Value Health Voices

Dr. Roger Seheult makes the clinical case for sunlight therapy. Discover the evidence for using infrared light to reduce hospital stays by 30% and cut costs.

Episode Resources:

Learn from Dr. Seheult on his YouTube ChannelExplore MedCram's Health Optimization Courses (CME available)Watch the Guy Foundation's Autumn Series on Light & HealthRead the Glen Jeffery study in Nature Scientific ReportsExplore the Swedish study on sun exposure and all-cause mortality

Could a simple, free resource dramatically reduce hospital stays and save the healthcare system billions? In this episode, we explore the powerful clinical case for sunlight therapy w...

Duration: 01:00:45

Learn how physician advocacy in California is tackling the industry's biggest threats. Discover how the CMA fights Medi-Cal cuts, private equity, and physician burnout.

Episode Resources:

Learn about the California Medical Association (CMA)Explore the AMA's Resources on the Corporate Practice of MedicineAccess the CMA's Model Medical Staff BylawsAMA Venture capital and private equity investment snapshotAMA Legislative approaches to curb corporate influence in health careRead about SB 306 (Prior Authorization Reform)Follow Dr. Shannon Udovic-Constant on LinkedIn

In this pivotal episode of Value Health Voices, we explore how physician advocacy in California is at the...

Duration: 00:45:22

Is the rapid rise of artificial intelligence a threat to medicine or its greatest hope? In this episode, we tackle the massive hype and complex reality of AI in oncology with one of the leading voices in the field, Dr. Sanjay Juneja, also known as TheOncDoc. We break down what this technological revolution truly means for cancer patients, doctors, and the healthcare system at large. From uncovering hidden patterns in cancer data that defy human intuition to the practical challenges of implementation, we explore how AI is set to transform everything we thought we knew about medicine.

<...

Duration: 01:02:06

From a government shutdown halting FDA approvals to the looming expiration of ACA subsidies threatening to raise insurance premiums for millions, the American healthcare system is facing a perfect storm. These mounting US healthcare policy challenges are creating unprecedented uncertainty for patients, providers, and innovators alike. In this episode, we're joined by healthcare regulation and policy expert Matt Wetzel, a partner at Goodwin Procter LLP, to dissect the interconnected crises plaguing Washington, D.C. and what they mean for the future of your healthcare.

We connect the dots between the federal shutdown, expiring ACA enhanced premium tax...

Duration: 00:54:31

One of America's largest pharmacy benefit managers (PBMs) just announced they'll stop taking rebates from drug manufacturers. The Senate's response? "Not impressed."

Why? Because rebates are just one of five profit driving "tricks" PBMs use to quietly inflate your drug costs.

In this episode, Dr. Anthony Paravati breaks down the real money flow behind prescription drug pricing, how a system designed to reduce costs does the exact opposite

You'll learn:

The 7-player money map that explains where every healthcare dollar really goes

The 5 PBM "tricks" that turn generics into...

Duration: 00:20:23

The 340B drug pricing program was created to help safety-net hospitals and clinics stretch their resources to care for low-income and uninsured patients. But has it spiraled out of control? Originally a modest plan, the program has exploded into a $130 billion market, leading to a fierce debate over who truly benefits from the massive discounts. Is it the patients, as intended, or are for-profit corporations, PBMs, and large hospital systems capturing the profits? In this episode, we unpack the controversy and explore the future of 340B.

Joined by two of the nation's leading experts on the topic...

Duration: 01:03:33

How do we deliver high-quality cancer care in a system under pressure? Meagan O'Neill, Executive Director of the Association of Cancer Care Centers (ACCC), joins us to talk about workforce empowerment, technology as a multiplier, and building sustainable oncology systems for the future.

Meagan shares her journey from oncology business consulting to national advocacy, shaped by her own personal experience with cancer care. With two-thirds of U.S. cancer programs in its network, ACCC plays a pivotal role in driving change across the oncology landscape.

In this episode, we discuss:

Why personal experience...

Duration: 00:51:50

Dr. Bobby Mukkamala, President of the American Medical Association and practicing ENT surgeon in Flint, Michigan, joins Value Health Voices to discuss the critical challenges facing American healthcare from both the physician and patient perspective.

