Health Care Rounds

There's a wide gap between how medical breakthroughs get announced and what they actually do for patients. Few people have spent as much time inside that gap as Mary Roach, the author of eight New York Times bestsellers, including REPLACEABLE YOU: Adventures in Human Anatomy and STIFF: The Curious Lives of Human Cadavers.

Mary has spent years reporting on medical innovation and tracing the often complicated journey from scientific breakthrough to real-world impact on patients. More often than not, it’s a journey that’s far messier than the hype would have you believe.

In this...

More than 70 million Americans are covered by Medicaid, and the people with the most complex needs, those juggling mental illness, housing insecurity, and chronic disease simultaneously, are the ones the traditional health care system is least equipped to reach.

Dr. Toyin Ajayi, Co-Founder and CEO, and Mike Roaldi, President of Cityblock Health, join host John Marchica to break down how a trust-first, interdisciplinary care model is producing measurable outcomes for over 100,000 Medicaid and dual-eligible members, and why value-based care may be more essential than ever as federal Medicaid policy undergoes some of its most significant changes in...

American health care is too expensive, too inconsistent, and too difficult to navigate. And the payer-provider AI arms race that has emerged over the last several years is making all three problems worse, not better.

Dr. Marc Harrison, Chair of the TowerBrook Health Care Institute, former CEO of Intermountain Health, and co-founder of HATCo, joins host John Marchica to examine why the health care system remains stubbornly stuck in an analog model and how AI-driven abundance could finally close the gap between the care Americans need and the care they can actually access.

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On this week's mailbag, John tackles three reader questions: How are health systems using AI to address the nursing shortage, and do these solutions solve the underlying problem? Are bundled payments becoming the norm for value-based payment models, and what does CMS's shift toward mandatory models like TEAM and CJR-X mean for providers and suppliers? And will the U.S. ever become a Canadian-style, single-payer system? 

Have any questions or comments? Send them our way! 👇 [email protected]. 

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Between 80% and 90% of health outcomes are shaped by what happens between doctor visits. Yet the entire U.S. health care system, from payment models to primary care, is built around the visit itself. 

Wei-Li Shao, President of Omada Health, joins host John Marchica to break down why persistent, in-between-visit care is the missing layer in chronic disease management, and how pairing GLP-1 therapy with the right behavioral support program could be one of the most powerful levers the health care system has yet to fully pull. 

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🎙 ABOUT WEI-LI SHAO 

Wei-Li Shao is Pres...

Health misinformation is no longer a fringe problem on the margins of public health. It has a measurable body count, and the systems that once reliably corrected it, local journalism, trusted institutions, and federal health agencies, are eroding fast.

Dr. Joshua Sharfstein, Vice Dean for Public Health Practice and Community Engagement and Distinguished Professor of the Practice at the Johns Hopkins Bloomberg School of Public Health, and co-author of "Information Sick," joins host John Marchica to examine why the collapse of local news and the flood of health misinformation now constitute a public health crisis in their...

A few weeks ago we conducted a survey of Our Take readers that included both listeners to our podcast and those who don’t (the latter group, we assume, was interested enough to complete a survey). We asked for questions you would like John to answer, and we got some great ones, including today’s question about vaccines and the long-debunked link between the MMR vaccine and autism spectrum disorder. In this first mailbag episode, John reviews the evidence, calls out the "revised" CDC website, and provides his thoughts on the cost of misinformation and disinformation — and what to do abo...

Health care is 18% of U.S. GDP, the number one affordability concern for consumers, and the single biggest line item employers are trying to manage. Every major policy fight in American health care, at its core, comes down to money and who bears the cost.

Larry Levitt, incoming CEO of KFF and one of the most trusted nonpartisan voices in health policy, joins host John Marchica to examine why value-based care has yet to deliver on its promise, and why a deepening public distrust in science and health institutions may be the most dangerous obstacle standing between...

Decades of quality measurement programs were designed to make U.S. health care better. The evidence suggests they have, just not nearly as much as anyone hoped, and sometimes in ways that hurt the patients who needed help most. 

Dr. Rachel Werner, Professor of Medicine, Perelman School of Medicine at the University of Pennsylvania, joins host John Marchica to examine why well-designed quality incentives so often produce unintended consequences, and why the long-term care system, despite years of reform attempts, remains structurally broken. 

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🎙 ABOUT DR. RACHEL WERNER:
 Dr. Rachel M. Werner...

After a year of interviews about value-based care, the same things keep coming up. Fee-for-service is still the problem. Payers want to pay less, providers want to bill more. And twenty years in, the people who helped build value-based care are grading it a C-minus.

In his first solo episode, host John Marchica goes back through the transcripts and pulls out what guests agree on: the problems value-based care is trying to fix, the fixes they keep proposing — mandatory participation, full-risk capitation, payer-provider integration — how it's going so far, and where the real progress is likely to come...

Decades after the research that proved high-spending regions don't produce better care, and 20 years after the term "accountable care organization" was coined, the U.S. health care system still runs overwhelmingly on fee-for-service. The incentives haven't changed, and the results show it.

Dr. Elliott Fisher, Professor of Health Policy at the Dartmouth Institute and the Geisel School of Medicine and the researcher who coined the term ACO, joins host John Marchica for a frank look at why value-based care has fallen short of its promise, and whether a public utility model for health care regulation might be...

