodil Health.

Navin spent nearly two years inside Multiplan trying to modernize their repricing model from the inside — went to the board three times, couldn't get alignment, and left to build the AI-native version himself.

Blake and Navin get into the No Surprises Act arbitration imbalance (88% provider win rate), why the "percent of savings" model is built on a fake pricing anchor, and Daffodil's vision to evolve from OON repricing into a full smart plan platform.

Plus, Navin shares why a 10-day silent meditation retreat is a founder development hack.

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.

⁠https://navvishealthcare.com/vbc⁠

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠ 

Be sure to leave us a review, and share our podcast with colleagues.

Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠ 

---

To learn more about Daffodil Health, check out their website: https://daffodilhealth.com/

Follow Navin Nagiah on LinkedIn: ⁠https://www.linkedin.com/in/navin-nagiah-8ab16⁠

]]> 2821 MA is a Flat Circle, the Physician Subsidy Bear Case, and Why Density Beats Scale (with Jason Ross, EVP at Privia Health) Hospitalogy's Blake Madden sits down with Jason Ross, EVP of Medical Groups at Privia Health, a guy who has worked basically every seat at the healthcare table. Jason is currently running the largest portion of Privia's single-TIN medical group footprint across a publicly traded enabler. Coming out of Privia's Q1 print, Blake and Jason leaned into on the stuff Wall Street keeps missing. The MA down-cycle and whether VBC is actually broken or just on a familiar back-half-of-the-cycle slump. Privia’s portfolio philosophy — why Privia runs 100+ FFS contracts alongside 100+ VBC contracts when half the market chased pure-play full-risk.  The unsustainability of the health system physician subsidy model from somebody who lived it. Density vs. scale. The PE second-bite math falling apart in real time. Privia is hitting singles and doubles (Not flashy, but Tony Gwynn never hit for power either...and he ended up in the Hall of Fame!) --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠  Be sure to leave us a review, and share our podcast with colleagues. Follow Jason Ross on LinkedIn: https://www.linkedin.com/in/jasonwross/ Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠  Tue, 02 Jun 2026 12:00:00 -0000 full Blake Madden Hospitalogy's Blake Madden sits down with Jason Ross, EVP of Medical Groups at Privia Health, a guy who has worked basically every seat at the healthcare table. Jason is currently running the largest portion of Privia's single-TIN medical group footprint across a publicly traded enabler. Coming out of Privia's Q1 print, Blake and Jason leaned into on the stuff Wall Street keeps missing. The MA down-cycle and whether VBC is actually broken or just on a familiar back-half-of-the-cycle slump. Privia’s portfolio philosophy — why Privia runs 100+ FFS contracts alongside 100+ VBC contracts when half the market chased pure-play full-risk.  The unsustainability of the health system physician subsidy model from somebody who lived it. Density vs. scale. The PE second-bite math falling apart in real time. Privia is hitting singles and doubles (Not flashy, but Tony Gwynn never hit for power either...and he ended up in the Hall of Fame!) --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠  Be sure to leave us a review, and share our podcast with colleagues. Follow Jason Ross on LinkedIn: https://www.linkedin.com/in/jasonwross/ Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠  Hospitalogy's Blake Madden sits down with Jason Ross, EVP of Medical Groups at Privia Health, a guy who has worked basically every seat at the healthcare table. Jason is currently running the largest portion of Privia's single-TIN medical group footprint across a publicly traded enabler.

Coming out of Privia's Q1 print, Blake and Jason leaned into on the stuff Wall Street keeps missing.

  • The MA down-cycle and whether VBC is actually broken or just on a familiar back-half-of-the-cycle slump.
  • Privia’s portfolio philosophy — why Privia runs 100+ FFS contracts alongside 100+ VBC contracts when half the market chased pure-play full-risk. 
  • The unsustainability of the health system physician subsidy model from somebody who lived it.
  • Density vs. scale.
  • The PE second-bite math falling apart in real time.
  • Privia is hitting singles and doubles (Not flashy, but Tony Gwynn never hit for power either...and he ended up in the Hall of Fame!)

---

Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.


https://navvishealthcare.com/vbc

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ 

Be sure to leave us a review, and share our podcast with colleagues.


Follow Jason Ross on LinkedIn: https://www.linkedin.com/in/jasonwross/


Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ 

]]> 3327 Insuring Against the Incumbents: Why Indigo Technologies' Jared Kaplan Is Betting MedMal Is Ripe for Disruption You may think the insurance industry is dull, but not this conversation! For this episode, I sat down with Jared Kaplan, CEO and founder of Indigo Technologies, to talk about why medical malpractice insurance is one of the last bastions of healthcare that hasn't been touched by modern technology.  We also discussed how Indigo is using 1,500+ predictive attributes to blow up the 15-page application and individualize physician risk in a $13B market.  And we got into InsureTech 3.0, nuclear verdicts reshaping hospital balance sheets, why the best technology in the world means nothing without broker trust, and whether AI-enabled clinical care will eventually become a malpractice discount the way a burglar alarm lowers your homeowners’ premium.  --- Learn more about Indigo Technologies: https://www.getindigo.com/ Follow Jared Kaplan on LinkedIn: https://www.linkedin.com/in/jared-kaplan-683412/ --- Follow Blake Madden on LinkedIn: ⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠  For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠https://hospitalogy.com/⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠https://hospitalogy.com/podcast/⁠⁠  Be sure to leave us a review, and share our podcast with colleagues. Tue, 26 May 2026 18:22:00 -0000 full Blake Madden You may think the insurance industry is dull, but not this conversation! For this episode, I sat down with Jared Kaplan, CEO and founder of Indigo Technologies, to talk about why medical malpractice insurance is one of the last bastions of healthcare that hasn't been touched by modern technology.  We also discussed how Indigo is using 1,500+ predictive attributes to blow up the 15-page application and individualize physician risk in a $13B market.  And we got into InsureTech 3.0, nuclear verdicts reshaping hospital balance sheets, why the best technology in the world means nothing without broker trust, and whether AI-enabled clinical care will eventually become a malpractice discount the way a burglar alarm lowers your homeowners’ premium.  --- Learn more about Indigo Technologies: https://www.getindigo.com/ Follow Jared Kaplan on LinkedIn: https://www.linkedin.com/in/jared-kaplan-683412/ --- Follow Blake Madden on LinkedIn: ⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠  For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠https://hospitalogy.com/⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠https://hospitalogy.com/podcast/⁠⁠  Be sure to leave us a review, and share our podcast with colleagues. You may think the insurance industry is dull, but not this conversation!

For this episode, I sat down with Jared Kaplan, CEO and founder of Indigo Technologies, to talk about why medical malpractice insurance is one of the last bastions of healthcare that hasn't been touched by modern technology. 

We also discussed how Indigo is using 1,500+ predictive attributes to blow up the 15-page application and individualize physician risk in a $13B market. 

And we got into InsureTech 3.0, nuclear verdicts reshaping hospital balance sheets, why the best technology in the world means nothing without broker trust, and whether AI-enabled clinical care will eventually become a malpractice discount the way a burglar alarm lowers your homeowners’ premium. 

---

Learn more about Indigo Technologies: https://www.getindigo.com/

Follow Jared Kaplan on LinkedIn: https://www.linkedin.com/in/jared-kaplan-683412/

---

Follow Blake Madden on LinkedIn: ⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠ 

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠https://hospitalogy.com/⁠⁠

Like our podcast? Listen to previous episodes here: ⁠⁠https://hospitalogy.com/podcast/⁠⁠ 

Be sure to leave us a review, and share our podcast with colleagues.

