Startups Episodes

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.

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. history. More than 40 million stimulant pills, over $100 million in revenue, and a business model engineered around speed, volume, and automated prescribing — all built with no real clinical guardrails.


In this episode, host Alex Yarijanian breaks down not only what happened, ...

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 know:



Shorter, billable windows for remote monitoring


New behavioral health add-ons to primary care


Incentives that reward value-based care


Expanded reimbursement for digital therapeutics & telehealth


A major shift from inpatient to outpatient procedures




Whethe...

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 leadership effectiveness. Alex shares personal experiences and insights on how emotional labor can be both a powerful tool and a silent tax on leaders, especially for those challenging dominant norms. Tune in to learn how to harness emotional intelligence to build trust and lead with e...

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.

Whether you're a founder, operator, or policy strategist, you'll walk away with a clear understanding of how to position your company for payer partnerships, structure risk-based contracts, and avoid common pitfalls in the healthcare financing space. We explore real-world examp...

The health insurance industry is confronting a convergence of rising healthcare costs, increased patient demand, and heightened legislative scrutiny as we approach 2025. Medicare Advantage plans, once highly profitable, are now under significant pressure due to these factors. Major insurers like Humana and UnitedHealth are experiencing challenges that may redefine managed care. However, this period of disruption presents opportunities for healthcare providers and entrepreneurs to innovate and adapt. By focusing on high-cost patient areas and exploring innovative contracts, stakeholders can position themselves to thrive in this evolving landscape.

Key Takeaways:

The health insurance sector is facing significant challenges due to rising costs and increased scrutiny.

Medicare Advantage plans are experiencing financial strain from surging patient demand and utilization rates.

Healthcare providers should analyze their patient populations to identify high-cost areas and develop …

In this episode of the VBCA Podcast, host Alex Yarijanian delves into the challenges faced by healthcare startups in the value-based care (VBC) sector, emphasizing the critical importance of robust patient acquisition strategies. The discussion highlights how many startups, despite ambitious goals to enhance patient outcomes and reduce costs, struggle to meet volume requirements and maintain contracts due to inadequate patient engagement approaches.

No two states are alike in how telehealth is defined and regulated. While there are some similarities in language, perhaps indicating states may have utilized existing verbiage from other states, noticeable differences exist.

These differences are to be expected, given that each state defines its Medicaid policy parameters, but it also creates a confusing environment for telehealth participants to navigate, particularly when a health system or practitioner provides health care services in multi...