PAC & Forth

PAC & Forth – Ep. 8 – Featuring Tyler Tracewski – "What if staying independent in primary care didn't have to mean doing it alone?"

26 min · 12. maj 2026
episode PAC & Forth – Ep. 8 – Featuring Tyler Tracewski – "What if staying independent in primary care didn't have to mean doing it alone?" cover

Description

What if staying independent didn't have to mean going it alone? In this episode of PAC & Forth, we sit down with Tyler Tracewski, President of Astrana Care Partners, to unpack PAC's new collaboration with Astrana and what it means for independent primary care physicians navigating Medicare's shift to value-based care. This episode dives into: * What an Accountable Care Organization (ACO) is, how shared savings work in traditional Medicare, and why Astrana's model carries no downside risk for participating physicians * The real financial picture: in 2024, participating providers supplemented their fee-for-service income by an average of 50%, with top performers more than doubling it * Why independence is protected in this model, with no changes to clinical workflows, networks, or patient choice * How prior authorization, reporting, and administrative burdens get absorbed by the ACO so the practice doesn't carry them How independent physicians can join Medicare's value-based future without giving up autonomy, taking on risk, or adding to their administrative load. Tyler shares Astrana's track record of shared savings and why its wraparound model is built to keep small practices independent. For any primary care physician trying to stay independent in a consolidating system, this is essential listening. Tune in to hear what value-based care looks like when it's built around the physician, not the payer.

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10 episodes

episode PAC & Forth - Ep.9 - Featuring Dr. Todd Otten - "What does it take for a physician to finally say enough?" artwork

PAC & Forth - Ep.9 - Featuring Dr. Todd Otten - "What does it take for a physician to finally say enough?"

What does it take for a physician to finally say enough? In this episode of PAC & Forth, we sit down with Dr. Todd Otten, board-certified family physician, former U.S. Navy flight surgeon, co-author of Ripple of Change, and executive producer of the documentary Suck It Up, Buttercup. After two decades in practice and his own experience with burnout, Dr. Otten is one of the most candid voices on what is breaking the people who deliver care. Dr. Otten shares: * The moment he walked away from a 13-year practice and what it taught him about moral injury. * Why the "quadruple aim" must include the well-being of those providing care. * Physician suicide, the stigma around getting help, and why speaking up feels risky. * Direct primary care, Mark Cuban Cost Plus Drugs, and the workarounds physicians are building. A raw, honest look at what corporate medicine costs the people inside it.  If you've ever wondered why so many physicians are quietly stepping back from medicine, or what it would take to bring them back, this conversation is for you. Tune in to hear why change starts with physicians willing to draw a line in the sand.

26. maj 202627 min
episode PAC & Forth – Ep. 8 – Featuring Tyler Tracewski – "What if staying independent in primary care didn't have to mean doing it alone?" artwork

PAC & Forth – Ep. 8 – Featuring Tyler Tracewski – "What if staying independent in primary care didn't have to mean doing it alone?"

What if staying independent didn't have to mean going it alone? In this episode of PAC & Forth, we sit down with Tyler Tracewski, President of Astrana Care Partners, to unpack PAC's new collaboration with Astrana and what it means for independent primary care physicians navigating Medicare's shift to value-based care. This episode dives into: * What an Accountable Care Organization (ACO) is, how shared savings work in traditional Medicare, and why Astrana's model carries no downside risk for participating physicians * The real financial picture: in 2024, participating providers supplemented their fee-for-service income by an average of 50%, with top performers more than doubling it * Why independence is protected in this model, with no changes to clinical workflows, networks, or patient choice * How prior authorization, reporting, and administrative burdens get absorbed by the ACO so the practice doesn't carry them How independent physicians can join Medicare's value-based future without giving up autonomy, taking on risk, or adding to their administrative load. Tyler shares Astrana's track record of shared savings and why its wraparound model is built to keep small practices independent. For any primary care physician trying to stay independent in a consolidating system, this is essential listening. Tune in to hear what value-based care looks like when it's built around the physician, not the payer.

12. maj 202626 min
episode PAC & Forth - Ep. 7 - Featuring Dr. Hailey MacNear - "What happens when TikTok becomes your second opinion?" artwork

PAC & Forth - Ep. 7 - Featuring Dr. Hailey MacNear - "What happens when TikTok becomes your second opinion?"

What happens when TikTok becomes your second opinion? In this episode of PAC & Forth, we sit down with Dr. Hailey MacNear, OB-GYN and partner at Sacramento Women's Health, for an honest conversation about health misinformation, patient trust, and the growing challenge of navigating medicine in the age of social media, from menopause advice on Instagram to "doctor versus Google" debates in the exam room. This episode dives into: * Why patient research can be helpful and when it becomes a barrier to care * The biggest myths she wishes patients would stop believing * How social media has fueled anxiety around perimenopause and menopause * Why so much online "health advice" is really just marketing in disguise * How private practice creates stronger physician-patient trust * The balance between patient autonomy and good medical care This episode explores how physicians can build relationships with their patients strong enough to cut through noise, fear, and bad advice. It's about getting back to what medicine should be: trust, expertise, and real conversation. If you care about women's health, private practice, and how physicians can navigate a world where everyone has "done their own research," this episode is a must-listen.

28. apr. 202620 min
episode PAC & Forth - Ep. 6 - Featuring John Latimer - Who actually shapes health care policy in California? artwork

PAC & Forth - Ep. 6 - Featuring John Latimer - Who actually shapes health care policy in California?

In this episode of PAC & Forth, we go inside the Capitol with John Latimer, founder and managing partner of Capital Advocacy — one of Sacramento’s most influential lobbying firms — for a no-nonsense look at how decisions really get made. This conversation pulls back the curtain on: * Why health care policy is dominated by big institutions — and how smaller voices can still break through * The real meaning of “affordability” in Sacramento (and why it’s more complicated than it sounds) * How California’s budget deficit is already reshaping health care debates * What the next governor’s race could mean for single-payer, access, and quality * Why grassroots physician voices matter more now than ever A candid, insider’s view of power, politics, and persuasion and how independent physicians can stop being spectators and start being heard. If you’ve ever wondered why common-sense health care fixes are so hard to pass or how PAC turned a brand-new association into a legislative win, this episode is essential listening.

14. apr. 202624 min
episode PAC & Forth - Ep. 5 - Featuring Dr. Lamia Gabal - What does it really take to build and keep an independent medical practice in today’s healthcare system? artwork

PAC & Forth - Ep. 5 - Featuring Dr. Lamia Gabal - What does it really take to build and keep an independent medical practice in today’s healthcare system?

In this episode of PAC & Forth, we’re joined by Dr. Lamia Gabal, board-certified urologist, founder of Prestige Medical Group, and PAC board member, for one of our most honest and human conversations yet. Dr. Gabal shares: * Her family’s immigrant journey and how it shaped her drive as a physician and entrepreneur * Why she chose private practice and why so many doctors no longer can * The hidden administrative and financial pressures squeezing independent physicians * How insurance practices like downcoding and prior authorization delay care and raise costs * Why autonomy in medicine is about doing what’s right for patients * What it’s really like being a woman building a business in a male-dominated specialty This episode blends policy, practice, and personal experience, from the exam room to the Capitol, and makes clear what’s at stake if independent medicine disappears. If you care about patient choice, physician leadership, and preserving a healthcare system that values relationships over volume, this is a must-listen. Tune in to hear why independence still matters.

31. mar. 202618 min