Claims Denied: A Hospitalogy Podcast

MA is a Flat Circle, the Physician Subsidy Bear Case, and Why Density Beats Scale (with Jason Ross, EVP at Privia Health)

Hospitalogy's Blake Madden sits down with Jason Ross, EVP of Medical Groups at Privia Health, a guy who has worked basically every seat at the healthcare table. Jason is currently running the largest portion of Privia's single-TIN medical group footprint across a publicly traded enabler. Coming out of Privia's Q1 print, Blake and Jason leaned into on the stuff Wall Street keeps missing. * The MA down-cycle and whether VBC is actually broken or just on a familiar back-half-of-the-cycle slump. * Privia’s portfolio philosophy — why Privia runs 100+ FFS contracts alongside 100+ VBC contracts when half the market chased pure-play full-risk.  * The unsustainability of the health system physician subsidy model from somebody who lived it. * Density vs. scale. * The PE second-bite math falling apart in real time. * Privia is hitting singles and doubles (Not flashy, but Tony Gwynn never hit for power either...and he ended up in the Hall of Fame!) --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc [https://navvishealthcare.com/vbc] --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ [https://hospitalogy.com/] Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ [https://hospitalogy.com/podcast/]  Be sure to leave us a review, and share our podcast with colleagues. Follow Jason Ross on LinkedIn: https://www.linkedin.com/in/jasonwross/ [https://www.linkedin.com/in/jasonwross/] Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠ [https://www.linkedin.com/in/blakecmadden/]

The Most Boring Industry You're Not Paying Attention To (And Why You Should Be): Inside Indigo's AI-Native Insurance Model | Jared Kaplan, CEO and Founder, Indigo Technologies

You may think the insurance industry is dull, but not this conversation! For this episode, I sat down with Jared Kaplan, CEO and founder of Indigo Technologies, to talk about why medical malpractice insurance is one of the last bastions of healthcare that hasn't been touched by modern technology.  We also discussed how Indigo is using 1,500+ predictive attributes to blow up the 15-page application and individualize physician risk in a $13B market.  And we got into InsureTech 3.0, nuclear verdicts reshaping hospital balance sheets, why the best technology in the world means nothing without broker trust, and whether AI-enabled clinical care will eventually become a malpractice discount the way a burglar alarm lowers your homeowners’ premium.  --- Learn more about Indigo Technologies: https://www.getindigo.com/ [https://www.getindigo.com/] Follow Jared Kaplan on LinkedIn: https://www.linkedin.com/in/jared-kaplan-683412/ [https://www.linkedin.com/in/jared-kaplan-683412/] --- Follow Blake Madden on LinkedIn: ⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠ [https://www.linkedin.com/in/blakecmadden/]  For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠https://hospitalogy.com/⁠⁠ [https://hospitalogy.com/] Like our podcast? Listen to previous episodes here: ⁠⁠https://hospitalogy.com/podcast/⁠⁠ [https://hospitalogy.com/podcast/]  Be sure to leave us a review, and share our podcast with colleagues.

From Surgery Center Newsletter to Healthcare Media Empire (with Scott Becker)

In this episode, Blake Madden sits down with Scott Becker, founder of Becker's Healthcare, practicing healthcare lawyer at McGuireWoods, and one of the longest-running names in healthcare media, for a wide-ranging conversation that ended up being as much about building businesses as it was about healthcare itself. This was Blake's first time meeting Scott, and yeah, they are nominally competitors. But Scott immediately reframes it: rising tide, abundant landscape, etc. Then he proceeds to show he walks the walk, sharing what he's learned building one of healthcare's most recognized media brands over 30+ years. Blake and Scott get into: * The origin of Becker's (Spoiler Alert: zero genius involved, just disciplined doubling down!) * Why short-form journalism was a battlefield internally before it was obvious externally, the 10–20 relationships that actually build careers * Scott's pretty blunt takes on the state of U.S. healthcare This is a great one for anyone building something, in healthcare or otherwise. --- Becker’s Healthcare: https://www.beckershospitalreview.com/ [https://www.beckershospitalreview.com/] Follow Scott Becker on LinkedIn: https://www.linkedin.com/in/scott-becker-ab7056176/ [https://www.linkedin.com/in/scott-becker-ab7056176/] --- Follow Blake Madden on LinkedIn: ⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠ [https://www.linkedin.com/in/blakecmadden/]  For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠ [https://hospitalogy.com/] Like our podcast? Listen to previous episodes here: ⁠https://hospitalogy.com/podcast/⁠ [https://hospitalogy.com/podcast/]  Be sure to leave us a review, and share our podcast with colleagues.