Rural hospitals in the U.S. have been closing at a steady pace for over 50 years, and the country now has one of the lowest rates of acute hospital beds per capita among OECD nations. A five-year, $50 billion federal program aims to slow the bleeding, but it may only be a stopgap.

 Dr. Tim Ferris, Vice President of the Health Care Practice at InterSystems and former National Director of Transformation for the NHS in England, joins host John Marchica to unpack the Rural Health Transformation Program, why value-based care models built for large health systems don't translate t...

U.S. health care spending keeps rising, quality scores keep climbing, and yet the care most Americans receive has barely improved. The measurement systems designed to drive better outcomes may be making things worse.

Dr. Michael Chernew, Professor of Health Care Policy at Harvard Medical School and former Chair of MedPAC, joins host John Marchica to examine why decades of quality measurement have failed to move the needle on actual care quality, and whether value-based payment models can survive the incentive distortions they were built to fix.

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🎙 ABOUT DR. MICHAEL CHERNEW
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Value-based care has been the defining promise of health care reform for two decades. Yet new evidence still takes an average of 17 years to reach standard clinical practice, payers and providers remain structurally misaligned, and most VBC models still prioritize payment mechanics over actual patient outcomes. 

Don Calcagno, Founder of ValuesEdge and former Chief Population Health Officer at Advocate Health, joins host John Marchica to talk about why value-based care is still in the early innings despite years of promise, and how closing the structural gap between payers and providers is the real unlock that the industry k...

Primary care physicians are burning out, and patients are paying the price. With the average primary care visit lasting just 15 minutes, the volume-based treadmill is pushing doctors out of the profession and leaving patients without meaningful, preventive care. 

Larry Kutscher, CEO of MDVIP, joins host John Marchica to make the case for a fundamentally different model. They dig into why membership medicine may be the structural fix that value-based care never delivered, and how reducing patient panels from thousands to hundreds could be the key to restoring both physician fulfillment and long-term patient outcomes. 

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Health care spends trillions treating disease, but far less preventing it. The gap between what we know works and what actually gets implemented may be the most expensive problem in medicine. 

Dr. Barry Davis, physician, professor, and author of Preventioneers, joins host John Marchica to explore why prevention so rarely makes it from research to reality, and what it would take for health system leaders to finally close that gap. ================================================ 

🎙 ABOUT DR. BARRY R. DAVIS 
Barry R. Davis is a physician-scientist, biostatistician, and clinical trialist whose career has centered on prevention — not only as a medica...

Value-based care has been the goal for decades. So why does it still feel like we're moving in slow motion? The answer may come down to data, incentives, and the willingness to cross what one industry veteran calls "the rickety bridge over a chasm of death." 

David Snow, Chairman and CEO, Cedar Gate Technologies, an IQVIA Business joins host John Marchica to discuss why technology has finally caught up to the promise of value-based care, how prospective bundles are changing the game for providers and payers, and what it will take to move American health care past t...

Pediatric care is one of the most fragmented and underfunded corners of the American health system. Parents are left as de facto care coordinators, specialists work in silos, and children with complex needs fall through the cracks. What would it look like to actually fix that?

Danish Qureshi, Founder and CEO, Zarminali Pediatrics joins host John Marchica to discuss the personal experience that sparked a new model for pediatric care, why fragmentation in pediatrics is a problem the system has ignored for too long, and what it takes to build an integrated multi-specialty practice designed around children...

On Chicago's West Side, a 100-year-old safety net hospital serves a community where the average life expectancy is 20 years shorter than it is just seven minutes away. Loretto Hospital collects 32 cents on the dollar, runs on 84% Medicaid, and still finds ways to innovate, collaborate, and show up for people that the rest of the system has left behind. 

Tesa Anewishki, CEO, Loretto Hospital joins host John Marchica to discuss what it really takes to lead a safety net hospital, how community-rooted care models are closing the gap on health disparities, and why collaboration beats competition when people's l...

The VA is one of the largest integrated health systems in the country, but it operates unlike anything in the private sector. What can pharmacy leaders and health system executives learn from an organization that has embedded pharmacists into clinical care for decades, given them prescriptive privileges, and built virtual urgent care teams from the ground up? 

Dr. Eric Scott, Former Chief of Pharmacy, US Department of Veterans Affairs, joins Health Care Rounds to discuss what makes the VA uniquely positioned to innovate, how the evolving role of pharmacists challenges private sector norms, and what a mission-driven h...

Physician leadership can make or break a health system. What does it really take to earn doctors’ trust and move an organization forward? 

Dr. Jonathan Stallkamp, Chief Medical Officer of Main Line Health, joins host John Marchica to discuss building physician engagement, developing future clinical leaders, and strengthening culture inside a complex health system.  

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🎙 ABOUT JONATHAN STALLKAMP 
 Dr. Jonathan Stallkamp serves as Senior Vice President and Chief Medical Officer for Main Line Health. Dr. Stallkamp, a leader focused on safe, high-quality and equitable care, joined the System in 2005. 

As the Chief Medi...

Regional health leaders are being asked to do the impossible right now: deliver on systemwide strategy while staying deeply responsive to the realities on the ground. In rural markets especially, the pressures around access, staffing, and infrastructure are forcing health systems to rethink what “care delivery” looks like in practice. 

Natalie Baggio, President, Corewell Health South joins Health Care Rounds host John Marchica, CEO of Darwin Research Group, to discuss balancing local priorities with system strategy, strengthening workforce pipelines to improve retention and reduce burnout, and expanding access through partnerships and new care models. 

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