Believe it or not, 60% of healthcare payments in the US are tied to value. But it’s still surprisingly hard to find examples of health systems that have been doing VBC at scale, successfully, over time. So that’s what Advisory Board researchers set out to do. And across 66 conversations with 44 systems, we found four systems with approaches worth emulating. This week, we’re unpacking the approach at one of those systems: Advocate Health.

Host Abby Burns sits down with Don Calcagno, Chief Population Health Officer and President of Advocate’s largest clinically integrated network, Advocate Physician Partners. Don lays out how putting operations at the center has led Advocate to become one of the top-performing systems in Medicare risk models, generate millions of dollars in savings, and, most importantly, improve quality of care. Not to mention, juggle over 100 VBC contracts across 13 accountable care organizations and clinically integrated networks, and carry $1 billion in capitated risk.

Links:

• Read the case study: Inside Advocate Health’s VBC approach that saved $136M
• VBC self-assessment: Find out where your organization stands
• 2025 Advisory Board Summit- Carlsbad, CA - join us for the full event, and check out our session featuring another VBC case study
• Registration is live for our VBC Roundtable in October: HOME - How to deliver the next era of VBC
• Ep. 243: What’s now and what’s next in value-based care
• How UNC Health made VBC sustainable in an academic health system
• Optum Advisory can help you create a VBC strategy for growth and profitability. Connect with an expert.
• How to succeed in VBC — according to Optum experts

VBC success is possible. Here’s how.

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

(This episode originally aired on October 22, 2024.)

For years, the best word to describe Medicare Advantage (MA) was “untouchable.” Hugely popular among seniors, profitable for health plans—the hybrid public-private payment model grew to the point that it now covers more seniors than traditional Medicare. But in the past few years, the tide has started to change. And if you’ve been paying attention in recent months, you’ll have seen headlines announcing that payers that are scaling back their MA offerings and providers are exiting MA contracts. The MA market has gone from “untouchable” to “volatile.”

The question is: why is this happening, and what does it mean for payers, providers, and seniors moving forward? In this episode, hosts Rachel (Rae) Woods and Abby Burns invite health plan experts Max Hakanson and Chelsea Needham to dissect what is going on in MA and how plans and providers are—or should be—navigating the changing tide.

Links:

• Ep. 203: Value series: Is the future of VBC in specialty care? Zing Health & Strive Health say yes.
• Ep. 149: Senior Care (Part 1): Specialized primary care for an aging population
• Ep. 150: Senior Care (Part 2): The rapid growth of Medicare Advantage
• 3 traits health plans want in a provider partner
• 4 traits providers want in a health plan partner
• Around the nation: CMS releases Medicare Advantage Star Ratings

Q&A: Cardiologist Navin Kapur discusses the future of complex PCI

The federal drug purchasing program known as 340B was created in 1992 to help select provider organizations stretch scarce resources to care for patients. More than three decades later, health systems of all shapes and sizes have come to rely on 340B for their financial sustainability. But the program has come under criticism. And in recent years, it’s been under more scrutiny, with manufacturers, state governments, and federal regulators proposing changes to how it operates.

In this episode, host Abby Burns invites Advisory Board experts Gina Lohr and Chloe Bakst to unpack the origin and controversy around 340B. They debate whether 340B has strayed from its intended purpose and break down the proposed changes to the program, how likely they are to go into effect, and what those changes would mean for health systems.

Plus, stay tuned to the end of the episode, where co-host Rae Woods discusses the recent healthcare-focused executive order and what it signals for the future of this administration’s drug policy.

Let us know what you think about today’s discussion, or share your ideas for future episode topics by leaving us a voice message or emailing us.

Links:

• 340B Drug Pricing Program
• 340B reimbursement cuts may be looming: What you need to know
• J&J's 340B rebate model is receiving pushback. Here's why.
• Congress is weighing spending cuts. How will they impact healthcare?
• [Relentless Health Value] EP448 (Part 1): 340B: Where It Started, Where It Is Now, and Who Is Really Benefiting From This Massive Program, With Shawn Gremminger
• [Relentless Health Value] EP448 (Part 2): 340B: Why Employers Should Probably Care About What’s Happening Here, With Shawn Gremminger

GLP-1 innovation showcase

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

In 2025, 6% of US adults are taking a GLP-1. But the popularity of weight-loss drugs isn’t the only thing changing the obesity care landscape. On Radio Advisory, we’ve talked about what comprehensive obesity care looks like, the reality of weight bias, and the strain high-cost drugs like GLP-1s are having on employers and plans. But we haven’t done an updated scan of the obesity care landscape, until now.

