The Road to Care

Behind every prior authorization, coverage decision, and patient estimate is a much bigger question: how do we ensure patients can actually access the care they need?

In this episode of The Road to Care, Kip Theno sits down with Sara Julson, RHIT, Revenue Cycle Manager, to discuss the growing financial challenges facing specialty care. Drawing on more than 20 years of experience in revenue cycle management, Sara shares why patient financial health has become just as important as clinical health, and how providers can better navigate rising patient responsibility, prior authorization complexity, and evolving payer policies.

The conversation explores everything from the No Surprises Act and patient financial transparency to the challenges of securing coverage for innovative therapies like artificial iris implants and corneal cross-linking.

Whether you work in patient access, revenue cycle, or specialty practice operations, this episode offers practical insights into one of healthcare's biggest challenges: helping patients receive the care they need without unnecessary financial or administrative barriers.

Tune in to learn:

*How the No Surprises Act is improving transparency while introducing new operational challenges for providers.

*Why obtaining coverage for innovative therapies often lags years behind FDA approval, delaying patient access.

*How data and prior authorization reporting can help practices identify payer trends, reduce denials, and improve workflows.

*Why early financial conversations, accurate estimates, and thoughtful technology adoption can improve both the patient experience and practice operations.

Together, we can make healthcare right. Here are some of the outstanding organizations and associations championing patient health mentioned in this episode:

-Centers for Medicare and Medicaid Services: https://www.cms.gov/

-Minnesota Rare Disease Advisory Council: https://mnraredisease.org/

-Epioxa: https://www.epioxa.com/

For more information on SamaCare’s free prior authorization management platform for specialty practices, visit https://www.samacare.com/?utm_source=podcast&utm_medium=r2c

This podcast was produced by JFACTOR for SamaCare. Learn more at https://www.jfactor.com/

What does “value” really mean in healthcare, and who gets to define it?

In this special roundtable episode of The Road to Care, SamaCare CEO Syam Palakurthy joins our host Kip Theno and three global leaders in pricing, market access, and health economics:

Amitabh Singh, PhD – Former Worldwide Head & VP of HEOR, Novartis Oncology

Indranil Bagchi, PhD – Global Head of Pricing & Market Access, GSK

Cristina Masseria, PhD – VP of Value & Access, AESARA; former Pfizer & GSK executive

Together, they explore how value assessment differs between the U.S. and Europe, why reference pricing is not the same as value-based pricing, and what today’s policy shifts could mean for innovation and patient access.

The panel also tackles a central challenge: how to align payers, providers, pharma, and policymakers around a shared goal — ensuring patients get the right treatment at the right time.

This episode offers a rare global perspective on access, pricing, and the structural shifts needed to make healthcare more holistic, prevention-oriented, and sustainable.

Together, we can make healthcare right.

Here are some of the outstanding organizations and technologies mentioned in this episode:

FDA

NICE

Medicare

Medicaid

AbbVie

Wyeth

Pfizer

Novartis

GSK

AESARA

This podcast was produced by JFACTOR for SamaCare. Learn more at www.jfactor.com.

On this episode of The Road to Care, we’re joined by Luba Sobolevsky, PharmD, IgCP®, President & CEO of the Immunoglobulin National Society (IgNS), and Amy E. Clarke, DNP, RN, IgCN®, Chief Clinical Officer at IgNS, two nationally recognized leaders advancing standards, education, certification, and patient advocacy in immunoglobulin (IG) therapy and biologics.

Dr. Sobolevsky and Dr. Clarke walk through how IgNS built an interdisciplinary model including standards, education, certification (IgCN®/IgCP®), and outcomes research, to close dangerous training gaps in IG therapy, and preview what’s next as the pipeline accelerates (FcRn and complement inhibitors, hyaluronidase-facilitated SCIG), the workforce ages, and plasma supply and site-of-care complexity grow.

Tune in to learn:

-Why certification matters (IgCN®/IgCP®) as a measurable competency metric tied to safer infusions and better outcomes.

-The power of interdisciplinary education across nurses, pharmacists, and physicians—and how to embed standards into policy and practice.

-What’s changing in IG therapy: new biologics, site-of-care variability (home, AICs, hospital), and implications for clinician training and patient experience.

-Patient voice as a “fourth pillar”—how shared decision-making and outcomes research inform continuous improvement.

Together, we can make healthcare right. Here are some of the outstanding organizations and associations championing patient health mentioned in this episode:

Immunoglobulin National Society (IgNS): https://ig-ns.org

National Infusion Center Association (NICA): https://infusioncenter.org/

Infusion Nurses Society (INS): https://www.ins1.org/

For more information on SamaCare’s free prior authorization management platform for specialty practices, visit https://www.samacare.com/?utm_source=podcast&utm_medium=r2c

This podcast was produced by JFACTOR for SamaCare. Learn more at https://www.jfactor.com/

On this episode of The Road to Care, we sit down with Jim Breidenstein, CEO of Adhere+, a remote therapeutic monitoring platform reshaping how patients and care teams stay connected. Jim is a seasoned healthcare leader whose career spans game-changing innovations — from launching the first minimally invasive spinal surgery device at Kyphon, to pioneering prescription digital therapeutics at Pear, to scaling novel interventions in pain management, psychiatry, and cardiology.

