Health Care Rounds

Rebuilding Pediatric Care From the Ground Up w/ Danish Qureshi, Founder & CEO, Zarminali Pediatrics

dyllen@grippimedia.com (John Marchica) — Fri, 3 Apr 2026 10:00:00 +0000

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 and families.

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🎙 ABOUT DANISH QURESHI
Having personally dealt with the struggles of finding comprehensive pediatric care for a child with an autoimmune disorder, and the overwhelming stress that can place on a family left having to coordinate their own care, Danish is committed to the mission of changing the way that pediatric care is delivered across the country.

Prior to Zarminali, Danish was the Co-Founder, President and Chief Operating Officer of LifeStance Health (NASDAQ: LFST). Founded with the mission of increasing access to trusted, affordable, and personalized mental health care, LifeStance has grown into the nation’s largest provider of virtual and in-person outpatient mental health care, with approximately 7,000 clinicians and more than 550 centers across 33 states. Danish oversaw all operations nationwide of LifeStance-supported practices as well as the shared services teams including marketing, customer care, real estate, credentialing, integrations, and payor contracting. Prior to the role of President and COO, Danish served as the Chief Growth Officer of LifeStance, overseeing all growth initiatives, including de novo site openings and the expansion of LifeStance’s existing footprint into new markets, clinician recruiting, and patient marketing nationwide.

Prior to LifeStance, Danish was the former SVP of Strategic Initiatives at Accelecare Wound Centers, Inc., and COO of the post-acute division, Accelecare Wound Professionals, LLC. During his tenure, the post-acute division launched and grew into a nationwide network of 400 skilled nursing facilities under contract, with physicians employed across 22 states. Prior to Accelecare, Danish worked at Nautic Partners, a Providence, RI-based mid-market private equity firm, with a focus on health care services. He began his career as a management consultant with Bain & Company.

Danish holds a BA from Northwestern University.

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

Lessons From Leading a Safety Net Hospital w/ Tesa Anewishki, President & CEO, Loretto Hospital

dyllen@grippimedia.com (John Marchica) — Fri, 20 Mar 2026 10:00:00 +0000

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 lives are on the line.

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🎙 ABOUT TESA ANEWISHKI
Tesa Anewishki is the first African and Native American woman to serve as president and chief executive officer in the hospital’s 100-year history. Loretto is an acute care, safety net hospital that provides access to essential medical services to the Austin Community and adjacent west side neighborhoods. She governs operations for 20 primary care and specialty clinics and leads more than 500 team members.

An equity advocate and patient ambassador, Tesa knows that accessibility to high-quality healthcare is more than an individual’s right – but what is, humane and just! Tesa seeks to address the death gap through transformative investment in communities of color that have often been overlooked and underserved. She is a catalyst for creative and innovative solutions that address the political and social determinants of health that contribute to the decrease in life expectancy.

Tesa started working at Loretto Hospital in 2010 as the director of marketing and foundation administrator directing media, public relations, advertising, and community and clinical outreach. Later, she became the chief development officer and executive director, securing more than $36 million dollars in grant funding and donations. A seasoned strategist, she began her career working in advertising and brand management for national consumer products and media firms, including American Urban Radio Networks, GeoSegment Marketing for General Mill,s and Proctor & Gardner Advertising. She later joined the iconic Johnson Publishing Company as the marketing director of JET Magazine, with responsibility for the strategic planning, management, budget, execution, and evaluation of nationwide marketing programs and merchandising activities for advertisers.

A Chicago native, Tesa holds an MBA from the Keller Graduate School of Management and is a graduate of Roosevelt University with a degree in Integrated Marketing Communications. Tesa has been a community advocate and involved in community service for over 30 years. She is a current Board Member and previous Board Chair of Featherfist, one of Chicago’s largest homeless outreach agencies. She also serves on the Westside Community Stakeholders Executive Committee. She is a 2023 recipient of the 100 Westside Women of Wisdom and Inspiration Awards and received an honorary award from the Westside Chamber of Commerce for outstanding service to the community. She often volunteers her time at Claudia’s & Eddie’s Place, a recovery home, to mentor women on job readiness and career paths.

How the VA Proved The Pharma Model Wrong w/ Dr. Eric Scott, U.S. Dept. of Veteran Affairs

dyllen@grippimedia.com (John Marchica) — Fri, 6 Mar 2026 11:00:00 +0000

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 health system looks like from the inside.

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🎙 ABOUT DR. ERIC G. SCOTT
Eric G. Scott, PharmD, is an innovative health care leader and recently retired from VA as the founding Chief of Pharmacy at VHA VISN 2 VA Health Connect, a virtual health care center serving the Veterans of New York and New Jersey. Throughout a distinguished 28-year career in VA, Dr. Scott has specialized in bridging the gap between complex clinical services and large-scale contact center technology. As a champion of "upstream" health care, he developed the first-of-its-kind virtual urgent care Clinical Pharmacist Provider (CPP) model and has overseen clinical operations handling millions of annual contacts. His work focuses on pharmacist-led disease management, clinical quality, and the strategic modernization of federal health care infrastructure.

How Health Systems Build Elite Clinical Leaders w/ Dr. Jonathan Stallkamp, CMO, Main Line Health

dyllen@grippimedia.com (John Marchica) — Fri, 20 Feb 2026 11:00:00 +0000

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 Medical Officer for Main Line Health, Dr. Stallkamp provides executive oversight of all clinical operations, ensuring the delivery of safe, high-quality and patient-centered care across the System. He leads initiatives that advance clinical excellence, quality improvement, patient safety and physician engagement, while fostering collaboration among Main Line Health’s hospitals, physician practices and clinical programs. In this role, Dr. Stallkamp works to align clinical performance with organizational goals, regulatory standards and best practices that support Main Line Health’s mission to deliver superior care to the communities it serves.

A New Blueprint for Rural Health Care w/ Natalie L. Baggio, President, Corewell Health South

dyllen@grippimedia.com (John Marchica) — Fri, 6 Feb 2026 11:00:00 +0000

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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🎙 ABOUT NATALIE L. BAGGIO
Prior to joining Corewell Health, Baggio served in multiple health care leadership roles at Mercy Health South in St. Louis, Missouri. Natalie earned a bachelor’s degree in organizational leadership from Greenville College, a bachelor of science in nursing from Chamberlain College of Nursing, a master of business administration from Webster University, and a doctor of nursing practice from Baylor University. Natalie is currently enrolled in the Johnson & Johnson Nurse Innovation Fellowship Program

Standing Strong as an Independent Health System w/ Dr. Allen Smith & Dr. Sam Ash, South Shore Health

dyllen@grippimedia.com (John Marchica) — Fri, 23 Jan 2026 11:00:00 +0000

Independent community health systems are under increasing pressure as health care continues to consolidate. What does it really take to remain independent while continuing to deliver high-quality care at scale?

Dr. Allen Smith, President & CEO, and Dr. Sam Ash, CIO of South Shore Health join Health Care Rounds host John Marchica, to discuss maintaining independence as a community health system, building connected infrastructure across care settings, and approaching technology adoption with discipline and purpose.

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🎙 ABOUT ALLEN L. SMITH, MD, MS
Allen L. Smith is President and CEO of South Shore Health. Previously Dr. Smith was President of the Brigham and Women’s Physicians Organization (BWPO), a faculty practice plan for over 1,800 physicians. Earlier in his career, Dr. Smith served as Assistant Vice President for Strategy and Business Planning at Tufts Health Plan. He began his medical career as a primary care physician at North Shore Medical Center.

Dr. Smith earned his Master of Science degree in Health Administrative Medicine and Population Health from the University of Wisconsin, Madison. He earned his Medical Degree at the University of Massachusetts Medical School. He has a BA from Dartmouth College, graduating magna cum laude.

🎙 ABOUT SAMUEL ASH, MD, MPH
Samuel Y. Ash, MD, MPH is Chief Information Officer and Vice President of Information Technology Operations and Innovation at South Shore Health, where he also practices as a critical care physician. At Tufts University School of Medicine, Dr. Ash serves as an Assistant Professor of Medicine, blending clinical expertise with leadership in health technology. His work focuses on creating innovative solutions that enhance patient safety, improve clinician experience, and advance interoperability across care settings.

Making Health Care Costs Simple and Transparent w/ Mark Cuban, Co-Founder, Cost Plus Drugs

dyllen@grippimedia.com (John Marchica) — Fri, 9 Jan 2026 11:00:00 +0000

We’re ringing in 2026 with Mark Cuban!

Prescription pricing remains one of the most opaque and frustrating parts of the health care system, leaving employers, providers, and patients struggling to understand where costs come from and who truly benefits.

Mark Cuban joins Health Care Rounds to talk about why prescription pricing became so complex, how a lack of transparency drives higher costs, and how his company Cost Plus Drugs is stripping away unnecessary layers and markups to deliver simpler, more predictable pricing built on trust.

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🎙 ABOUT MARK CUBAN
Mark Cuban is a self-made billionaire entrepreneur known for his early tech ventures like Broadcast.com, his ownership of the Dallas Mavericks, and his role as a "Shark" on ABC's Shark Tank, investing in numerous startups and expanding into media, film, and healthcare, always championing innovation and disruption.

In 2019, Mark co-founded Costplusdrugs.com with the aim of lowering generic drug prices for end consumers in the U.S., starting the company after receiving an email from a radiologist named Alex Oshmyansky, who pitched the idea of an online-based pharmacy. He often refers to Cost Plus Drugs as a critique and disruptor of the US health care system, including offering transparent, direct-to-consumer pricing and reducing the role of pharmacy benefit managers.

Mark has earned a number of accolades including being named to the Texas Business Hall of Fame, the Horatio Alger Award, the SXSW Hall of Fame, Ernst and Young Entrepreneur of the Year, and GQ Man of the Year.

Physician Leadership in a New Era of Health Care w/ Dr. Sowmya Viswanathan, Baycare

dyllen@grippimedia.com (John Marchica) — Fri, 19 Dec 2025 11:00:00 +0000

Health systems are facing unprecedented pressure as physician burnout, workforce shortages, population growth, and rapid technology adoption collide. Leaders are being asked to improve care quality, support clinicians, and transform delivery models all at once.

Dr. Sowmya Viswanathan, Chief Physician Executive at BayCare Health System, joins Health Care Rounds podcast to discuss physician engagement and burnout, BayCare’s shift toward academic medicine, how technology and AI can restore joy in practice, and why flexible physician alignment models are critical for the future of care.

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🎙 ABOUT THE DR. SOWMYA VISWANATHAN
Dr. Sowmya Viswanathan, MD, MHCM, MBA, FACP, is the chief physician executive for BayCare Health System and president of BayCare Medical Group. BayCare is one of the nation’s top-performing academic health systems, serving West Central Florida through 16 hospitals, 400+ care centers, and a network of over 6,000 physicians. Dr. Viswanathan oversees enterprise-wide clinical operations, strategy, and innovation, driving high-quality, value-based care across hospitals, ambulatory services, graduate medical education, research and digital health.

An internal medicine physician with over 20 years of clinical experience, Dr. Viswanathan has held leadership roles at major health systems including Dartmouth Hitchcock, UMass, and Tenet Health, and has taught at Harvard School of Public Health. She earned her MHCM from Harvard and is a nationally recognized speaker and mentor for emerging physician leaders. In 2025, Becker’s Hospital Review named her a “CMO to Know.”