]]> 3292 From Surgery Center Newsletter to Healthcare Media Empire (with Scott Becker) In this episode, Blake Madden sits down with Scott Becker, founder of Becker's Healthcare, practicing healthcare lawyer at McGuireWoods, and one of the longest-running names in healthcare media, for a wide-ranging conversation that ended up being as much about building businesses as it was about healthcare itself. This was Blake's first time meeting Scott, and yeah, they are nominally competitors. But Scott immediately reframes it: rising tide, abundant landscape, etc. Then he proceeds to show he walks the walk, sharing what he's learned building one of healthcare's most recognized media brands over 30+ years. Blake and Scott get into: The origin of Becker's (Spoiler Alert: zero genius involved, just disciplined doubling down!) Why short-form journalism was a battlefield internally before it was obvious externally, the 10–20 relationships that actually build careers Scott's pretty blunt takes on the state of U.S. healthcare This is a great one for anyone building something, in healthcare or otherwise. --- Becker’s Healthcare: https://www.beckershospitalreview.com/ Follow Scott Becker on LinkedIn: https://www.linkedin.com/in/scott-becker-ab7056176/ --- Follow Blake Madden on LinkedIn: ⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠  For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠ Like our podcast? Listen to previous episodes here: ⁠https://hospitalogy.com/podcast/⁠  Be sure to leave us a review, and share our podcast with colleagues. Tue, 19 May 2026 10:00:00 -0000 full Blake Madden In this episode, Blake Madden sits down with Scott Becker, founder of Becker's Healthcare, practicing healthcare lawyer at McGuireWoods, and one of the longest-running names in healthcare media, for a wide-ranging conversation that ended up being as much about building businesses as it was about healthcare itself. This was Blake's first time meeting Scott, and yeah, they are nominally competitors. But Scott immediately reframes it: rising tide, abundant landscape, etc. Then he proceeds to show he walks the walk, sharing what he's learned building one of healthcare's most recognized media brands over 30+ years. Blake and Scott get into: The origin of Becker's (Spoiler Alert: zero genius involved, just disciplined doubling down!) Why short-form journalism was a battlefield internally before it was obvious externally, the 10–20 relationships that actually build careers Scott's pretty blunt takes on the state of U.S. healthcare This is a great one for anyone building something, in healthcare or otherwise. --- Becker’s Healthcare: https://www.beckershospitalreview.com/ Follow Scott Becker on LinkedIn: https://www.linkedin.com/in/scott-becker-ab7056176/ --- Follow Blake Madden on LinkedIn: ⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠  For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠ Like our podcast? Listen to previous episodes here: ⁠https://hospitalogy.com/podcast/⁠  Be sure to leave us a review, and share our podcast with colleagues. In this episode, Blake Madden sits down with Scott Becker, founder of Becker's Healthcare, practicing healthcare lawyer at McGuireWoods, and one of the longest-running names in healthcare media, for a wide-ranging conversation that ended up being as much about building businesses as it was about healthcare itself.

This was Blake's first time meeting Scott, and yeah, they are nominally competitors. But Scott immediately reframes it: rising tide, abundant landscape, etc. Then he proceeds to show he walks the walk, sharing what he's learned building one of healthcare's most recognized media brands over 30+ years.

Blake and Scott get into:

  • The origin of Becker's (Spoiler Alert: zero genius involved, just disciplined doubling down!)
  • Why short-form journalism was a battlefield internally before it was obvious externally, the 10–20 relationships that actually build careers
  • Scott's pretty blunt takes on the state of U.S. healthcare

This is a great one for anyone building something, in healthcare or otherwise.

---

Becker’s Healthcare: https://www.beckershospitalreview.com/

Follow Scott Becker on LinkedIn: https://www.linkedin.com/in/scott-becker-ab7056176/

---

Follow Blake Madden on LinkedIn: ⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠ 

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠

Like our podcast? Listen to previous episodes here: ⁠https://hospitalogy.com/podcast/⁠ 

Be sure to leave us a review, and share our podcast with colleagues.

]]> 3320 Debating AI, ICHRA, and the Employer Exit (with Teira Gunlock & Dr. Eric Bricker) In this latest episode of Claims Denied, Hospitalogy's Blake Madden pulls in two co-hosts — Teira Gunlock, CEO of First Stop Health, and Dr. Eric Bricker, Chief Medical Officer of AHealthcareZ — and the crew battle it out! Three topics. No script. Just healthcare's messiest debates. Listen as Tiera, Eric, and Blake get deep into AI regulation and whether EMRs need to be forced open. They jump into ICHRA vs. captives and why small/mid employers keep getting crushed on renewals. And you won't want to miss when Tiera pushes back on whether any of this is actually good for patients vs. just good for employers, the federal government, and everyone else trying to pass the healthcare cost hot potato (the “not it” dynamic). They even get philosophical about what work even looks like when intellectual labor gets commoditized.  Oh, and Eric lost a chicken the day he and Blake were supposed to meet for lunch. So there's that.  --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠ Like our podcast? Listen to previous episodes here: ⁠https://hospitalogy.com/podcast/⁠  Be sure to leave us a review, and share our podcast with colleagues. --- First Stop Health: https://www.firststophealth.com/  AHealthcareZ: https://www.ahealthcarez.com/ Follow Teira Gunlock on LinkedIn: https://www.linkedin.com/in/teiragunlock/ Follow Dr. Eric Bricker on LinkedIn: https://www.linkedin.com/in/ericbrickermd/  Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/  Tue, 12 May 2026 18:48:00 -0000 full Blake Madden In this latest episode of Claims Denied, Hospitalogy's Blake Madden pulls in two co-hosts — Teira Gunlock, CEO of First Stop Health, and Dr. Eric Bricker, Chief Medical Officer of AHealthcareZ — and the crew battle it out! Three topics. No script. Just healthcare's messiest debates. Listen as Tiera, Eric, and Blake get deep into AI regulation and whether EMRs need to be forced open. They jump into ICHRA vs. captives and why small/mid employers keep getting crushed on renewals. And you won't want to miss when Tiera pushes back on whether any of this is actually good for patients vs. just good for employers, the federal government, and everyone else trying to pass the healthcare cost hot potato (the “not it” dynamic). They even get philosophical about what work even looks like when intellectual labor gets commoditized.  Oh, and Eric lost a chicken the day he and Blake were supposed to meet for lunch. So there's that.  --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠ Like our podcast? Listen to previous episodes here: ⁠https://hospitalogy.com/podcast/⁠  Be sure to leave us a review, and share our podcast with colleagues. --- First Stop Health: https://www.firststophealth.com/  AHealthcareZ: https://www.ahealthcarez.com/ Follow Teira Gunlock on LinkedIn: https://www.linkedin.com/in/teiragunlock/ Follow Dr. Eric Bricker on LinkedIn: https://www.linkedin.com/in/ericbrickermd/  Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/  In this latest episode of Claims Denied, Hospitalogy's Blake Madden pulls in two co-hosts — Teira Gunlock, CEO of First Stop Health, and Dr. Eric Bricker, Chief Medical Officer of AHealthcareZ — and the crew battle it out!

Three topics. No script. Just healthcare's messiest debates.

Listen as Tiera, Eric, and Blake get deep into AI regulation and whether EMRs need to be forced open. They jump into ICHRA vs. captives and why small/mid employers keep getting crushed on renewals. And you won't want to miss when Tiera pushes back on whether any of this is actually good for patients vs. just good for employers, the federal government, and everyone else trying to pass the healthcare cost hot potato (the “not it” dynamic).

They even get philosophical about what work even looks like when intellectual labor gets commoditized. 

Oh, and Eric lost a chicken the day he and Blake were supposed to meet for lunch. So there's that. 

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠

Like our podcast? Listen to previous episodes here: ⁠https://hospitalogy.com/podcast/⁠ 

Be sure to leave us a review, and share our podcast with colleagues.

---

First Stop Health: https://www.firststophealth.com/ 

AHealthcareZ: https://www.ahealthcarez.com/

Follow Teira Gunlock on LinkedIn: https://www.linkedin.com/in/teiragunlock/

Follow Dr. Eric Bricker on LinkedIn: https://www.linkedin.com/in/ericbrickermd/ 

Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/ 

]]> 3969 1,300 Point Solutions Killed, CHF Admissions Halved, and the Mercy Playbook | Steve Mackin, Mercy CEO Blake sits down with Steve Mackin, CEO of Mercy — one of the top 15 health systems in the country with 55+ hospitals across Missouri, Oklahoma, Arkansas, and Kansas — to talk about how Mercy is quietly building one of the most interesting care model playbooks in the industry. Steve and Blake get into everything: why Mercy deliberately conceded on price to win on care model, how they cut CHF ED admissions in half, a 1,300 point solution purge, the Mayo data partnership, AI deployment at scale, and why Steve thinks there will be clear winners and losers among health systems over the next few years. This one's packed! --- Mercy: https://www.mercy.com/ Follow Steve Mackin on LinkedIn: https://www.linkedin.com/in/steve-mackin-18771021/ Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/  --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our podcast? Listen to previous episodes here: https://hospitalogy.com/podcast/  Be sure to leave us a review, and share our podcast with colleagues. Tue, 05 May 2026 10:00:00 -0000 full Blake Madden Blake sits down with Steve Mackin, CEO of Mercy — one of the top 15 health systems in the country with 55+ hospitals across Missouri, Oklahoma, Arkansas, and Kansas — to talk about how Mercy is quietly building one of the most interesting care model playbooks in the industry. Steve and Blake get into everything: why Mercy deliberately conceded on price to win on care model, how they cut CHF ED admissions in half, a 1,300 point solution purge, the Mayo data partnership, AI deployment at scale, and why Steve thinks there will be clear winners and losers among health systems over the next few years. This one's packed! --- Mercy: https://www.mercy.com/ Follow Steve Mackin on LinkedIn: https://www.linkedin.com/in/steve-mackin-18771021/ Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/  --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our podcast? Listen to previous episodes here: https://hospitalogy.com/podcast/  Be sure to leave us a review, and share our podcast with colleagues. Blake sits down with Steve Mackin, CEO of Mercy — one of the top 15 health systems in the country with 55+ hospitals across Missouri, Oklahoma, Arkansas, and Kansas — to talk about how Mercy is quietly building one of the most interesting care model playbooks in the industry.