In our wide-ranging conversation, Jim unpacks how his journey from the medtech front lines led him to digital health, why he believes remote monitoring will soon be a first-line standard, and how real-time patient-reported data is poised to transform outcomes and costs across the system.

Tune in to learn:

*Why remote therapeutic monitoring (RTM) is more than the next RPM

*How Adhere+ turns daily patient “Polaroids” into meaningful clinical interventions

*What it takes to lead commercial healthcare teams through industry-defining change

*How the shift away from hospital-based care is shaping the future of patient access, affordability, and outcomes

Together, we can make healthcare right.

Here are some of the outstanding organizations and technologies mentioned in this episode:

-Centers for Medicare & Medicaid Services (CMS) (https://www.cms.gov/)

-American Medical Association (AMA) (https://www.ama-assn.org/)

-National Institutes of Health (NIH) (https://www.nih.gov/)

-Adhere+ (https://adhereplus.com/)

This podcast was produced by JFACTOR for SamaCare. Learn more at www.jfactor.com.

On this episode of The Road to Care, we’re joined by Jim Alecxih, CEO of DH Medical and a veteran leader in medical technology innovation. With more than 30 years in the industry, Jim has helped bring groundbreaking technologies to market, including the Da Vinci Robotic Surgical System during his tenure at Intuitive Surgical. He now leads DH Medical, a company pioneering AI-driven image enhancement and predictive signal processing in healthcare.

Jim shares powerful insights from his decades-long journey — from the chaotic early days of Intuitive to the emerging challenges and opportunities posed by AI in medicine today.

Tune in to learn:

*Why Intuitive Surgical scrapped its original business model — and how that bold pivot pioneered a revolution

*How predictive signal processing could help identify seizures before they happen

*The difference between generative AI and “blunt AI” — and why it matters for patient safety

How high-quality input data could be the key to unlocking AI’s full potential in medicine

Together, we can make healthcare right. Here are some of the outstanding organizations and technologies mentioned in this episode:

DH Medical (https://dhmedical.com/)

PRS Guitars (https://prsguitars.com/)

The Success Chain Podcast (Jim Alecxih's podcast: https://www.thesuccesschain.com/)

For more information on SamaCare’s free prior authorization management platform for specialty practices, visit https://www.samacare.com/?utm_source=podcast&utm_medium=r2c

This podcast was produced by JFACTOR for SamaCare. Learn more at https://www.jfactor.com.

On this episode of The Road to Care we’re joined by NHL Hall of Famer Jeremy Roenick to discuss his journey from hockey to healthcare. Our host, Kip Theno, and Jeremy discuss MediChainX, Roenick’s latest power move to forecheck healthcare data breaches and empower patients to take control of their own health data. As a blockchain solution, MediChainX.io is the future of secure, reliable and efficient healthcare data exchange across patients, providers, payers, and healthcare companies.

Now how’s this for a hat-trick? Tune in to learn how the blockchain can:

Make medical data safer from data breaches

Give patients control over their own health data

Save medical practices, hospital, payers, and other healthcare companies billions of dollars

Whether you’re looking for the inside scoop on healthcare innovation, or you just want to hear our host Kip Theno and Jeremy Roenick talk about the toughest hockey player of all time, this is an episode you won’t want to miss.

Together, we can make healthcare right. Here are some of the outstanding organizations and associations championing patient health mentioned in this episode:

MediChainX (https://www.medichainx.io/)

UHC (https://www.uhc.com/)

Change Healthcare (https://www.changehealthcare.com/)

For more information on SamaCare’s free prior authorization management platform for specialty practices, visit https://www.samacare.com/?utm_source=podcast&utm_medium=r2c

This podcast was produced by JFACTOR for SamaCare. Learn more at https://www.jfactor.com/.

On this episode of The Road to Care we’re joined by Dr. Krishnan Chakravarthy, MD PhD, scientist, interventional pain and spine physician, and CEO of NXTSTIM. Dr. Chakravarthy is in the top 0.1% of global scholars writing about innovations in nanomedicine, neuromodulation, accessible delivery models for care over the past 10 years and has won numerous national and international awards for his clinical and research work.

Dr. Chakravarthy joins us to discuss groundbreaking advances in technology and delivery models that will expand chronic pain patients’ access to treatment, while lowering overall cost to the medical system.

