Modern Healthcare's Healthcare Insider Podcast

Lessons From the Front Lines of Military and Veterans' Healthcare

Military and veterans' health systems operate in some of the most complex, high-demand environments in healthcare. Their experience managing limited resources, coordinating care across large populations and adopting new technologies offers valuable lessons for health systems nationwide. In this episode of Healthcare Insider, Modern Healthcare Content Studio host Shannon Mortland speaks with Lt. Gen. (Ret.) Telita Crosland, MD, MPH, MS, former director of the Defense Health Agency, and The Honorable David J. Shulkin, MD, former U.S. Secretary of Veterans Affairs. The conversation explores how government-driven innovation, operational discipline and emerging care models can help healthcare leaders improve access, strengthen coordination and address challenges such as fragmented care and delayed diagnosis.

The Next Phase of Value-Based Care: Policy, Tech & What Comes Next

Value-based care continues to evolve as healthcare organizations balance new policy priorities, growing technology capabilities and the realities of delivering coordinated, patient-centered care. In this episode of Healthcare Insider, host Shannon Mortland sits down with Dan Brillman, deputy administrator at the Centers for Medicare & Medicaid Services (CMS) and director of the Center for Medicaid & CHIP Services (CMCS), and Dr. Rob Bessler, CEO of Honest Health, for a timely discussion on what's driving the next generation of value-based care. Drawing on experience from both the public and private sectors, Brillman and Bessler explore how CMS is shaping policies that support coordinated care, the role of technology and data connectivity in improving outcomes, and the practical challenges health systems and physicians face as they transition to increasingly sophisticated value-based care models. The conversation also examines how organizations can simplify risk for clinicians, invest strategically in infrastructure and prepare for the future of healthcare transformation.

Protecting Healthcare Payments: New Strategies to Reduce Fraud Risk

In this episode of Healthcare Insider, Sarah Loeffler, host with Modern Healthcare's Content Studio, speaks with Yusuf Qasim, President of Payments Optimization at Zelis, about how health plans can strengthen payment security without sacrificing speed. Drawing on insights from one of the nation's largest payer and provider payment networks, the conversation explores why traditional fraud strategies are no longer enough and what leading organizations are doing differently. You'll Learn: Why fraud prevention must extend beyond claims integrity into the payment lifecycle. How fraudsters exploit gaps between claims review and payment execution. The role of real-time intelligence, provider validation and network-wide data in identifying payment risk. How health plans can accelerate digital payments while maintaining strong security controls. Practical strategies for building a more proactive, scalable approach to payment integrity.

Advancing cancer care through foundational research and immunotherapy

Breakthroughs in cancer care often begin long before a therapy reaches patients. Foundational research into disease biology, cellular mechanisms and immune system function continues to drive innovations that are transforming how cancer is understood and treated. In this episode of Healthcare Insider, Shannon Mortland sits down with Dr. Siddharth Balachandran, PhD, of Temple Health's Fox Chase Cancer Center, to discuss the scientific discoveries helping fuel the future of cancer immunotherapy. The conversation explores how research into influenza viruses and cell death pathways contributed to advances in immunology, why foundational science remains critical to clinical innovation, and how today's laboratory discoveries are informing tomorrow's cancer treatments. What You'll Learn How foundational research helps drive breakthroughs in cancer care The connection between influenza research and advances in immunology Why basic science remains essential to developing new therapies How immune system discoveries are influencing cancer immunotherapy The role of translational research in bringing innovations from the lab to patients What emerging research may mean for the future of cancer treatment and clinical trials

Modernizing Healthcare Infrastructure in a High-Cost Environment

Hospitals are under pressure to maintain safe, efficient care environments while managing rising operating costs, aging infrastructure and limited capital budgets. In this episode of Healthcare Insider, Christy Fetsch and Michael Pickard of Trane discuss how healthcare leaders can rethink deferred maintenance, evaluate the hidden cost of inaction and structure facility investments in more predictable, budget-friendly ways. The conversation explores how aging building systems can affect patient care, why emergency repairs often cost more than planned modernization, and how aligning facilities, finance and clinical leaders can help organizations move from reactive spending to strategic infrastructure planning. What You'll Learn How deferred maintenance can disrupt clinical operations and patient environments Why aging infrastructure may affect lending, bond ratings and long-term financial risk How flexible financing can help turn large capital projects into predictable payments Ways to align facility upgrades with patient care, safety, resilience and operating performance