As a solo practice physician treating cancer patients while leading the nation's largest physician organization, Dr. Mukkamala provides unique insights into the policy battles affecting healthcare delivery. The conversation covers prior authorization barriers that delay cancer care, the Medicare payment crisis with 25 years of declining physician reimbursement, and the collapse of independent medical practices due to site neutrality issues.

Dr...

Duration: 00:57:23

The presidents of ASTRO and ACRO provide focused analysis of CMS's 2026 proposed rules and their specific implications for radiation oncology practice. This executive briefing examines key policy changes without background context, concentrating on immediate implementation concerns and the September 12 comment period.

Key Topics Covered:

Critical APC "crosswalk" methodology issues affecting new treatment delivery codes CMS's new "efficiency adjustment" reducing procedural service payments by 2.5% Transition from survey-based valuations to hospital cost data methodology Image guidance and port film bundling into treatment delivery codes Surface radiation therapy coding updates and valuation changes RUC committee dynamics and specialty representation...

Duration: 00:36:52

The presidents of ASTRO and ACRO join the VHV guys to provide expert analysis of CMS's newly released 2026 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS) proposed rules. Dr. Sameer Keole (ASTRO President) and Dr. Brian Lally (ACRO President) join us one week after the July 2025 release to examine the implications for radiation oncology and procedural specialties.

Key Topics Covered:

CMS's new "efficiency adjustment"—a 2.5% reduction to work RVUs for procedural services New treatment delivery codes and potential APC "crosswalk" issues in radiation oncology Budget neutrality's role in specialty medicine reimbursement competition Th...

Duration: 00:58:31

Alice Ayres, President and CEO of the Association for Healthcare Philanthropy, reveals the critical funding lifeline that most people don't know exists. As Congress slashes healthcare budgets and millions face losing Medicaid coverage, Alice exposes how healthcare philanthropy returns $4.16 for every dollar invested and why it's becoming the difference between hospitals thriving and closing their doors.

This powerhouse leader, former Advisory Board Company executive who worked with 4,500+ healthcare organizations and 200,000+ leaders, breaks down the urgent shift happening in healthcare funding. With 10,000 baby boomers daily moving from private insurance to Medicare, operating margins are shrinking fast.

...

Duration: 00:41:53

Dr. Eric Bricker returns for Part 2 of our analysis of the "One Big Beautiful Bill" and the timing couldn't be more critical. Just as the Senate moves toward a final vote, the nonpartisan Congressional Budget Office reported Sunday (6/29/25) that the Senate version would add at least $3.3 trillion to the national debt over the next decade.

This internal medicine physician and founder of AHealthcareZ (400+ healthcare finance videos, 100,000+ subscribers) delivers his signature straight-talk analysis on what will be the most earth-shattering healthcare legislation in decades. Dr. Bricker exposes how this bill would strip Medicaid coverage from 11-16 million Americans...

Duration: 00:46:43

Dr. Eric Bricker, the powerhouse behind AHealthcareZ's 400+ healthcare finance videos with 100,000+ subscribers, joins Value Health Voices to decode the labyrinthine money flows that determine which hospitals succeed with Medicaid—and which avoid it entirely. This internal medicine physician and former co-founder of Compass Professional Health Services (which grew to 1.8M members across 2,000+ clients including T-Mobile and Southwest Airlines before being acquired) reveals the complex "scavenger hunt" that separates thriving hospital systems from struggling ones.

Discover why Medicaid isn't actually one program but 50+ different state systems with wildly different funding mechanisms. Dr. Bricker exposes how provider taxes, DSH pa...

Duration: 00:46:00

RECORDED BEFORE THE HOUSE RECONCILIATION BILL PASSED - Tricia Neuman of KFF's predictions proved accurate THE REALITY: 55% of Medicare beneficiaries are now in private Medicare Advantage plans, yet Medicare pays $83 BILLION more annually for these enrollees than similar patients in traditional Medicare. That's more than what Medicare spends on ALL physician payments combined. In this prescient conversation with KFF's Tricia Neuman, we explore the hard truths about Medicare's trajectory. Takeaways: ✅ Hundreds of billions in Medicaid cuts moving through reconciliation - PASSED by House May 22nd ✅ Traditional Medicare becoming the "forgotten stepsister" ✅ Medicare's path toward privatization accelerating ✅ Critical support programs being sl...