Steve and Blake get into everything: why Mercy deliberately conceded on price to win on care model, how they cut CHF ED admissions in half, a 1,300 point solution purge, the Mayo data partnership, AI deployment at scale, and why Steve thinks there will be clear winners and losers among health systems over the next few years. This one's packed!

---

Mercy: https://www.mercy.com/

Follow Steve Mackin on LinkedIn: https://www.linkedin.com/in/steve-mackin-18771021/

Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/ 

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our podcast? Listen to previous episodes here: https://hospitalogy.com/podcast/ 

Be sure to leave us a review, and share our podcast with colleagues.

]]> 2999 Cancer's $220B Tab Isn't Going Anywhere: Reimagine Care, Oncology Ventures, and the Evolving State of the Cancer Care Space | Dan Nardi, Reimagine Care and Ben Freeberg, Oncology Ventures In this episode, Hospitalogy's Blake Madden talks with two operators who actually walk the walk in oncology: Ben Freeberg, founder of Oncology Ventures (recently announced Fund II) and Dan Nardi, CEO of Reimagine Care.  They deep-dive on why 1,000 of the 1,700 Americans who die of cancer every day don't have to, why 97% of the cancer journey happens outside the clinic (and almost nobody is building for it), and how Remy, Reimagine's AI-based virtual cancer center, is resolving half of all patient interactions autonomously while cutting ED visits by 67%. Blake also pushes Dan on the drug-distributor vertical integration question (the one nobody wants to answer on the record), and Ben goes into the Fund II thesis: life insurance as a new buyer, outpatient CAR-T, and the coming consolidation wave in digital oncology. If you care about where oncology care delivery is actually headed over the next 3-5 years, this one's for you! --- 00:00:00 - Introduction to Oncology Ventures and Reimagine Care 00:04:40 - Current State of Oncology and Investment Opportunities 00:09:43 - The Value Proposition of Reimagine Care 00:14:43 - The Role of Technology in Cancer Care 00:19:45 - Personalized Patient Engagement and Data Utilization 00:30:19 - Understanding Stakeholder Value in Oncology 00:32:41 - Fee-for-Service vs. Value-Based Care Dynamics 00:34:22 - Rethinking Incentives in Cancer Care 00:39:06 - The Role of Orchestration in Patient Care 00:42:10 - Convergence of Care Models and Patient Experience 00:45:19 - The Importance of Ambulatory Strategies 00:47:17 - Future Directions for Reimagine Care 00:52:06 - Exploring Partnerships and Growth Opportunities Oncology Ventures: https://www.oncology.ventures/ Reimagine Care: https://reimaginecare.com/ Follow Ben Freeberg on LinkedIn: https://www.linkedin.com/in/ben-freeberg/  Follow Dan Nardi on LinkedIn: https://www.linkedin.com/in/danjnardi/  Subscribe to Ben Freeberg’s newsletter: https://oncologyventures.substack.com/ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our podcast? Listen to previous episodes here: https://hospitalogy.com/podcast/  Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠https://www.linkedin.com/in/blakecmadden/⁠  Tue, 28 Apr 2026 10:00:00 -0000 full Blake Madden In this episode, Hospitalogy's Blake Madden talks with two operators who actually walk the walk in oncology: Ben Freeberg, founder of Oncology Ventures (recently announced Fund II) and Dan Nardi, CEO of Reimagine Care.  They deep-dive on why 1,000 of the 1,700 Americans who die of cancer every day don't have to, why 97% of the cancer journey happens outside the clinic (and almost nobody is building for it), and how Remy, Reimagine's AI-based virtual cancer center, is resolving half of all patient interactions autonomously while cutting ED visits by 67%. Blake also pushes Dan on the drug-distributor vertical integration question (the one nobody wants to answer on the record), and Ben goes into the Fund II thesis: life insurance as a new buyer, outpatient CAR-T, and the coming consolidation wave in digital oncology. If you care about where oncology care delivery is actually headed over the next 3-5 years, this one's for you! --- 00:00:00 - Introduction to Oncology Ventures and Reimagine Care 00:04:40 - Current State of Oncology and Investment Opportunities 00:09:43 - The Value Proposition of Reimagine Care 00:14:43 - The Role of Technology in Cancer Care 00:19:45 - Personalized Patient Engagement and Data Utilization 00:30:19 - Understanding Stakeholder Value in Oncology 00:32:41 - Fee-for-Service vs. Value-Based Care Dynamics 00:34:22 - Rethinking Incentives in Cancer Care 00:39:06 - The Role of Orchestration in Patient Care 00:42:10 - Convergence of Care Models and Patient Experience 00:45:19 - The Importance of Ambulatory Strategies 00:47:17 - Future Directions for Reimagine Care 00:52:06 - Exploring Partnerships and Growth Opportunities Oncology Ventures: https://www.oncology.ventures/ Reimagine Care: https://reimaginecare.com/ Follow Ben Freeberg on LinkedIn: https://www.linkedin.com/in/ben-freeberg/  Follow Dan Nardi on LinkedIn: https://www.linkedin.com/in/danjnardi/  Subscribe to Ben Freeberg’s newsletter: https://oncologyventures.substack.com/ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our podcast? Listen to previous episodes here: https://hospitalogy.com/podcast/  Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠https://www.linkedin.com/in/blakecmadden/⁠  In this episode, Hospitalogy's Blake Madden talks with two operators who actually walk the walk in oncology: Ben Freeberg, founder of Oncology Ventures (recently announced Fund II) and Dan Nardi, CEO of Reimagine Care. 

They deep-dive on why 1,000 of the 1,700 Americans who die of cancer every day don't have to, why 97% of the cancer journey happens outside the clinic (and almost nobody is building for it), and how Remy, Reimagine's AI-based virtual cancer center, is resolving half of all patient interactions autonomously while cutting ED visits by 67%.

Blake also pushes Dan on the drug-distributor vertical integration question (the one nobody wants to answer on the record), and Ben goes into the Fund II thesis: life insurance as a new buyer, outpatient CAR-T, and the coming consolidation wave in digital oncology.

If you care about where oncology care delivery is actually headed over the next 3-5 years, this one's for you!

---

00:00:00 - Introduction to Oncology Ventures and Reimagine Care

00:04:40 - Current State of Oncology and Investment Opportunities

00:09:43 - The Value Proposition of Reimagine Care

00:14:43 - The Role of Technology in Cancer Care

00:19:45 - Personalized Patient Engagement and Data Utilization

00:30:19 - Understanding Stakeholder Value in Oncology

00:32:41 - Fee-for-Service vs. Value-Based Care Dynamics

00:34:22 - Rethinking Incentives in Cancer Care

00:39:06 - The Role of Orchestration in Patient Care

00:42:10 - Convergence of Care Models and Patient Experience

00:45:19 - The Importance of Ambulatory Strategies

00:47:17 - Future Directions for Reimagine Care

00:52:06 - Exploring Partnerships and Growth Opportunities


Oncology Ventures: https://www.oncology.ventures/

Reimagine Care: https://reimaginecare.com/

Follow Ben Freeberg on LinkedIn: https://www.linkedin.com/in/ben-freeberg/ 

Follow Dan Nardi on LinkedIn: https://www.linkedin.com/in/danjnardi/ 

Subscribe to Ben Freeberg’s newsletter: https://oncologyventures.substack.com/

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our podcast? Listen to previous episodes here: https://hospitalogy.com/podcast/ 

Be sure to leave us a review, and share our podcast with colleagues.

