Health Tech Nerds Radio

Kevin sits down with Jacob Shiff, the Chief AI & Technology Officer at CMMI, to unpack the new ACCESS model and what it means for healthcare innovators looking to reshape care delivery for Medicare populations. For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

On January 29th, CMS announced that Medicaid Technology Companies had pledged $600 million in savings to support the implementation of community engagement requirements from H.R. 1 and other improvements to the Medicaid tech stack. To discuss the current state of the Medicaid tech stack, how preparations for the January 1st 2027 implementation of community engagement requirements and twice yearly...

Martin and Kevin unpack CMMI’s new Access program, focusing on reimbursement rates that landed well below digital health expectations and what that signals about CMS pushing AI-enabled, lower-labor care models. They discuss Humana’s earnings and its $1B Max acquisition, debates over Medicare Advantage costs versus traditional Medicare, healthcare job growth amid AI narratives, and an earnings roun...

In this episode, meet Kelsie Brandt, Chief Clinical Officer at Nest, as she discusses the launch of Nest Origin, a new comprehensive prenatal, postpartum, and infant care program for Medicaid families. Kelsie explains her background in pediatric nursing and the critical role caregivers play in child and infant health. The conversation delves into the challenges Medicaid mothers face, the structure...

In this special report episode recorded on February 11th, the Health Tech Nerds team dives into the key takeaways from Humana's recent earnings call. The discussion covers Humana's 25% growth in their individual Medicare Advantage book. Despite their stock trading down, the team finds reasons for optimism, particularly around retention rates and profitable plan sales. They also explore larger indu...

In this insightful episode, we sit down with Anurati Mathur, co-founder and CEO of a Sempre Health, which is focused on improving medication affordability. The main focus of the discussion is on the complex landscape of medication affordability and how his company addresses it by creating a two-sided marketplace between pharmaceutical manufacturers and health plans. The CEO explains the company's...

In this episode, we delve into major developments in the healthcare industry, including the recent bankruptcy of Carbon Health and its ambitious goals, the evolving landscape of AI in primary care, and funding trends. We also discuss primary care access challenges, recent earnings reports from major companies like Molina, Centene, and DaVita, and the outlook for PACE models and vertically integrat...

In this episode, Kevin and Martin discuss significant developments in the healthcare sector, focusing on recent changes to Medicare Advantage announced by CMS, which resulted in a $100 billion overnight loss in market cap for publicly traded insurers. They delve into the nuances of effective growth rates, risk adjustment changes, and their potential long-term impact on the industry. They also cove...

Dr. Rebekah Gee and Rebecca Kavoussi, founders of Nest, discuss their innovative approach to healthcare for Medicaid populations, emphasizing an in-home, family-centered model. They share their experiences and strategies for addressing social determinants of health, improving accessibility, and harnessing the power of data to enhance healthcare outcomes. The discussion covers Nest's business model...

In this episode, the hosts are joined by Tim and Dr. Malick, the CEO and CMO of Hopscotch Primary Care, a company dedicated to transforming rural primary care through innovative models and technology. They discuss the unique challenges faced by rural healthcare providers, such as access issues, worse payer mixes, and workforce shortages. The conversation highlights Hopscotch's high-touch, high-tec...

In this episode, Kevin and Adam discuss a new pilot program in Utah that uses AI to process prescription refills for a specific set of medications without human intervention. They delve into the details provided by a recent Politico article, explain the problem of medication noncompliance, and discuss how AI can improve accessibility to medication renewals, particularly in rural areas. The convers...