To share the state of the Obesity market in 2025, host Rachel (Rae) Woods invites Advisory Board experts Gaby Marmolejos and Madeline Vogel to share the latest on bariatric surgery volumes, coverage decisions, patient preferences, drug shortages, compounding, and the new competitive landscape for direct-to-consumer obesity care. Given the pace of change in just a few short years, Rae also invites her guests make predictions about the obesity market two years from now.

Links:

• Ep. 159: Ozempic, Wegovy, and our questions on weight management drugs
• Ep. 222: It's not just GLP-1s; here's what comprehensive weight management looks like
• Diabetes and obesity care growth forecast: What you need to know

GLP-1 innovation showcase

2025 Nursing Survey

Upcoming Webinar: Obesity market trends and forecasts

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Let’s face it: Hospitals and post-acute providers can find themselves at odds. Post-acute is an area of the industry that is often misunderstood and sometimes villainized. But when post-acute care struggles, it directly impacts hospital operations. The industry needs a solution. It starts with understanding that the post-acute space is not a monolith. Because only by understanding how different facilities struggle—and how systems can support or partner with them—can we unlock their potential.

That’s why this week, host Abby Burns invites Advisory Board expert Monica Westhead, and Optum Advisory post-acute care expert Jennifer Skaggs to unpack the post-acute landscape and break down what effective acute-post-acute partnerships looks like. Throughout the discussion, they explore why post-acute facilities are struggling to stay afloat, and why partnering with post-acute facilities is better avenue than building or buying.

Links:

• The Playbook for Hospital/Post-Acute Care Collaboration
• Optum Advisory partners with hospitals nationwide to improve efficiency and optimize resource utilization to reduce labor expenses.
• New staffing mandates for SNFs will have broad effects. Here's how to prepare.
• Post-acute care Landing Page

2025 Nursing Survey

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Every stakeholder in healthcare is getting squeezed by mounting financial pressures, and health plans are no exception. Higher utilization and rising treatment costs are hitting plans hard. At the same time, plans are facing heightened public scrutiny. It may seem like the wrong time for plans to focus on cost management, but the combination of market and public pressures is exactly why it is so important for plans to get a handle on their clinical costs. If not, they risk passing those costs on to employers or members.

The good news is, health plans already have a comprehensive playbook for managing their clinical costs. The bad news is, these strategies don’t often take a targeted approach.

This week, host Rachel (Rae) Woods invites Advisory Board experts Chelsea Needham, Morghen Philippi, and Rhea Jain to unpack how plans should think about tailoring their approach to cost management, how leaders can deploy their tools with greater precision, and why plans’ actions in this space will impact healthcare stakeholders across the board.

Stay tuned to the end of the episode, where co-host Abby Burns provides an update on the recent layoffs and restructuring of HHS, and the near and long-term impacts of the shakeup. Let us know what you think about today’s discussion, or share your ideas for future episode topics by leaving us a voice message or emailing us.

Links:

• 5 care navigation strategies to help employers cut healthcare costs
• 3 strategies for sustainable health plan growth
• Health plan utilization management

Learn more about the key features and benefits of Optum Integrity One™, and how it can transform your revenue cycle

Q&A with iRhythm Technologies: The importance of arrhythmia detection

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

It feels like only yesterday that workforce challenges were the biggest problem facing the healthcare industry. While COVID-19-related staffing shortages may have declined, an inefficient workforce can still threaten health system operations and finances. Often, systems turn to staffing ratios or benchmarks to determine whether they need more cuts or more hires. However, systems need more than staffing ratios to make sure they have the right headcount and the right expertise in place to safely and effectively care for patients. The question is: if workforce benchmarks aren’t enough, then what is?

To answer that question, host Rachel (Rae) Woods invites Advisory Board nursing expert Ali Knight to unpack the state of the workforce five years after the peak of COVID-19. Later, Rae brings on Optum Advisory workforce management experts Sherilynn Quist and Anne Schmidt to break down their work in the field, addressing what they call the “blocking and tackling” of workforce efficiency within a hospital.