Follow Blake Madden on LinkedIn: ⁠https://www.linkedin.com/in/blakecmadden/⁠ 

]]> 3721 Going Back to the Future: How Aetna is Redefining Itself and the Current State of Value-Based Care | Dr. Ali Khan, Chief Medical Officer of Medicare, Aetna/CVS Health What does it actually look like to run clinical strategy inside a vertically integrated giant when payor-provider trust is at a historic low? Blake Madden sits down with Dr. Ali Khan, Chief Medical Officer for Aetna Medicare, to get the answer to this question and more.  Dr. Khan has been employee 34 at Iora Health, a hospitalist/UM and CM medical director at CareMore, a division leader who scaled Oak Street Health from 23 to 75 clinics through the pandemic, and now he's trying to make CVS's vertical integration thesis actually work at the last mile. Key Topics: The real state of value-based care (spoiler: it's not as far along as anyone claims), Why Aetna is bringing nurses back to hospital bedsides, How behavioral economics is driving member engagement, and What AI should actually be used for in MA Amazing learnings in healthcare operations from someone who's practiced medicine and run P&Ls across every care model that matters. --- 00:00:00 - Introduction to Dr. Ali Khan and His Background 00:09:48 - The Evolution of Value-Based Care 00:18:45 - High Value Care vs. Value-Based Care 00:22:31 - Aetna's Transformation and Integrated Care Models 00:32:20 - Behavioral Economics in Healthcare 00:35:16 - Creating a Connected Ecosystem 00:38:54 - Navigating Structural Challenges in Healthcare 00:45:20 - Building Trust Between Payers and Providers 00:49:13 - Collaborative Care Models for Better Outcomes 00:55:11 - Triage of Current Healthcare Challenges 01:00:21 - Lessons from Healthcare Acquisitions --- Aetna Medicare: https://www.aetna.com/medicare.html  Follow Dr. Ali Khan on LinkedIn: https://www.linkedin.com/in/alikhan28/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 21 Apr 2026 10:00:00 -0000 full Blake Madden What does it actually look like to run clinical strategy inside a vertically integrated giant when payor-provider trust is at a historic low? Blake Madden sits down with Dr. Ali Khan, Chief Medical Officer for Aetna Medicare, to get the answer to this question and more.  Dr. Khan has been employee 34 at Iora Health, a hospitalist/UM and CM medical director at CareMore, a division leader who scaled Oak Street Health from 23 to 75 clinics through the pandemic, and now he's trying to make CVS's vertical integration thesis actually work at the last mile. Key Topics: The real state of value-based care (spoiler: it's not as far along as anyone claims), Why Aetna is bringing nurses back to hospital bedsides, How behavioral economics is driving member engagement, and What AI should actually be used for in MA Amazing learnings in healthcare operations from someone who's practiced medicine and run P&Ls across every care model that matters. --- 00:00:00 - Introduction to Dr. Ali Khan and His Background 00:09:48 - The Evolution of Value-Based Care 00:18:45 - High Value Care vs. Value-Based Care 00:22:31 - Aetna's Transformation and Integrated Care Models 00:32:20 - Behavioral Economics in Healthcare 00:35:16 - Creating a Connected Ecosystem 00:38:54 - Navigating Structural Challenges in Healthcare 00:45:20 - Building Trust Between Payers and Providers 00:49:13 - Collaborative Care Models for Better Outcomes 00:55:11 - Triage of Current Healthcare Challenges 01:00:21 - Lessons from Healthcare Acquisitions --- Aetna Medicare: https://www.aetna.com/medicare.html  Follow Dr. Ali Khan on LinkedIn: https://www.linkedin.com/in/alikhan28/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. What does it actually look like to run clinical strategy inside a vertically integrated giant when payor-provider trust is at a historic low?

Blake Madden sits down with Dr. Ali Khan, Chief Medical Officer for Aetna Medicare, to get the answer to this question and more. 

Dr. Khan has been employee 34 at Iora Health, a hospitalist/UM and CM medical director at CareMore, a division leader who scaled Oak Street Health from 23 to 75 clinics through the pandemic, and now he's trying to make CVS's vertical integration thesis actually work at the last mile.


Key Topics:

  • The real state of value-based care (spoiler: it's not as far along as anyone claims),

  • Why Aetna is bringing nurses back to hospital bedsides,

  • How behavioral economics is driving member engagement, and

  • What AI should actually be used for in MA

Amazing learnings in healthcare operations from someone who's practiced medicine and run P&Ls across every care model that matters.

---

00:00:00 - Introduction to Dr. Ali Khan and His Background

00:09:48 - The Evolution of Value-Based Care

00:18:45 - High Value Care vs. Value-Based Care

00:22:31 - Aetna's Transformation and Integrated Care Models

00:32:20 - Behavioral Economics in Healthcare

00:35:16 - Creating a Connected Ecosystem

00:38:54 - Navigating Structural Challenges in Healthcare

00:45:20 - Building Trust Between Payers and Providers

00:49:13 - Collaborative Care Models for Better Outcomes

00:55:11 - Triage of Current Healthcare Challenges

01:00:21 - Lessons from Healthcare Acquisitions

---

Aetna Medicare: https://www.aetna.com/medicare.html 

Follow Dr. Ali Khan on LinkedIn: https://www.linkedin.com/in/alikhan28/

For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.

]]> 4062 The Grifters and the Builders: Pharmacy's Gray Market, AI Prescribing, and the Medvi Meltdown | Otto Sipe, CEO and Co-founder at Photon Health I sat down with Otto Sipe, co-founder of Photon Health, for what turned into one of the most wide-ranging Claims Denied conversations we've had. We riffed on the Medvi debacle, why the NYT whiffed on due diligence, the entire arc from Hims to Cerebral to vibe-coded pill mills, and Otto's vision for AI prescribing modeled after self-driving cars. Otto's April Fool's satire about AI-powered peptide prescriptions literally came true the next day. You can't make this stuff up. For anyone thinking about DTC telehealth, pharmacy economics, PBM reform, or where AI meets clinical care, this one's a must-listen! --- To learn more about Photon Health, check them out at https://photonhealth.com/  Follow Otto Sipe on LinkedIn: https://www.linkedin.com/in/ottosipe/  --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe at https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, subscribe, and share our podcast with colleagues. Tue, 14 Apr 2026 16:30:00 -0000 full Blake Madden I sat down with Otto Sipe, co-founder of Photon Health, for what turned into one of the most wide-ranging Claims Denied conversations we've had. We riffed on the Medvi debacle, why the NYT whiffed on due diligence, the entire arc from Hims to Cerebral to vibe-coded pill mills, and Otto's vision for AI prescribing modeled after self-driving cars. Otto's April Fool's satire about AI-powered peptide prescriptions literally came true the next day. You can't make this stuff up. For anyone thinking about DTC telehealth, pharmacy economics, PBM reform, or where AI meets clinical care, this one's a must-listen! --- To learn more about Photon Health, check them out at https://photonhealth.com/  Follow Otto Sipe on LinkedIn: https://www.linkedin.com/in/ottosipe/  --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe at https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, subscribe, and share our podcast with colleagues. I sat down with Otto Sipe, co-founder of Photon Health, for what turned into one of the most wide-ranging Claims Denied conversations we've had.

We riffed on the Medvi debacle, why the NYT whiffed on due diligence, the entire arc from Hims to Cerebral to vibe-coded pill mills, and Otto's vision for AI prescribing modeled after self-driving cars.

Otto's April Fool's satire about AI-powered peptide prescriptions literally came true the next day. You can't make this stuff up.

For anyone thinking about DTC telehealth, pharmacy economics, PBM reform, or where AI meets clinical care, this one's a must-listen!

---

To learn more about Photon Health, check them out at https://photonhealth.com/ 

Follow Otto Sipe on LinkedIn: https://www.linkedin.com/in/ottosipe/ 

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe at https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, subscribe, and share our podcast with colleagues.

]]> 4011 Oura's Healthcare Pivot: How a Smart Ring Is Outperforming Every Engagement Play in Digital Health by 6x | Dorothy Kilroy, Chief Commercial Officer, Oura I went into this conversation expecting a consumer wearables story. I came out thinking Oura might be quietly building one of the more compelling engagement platforms in healthcare. In this episode, I sit down with Dorothy Kilroy, Chief Commercial Officer at Oura. Dorothy breaks down how a ring originally built around sleep and women's health is now generating 6x engagement vs. prior programs in Medicare Advantage, driving a Cigna partnership built on redesigning chronic care around continuous biometric data, and heading toward FDA submission on hypertension detection. The consumer wedge was never the end game. It was the proof point. --- Listen to hear why: 77% of Oura's MA members are active 5+ days a week, and why that number matters more than any wellness benefit stat you've seen. Oura built a custom women's health LLM, designed and vetted by in-house clinicians, specifically tuned to not be dismissive. (A low bar in healthcare. Somehow still rare.) The Cigna partnership isn't a wellness perk. It's a bet that chronic care management gets rebuilt around continuous biometric data, not episodic claims. Why Dorothy thinks clinicians don't need more data. They need filtered intelligence that fits real workflows. Awareness beats perfection, and why that mindset shapes both Oura's product philosophy and Dorothy's own approach to executive parenthood and imposter syndrome. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Oura Ring: https://www.ouraring.com Follow Dorothy Kilroy on LinkedIn: https://www.linkedin.com/in/dorothy-kilroy-31671a21/ Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 31 Mar 2026 10:00:00 -0000 full Blake Madden I went into this conversation expecting a consumer wearables story. I came out thinking Oura might be quietly building one of the more compelling engagement platforms in healthcare. In this episode, I sit down with Dorothy Kilroy, Chief Commercial Officer at Oura. Dorothy breaks down how a ring originally built around sleep and women's health is now generating 6x engagement vs. prior programs in Medicare Advantage, driving a Cigna partnership built on redesigning chronic care around continuous biometric data, and heading toward FDA submission on hypertension detection. The consumer wedge was never the end game. It was the proof point. --- Listen to hear why: 77% of Oura's MA members are active 5+ days a week, and why that number matters more than any wellness benefit stat you've seen. Oura built a custom women's health LLM, designed and vetted by in-house clinicians, specifically tuned to not be dismissive. (A low bar in healthcare. Somehow still rare.) The Cigna partnership isn't a wellness perk. It's a bet that chronic care management gets rebuilt around continuous biometric data, not episodic claims. Why Dorothy thinks clinicians don't need more data. They need filtered intelligence that fits real workflows. Awareness beats perfection, and why that mindset shapes both Oura's product philosophy and Dorothy's own approach to executive parenthood and imposter syndrome. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Oura Ring: https://www.ouraring.com Follow Dorothy Kilroy on LinkedIn: https://www.linkedin.com/in/dorothy-kilroy-31671a21/ Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. I went into this conversation expecting a consumer wearables story. I came out thinking Oura might be quietly building one of the more compelling engagement platforms in healthcare.

