Health Care Rounds

Healthcare affordability is the top concern for Americans, and value-based care has been the promised answer for decades. But scaling it across an entire country is a different problem than proving it works. Dr. Patrick Conway, CEO of Optum, joins host John Marchica, CEO of Darwin Research Group, to discuss what he learned architecting value-based models at CMS and how he is now applying those les...

There's a wide gap between how medical breakthroughs get announced and what they actually do for patients. Few people have spent as much time inside that gap as Mary Roach, the author of eight New York Times bestsellers, including REPLACEABLE YOU: Adventures in Human Anatomy and STIFF: The Curious Lives of Human Cadavers. Mary has spent years reporting on medical innovation and tracing the of...

More than 70 million Americans are covered by Medicaid, and the people with the most complex needs, those juggling mental illness, housing insecurity, and chronic disease simultaneously, are the ones the traditional health care system is least equipped to reach. Dr. Toyin Ajayi, Co-Founder and CEO, and Mike Roaldi, President of Cityblock Health, join host John Marchica to break down how a trust-fi...

American health care is too expensive, too inconsistent, and too difficult to navigate. And the payer-provider AI arms race that has emerged over the last several years is making all three problems worse, not better. Dr. Marc Harrison, Chair of the TowerBrook Health Care Institute, former CEO of Intermountain Health, and co-founder of HATCo, joins host John Marchica to examine why the health care...

On this week's mailbag, John tackles three reader questions: How are health systems using AI to address the nursing shortage, and do these solutions solve the underlying problem? Are bundled payments becoming the norm for value-based payment models, and what does CMS's shift toward mandatory models like TEAM and CJR-X mean for providers and suppliers? And will the U.S. ever become a Cana...

Between 80% and 90% of health outcomes are shaped by what happens between doctor visits. Yet the entire U.S. health care system, from payment models to primary care, is built around the visit itself.  Wei-Li Shao, President of Omada Health, joins host John Marchica to break down why persistent, in-between-visit care is the missing layer in chronic disease management, and how pairing GLP-1 therapy...

Health misinformation is no longer a fringe problem on the margins of public health. It has a measurable body count, and the systems that once reliably corrected it, local journalism, trusted institutions, and federal health agencies, are eroding fast. Dr. Joshua Sharfstein, Vice Dean for Public Health Practice and Community Engagement and Distinguished Professor of the Practice at the Johns Hopki...

A few weeks ago we conducted a survey of Our Take readers that included both listeners to our podcast and those who don’t (the latter group, we assume, was interested enough to complete a survey). We asked for questions you would like John to answer, and we got some great ones, including today’s question about vaccines and the long-debunked link between the MMR vaccine and autism spectrum disorder...

Health care is 18% of U.S. GDP, the number one affordability concern for consumers, and the single biggest line item employers are trying to manage. Every major policy fight in American health care, at its core, comes down to money and who bears the cost. Larry Levitt, incoming CEO of KFF and one of the most trusted nonpartisan voices in health policy, joins host John Marchica to examine why value...

Decades of quality measurement programs were designed to make U.S. health care better. The evidence suggests they have, just not nearly as much as anyone hoped, and sometimes in ways that hurt the patients who needed help most.  Dr. Rachel Werner, Professor of Medicine, Perelman School of Medicine at the University of Pennsylvania, joins host John Marchica to examine why well-designed quality ince...

After a year of interviews about value-based care, the same things keep coming up. Fee-for-service is still the problem. Payers want to pay less, providers want to bill more. And twenty years in, the people who helped build value-based care are grading it a C-minus. In his first solo episode, host John Marchica goes back through the transcripts and pulls out what guests agree on: the problems valu...

Decades after the research that proved high-spending regions don't produce better care, and 20 years after the term "accountable care organization" was coined, the U.S. health care system still runs overwhelmingly on fee-for-service. The incentives haven't changed, and the results show it. Dr. Elliott Fisher, Professor of Health Policy at the Dartmouth Institute and the Geisel School of Medicine a...

