Value Health Voices

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...

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 im...

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...

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 n...

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...

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...

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 t...

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 reco...

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 po...

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 highligh...

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...