The Strategy of Health

Kidney Care Innovation: The Next Best Action Strategy

Chronic kidney disease care is moving beyond risk scores. In this episode of Strategy of Health, Cole Lyons speaks with Joseph Vattamattam and Stephanie Toth-Manikowski, MD, MHS, FASN of Healthmap Solutions about next best action, CKD population health, AI/ML-enabled care workflows, care gap prioritization, and value-based kidney care.The conversation covers how Healthmap Solutions helps identify which interventions matter most for complex kidney patients, how clinicians and analytics teams work together, and how better prioritization can improve outcomes while reducing avoidable hospital and emergency department utilization.Guests: Joseph Vattamattam and Stephanie Toth-Manikowski, MD, MHS, FASNHosted by Cole Lyons for the American Journal of Healthcare Strategy.Timestamps00:00 [https://www.youtube.com/watch?v=wmRHy8g6zy4] Introduction: kidney care, CKD, and the challenge after risk identification01:21 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=81s] Why “next best action” matters in chronic kidney disease care04:57 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=297s] How clinical teams and AI/ML teams work together06:13 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=373s] A real-world CKD patient example08:16 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=496s] Recommendation systems, alert fatigue, and physician trust12:20 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=740s] Turning care gaps into high-impact clinical action15:52 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=952s] AI, prediction, and personalization in kidney care20:30 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=1230s] Improving outcomes for CKD stage 3 and stage 4 patients23:10 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=1390s] The financial case for better kidney care coordination25:37 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=1537s] Risk-based contracting and aligned incentives28:27 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=1707s] What health plans and providers should ask vendors30:11 [https://www.youtube.com/watch?v=wmRHy8g6zy4&t=1811s] Closing thoughts

The Last Unmanaged Benefit: Why Medical Transportation is Healthcare's Next Frontier

Did you know that the medical transportation system has become a massive, unseen liability for healthcare payers? On this episode of The Strategy of Health (TSoH) podcast, host Cole Lyons sits down with Ken Van Cara, CEO of Alacura, and Steve Fox, Chief Growth Officer, to uncover the hidden costs of air and ground medical transports.Healthcare leaders are currently facing severe transportation inefficiencies, where an excessive reliance on air transport for short-distance inter-hospital transfers is driving significant and unexpected costs. Ken and Steve break down the economic drivers of this overutilization, the unintended consequences of the No Surprises Act, and the explosion of Independent Dispute Resolution (IDR) claims.Learn how Alacura is combatting these issues by implementing 24/7 clinical triage to match patients to the most appropriate transport modes, lowering costs while improving patient outcomes.🕒 Chapters & Timestamps00:00:00 - Introductions and the current challenges in medical transportation 00:08:48 - Why medical transport is an "iceberg" of hidden liability for payers 00:13:17 - The economic drivers of overutilization and unnecessary air ambulance flights 00:15:32 - Alacura's solution: 24/7 clinical triage and logistical oversight 00:27:02 - The No Surprises Act and the explosion of Independent Dispute Resolution (IDR) claims 00:34:14 - Keeping a "human in the loop": The ethical application of AI in healthcare 00:41:11 - Using data and predictive intelligence to identify vulnerable members 00:59:30 - How hospital hub-and-spoke models impact transport logistics 01:01:33 - Air ambulance market consolidation and the top 3 dominating companies 01:02:21 - The hidden role of private equity in driving transport costs

Kidney Care's Breakout Year: Healthmap Solutions on Growth, AI, and the Future of Healthcare

Healthmap Solutions' CEO Eric Reimer and Chief Growth Officer Tom Gaffney return to The Strategy of Health for a 2025 year-in-review. They discuss how the company delivered record savings rates amid industry headwinds, the integration of the Carium, and why chronic care management is finally getting the scrutiny it deserves. The conversation covers their expanding comorbidity strategy, plans to grow spend under management by 30-40% in 2026, and how AI is making their clinical teams more effective without replacing them.

Are Traditional Health Systems Doomed? | Dr. Roger Kerzner on the Ambulatory Care Battle

Digital disruptors are coming for ambulatory care—but 2024 revealed the fight is far from over. Walmart shuttered all 51 health clinics. Walgreens wrote down $12.7 billion. Teladoc's stock fell 98%. Meanwhile, Optum now employs 10% of U.S. physicians and Bain projects nontraditional providers will capture 30% of primary care by 2030.So what's actually happening—and can traditional health systems survive?In this conversation, Dr. Roger Kerzner, Medical Director at Heartbeat Health, joins Cole Lyons to unpack why the old episodic care model is failing, what health systems can learn from disruptor failures, and the leadership courage required to navigate a decade-long transformation.00:00 Introduction and Guest Welcome00:23 Discussion on Healthcare Disruption01:56 Ambulatory Care and Business Models04:18 Challenges and Solutions for Incumbents06:48 Value-Based Care and Future Vision11:49 Conclusion and Final Thoughts

How Systems Engineering Can Transform Healthcare

Welcome to Strategy of Health by the American Journal of Healthcare Strategy! In this episode, host Cole Lyons sits down with Dr. Matthew Montoya—professor of Systems Engineering at Johns Hopkins and veteran systems thinker—to discuss:-What “systems engineering” really means in healthcare-Dr. Montoya’s career path: from math and engineering to health systems and executive leadership at Johns Hopkins-How systems thinking brings clarity to organizational chaos—and why that matters for patient outcomes-Real-world examples: orchestrating complex projects at scale (like defense, national security, and multi-stakeholder healthcare efforts)-Where AI fits (and doesn’t fit) in system-based problem solving-How healthcare professionals and executives can “get started” with systems engineering or infuse systems thinking into their organizations-Plus: book recommendations like The Fifth Discipline by Peter Senge, and practical tips on education and training for healthcare leaders seeking to implement systems approaches.About Dr. Matthew Montoya:Dr. Montoya serves as professor and mentor at Johns Hopkins University’s Systems Engineering and Healthcare Systems Engineering programs, with over 35 years at Johns Hopkins and national recognition as an outstanding instructor and principal chief engineer. His work applies engineering, systems science, and business acumen to tackle complex problems across industries—from healthcare delivery to national security. 0:00 [https://www.youtube.com/watch?v=9YOB4H8iuwo] – Introduction1:24 [https://www.youtube.com/watch?v=9YOB4H8iuwo&t=84s] – Dr. Montoya’s career, background, and role at Johns Hopkins5:32 [https://www.youtube.com/watch?v=9YOB4H8iuwo&t=332s] – Why systems engineering?9:50 [https://www.youtube.com/watch?v=9YOB4H8iuwo&t=590s] – Clarifying chaos: applying systems thinking in practice15:10 [https://www.youtube.com/watch?v=9YOB4H8iuwo&t=910s] – Case study: large-scale defense health project19:00 [https://www.youtube.com/watch?v=9YOB4H8iuwo&t=1140s] – Project management vs. systems engineering in healthcare22:45 [https://www.youtube.com/watch?v=9YOB4H8iuwo&t=1365s] – Building “pilot” efforts and measuring outcomes28:00 [https://www.youtube.com/watch?v=9YOB4H8iuwo&t=1680s] – The impact of AI tools in systems engineering35:40 – Practical advice for healthcare organizations40:55 – Getting started: mindset, books, and educational resources44:00 – Closing thoughts