In this episode, I sit down with Dorothy Kilroy, Chief Commercial Officer at Oura.

Dorothy breaks down how a ring originally built around sleep and women's health is now generating 6x engagement vs. prior programs in Medicare Advantage, driving a Cigna partnership built on redesigning chronic care around continuous biometric data, and heading toward FDA submission on hypertension detection.

The consumer wedge was never the end game. It was the proof point.

---

Listen to hear why:

  • 77% of Oura's MA members are active 5+ days a week, and why that number matters more than any wellness benefit stat you've seen.

  • Oura built a custom women's health LLM, designed and vetted by in-house clinicians, specifically tuned to not be dismissive. (A low bar in healthcare. Somehow still rare.)

  • The Cigna partnership isn't a wellness perk. It's a bet that chronic care management gets rebuilt around continuous biometric data, not episodic claims.

  • Why Dorothy thinks clinicians don't need more data. They need filtered intelligence that fits real workflows.

  • Awareness beats perfection, and why that mindset shapes both Oura's product philosophy and Dorothy's own approach to executive parenthood and imposter syndrome.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠

---

Oura Ring: https://www.ouraring.com

Follow Dorothy Kilroy on LinkedIn: https://www.linkedin.com/in/dorothy-kilroy-31671a21/

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/

---

For expert analysis on healthcare M&A, strategy, finance, and markets, join 67K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.

]]> 3394 The Primary Care Manifesto: Lumeris, Ochsner’s Bold AI Bet with Tom, and the End of the 15-Minute Visit | Dr. David Carmouche, Chief Medical and Commercial Officer, Lumeris In this episode, we’re going DEEP on what’s broken in primary care and what it actually takes to fix it - not with another point solution, but with an AI-first care delivery platform. Dr. David Carmouche, Chief Medical and Commercial Officer at Lumeris, has a resume that reads like a masterclass in healthcare transformation: practicing PCP → Blue Cross Louisiana CMO → Ochsner VP of Primary Care & VBC → Head of Walmart Health → now Lumeris. He's seen every angle of the primary care crisis firsthand, and he's not sugarcoating it. We got into the real reason Walmart Health shut down, why Ochsner just went all-in on Lumeris's AI agent "Tom," and David's provocative white paper arguing a single PCP could manage 5,000 patients with the right AI stack.  Listen to hear why: -The ROI case for AI-enabled primary care is almost embarrassingly simple once you model it as a front door strategy, not a cost center. -Health systems face two internal sales: a fast one with the C-suite and a slow one with clinicians. Confusing the two kills deals. -The in-office primary care visit is the exception, not the rule, in 10 years. David lays out what replaces it. -First movers who crack AI-enabled primary care access don't just improve outcomes; they structurally take market share from competitors who don't. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Follow Dr. David Carmouche on LinkedIn: https://www.linkedin.com/in/david-carmouche-md/  Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 24 Mar 2026 15:25:00 -0000 full Blake Madden In this episode, we’re going DEEP on what’s broken in primary care and what it actually takes to fix it - not with another point solution, but with an AI-first care delivery platform. Dr. David Carmouche, Chief Medical and Commercial Officer at Lumeris, has a resume that reads like a masterclass in healthcare transformation: practicing PCP → Blue Cross Louisiana CMO → Ochsner VP of Primary Care & VBC → Head of Walmart Health → now Lumeris. He's seen every angle of the primary care crisis firsthand, and he's not sugarcoating it. We got into the real reason Walmart Health shut down, why Ochsner just went all-in on Lumeris's AI agent "Tom," and David's provocative white paper arguing a single PCP could manage 5,000 patients with the right AI stack.  Listen to hear why: -The ROI case for AI-enabled primary care is almost embarrassingly simple once you model it as a front door strategy, not a cost center. -Health systems face two internal sales: a fast one with the C-suite and a slow one with clinicians. Confusing the two kills deals. -The in-office primary care visit is the exception, not the rule, in 10 years. David lays out what replaces it. -First movers who crack AI-enabled primary care access don't just improve outcomes; they structurally take market share from competitors who don't. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Follow Dr. David Carmouche on LinkedIn: https://www.linkedin.com/in/david-carmouche-md/  Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. In this episode, we’re going DEEP on what’s broken in primary care and what it actually takes to fix it - not with another point solution, but with an AI-first care delivery platform.

Dr. David Carmouche, Chief Medical and Commercial Officer at Lumeris, has a resume that reads like a masterclass in healthcare transformation: practicing PCP → Blue Cross Louisiana CMO → Ochsner VP of Primary Care & VBC → Head of Walmart Health → now Lumeris. He's seen every angle of the primary care crisis firsthand, and he's not sugarcoating it.

We got into the real reason Walmart Health shut down, why Ochsner just went all-in on Lumeris's AI agent "Tom," and David's provocative white paper arguing a single PCP could manage 5,000 patients with the right AI stack. 

Listen to hear why:

-The ROI case for AI-enabled primary care is almost embarrassingly simple once you model it as a front door strategy, not a cost center.

-Health systems face two internal sales: a fast one with the C-suite and a slow one with clinicians. Confusing the two kills deals.

-The in-office primary care visit is the exception, not the rule, in 10 years. David lays out what replaces it.

-First movers who crack AI-enabled primary care access don't just improve outcomes; they structurally take market share from competitors who don't.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠

---

Follow Dr. David Carmouche on LinkedIn: https://www.linkedin.com/in/david-carmouche-md/ 

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/

For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.


]]> 3473 De Novo Clinics to National Enabler: How Karoo Health Is Architecting the Future of Cardiology Care | Ian Koons, Co-Founder and CEO, Karoo Health Blake sits down with Ian Koons, CEO and co-founder of Karoo Health, to unpack why cardiology is having its “VBC moment” and why most attempts to “do value” in specialty care fail the second they collide with real-world provider incentives. Ian breaks down how Karoo went from planning de novo cardiac clinics to becoming a single source of truth for cardiology VBC.  They also get into Karoo's Humana partnership, rumors of a newly signed term sheet with a top-tier investor, why V28 is reshaping the payor landscape, and the death of siloed specialty models.  Listen to hear why: -Payers are under real performance pressure (hello, MA economics), and cardiology spend is now too big to ignore. -“One-size-fits-all” specialty VBC is fantasy. Karoo partners with payers to architect market-specific cardiology contracts, then wraps physicians with the services, tech, and operational muscle to actually deliver savings without breaking the clinician experience. -The next wave isn’t 70 point solutions; it’s collaborative specialty models with fewer contracts, clearer accountability, and a single source of truth. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 17 Mar 2026 10:00:00 -0000 full Blake Madden Blake sits down with Ian Koons, CEO and co-founder of Karoo Health, to unpack why cardiology is having its “VBC moment” and why most attempts to “do value” in specialty care fail the second they collide with real-world provider incentives. Ian breaks down how Karoo went from planning de novo cardiac clinics to becoming a single source of truth for cardiology VBC.  They also get into Karoo's Humana partnership, rumors of a newly signed term sheet with a top-tier investor, why V28 is reshaping the payor landscape, and the death of siloed specialty models.  Listen to hear why: -Payers are under real performance pressure (hello, MA economics), and cardiology spend is now too big to ignore. -“One-size-fits-all” specialty VBC is fantasy. Karoo partners with payers to architect market-specific cardiology contracts, then wraps physicians with the services, tech, and operational muscle to actually deliver savings without breaking the clinician experience. -The next wave isn’t 70 point solutions; it’s collaborative specialty models with fewer contracts, clearer accountability, and a single source of truth. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Blake sits down with Ian Koons, CEO and co-founder of Karoo Health, to unpack why cardiology is having its “VBC moment” and why most attempts to “do value” in specialty care fail the second they collide with real-world provider incentives.

Ian breaks down how Karoo went from planning de novo cardiac clinics to becoming a single source of truth for cardiology VBC. 

They also get into Karoo's Humana partnership, rumors of a newly signed term sheet with a top-tier investor, why V28 is reshaping the payor landscape, and the death of siloed specialty models. 

Listen to hear why:

-Payers are under real performance pressure (hello, MA economics), and cardiology spend is now too big to ignore.

-“One-size-fits-all” specialty VBC is fantasy. Karoo partners with payers to architect market-specific cardiology contracts, then wraps physicians with the services, tech, and operational muscle to actually deliver savings without breaking the clinician experience.

