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Full Circle with Nicole Bradberry Part -2
Join us on Full Circle for part two of our conversation with Nicole Bradberry — ACO architect and founder of Value Service Management. In this episode, Nicole opens with three real ACO wins — Sound Physicians saving $80M, a long-term care facility saving $40M, and Bluestone saving $26M in assisted living — then takes on the harder question: why haven't overall healthcare costs come down despite years of reform? Her answer cuts through the noise: Medicare Advantage plans optimized the revenue side through risk coding instead of actually reducing costs, and CMS just forced a reckoning. She also gets into AI's most tangible impact today — patient engagement and intelligent call handling — and why 90% of teenagers saying they'd consult an AI doctor first is a signal the entire industry needs to take seriously.
0:17 Three real ACO wins — Sound Physicians $80M, long-term care $40M, Bluestone $26M in assisted living
0:55 The Sunflower ACO — 60% long-term care, and why Nicole calls this work doing God's work
2:02 Why costs haven't come down — Medicare Advantage optimized risk coding, not actual cost reduction
3:10 CMS forces the correction — V28 risk formula changes pushing MA plans toward back-end cost management
4:49 Why US costs are 100x India's — removing the consumer from the negotiation entirely
6:22 Root cause healthcare by design — food as medicine, movement, detox, and getting ahead of conditions
7:42 Where AI is winning now — closing care gaps and scheduling entire patient panels cost-effectively
8:20 SENA Health — AI handling 80% of inbound practice calls while surfacing care gaps in real time
10:02 Patients arriving pre-informed by AI — and why providers need to adapt, not resist
10:37 90% of teenagers would see an AI doctor first — a trend extending well beyond Gen Z
11:26 AI discharge summaries in plain language — reducing readmissions without an extra physician visit
11:54 NCQA's AI task force and legal guardrails — the governance work already underway
Guest: Nicole Bradberry | Founder, Value Service Management | Founder, FL & TX Associations of ACOs
Host: Circle Health
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By Circle HealthJoin us on Full Circle for part two of our conversation with Nicole Bradberry — ACO architect and founder of Value Service Management. In this episode, Nicole opens with three real ACO wins — Sound Physicians saving $80M, a long-term care facility saving $40M, and Bluestone saving $26M in assisted living — then takes on the harder question: why haven't overall healthcare costs come down despite years of reform? Her answer cuts through the noise: Medicare Advantage plans optimized the revenue side through risk coding instead of actually reducing costs, and CMS just forced a reckoning. She also gets into AI's most tangible impact today — patient engagement and intelligent call handling — and why 90% of teenagers saying they'd consult an AI doctor first is a signal the entire industry needs to take seriously.
0:17 Three real ACO wins — Sound Physicians $80M, long-term care $40M, Bluestone $26M in assisted living
0:55 The Sunflower ACO — 60% long-term care, and why Nicole calls this work doing God's work
2:02 Why costs haven't come down — Medicare Advantage optimized risk coding, not actual cost reduction
3:10 CMS forces the correction — V28 risk formula changes pushing MA plans toward back-end cost management
4:49 Why US costs are 100x India's — removing the consumer from the negotiation entirely
6:22 Root cause healthcare by design — food as medicine, movement, detox, and getting ahead of conditions
7:42 Where AI is winning now — closing care gaps and scheduling entire patient panels cost-effectively
8:20 SENA Health — AI handling 80% of inbound practice calls while surfacing care gaps in real time
10:02 Patients arriving pre-informed by AI — and why providers need to adapt, not resist
10:37 90% of teenagers would see an AI doctor first — a trend extending well beyond Gen Z
11:26 AI discharge summaries in plain language — reducing readmissions without an extra physician visit
11:54 NCQA's AI task force and legal guardrails — the governance work already underway
Guest: Nicole Bradberry | Founder, Value Service Management | Founder, FL & TX Associations of ACOs
Host: Circle Health