Podcast - The Math Behind Hospital-Based ACOs

Podcast -Why VBC Makes Healthcare More Expensive

Description Value-based care was designed to make healthcare cheaper and better. But in the last 15 years, it has done the exact opposite. This podcast explains how VBC is implemented in real life as risk-based contracts, leading to consolidation and, in turn, higher costs across the entire economy. Chapter Markers * 00:00 - Intro * 00:25 - The Misdiagnosis * 01:45 - Value-Based Care: Background & Assumptions * 02:20 - The Game of VBC * 02:53 - What is a Budget/Benchmark under VBC? * 03:22 - Gaming the Benchmark * 04:13 - Impact on Small Practices * 05:29 - Quick Recap * 06:09 - Why Small Practices Matter * 06:33 - Consolidation * 07:39 - Types of Consolidation * 09:06 - 1 Contract vs TCOC * 10:29 - Effects of Consolidation * 13:00 - Medicare Advantage & Value-Based Care * 13:26 - VBC, Consolidation & Medicaid * 14:40 - Conclusion * 15:50 - The Question to Ponder? Link to Written Article [https://www.pcplens.com/p/why-vbc-makes-healthcare-more-expensive] Link to Video Subscribe to my YouTube Channel [https://www.youtube.com/@PCPLens?sub_confirmation=1] Please see the Disclaimer on the PCPLens " [https://www.pcplens.com/about]About [https://www.pcplens.com/about]" Page [https://www.pcplens.com/about]. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.pcplens.com [https://www.pcplens.com?utm_medium=podcast&utm_campaign=CTA_1]

Podcast - VBC & PE: A Match Made in DC

Description In this episode, I discuss why Private Equity (PE) is so interested in funding Accountable Care Organizations (ACOs) participating in Value-Based Care (VBC) contracts. I break down the math to show why PE always wins at the expense of independent physicians. Chapter Markers * 00:00 - Intro * 00:33 - Step 1 to 3: Setup, Pot of Gold & Infrastructure * 03:11 - Step 4: Private Equity as Funder * 07:08 - Step 5: Outcomes * 10:51 - Step 6: Multi-Year Projections * 12:48 - Final Thoughts Link to Written Article [https://www.pcplens.com/p/vbc-and-pe-a-match-made-in-dc] Link to Video [https://www.pcplens.com/p/podcast-vbc-and-pe-a-match-made-in-dc] Subscribe to my YouTube Channel [https://www.youtube.com/@PCPLens?sub_confirmation=1] Please see the Disclaimer on the PCPLens " [https://www.pcplens.com/about]About [https://www.pcplens.com/about]" Page [https://www.pcplens.com/about]. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.pcplens.com [https://www.pcplens.com?utm_medium=podcast&utm_campaign=CTA_1]

Podcast - Good Intentions, Bankrupt Doctors

Description Value-based care is supposed to save money, but for independent physicians, it's often a structural trap. Using a custom financial simulation model, I break down the mechanics of these contracts when well-meaning insurance companies try to help independent ACOs by funding the infrastructure costs. Discover how and why primary care physicians can go bankrupt even when they get “free money” under value-based care. Chapter Markers * 00:00 - Intro * 00:48 - Step 1-3: Setting up ACO, Pot of Gold, and Reality Sets in * 03:19 - Step 4: Insurance Company as Funder * 05:54 - Step 5: Outcomes * 10:01 - Step 6: Multi-Year Projection * 10:24 - Step 7: Monte Carlo Simulation * 12:27 - Final Thoughts Link to Written Article [https://www.pcplens.com/p/good-intentions-bankrupt-doctors] Link to Video [https://www.pcplens.com/p/podcast-good-intentions-bankrupt-doctors] Subscribe to my YouTube Channel [https://www.youtube.com/@PCPLens?sub_confirmation=1] Please see the Disclaimer on the PCPLens " [https://www.pcplens.com/about]About [https://www.pcplens.com/about]" Page [https://www.pcplens.com/about]. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.pcplens.com [https://www.pcplens.com?utm_medium=podcast&utm_campaign=CTA_1]

Podcast - The Math Behind Hospital-Based ACOs

Description Value-based care is supposed to save money, but for independent physicians, it's often a structural trap. Using a custom financial simulation model, I break down the exact contract mechanics of what happens when independent ACOs partner with hospital systems for funding. Discover how this setup actively works against independent doctors and accelerates healthcare consolidation. Link to access the model [https://vbcsim.pcplens.com] Chapter Markers * 00:00 - Intro * 00:55 - Step 1: Financial Model Setup * 02:07 - Step 2: Opportunity (Pot of Gold) * 02:52 - Step 3: Cost of Running an ACO * 04:05 - Step 4: Hospital as the Funding Partner * 07:32 - Step 5: Year 1 Outcomes * 14:37 - Final Thoughts on Hospitals Funding ACOs Link to Written Article [https://www.pcplens.com/p/the-math-behind-hospital-based-acos] https://www.pcplens.com/p/the-math-behind-hospital-based-acos Link to Video [https://www.pcplens.com/p/podcast-the-math-behind-hospital-acos] Subscribe to my YouTube Channel [https://www.youtube.com/@PCPLens?sub_confirmation=1] Please see the Disclaimer on the PCPLens " [https://www.pcplens.com/about]About [https://www.pcplens.com/about]" Page [https://www.pcplens.com/about]. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.pcplens.com [https://www.pcplens.com?utm_medium=podcast&utm_campaign=CTA_1]

Podcast - VBC Financial Simulation Model

Description I created a financial simulation model to mimic value-based care contracts. This screencast explains how the model is structured, what the different variables mean, and shows some of the capabilities. It also demonstrates how a value-based care contract works in real life and often why it paradoxically increases the total cost of care. Chapter Markers * 00:00 - Intro * 02:20 - Step 1: Financial Model Setup * 09:01 - Step 2: Opportunity (Pot of Gold) * 10:46 - Step 3: Cost of Running an ACO * 16:09 - Step 4: Choosing a Funding Model * 19:28 - Step 5: Year 1 Outcomes * 24:18 - Step 6: Multi-Year Projection * 33:13 - Step 7: Monte Carlo Simulation * 44:05 - My Thoughts Based on Model Findings Link to Written Article [https://www.pcplens.com/p/vbc-financial-simulation-model] Link to YouTube Video Version Subscribe to my YouTube Channel [https://www.youtube.com/@PCPLens?sub_confirmation=1] Please see the Disclaimer on the PCPLens " [https://www.pcplens.com/about]About [https://www.pcplens.com/about]" Page [https://www.pcplens.com/about]. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.pcplens.com [https://www.pcplens.com?utm_medium=podcast&utm_campaign=CTA_1]