Tune in to learn:

How NXTSTIM is cutting the cost of neurostimulation from $150K to $150

Why AI & RPM is critical to successfully managing chronic pain over the long term

How Miniaturization, AI & RPM can solve access to care

How your own body will power future medical devices

Why biofuel is NOT science fiction!

Together, we can make healthcare right. Here are some of the outstanding organizations and associations championing patient health mentioned in this episode:

-Empower You Chronic Pain Foundation (https://www.empoweryoufdn.org/)

-American Society of Pain and Neuroscience (ASPN) (https://aspnpain.com/)

-National Institute of Health (NIH) (https://www.nih.gov/)

-Centers for Disease Control and Prevention (CDC) (https://www.cdc.gov/)

-NXTSTIM (https://nxtstim.com/)

For more information on SamaCare’s free prior authorization management platform for specialty practices, visit https://www.samacare.com/?utm_source=podcast&utm_medium=r2c

This podcast was produced by JFACTOR for SamaCare. Learn more at https://www.jfactor.com/.

On this episode of The Road to Care, we’re joined by leaders in rheumatology practice administration, Nancy Ellis, practice administrator at Piedmont Arthritis Clinic, and Stacy Yonker, Chief Executive Officer at Sarasota Arthritis Center. Tune in for a no holds barred discussion about the unintended consequences of recent healthcare legislation, how PBMs and the vertical integration of healthcare impacts patients and clinicians, how to overcome key points of friction in the prior authorization process and more.

This episode has something for everyone! Listen to learn:

*Which metrics matter, and which don’t for your practice

*How practices can fight declining reimbursement rates

*What patients, employers, and clinicians can do to confound abuses of the healthcare system

… and more!

Together, we can make healthcare right. Here are some of the outstanding organizations and associations championing patient health mentioned in this episode:

 National Organization of Rheumatology Managers (NORM) (https://normgroup.org/)

Medical Group Management Association (MGMA) (https://www.mgma.com/)

Trio Health (https://www.triohealth.com/)

For more information on SamaCare’s free prior authorization management platform for specialty practices, visit https://www.samacare.com/?utm_source=podcast&utm_medium=r2c

On this episode of The Road to Care, we’re joined by industry thought leader Dr. Scott Howell and special guest co-host, SamaCare CEO Syam Palakurthy. Scott is best known for leading innovations to improve coverage, reimbursement and affordability of medicines as well as services supporting patient access at GSK, Genentech, Jazz, and Novartis. Scott has been teaching, researching and writing about improving pricing and access of medicines for 15 years, primarily at the University of California – Berkeley, and is a thought leader on the topic of value-based pricing and access for medicines. Scott spent the first decade of his career in clinical medicine as a general internist.

Tune in to this episode to learn:

*Why the business model for pharmaceutical development no longer works

*How to reduce the cost of failure in drug R&D

*The impact of decentralizing drug development on pricing and patient access

And, be sure to check out Scott’s podcast, Prescription for Better Access: (https://open.spotify.com/show/659fsjTHJGdqHdfrmqDBkw).

Together, we can make healthcare right. Here are some of the outstanding organizations and associations championing patient health mentioned in this episode:

-National Academy of Medicine (https://nam.edu/)

-GSK (https://www.gsk.com/en-gb/)

-Genentech (https://www.gene.com/)

-Novartis (https://www.novartis.com/)

-Flagship Pioneering (https://www.flagshippioneering.com/)

-Merck (https://www.merck.com/)

-Synapse Sciences (https://www.synapsesciences.com)

For more information on SamaCare’s free prior authorization management platform for specialty practices, visit https://www.samacare.com/?utm_source=podcast&utm_medium=r2c

SamaCare is joined by Vive Collective (https://www.vivecollective.com/) partner and digital health investor Cheryl Cheng for a candid discussion on the opportunities – and challenges — for digital health companies in today’s venture climate. Tune in for valuable advice for startup founders and technologists, and an inside-look for practices into what goes into building healthcare technology.

You’ll learn:

How Cheryl’s experience working with The Clorox Company and Proctor & Gamble shaped her human-driven approach to healthcare innovation

The surprising factors working for – and against – health tech startups

AI’s impact on the future of healthcare

Whether you're a medical provider working with health technology partners, or an entrepreneur thinking of building your own health technology company, this episode has great behind-the-curtains insights into the process of building technology to solve healthcare problems.

Together, we can make healthcare right. Here are some of the outstanding

organizations and associations championing patient health mentioned in

this episode:

Kiddo Health (https://kiddo.health/)

The Clorox Company (https://www.thecloroxcompany.com/)

Procter & Gamble (https://us.pg.com/)

Gennev (https://www.gennev.com/)

For more information on SamaCare free prior authorization management platform for specialty practices, visit https://www.samacare.com/?utm_source=podcast&utm_medium=r2c.