VBCA Podcast
The Value Based Care Advisory (VBCA) Podcast is a solution-focused platform dedicated to advancing the transformation of healthcare through value-based care (VBC) models. Our mission is to break down complex healthcare topics into accessible, actionable insights for leaders, entrepreneurs, engaged consumers, and anyone passionate about meaningful change in healthcare. By challenging the healthcare industrial complex, we provide tools, strategies, and expert perspectives that empower our listeners to navigate and accelerate the shift toward better outcomes, lower costs, and improved patient experiences.
Each episode delivers thought-provoking discussions and practical advice from industry experts, spotlighting innovative approaches to healthcare reform and highlighting voices that are often overlooked in traditional dialogues. Whether you're a healthcare executive, provider, payer, policy influencer, entrepreneur, or informed patient, we aim to inspire new ideas and support you in driving transformation in the healthcare space.
Powered by Carenodes.
Each episode delivers thought-provoking discussions and practical advice from industry experts, spotlighting innovative approaches to healthcare reform and highlighting voices that are often overlooked in traditional dialogues. Whether you're a healthcare executive, provider, payer, policy influencer, entrepreneur, or informed patient, we aim to inspire new ideas and support you in driving transformation in the healthcare space.
Powered by Carenodes.
Choose your favorite podcast player
RSS Feed 
Latest Episode 
Apple Podcasts Apple Podcasts 
Spotify Spotify 
YouTube YouTube 
Amazon Music Amazon Music 
iHeartRadio iHeartRadio 
Pandora Pandora 
Goodpods Goodpods 
Castbox Castbox 
PlayerFM PlayerFM 
Podchaser Podchaser 
Audible Audible 
Podcast Addict Podcast Addict 
Deezer Deezer 
JioSaavn JioSaavn 
Youtube Music Youtube Music 
PocketCasts PocketCasts
A podcast exploring the future of healthcare
I Ask: Could Theranos Get a Health Plan Contract Today?
I ask whether Theranos could be contracted by health plans today, and I argue that our current gates often check paperwork rather than test performance. I walk through four gates: CLIA certification, state and FDA rules, Medicare enrollment checks, and commercial payer contracting. I note that CLIA and state reviews eventually caught Theranos, but payers and investors did not detect the fraud. I explain that a reporter and regulators exposed the problem years into the misconduct, which shows a d
Apple Podcasts Apple Podcasts Spotify Spotify YouTube YouTube Amazon Music Amazon Music iHeartRadio iHeartRadio Pandora Pandora Goodpods Goodpods Castbox Castbox PlayerFM PlayerFM Podchaser Podchaser Audible Audible Podcast Addict Podcast Addict Deezer Deezer JioSaavn JioSaavn Youtube Music Youtube Music PocketCasts PocketCasts New to VBCA Podcast?
Ep. 21 21
Feb. 26, 2026
Medicare Advantage Negotiates Like an Owner. Commercial Doesn’t.
Why are employers paying up to four times Medicare rates for identical procedures? Dr. Kumar Dharmarajan joins Alex Yarijanian to break down incentive alignment, Medicare Advantage contracting, AI-driven engagement, and the structural pricing gap between MA and commercial markets.
29
Sept. 20, 2026
She Built a Peer Mentorship Program to End Youth Loneliness
We sit down with Esha Mittal and Dr. Todd May of Health Net to examine the gap between societal perception and the reality of teen loneliness.
28
Aug. 30, 2026
Bonus: 5 Contract Clauses Killing Your Reimbursement
This bonus episode is the full recording of Alex Yarijanian's HBMA continuing-education webinar. It runs longer than a standard VBCA episode — treat it as a resource, not a highlight reel.
30
Oct. 22, 2026
I Ask: Could Theranos Get a Health Plan Contract Today?
