Join us on Full Circle for part two of our conversation with Dr. Milan Patel — physician executive across a 50-hospital system and one of the clearest thinkers on where value-based care is actually heading. In this episode, he gets into the operational detail: why RPM programs fail when devices ship without education, how virtual nursing from Costa Rica is already reducing burnout and cutting costs simultaneously, and why behavioral health screening during a hospital stay — not after — is the most underused readmission prevention tool available. He also answers the question every small practice asks: where do I even start? And closes with the startup opportunity he thinks is being left on the table — AI billing automation that could free up more clinical time than almost anything else.

0:22 Why RPM programs fail — devices sent without onboarding are devices that never get used

2:26 Virtual care as the biggest revolution — COVID compressed a 10-year telehealth roadmap into one month

3:39 Virtual nursing application 1 — admission and discharge documentation without the hour at the computer

4:11 Virtual nursing application 2 — specialty expertise extended to every site, not just the flagship

4:57 Virtual nursing application 3 — one remote sitter monitoring multiple patients instead of one-to-one watchers

5:46 Already happening from Costa Rica — less burnout, faster response, more patient face time, lower cost

7:22 Virtual visits for transitional and chronic care — the growing opportunity between value-based contracts

9:04 Behavioral health during the inpatient stay — screening and connecting before discharge, not after

10:22 New Jersey's NJQIP program — millions tied to behavioral health follow-up within 14 and 30 days

11:52 Where a small practice starts — ACOs, HMO risk models, and direct primary care with 200-patient panels

13:38 The underutilized startup opportunity — RPM in chronic care, Medicare-funded and proven but underdeployed

14:26 AI billing automation — the clinical time it could free up is bigger than most people realize

Guest: Dr. Milan Patel | Physician Executive & Medical Strategist, 50-Hospital Health System

Host: Circle Health