The Leadership Lab with Asbel Montes

The War on Waste: CMS Priorities in a New Era with Kimberly Brandt

What happens when healthcare leaders stop chasing fraud after the fact — and start preventing it before the money ever leaves the door? In this Clarity Special Edition, Asbel Montes sits down with Kimberly Brandt, JD, Deputy Administrator & Chief Operating Officer at the Centers for Medicare & Medicaid Services (CMS). With experience spanning CMS, the U.S. Senate Finance Committee, HHS OIG, and the private sector, Kim offers a rare inside look at how federal healthcare leadership is rethinking program integrity, modernization, and accountability in a rapidly shifting landscape. From "war room" initiatives that stopped over $2.5 billion in suspicious payments — before they were made — to the growing role of artificial intelligence in healthcare oversight, this conversation lives at the intersection of leadership, policy, technology, and patient-centered reform. What you'll hear in this episode: * How CMS is using AI and machine learning to proactively detect fraud, waste, and abuse * Why program integrity is a leadership issue, not just a compliance one * What CMS priorities mean for providers, payers, EMS agencies, and healthcare leaders * How organized healthcare fraud networks are evolving — and how oversight is keeping pace * The balance between regulation, competition, and patient access * How value-based care, Medicare Advantage, and program integrity intersect * Why innovation and accountability are not opposing forces — and what it looks like when leaders treat them as one The bottom line: Healthcare reform is no longer just about reimbursement. It's about accountability, modernization, leadership, and trust. This conversation challenges healthcare leaders to think differently about how we protect patients, strengthen systems, and responsibly innovate. If you're a healthcare executive, EMS leader, policymaker, revenue cycle professional, or physician trying to understand where healthcare is heading — this episode is for you. Subscribe to The Leadership Lab for conversations at the intersection of healthcare leadership, finance, technology, and systems-level thinking. Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 [https://www.linkedin.com/in/asbel-montes-31027634] Jeff Beeson LinkedIn - https://www.linkedin.com/in/jeffrey-beeson-ph-d-082b5381 [https://www.linkedin.com/in/jeffrey-beeson-ph-d-082b5381] Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices [https://www.linkedin.com/company/solutionsgroupservices] Instagram - https://www.instagram.com/solution_sgroup/ [https://www.instagram.com/solution_sgroup/] Facebook - https://www.facebook.com/solutionsgroupservices [https://www.facebook.com/solutionsgroupservices] Website - https://www.solutionsgroup.com/ [https://www.solutionsgroup.com/]

The Crosswalk Between Payers, Physicians, and Patients with Dr. Jeff Beeson

What happens when physicians realize they've been practicing medicine inside a financial system they were never trained to understand? In this episode of The Leadership Lab, Adam sits down with Dr. Jeff Beeson, emergency physician, EMS leader, educator, and healthcare innovator, for an in-depth conversation about physician leadership, healthcare finance, value-based care, EMS transformation, and the future of AI in healthcare. Drawing from decades of experience as an EMT, paramedic, flight nurse, physician, medical director, and healthcare executive, Dr. Beeson shares the growing disconnect between patient care and reimbursement systems, and why clinicians must play a larger role in shaping healthcare reform. The conversation explores how EMS and prehospital medicine are evolving beyond transportation into integrated, patient-centered care models focused on outcomes, prevention, and community health. Adam and Dr. Beeson also discuss physician burnout, healthcare economics, payment reform, data fragmentation, community paramedicine, nurse navigation, and the promise and risks of artificial intelligence in healthcare. In this episode, you'll learn: ✅Why physicians are increasingly stepping into healthcare leadership and payment reform ✅How fee-for-service reimbursement impacts EMS and patient care ✅The role of value-based care in building sustainable healthcare systems ✅Why EMS is central to the future of community health and integrated care ✅How healthcare economics contributes to clinician burnout ✅The opportunities and challenges AI presents in healthcare operations and clinical decision-making ✅Why data integration between EMS, hospitals, and payers remains a major healthcare challenge ✅How leadership, storytelling, and collaboration can accelerate healthcare transformation If you're a healthcare executive, EMS leader, physician, policymaker, or healthcare innovator, this episode offers a forward-thinking look at the future of healthcare finance, physician leadership, reimbursement reform, and patient-centered care delivery. 👉🏻 Subscribe to The Leadership Lab with Asbel Montes for more conversations with industry innovators. 👉🏻 Follow and rate the show to help others discover the future of healthcare transformation. 👉🏻 Share this episode with your team to spark meaningful change. Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 [https://www.linkedin.com/in/asbel-montes-31027634] Jeff Beeson LinkedIn - https://www.linkedin.com/in/jeffrey-beeson-ph-d-082b5381 [https://www.linkedin.com/in/jeffrey-beeson-ph-d-082b5381] Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices [https://www.linkedin.com/company/solutionsgroupservices] Instagram - https://www.instagram.com/solution_sgroup/ [https://www.instagram.com/solution_sgroup/] Facebook - https://www.facebook.com/solutionsgroupservices [https://www.facebook.com/solutionsgroupservices] Website - https://www.solutionsgroup.com/ [https://www.solutionsgroup.com/]

