Health Care Rounds

More than 70 million Americans are covered by Medicaid, and the people with the most complex needs, those juggling mental illness, housing insecurity, and chronic disease simultaneously, are the ones the traditional health care system is least equipped to reach.

Dr. Toyin Ajayi, Co-Founder and CEO, and Mike Roaldi, President of Cityblock Health, join host John Marchica to break down how a trust-first, interdisciplinary care model is producing measurable outcomes for over 100,000 Medicaid and dual-eligible members, and why value-based care may be more essential than ever as federal Medicaid policy undergoes some of its most significant changes in decades.

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🎙 ABOUT DR. TOYIN AJAYI
Dr. Toyin Ajayi is co-founder and CEO of Cityblock, a value-based healthcare provider serving Medicaid and dually eligible beneficiaries in underserved communities through integrated medical, behavioral health, and social care.

Previously, she served as Chief Medical Officer of Commonwealth Care Alliance, where she led clinical operations and care delivery innovation. Dr. Ajayi has been recognized by Modern Healthcare, STAT, and the Aspen Institute, and serves on the Board of Directors of Evolent Health and the Congressional Budget Office’s Panel of Health Advisers.

She earned degrees from Stanford University, the University of Cambridge, and King’s College London School of Medicine. Board certified in Family Medicine, she continues to practice primary care with a focus on patients with complex needs.

🎙 ABOUT MIKE ROALDI
Mike's career has spanned both legal and healthcare leadership roles, starting as a commercial litigator before joining UnitedHealth Group as National Vice President of Medicaid Policy and Product. He went on to serve as CEO of UnitedHealthcare Community Plan of Ohio, then as Chief Transformation Officer and President of Government Programs for Optum BH Solutions, and later as Chief Growth Officer and SVP of Growth and Product at UnitedHealth Community and State. In 2024, he joined Cityblock as President to help drive the company's next phase of growth.

Mike holds an undergraduate degree from the University of Notre Dame, a JD from Notre Dame Law School, and attended an Executive Education Program at Stanford Graduate School of Business.

🎙 ABOUT HEALTH CARE ROUNDS
Smart conversations with the people moving health care forward.

Health Care Rounds podcast brings together the leaders changing the future of health care and pharma, from how it's delivered and paid for, to where it's headed. Each episode goes deep on the decisions, innovations, and ideas reshaping the industry from the inside out. Hosted by John Marchica, CEO of Darwin Research Group and a longtime industry insider, every episode has one goal: leave you thinking differently than when you arrived.

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

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⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

American health care is too expensive, too inconsistent, and too difficult to navigate. And the payer-provider AI arms race that has emerged over the last several years is making all three problems worse, not better.

Dr. Marc Harrison, Chair of the TowerBrook Health Care Institute, former CEO of Intermountain Health, and co-founder of HATCo, joins host John Marchica to examine why the health care system remains stubbornly stuck in an analog model and how AI-driven abundance could finally close the gap between the care Americans need and the care they can actually access.

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🎙 ABOUT DR. MARC HARRISON

Marc Harrison, M.D. is Chair of the TowerBrook Healthcare Institute, Senior Advisor to TowerBrook Capital Partners, and Strategic Advisor to General Catalyst. Previously, he was the founding CEO of Health Assurance Transformation Company (HATCo), where he led digital transformation initiatives and the acquisition of Summa Health. Before that, he served as President and CEO of Intermountain Healthcare, driving growth across the Mountain West through telehealth, rural health strategies, and value-based care. Earlier in his career, he held senior roles at Cleveland Clinic, including founding CEO of Cleveland Clinic Abu Dhabi and Chief Medical Operations Officer. Dr. Harrison is a pediatric critical care physician with 20 years of clinical practice.

🎙 ABOUT HEALTH CARE ROUNDS
Smart conversations with the people moving health care forward.