Duration: 00:48:00

Michael Chernew is a distinguished Harvard economist, Chair of MedPAC, and leading healthcare policy expert with decades of experience in healthcare economics. In this episode, Michael provides a masterclass on why healthcare economics differs fundamentally from other markets, unpacking information asymmetry, moral hazard, and adverse selection in accessible terms. He reveals the surprising truth that Medicare Advantage plans cost the government approximately 20% more than traditional Medicare despite delivering care more efficiently, explains how these plans use this payment gap to finance enhanced benefits, and discusses the future challenges of healthcare payment reform. Michael shares breaking news about MedPAC's upcoming...

Duration: 00:59:54

Even seasoned healthcare leaders—those with decades of clinical, financial, or operational experience—often miss the two most powerful levers behind how care gets paid for: the CPT process and the RUC committee. These aren't just billing codes and obscure meetings. They're the gatekeepers of what and how much is paid for care in the U.S. healthcare system.

To truly understand healthcare in the U.S., an understanding of CPT and RUC is fundamental.

EPISODE SUMMARY: A Rare Insider's View on the Hidden Machinery of U.S. Healthcare Payment

In this special episode of Valu...

Duration: 00:35:11

In this episode of Value Health Voices, Dr. Vipan Nikore discusses his journey as an entrepreneur in the healthcare sector, focusing on the innovative concept of Home Care Hub. He shares insights on the challenges and opportunities in home-based care, the importance of metrics in measuring outcomes, and the regulatory hurdles faced in the industry. Dr. Nikore emphasizes the need for policy changes to support alternative care models and advocates for a future where smaller care homes provide dignified and personalized care for the aging population. He also offers advice for aspiring healthcare entrepreneurs, highlighting the importance of mentorship...

Duration: 00:42:29

As the cost of healthcare continues to rise, more employers are turning to direct employer contracting and self-insured models to take control of their healthcare costs. But how do these models compare to fully insured arrangements? And what are the key considerations for health systems, PBMs, and employers looking to engage in value-based care?

In this episode of Value Health Voices, Dr. Anthony Paravati and Dr. Amar Rewari sit down with Ned Laubacher, CEO of Health Spectrum Advisors and an expert in direct-to-employer contracting, to break down: ✅ The shift toward self-insured models and employer-driven health benefits ✅ The role...

Duration: 00:52:07

In this episode of Value Health Voices, hosts Anthony Paravati and Amar Rewari welcome Matt Wetzel, a trustee at the American Health Law Institute, to discuss the complex regulatory environment surrounding healthcare. The conversation covers insights from the JPMorgan Healthcare Conference, changes in NIH grant funding, Medicaid spending, and the future of FDA regulations. Wetzel emphasizes the importance of understanding the nuances of healthcare policy and encourages listeners to look beyond sensational headlines to grasp the underlying issues affecting the industry.

Takeaways

Matt Wetzel is a lawyer specializing in medical technology and life sciences. The...

Duration: 00:45:00

In episode 8 Dr. Anthony Paravati and Dr. Amar Rewari explore the concept of "site neutrality" in U.S. healthcare finance, discussing the disparities in reimbursement rates for the same medical services based on the location of care. They delve into the legislative efforts aimed at achieving site neutrality, the implications for healthcare providers and patients, and the unique healthcare model in Maryland. The conversation highlights the complexities of payment systems in American healthcare and the ongoing challenges in maintaining critical infrastructure. Chapters 00:00 Introduction to Site Neutrality in Healthcare 02:10 Understanding Payment Differentials 04:54 Legislative Efforts Towards Site Neutrality 07:00 Impact of Site Neutral...

Duration: 00:21:52

In this episode, Dr. Anthony Paravati and Dr. Amar Rewari discuss the aggressive expansion of private equity (PE) in the U.S. healthcare system, highlighting its detrimental effects on quality care and patient safety. They explore how PE firms prioritize profits over patient care, leading to significant financial burdens on healthcare facilities. Through various case studies, they illustrate the negative consequences of PE ownership, including hospital closures and reduced services. The conversation also addresses the regulatory gaps that allow PE firms to operate with minimal oversight, ultimately calling for action to protect healthcare quality.