Why Primary Care Is Under Strain w/ Dr. Greg Whisman, Chief Medical Officer, CareMore Health

dyllen@grippimedia.com (John Marchica) — Fri, 12 Dec 2025 11:00:00 +0000

Primary care sits at the center of American health care, yet clinicians face mounting burnout, shrinking margins, and a system that often rewards procedures over prevention. With physician shortages growing and patient needs rising, the future of primary care is at a crossroads.

Dr. Greg Whisman, Chief Medical Officer at CareMore Health, joins Health Care Rounds to discuss the pressures driving the primary care crisis, why reimbursement and workforce models need a reset, and how team-based care, tech enablement, and value-based strategies can restore sustainability and meaning to frontline medicine.

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🎙 ABOUT DR. GREG WHISMAN MD, MBA

Chief national clinical leader for Advance Primary Care responsible for comprehensive care delivery. Leading population health innovation over CareMore's chronic and complex patients. Oversees the Medical Services Organization including the Case Management, Medical Management and Pharmacy. Develops, implements, and directs the clinical activities that impact health care quality and cost outcomes across the continuum.

Why Health Care Reform Keeps Failing w/ Dr. David Shulkin

dyllen@grippimedia.com (John Marchica) — Fri, 28 Nov 2025 12:24:31 +0000

Behind every headline about rising premiums is a deeper truth: our health care system is structurally unsustainable.

In this episode of Health Care Rounds Podcast, former US Secretary of Veteran Affairs, Dr. David Shulkin, explains why real reform requires more than subsidies and payment tweaks. We cover everything from misaligned incentives to lessons from the VA’s population-based model and what it’ll take to actually fix U.S. health care.

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🎙 ABOUT THE DR. DAVID SHULKIN

The Honorable David J. Shulkin was nominated by President Trump to serve as the ninth Secretary of Veterans Affairs (VA) and was confirmed by the United States Senate on February 13, 2017.

Prior to his confirmation as Secretary, Dr. Shulkin served as VA’s Under Secretary for Health for 18 months, leading the Nation’s largest integrated health care system, with over 1,700 sites of care serving nearly nine million Veterans.

Before he began his service with VA, Dr. Shulkin held numerous chief executive roles at Morristown Medical Center, and the Atlantic Health System Accountable Care Organization. He also served as President and CEO of Beth Israel Medical Center in New York City.

Dr. Shulkin has held numerous physician leadership roles including Chief Medical Officer of the University of Pennsylvania Health System, Temple University Hospital, and the Medical College of Pennsylvania Hospital. He has also held academic positions including Chairman of Medicine and Vice Dean at Drexel University School of Medicine.

As an entrepreneur, Dr. Shulkin founded and served as Chairman and CEO of DoctorQuality, one of the first consumer-oriented sources of information on quality and safety in healthcare. A board-certified internist, Dr. Shulkin is also a fellow of the American College of Physicians. He received his medical degree from the Medical College of Pennsylvania, and he completed his internship at Yale University School of Medicine and a residency and fellowship in General Medicine at the University of Pittsburgh Presbyterian Medical Center. He also received advanced training in outcomes research and economics as a Robert Wood Johnson Foundation Clinical Scholar at the University of Pennsylvania.

Dr. Shulkin has been named as one of the “50 Most Influential Physician Executives in the Country” by Modern Healthcare. He has also previously been named among the “One Hundred Most Influential People in American Healthcare.” He has been married to his wife, Dr. Merle Bari, for more than 30 years. They are the parents of two grown children.

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

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The New Model for Specialty Pharmacy w/ Jigar Thakkar, PharmD

dyllen@grippimedia.com (John Marchica) — Fri, 14 Nov 2025 11:00:00 +0000

Specialty pharmacy plays a critical role in patient outcomes, but health systems often struggle to manage operations effectively while maintaining continuity of care.

In this episode of Health Care Rounds, host John Marchica talks with Jigar Thakkar, PharmD, CEO of Longitude Rx, about how his company is helping leading health systems reimagine specialty pharmacy through technology, data integration, and partnership.

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🎙 ABOUT JIGAR THAKKAR, PHARMD
Jigar is leading Longitude Rx, the first launched solution from Longitude Health. Previously, he built a $470 million specialty pharmacy at OU Health, served as Managing Director at FTI Consulting, and led engagements with health systems and Fortune 100 companies. He holds advanced degrees from Midwestern University, Dartmouth College, and Northwestern University.

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

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Making Value-Based Care Work at Scale w/ David Carmouche, MD

dyllen@grippimedia.com (John Marchica) — Fri, 31 Oct 2025 10:00:00 +0000

Across the country, health systems are chasing the promise of value-based care, but few have figured out how to make it work.

David Carmouche, MD, Executive Vice President and Chief Clinical Transformation Officer at Lumeris, joins host John Marchica to discuss what it really takes to make value-based care work at scale.

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🎙 ABOUT DAVID CARMOUCHE
David Carmouche, MD, is the Executive Vice President & Chief Clinical Transformation Officer at Lumeris. Dr. Carmouche is a visionary leader in transformational healthcare delivery, with a unique blend of provider, payer, retail, and integrated delivery network leadership experience.

Prior to joining Lumeris, Dr. Carmouche served as Walmart’s Senior Vice President of Healthcare Delivery, where he led the fleet of Walmart Health centers, Walmart Health Virtual Care, a value-based care partnership with Optum, and Walmart’s work to address Social Determinants of Health. Dr. Carmouche has also held significant leadership roles with Ochsner Health, the largest nonprofit academic healthcare system in the Gulf South, and Blue Cross Blue Shield of Louisiana, where he introduced the company’s first value-based care contracts. Earlier in his career, he built and led a multidisciplinary internal medicine and preventive cardiology practice.

Dr. Carmouche attended Tulane University and LSU Medical School in New Orleans. Board-certified in Internal Medicine, he completed his residency at the University of Alabama at Birmingham, where he later served as Chief Resident. He serves as President of the Board of the Consortium for Southeastern Healthcare Quality and on the advisory board at Stellar Health. He has served on the board of the National Association of Accountable Care Organizations.

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

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Curing Nursing Burnout Through Education w/ Dr. Adele Webb

dyllen@grippimedia.com (John Marchica) — Fri, 17 Oct 2025 10:00:00 +0000

Burnout among health care workers remains a critical issue years after the height of COVID-19.

In this episode of Health Care Rounds, Dr. Adele Webb, Executive Dean of Healthcare Initiatives at Strategic Education, Inc. shares insights from a national survey of health care workers, revealing what’s really driving nursing burnout and how education can help retain talent.

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🎙 ABOUT DR. ADELE WEBB
Adele Webb earned her Bachelor of Science in Nursing degree from the University of Akron, her Master’s in Nursing from The Ohio State University, and her Ph.D. in Nursing from Wayne State University. She began her nursing career as a NICU nurse and transitioned into the emergency room in a pediatric setting.

In the early 1990s, Adele began focusing on HIV in underdeveloped countries. Over the last 25 years, Adele’s focus has been on international nurse capacity building as it relates to both communicable and non-communicable diseases. She has received extensive funding for her international work and has published her findings in several refereed journals. She has contributed to WHO guidelines, testified to the Institute of Medicine, and given testimony to the White House on nursing workforce issues.

A sought-out speaker on international nursing care issues, Adele continues to collaborate with the World Health Organization as well as the World NCD Congress. This work has resulted in Adele’s contributions to nurse capacity building in 56 countries. In recognition of her body of work, Adele has received not only the Association of Nurses in AIDS Care Lifetime Achievement Award she has also received the Nicholas Andrew Cummings Award for Excellence in Interprofessional Practice from the National Academies of Practice. Adele is an International Council of Nurses Global Health Fellow, a Fellow in the National Academies of Practice, and a Fellow in the American Academy of Nursing.

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

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The New Rules of Health System Leadership w/ John D’Angelo, MD, FACEP

dyllen@grippimedia.com (John Marchica) — Fri, 3 Oct 2025 10:00:00 +0000

What does it take to lead 100,000 health care workers through constant disruption?

In this episode of Health Care Rounds, host John Marchica sits down with John D’Angelo, MD, FACEP, President & CEO of Northwell Health, to discuss his journey from physician to chief executive. Dr. D'Angelo shares critical lessons learned from managing COVID-19 surges, his vision for maintaining organizational culture across 100,000 employees, and where he sees the greatest opportunities in healthcare delivery.

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🎙 ABOUT JOHN D’ANGELO, MD, FACEP
A physician first and foremost, Dr. John D’Angelo leads with compassion. With over 25 years of practical experience, he continues to transform health care operations with his recent appointment as president and CEO of Northwell Health, the Northeast’s largest nonprofit health system.

Dr. D’Angelo oversees a complex network of 28 hospitals and 104,000 employees, including over 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians with an operating budget of $22.6 billion. Northwell cares for more than 3 million people annually in the New York metro area, including Long Island, the Hudson Valley, western Connecticut and beyond.

His background in emergency medicine informed his leadership in Northwell’s operational response to COVID-19, expanding his role to become the chief of integrated operations for the entire health system. He also co-led an innovative, award-winning data solution, Real-Time Actionable Data, to enhance operational visibility. Previously, he oversaw all of Northwell’s emergency departments and was instrumental in the health system’s lifesaving sepsis prevention initiatives. A Long Island native, Dr. D'Angelo received his medical degree from SUNY Stony Brook and subsequently completed a residency in emergency medicine at Geisinger Medical Center, Danville, PA. He also served as medical director to numerous EMS agencies throughout his career and served in the United States Army Reserve from 2001-2011.

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

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Fighting Back Against Insurance Denials w/ Neal Shah

dyllen@grippimedia.com (John Marchica) — Fri, 19 Sep 2025 20:57:51 +0000

Insurance denials are exploding, and they’re costing lives.

In this episode of Health Care Rounds, host John Marchica sits down with Neal Shah, CEO of CareYaya and Counterforce Health, to unpack the broken insurance system and the AI-driven surge in claim rejections. Neal shares how his personal caregiving experiences shaped his mission, why most patients never appeal, and how new tools can help level the playing field for families, physicians, and hospitals.

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🎙 ABOUT NEAL SHAH

America's Chief Elder Officer. CEO of CareYaya Health Technologies. Working hard to improve healthcare. Author of “Insured to Death: How Health Insurance Screws Over Americans - And How We Take It Back". Chairman of Counterforce Health.

After a successful career as a $250 million hedge fund manager, deeply personal caregiving experiences inspired a pivot to social entrepreneurship. Now, determined to transform care delivery through technology.

Building a rapidly-growing tech startup to expand access to affordable care. Pioneering cutting-edge AI applications to fundamentally elevate quality of life for those needing care. Motivated by creativity and humanitarian progress.

Leveraging experiences guiding multi-billion dollar investments to make an impact on improving care for our most vulnerable populations. Leading with both heart and analytical rigor. Wearing scrubs to elevate the important role of caregivers in our healthcare system.

Building unrivaled technical capabilities and strategic partnerships to establish CareYaya as America's leading launchpad for care innovation.

🎙 ABOUT HEALTH CARE ROUNDS

Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

Treating Healthcare's Misinformation Problem w/ Dr. Geeta Nayyar

dyllen@grippimedia.com (John Marchica) — Fri, 5 Sep 2025 09:00:00 +0000

Why do people trust Google and TikTok more than their doctors?