I ask whether Theranos could be contracted by health plans today, and I argue that our current gates often check paperwork rather than test performance. I walk through four gates: CLIA certification, state and FDA rules, Medicare enrollment checks, and commercial payer contracting. I note that CLIA and state reviews eventually caught Theranos, but payers and investors did not detect the fraud. I explain that a reporter and regulators exposed the problem years into the misconduct, which shows a d
27
Aug. 25, 2026
Lindsay Clancy: Examining the Healthcare System's Failures
17 minutes. That's how long Lindsay Clancy's last psychiatric visit lasted — the day before her three children died. Nine prescribers. Two hospitals. A suicide hotline called twice. And allegedly, not one person connecting the dots.
Latest Episodes
Oct. 22, 2026
Why the Healthcare System Still Can't Stop the Next Theranos
This is a video about Could Theranos 2.0 Get Through? — Health Plan Contracting Gates
Could a Theranos-level fraud happen again? We analyze the specific gates that health plan contracting systems use today.
While the Elizabeth Holmes era concluded with a 90-year industry exclusion, the mechanisms used by insurance companies to verify new medical entities remain under scrutiny. We break down the four gates that providers must clear to get paid and examine the vulnerabilities that might allow a
Could a Theranos-level fraud happen again? We analyze the specific gates that health plan contracting systems use today.
While the Elizabeth Holmes era concluded with a 90-year industry exclusion, the mechanisms used by insurance companies to verify new medical entities remain under scrutiny. We break down the four gates that providers must clear to get paid and examine the vulnerabilities that might allow a
Ep. 30 30
Oct. 22, 2026
I Ask: Could Theranos Get a Health Plan Contract Today?
I ask whether Theranos could be contracted by health plans today, and I argue that our current gates often check paperwork rather than test performance. I walk through four gates: CLIA certification, state and FDA rules, Medicare enrollment checks, and commercial payer contracting. I note that CLIA and state reviews eventually caught Theranos, but payers and investors did not detect the fraud. I explain that a reporter and regulators exposed the problem years into the misconduct, which shows a d
Oct. 16, 2026
Check your contract before it's too late #contractmanagement #revenue
Are you losing money because of poor contract management?
73% of providers don't actually know what they are supposed to be paid. We break down how complex payer rules and system errors create significant revenue leakage, often occurring entirely outside the scope of your initial agreement.
Learn how to audit your fee schedules to protect your bottom line.
Subscribe for weekly healthcare industry breakdowns, and comment below if you want to hear more about revenue cycle management.
73% of providers don't actually know what they are supposed to be paid. We break down how complex payer rules and system errors create significant revenue leakage, often occurring entirely outside the scope of your initial agreement.
Learn how to audit your fee schedules to protect your bottom line.
Subscribe for weekly healthcare industry breakdowns, and comment below if you want to hear more about revenue cycle management.
Oct. 12, 2026
When providers misunderstand financial risk #business #healthcare
Many new provider types are struggling with risk-based contracting models that assume they are as mature as established medical groups.
We examine why recent market entrants face friction when forced into financial structures designed for long-standing organizations. The industry often treats these emerging provider models with the same expectations applied to mature groups, creating significant operational tension.
This misalignment creates hesitation regarding healthcare payments, specifical
We examine why recent market entrants face friction when forced into financial structures designed for long-standing organizations. The industry often treats these emerging provider models with the same expectations applied to mature groups, creating significant operational tension.
This misalignment creates hesitation regarding healthcare payments, specifical
Oct. 9, 2026
The Dark Side of California Medicare: What They're Not Telling You #medicare #exposed
Shorts: 3 payers. 76% of California Medicare Advantage. #Shorts
Description:
Kaiser, UnitedHealthcare, and SCAN cover 75.8% of California's 2.6M Medicare Advantage enrollees. Medicare TME rose 6.1% in 2023, and four plans hold over half of Medi-Cal managed care.
Source: CA Health Care Spending Growth Trends, 2022–2023.
