The Disrupted Podcast

By James Preston, Scott MiddletonBusiness Entrepreneurship Medicine Health & Fitness Education Self-Improvement

The Disrupted Podcast episodes

April 25The Nurse Case Manager
What if the people case-managing your care had a financial reason to keep you sicker? That's the uncomfortable question Scott Middleton puts on the table in this episode — recorded live from the American Case Managers Conference in Orlando, where Scott went to learn, and ended up being told Your Health didn't "fit" because they weren't a hospital.
Jamie and Scott unpack what the nurse case manager role actually looks like at Your Health — and why moving case management out of hospitals and into patients' homes isn't just better care, it's better economics. Scott shares the research proving the model works: 50% reduction in Medicare spend when patients are seen at the right frequency by the right people.
In this episode:
Why hospitalists may be "the demise of the American healthcare system"

The difference between nurse practitioners (diagnose and treat) and nurse case managers (assess and guide) — and why blurring them costs patients

The 16.05-visits-per-risk-point model David Clemens' research validated

How coding departments are quietly diagnosing patients with diseases they don't have

Why Medicare's 6-year insolvency window may be the disruption we need

Head-to-toe assessments, delegation rights, and the real job of an RN in the home
If you've ever suspected the system is working exactly as designed — just not for the patient — press play.
www.YourHealth.Org
27 min
April 18The Care Group Model
What if the reason healthcare teams burn out isn't the workload — it's the org chart?
On this episode of The Disrupted Podcast, Jamie and Scott, break down the evolution of The Care Group Model — and why the instinct to build a "separate hospice team" is exactly the wrong move. Scott walks through what a true care team looks like when nurse practitioners, nurses, community health workers, social workers, chaplains, and triage nurses are orchestrated around the patient — not siloed around a diagnosis.
Inside the episode:
Why adding hospice to existing care groups beats building a parallel hospice division

The new non-clinical "administrator" role Your Health is rolling out — and why every nurse needs one at their side

Using DISC assessments to build teams that actually function (and why nurses aren't the same personality type)

How mutual accountability and group-based bonuses fix the "don't bill too much CCM" problem

Why matching a chaplain to a patient's faith tradition matters more than checking the box

The $110 million Medicare savings story the industry still doesn't understand
If you lead a clinical team, run an operation, or care about what healthcare could look like when it's built around people instead of paperwork — press play.
www.YourHealth.Org
42 min
April 10Social Services
A man is dying — literally in his last hour, the death rattle audible — and the hospital team arrives to take him for a radiation treatment. His family had no idea. No one had told them. No one had started the conversation. This is not a rare exception. This is what happens when social services is treated as an afterthought.
In this episode of The Disrupted Podcast, host Jamie Preston and Scott Middleton, Owner and Chief Disruption Officer of Your Health, go deep on one of the most overlooked levers in healthcare — social services. From the social determinants that drive healthcare costs more than healthcare itself, to the care team structures Your Health is building to close the gap, this is a candid, unfiltered look at what's broken, what's possible, and what it actually costs when we don't act.
What you'll hear in this episode:
Why social determinants of health — food access, medication literacy, housing instability, social isolation — are the real drivers of healthcare spending, and why most systems still ignore them

The truth about advanced care planning: why it's quietly dropping, why every patient within two to three years of death needs that conversation, and the story of Janet Denino's cousin that makes the cost of silence impossible to ignore

How the mental health stigma is shifting generationally — and how telehealth, AI-assisted tools, and a smarter therapy cadence are changing who actually gets support

The billing math behind 280,000 possible care management hours that were built down to 110 — and why that gap isn't just a business problem, it's a human one

What it actually takes to build a social services program that works: the right roles, the right ratios, and why getting out to see patients is non-negotiable
The system won't fix itself. But the people in it can. This episode shows you how.
www.YourHealth.Org
36 min
March 13The Role That Could Eliminate Most Hospitalizations: The Care Manager
In this episode of The Disrupted Podcast, Jamie and Scott have a raw, specific, and deeply personal conversation about Care Managers: who they are, what they're actually supposed to do, and why getting this role wrong is costing patients their health and organizations millions of dollars.
Scott opens with a story that hits hard: his 91-year-old father's recent hospitalization, the mistakes that nearly happened, and what it cost him — financially and emotionally — to navigate a system that wasn't built for the patient.
What you'll hear in this episode:
Why care managers are controllers, not schedulers — and what happens when organizations get that wrong

The medication reconciliation crisis: how discharge errors are sending patients straight back to the ER

How Your Health's new geographic mapping tool is transforming how care teams schedule 30 days of visits in advance

The shared bonus model designed to stop care team members from fighting over visits — and start winning together

What care managers should never be doing — and the analytical skill set that separates great ones from average ones
If you're building care teams, leading a healthcare organization, or just trying to keep a loved one safe in a broken system, this episode will change how you think about the people standing between your patients and the hospital.
www.YourHealth.Org
54 min
March 06The Visit That Saves a Life Has No Diagnosis Code: The Community Health Worker
What if the most powerful person on your care team isn't a nurse, a doctor, or a specialist — but someone showing up at 8:00 AM to check blood pressure, eat lunch with residents, and play vital signs bingo?
In this episode, we go deep on the Community Health Worker role: what it is, what it isn't, and why most organizations are dramatically underusing it. Scott pulls no punches on the disconnect between what CHWs are doing and what they should be doing — and why the difference is costing patients their health and workers their bonuses.
What you'll hear in this episode:
Why the #1 complaint about CHW visits ("you're seeing our patients too much") is actually a communication failure, not a frequency problem — and how to fix it