Dr. Geeta Nayyar, MD, MBA, the author of Dead Wrong: Diagnosing and Treating Healthcare's Misinformation Illness, joins the show to break down how misinformation spreads, why patient trust continues to decline, and what health leaders must do to lead the cure.

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🎙 ABOUT DR. GEETA NAYYAR
Geeta Nayyar, MD, MBA, is a globally recognized chief medical officer, technologist, and bestselling author who helps leaders leverage a human approach to innovation, including rapid advances in AI, to achieve better health and business outcomes.

A widely sought-after speaker and author of the Wall Street Journal and USA Today bestseller “Dead Wrong: Diagnosing and Treating Healthcare’s Misinformation Illness,” Dr. G has appeared on CNBC, CNN, FOX, and other prominent media outlets. She has served as chief medical officer for Salesforce and AT&T, among other executive roles. She currently serves on the board of the American Telemedicine Association and as an advisor to the American Medical Association.

A rheumatologist, Dr. G earned her medical degree at the University of Miami Miller School of Medicine, where she was admitted into an accelerated program at age 17, and her MBA at The George Washington University School of Business.

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

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The Truth About PBMs and Drug Pricing w/ Dr. Alan Pannier

dyllen@grippimedia.com (John Marchica) — Fri, 22 Aug 2025 09:00:00 +0000

Pharmacy benefit managers (PBMs) play a pivotal role in drug pricing, yet their practices often remain shrouded in a black box of rebates, spread pricing, and misaligned incentives. In this installment of our Pharma Series, Alan Pannier, Senior Vice President of Product Strategy at SmithRx, breaks down how legacy PBMs use opaque contracts and vertical integration to drive up costs, why employers are beginning to push back, and how transparent, cost-based models are reshaping the future of pharmacy benefits.

🎙 ABOUT ALAN PANNIER
Alan Pannier, Pharm D,MBA has extensive experience in the pharmaceutical industry, with a background in managed care pharmacy. Alan has held various leadership positions at companies such as SmithRx, Magellan Health, and Veridicus Health. Alan completed their Doctorate of Pharmacy and Master of Business Administration at Idaho State University, following a Bachelor of Science in Chemistry at Westminster University.

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

How Health Systems Win in Specialty Pharmacy w/ Dr. Tim Affeldt

dyllen@grippimedia.com (John Marchica) — Thu, 24 Jul 2025 10:00:00 +0000

Specialty pharmacy is big business. And while PBMs and big pharma dominate the spotlight, health systems are quietly carving out their own advantage.

In this episode of Health Care Rounds, host, John Marchica, sits down with Tim Affeldt, PharmD, Vice President, Specialty/Infusion Operations, Fairview Pharmacy Services, to unpack why health systems don’t just belong in specialty pharmacy - they may be unqiuely positioned to lead it.

From tighter care integration and faster clinical decisions to improved outcomes and patient experience, Dr. Affeldt lays out a clear case: when pharmacists are embedded in the care team, everyone benefits, except the status quo.

🎙 ABOUT DR. TIM AFFELDT
Tim Affeldt, PharmD serves as the Vice President of Specialty/Infusion Operations at Fairview Pharmacy Solutions. Dr. Affeldt is a graduate of the University of Minnesota, College of Pharmacy. He joined Fairview Pharmacy Services in September 2013. Prior to being a VP, he was the Director of Specialty/Infusion Operations. During his time with Fairview, he has provided overall strategic direction and leadership to the Specialty and Mail Order pharmacies, Infusion Center pharmacy, Home Infusion, Compounding pharmacy, Specialty Clinic and Discharge pharmacy, Facilities and Shipping/Receiving. He is a former Pharmacy Alumni Society board member, mentor to first year students and preceptor for APPE leadership rotations for the College of Pharmacy.

Dr. Affeldt has chaired and served as a member on multiple committees and is a current member of the National Home Infusion Association Board (Past Chair), the National Home Infusion Association Government Affairs Committee, the Juvenile Diabetes Research Foundation MinnDakotas Chapter Board (Board of Chancellors), the Health System Owned Specialty Pharmacy Alliance Board (Vice President) and the National Association of Specialty Pharmacy (GAC Committee).

🎙 ABOUT HEALTH CARE ROUNDS
Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

Better Health Policy Starts with Better Data w/ David C. Radley, Ph.D., M.P.H.

dyllen@grippimedia.com (John Marchica) — Thu, 5 Jun 2025 10:00:00 +0000

What happens when state health policymakers lose access to the very data they rely on?

In this episode of Health Care Rounds, John Marchica talks with David C. Radley, Ph.D., M.P.H., Director of Data and Analytics at The Center for Evidence-Based Policy and Senior Scientist at the Commonwealth Fund. They explore how states use administrative data to make informed Medicaid decisions, and why recent threats to public data infrastructure could undermine that progress.

Dr. Radley breaks down how his team turns raw data into actionable insights, how states are planning for the financial impact of high-cost therapies, and why cutting long-standing federal data sets could cripple efforts to address health disparities.

🎙 ABOUT DAVID C. RADLEY
David C. Radley is the Center’s inaugural Director of Data and Analytics. Dr. Radley has 18 years of experience in health policy evaluation, quality and performance measurement, and in public reporting and visualization of healthcare data. Prior to joining the Center, David served as scientific lead for the Commonwealth Fund’s Health System Performance Tracking initiative, where he was responsible for defining national, state, and sub-state performance evaluations; measure selection and development; procuring and analyzing relevant data; and curating performance information for visualization and public reporting. He has authored over 50 articles, issue briefs, and technical reports focusing on access to care, healthcare affordability, healthcare quality, health equity, and population health outcomes. Dr. Radley received his PhD in Health Policy from the Dartmouth Institute for Health Policy and Clinical Practice and M.P.H. from Yale University. As Director of Data and Analytics, Dr. Radley will direct data related research and build the Center’s capacity to meet the growing data needs of states.

Building Sustainable Primary Care for Seniors w/ Tom Yackel, MD, MPH, MS, MBA

dyllen@grippimedia.com (John Marchica) — Thu, 8 May 2025 10:00:00 +0000

Value-based care isn’t a new idea—but making it work in today’s fragmented system is anything but simple. In this episode of Health Care Rounds, John Marchica talks with Dr. Tom Yackel, Chief Clinical Excellence Officer at CenterWell Senior Primary Care, about what it really takes to deliver high-quality, cost-effective care to Medicare patients.

Dr. Yackel shares insights from his decades-long career in primary care, informatics, and practice leadership, explaining how CenterWell is scaling value-based care models in communities that need it most. From the business realities of Medicare Advantage to why primary care must be run like a business, not a charity, this is a frank and timely conversation about the future of senior care.

🎙 ABOUT TOM YACKEL, MD, MPH, MS, MBA

Dr. Tom Yackel is a seasoned physician executive with a distinguished career in clinical informatics, graduate medical education, and health system leadership. He currently serves as the Chief Clinical Excellence Officer for Humana’s Primary Care Organization, which includes CenterWell and Conviva Senior Primary Care, which together make up the largest senior-focused primary care group in the United States. The organization delivers comprehensive, team-based care to older adults through a value-based model that strives for patient-centered, quality outcomes for Original Medicare and Medicare Advantage populations across the country.

In his role at CenterWell, Dr. Yackel leads initiatives to advance evidence-based care, specialty programs, clinical education, informatics, and clinical governance. He brings deep expertise in healthcare operations, quality improvement, and health information technology, with board certifications in internal medicine and clinical informatics.

Dr. Yackel has been a strong advocate for graduate medical education and workforce development, particularly in clinical informatics. He played a key role in the early establishment of ACGME-accredited clinical informatics fellowships, contributing to one of the first accredited programs in the country. His work has helped shape medical informatics education and training, ensuring a pipeline of physician leaders proficient in health IT, data-driven care models, and digital transformation.

Prior to joining CenterWell, Dr. Yackel was President of MCV Physicians and Senior Associate Dean for Clinical Affairs at Virginia Commonwealth University (VCU), overseeing clinical strategy and faculty practice operations. He also served as Chief Health Information Officer and Value-Based Care Officer at Oregon Health & Science University (OHSU), leading enterprise-wide initiatives in health system performance, digital transformation, and value-based care. He has also chaired the American Hospital Association’s Committee on Clinical Leadership, shaping policies and strategies to improve health system/faculty relationships and patient outcomes.

Dr. Yackel earned his medical and public health degrees from George Washington University and holds additional qualifications in medical informatics and business from OHSU. He is a recognized thought leader in electronic health records, value-based care, and clinical leadership, frequently sharing insights through publications and national presentations.

🎙 ABOUT HEALTH CARE ROUNDS

How Patient-Reported Outcomes Create Value and Improve Health w/ Trafford Crump, Ph.D

dyllen@grippimedia.com (John Marchica) — Thu, 1 May 2025 10:00:00 +0000

Value-based care is more than just a buzzword - it’s a fundamental shift in how we measure success in health care. In this episode of Health Care Rounds, John Marchica sits down with Dr. Trafford Crump, Associate Professor at McGill University, to discuss how patient-reported outcomes (PROs) can help us better understand the value of care from the patient’s perspective. Trafford explains where PROs fit into clinical trials, delivery systems, and the broader goals of value-based care and why measuring what actually matters to patients is harder (and more important) than it looks.

🎙ABOUT DR. TRAFFORD CRUMPP

Dr. Trafford Crump is an associate professor and holds the Jarislowsky Foundation Chair in Thoracic Surgery at McGill University’s Faculty of Medicine and Health Sciences. He is a health services researcher with a focus on surgery and surgical oncology. He leads a research program focused on improving patient-centeredness and the value of surgical care. Through this program, he has developed an expertise in the collection, analyses, and interpretation of patient-reported end points, including treatment preferences, outcomes, and experiences. Dr. Crump trained at the Centre for Health Services and Policy Research at the University of British Columbia and received a Ph.D. in the evaluative clinical sciences from Dartmouth College.

🎙ABOUT HEALTH CARE ROUNDS

Pharmacy as a Strategic Asset in Health Systems w/ Dr. Tyson Frodin, AVP of Pharmacy, MultiCare

dyllen@grippimedia.com (John Marchica) — Thu, 3 Apr 2025 04:00:00 +0000

In another installment of our Pharma Series, we're joined by Dr. Tyson Frodin, Assistant Vice President of Pharmacy at MultiCare, to explore the evolving role of pharmacy in health care. Tyson shares insights from his diverse career path - from his early experience in telehealth on a Navajo reservation, to leading pharmacy initiatives at a top health system in the Pacific Northwest. They dive into the challenges of critical access hospitals, the importance of innovation in pharmacy, and how MultiCare is leveraging technology to improve patient care.

🎙 ABOUT DR. TYSON FRODIN

Dr. Tyson Frodin is a results-driven pharmacy executive with over 15 years of experience leading large-scale transformations in pharmacy operations, supply chain, revenue cycle, and technology. As the Assistant Vice President of Clinical Pharmacy Services, Pharmacy Supply Chain, Revenue Cycle, and Technology at MultiCare Health System, he oversees a $360 million drug spend and $1 billion in revenue, driving enterprise-wide efficiencies, cost savings, and high-quality patient care.

A proven innovator in pharmacy technology, regulatory compliance, and 340B program management, Tyson has successfully centralized supply chain operations, optimized drug utilization, and led strategic partnerships—most notably securing over$1.75 million in savings through a collaboration with Mark Cuban’s Cost Plus Drugs. His leadership extends to implementing advanced data analytics, negotiating direct manufacturer contracts, and improving financial sustainability through revenue cycle enhancements.