From the Field to Finance: Building Winning Teams in Healthcare with Griffin Hebert

What if the biggest challenge in healthcare revenue cycle management isn't effort, talent, or technology, but how the entire system is structured to win? In this episode of The Leadership Lab with Asbel Montes, healthcare finance meets high-performance sports as we break down what football can teach us about building stronger, more efficient revenue cycle teams. Joining Asbel Montes is Griffin Hebert, former NFL wide receiver for the Seattle Seahawks and Philadelphia Eagles, now working in healthcare operations and business development at Solutions Group Services. Drawing from years inside elite football systems, Griffin unpacks how championship teams are built, and why many healthcare organizations are unknowingly operating without the structure needed to consistently perform at a high level. Because in football, every position has a role. Every player has accountability. And every breakdown is reviewed, studied, and corrected. In healthcare revenue cycle management, that level of clarity is often missing. And it's costing organizations more than they realize. Here's the tension: Many healthcare organizations still rely on "all-in-one" billers expected to manage the entire revenue cycle process. But elite systems don't work that way. They rely on specialization, defined roles, leadership alignment, and continuous feedback loops that drive improvement over time. So what happens when healthcare tries to operate without that structure? This episode explores how that gap impacts performance, staffing, denials, vendor relationships, and overall financial sustainability. In this episode, we share: Why the "super biller" mindset limits revenue cycle performance How football positions translate directly into specialized RCM roles The difference between offensive (preventative) and defensive (denials and recovery) revenue cycle strategies Why revenue cycle leaders must operate like general managers building a roster, not just managing tasks How bench strength and depth protect organizations from operational breakdowns Why vendor selection should function like a strategic "draft," not a transactional decision How film study in football mirrors healthcare data, reporting, and performance improvement Why short-term wins can create long-term complacency in financial performance The importance of structured review cycles to sustain continuous improvement If you are a healthcare finance executive, revenue cycle leader, or healthcare operations strategist, this conversation will challenge how you think about team design, performance structure, and what it truly takes to build a winning healthcare system. Because in healthcare, just like in football, the strongest organizations do not rely on individual effort alone. They build systems that make every part of the team perform better. 🔔 Subscribe to The Leadership Lab with Asbel Montes and join the conversation about what's next for healthcare leadership. Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 [https://www.linkedin.com/in/asbel-montes-31027634] Griffin Herbert Facebook - https://www.facebook.com/griffin.hebert.1/ [https://www.facebook.com/griffin.hebert.1/] Griffin Herbert TikTok - https://www.tiktok.com/@hebertgriffin [https://www.tiktok.com/@hebertgriffin] Griffin Herbert X - https://x.com/lanettehebert [https://x.com/lanettehebert] Griffin Herbert Instagram - https://www.instagram.com/hebertgriffin/ [https://www.instagram.com/hebertgriffin/] Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices [https://www.linkedin.com/company/solutionsgroupservices] Instagram - https://www.instagram.com/solution_sgroup/ [https://www.instagram.com/solution_sgroup/] Facebook - https://www.facebook.com/solutionsgroupservices [https://www.facebook.com/solutionsgroupservices] Website - https://www.solutionsgroup.com/ [https://www.solutionsgroup.com/]

From Entrepreneur to Lieutenant Governor: A Leadership Journey with Lt. Gov. Pamela Evette

