Value-Based Care Insights

In this special episode of Value-Based Care Insights, host Daniel Marino brings you exclusive interviews recorded live at HIMSS25, where healthcare innovation took center stage. The first interview features Stephen Overman, CEO & Founder of Standpoint Solutions, who shares their groundbreaking technology aimed at improving communication within perioperative services. Next, Dr. Alan Young, Client Executive at Point B Solutions, dives into the transformative role of artificial intelligence in patient care. The future of AI-driven healthcare is explored, including the rise of intelligent agents and their potential to influence clinical decision-making. Tune in for an insightful discussion on the future of healthcare, technology, and how innovation is reshaping patient care.

National healthcare organizations like the Healthcare Financial Management Association (HFMA), American Hospital Association (AHA), and Medical Group Management Association (MGMA) offer valuable industry-wide insights and legislative guidance. However, state associations provide a more tailored, in-depth understanding of the specific challenges healthcare providers face in their local markets. In this episode of Value-Based Care Insights, host Daniel Marino sits down with fellow Illinois MGMA board members, Meghan Heiy and Jenny Kovich, and explores the growing importance of state healthcare associations in effectively navigating today’s rapidly evolving healthcare landscape.

The healthcare industry is grappling with a growing shortage of providers in every specialty, with primary care being hit the hardest. In this episode, host Daniel Marino is joined by primary care physician, Dr. Leila Obeid, to discuss how physician shortages and rising patient demands are forcing many primary care physicians to seek better work-life balance through alternative practice models. One solution? Concierge medicine. Tune in as we discuss how this model helps physicians regain control, improve patient care, and create a sustainable future in healthcare.

In 2025, the continued growth of Medicare Advantage underscores the increasing importance of specialists in value-based care, as healthcare models shift toward more integrated, patient-centered approaches. In this episode of Value-Based Care Insights, host Dan Marino sits down with Lynn Carroll, COO and Head of Strategy at HSblox, to explore how specialists can successfully engage in value-based care models. Tune in to explore current value-based programs that incorporate specialty providers, key challenges encountered, and the critical infrastructure required for success in this evolving healthcare landscape.

The Physician Fee Schedule (PFS) Final Rule for Calendar Year (CY) 2025 introduces several key updates to Medicare payment policies, aiming to enhance care delivery and reduce administrative burdens. In this episode, Daniel Marino is joined by Managing Partner, Lucy Zielinski, as well as Sarah Hartley, to explore the implications of the PFS Final on physicians and other billing professionals. Together, they discuss the key changes and opportunities for physician services furnished in a variety of settings including physician offices, hospitals, ambulatory surgery centers (ASCs), and others. Tune in to stay informed and gain valuable perspectives on navigating these critical regulatory updates.

Healthcare providers will continue to move toward value-based care, fostering a more equitable healthcare system that enhances accessibility, quality, affordability, and innovation. In this episode of Value-Based Care Insights, I sit down with Lumina’s Managing Partner, Lucy Zielinski, to explore the healthcare trends of 2025, the effects of new regulatory changes, and the pressures these developments place on providers. Tune in to learn about the top five trends that health systems should include in their strategic planning. 

Based on your feedback, our listeners, we've selected the top three episodes for 2024. We dive into the key challenges and opportunities defining healthcare trends this past year through three captivating Value-Based Care Insights episodes. In Episode 102, Sarah Hartley discusses the unique demands of managing Medicare Advantage contracts, offering creative strategies to align providers and patients. Episode 98 features Dr. Riya Pulicharam and Kevin Zhao exploring how integrating clinical data and fostering cultural change within care management transforms patient outcomes. In Episode 106, Tim Hanners and Dr. Dave Lebec tackle the anesthesia provider shortage and delve into tactics to boost financial performance, optimize staffing models, and improve payer reimbursement.

Accountable Care Organizations (ACOs) have made great strides in enhancing patient care and reducing costs, saving $3.1 billion in 2023. The recently released report based on ACO performance in 2023 (PY2023) provides valuable insights into where ACOs are excelling. In this episode of Value-Based Care Insights, Dan Marino sits down with Sarah Kachur PharmD, MBA, BCACP, Executive Director of Strategy and Solutions at Johns Hopkins Population Health Analytics, to discuss the key findings of the report and what they reveal about the future of ACOs. Gain insights into the priorities of the most successful ACOs (in PY 2023) and their predictions for changes and challenges in 2025 and beyond.

LinkedIn https://www.linkedin.com/in/sarahgracekachur/

[email protected]

Hopkins ACGs: https://www.hopkinsacg.org/

Illustra Health from Johns Hopkins: https://illustra.health/

Care management is critical, especially for individuals with chronic conditions like dementia, because it ensures coordinated, comprehensive, and individualized care. Currently, more than 6.7 million Americans are living with dementia and Alzheimer’s disease, and this number is projected to continue rising. While the impact of the disease on individuals is widely recognized, the personal and financial burden it places on caregivers is less often highlighted. Today, on Values-Based Care Insights, Dan Marino sits down with JVS Health’s CEO Vanessa Guzman and Co-founder Seth Hyman to discuss the GUIDE Model, a Centers for Medicare & Medicaid Services (CMS) supplement for caregivers of patients with dementia and Alzheimer’s disease. Gain insights into the valuable services within the GUIDE model that can support and benefit individuals living with dementia and their unpaid caregivers.

This year, 2024, presented significant challenges for clinically integrated networks (CINs) delivering value-based care, with the disruption from Medicare Advantage reaching widespread levels. As we look toward 2025, it is crucial for CINs to reflect and gear up for success in the coming year by focusing on risk-based contracting, engaging specialists, and investing in care management. In this episode of Value-Based Care Insights, Dan Marino sits down with Dr. Will Faber, to tackle several challenges, including the lack of structure among commercial payers to effectively handle value-based contracts and obstacles in negotiating such contracts with specialty providers. Gain insights into strategies and data utilization that will position your provider organization for success in 2025.