Tyson holds a Doctorate of Pharmacy from Idaho State University and a Master of Health Care Administration from the University of Minnesota School of Public Health. He is a Fellow of the American College of Healthcare Executives (FACHE) and a Certified Pharmacy Executive Leader (CPEL). Passionate about innovation, collaboration, and strategic leadership, he is dedicated to advancing pharmacy practice and shaping the future of healthcare.

🎙 ABOUT HEALTH CARE ROUNDS Health Care Rounds is a weekly podcast developed for health care leaders who are at the forefront of health care delivery and payment reform. Join Darwin Research Group founder and CEO John Marchica as he discusses the latest advancements in health care business news and policy developments.

The Hidden Cost of Health Care Data Silos w/ Jason Bryll, Principal, Parable Associates

dyllen@grippimedia.com (John Marchica) — Tue, 25 Mar 2025 04:00:00 +0000

In this episode of Health Care Rounds, Host John Marchica sits down with Jason Bryll, Principal at Parable Associates, to unpack why health care organizations struggle with managing financial and patient data. They discuss the challenges of revenue cycle management, the headache of disconnected systems, and how better data practices can lead to better care. Jason also breaks down where AI and automation can help - and where they fall short.

🎙 ABOUT JASON BRYLL
Jason has specialized in the health care industry for over a decade with his core focus on Revenue Cycle performance improvement, Information Systems, and Business Intelligence reporting. Over this time, he has served clients operating in specialties such as Behavioral Health, Dermatology, ENT, Orthopedics, large multi-specialty physician practices, Home Health, and large acute care facilities. Jason has an intricate understanding of the information management challenges the industry faces. He uses his background in Revenue Cycle operations, Information Technology, and Finance to bridge the communication gaps that often exist between departments.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS
John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a strategic consulting and market intelligence firm focused on hospitals, health systems, physician groups, and the evolving health care ecosystem. John has a degree in economics from Knox College, an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is an active member of the American College of Healthcare Executives and is pursuing certification as a Fellow.

The Intersection of Pharma, Business and Patient Care w/ Jon Brown, MHA, DPLA

dyllen@grippimedia.com (John Marchica) — Thu, 6 Mar 2025 11:00:00 +0000

In another installment of our Pharma Series, we sit down with Jon Brown, MHA, DPLA, Director of Pharmacy-System Operations and Logistics at IU Health, to explore how his team is transforming pharmacy services. From launching one of the most advanced centralized pharmacy facilities in the country to navigating drug shortages and cutting costs, Jon shares how IU Health is rethinking the role of pharmacy in patient care.

We discuss:

✅ The shift from pharmacy as a cost center to a value driver

✅ How centralized operations improve efficiency and safety

✅ The role of automation and technology in modern pharmacy

✅ Why collaboration between health systems and pharma companies needs to evolve

🎙 ABOUT JON BROWN, MHA, DPLA
Jon Brown MHA, DPLA is the Director of Pharmacy-System Operations and Logistics at IU Health He has his Master’s in Healthcare Administration from Simmons University and a Diplomate from the Pharmacy Leadership Academy (ASHP) and is a proud Butler University Bulldog where he received his PharmD and is currently an Adjunct Associate.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:
John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a strategic consulting and market intelligence firm focused on hospitals, health systems, physician groups, and the evolving health care ecosystem. John has a degree in economics from Knox College, an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is an active member of the American College of Healthcare Executives and is pursuing certification as a Fellow.

HCR Matt Porch Encore

dyllen@grippimedia.com (John Marchica) — Thu, 20 Feb 2025 11:00:00 +0000

In this encore episode of Health Care Rounds, Matt Portch, Consultant at MPC&R LLC, joins host John Marchica to explore the evolving collaboration between pharmaceutical companies and Integrated Delivery Networks (IDNs).

Additionally, Matt sheds light on how both have adapted to new technologies and market shifts.

Matt is a seasoned pharmaceutical executive with successful leadership experience at Sunovion Pharmaceuticals, Pfizer, and Bristol Myers Squibb.

TOPICS

(0:19) Introduction

(0:45) Meet John Driscoll

(2:40) The Future of Pharma

(8:28) How Pharmacies Can Put Patients First

(12:25) Key Trends in Primary Care

(15:16) The Challenges of Improving Quality Patient Care

(19:25) Incoming Health Care Policy

(25:48) The Impact of RFK and Trump's Nominees on Health Care

(30:12) Where AI Can Have the Biggest Impact on Health Care

(33:04) Increasing Efficiency with AI

(35:04) John Driscoll's New Book: Pay the People

(37:29) The Importance of Paying Workers a Living Wage

🎙 ABOUT HEALTH CARE ROUNDS

🎙 ABOUT MATT PORTCH

Matt Portch is a seasoned professional in the life sciences sector, currently serving as an independent consultant specializing in supporting clients within the industry. With a focus on fostering B2B relationships with Organized Customers and Payers, Matt collaborates closely with market and portfolio teams to bolster Key Account Management capabilities.

Prior to his consultancy role, Matt held notable leadership positions at renowned pharmaceutical companies including Sunovion Pharmaceuticals, Pfizer, and Bristol Myers Squibb. His tenure in these organizations provided him with extensive experience in strategic management, business development, and enhancing operational efficiency within the life sciences domain.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a strategic consulting and market intelligence firm focused on hospitals, health systems, physician groups, and the evolving health care ecosystem. John has a degree in economics from Knox College, an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is an active member of the American College of Healthcare Executives and is pursuing certification as a Fellow.

2025 Health Care Trends and Policy Predictions with John Driscoll

dyllen@grippimedia.com (John Marchica) — Tue, 4 Feb 2025 05:00:00 +0000

What does it take to transform health care and address its most pressing challenges? Few individuals are as uniquely positioned to answer as John Driscoll. With a storied career as an author, chairman, investor, CEO, and host of the CareTalk podcast, John has had an impact on nearly every facet of the health care industry.

Drawing from decades of leadership, John joins Health Care Rounds to share his thoughts on prescription drug pricing models, health care policies under Trump 2.0, the areas of health care ripe for AI disruption and much more.

TOPICS

(0:19) Introduction

(0:45) Meet John Driscoll

(2:40) The Future of Pharma

(8:28) How Pharmacies Can Put Patients First

(12:25) Key Trends in Primary Care

(15:16) The Challenges of Improving Quality Patient Care

(19:25) Incoming Health Care Policy

(25:48) The Impact of RFK and Trump's Nominees on Health Care

(30:12) Where AI Can Have the Biggest Impact on Health Care

(33:04) Increasing Efficiency with AI

(35:04) John Driscoll's New Book: Pay the People

(37:29) The Importance of Paying Workers a Living Wage

🎙 ABOUT HEALTH CARE ROUNDS

🎙 ABOUT JOHN DRISCOLL

John Driscoll, Chairman at Waystar, is a seasoned healthcare executive with a distinguished career. He has served as President, U.S. Healthcare and EVP of Walgreens Boots Alliance, CEO of CareCentrix, President of Castlight Health, and Group President for new markets at Medco, where he played a key role in its spin-off from Merck and its recognition as Fortune's most admired healthcare services company. As founder and chair of the Surescripts ePrescribing Network, John has been a pioneer in healthcare innovation. He has also advised Oak Investment Partners, held senior roles at Oxford Health Plans, and participated in the White House’s Entrepreneurs in Residence program, advising the FDA on innovation pathways. John is also the co-host of the successful healthcare podcast, CareTalk.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Expanding Health Care Access with Portable Care Solutions w/ OnMed CEO Karthik Ganesh

dyllen@grippimedia.com (John Marchica) — Thu, 23 Jan 2025 05:00:00 +0000

Health care access, especially rural health care, has long been defined by systemic challenges, including limited access to specialists, provider shortages, and geographic barriers hindering patient care.

These obstacles continue to strain health systems and impact outcomes in underserved communities.

But what if new technologies could address these challenges by combining the convenience of telemedicine with the familiarity and comfort of an in-person doctor’s office?

In this episode of Health Care Rounds, Karthik Ganesh, CEO of OnMed, shares insights on how their OnMed Care Stations transform health care access and deploy tech-enable hybrid care to underserved communities nationwide.

TOPICS

(0:50) Introduction

(1:33) Karthik Ganesh: Background and Transition to OnMed

(6:02) Lessons Learned in Health Care

(11:39) Navigating the Complexity of Health Care

(14:00) Obstacles in Rural Health Care

(23:50) Why Health Care Issues Differ from Other Industries

(27:16) Exploring OnMed Care Stations

(34:35) OnMed's B2B Growth Strategy

(38:23) Expanding Access and Collaborating with IDNs

(42:18) Conclusion

🎙 ABOUT HEALTH CARE ROUNDS

🎙 ABOUT KARTHIK GANESH

Karthik Ganesh is an accomplished leader in tech-enabled healthcare services, renowned for building and transforming companies, driving market-leading results, and creating significant value through strategic M&A transactions. As CEO of OnMed, a hybrid care company, he is dedicated to reimagining healthcare access and improving health equity in underserved communities across the U.S. Previously, Karthik served as CEO of EmpiRx Health, SVP at CareAllies, and COO of QualCare, where he led successful transformations and strategic growth initiatives.

🎙 ABOUT ONMED

OnMed is revolutionizing healthcare with state-of-the-art telemedicine technology, providing a seamless and accessible solution for patients to connect with healthcare professionals. By combining innovative OnMed Care Stations with cutting-edge video and diagnostic tools, OnMed ensures high-quality, convenient care anytime, anywhere. Dedicated to improving access and addressing the evolving needs of modern healthcare, OnMed is setting a new standard in telemedicine.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Increasing Transparency with Cost-Plus Drug Pricing w/ MakoRx Founder Vinay Patel

dyllen@grippimedia.com (John Marchica) — Thu, 16 Jan 2025 05:00:00 +0000

Every year, medication prices keep going up, putting even more strain on Americans’ budgets.

To make it worse, the price you see online often doesn’t match what you’re charged at the pharmacy counter.

So why the lack of transparency?

And equally important, what can be done to ease the pressure of these rising costs?

Join Vinay Patel, founder of MakoRx, as he unpacks the complexities of prescription drug pricing and reveals how MakoRx is disrupting traditional models with cost-plus pricing to make medications more affordable and accessible for everyone.

This episode is part of our Pharma Series, an ongoing collection of episodes featuring interviews with the leaders and innovators who are reshaping the future of the pharmaceutical industry.

TOPICS:

(0:15) Intro

(1:17) What Got Vinay Patel Into the Industry

(4:00) Understanding Drug Pricing Models

(11:01) What Is a Limited Distribution Network?

(13:46) What Is Distribution Direct?

(15:21) Looking at the Supply Side of Pharmaceuticals

(19:34) Structuring Pharmacy Benefits

(26:00) The Difference Between Fixed Dollar Rebates and Percentages

(31:14) What Role Do Generic Companies Have in Product Use?

(37:24) Moment-to-Moment Drug Pricing and Buying

(39:07) How MakoRx Is Tackling Drug Pricing Issues

(42:44) The Argument for Giving Drug Cost Transparency

(47:19) What Is MakoRx's Value Proposition?

(50:12) What's Behind the Drive for Pharmacy Innovation?