Rural hospitals in the U.S. have been closing at a steady pace for over 50 years, and the country now has one of the lowest rates of acute hospital beds per capita among OECD nations. A five-year, $50 billion federal program aims to slow the bleeding, but it may only be a stopgap.  Dr. Tim Ferris, Vice President of the Health Care Practice at InterSystems and former National Director of Transforma...

U.S. health care spending keeps rising, quality scores keep climbing, and yet the care most Americans receive has barely improved. The measurement systems designed to drive better outcomes may be making things worse. Dr. Michael Chernew, Professor of Health Care Policy at Harvard Medical School and former Chair of MedPAC, joins host John Marchica to examine why decades of quality measurement have...

Value-based care has been the defining promise of health care reform for two decades. Yet new evidence still takes an average of 17 years to reach standard clinical practice, payers and providers remain structurally misaligned, and most VBC models still prioritize payment mechanics over actual patient outcomes.  Don Calcagno, Founder of ValuesEdge and former Chief Population Health Officer at Advo...

Primary care physicians are burning out, and patients are paying the price. With the average primary care visit lasting just 15 minutes, the volume-based treadmill is pushing doctors out of the profession and leaving patients without meaningful, preventive care.  Larry Kutscher, CEO of MDVIP, joins host John Marchica to make the case for a fundamentally different model. They dig into why membershi...

Health care spends trillions treating disease, but far less preventing it. The gap between what we know works and what actually gets implemented may be the most expensive problem in medicine.  Dr. Barry Davis, physician, professor, and author of Preventioneers, joins host John Marchica to explore why prevention so rarely makes it from research to reality, and what it would take for health system l...

Value-based care has been the goal for decades. So why does it still feel like we're moving in slow motion? The answer may come down to data, incentives, and the willingness to cross what one industry veteran calls "the rickety bridge over a chasm of death."  David Snow, Chairman and CEO, Cedar Gate Technologies, an IQVIA Business joins host John Marchica to discuss why technology has finally caug...

Pediatric care is one of the most fragmented and underfunded corners of the American health system. Parents are left as de facto care coordinators, specialists work in silos, and children with complex needs fall through the cracks. What would it look like to actually fix that? Danish Qureshi, Founder and CEO, Zarminali Pediatrics joins host John Marchica to discuss the personal experience that spa...

On Chicago's West Side, a 100-year-old safety net hospital serves a community where the average life expectancy is 20 years shorter than it is just seven minutes away. Loretto Hospital collects 32 cents on the dollar, runs on 84% Medicaid, and still finds ways to innovate, collaborate, and show up for people that the rest of the system has left behind.  Tesa Anewishki, CEO, Loretto Hospital joins...

The VA is one of the largest integrated health systems in the country, but it operates unlike anything in the private sector. What can pharmacy leaders and health system executives learn from an organization that has embedded pharmacists into clinical care for decades, given them prescriptive privileges, and built virtual urgent care teams from the ground up?  Dr. Eric Scott, Former Chief of Pharm...

Physician leadership can make or break a health system. What does it really take to earn doctors’ trust and move an organization forward?  Dr. Jonathan Stallkamp, Chief Medical Officer of Main Line Health, joins host John Marchica to discuss building physician engagement, developing future clinical leaders, and strengthening culture inside a complex health system.   ===============================...

Regional health leaders are being asked to do the impossible right now: deliver on systemwide strategy while staying deeply responsive to the realities on the ground. In rural markets especially, the pressures around access, staffing, and infrastructure are forcing health systems to rethink what “care delivery” looks like in practice.  Natalie Baggio, President, Corewell Health South joins Health...

Independent community health systems are under increasing pressure as health care continues to consolidate. What does it really take to remain independent while continuing to deliver high-quality care at scale?  Dr. Allen Smith, President & CEO, and Dr. Sam Ash, CIO of South Shore Health join Health Care Rounds host John Marchica, to discuss maintaining independence as a community health system, b...

We’re ringing in 2026 with Mark Cuban!   Prescription pricing remains one of the most opaque and frustrating parts of the health care system, leaving employers, providers, and patients struggling to understand where costs come from and who truly benefits.   Mark Cuban joins Health Care Rounds to talk about why prescription pricing became so complex, how a lack of transparency drives higher costs,...