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.
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
New to VBCA Podcast?
Medicare Advantage Negotiates Like an Owner. Commercial Doesn’t.
She Built a Peer Mentorship Program to End Youth Loneliness
Bonus: 5 Contract Clauses Killing Your Reimbursement
I Ask: Could Theranos Get a Health Plan Contract Today?
Lindsay Clancy: Examining the Healthcare System's Failures
Latest Episodes
Parents of kids 13 and under may be exempt from new Medicaid work rules #Medicaid
We break down the 80-hour monthly mandate, including qualifying activities like work, school, and volunteering. If you fall within the 19-64 age range, understanding these Medicaid eligibility rules is critical to maintaining your coverage. We also cover the specific exemptions for caregivers and the medically frail to help you prepare for these upcoming policy shifts.
Subscribe for weekly healthcare indus
Why the Healthcare System Still Can't Stop the Next Theranos
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
I Ask: Could Theranos Get a Health Plan Contract Today?
Check your contract before it's too late #contractmanagement #revenue
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.
When providers misunderstand financial risk #business #healthcare
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
The Dark Side of California Medicare: What They're Not Telling You #medicare #exposed
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
What you need to know about Medicaid eligibility changes #medicaid #update
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
Recent Blog Posts
Access Without Coordination: The Hidden Crisis in Postpartum Mental Healthcare
How to Audit Payer Contracts for Ambiguous Effective Dates and Missing Rate Updates
About the Host
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.
Apple Podcasts
Spotify
YouTube
Amazon Music
iHeartRadio
Pandora
Goodpods
Castbox
PlayerFM
Podchaser
Audible
Podcast Addict
Deezer
JioSaavn
Youtube Music
PocketCasts
RSS Feed