The specific visit types every community health worker should be scheduling: vital signs, medication reconciliation, lab draws, wound care, advanced care plans, and more

How Mary White, a CHW in Gainesville, Georgia, goes in with 5 patients on her list and leaves having seen 15 — and what her approach reveals about what this role is really for

Why buildings that aren't growing have either the wrong person or not enough people — and how to think through both

The full compensation breakdown: base salary, guaranteed bonus, and how the right CHW can earn close to $80,000 a year
If you hire, manage, or are a community health worker, this episode will reshape how you think about the role. Hit play.
www.YourHealth.Org
52 min
February 27 The Yeses Have Butts: How to Find the Yes in Every Healthcare Conversation
What does it actually take to say yes in healthcare when the system is wired to say no?
In this episode of The Disrupted Podcast, Scott takes you straight into the field — from a brand-new administrator in Marietta, Georgia who's already revolutionizing her building eight days in, to a 190-patient facility in Charleston where the real conversation isn't about hospice referrals, it's about whether you have the staff to back it up.
Scott gets honest about the moments where healthcare organizations talk a big game but fold when it matters — refusing acute visits to non-panel patients, locking providers into rigid workflows, and hiring bodies instead of talent. He challenges all of it. And he does it with the kind of clarity that only comes from someone who's actually in the buildings, at the dinner tables, and on the phone doing the hard work every day.
From a nurse who deserves a Tesla to a wristband that could change emergency response forever, this episode is packed with real stories, bold ideas, and a simple but radical belief: that getting to the yes isn't just good business — it's the whole point of healthcare.
If you're a provider, administrator, nurse, or healthcare leader who's tired of the way things have always been done, this one's for you.
www.YourHealth.Org
41 min
February 17 Stop the Fragmentation: Integrating Hospice Into Primary Care
Healthcare didn’t get expensive because patients got worse — it got expensive because the system got fragmented. In this episode of The Disruptive Podcast, Scott Middleton breaks down why hospice can’t live “over there,” separate from primary care, nursing, therapy, and care management.
Scott explains the Your Health Hospice rollout, the staffing reality that determines whether integration is real, and the math behind a new model: caseload reductions for nurses when hospice patients are added, plus incentives that acknowledge the complexity of end-of-life care.
This conversation is about building a care system where the patient doesn’t have to juggle providers, phone numbers, and handoffs — because they shouldn’t have to. One team. One plan. One umbrella.
www.YourHealth.Org
42 min
January 31 Find A Way To A Yes
In this episode, Jamie and Scott discuss a simple leadership posture that changes outcomes: default to “yes” when it protects patients—then solve the obstacles. Scott shares real examples from winter-storm outreach, hospice and palliative care misconceptions, and operational “rules” that block care (often driven by language, software, or habit—not true limitations). They dig into how patient-centered thinking, clearer communication (ditch the acronyms), and smarter systems—like a new mapping tool—can drive more visits, better coordination, and better results.
www.YourHealth.Org
41 min
January 16 Healthcare Isn’t Complicated—Go See Your Patients
In this episode of The Disrupted Podcast, Scott Middleton returns from the JP Morgan healthcare conference with a blunt takeaway: the future of care is not a magic pill, another telehealth platform, or a clever financial structure — it’s showing up. Scott breaks down why healthcare has become unnecessarily complicated, how fee-for-service incentives distort decision-making, and why “easy-entry” models won’t hold up long-term.
He makes the case that Your Health’s home-based care model is hard to replicate because it requires operational excellence—routing, scheduling, team coordination, and intentional touchpoints. Scott also challenges internal culture issues: finger-pointing, poor communication, inefficient scheduling, and employees misunderstanding the mission. The solution is both simple and demanding: build systems that make weekly in-person encounters possible for high-risk patients and hold the line on execution.
www.YourHealth.Org
38 min
January 09 The Stakes Are High: Why Facilitated Visits Will Save the System
In this first Disrupted Podcast episode of 2026, Jamie and Scott unpack the reality of a new “High Needs ACO” and what it demands from frontline care teams. Scott explains why spending more in primary care reduces total cost, how care management codes are expanding, and why the real win is keeping patients out of the hospital through proactive, consistent engagement.
The centerpiece is a clear operational playbook for facilitated visits: facilitators gather the full story in the home or facility, loop in the provider through audio/video when possible, document in the system, and never delete encounters—because billing isn’t just revenue, it’s the data trail that proves prevention works. The conversation closes with the bigger picture: this isn’t a workflow tweak—it’s a way to reduce hospital dependency, protect families, and help stabilize the healthcare economy.

www.YourHealth.Org
47 min

About The Disrupted Podcast

From the publisher's feed

Entrepreneur and Chief Disruption Officer Scott Middleton share's his experiences of how he uses disruption to innovate and keep an organization moving forward and growing. Scott shares these weekly…

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