-The next wave isn’t 70 point solutions; it’s collaborative specialty models with fewer contracts, clearer accountability, and a single source of truth.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠

---

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/

For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.


]]> 3001 From Words to Actions: Nabla's New Clinical Chief on the Post-Ambient AI Frontier | Matt Sakumoto, MD On just Day 4 of his new role as Chief Clinical Product Officer at Nabla, Matt Sakumoto, MD, sat down with me for this live recording at the Nabla Summit in late January. Matt, who was still practicing as a virtual primary care physician, hadn't even finished onboarding, but he was already dropping takes on the future of agentic AI, physician independence, and why your health system's AI readiness problem is actually a people problem. Listen to hear why: Ambient scribes may be table stacks, but the next frontier is agentic AI that executes clinical workflows, not just documents them. AI may enable something healthcare hasn’t seen in decades: the return of independent primary care practices, powered by automated back offices and AI-driven operations. The success of AI adoption is about leadership buy-in, training infrastructure, governance, communication cadence, and an organization’s appetite for speed of change. Healthcare consumerism may create a new industry entirely: an “H&R Block for health insurance” to help people navigate coverage decisions. True value-based care still hinges on one unsolved challenge: how do you measure prevention when success is something that never happens? Building tools with nurses, front desks, and back offices in mind is just as important as helping doctors. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads. Tom serves as the AI member of a patient’s primary care team. Learn more at ⁠⁠⁠⁠⁠⁠Lumeris.com/platform⁠⁠⁠⁠ ⁠ --- Nabla: ⁠https://www.nabla.com/ Follow Matt Sakumoto on LinkedIn: https://www.linkedin.com/in/mattsakumoto/  Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 10 Mar 2026 10:00:00 -0000 full Blake Madden On just Day 4 of his new role as Chief Clinical Product Officer at Nabla, Matt Sakumoto, MD, sat down with me for this live recording at the Nabla Summit in late January. Matt, who was still practicing as a virtual primary care physician, hadn't even finished onboarding, but he was already dropping takes on the future of agentic AI, physician independence, and why your health system's AI readiness problem is actually a people problem. Listen to hear why: Ambient scribes may be table stacks, but the next frontier is agentic AI that executes clinical workflows, not just documents them. AI may enable something healthcare hasn’t seen in decades: the return of independent primary care practices, powered by automated back offices and AI-driven operations. The success of AI adoption is about leadership buy-in, training infrastructure, governance, communication cadence, and an organization’s appetite for speed of change. Healthcare consumerism may create a new industry entirely: an “H&R Block for health insurance” to help people navigate coverage decisions. True value-based care still hinges on one unsolved challenge: how do you measure prevention when success is something that never happens? Building tools with nurses, front desks, and back offices in mind is just as important as helping doctors. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads. Tom serves as the AI member of a patient’s primary care team. Learn more at ⁠⁠⁠⁠⁠⁠Lumeris.com/platform⁠⁠⁠⁠ ⁠ --- Nabla: ⁠https://www.nabla.com/ Follow Matt Sakumoto on LinkedIn: https://www.linkedin.com/in/mattsakumoto/  Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. On just Day 4 of his new role as Chief Clinical Product Officer at Nabla, Matt Sakumoto, MD, sat down with me for this live recording at the Nabla Summit in late January.

Matt, who was still practicing as a virtual primary care physician, hadn't even finished onboarding, but he was already dropping takes on the future of agentic AI, physician independence, and why your health system's AI readiness problem is actually a people problem.

Listen to hear why:

  • Ambient scribes may be table stacks, but the next frontier is agentic AI that executes clinical workflows, not just documents them.
  • AI may enable something healthcare hasn’t seen in decades: the return of independent primary care practices, powered by automated back offices and AI-driven operations.
  • The success of AI adoption is about leadership buy-in, training infrastructure, governance, communication cadence, and an organization’s appetite for speed of change.
  • Healthcare consumerism may create a new industry entirely: an “H&R Block for health insurance” to help people navigate coverage decisions.
  • True value-based care still hinges on one unsolved challenge: how do you measure prevention when success is something that never happens?
  • Building tools with nurses, front desks, and back offices in mind is just as important as helping doctors.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads. Tom serves as the AI member of a patient’s primary care team.

Learn more at ⁠⁠⁠⁠⁠⁠Lumeris.com/platform⁠⁠⁠⁠ ⁠

---

Nabla: ⁠https://www.nabla.com/

Follow Matt Sakumoto on LinkedIn: https://www.linkedin.com/in/mattsakumoto/ 

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/

For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.

]]> 2325 The Year of the G's: Sean Duffy on GLPs, GPTs, and Chronic Care's Inflection Point What does it take to build a real between-visit care engine at scale? In this episode, Blake talks with Sean Duffy, CEO and co-founder of Omada Health, about why the “visit model” is structurally broken for chronic disease, and what Omada is doing about it.  Sean breaks down Omada’s provider model, why they’re leaning into GLP-1 support as employers and plans grapple with cost and adherence, and why Omada ultimately decided to add prescribing capabilities as the GLP landscape explodes from “two injectables” to a future of dozens of options.  Sean also shares Omada’s practical approach to AI: not chatbot theater, but automation that makes care teams faster, more personalized, and more effective. Listen to hear why: -GLP-1s don’t work like a “vaccine moment”; behavior + psychology still decide outcomes -The next GLP wave is about complexity (single/dual/tri-agonists, orals, pricing tiers) -AI can expand margins, but there’s a bigger unlock -The moat is personalization: making a 23-year-old in Seattle and a grandma in Boca both feel like the program was built for them --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Follow Blake on LinkedIn: ⁠https://www.linkedin.com/in/blakecmadden/⁠ For expert analysis on healthcare M&A, strategy, finance, and markets, join 66K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 03 Mar 2026 11:00:00 -0000 full Blake Madden What does it take to build a real between-visit care engine at scale? In this episode, Blake talks with Sean Duffy, CEO and co-founder of Omada Health, about why the “visit model” is structurally broken for chronic disease, and what Omada is doing about it.  Sean breaks down Omada’s provider model, why they’re leaning into GLP-1 support as employers and plans grapple with cost and adherence, and why Omada ultimately decided to add prescribing capabilities as the GLP landscape explodes from “two injectables” to a future of dozens of options.  Sean also shares Omada’s practical approach to AI: not chatbot theater, but automation that makes care teams faster, more personalized, and more effective. Listen to hear why: -GLP-1s don’t work like a “vaccine moment”; behavior + psychology still decide outcomes -The next GLP wave is about complexity (single/dual/tri-agonists, orals, pricing tiers) -AI can expand margins, but there’s a bigger unlock -The moat is personalization: making a 23-year-old in Seattle and a grandma in Boca both feel like the program was built for them --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Follow Blake on LinkedIn: ⁠https://www.linkedin.com/in/blakecmadden/⁠ For expert analysis on healthcare M&A, strategy, finance, and markets, join 66K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. What does it take to build a real between-visit care engine at scale? In this episode, Blake talks with Sean Duffy, CEO and co-founder of Omada Health, about why the “visit model” is structurally broken for chronic disease, and what Omada is doing about it. 

Sean breaks down Omada’s provider model, why they’re leaning into GLP-1 support as employers and plans grapple with cost and adherence, and why Omada ultimately decided to add prescribing capabilities as the GLP landscape explodes from “two injectables” to a future of dozens of options. 

Sean also shares Omada’s practical approach to AI: not chatbot theater, but automation that makes care teams faster, more personalized, and more effective.

Listen to hear why:

-GLP-1s don’t work like a “vaccine moment”; behavior + psychology still decide outcomes

-The next GLP wave is about complexity (single/dual/tri-agonists, orals, pricing tiers)

-AI can expand margins, but there’s a bigger unlock

-The moat is personalization: making a 23-year-old in Seattle and a grandma in Boca both feel like the program was built for them

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠

---

Follow Blake on LinkedIn: ⁠https://www.linkedin.com/in/blakecmadden/⁠

For expert analysis on healthcare M&A, strategy, finance, and markets, join 66K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.

