In this discussion, we examine how many health plans, especially medicare advantage plans, have historically served affluent members, often overlooking those with socioeconomic challenges. This approach raises crucial questions about equitable access to care within our healthcare system. Understanding these dynamics is key to improving health insurance and overall healthcare…
Joined by Dr. Kumar Dharmarajan of World Class Health, we explore Medicare Advantage, a key area where health plans take on full financial risk. This creates opportunities for patients and plans to benefit from investing in non-traditional resources like home care and telehealth. Understanding medicare explained is crucial for those…
Multiplan’s pricing tactics are raising serious questions across the health insurance industry. Many physicians say these practices are squeezing providers while boosting insurer profits. What’s really going on behind the scenes—and who pays the price in our healthcare system? We explore the impact on medical bills and the broader cost…
Multiplan’s pricing tactics are raising serious questions across the healthcare industry. Many physicians say these practices are squeezing providers while boosting insurer profits. What’s really going on behind the scenes—and who pays the price? #healthcare #insurance #doctors #multiplan #healthpolicy #medicalbilling This video clarifies the crucial distinction between 'Line of Business'…
We explore how greater controls in health insurance lead to lower premiums, with the insurance company determining benefit access. The HMO (Health Maintenance Organization) plan, a key part of the broader healthcare system, is highlighted as the most restrictive yet least costly option, impacting overall health policy. Understanding these dynamics…
Are you planning to enter a new market in the healthcare industry? Before you take the leap, it's crucial to conduct thorough tests to ensure your success. In this video, we'll walk you through the 4 essential tests you must run before entering a market. These tests will help you…
Multiplan’s pricing tactics are raising serious questions across the healthcare industry. Many physicians say these practices are squeezing providers while boosting insurer profits. What’s really going on behind the scenes—and who pays the price? #healthcare #insurance #doctors #multiplan #healthpolicy #medicalbilling
This video offers a comprehensive playbook for selecting a winning behavioral health market. We analyze market fundamentals, existing infrastructure, and competitive landscapes to pinpoint "sweet spot" markets for mental health treatment. Discover how to evaluate and choose the most promising locations for mental health help and services, ensuring strategic growth…
Resilience, ROI & Results Discover the proven neuroscience strategies transforming mindful leadership from concept into measurable healthcare outcomes. Alex Yarijanian, CEO of Carenodes and host of the VBCA Podcast, breaks down the practical tools executives need to drive resilience, productivity, and value-based results. In this actionable session, you'll uncover: -…
Doulas and Value-Based Maternity Care: Driving Cost Reduction & Improved Outcomes. Discover the impact of abandoning traditional birth methods and how doulas and value-based care are revolutionizing the birthing experience. In this episode, healthcare expert Alex Yarijanian takes a deep dive into the role of doulas within the modern healthcare…
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 reimbursements. In this episode, host Alex Yarijanian breaks down the allegations against MultiPlan, a third-party repricing company accused…
Healthcare expenditures currently total about $3.5 trillion a year, and that figure is projected to rise to $4.7 trillion in just a few years. This growth represents a widening opportunity for health tech entrepreneurs, as the cost gap continues to expand. Given these shifting market dynamics and the ongoing challenges…
But in 1980, the New England Journal of Medicine warned us, medicine will no longer be an art, a profession, a science. It will be a business. A business like @ExxonMobil and US Steel. But remember, insurance companies are making decisions and their goal is to make money, not to…
Millions of young people in the U.S. are struggling with mental health challenges, but many aren't receiving the care they need. 🌎 Discover the states leading the way—and those falling behind—in addressing youth mental health. Let's close the treatment gap and build a healthier future together! 🧠💙 Youth mental health…
They will not pursue an appeal that they’re entitled to. In this case, Nataline Sarkisyan's family did. Cigna still said no. So the company became a, the family became a very squeaky wheel and it became a huge PR nightmare for Cigna and the company eventually relented. Nataline Mary Sarkisyan…
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. As we move into 2025, the challenges confronting Medicare Advantage plans, once considered the crown jewel of insurer…
At one point, the mother of three took to TikTok with her guitar, hoping someone might be able to help them. "Surgery was only $42,000. They put a price tag on my husband's life and they decided he wasn't worth $42 grand".
Discover how a major healthcare cartel, including MultiPlan and top insurers, faces allegations of "mafia-like" practices in suppressing out-of-network reimbursements. This episode of the VBCA Podcast explores the antitrust lawsuit, its impact on providers and patients, and the call for transparency
For instance, transportation, access at home. So if you have, you know, if you have a, if you have a step, a lip in order to get into your home with no ramp, well, you might be fought. And there was a patient with this story. She would hurl herself…
And that fee itself was $15,666, even though the baby wasn't actually treated for trauma because there was no trauma. He napped, had a bottle of formula, and was fine. Can you believe that? The incident involves a South Korean family whose 8-month-old son, Park Jeong Whan, fell off a…
She just found out. She just. She's 68 years old and she just found out about the wonderful world of Humana. I'm not going to do the little plug, but for her it works. But she wanted to lose some weight. She's carrying some extra pounds. But she found out…
What's important for you to know is lines of business. These are the flow of funds. So for you to know, okay, if I'm going to place my business in one, if you're going to position your business, you really have to know where in the spectrum are you going…
Life saving treatment apparently not necessary. Deidre O'Reilly's son had a life threatening allergic reaction and was rushed to the emergency room. Doctors saved him with epinephrine and steroids, but the family's insurance company denied the claim. Wait, but it was an emergency treatment and they denied the claim. How…
Imagine being on a family vacation only to face an $18,000 hospital bill for what seemed like a harmless check-up! In this shocking healthcare billing story, we dive into how a routine visit for a baby’s safety turned into a financial nightmare. Discover the challenges families face with unexpected hospital…