(54:54) How Pharmacies Will Change in 2025

🎙 ABOUT HEALTH CARE ROUNDS

🎙ABOUT VINAY PATEL

Vinay Patel, the founder of MakoRx and a pharmacist executive with 16 years of experience has been a driving force in advancing population health, community pharmacy, and pharmacy benefits, positively impacting chronic care for thousands of patients. Clinically, he has managed chronic diseases in primary care settings, optimized diabetes care, and supported geriatric medication management. As a leader, he has spearheaded Medicaid asthma programs and initiatives that saved physician hours while generating revenue. Passionate about teaching and innovation, Vinay fosters growth within healthcare teams, enhancing their efficiency and improving patient outcomes.

🎙ABOUT MAKORX

MakoRx provides accessible, affordable healthcare solutions through innovative pharmacy services, including cost-plus drug pricing, subscription health plans, and in-pharmacy urgent care and testing. Their model challenges traditional healthcare by offering both individual and employer-focused options that enhance patient quality of life while optimizing healthcare costs. Committed to advocacy, MakoRx ensures patients have access to knowledgeable pharmacists and technicians who offer guidance on medication plans and cost-saving alternatives.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Empowering In-home Care With Private-Duty Nursing, with Jasmine Bhatti

dyllen@grippimedia.com (John Marchica) — Thu, 21 Nov 2024 05:00:00 +0000

Value-based care has rapidly gained momentum in recent years, but challenges persist — particularly when care is delivered in the home. Our guest, Jasmine Bhatti, Founder and CEO of Navi Nurses, explains how private-duty nursing can deliver better clinical and financial outcomes for providers while offering compassionate at-home care to patients in need.

TOPICS

(0:20) Introduction

(1:05) What Led Jasmine Bhatti to Healthcare

(4:00) Going from Nurse to Business Owner

(7:58) Looking at the Success of Care Transitions

(12:38) The Difference in Home Care Coverage

(15:40) The Complexities of Home Care

(18:54) The Cost Equation for PRNs

(23:43) How to Prevent Readmissions

(25:12) Do Health Systems Understand Home Care?

(28:40) How Can Home Care Generate a Profit?

(31:09) Real-World Benefits of Navi Nurses

(36:00) The Future of Home Health Care

🎙 ABOUT HEALTH CARE ROUNDS

🎙ABOUT JASMINE BHATTI

Jasmine, a Registered Nurse (RN), founded Navi Nurses to transform healthcare for Arizonans by providing personalized, in-home medical care through a team of skilled RNs. Driven by a mission to “help nurses rediscover their joy,” she understands how empowered nurses enhance patient outcomes and family peace of mind. Her inspiration to become an RN came from her own family caregiving experience, where she identified critical gaps in care during hospital-to-home transitions and long-term health management. Previously, she worked with neurology, plastics, and ENT patients at Barrow Neurological Institute and Mayo Clinic. Now pursuing her doctorate at Arizona State University, Jasmine leads Navi Nurses with a commitment to a new standard of care focused on empowerment, engagement, and education.

🎙ABOUT NAVI NURSES

Navi Nurses is an Arizona-based private-duty nursing service focused on delivering personalized, in-home care through a team of experienced RNs. They prioritize compassionate, relationship-driven healthcare that respects each client’s unique needs. Using a self-pay model, Navi Nurses offers flexible, culturally sensitive, and high-quality medical support without insurance limitations. Their approach emphasizes patient and family empowerment, active engagement, and comprehensive education to ensure a trusted, holistic care experience.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Advancing Health Care Policies to Meet People's Needs w/ Natalie Davis

dyllen@grippimedia.com (John Marchica) — Thu, 7 Nov 2024 05:00:00 +0000

It’s no secret that the health care for millions of Americans isn’t working, with many in dire need of immediate action.

The demand for bipartisan solutions, new policies, and technological advancements for the health care system has never been greater.

Our guest, Natalie Davis, co-founder and CEO of United States of Care, joins us to share her thoughts on the current state of health care, AI’s growing role in it, and how she’s advocating for policy changes that could shape the future of health.

TOPICS

(0:16) Intro

(1:07) How Natalie Davis Got Started in Health Care

(3:25) The Origins of United States of Care

(8:00) Where Can We Find Common Ground in Health Care?

(14:34) Where Do Policymakers Stand on Medicare for All?

(19:00) Are People Paying Attention to Health Care in This Election?

(21:08) Is United States of Care an Advocacy Organization?

(21:54) United States of Care's Biggest Policy Wins

(23:17) How AI Relates to Health Care Advocacy

(25:25) How Do Patients Feel About AI?

(30:57) The Current State of Value-Based Care

(39:38) The Complicated Nature of Universal Health Care

🎙 ABOUT HEALTH CARE ROUNDS

🎙ABOUT NATALIE DAVIS

Natalie Davis has spent nearly two decades shaping American healthcare policy, working to ensure that all people have access to affordable, quality care. In 2018, she co-founded United States of Care with Andy Slavitt, focusing on a person-centered approach to healthcare solutions and forging partnerships with organizations, advocacy groups, and communities to drive systemic change.

Her prior roles include serving as Senior Advisor at CMS, where she supported a major healthcare expansion, and as Director at the Bipartisan Policy Center, launching reform initiatives to develop innovative, politically viable healthcare solutions.

🎙ABOUT UNITED STATES OF CARE

United States of Care is a non-profit organization focused on building a healthcare system that serves everyone. Their mission is to ensure people have access to affordable, quality care that meets their needs regardless of their background or circumstances. Working with leaders, communities, and individuals across the country, they focus on developing innovative, non-partisan solutions to healthcare challenges, emphasizing policy, patient experience, and health equity.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Easing Cancer Treatment with Personalized Nutrition with Dr. Erika Ebbel Angle

dyllen@grippimedia.com (John Marchica) — Thu, 24 Oct 2024 10:00:00 +0000

Fact: 80 percent of cancer patients face significant side effects throughout their treatment, potentially worsening outcomes and making a difficult journey even more challenging for patients fighting for their lives.

In this episode, we’re joined by Dr. Erika Ebbel Angle, CEO of Ixcela, to discuss her personalized approach to improving cancer patient treatment outcomes by prioritizing gut health, nutritional therapy, and lifestyle adjustments.

🎙 ABOUT HEALTH CARE ROUNDS

🎙 ABOUT ERIKA EBBEL ANGLE

Dr. Erika Ebbel Angle, CEO and co-founder of Ixcela, earned her Ph.D. in Biochemistry from Boston University and a B.S. from MIT. In 2002, she founded Science from Scientists, a nonprofit improving STEM education for children. She has received numerous accolades, including Boston University’s Young Alumni Award, Boston Business Journal's 40 Under 40, and L’Oreal’s Woman of Worth. She serves on MIT’s visiting committee and is a STEM speaker for the U.S. Department of State, also hosting educational TV shows for kids.

🎙 ABOUT IXCELA

Ixcela is a health company focused on restoring internal balance and improving gut microbiome health. Using a simple pinprick blood test, Ixcela analyzes key small-molecule metabolites linked to gut health, identifying imbalances that may lead to chronic conditions like Alzheimer's, diabetes, and digestive issues. Their personalized approach includes proprietary supplements, nutrition, and fitness plans to restore optimal health. Co-founded by Dr. Erika Ebbel Angle and Dr. Wayne Matson, Ixcela combines cutting-edge technology with individualized therapy to support better overall wellness through gut microbiome regulation.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Achieving Health Equity Through All-Payer Models with Dr. Trudy Hall

dyllen@grippimedia.com (John Marchica) — Thu, 10 Oct 2024 10:00:00 +0000

Tackling rising healthcare costs while improving quality is no small task, and many states are left struggling.

But one state might have the solution.

In this episode, we explore Maryland’s All-Payer system with Dr. Trudy Hall, Vice President of Medical Affairs and Chief Medical Officer at TidalHealth, discussing how this innovative approach is changing the game by streamlining healthcare costs while keeping patient care at the forefront.

🎙 ABOUT DR. TRUDY HALL

Dr. Trudy R. Hall has been the Vice President of Medical Affairs and Chief Medical Officer at TidalHealth since July 2022. She previously served in leadership roles at the University of Maryland's Capital Region Health and other UM health centers, overseeing major facilities, including a 345-bed COVID care site during the pandemic. With over 20 years of healthcare leadership experience, Dr. Hall has held various medical directorships, contributed to Maryland's health policy, and led initiatives like the Quality-Based Reimbursement program. She is board-certified in Physical Medicine and Rehabilitation.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Repairing Fragmented Care with Value-Based Strategies with Dr. Kamal Golla

dyllen@grippimedia.com (John Marchica) — Thu, 19 Sep 2024 16:06:23 +0000

While demand for specialty care has never been higher, this demand hasn't resulted in better coordination among PCPs.

Can value-based care bridge the gap? Our guest Dr. Kamal Golla thinks so.

In this episode explore the importance of value-based care and how it can create exceptional patient experiences and better outcomes.

🎙 ABOUT DR VISHNUKAMAL GOLLA

Dr. Vishnukamal Golla is the medical director for value transformation at Evolent, a specialty and primary care management company. In this role, Dr. Golla leads the implementation of innovative value-based care models in specialty care. In helping Evolent manage approximately $1 billion of risk-based oncology and cardiology spend, Dr. Golla oversees the development of alternative payment models, prioritizing exceptional patient outcomes through innovative strategies and cost-effective treatment pathways.

Dr. Golla’s research interests include the development and integration of value-based care models, methods of supporting healthcare transformation initiatives at both the state and national level, and the impact of financial toxicity in vulnerable patient populations and caregivers. Past research includes the development of business and policy recommendations to improve specialist engagement with primary care physicians, including design of the specialty strategy for the recently released CMS Innovation Center model called Making Care Primary. Dr. Golla has served as a consultant for the Healthcare Transformation Task force and is also a frequent speaker at value-based care conferences such as the Association for Value-Based Cancer Care to help drive policy recommendations on alternative payment models and specialty alignment.

Dr. Golla received his medical degree and Master of Public Health from the University of Texas Medical School and completed his urologic surgery residency at the University of California, Los Angeles. He completed an advanced fellowship in the Duke University National Clinician Scholars Program, one of the premier health services research and public policy programs in the country. He is also a board-certified and practicing urologist with a deep expertise in urologic oncology, integrating evidence-based practices with value-based care in order to improve care accessibility and quality for all. Dr. Golla maintains a faculty appointment at the Duke University School of Medicine and the Duke Margolis Center for Health Policy.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Advancing Medicine With Placenta-Derived Cells with Dr. Robert Hariri

dyllen@grippimedia.com (John Marchica) — Thu, 15 Aug 2024 10:00:00 +0000

Join us as we delve into the groundbreaking world of cellular therapies with Dr. Robert Hariri, CEO of Celularity.

In this episode, Dr. Hariri takes us on a journey through the cutting-edge innovations that are reshaping the future of medicine.

Discover how harnessing the power of the body’s own cells is not just a promise for the future, but a reality today—transforming hope into tangible results across a wide spectrum of diseases. Don’t miss this insightful conversation on the therapies that are revolutionizing healthcare.

🎙ABOUT DR. ROBERT HARIRI:

Dr. Bob Hariri is a pioneering surgeon, biomedical scientist, and serial entrepreneur with expertise in biomedicine and aerospace. He is the founder, chairperson, and CEO of Celularity, Inc., a leader in human cellular therapeutics, and previously founded Anthrogenesis Corporation, which was acquired by Celgene, where he served as CEO of Celgene Cellular Therapeutics.

