In this thought-provoking episode of the Advancing Healthcare Innovation Show, host Michael Stamatinos is joined by two of the most respected figures guiding the future of healthcare transformation—Dr. Andrew Hurwitz and Dr. Jeff Ballou of Mathematica. Together, they offer a front-row seat into how rigorously collected evidence, deep policy fluency, and commercial insight are being combined to address one of healthcare’s biggest challenges: how to transition from volume-based systems to truly value-based care.
Dr. Andrew Hurwitz leads Mathematica’s Healthcare and Life Sciences Practice. His work sits at the intersection of data science, commercial strategy, and mission-driven advisory, helping private and public sector organizations convert complexity into clarity.
Dr. Jeff Ballou, an economist by training and reformer by conviction, has helped design and refine some of Medicare’s most consequential alternative payment models. His unique vantage point from CMMI gives him rare insight into what’s working—and what still needs fixing.
In this conversation, we cover:
* Why many private ACOs misunderstand or misapply lessons from public sector models—and how Mathematica is stepping in to bridge that knowledge gap
* The evolution of the Medicare Shared Savings Program and what the new “prospective trend” means for provider accountability and financial performance
* The critical importance of shaping the right analytical question, before diving into any dataset
* Why high-quality, research-grade data remains elusive for many organizations and what it takes to build it
* The cultural and operational differences between organizations that succeed with value-based care and those that stall out
* A candid exploration of the gap between belief in data and the human decisions that must follow, especially when lives are on the line
* Deep reflections on personal stories, including Jeff’s moving account of his mother’s care journey, and how it shaped his approach to healthcare reform
* Mathematica’s ambitious push into the private ACO space and why they believe now is the time to extend decades of public-sector experience into commercial innovation
* ACO readiness is not one-size-fits-all. Whether you're new to value-based care or looking to optimize mature models, success depends on tailoring strategy to your organization's level of preparedness.
Culture eats strategy, especially in value-based care. No model or technology will drive outcomes without committed leadership and aligned teams.
Data is only as useful as the workflow it informs. Too many organizations build the “bridge halfway across the river,” failing to integrate analytics into real decision-making moments.
Policy and payment reform can only go so far without execution. Mathematica’s team emphasizes not just theory, but tactical, scalable, on-the-ground problem-solving.
What sets this episode apart:
Rather than a generic discussion of healthcare trends, this episode offers a deep, nuanced, and often emotional exploration of what it really takes to lead transformation in a system that resists change. It blends technical rigor with human-centered thinking, and provides rare access to two advisors helping reshape the scaffolding of how care is delivered and valued.
Connect with Mathematica:
Website: https://www.mathematica.org
LinkedIn: https://www.linkedin.com/company/mathematica/
Stay Connected with the Show:
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The Advancing Healthcare Innovation Show started with the idea of wanting to highlight stories of what healthcare innovation truly looks like in action. Our mission, highlight real people who are really innovating within healthcare. Guests include healthcare entrepreneurs, providers, payers, and professionals from the investment community. We showcase little wins as well as valuable lessons learned from setbacks through these interviews. The real innovators in healthcare are often the ones in the trenches doing the work with razor-sharp focus. We find these innovators and bring their stories to light.
Find out more about how we are building bridges within healthcare. Join our group, Advancing Healthcare Innovation Forum on LinkedIn.
https://www.linkedin.com/groups/7056196/