#MedicareAdvantage #MediCal #HealthPolicy #ValueBasedCare #PayerContracting
Description:
Kaiser, UnitedHealthcare, and SCAN cover 75.8% of California's 2.6M Medicare Advantage enrollees. Medicare TME rose 6.1% in 2023, and four plans hold over half of Medi-Cal managed care.
Source: CA Health Care Spending Growth Trends, 2022–2023.
#MedicareAdvantage #MediCal #HealthPolicy #ValueBasedCare #PayerContracting
Oct. 8, 2026
What you need to know about Medicaid eligibility changes #medicaid #update
We examine the risks of Medicaid coverage reduction and what it means for patient access at community health centers.
Financial constraints are creating significant uncertainty for patients like Destiny Rosa at the Waianae Coast Comprehensive Health Center. We discuss the structural challenges that threaten to limit health insurance eligibility for vulnerable populations who rely on these services for essential care.
This conversation addresses why funding gaps often result in reduced Medicaid
Financial constraints are creating significant uncertainty for patients like Destiny Rosa at the Waianae Coast Comprehensive Health Center. We discuss the structural challenges that threaten to limit health insurance eligibility for vulnerable populations who rely on these services for essential care.
This conversation addresses why funding gaps often result in reduced Medicaid
Oct. 7, 2026
Why I really left my high school #storytime #freshman #chronicillness
Living with a chronic illness during high school creates unique challenges for students. We discuss the reality of that journey.
Being diagnosed with a chronic illness during freshman year of high school changes everything. We look at how a health diagnosis can impact your academic path and the difficult decision to transfer schools just to keep up with attendance.
Navigating a high school diagnosis requires more than just medical care; it demands flexibility from our educational systems. We e
Being diagnosed with a chronic illness during freshman year of high school changes everything. We look at how a health diagnosis can impact your academic path and the difficult decision to transfer schools just to keep up with attendance.
Navigating a high school diagnosis requires more than just medical care; it demands flexibility from our educational systems. We e
Recent Blog Posts
Sept. 1, 2026
Access Without Coordination: The Hidden Crisis in Postpartum Mental Healthcare
Welcome back to the blog companion for the podcast. If you listened to our latest audio episode, you know we are tackling one of the most difficult and structural conversations we have ever hosted on this platform. Today, we are expanding heavily on…
Sept. 1, 2026
How to Audit Payer Contracts for Ambiguous Effective Dates and Missing Rate Updates
When medical billing teams face persistent underpayments, they typically look for coding errors or clearinghouse rejections at the claims desk. However, many systemic revenue leaks originate upstream in payer contract language, specifically through …
About the Host
Alex Yarijanian
Welcome to the Value-Based Care Advisory Podcast (VBCA Podcast), where host Alex Yarijanian takes you behind the scenes of healthcare's most pressing challenges and transformative breakthroughs. A recognized thought leader with over 15 years of experience, Alex has revolutionized payer-provider relations, shaped the future of value-based care, and led digital health innovations that have impacted millions of lives nationwide.
As the CEO and founder of Carenodes, Alex is a trailblazer in creating healthcare systems that are not only innovative but also equitable and impactful. From negotiating groundbreaking contracts that saved Medicaid plans $58 million to expanding access to maternal and youth mental health care across 43 states, his work embodies the belief that healthcare is a right, not a privilege.
Alex's career is a blend of bold strategy and heartfelt advocacy. He's the driving force behind operational overhauls in behavioral health, an architect of cutting-edge digital health solutions, and a trusted advisor to national healthcare boards. Fluent in English, Persian, and Armenian, Alex brings a global lens to healthcare innovation, connecting the dots between policy, technology, and the human experience.
Tune in as Alex combines sharp insights, captivating storytelling, and industry expertise to spotlight the innovators and disruptors redefining healthcare. Whether you're a policymaker, a clinician, or simply a curious mind, the VBCA Podcast promises to inspire, inform, and ignite your passion for building a healthier future.