Health Care Rounds podcast brings together the leaders changing the future of health care and pharma, from how it's delivered and paid for, to where it's headed. Each episode goes deep on the decisions, innovations, and ideas reshaping the industry from the inside out. Hosted by John Marchica, CEO of Darwin Research Group and a longtime industry insider, every episode has one goal: leave you thinking differently than when you arrived.

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

On this week's mailbag, John tackles three reader questions: How are health systems using AI to address the nursing shortage, and do these solutions solve the underlying problem? Are bundled payments becoming the norm for value-based payment models, and what does CMS's shift toward mandatory models like TEAM and CJR-X mean for providers and suppliers? And will the U.S. ever become a Canadian-style, single-payer system? 

Have any questions or comments? Send them our way! 👇 [email protected]. 

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

Between 80% and 90% of health outcomes are shaped by what happens between doctor visits. Yet the entire U.S. health care system, from payment models to primary care, is built around the visit itself. 

Wei-Li Shao, President of Omada Health, joins host John Marchica to break down why persistent, in-between-visit care is the missing layer in chronic disease management, and how pairing GLP-1 therapy with the right behavioral support program could be one of the most powerful levers the health care system has yet to fully pull. 

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🎙 ABOUT WEI-LI SHAO 

Wei-Li Shao is President of Omada Health, a digital health company focused on patient-centered technology and medical-grade evidence for chronic condition management. He came to Omada in 2019 following an 18-year career as an executive at Eli Lilly and Company, where he built and led biopharmaceutical and diagnostic imaging businesses across the United States, New Zealand, China, and Taiwan. At Omada, he has guided the company's expanded product offerings, partner integrations, and overall strategic vision. 

He holds dual BS degrees in Biochemistry and Molecular Biology from the University of Wisconsin-Madison and an MBA from the Kelley School of Business at Indiana University. He is also a published children's book author, having written Anny The Tall Girl, a story centered on diversity, equity, and inclusion. 

🎙 ABOUT HEALTH CARE ROUNDS 

Smart conversations with the people moving health care forward. 

Health Care Rounds podcast brings together the leaders changing the future of health care and pharma, from how it's delivered and paid for, to where it's headed. Each episode goes deep on the decisions, innovations, and ideas reshaping the industry from the inside out. Hosted by John Marchica, CEO of Darwin Research Group and a longtime industry insider, every episode has one goal: leave you thinking differently than when you arrived. 

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

Health misinformation is no longer a fringe problem on the margins of public health. It has a measurable body count, and the systems that once reliably corrected it, local journalism, trusted institutions, and federal health agencies, are eroding fast.

Dr. Joshua Sharfstein, Vice Dean for Public Health Practice and Community Engagement and Distinguished Professor of the Practice at the Johns Hopkins Bloomberg School of Public Health, and co-author of "Information Sick," joins host John Marchica to examine why the collapse of local news and the flood of health misinformation now constitute a public health crisis in their own right, and what health systems, clinicians, and institutions can actually do about it before the next outbreak arrives.

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🎙 ABOUT DR. JOSHUA SHARFSTEIN
Dr. Sharfstein is Vice Dean for Public Health Practice and Community Engagement, director of the Bloomberg American Health Initiative, and Professor of the Practice in Health Policy and Management. Previously, he served as the Secretary of the Maryland Department of Health and Mental Hygiene, the Principal Deputy Commissioner of the U.S. Food and Drug Administration, as Commissioner of Health for Baltimore City, and as health policy advisor for Congressman Henry A. Waxman. He is an elected member of the National Academy of Medicine and the National Academy of Public Administration.

🎙 ABOUT HEALTH CARE ROUNDS
Smart conversations with the people moving health care forward.

Health Care Rounds podcast brings together the leaders changing the future of health care and pharma, from how it's delivered and paid for, to where it's headed. Each episode goes deep on the decisions, innovations, and ideas reshaping the industry from the inside out. Hosted by John Marchica, CEO of Darwin Research Group and a longtime industry insider, every episode has one goal: leave you thinking differently than when you arrived.