Debating AI, ICHRA, and the Employer Exit with Teira Gunlock & Dr. Eric Bricker

In this latest episode of Claims Denied, Hospitalogy's Blake Madden pulls in two co-hosts — Teira Gunlock, CEO of First Stop Health, and Dr. Eric Bricker, Chief Medical Officer of AHealthcareZ — and the crew battle it out! Three topics. No script. Just healthcare's messiest debates. Listen as Tiera, Eric, and Blake get deep into AI regulation and whether EMRs need to be forced open. They jump into ICHRA vs. captives and why small/mid employers keep getting crushed on renewals. And you won't want to miss when Tiera pushes back on whether any of this is actually good for patients vs. just good for employers, the federal government, and everyone else trying to pass the healthcare cost hot potato (the “not it” dynamic). They even get philosophical about what work even looks like when intellectual labor gets commoditized.  Oh, and Eric lost a chicken the day he and Blake were supposed to meet for lunch. So there's that.  --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠https://hospitalogy.com/⁠ [https://hospitalogy.com/] Like our podcast? Listen to previous episodes here: ⁠https://hospitalogy.com/podcast/⁠ [https://hospitalogy.com/podcast/]  Be sure to leave us a review, and share our podcast with colleagues. --- First Stop Health: https://www.firststophealth.com/ [https://www.firststophealth.com/]  AHealthcareZ: https://www.ahealthcarez.com/ [https://www.ahealthcarez.com/] Follow Teira Gunlock on LinkedIn: https://www.linkedin.com/in/teiragunlock/ [https://www.linkedin.com/in/teiragunlock/] Follow Dr. Eric Bricker on LinkedIn: https://www.linkedin.com/in/ericbrickermd/ [https://www.linkedin.com/in/ericbrickermd/]  Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/ [https://www.linkedin.com/in/blakecmadden/]

1,300 Point Solutions Killed, CHF Admissions Halved, and the Mercy Playbook | Steve Mackin, Mercy CEO

Blake sits down with Steve Mackin, CEO of Mercy — one of the top 15 health systems in the country with 55+ hospitals across Missouri, Oklahoma, Arkansas, and Kansas — to talk about how Mercy is quietly building one of the most interesting care model playbooks in the industry. Steve and Blake get into everything: why Mercy deliberately conceded on price to win on care model, how they cut CHF ED admissions in half, a 1,300 point solution purge, the Mayo data partnership, AI deployment at scale, and why Steve thinks there will be clear winners and losers among health systems over the next few years. This one's packed! --- Mercy: https://www.mercy.com/ [https://www.mercy.com/] Follow Steve Mackin on LinkedIn: https://www.linkedin.com/in/steve-mackin-18771021/ [https://www.linkedin.com/in/steve-mackin-18771021/] Follow Blake Madden on LinkedIn: https://www.linkedin.com/in/blakecmadden/ [https://www.linkedin.com/in/blakecmadden/]  --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: https://hospitalogy.com/ [https://hospitalogy.com/] Like our podcast? Listen to previous episodes here: https://hospitalogy.com/podcast/ [https://hospitalogy.com/podcast/]  Be sure to leave us a review, and share our podcast with colleagues.