He also co-founded Human Longevity, Inc. Dr. Hariri is renowned for pioneering the use of stem cells in treating life-threatening diseases, including the discovery of pluripotent stem cells from the human placenta. His innovations have led to over 170 patents and numerous accolades, including the Pontifical Medal for Innovation and the Thomas Alva Edison Award.

He is an Adjunct Professor of Neurosurgery at Weill Cornell Medical College and serves on various prestigious boards, including the Liberty Science Center and the X PRIZE Foundation. Beyond his medical and scientific contributions, Dr. Hariri is an accomplished jet-rated pilot and film producer.

🎙 ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS:

Driving Better Outcomes with Ambulatory Surgical Centers

dyllen@grippimedia.com (John Marchica) — Thu, 8 Aug 2024 10:00:00 +0000

Ambulatory Surgery Centers (ASC) specialize in providing surgical, diagnostic, and preventive procedures without lengthy and costly hospital stays.

As the demand for convenient, accessible, and affordable care grows, ASCs have become an increasingly popular alternative.

Joins us as Aric Burke, President and CEO of Atlas Healthcare Partners explores ASCs' role in everything from lowering out-of-pocket expenses and reducing the surgical burden on hospitals to expanding care access and creating jobs.

ABOUT ARIC BURKE

Aric brings over eighteen years of experience in ASC consulting, development, and operations. He oversees the strategic vision, operational management, and organizational structure of Atlas, driving its profitability and strategic direction. Before founding Atlas, Aric was the West Market President for United Surgical Partners International (USPI), the leading ASC management company in the industry. In this role, he managed the development and operations across USPI’s Western markets.

During his five-year tenure, Aric expanded the West Market to include over 30 ASCs and three surgical hospitals, which collectively handled more than 150,000 cases annually and generated over $450M in net revenue and $90M in EBITDA, employing over 2,500 staff. He also collaborated with major not-for-profit health systems, such as Dignity Health in Phoenix and Las Vegas, Centura Health in Denver, and Carondelet Health in Tucson, to develop their ASC networks.

ABOUT ATLAS HEALTHCARE PARTNERS

Founded in 2018 to address the rising need for ASC strategy and development in the nonprofit sector, Atlas has rapidly become one of the fastest-growing ASC management companies in the U.S. They were recognized on the Inc. 5000 list of Fastest Growing Private Companies in 2022 and 2023. Since partnering with Banner Health in 2019 to develop and manage its ASC operations, we have expanded to 32 ASCs, employing over 1,100 team members and handling 250,000 cases annually. Leading health systems have invested in Atlas, offering a chance to diversify revenue models beyond traditional regional care.

With an estimated $90 billion expected to shift from inpatient and HOPD to the ASC market by the end of 2024, they provide the infrastructure and expertise necessary to develop, manage, and scale ASC networks to capitalize on this significant industry shift.

ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS

Working with IDNs: The Pharma Perspective

dyllen@grippimedia.com (John Marchica) — Thu, 20 Jun 2024 10:00:00 +0000

In this episode of Health Care Rounds, Matt Portch, Consultant at MPC&R LLC, joins host John Marchica to explore the evolving collaboration between pharmaceutical companies and Integrated Delivery Networks (IDNs).

Additionally, Matt sheds light on how both have adapted to new technologies and market shifts.

Matt is a seasoned pharmaceutical executive with successful leadership experience at Sunovion Pharmaceuticals, Pfizer, and Bristol Myers Squibb.

ABOUT HEALTH CARE ROUNDS

ABOUT MATT PORTCH

ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS

Why Accountable Care Models Are So Important w/ Bill Lane

dyllen@grippimedia.com (Bill Lane, John Marchica) — Thu, 9 May 2024 10:00:00 +0000

Having equal access to quality health care across the United States shouldn't be a privilege, but a reality. Yet, seniors battling multiple chronic conditions often face disparities. The challenges are significant, from struggling to reach appointments to affording basic needs.

Enter Accountable Care Organizations (ACOs). Are they the answer to improving coordinated care and reducing costs for seniors?

In this episode of Health Care Rounds, Bill Lane joins John to explore how Accountable Care Organizations (ACOs) are transforming health care delivery, particularly for seniors.

ABOUT HEALTH CARE ROUNDS

ABOUT BILL LANE

Bill is ilumed’s Executive Vice President of Network Development, leading the ACO REACH’s contracted provider and beneficiary growth over 200% from 2022 to 2024. Prior to ilumed, he spent over 15 years with Humana and held leadership roles in hospital/hospital system contracting, alternative payment model creation and deployment, including the nationwide lead for Humana’s adoption of CMS’ Primary Care First model. Before Humana, Bill was with the national PPO, MultiPlan for over ten years, where he held progressively responsible network leadership roles in the southeast.

Bill and his wife of 32 years, Kathy, live in south Florida, where he enjoys golf most of the time and looks forward to welcoming his three grown children home as much as possible.

ABOUT JOHN MARCHICA, HOST OF HEALTH CARE ROUNDS

John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a strategic consulting and market intelligence firm focused on hospitals, health systems, physician groups, and the evolving health care ecosystem. John has a degree in economics from Knox College, an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is an active member of the American College of Health care Executives and is pursuing certification as a Fellow.

How AI is Reshaping the Future of Medicine w/ Dr. Robert Pearl

dyllen@grippimedia.com (Dr. Robert Pearl, John Marchica) — Thu, 18 Apr 2024 10:00:00 +0000

Enjoyed this episode? You might also like "An Honest Conversation on the State of Current Medicine with Dr. Robert Pearl"

Revolutionizing Pharmacy Care w/ Alison Lum

dyllen@grippimedia.com (Alison Lum, John Marchica) — Thu, 4 Apr 2024 10:00:00 +0000

Topics:

(11:00) Pharmacy benefit management basics

(15:28) Rebates and pricing benchmarks

(18:34) Blue Shield of California’s pharmacy care reimagined initiative

(21:25) Capturing real-world evidence to asses new medications

(23:52) Transforming the pharmacy benefits industry with partnerships and alliances

(29:32) Baseline drug prices and innovative contracting approaches

(33:52) Shifting to a value-based model to make drug pricing more cost-effective

(37:13) The need for systemic change and holistic health in the pharmacy benefit industry

Podcast #164: Insights into Sepsis Management with Dr. Robert Scoggins

dyllen@grippimedia.com (John Marchica) — Sun, 11 Feb 2024 07:00:00 +0000

Dr. Robert Scoggins, Chief Medical Officer, Cytovale

Robert Scoggins, MD, PhD is a seasoned pulmonary and critical care physician and the Chief Medical Officer (CMO) at Cytovale. He began his career in science with an undergraduate degree in Molecular Biology from Vanderbilt University and completed a PhD in Microbiology at the University of Virginia as part of a combined MD, and PhD program. Dr. Scoggins completed his residency in Internal Medicine and fellowship in Pulmonary and Critical Care at Vanderbilt University. Over the last 15 years, he has held a variety of clinical and leadership positions within several health systems across the country, including Chief of Staff and ICU Medical Director at Kootenai Health where he served on the frontlines during the height of the COVID-19 pandemic. As CMO at Cytovale, Dr. Scoggins combines his science, clinical, and hospital organizational skills to oversee Cytovale’s development and commercialization of host response technologies to improve care and outcomes of patients with sepsis.

John Marchica, CEO, Darwin Research Group

John Marchica is a veteran health care strategist and CEO of Darwin Research Group. He is leading ongoing, in-depth research initiatives on integrated health systems, accountable care organizations, and value-based care models. He is a faculty associate in the W.P. Carey School of Business and the graduate College of Health Solutions at Arizona State University.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is an active member of the American College of Healthcare Executives and is pursuing certification as a Fellow.

About Darwin Research Group

Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

Podcast #163: Navigating Leadership Polarities to Foster a Resilient Work Environment with Dr. Tracy Christopherson and Michelle Troseth

dyllen@grippimedia.com (John Marchica) — Mon, 5 Feb 2024 12:15:09 +0000

Dr. Tracy Christopherson and Michelle Troseth, Co-Founders of MissingLogic®

Dr. Tracy Christopherson and Michelle Troseth are co-founders of MissingLogic®. The core of their work is to help leaders to overcome leadership norms that cause suffering, achieve work life balance, create healthy work cultures and environments by leveraging Polarity IntelligenceTM.

Tracy and Michelle are co-authors of the book Polarity Intelligence: The Missing Logic in Leadership and co-hosts of The TRU Leader Podcast (previously known as Healthcare’s MissingLogic Podcast). The dynamic duo is known for helping leaders balance leading and living so they can be TRU leaders—thriving, resilient, and unstoppable.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

Podcast #162: Revolutionizing Health Care: A Disruptive Approach to Primary Care and Employer Partnerships with Dr. Jeff Wells

dyllen@grippimedia.com (John Marchica) — Sun, 14 Jan 2024 07:00:00 +0000

Jeff Wells, MD, CEO & Co-Founder, Marathon Health

Jeff Wells, MD, is the CEO and co-founder of Marathon, a modern health company that partners with employers, benefit consultants and unions to deliver a health care experience that focuses on driving real behavior change, resulting in better employee health and financial savings. Marathon Health’s model consists of onsite health centers, Network health centers and virtual advanced primary care. Wells, who earned his MD in internal medicine from Indiana University, was president and co-founder of OurHealth, which merged with Marathon Health in January 2020. He is the former director of Indiana's Office of Medicaid Policy and Planning.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#161: Guiding Health Care Organizations with a Targeted Leadership Approach, with Laurie Lee Smith

dyllen@grippimedia.com (John Marchica) — Fri, 18 Aug 2023 07:00:00 +0000

Holding more than 20 years of experience in healthcare leadership, Laurie Lee Smith is the founder of Laurie Lee Leadership and former system CNO of Billings Clinic. Her expertise lies in supporting healthcare professionals to overcome challenges, shift mindsets, uncover blind spots, and sustain progress by incorporating the neuroscience of human behaviors. She has developed the Elevating Healthcare Leadership Impact program and the STAR methodology, both of which have proven to be instrumental in transforming teams and driving tangible results. Laurie holds a BSN from the University of Alaska aAnchorage, a masters of science in nursing administration from the University of Mary, and executive coaching certifications from the Hudson Institute of Coaching and the International Coaching Federation.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#160: Closing Care Gaps With Data in the Right Place, at the Right Time, with Ruth Krystopolski, MBA

dyllen@grippimedia.com (John Marchica) — Fri, 23 Jun 2023 07:00:00 +0000

Ruth Krystopolski is President of Ayin Health Solutions at Providence Health Systems. In her role as President, Ruth leads the development of population health capabilities across Providence’s ministries and extends them externally to reach additional communities.

Ruth joined Ayin in November 2021 after serving as the Senior Vice President of Population Health at Atrium Health, where she was responsible for the development and implementation of value-based care models across the organization. Ruth also led the system-level Care Management, Employer Solutions and other Value-Based Programs and provided oversight of the Poison Control Center in Charlotte, NC.