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

A few weeks ago we conducted a survey of Our Take readers that included both listeners to our podcast and those who don’t (the latter group, we assume, was interested enough to complete a survey). We asked for questions you would like John to answer, and we got some great ones, including today’s question about vaccines and the long-debunked link between the MMR vaccine and autism spectrum disorder. In this first mailbag episode, John reviews the evidence, calls out the "revised" CDC website, and provides his thoughts on the cost of misinformation and disinformation — and what to do about it.

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References:

Gallup polling on trust: https://news.gallup.com/poll/1597/confidence-institutions.aspx

2002 NEJM study: https://www.nejm.org/doi/full/10.1056/NEJMoa021134

2014 Vaccine study: https://www.sciencedirect.com/science/article/abs/pii/S0264410X14006367

2015 JAMA study: https://jamanetwork.com/journals/jama/fullarticle/2275444

2019 Annals study: https://www.acpjournals.org/doi/10.7326/M18-2101

1998 Wakefield Lancet study (retracted). https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(97)11096-0/fulltext

CDC webpage on the history of measles: https://cdc.gov/measles/about/history.html

CDC’s interactive page on measles cases and outbreaks: https://cdc.gov/measles/data-research/index.html

CDC webpage on Autism and Vaccines: https://www.cdc.gov/vaccine-safety/about/autism.html#toc

Original CDC page on vaccines and autism, before the rewrite: https://www.restoredcdc.org/www.cdc.gov/vaccine-safety/about/autism.html

Internet Wayback Machine instructions: Go to https://web.archive.org and search cdc.gov/vaccine-safety/about/autism.html, then pick a date before November 19, 2025.

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

Health care is 18% of U.S. GDP, the number one affordability concern for consumers, and the single biggest line item employers are trying to manage. Every major policy fight in American health care, at its core, comes down to money and who bears the cost.

Larry Levitt, incoming CEO of KFF and one of the most trusted nonpartisan voices in health policy, joins host John Marchica to examine why value-based care has yet to deliver on its promise, and why a deepening public distrust in science and health institutions may be the most dangerous obstacle standing between the U.S. and any meaningful reform.

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🎙 ABOUT LARRY LEVITT:

Larry Levitt is Executive Vice President for Health Policy at KFF, overseeing the organization's policy work on Medicare, Medicaid, the Affordable Care Act, the health care marketplace, racial equity, women's health, and global health. He previously served as editor-in-chief of kaisernetwork.org and directed KFF's communications. In May 2026, KFF announced that Levitt will assume the role of CEO in January 2027, alongside Dr. Mollyann Brodie as President.

Prior to joining KFF, Levitt served as a senior health policy adviser to the White House and the Department of Health and Human Services, where he worked on the development of the Clinton Administration's Health Security Act and other health policy initiatives. Earlier in his career, he served as special assistant for health policy with California Insurance Commissioner John Garamendi, as a medical economist with Kaiser Permanente, and held several positions in Massachusetts state government.

Levitt holds a bachelor's degree in economics from UC Berkeley and a master's degree in public policy from Harvard's Kennedy School of Government.

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🎙 ABOUT HEALTH CARE ROUNDS:

Smart conversations with the people moving health care forward.

Health Care Rounds podcast brings together the leaders changing the future of health care and pharma, from how it's delivered and paid for, to where it's headed. Each episode goes deep on the decisions, innovations, and ideas reshaping the industry from the inside out. Hosted by John Marchica, CEO of Darwin Research Group and a longtime industry insider, every episode has one goal: leave you thinking differently than when you arrived.

===

CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

Decades of quality measurement programs were designed to make U.S. health care better. The evidence suggests they have, just not nearly as much as anyone hoped, and sometimes in ways that hurt the patients who needed help most. 