]]> 3825 Carving Out Primary Care: AdventHealth's Standalone Division Experiment | Brent Davis, CEO, Primary Health Division at AdventHealth What happens when a health system stops treating ambulatory like a side project and starts running it like a strategic priority? In this episode, Blake talks with Brent Davis, CEO of the Primary Health Division at AdventHealth. Brent explains why AdventHealth created a standalone division to build “outside-the-hospital” businesses with the focus, capital, and talent they rarely get when they’re managed inside hospital infrastructure.  He breaks down the division’s three north stars - primary care preeminence, winning in the home, and value-based care competency - and shares the hard-numbers story: ~$500M committed over six years, primary care visits up sharply, and the operating subsidy meaningfully down. Listen to hear why: -“Primary care is subsidized” isn’t a strategy.-Co-located clinics, standardized templates, and smarter staffing are the unsexy moves that actually change unit economics.-The next frontier isn’t just urgent care and senior clinics.-Value-based care isn’t one grand theory; it’s market-by-market underwriting. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- AdventHealth: https://www.adventhealth.com/ Follow Brent Davis on LinkedIn: https://www.linkedin.com/in/brentwdavis/  Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 66K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 24 Feb 2026 11:00:00 -0000 full Blake Madden What happens when a health system stops treating ambulatory like a side project and starts running it like a strategic priority? In this episode, Blake talks with Brent Davis, CEO of the Primary Health Division at AdventHealth. Brent explains why AdventHealth created a standalone division to build “outside-the-hospital” businesses with the focus, capital, and talent they rarely get when they’re managed inside hospital infrastructure.  He breaks down the division’s three north stars - primary care preeminence, winning in the home, and value-based care competency - and shares the hard-numbers story: ~$500M committed over six years, primary care visits up sharply, and the operating subsidy meaningfully down. Listen to hear why: -“Primary care is subsidized” isn’t a strategy.-Co-located clinics, standardized templates, and smarter staffing are the unsexy moves that actually change unit economics.-The next frontier isn’t just urgent care and senior clinics.-Value-based care isn’t one grand theory; it’s market-by-market underwriting. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- AdventHealth: https://www.adventhealth.com/ Follow Brent Davis on LinkedIn: https://www.linkedin.com/in/brentwdavis/  Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 66K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. What happens when a health system stops treating ambulatory like a side project and starts running it like a strategic priority?

In this episode, Blake talks with Brent Davis, CEO of the Primary Health Division at AdventHealth. Brent explains why AdventHealth created a standalone division to build “outside-the-hospital” businesses with the focus, capital, and talent they rarely get when they’re managed inside hospital infrastructure. 

He breaks down the division’s three north stars - primary care preeminence, winning in the home, and value-based care competency - and shares the hard-numbers story: ~$500M committed over six years, primary care visits up sharply, and the operating subsidy meaningfully down.

Listen to hear why:

-“Primary care is subsidized” isn’t a strategy.
-Co-located clinics, standardized templates, and smarter staffing are the unsexy moves that actually change unit economics.
-The next frontier isn’t just urgent care and senior clinics.
-Value-based care isn’t one grand theory; it’s market-by-market underwriting.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠

---

AdventHealth: https://www.adventhealth.com/

Follow Brent Davis on LinkedIn: https://www.linkedin.com/in/brentwdavis/ 

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/

For expert analysis on healthcare M&A, strategy, finance, and markets, join 66K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.


]]> 3921 The Bill Parcells of Healthcare: Charlie Martin on 60 Years of Hospital Turnarounds and Where Martin Ventures is Investing Next | Charlie Martin and Devin Carty Welcome to Claims Denied, a podcast from Hospitalogy. In this episode, Blake sits down with Charlie Martin (the “wartime general” behind General Care, HealthTrust, OrNda, and Vanguard), founder and chairman of Martin Ventures, and Devin Carty, CEO of Martin Ventures, for a rare, behind-the-scenes masterclass on how healthcare systems actually get built, fixed, and scaled. Charlie unpacks the gritty reality of turning around broken hospitals (including a wild Detroit Medical Center story) and why most operators never truly manage costs until they’re forced to.  Devin connects those battle scars to Martin Ventures’ current playbook: building and backing companies at the intersection of value-based care, AI, and capital-light services, with an obsession for talent, culture, and aligned incentives. If you want the real talk on why healthcare transformation is still so hard, and where the next decade of value creation is headed, don’t miss this one. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Martin Ventures: https://www.martinventures.com/ Charlie Martin: https://www.martinventures.com/our-firm/ Follow Devin Carty on LinkedIn: https://www.linkedin.com/in/devincarty/ Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 17 Feb 2026 16:39:00 -0000 full Blake Madden Welcome to Claims Denied, a podcast from Hospitalogy. In this episode, Blake sits down with Charlie Martin (the “wartime general” behind General Care, HealthTrust, OrNda, and Vanguard), founder and chairman of Martin Ventures, and Devin Carty, CEO of Martin Ventures, for a rare, behind-the-scenes masterclass on how healthcare systems actually get built, fixed, and scaled. Charlie unpacks the gritty reality of turning around broken hospitals (including a wild Detroit Medical Center story) and why most operators never truly manage costs until they’re forced to.  Devin connects those battle scars to Martin Ventures’ current playbook: building and backing companies at the intersection of value-based care, AI, and capital-light services, with an obsession for talent, culture, and aligned incentives. If you want the real talk on why healthcare transformation is still so hard, and where the next decade of value creation is headed, don’t miss this one. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠ --- Martin Ventures: https://www.martinventures.com/ Charlie Martin: https://www.martinventures.com/our-firm/ Follow Devin Carty on LinkedIn: https://www.linkedin.com/in/devincarty/ Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Welcome to Claims Denied, a podcast from Hospitalogy.

In this episode, Blake sits down with Charlie Martin (the “wartime general” behind General Care, HealthTrust, OrNda, and Vanguard), founder and chairman of Martin Ventures, and Devin Carty, CEO of Martin Ventures, for a rare, behind-the-scenes masterclass on how healthcare systems actually get built, fixed, and scaled.

Charlie unpacks the gritty reality of turning around broken hospitals (including a wild Detroit Medical Center story) and why most operators never truly manage costs until they’re forced to. 

Devin connects those battle scars to Martin Ventures’ current playbook: building and backing companies at the intersection of value-based care, AI, and capital-light services, with an obsession for talent, culture, and aligned incentives.

If you want the real talk on why healthcare transformation is still so hard, and where the next decade of value creation is headed, don’t miss this one.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠⁠Lumeris.com/platform ⁠⁠

---

Martin Ventures: https://www.martinventures.com/

Charlie Martin: https://www.martinventures.com/our-firm/

Follow Devin Carty on LinkedIn: https://www.linkedin.com/in/devincarty/

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/

For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.


]]> 3805 What to Expect in Healthcare for 2026 | Clete Madden and the JTaylor Podcast Crew Welcome to Claims Denied, a new podcast from Hospitalogy. In this episode, Blake discusses the year in review and what to expect next with Clete Madden (yes, that’s Blake’s dad!) and the JTaylor Podcast Crew, including Herd Midkiff, Kyle Kirkpatrick, and Anna Brewer. If it feels like healthcare keeps “solving” the same problems with shinier tools, this conversation gets right to the why. The group breaks down what’s actually changing (AI adoption getting real, consumer expectations rising, the deal market re-accelerating), and what’s about to get messier (Medicaid/ACA changes, 340B economics, Medicare Advantage’s growing gravitational pull). It’s part year-end reckoning, part 2026 forecast, with a few spicy detours on GLP-1s, cash-pay “parallel” systems, and who really controls innovation: the people or the payors. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠Lumeris.com/platform ⁠ --- Subscribe to the JTaylor Healthcare Podcast: https://podcasts.apple.com/us/podcast/the-jtaylor-healthcare-podcast/id1577266916  Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 10 Feb 2026 16:40:00 -0000 full Blake Madden Welcome to Claims Denied, a new podcast from Hospitalogy. In this episode, Blake discusses the year in review and what to expect next with Clete Madden (yes, that’s Blake’s dad!) and the JTaylor Podcast Crew, including Herd Midkiff, Kyle Kirkpatrick, and Anna Brewer. If it feels like healthcare keeps “solving” the same problems with shinier tools, this conversation gets right to the why. The group breaks down what’s actually changing (AI adoption getting real, consumer expectations rising, the deal market re-accelerating), and what’s about to get messier (Medicaid/ACA changes, 340B economics, Medicare Advantage’s growing gravitational pull). It’s part year-end reckoning, part 2026 forecast, with a few spicy detours on GLP-1s, cash-pay “parallel” systems, and who really controls innovation: the people or the payors. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠Lumeris.com/platform ⁠ --- Subscribe to the JTaylor Healthcare Podcast: https://podcasts.apple.com/us/podcast/the-jtaylor-healthcare-podcast/id1577266916  Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Welcome to Claims Denied, a new podcast from Hospitalogy. In this episode, Blake discusses the year in review and what to expect next with Clete Madden (yes, that’s Blake’s dad!) and the JTaylor Podcast Crew, including Herd Midkiff, Kyle Kirkpatrick, and Anna Brewer.

If it feels like healthcare keeps “solving” the same problems with shinier tools, this conversation gets right to the why. The group breaks down what’s actually changing (AI adoption getting real, consumer expectations rising, the deal market re-accelerating), and what’s about to get messier (Medicaid/ACA changes, 340B economics, Medicare Advantage’s growing gravitational pull).

It’s part year-end reckoning, part 2026 forecast, with a few spicy detours on GLP-1s, cash-pay “parallel” systems, and who really controls innovation: the people or the payors.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠⁠Lumeris.com/platform ⁠

---

Subscribe to the JTaylor Healthcare Podcast: https://podcasts.apple.com/us/podcast/the-jtaylor-healthcare-podcast/id1577266916 

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/

For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.