Ruth holds an undergraduate degree in Health Policy and Administration from Pennsylvania State University and a Master of Business Administration in Finance from the University of Pittsburgh.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#159: Organizational Performance and Physician Engagement, with John Neil, MD

dyllen@grippimedia.com (John Marchica) — Fri, 5 May 2023 07:00:00 +0000

Dr. John Neil is the Executive Vice President and Chief Physician Executive and Network Strategy Officer for HonorHealth in Scottsdale, Arizona. Dr. Neil drives physician engagement throughout HonorHealth, working to ensure that physicians have input and involvement in the decision-making processes of the healthcare system. His work with clinical teams focuses on strategic initiatives, operations, clinical services and the continuum of patient care.

An interventional radiologist by clinical training, he joined HonorHealth as the organization’s senior physician leader in 2015 and has since held leadership roles with the organization's medical staff, Scottsdale Health Partners, and the HonorHealth Board of Directors. His professional experience includes serving as the chairman of Southwest Medical Imaging, a large radiology practice that has been active in ambulatory development, practice mergers and joint ventures.

Dr. Neil holds a bachelor's degree in biochemistry from the University of Kansas and graduated with honors from Washington University School of Medicine.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#158: Leading with Purpose and Finding a ‘Why’, with Chanda Chacon

dyllen@grippimedia.com (John Marchica) — Fri, 14 Apr 2023 07:00:00 +0000

Chanda Chacón is the president and CEO of Children’s Hospital and Medical Center in Omaha, Nebraska. Chacón came to Children’s from Arkansas Children’s, where she served as Executive Vice President and System Chief Operating Officer. In Arkansas, she oversaw the system operations of two hospital campuses, clinical services, human resources and support services. Prior to leading in Arkansas, she served as the President for Texas Children’s Hospital West Campus, Houston’s first community hospital designed exclusively for children. Chacón spent 14 years at Texas Children’s Hospital—one of the nation’s top pediatric health care institutions—serving in progressive leadership roles, including ambulatory operations, Heart Center, Fetal Center, Women’s Services and Pharmacy.

Chacón earned undergraduate degrees in Biology and Spanish from Vanderbilt University and a Master’s Degree in Public Health Management from Yale University. She is a Fellow of the American College of HealthCare Executives. She has also volunteered as a court-appointed Child Advocate serving children in custody.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#157: Delivering Health Care On An International Scale, with Heitham Hassoun, MD

dyllen@grippimedia.com (John Marchica) — Fri, 16 Dec 2022 07:00:00 +0000

Heitham Hassoun, MD, Vice President & Medical Director, Cedars-Sinai International

Dr. Heitham Hassoun is the Vice President & Medical Director for Cedars-Sinai International in Los Angeles, California. He previously served as Global Medical Director for Johns Hopkins Medicine and was an Associate Professor in the Department of Surgery at The Johns Hopkins University School of Medicine.

Dr. Hassoun has a wealth of experience in international patient services, global collaborations and health system development. He was instrumental in the creation of Johns Hopkins Aramco Healthcare, a joint venture between Saudi Aramco and Johns Hopkins Medicine, as well as a number of other institutional management and affiliation agreements throughout the Middle East and Asia. Currently, he aims to expand the global footprint of Cedars-Sinai.

Dr. Hassoun maintains a clinical practice in vascular & endovascular surgery and he continues to educate and research in a variety of topics related to global collaborative healthcare and academic medicine. He completed his fellowship training in vascular and endovascular surgery at Northwestern University in Chicago and earned his medical degree at Baylor College of Medicine in Houston.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#156: Maximizing Value by Meeting People Where They Are, with Rob Allen, FACHE

dyllen@grippimedia.com (John Marchica) — Fri, 2 Dec 2022 16:10:00 +0000

Rob Allen, FACHE, President and Chief Executive Officer, Intermountain Healthcare

Rob Allen, FACHE, was named as the new president and chief executive officer of Intermountain Healthcare and began serving in that role on December 1, 2022. Previously, Rob served as the organization's senior vice president and chief operating officer. In addition to Rob’s 25-plus years of executive leadership at Intermountain, he has also held CEO roles at hospitals and health systems in Wyoming, New Jersey, and Massachusetts.

A fellow of the American College of Healthcare Executives, Rob has served on many foundation, chamber, and service boards. Rob earned a Master of Business Administration degree from Utah State University and a Bachelor of Science degree in operations management from Brigham Young University. His passion for healthcare began during his childhood as he was raised on a farm in Star Valley, Wyoming, where his mother served as a nurse and later as administrator at Star Valley Hospital. He and his wife, Becky, have three children and four grandchildren.

Intermountain Healthcare is headquartered in Utah with locations in eight states and additional operations across the western U.S. Intermountain is a nonprofit system of 33 hospitals, 385 clinics, 60,000 employees, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called SelectHealth with more than one million members, and other health services. With its mission of “Helping people live the healthiest lives possible,” Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#155: Complex Population Health Management and Comprehensive Value-Based Models for High-Risk Patients, with Dr. Robert Jarve

dyllen@grippimedia.com (John Marchica) — Fri, 18 Nov 2022 07:00:00 +0000

Dr. Robert Jarve is the Associate Chief Medical Officer for Population Health at Corewell Health West. In this role, he leads the strategy and development of population health analytics capabilities for the system, as well as the implementation of a value-based care model for underserved, high-risk patients. He is also leading a pilot to help house at-risk patients who are experiencing homelessness.

In addition to his administrative responsibilities, Dr. Jarve practices as an internal medicine and pediatrics physician, providing primary care to high-risk patients one day a week. He has diverse experience in population health management, including implementing and leading care management teams, developing care pathways and analytics solutions, and leading the change management of health care teams to more integrated team care models. Dr. Jarve holds BS and MSc degrees from Michigan State University, an MD degree from Wayne State University, and an MBA from Grand Valley State University.

Dr. Jarve has lived in Michigan his whole life and enjoys spending time with his wife, two teenage boys, and pets. Outside work, his favorite activities are hiking, reading, traveling, and snowboarding.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#154: Reimagining a High-Touch, Whole-Person Care Model for Kidney Disease, with Jackson Brasher

dyllen@grippimedia.com (John Marchica) — Fri, 4 Nov 2022 07:00:00 +0000

In his role as Strive Health’s Vice President of Strategy & Development, Jackson Brasher draws on more than 15 years of experience to lead Strive Health's system team in their company mission to transform kidney care.

Before joining the leadership team at Strive, Jackson held corporate strategy and business development roles at The Advisory Board Company, Trilliant Health, and Cardinal Health – working with hospitals, health systems, and provider practices across the country on various innovation and growth initiatives. Jackson holds a B.A. from the University of Virginia and an M.B.A. from Duke.

A Nashville native, Jackson enjoys spending time with his wife, daughter and the family’s playful black lab. Outside of the office, he can be found on the lake, at a concert, or planning his next big trip.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#153: Overcoming the Costly Roadblocks to Developing Novel Cancer Therapies, with Dr. David Stewart

dyllen@grippimedia.com (John Marchica) — Fri, 21 Oct 2022 07:00:00 +0000

David Stewart, MD; Head, Division of Medical Oncology, University of Ottawa; Author, A Short Primer on Why Cancer Still Sucks

Dr. Stewart received his MD degree from Queen’s University, Kingston, followed by training in internal medicine at McGill University and in medical oncology in the Department of Developmental Therapeutics at the UT MD Anderson Cancer Center. He first moved from MD Anderson to the University of Ottawa in 1980, and served as Chief of Medical Oncology at the Ottawa Civic Hospital from 1989 to 1999. He returned to the Department of Thoracic/Head and Neck Medical Oncology at MD Anderson Cancer Center from 2003 to 2011 where he served as Chief of the Section of Experimental Therapeutics (2003-2005), Chair Ad Interim (2005), Deputy Chair (2006-2009), and Director of Translational Research (2009-2011). He was also the Principle Investigator of MD Anderson’ phase II N01 contract with the National Cancer Institute, and was the clinical leader of a number of other federally-funded translational research projects. In 2011, Dr. Stewart returned to Ottawa from the University of Texas MD Anderson Cancer Center (Houston, TX) in 2011 to assume the position of Head of the Division of Medical Oncology at The Ottawa Hospital and the University of Ottawa.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#152: Tracking the Ever-Changing Life Science Landscape with BioPharmGuy's Adam Wilson

dyllen@grippimedia.com (John Marchica) — Fri, 7 Oct 2022 07:00:00 +0000

Adam Wilson founded BioPharmGuy in 2008 after gaining engineering and government experience in biotech. Professional stops prior to BioPharmGuy include Biopure (Cambridge, MA), FDA (Detroit, MI) & Henry Ford Hospital (Detroit, MI). His formal educational background consists of a Chemical Engineering Bachelors ('02) and Pharmaceutical Engineering Masters ('06) both from the University of Michigan. BioPharmGuy currently operates out of West Lafayette, IN.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#151: Defragmenting and Rethinking Care Delivery For America’s Aging Adults

dyllen@grippimedia.com (John Marchica) — Fri, 23 Sep 2022 07:00:00 +0000

Chris is the Chief Executive Officer (CEO) of Landmark Health. Chris joined Landmark in 2017 as Vice President and General Manager responsible for launching the New England market. Most recently, Chris has served as Landmark’s Head of Corporate Development responsible for the company’s growth strategy, strategic partnerships, mergers and acquisitions, and public policy. In this position, Chris played an integral role in spearheading Landmark’s merger with Optum and leading the company’s integration into Optum’s Home and Community platform.

Prior to Landmark, Chris was a Principal at Innosight, a healthcare focused growth strategy consultancy and Co-founder of Predilytics, a healthcare analytics business. Chris holds a Bachelor of Arts in economics from Harvard College. He also received his M.B.A. from Harvard Business School. Chris resides in Newton, Massachusetts with his wife and three young children.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#150: ENCORE Investing in Social Determinants of Health with John Gorman

dyllen@grippimedia.com (John Marchica) — Fri, 9 Sep 2022 07:00:00 +0000

John Gorman is the founder and Chairman of Nightingale Partners, the first Opportunity Zone fund to invest in social determinants of health interventions with health insurers, states, and provider organizations. He also founded and is the former Executive Chairman of Gorman Health Group. John’s work focuses on Medicare, Medicaid, and Affordable Care Act strategy, governance, and turnaround of distressed health plans. Prior to founding his firm, John served as Assistant to the Director of Health Care Financing Administration’s (HCFA, now CMS) Office of Managed Care, where he provided day-to-day management and served as the external liaison for the Medicare and Medicaid managed care programs.

John’s career in Washington began as Press Secretary and Staff Director for U.S. Representative John Conyers, Jr. (D-MI), then Chairman of the Government Operations Committee. John serves on the Board of Directors of Henry Ford Health System’s Health Alliance Plan in his birthplace of Detroit, MI, and serves as a Senior Advisor to Premier, Inc., the hospital purchasing cooperative, on Medicare Advantage and Medicaid matters.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#149: ENCORE Reinventing the PBM Model with A.J. Loiacono

dyllen@grippimedia.com (John Marchica) — Fri, 5 Aug 2022 07:00:00 +0000

A.J. Loiacono

AJ is a successful entrepreneur, with 20 years of experience in pharmacy benefits and software development. As the CEO of Capital Rx, his mission is to change the way pharmacy benefits are priced and administrated in the US. Prior to Capital Rx, AJ was a co-founder of Truveris, where he served for eight years as CEO, Chief Innovation Officer, and Board Member, leading the company to record growth (Deloitte FAST 500 and Crain’s Fast50). Prior to Truveris, AJ co-founded SMS Partners, a joint venture with Realogy (RLGY), and in 2010 exited the partnership with a buyout. In his first venture, AJ started Victrix, a pharmaceutical supply chain software consultancy, and successfully sold the company to Chrysalis Solutions in 2007.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#148: ENCORE What’s Wrong with American Health Care, and How Do We Fix It? with Dr. Robert Pearl

dyllen@grippimedia.com (John Marchica) — Fri, 22 Jul 2022 07:00:00 +0000

Dr. Robert Pearl

Named one of Modern Healthcare’s 50 most influential physician leaders, Dr. Pearl is an advocate for the power of integrated, prepaid, technologically advanced and physician-led healthcare delivery.

