Definitively Speaking

In the U.S., payors and providers need each other to deliver the highest-quality care at the lowest cost—but they don’t always get along. Russ Thomas, CEO of Availity, joins Justin to discuss the systemic factors driving the misalignment between payors and providers. Russ and Justin discuss how technology and a new perspective might be able to simplify two of biggest points of friction: utilization management and authorization workflow.

Justin and Russ ask the tricky questions facing our overly complicated system of healthcare reimbursement: How can payors and providers create more transparency in the claims process? Can AI and other tech solve payors’ yield problems? And is a single-payor system really the answer to our healthcare woes?

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

On a snowy January day in 2022, Dr. Muhammad Mohiuddin, director of cardiac xenotransplantation at the University of Maryland School of Medicine, oversaw the first transplantation of a pig heart into a human body. Dr. Mohiuddin joins Justin to discuss this landmark procedure—from the selection of patient David Bennett to the complications that ultimately led to the transplanted heart’s failure 60 days after the successful surgery—and what comes next for this rapidly advancing field.

Dr. Mohiuddin describes the next ideal xenotransplant recipient and explains how drug companies can support the field. Plus, Justin and Dr. Mohiuddin examine how xenotransplantation has evolved over the past 30 years and why on-demand organs may be closer to reality than science fiction.

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

More than 4.8 billion prescriptions were filled in the U.S. in 2022, and a medical affairs team had a hand in each one—even if the average patient doesn’t know they exist. Steve Casey, managing partner of Omni Healthcare Communications, joins Justin to explain the evolving role of medical affairs and why life science organizations are struggling to find KPIs that accurately measure the impact of their work from drug development through provider and payor education and beyond.

Justin and Steve look at the big questions facing medical affairs teams and the life science organizations they work for: Can developers use behavioral science to more effectively gauge MSL influence? How does the role of medical affairs change over the next decade? And how clearly defined is the line between medical affairs and marketing?

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

For hospitals and health systems, the lifetime value of a patient is around $1 million. So why are more than half of U.S. hospitals operating with outdated tech that adds friction to the patient experience and increases the likelihood of losing that patient to a different system? David Bennett, CEO of pCare, joins Justin to discuss how technology, amenities, and basic bedside manner intersect in a patient’s care experience—and what consumers can do to stay informed and navigate the healthcare system more effectively.

Justin and David explore the overwhelming wealth of data available to healthcare consumers and how hospitals can take steps to improve patients’ experiences before they even walk in the door. Plus, they examine the ongoing shift from patient-centric to family-centric care, and Dave shares how his wife’s recent healthcare journey has changed how he views his job as a CEO working in the healthcare industry.

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

Women make up more than half of the U.S. population and over two-thirds of the global healthcare workforce, but within the American healthcare system, they face significantly poorer outcomes than those in other similarly wealthy countries. Jo Lim, SVP of growth and engagement at Babylon, joins Justin and guest contributor Kate Shamsuddin, chief product officer at Definitive Healthcare, to explore how virtual care, artificial intelligence, and value-based reimbursement could help address the care disparities faced by women and improve population health management to make U.S. healthcare more affordable and accessible for everybody.

Justin, Kate, and Jo look across the pond to see what lessons we can learn from the U.K. and ask what incentives could get U.S. payors and providers to align on preventive, value-based care. They also examine how social determinants of health deliver insights into patient populations—and why AI excels at turning those insights into interventions.

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

Drug development is a highly expensive, risky venture for investors and researchers alike. Dr. Sasha Krupnick, chief of thoracic surgery and director of the lung transplant program for the University of Maryland Medical System, joins Justin to discuss why biotech needs more outsider perspectives, government support, and risk-takers to get the next industry-shaking innovation off the ground. Dr. Krupnick explains what led him from surgery to oncological drug discovery, why Big Pharma isn’t healthcare’s big bad, and why you should always bet on the surgeon.

Justin and Dr. Krupnick have a lively conversation around some tricky questions: What’s wrong with the drug development process today? What’s the role of small biotech and venture capital organizations in an industry dominated by massive developers? And why are so many potential cures for life-limiting illnesses dying on the vine?

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

What does it mean to be transgender? Dr. Ben Haseen, an openly transgender author, health advocate, and physician resident at Duke University Health System, joins Justin—and returning colleague Catherine Wright—to dig deep into the science, politics, and cultural factors underlying this deceptively simple question. Dr. Haseen dispels common misconceptions around gender identity and sexuality, outlines the challenges that trans people face when seeking healthcare, and explains how activism through academia means focusing on “the things that we don’t talk about, but we should.”

Justin, Catherine, and Dr. Haseen explore the personal and systemic aspects of the transgender experience: Does the medical education system adequately prepare providers to care for trans patients? Why are physical and mental health so closely related in transgender healthcare? And how is technology supporting trans people and their physicians?

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

The American Colleges of Nursing projects a shortage of 230,000 nurses by 2031, a figure that spells trouble for the country’s aging, increasingly sick population. Sean Burke, president of healthcare for Ascend Learning, joins Justin to examine the challenges facing the nursing pipeline—including workforce attrition, lack of professional preparedness, and constraints to educational capacity and access—and explore how providers, academia, and the government can contribute to a much-needed solution.

Justin and Sean discuss why it’s worth expanding the nursing pipeline to include more opportunities for allied health professionals, students from diverse backgrounds, and career switchers. They also raise questions about nursing’s emerging trends: Are travel nurses a double-edged sword for financially strained providers? Can simulations and generative AI help nursing schools do more with less faculty? And are coaches and academic partnerships the key to getting students ready for a career that’s more demanding than ever?

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

In the last five years, retail care has grown 200%, giving patients a more accessible and affordable pathway to preventive primary care outside of the traditional practice model. Is specialty care the next frontier for retail medicine? Network Eye CEO Jeremy Kirsch and Executive Chairman Steven Wisch join Justin to discuss how their company is using AI to bring ophthalmology into the retail setting, make diagnosis faster and less expensive, and blaze trails for other specialties in the retail care space.

Justin, Jeremy, and Steven examine how retail care and AI can get higher-risk patients into the care continuum earlier and keep them out of the emergency room. They also explore the mutual benefits of partnerships between medical specialists and retailers, the role of retail care under the transition toward value-based care, and why the retail model ultimately elevates—not replaces—private practices.

To learn more about Definitive Healthcare, please visit us at definitivehc.com.

Why is it easier for a gastrointestinal (GI) specialist to order an endoscopy than schedule a simple consultation with a patient? Dr. Sameer Berry, CMO and co-founder of Oshi Health, joins Justin and new podcast contributor Catherine Wright to examine the current approach to GI care that Dr. Berry calls “flawed to its core.” Dr. Berry shines a light on gastroenterology’s perverse incentives, misinformation, and stigma while sharing the benefits of a virtual-first, multidisciplinary care model that could – and should – deliver more cost savings, better patient outcomes, and even potentially reform the healthcare system itself.

Justin, Catherine, and Dr. Berry also discuss how payors, providers, and patients can improve GI care delivery through value-based reimbursement, higher-touch care plans, and greater self-advocacy. They ask: What can claims tell us—and not tell us—about the state of GI care? Are insurance companies responsible for ineffective care models? And can Oshi Health’s virtual-first success to-date be replicated by other specialties?

To learn more about Definitive Healthcare, please visit us at definitivehc.com.