Episodes
The Rural Health Transformation Fund: What States Are Funding in 2026
CMS is sending tens of billions of dollars to every state in 2026 to stabilize rural healthcare through targeted investments in workforce, technology, care coordination, and alternative payment models (not broad rate increases). In this VBCA episode, Alex explains what the Rural Health Transformation Fund (RHTF) is, how states are using it, and why it matters for payer strategy, provider contracting, network adequacy, and rural access risk going forward.
Medicare Advantage 2026: How Payers Are Choosing Partners
In this episode, Alex Yarijanian breaks down what’s actually showing up in payer conversations right now, long before final CMS rules are published. Drawing from real contracting, network, and delegation discussions, Alex explains why waiting for regulatory clarity is already costing providers and health tech companies leverage.
This episode also outlines who is most at risk heading into 2026, the three types of organizations positioned to win, and what provider and health tech leade…
Digital Health at a Crossroads: The Fallout from a $100M Adderall Fraud Scheme
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. histo...
Medicare 2026 Fee Schedule: 5 Big Opportunities for Providers & Startups
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 : S...
How to Win in Medicare Advantage 2026
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 policy cha...
Behind the Scenes of Power: Emotional Labor in Negotiation
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 ...
Meditate Like a CEO: Real ROI from Mindful Leadership
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-being bu...
Managed Care Contracting for Health Tech Startups
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. Whet...
Doulas and Value-Based Maternity Care: Driving Cost Reduction and Improved Outcomes
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 mortal...
Uncovering the Hidden Influencers of Our Health System
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, the ...
2025 Opportunities in Healthcare: Navigating the Perfect Storm
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 an…
EXPOSED: The MultiPlan Healthcare Cartel Costing Providers and Patients Billions
In this episode of the VBCA Podcast, host Alex Yarijanian delves into the complex issue of hidden healthcare fees, surprise billing, and the alleged antitrust activities surrounding out-of-network reimbursements. The discussion centers on MultiPlan, a third-party repricing company accused of collaborating with major insurers—such as UnitedHealthcare, Cigna, and Aetna—to suppress out-of-network payments, adversely affecting patients, providers, and employers.
Startup Pitfalls and Healthcare Horror Stories: Introduction to Value-Based Care
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.
Understanding the Mental Health Parity Act: A Guide for Providers (From Payer Executives)
In this episode of the VBCA Podcast, host Alex Yarijanian and guest Dr. Chris Esguerra delve into the complexities of mental health parity, emphasizing the necessity for behavioral health services to receive the same level of care and coverage as physical health services. They discuss the challenges providers face when navigating insurance plans and the barriers to accessing equitable care for patients.
Changing Demographics & Value-Based Care
This episode is also available as a blog post: https://healthcare-wiki.com/2022/03/12/changing-demographics-value-based-care/
Paying for Biopsychosocial Care
The system used to pay for health care today does not encourage the integration of health care and social care, nor can it adequately adapt to the trending shift toward value-based payments for care — paying for better qualit...
Telehealth Landscape Overview 50 States + DC
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....
Florida Market Telehealth Rule & Controlled Substances
During the 2019 legislative session, Florida passed Chapter 2019-137, Laws of Florida , which establishes standards of practice for telehealth services, including patient evaluations, record-keeping, and controlled substances...
How to Talk to Health Plans for Mental Health Coverage.
California Governor Gavin Newsom on September 25 signed Senate Bill 855, Health coverage: mental health or substance use disorders, into law. The law increases health and disability insurers' coverage obligations for mental h...