Duration: 00:30:22

We are back after the holiday break with Episode 6 which covers the rapidly evolving landscape of AI in healthcare. Is AI just another weapon for payers and providers to bludgeon each other or will it becpme a force for immeasurable public good? In this episode, Dr Anthony Paravati and Dr Amar Rewari discuss the transformative impact of AI in healthcare, exploring its potential to improve patient care, streamline insurance claims, and the ways it is used in clash between providers and insurers over the almighty dollar. They highlight success stories in cancer detection and stroke care, while also addressing...

Duration: 00:32:29

Every November, Medicare proposes physician pay cuts and every December, Congress tries to walk them back. But why? Dr Anthony Paravati and Dr Amar Rewari break down the hidden budget rules forcing specialties to fight over a fixed pie, why the much-celebrated MACRA law of 2015 did nothing to fix it, and how successful health systems are adapting their strategy. This episode is short and sweet but there's something for everyone. From basic, but often flubbed, must-know facts about the Medicare program to critical insights into payer contracting and service line decisions. Knowledge is power - especially when billions are...

Duration: 00:26:49

In this episode, Drs. Amar Rewari and Anthony Paravati discuss the nomination of RFK Jr. as the head of the Department of Health and Human Services. They explore his controversial views on vaccines, public health implications, agricultural policies, and the pharmaceutical industry. The conversation delves into the complexities of chronic disease management, the debate over fluoride in water, and the potential impacts of RFK Jr.'s policies on public trust in science and health.

Chapters

00:00 Introduction 03:24 Early Career and Background on RFK Jr. 04:23 Vaccine Controversies and Scientific Denialism 14:36 Agricultural Policies, Raw milk and Health Implications 17:18...

Duration: 00:39:26

In this week's episode of the VHV podcast we'll take a comprehensive look at utilization management (UM) and prior authorization (PA). Utilization management is the healthcare industry term for the various techniques health insurance companies employ to pay for care on their terms, according to their guidelines. Many times, their utilization management approach is in line with what physicians recommend. However, many times it is not. And when it's not, patients suffer delays in their care and physicians and their staff end up mired in extra work to make sure their patients get the care they have determined is...

Duration: 00:45:22

In this timely episode, Dr. Anthony Paravati and Dr. Amar Rewari break down the healthcare implications of a Trump or Harris presidency. From prescription drug pricing and Medicare reforms to Medicaid block grants and the Affordable Care Act, this episode provides a nonpartisan, in-depth analysis of each candidate's position on healthcare. Discover what the future could hold for U.S. healthcare policies, costs, and patient access depending on the election's outcome. This is a can't miss episode before heading to the polls.

Duration: 00:30:37

Drs. Anthony Paravati and Amar Rewari delve into the complexities of Medicare Advantage, exploring its appeal to seniors, the financial mechanisms behind its low premiums, and the challenges faced by providers. They discuss the demographics of Medicare Advantage enrollees, the revenue structures that sustain these plans, and the implications for healthcare providers. The conversation also highlights the pros and cons of Medicare Advantage for beneficiaries and speculates on the future sustainability of the program amidst tightening margins and regulatory pressures.takeaways

Medicare Advantage offers lower premiums, appealing to budget-conscious seniors. The program is administered by commercial insurance companies...

Duration: 00:32:24

In this VHH fundamentals episode, we provide a primer on the basics of Traditional Medicare (Parts A, B, and D) and Medicare Advantage (Part C) for physicians and healthcare leaders. We explore key differences in out-of-pocket costs, premiums, and coverage between the two, preparing you for a deeper dive into health policy and healthcare finance on our full podcast episode. Whether you're leading a practice or guiding patient care, understanding the fundamentals of Medicare is essential for navigating today's healthcare landscape. Don't miss this overview to better support your patients and organization! #MedicarePrimer #HealthcareLeaders #MedicareAdvantage #HealthPolicy #HealthcareFinance

Duration: 00:14:07