Rethinking Affordability in Healthcare

Leading the Next Era of Lung Transplant Care

What does the future of lung transplantation look like? In this new podcast episode, Dr. Rachel Ann Criner of Temple Health explores how one of the nation's leading transplant programs is advancing pulmonary care through innovation, operational excellence and research-driven treatment strategies. The conversation examines how Temple Health is expanding transplant eligibility, integrating clinical research into patient care and supporting increasingly complex patient populations through coordinated multidisciplinary care. Listeners will hear insights on: Advances in lung transplant technology and donor organ innovation How leading programs are redefining transplant candidacy The role of coordinated care and remote monitoring in improving outcomes Why clinical trials and targeted therapies are reshaping pulmonary medicine Tune in to learn how Temple Health is helping redefine what's possible in complex pulmonary and transplant care.

How AdventHealth is Scaling Cancer Risk Assessment Across a Health System

Health systems are under increasing pressure to detect cancer earlier and deliver more personalized care, but scaling those capabilities across a large organization remains a complex challenge. In this episode, leaders from AdventHealth share how they are addressing that challenge through their Genomics Risk Assessment for Cancer and Early Detection (GRACE) program, an initiative designed to identify high-risk patients earlier and guide them into appropriate care pathways. Dr. Wesley Walker, vice president of genomics and precision health, and Dr. Clark Rogers, medical director of the GRACE program, explain how the model integrates risk assessment seamlessly into routine clinical workflows. They also share how health systems can successfully implement a similar program at their own organization.

CVS Caremark's Strategy for Managing Chronic Conditions

Chronic disease management is growing more complex as new therapies reshape the treatment landscape. In this episode, Dr. Michelle Gourdine, senior vice president of CVS Health and chief medical officer of CVS Caremark, discusses how pharmacy leaders are balancing access to innovative treatments with long-term affordability and clinical outcomes. As more options emerge for conditions such as diabetes and heart disease, Gourdine outlines how evidence-based benefit design can help improve access while managing cost. She also explores the role of coordinated pharmacy support in improving medication adherence.

How Procurement Systems Grow Lung Transplant Access

Lung transplantation is often associated with surgical expertise, but expanding access depends just as much on the systems behind donor identification, evaluation and transport. Daniel Remer, transplant procurement manager at Temple University Hospital, explains why procurement serves as the operational engine of a transplant program and why strong systems are essential to helping more patients reach transplant. Remer also shares how donor evaluation has evolved over the past decade and how technologies such as ex vivo lung perfusion and portable organ preservation systems are allowing transplant teams to safely consider lungs that may once have been declined.

Infrastructure: The Overlooked Factor in Healthcare M&A

Healthcare mergers and acquisitions often focus on financial alignment and clinical integration, but physical infrastructure can play an equally critical role in long-term success. Christy Fetsch, healthcare vertical market strategy leader at Trane, shares why building systems and facility performance are frequently overlooked during M&A and how that oversight can introduce unexpected risks. Drawing on her experience advising health systems, Fetsch explains how infrastructure assessments can reveal hidden capital needs. She also outlines how these challenges can influence integration timelines and overall deal value. Additionally, the conversation offers strategies for aligning building systems across newly combined organizations, while highlighting opportunities to improve energy efficiency, advance sustainability goals and modernize facility operations.

Ambient AI That Goes Beyond Simple Scribing

Ambient AI has quickly moved from buzzword to bedside. In this new Healthcare Insider Podcast, Simon Kos, chief medical officer of Heidi, shares why he believes this moment represents a true turning point for clinicians. Unlike past top-down digital initiatives, ambient voice technology "returns time and attention back into their clinical workflow and frees them up for what they want to do, which is spend time and attention with their patients," he says. Kos explains why the ambient scribe is just the beginning — and how the next wave of AI care partners will address cognitive burden, regulatory demands and global scalability. He also outlines what health systems should measure during pilots, from activation and adoption rates to clinician and patient satisfaction. To learn more about Heidi's AI care partner and its approach to expanding healthcare capacity, visit heidihealth.com.