Links:

• Optum Advisory: Healthcare consulting services
• [Webinar, May 18] Broaden your definition of the nursing care team
• Insights from Advisory Board's 2024 workforce benchmarks
• [Roundtable, Aug. 18-19] How to thrive in an evolving nursing landscape
• Ep. 205: Live from ViVE 2024: Four leaders on how technology is redefining clinical work
• Ep. 207: Nurses Week 2024: Build care teams, not assembly lines

2025 Advisory Board Summit - Carlsbad, CA

Advisory Board Fellowship

Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent.

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

In the first two months of the Trump administration, the political and regulatory environment have shifted considerably. Since the inauguration, we’ve fielded dozens of questions about the slew of executive orders, cuts to research funding, HHS layoffs, tariffs, and an unstable economic outlook. All of that is coupled with the potential for major payment cuts to government-funded healthcare and rising scrutiny over public health and the healthcare industry writ large. The sheer pace of change leaves many healthcare leaders wondering where they need to focus their attention and energy.

This week, we’re here to clarify some of the chaos and help leaders focus their efforts on what is most pressing and most actionable. To do that, host Rachel (Rae) Woods invites Advisory Board experts Natalie Trebes and Max Hakanson to break down the operating conditions as the second Trump term takes shape.

We’re here to help: If there are specific policy areas or issues that you want to hear more about, or you are interested in talking to our research team (or getting access to our working documents), let us know by leaving us a voice message or emailing us.

Links:

• Ep. 230: Elections results are in: What healthcare leaders need to know
• How could Trump’s new tariffs impact healthcare?
• Thousands laid off at HHS: What you need to know
• RFK Jr. wants to change how Medicare pays doctors
• Health policy roundup: The latest on measles, abortion, and gender-affirming care
• Health policy roundup: Trump signs executive order on price transparency
• Learn more about the origins of Ozempic

Learn more about the Advisory Board Summit in Carlsbad, CA.

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

There is a lot happening in federal policy that may affect healthcare payment transformation and care delivery. But we’ve said it before: healthcare leaders can’t afford to focus on fighting near-term fires at the expense of driving long-term success and sustainability. Amidst the uncertainty, it’s more important than ever to push forward conversations about how we can structurally evolve our systems to align incentives to patient health.

So, in this episode, we’re talking about value-based care. Host Abby Burns invites Advisory Board expert Clare Wirth and Optum Advisory expert Erik Johnson to unpack the state of VBC in early 2025, and where they see it going next. They debate whether bundles can truly be considered “value-based care,” how specialty care will fit into the future VBC landscape, and which payer lines of business they have their eyes on.

Links:

• VBC in 2025: What's now and what's next
• Inside Advocate Health’s VBC approach that saved $136M
• How UNC Health made VBC sustainable in an academic health system
• The obstacles between health systems and VBC success
• Ep. 201: Value series: What does health system VBC adoption actually look like?
• Ep. 231: Big deal, little deal, or no deal? A 2024 health policy retrospective

Value-based care landing page

Optum Advisory can help you design a VBC strategy that drives sustainable growth and profitability. Get in touch

Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent.

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Partnerships between health systems and life sciences play a critical role in giving patients access to the best data, therapies, and technologies available in the market. However, these partnerships can be less fulfilling if both sides don’t align on purpose and expectations.

This week, host Rachel (Rae) Woods invites Advisory Board expert Fanta Cherif to break down the current state of health system and life sciences partnerships, share the spectrum of collaboration options, and the strategic middle ground that is often overlooked, but can serve as a lifeline in today’s challenging economic landscape.

Let us know what you think about today’s discussion, or share your ideas for future episode topics by leaving us a voice message or emailing us.

Links:

• Ep. 151: Making vendor-provider partnerships work
• Ep. 183: John Muir Health and Optum reflect on what makes their partnership work
• How to bridge the communication gap in vendor-provider partnerships
• Metrics that matter: How different stakeholders define value in healthcare

Join Advisory Board experts for these upcoming philanthropy webinars:

• March 20, 2025 (1-2 p.m. ET/10-11 a.m. PT): What the future of health system growth means for philanthropy leaders Register here: What the future of health system growth means for philanthropy leaders
• April 1, 2025 (1-2 p.m. ET/10-11 a.m. PT): How market data can transform your philanthropy strategy Register here: Using market data to inform your philanthropy strategy

A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.