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Value Based Care Advisory (VBCA) Podcast

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Value Based Care Advisory (VBCA) Podcast

Carenodes

Your Billing Problem Started in the Contract

June 28, 2026 10:12pm 6 min

Most revenue cycle teams are chasing the wrong fire. Persistent underpayment, denials that don't respond to appeals, patterns nobody can explain — these are often contract problems wearing a billing problem's disguise.In...

How to Decide to Contract with a Payer: Should You be Joining "the Network"?

May 31, 2026 4:17pm 11 min

You've built the operation — clinicians credentialed, tech stack running, compliance buttoned up. Then a regional Medicaid managed care plan wants to talk about contracting. Your first instinct: great, let's do it. Then ...

LEAD Model: The ACO Test Most Organizations Will Fail — Before They Apply

April 30, 2026 5:25pm 10 min

CMS has posted the LEAD (Long-Term Enhanced ACO Design) model application materials. Preliminary scoring is due April 27, 2026. Full applications are due May 17, 2026. LEAD replaces ACO REACH in 2027 and runs as a 10-yea...

The Definitive Playbook for Choosing Behavioral Health Markets

April 01, 2026 1:30am 9 min

Rate sheets don't tell the whole story.In this episode, Alex Yarijanian breaks down the 8-indicator playbook he uses to evaluate any tele-behavioral health market before committing capital — and names the specific states...

Medicare Negotiates Like an Owner. Commercial Doesn’t.

February 27, 2026 6:45pm 13 min

In this episode of the VBCA Podcast, Alex Yarijanian sits down with Dr. Kumar Dharmarajan — co-founder and Chief Medical Officer of World Class Health and former Chief Scientific and Medical Officer at Clover Health — to...

Billions for Rural Health: What CMS Is Funding in 2026

January 31, 2026 3:43pm 9 min

CMS is moving tens of billions of dollars into every state to stabilize rural healthcare heading into 2026—not through across-the-board rate increases, but through targeted investments in workforce, technology, care coor...

Medicare Advantage 2026: How Payers Are Choosing Partners

December 30, 2025 12:00pm 8 min

While most providers are waiting on CMS, payers are already narrowing networks and rewriting delegation terms.Payers are quietly narrowing networks and rewriting delegation expectations. This playbook explains how to do ...

Digital Health at a Crossroads: The Fallout from a $100M Adderall Fraud Scheme

November 26, 2025 5:30am 8 min

A federal jury has convicted the founders of Done, one of the fastest-growing telehealth companies in the stimulant-prescribing space, for orchestrating one of the largest Adderall distribution and fraud schemes in U.S. ...

2026 Medicare Fee Schedule: 5 Big Opportunities for Providers & Startups

October 03, 2025 4:30am 8 min

Medicare’s 2026 physician fee schedule is packed with change — but change means opportunity. In this episode of the VBCA Podcast, Alex Yarijanian breaks down the five biggest updates every provider and startup should kno...

How to Win in Medicare Advantage: 2026 Payment, Telehealth & Stars Update

August 31, 2025 6:17pm 16 min

Welcome back to the Value-Based Care Advisory podcast! In this episode, host Alex Yarijanian delves into the significant updates and strategies for 2026 in the Medicare Advantage space. He covers essential news and polic...

Behind the Scenes of Power: Emotional Labor in Negotiation

July 31, 2025 5:00am 5 min

In this episode of the VBCA podcast, host Alex Yarijanian delves into the often overlooked yet crucial aspect of leadership: emotional labor. Discover how managing emotions plays a pivotal role in negotiations and leader...

Meditate Like a CEO: Real ROI from Mindful Leadership

June 12, 2025 8:00am 18 min

This podcast episode delves into the intricate relationship between mindfulness meditation and its profound implications for healthcare leadership. We explore how mindfulness practices not only enhance emotional well-bei...

Managed Care Contracting for Health Tech Startups

April 09, 2025 6:00am 13 min

How Health Tech Startups Can Win at Managed Care Contracting: Insider Strategies for Scalable Payer Partnerships.This episode dives deep into the essentials of navigating managed care contracts as a health tech startup. ...

Doulas and Value-Based Maternity Care: Driving Cost Reduction and Improved Outcomes

March 17, 2025 4:00am 8 min

This conversation explores the historical context of childbirth, the current state of maternal mortality in the U.S., and the emerging role of doulas in modern maternity care. It highlights the paradox of high maternal m...

Profits Over Patients: Exposing the Big Healthcare Con

January 28, 2025 1:36pm 27 min

The podcast delves into the complexities and challenges of the American healthcare system, arguing that it often prioritizes profit over patient care. Through the lens of investigative journalism from More Perfect Union,...

2025 Opportunities in Healthcare: Navigating the Perfect Storm

January 02, 2025 6:45pm 13 min

What Every Provider and Innovator Must Know Going into 2025:The health insurance industry is facing a perfect storm characterized by rising healthcare costs, increased patient demand, and intense scrutiny from lawmakers....

EXPOSED: The MultiPlan Healthcare Cartel Costing Providers and Patients Billions

December 03, 2024 11:35am 10 min

Welcome to this eye-opening episode of the VBCA Podcast, where we tackle one of the most pressing yet underreported issues in healthcare: hidden fees, surprise bills, and the alleged cartel controlling out-of-network rei...

Startup Pitfalls and Healthcare Horror Stories: Introduction to Value-Based Care

November 12, 2024 9:48pm 21 min

This episode explores the rising tide of healthcare startups pursuing value-based care (VBC) with ambitious visions to improve patient outcomes and lower costs. However, without a robust patient acquisition strategy, man...

Understanding the Mental Health Parity Act: A Guide for Providers (From Payer Executives)

October 31, 2024 10:05pm 53 min

This podcast episode dives deep into the complexities of mental health parity and the implications of the Mental Health Parity Act. The conversation emphasizes the necessity for behavioral health services to be treated w...

Changing Demographics & Value-Based Care

February 12, 2023 4:41am 1 min

This episode is also available as a blog post: https://healthcare-wiki.com/2022/03/12/changing-demographics-value-based-care/

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