What Health System Executives Need to Know About AI and Value-Based Care

AI is poised to support value-based care by improving outcomes, reducing administrative burden and helping clinicians focus on what matters most: patient care. In this episode, Dr. Rob Bessler, CEO of Honest Health, and Seema Verma, Executive Vice President and General Manager at Oracle, explore how AI can be applied responsibly and effectively to advance healthcare transformation. Tune in for expert insights on: How AI is reducing administrative burden and helping clinicians focus on care What health systems should consider when evaluating AI solutions Guiding principles for making smart, sustainable AI investments

Inside Elevance Health's Responsible, Consumer Centered AI Strategy

Hospitals in the Value-Based Care Era: Navigating Today's Pressures and Tomorrow's Opportunities

Hospitals are under mounting financial pressure while also navigating a complex shift toward value-based care. In this episode, Dr. Rob Bessler, CEO of Honest Health, and Rick Pollack, CEO of the American Hospital Association, examine the critical decisions health systems face today and the long-term strategies needed for success tomorrow. Tune in for a timely discussion on: Strategic considerations for internal development vs. external partnerships What "success" in value-based care could look like a decade from now Practical guidance for CEOs planning for long-term transformation

Strategies for advancing value-based, post-acute care with OneHome's CEO Kirk Allen

The transition from hospital to home is one of the most critical—and complex—points in a patient's care journey. As demand for home-based and post-acute services grows, healthcare organizations face mounting pressure to coordinate across settings, reduce readmissions and deliver better outcomes at lower cost. In this episode of Healthcare Insider, Kirk Allen, CEO of OneHome, shares strategies for advancing value-based care models in the post-acute space. He discusses what's needed to align financial incentives, improve data integration and strengthen partnerships between payers and providers to drive sustainable change. Listeners will gain insights on how healthcare leaders can: Break down care silos and strengthen continuity across post-acute settings Align incentives around quality and outcomes rather than volume Use data and technology to identify high-risk patients and intervene earlier

Designing the next era of healthcare spaces

Healthcare facilities are under growing pressure to balance safety, sustainability, patient experience and budgets —all while meeting rising expectations for smarter, more flexible care environments. In this episode, Jennifer Michalski, Business Development Manager at Construction Specialties, shares how healthcare design priorities are evolving as organizations look to: Strengthen infection control through durable, easy-to-clean materials that maintain long-term performance Create holistic spaces that support patient comfort, staff workflow and intuitive wayfinding Adapt construction strategies for fast-growing care settings such as behavioral health, senior living and children's hospitals Align cost efficiency with long-term value without compromising safety or design goals Tune in to learn how hospitals, health systems and senior living providers are rethinking construction and design to support the next generation of care delivery.

Cutting Surgical Waste: Clinical and Financial Strategies for the OR

Operating rooms drive both patient care and hospital finances, but they're also a major source of clinical and financial waste. Each day, U.S. ORs generate up to 2,000 tons of waste, with variations in surgical practice adding unnecessary costs. In this episode, Dr. William Payne, orthopedic spine surgeon and the president of the medical staff at Franciscan Health - Olympia Fields, and Courtney Kleeb, senior director at HealthTrust Performance Group, share strategies to reduce surgical waste, including: Defining the biggest drivers of waste in surgery Leveraging physician leadership to improve consistency and outcomes Using data and analytics to capture savings without compromising care Tune in to learn how organizations can cut waste in the OR while strengthening outcomes and financial performance.

Improving the Patient Payment Journey in the Era of Transparency

The No Surprises Act and Good Faith Estimates were designed to protect patients, but they've also created new operational challenges for providers, particularly around patient credits and managing refunds. In this episode of Healthcare Insider, Jessica Lemoine, AVP and Healthcare Success Manager at Fifth Third Bank, shares her insights on how health systems can navigate these complexities and modernize the patient financial experience. Listeners will learn: How financial transparency rules are increasing patient credits and what that means for providers The biggest operational and patient experience challenges in refund management Innovative tools and workflows that streamline refunds and improve consumer trust Tune in to hear how health systems can embrace automation, flexible payment solutions and financial partnerships to create a more seamless and consumer-centric patient payment journey.

Unlock Hidden EBITDA and Turn RCM into a Strategic Asset

Is your organization thinking about revenue cycle management (RCM) the right way? In this episode of Healthcare Insider, Garett Kreitz, co-president of Med-Metrix, explains how to elevate RCM from a transactional function into a true strategic asset. Listeners will learn: What end-to-end RCM really means in practice How providers can uncover hidden EBITDA and strengthen their bottom line Real-world strategies Med-Metrix uses to help health systems maximize reimbursement and reduce revenue leakage Tune in to hear how aligning leadership, technology and execution can transform the revenue cycle into a powerful driver of financial health.