Dr. Rachel Werner, Professor of Medicine, Perelman School of Medicine at the University of Pennsylvania, joins host John Marchica to examine why well-designed quality incentives so often produce unintended consequences, and why the long-term care system, despite years of reform attempts, remains structurally broken. 

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🎙 ABOUT DR. RACHEL WERNER:
 Dr. Rachel M. Werner, MD, PhD is a Professor of Medicine at the University of Pennsylvania Perelman School of Medicine and Professor of Health Care Management and Economics at the Wharton School. She also serves as a physician at the Philadelphia VA and is a Core Investigator with the VA HSR&D Center for Health Care Evaluation, Research, and Promotion. 

Over the past two decades, Dr. Werner has built a research program examining the effects of health care payment and related policies on care delivery. She has investigated the unintended consequences of quality improvement incentives and was among the first to recognize that public reporting of quality information may worsen racial disparities. Her work has been published in NEJM, JAMA, and Health Affairs, and she has served on advisory committees to state and federal government agencies and research foundations. 

Dr. Werner has received numerous awards including the Presidential Early Career Award for Scientists and Engineers and the AFMR Outstanding Investigator Award. She is an elected member of the National Academy of Medicine and holds both her MD and PhD in Health Economics from the University of Pennsylvania. 

🎙 ABOUT HEALTH CARE ROUNDS:
 Smart conversations with the people moving health care forward. 

Health Care Rounds podcast brings together the leaders changing the future of health care and pharma, from how it's delivered and paid for, to where it's headed. Each episode goes deep on the decisions, innovations, and ideas reshaping the industry from the inside out. Hosted by John Marchica, CEO of Darwin Research Group and a longtime industry insider, every episode has one goal: leave you thinking differently than when you arrived.

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

After a year of interviews about value-based care, the same things keep coming up. Fee-for-service is still the problem. Payers want to pay less, providers want to bill more. And twenty years in, the people who helped build value-based care are grading it a C-minus.

In his first solo episode, host John Marchica goes back through the transcripts and pulls out what guests agree on: the problems value-based care is trying to fix, the fixes they keep proposing — mandatory participation, full-risk capitation, payer-provider integration — how it's going so far, and where the real progress is likely to come from.

Tell us how we're doing and take our survey here.

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🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.

Decades after the research that proved high-spending regions don't produce better care, and 20 years after the term "accountable care organization" was coined, the U.S. health care system still runs overwhelmingly on fee-for-service. The incentives haven't changed, and the results show it.

Dr. Elliott Fisher, Professor of Health Policy at the Dartmouth Institute and the Geisel School of Medicine and the researcher who coined the term ACO, joins host John Marchica for a frank look at why value-based care has fallen short of its promise, and whether a public utility model for health care regulation might be the structural fix the system has been missing.

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🎙 ABOUT DR. ELLIOTT FISHER
 Elliott Fisher is former primary care physician and now Professor of Health Policy at the Dartmouth Institute and the Geisel School of Medicine. His early research revealed that US regions with higher Medicare spending did not achieve better quality or outcomes, revealing the magnitude of unnecessary care and providing evidence that universal insurance should be affordable.  He worked with colleagues to develop the concept of Accountable Care Organizations and to achieve their inclusion in the Affordable Care Act. His current research and activism focuses on how to strengthen primary care, improve population health and make health care affordable for all.   He is a member of the Board of Directors of the Fannie E. Rippel Foundation.  

🎙 ABOUT HEALTH CARE ROUNDS
 Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

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CONNECT WITH US:

🌐 Visit us on the web 

🌐 Follow Health Care Rounds on LinkedIn 

🌐 Follow Darwin Research Group on LinkedIn

📺 Watch Health Care Rounds on YouTube

🎧 Listen on Apple Podcasts

🎧 Listen on Spotify

⚙️ Health Care Rounds is produced by Grippi Media: Healthcare Marketing & Media Consulting.