]]> 3676 From Basketball Coach to Health System Turnaround CEO: A Random Walk Through Healthcare | James Hereford, Fairview Health CEO In this episode, Fairview Health Services CEO James Hereford joins Blake Madden to unpack what a real health system turnaround looks like when you inherit “zero trust” and six years of organizational drift.  James walks through his unconventional path into healthcare, why lean management systems (not “lean tools”) became Fairview’s operating backbone, and how labor control, throughput, and supply discipline powered a $350M recovery without sacrificing quality, service, or engagement.  James and Blake also dig into the economics of specialty pharmacy/340B, and where Fairview Health has been able to win with AI. You won’t want to miss James’ conversation about his biggest AI implementation failures, the need to give employees agency, and the mistake most orgs make when they fall in love with technology. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠Lumeris.com/platform --- Fairview Health Services: https://www.fairview.org/ Follow James on LinkedIn: https://www.linkedin.com/in/james-hereford/ Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 03 Feb 2026 18:32:00 -0000 full Blake Madden In this episode, Fairview Health Services CEO James Hereford joins Blake Madden to unpack what a real health system turnaround looks like when you inherit “zero trust” and six years of organizational drift.  James walks through his unconventional path into healthcare, why lean management systems (not “lean tools”) became Fairview’s operating backbone, and how labor control, throughput, and supply discipline powered a $350M recovery without sacrificing quality, service, or engagement.  James and Blake also dig into the economics of specialty pharmacy/340B, and where Fairview Health has been able to win with AI. You won’t want to miss James’ conversation about his biggest AI implementation failures, the need to give employees agency, and the mistake most orgs make when they fall in love with technology. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠Lumeris.com/platform --- Fairview Health Services: https://www.fairview.org/ Follow James on LinkedIn: https://www.linkedin.com/in/james-hereford/ Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. In this episode, Fairview Health Services CEO James Hereford joins Blake Madden to unpack what a real health system turnaround looks like when you inherit “zero trust” and six years of organizational drift. 

James walks through his unconventional path into healthcare, why lean management systems (not “lean tools”) became Fairview’s operating backbone, and how labor control, throughput, and supply discipline powered a $350M recovery without sacrificing quality, service, or engagement. 

James and Blake also dig into the economics of specialty pharmacy/340B, and where Fairview Health has been able to win with AI. You won’t want to miss James’ conversation about his biggest AI implementation failures, the need to give employees agency, and the mistake most orgs make when they fall in love with technology.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at ⁠Lumeris.com/platform

---

Fairview Health Services: https://www.fairview.org/

Follow James on LinkedIn: https://www.linkedin.com/in/james-hereford/

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/


For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/


Like our episodes? Be sure to leave us a review, and share our podcast with colleagues.

]]> 4110 The New Age of Health System Consumerism | Pete McCanna, CEO, Baylor Scott & White Welcome to Claims Denied, a new podcast from Hospitalogy. In this episode, Blake talks with Pete McCanna, CEO of Baylor Scott & White. Pete explains how legacy health systems are built like “castle walls” (supply-driven, organization-centric, and built to protect themselves), but this design fails customers who are outside the four walls.  Pete walks through what it takes to transform a health system from supply-driven to demand-driven, which is essential in this new age of healthcare consumerism.  Listen to hear why: 50%+ of encounters start at the wrong site of care. Better routing is the real capacity unlock, not more hiring. Find out which move Pete says is a capacity strategy hiding in plain sight. If every system innovates solely on Epic, there's no differentiation, just commoditization.  Baylor refuses to let anyone get between them and the customer (and “customer” isn’t semantics). Epic can run the clinical backbone, but Baylor’s betting the winner is whoever owns orchestration, access, and the relationship. There are 3 buckets of AI strategy: customer solutions driven by AI, workflow efficiency for large organizations, and individual assistant tools for your daily work. Baylor's focused on bucket 1 to see how it can turbocharge their service offerings. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at Lumeris.com/platform --- Baylor Scott & White Health: https://www.bswhealth.com/ Follow Pete on LinkedIn: https://www.linkedin.com/in/peter-mccanna-784619104/ Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Tue, 27 Jan 2026 11:00:00 -0000 full Blake Madden Welcome to Claims Denied, a new podcast from Hospitalogy. In this episode, Blake talks with Pete McCanna, CEO of Baylor Scott & White. Pete explains how legacy health systems are built like “castle walls” (supply-driven, organization-centric, and built to protect themselves), but this design fails customers who are outside the four walls.  Pete walks through what it takes to transform a health system from supply-driven to demand-driven, which is essential in this new age of healthcare consumerism.  Listen to hear why: 50%+ of encounters start at the wrong site of care. Better routing is the real capacity unlock, not more hiring. Find out which move Pete says is a capacity strategy hiding in plain sight. If every system innovates solely on Epic, there's no differentiation, just commoditization.  Baylor refuses to let anyone get between them and the customer (and “customer” isn’t semantics). Epic can run the clinical backbone, but Baylor’s betting the winner is whoever owns orchestration, access, and the relationship. There are 3 buckets of AI strategy: customer solutions driven by AI, workflow efficiency for large organizations, and individual assistant tools for your daily work. Baylor's focused on bucket 1 to see how it can turbocharge their service offerings. --- Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.   Tom serves as the AI member of a patient’s primary care team . Learn more at Lumeris.com/platform --- Baylor Scott & White Health: https://www.bswhealth.com/ Follow Pete on LinkedIn: https://www.linkedin.com/in/peter-mccanna-784619104/ Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/ For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ Like our episodes? Be sure to leave us a review, and share our podcast with colleagues. Welcome to Claims Denied, a new podcast from Hospitalogy.

In this episode, Blake talks with Pete McCanna, CEO of Baylor Scott & White. Pete explains how legacy health systems are built like “castle walls” (supply-driven, organization-centric, and built to protect themselves), but this design fails customers who are outside the four walls. 

Pete walks through what it takes to transform a health system from supply-driven to demand-driven, which is essential in this new age of healthcare consumerism. 

Listen to hear why:

  • 50%+ of encounters start at the wrong site of care. Better routing is the real capacity unlock, not more hiring. Find out which move Pete says is a capacity strategy hiding in plain sight.
  • If every system innovates solely on Epic, there's no differentiation, just commoditization. 
  • Baylor refuses to let anyone get between them and the customer (and “customer” isn’t semantics).
  • Epic can run the clinical backbone, but Baylor’s betting the winner is whoever owns orchestration, access, and the relationship.
  • There are 3 buckets of AI strategy: customer solutions driven by AI, workflow efficiency for large organizations, and individual assistant tools for your daily work. Baylor's focused on bucket 1 to see how it can turbocharge their service offerings.

---

Tom™ is the agentic AI that delivers orchestrated Primary Care as a Service, expanding  care capacity and patient engagement while reducing clinicians’ busy workloads.  

Tom serves as the AI member of a patient’s primary care team . Learn more at Lumeris.com/platform

---

Baylor Scott & White Health: https://www.bswhealth.com/

Follow Pete on LinkedIn: https://www.linkedin.com/in/peter-mccanna-784619104/

Follow Blake on LinkedIn: https://www.linkedin.com/in/blakecmadden/

For expert analysis on healthcare M&A, strategy, finance, and markets, join 51K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/

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]]> 4317 Claims Denied: A Hospitalogy Podcast (Series Trailer) Welcome to Claims Denied. Join one man’s quest to learn everything there is to know about the business of healthcare. Blake Madden and friends cut through the fluff to talk shop with influential healthcare leaders across innovation, strategy, finance, policy, and more. Learn about disruptive health tech startups, hear war stories, stay up to date on emerging health system transformation strategies, and listen in to scalding hot takes on pressing topics and the future of the industry. New episodes drop Tuesdays. Subscribe to get the latest! Sun, 25 Jan 2026 01:59:00 -0000 trailer Blake Madden Welcome to Claims Denied. Join one man’s quest to learn everything there is to know about the business of healthcare. Blake Madden and friends cut through the fluff to talk shop with influential healthcare leaders across innovation, strategy, finance, policy, and more. Learn about disruptive health tech startups, hear war stories, stay up to date on emerging health system transformation strategies, and listen in to scalding hot takes on pressing topics and the future of the industry. New episodes drop Tuesdays. Subscribe to get the latest! Welcome to Claims Denied.

Join one man’s quest to learn everything there is to know about the business of healthcare.

Blake Madden and friends cut through the fluff to talk shop with influential healthcare leaders across innovation, strategy, finance, policy, and more.

Learn about disruptive health tech startups, hear war stories, stay up to date on emerging health system transformation strategies, and listen in to scalding hot takes on pressing topics and the future of the industry.

New episodes drop Tuesdays. Subscribe to get the latest!

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