Value Health Voices

Transitioning from directing Medicare for 170 million Americans to managing a $20 billion state healthcare budget requires a unique blend of clinical, economic, and policy expertise. In this episode, Dr. Meena Seshamani, Secretary of the Maryland Department of Health and former Director of CMS, joins the show to break down the complex forces shaping state and federal healthcare finance. Listeners...

Can AI replace physicians? Dr. Nadine Housri explains why Mednet merges AI in medicine with human expertise to solve the most complex patient cases. Episode Resources: Official Platform for Mednet Peter Densen Study on the Acceleration of Medical Knowledge JAMA Oncology Study on AI Accuracy vs. NCCN Guidelines Analysis of Evidence Levels within NCCN Guidelines Generative AI is rapidly entering hea...

Discover how health system consolidation impacts specialist stipends and care costs. Dr. Eric Bricker reveals how physicians can reclaim their market power. Episode Resources: AHealthcareZ DOJ Antitrust Lawsuits Against NY-Presbyterian and OhioHealth KFF Issue Brief on Provider Consolidation Overview of the No Surprises Act Dispute Resolution Process When it comes to negotiating healthcare payment...

Discover how government policies distort U.S. healthcare. Brian Blase exposes Medicaid gimmicks, ACA exchange flaws, and healthcare policy reforms. Episode Resources: The Great Obamacare Enrollment Fraud Report Report on Medicaid Financing Reform and Provider Gimmicks U.S. healthcare spending accounts for nearly a fifth of our GDP, yet systemic failures and physician burnout continue to reach hist...

Claimable founder Warris Bokhari exposes the truth behind medical insurance denials. Learn how to successfully appeal claims and win life-saving patient care. Episode Resources: Official Website for Claimable Marshall Allen’s Official Website and "Never Pay the First Bill" NBC News: How AI Helps Patients Fight Insurance Denials STAT News: Investigation into UnitedHealth’s "nH Predict" Algorithm Wh...

Dr. Sachin Jain reveals why healthcare faces a leadership crisis, not a payment crisis. Learn how SCAN Health Plan is transforming Medicare Advantage. Episode Resources: Healthcare in Action Official Website Dr. Sachin Jain on The Ethical Erosion of American Healthcare Details on SCAN Health Plan’s $250 Million Legal Victory SCAN Affirm Member Guide for LGBTQ+ Seniors American healthcare doesn’t h...

What is the MultiPlan lawsuit? Attorney Matt Lavin exposes how commercial insurers allegedly use price fixing to underpay out-of-network healthcare claims. Episode Resources Free Case Evaluation Form for Interested Providers and Physicians to Connect with an Attorney Gilbert LLP MultiPlan CMS: No Surprises Act Department of Labor: ERISA UnitedHealthcare A single intermediary company touches an est...

Quest Diagnostics CMO Dr. Yuri Fesko joins Value Health Voices to decode the Clinical Laboratory Fee Schedule, the impact of PAMA and SALSA, and the future of precision medicine. Episode Resources: Learn more about Quest Diagnostics Explore Quest's Consumer-Initiated Testing How does a flawed government policy threaten the very foundation of modern medicine? Nearly every clinical decision, from a...

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 Channel Explore MedCram's Health Optimization Courses (CME available) Watch the Guy Foundation's Autumn Series on Light & Health Read the Glen Jeffery study in  Nature Scientific Re...

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 Medicine Access the CMA's Model Medical Staff Bylaws AMA Venture capital and private equity investment...

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 uncoverin...

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 poli...

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 design...

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 c...

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 exp...

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 insigh...

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 tr...

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 procedu...

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...

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 AHealthcar...

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+ cli...

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 con...

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...

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...

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...