What happens when a $1.5B business leader steps into government, and starts questioning how healthcare and EMS are funded? In this episode, Asbel Montes sits down with Lt. Gov. Pamela Evette to explore the intersection of healthcare finance, public policy, and frontline care delivery. With a background in scaling a national company across 49 states, Pamela brings a private-sector mindset into public leadership, focused on efficiency, accountability, and measurable outcomes. But here's the tension: EMS providers deliver critical care every day… yet many aren't reimbursed unless a patient is transported. That gap exposes a larger issue. Healthcare payment models are not aligned with how care is actually delivered. In this episode, we discuss: EMS reimbursement and the "treat-no-transport" financial gap. The growing pressure on rural healthcare systems. Why must the government adopt private-sector efficiency and accountability. The role of data, technology, and leadership in healthcare transformation. How policy and payment reform can support sustainable EMS systems. Why EMS must have a seat at the table in healthcare decision-making. As healthcare costs rise and rural systems face increasing strain, leaders must confront a difficult reality: If reimbursement models don't evolve, access to care may decline, especially in the communities that need it most. This conversation is essential for anyone working at the intersection of healthcare finance, policy, and system design. 🔔 Subscribe to The Leadership Lab with Asbel Montes and join the conversation about what's next for healthcare leadership. Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 [https://www.linkedin.com/in/asbel-montes-31027634] Pamela Evette Facebook - https://www.facebook.com/pamelaevettesc [https://www.facebook.com/pamelaevettesc] Pamela Evette LinkedIn - https://www.linkedin.com/in/pamela-evette [https://www.linkedin.com/in/pamela-evette] Pamela Evette Instagram - https://www.instagram.com/pamelasevette [https://www.instagram.com/pamelasevette] Pamela Evette X - https://x.com/PamelaEvette [https://x.com/PamelaEvette] Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices [https://www.linkedin.com/company/solutionsgroupservices] Instagram - https://www.instagram.com/solution_sgroup/ [https://www.instagram.com/solution_sgroup/] Facebook - https://www.facebook.com/solutionsgroupservices [https://www.facebook.com/solutionsgroupservices] Website - https://www.solutionsgroup.com/ [https://www.solutionsgroup.com/]

The Economics of Care: Why Physicians Must Engage in Reimbursement with Dr. Nicholas Cozzi

Healthcare systems are being reshaped by innovation, policy pressure, and financial reform, but one of the most overlooked drivers of change is how care is actually paid for. In this episode of The Leadership Lab with Asbel Montes, Dr. Nicholas Cozzi—emergency physician and EMS Medical Director—explores a foundational tension in healthcare finance: a reimbursement model that continues to prioritize transport over care delivered. Even as EMS evolves into mobile integrated healthcare and value-based care frameworks expand, reimbursement structures often fail to reflect clinical reality. Patients are assessed, stabilized, and treated in real time outside the hospital. Yet without transport, that work frequently goes unpaid. Through a powerful clinical scenario involving a severe asthma patient treated at home with advanced interventions and physician oversight, Dr. Cozzi highlights a stark contrast: the same level of care that would be billable in the emergency department is not recognized within EMS payment systems. This disconnect raises a broader systems question for healthcare leaders: How do we define value in a system where care is increasingly delivered outside traditional settings? The episode also reframes EMS not as a standalone service, but as part of a continuous care ecosystem that spans the home, the field, and the hospital. Yet current financial systems continue to treat these stages as separate rather than interconnected. For healthcare executives, finance leaders, policymakers, and EMS professionals, this episode surfaces critical questions about alignment, accountability, and the future of healthcare funding. This episode dives into: Why EMS reimbursement remains tied to transport instead of clinical care value How high-acuity prehospital care is often uncompensated under current models Why physician engagement in healthcare finance is becoming essential How the gap in healthcare economics education impacts system-level decisions Why the shift from "fair" to measurable reimbursement matters for reform How mobile emergency medicine is reshaping acute care delivery Why EMS and ED systems must be viewed as one continuous care pathway For healthcare leaders, the implications are clear: reimbursement design is not just a financial mechanism, it is a behavioral force that shapes how care is delivered, documented, and ultimately valued. And as healthcare continues to move beyond hospital walls, the systems that fail to evolve will increasingly fall out of alignment with the care patients are already receiving. 🔔 Subscribe to The Leadership Lab with Asbel Montes and join the conversation about what's next for healthcare leadership. Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 [https://www.linkedin.com/in/asbel-montes-31027634] Dr. Nicholas Cozzi LinkedIn - https://www.linkedin.com/in/nicholaspcozzi/ [https://www.linkedin.com/in/nicholaspcozzi/] Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices [https://www.linkedin.com/company/solutionsgroupservices] Instagram - https://www.instagram.com/solution_sgroup/ [https://www.instagram.com/solution_sgroup/] Facebook - https://www.facebook.com/solutionsgroupservices [https://www.facebook.com/solutionsgroupservices] Website - https://www.solutionsgroup.com/ [https://www.solutionsgroup.com/]