He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy.

Dr. Pearl is the author of “Mistreated: Why We think We’re Getting Good Healthcare—And Why We’re Usually Wrong,” a Washington Post bestseller that offers a roadmap for transforming American healthcare. He hosts the popular podcast Fixing Healthcare, publishes a newsletter with over 10,000 subscribers called Monthly Musings on American Healthcare and is a regular contributor to Forbes. He has published more than 100 articles in medical journals and contributed to numerous books.

Board certified in plastic and reconstructive surgery, Pearl received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#147: The Virtual-First Health Care Movement with Teladoc CEO Jason Gorevic

dyllen@grippimedia.com (John Marchica) — Fri, 17 Jun 2022 07:00:00 +0000

Jason Gorevic is chief executive officer and a member of Teladoc Health's board of directors. Since taking the reins in 2009, he has led Teladoc Health to its position today as the world leader in virtual care, achieving significant growth in revenue, membership, and telehealth utilization. Under his leadership the company has established a proven track record of successfully shaping the market and driving healthcare transformation by executing on the strategic vision, delivering award-winning innovation, and effectively integrating each corporate acquisition.

Nationally recognized as a thought leader and trailblazer in the virtual delivery of healthcare, Mr. Gorevic is fueled by a passion for improving healthcare outcomes and providing universal access to care. His extensive career in healthcare began at Oxford Health, and he has also held executive leadership roles at WellPoint, Inc. (now Anthem, Inc.) and Empire BlueCross BlueShield.

He holds a Bachelor of Arts in International Relations from the University of Pennsylvania.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#146: Championing Patient Centricity with Tzvia Bader

dyllen@grippimedia.com (John Marchica) — Fri, 3 Jun 2022 07:00:00 +0000

Tzvia Bader, CEO and Co-Founder of TrialJectory is a savvy and experienced entrepreneur, with decades of experience in business development, product marketing, and strategy. Prior to co-founding TrialJectory, Tzvia headed the global business unit at Amdocs where she was responsible for building a new product growth strategy, as well as for global sales and marketing. Tzvia has held different business development and marketing positions in several tech companies, both B2B and B2C. She holds a Master of Science degree from the University of Nottingham, in Nottingham, UK.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#145: Addressing America’s Nursing Crisis with Nurse Alice

dyllen@grippimedia.com (John Marchica) — Fri, 20 May 2022 07:00:00 +0000

Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, also known as 'Nurse Alice', is a cardiac clinical nurse specialist and family nurse practitioner with over 23 years of healthcare experience. Alice is Nurse.org's Chief Nursing Officer and Correspondent and is a regular contributor to NBC Los Angeles. She hosts the popular 'Ask Nurse Alice' podcast that reached #9 in the Apple Podcasts medical category.

Nurse Alice is passionate about empowering nurses to use their voices on a grander scale. She has spoken on the subject of Nurses Using Media as a Form of Advocacy at several nursing schools and organizations including UCLA, Howard University, and UC Davis.

John Marchica, CEO, Darwin Research Group

John Marchica is a veteran health care strategist and CEO of Darwin Research Group. He is leading ongoing, in-depth research initiatives on integrated health systems, accountable care organizations, and value-based care models. He is a faculty associate in the W.P. Carey School of Business and the Graduate College of Health Solutions at Arizona State University.

About Darwin Research Group

#144: Fighting Burnout in Healthcare with Michelle Troseth and Tracy Christopherson

Fri, 6 May 2022 07:00:00 +0000

Michelle Troseth and Tracy Christopherson are co-founders of MissingLogic®. They help healthcare organizations and healthcare leaders combat burnout through the power of a framework driven approach founded on Polarity Intelligence™. The core of their work is leading healthcare organizations through transformational change that results in the best place to give and receive care, and for leaders to live their best lives both personally and professionally.

Michelle and Tracy have been interprofessional leaders, friends and colleagues for over 30 years. They are co-hosts of a top healthcare leadership podcast, Healthcare’s MissingLogic.

Michelle and Tracy have a combined experience of more than 60 years working as consultants and coaches for healthcare organizations across North America supporting healthcare leaders as they strive to create healthy, healing work cultures. They frequently speak at national and international leadership conferences on the topics of managing healthcare polarities, achieving work life balance and living a resilient life.

John Marchica, CEO, Darwin Research Group

#143: Proactive Care Management with Linda Hand

dyllen@grippimedia.com (John Marchica) — Fri, 22 Apr 2022 07:00:00 +0000

Linda Hand brings 35 years of experience to her role as CEO of Prealize Health, with an emphasis in organizational leadership, product development, solutions delivery and go-to-market strategies across a diverse portfolio of industries.

Before joining Prealize, Linda led the Clinical Trial Optimization Solutions division at IQVIA, where she was responsible for creating and delivering a suite of innovative clinical technology products, fueled by predictive analytics and machine learning algorithms, to drug development organizations worldwide.

Linda is a past President and CEO of the San Francisco-based DecisionView, the leading provider of clinical trial enrollment optimization solutions. She also ran product development and delivery at a number of leading software companies, including DigitalThink, Hyperion, Arbor Software and Sybase.

Linda holds a BA in Computer Science from the University of California, Berkeley, and completed the Haas School of Business Executive Program.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#142: Humanizing Health Care With Dr. Summer Knight

dyllen@grippimedia.com (John Marchica) — Fri, 8 Apr 2022 07:00:00 +0000

Summer Knight, MD, MBA, a former firefighter/paramedic-turned primary care and emergency room doctor, is a Managing Director in Deloitte Consulting’s Life Sciences & Health Care practice. She is a passionate advocate for humanizing healthcare, an innovative leader in digital and virtual health, and a pragmatic futurist who helps clients act upon today’s rapid changes in healthcare.

Dr. Knight maintains an active physician license, is board certified in family medicine and was Chief of Staff of a 4-hospital healthcare system and Emergency and Urgent Care Department Chair. She is an accomplished leader having held key executive positions in F100 Plan, Digital Health, Provider, Government and Private Equity. She also has academic credentials having been an adjunct Professor and Executive-in-Residence for Healthcare at the Fox School of Business at Temple University. Her perspective on healthcare is informed not only by her professional experience, but also by her role as a patient and sandwich generation caregiver.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#141: Oncology Super-Networks, Payers, And Their Impact On Patient Care with Robin Shah

dyllen@grippimedia.com (John Marchica) — Fri, 25 Mar 2022 15:00:00 +0000

Robin Shah is the Founder and CEO of Thyme Care, an oncology care management solution providing high-touch, tech-enabled cancer care navigation. Thyme Care was founded with the mission to radically improve the journey for every person diagnosed with cancer. At the heart of it all is the belief that providing patients with access to the right team at the right time will lead to better quality, outcomes, costs, and ultimately patient experience.

Before launching Thyme Care, Robin was a founding member of OneOncology, where he served as the Chief Development and Marketing Officer. Robin’s passion for building a stronger future for community oncology then brought him to Flatiron Health, a leading healthcare technology company. There, Robin served as Vice President of Provider Marketing and Strategy. Robin also helped manage a comprehensive community cancer center in his hometown, Gettysburg, PA.

Robin earned his bachelor’s degree in biomedical engineering from George Washington University and holds an M.B.A from the Carey Business School at Johns Hopkins University.

John Marchica, CEO, Darwin Research Group

About Darwin Research Group

#140: The Rise of Consumerism-based Healthcare with Dr. John Shufeldt

dyllen@grippimedia.com (John Marchica) — Fri, 18 Jun 2021 07:00:00 +0000

Dr. John Shufeldt founded NextCare Inc. in 1993 and served as the CEO and Chairman of the Board until 2010. He now serves as the business manager and one of the founding partners of Empower Emergency Physicians and continues to practice emergency medicine at St. Joseph’s Hospital and Medical Center. Dr. Shufeldt also founded MeMD, LLC, a platform used by more than 300 medical and mental health providers in 50 states to virtually treat patients on-demand and in the comfort of their home or place of work. Dr. Shufeldt has authored 11 books on leadership, self-improvement, business, entrepreneurism, urgent care management and urgent care medicine.

Dr. Shufeldt received his BA from Drake University and his MD from the University of Health Sciences, The Chicago Medical School. He completed his Emergency Medicine Residency at Christ Hospital and Medical Center where he spent his final year as Chief Resident. Dr. Shufeldt received his MBA and his Juris Doctorate from Arizona State University. His certifications include Fellow, American Board of Emergency Medicine, College of Legal Medicine and American College of Emergency Physicians and completed a certificate program in Artificial Intelligence at MIT’s Sloan School of Management. Dr. Shufeldt also completed his Six Sigma Black Belt from the Fulton School of Engineering at Arizona State University.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#139: Building A Platform to Match the Demands of Healthcare Transportation with Josh Komenda

dyllen@grippimedia.com (John Marchica) — Fri, 11 Jun 2021 07:00:00 +0000

Josh Komenda is co-founder, CEO and president of healthcare logistics leader, Veyo, a full service NEMT broker using technology to better manage NEMT benefits for Medicaid and Medicare programs, state governments, and Managed Care Organizations.

While focusing on the technology platform, Josh and his team recognized the need for Non-emergency Medical Transportation (NEMT) in the industry and created Veyo. Combined with the healthcare logistics and transportation division of Total Transit, Veyo is a full-service transportation brokerage designed specifically to provide access to healthcare for people who need assistance getting to and from medical appointments. Veyo’s new tech-enabled healthcare approach has the most powerful network in NEMT and continues to deliver higher levels of reliability, quality, and transparency to customers, partners, and members.

Josh received his degree in Computer Engineering from the University of Waterloo and his graduate degree in Business from the Marshall School of Business at University of Southern California.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#138: An Honest Conversation on the State of Current Medicine with Dr. Robert Pearl

dyllen@grippimedia.com (John Marchica) — Fri, 4 Jun 2021 07:00:00 +0000

Dr. Robert Pearl is the former CEO of The Permanente Medical Group and former president of The Mid-Atlantic Permanente Medical Group. In these roles was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts.

Named one of Modern Healthcare’s 50 most influential physician leaders, Pearl is an advocate for the power of integrated, prepaid, technologically advanced and physician-led healthcare delivery.

He is the author of “Mistreated: Why We think We’re Getting Good Healthcare—And Why We’re Usually Wrong,” a Washington Post bestseller that offers a roadmap for transforming American healthcare. His most recent book, Uncaring: How the Culture of Medicine Kills Doctors and Patients was published May 2021.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#137: The Stigmas within Healthcare Regarding Behavioral Health with Spencer Hutchins

dyllen@grippimedia.com (John Marchica) — Fri, 28 May 2021 07:00:00 +0000

Spencer Hutchins is the CEO and co-founder of Concert Health, America’s leading behavioral health medical group with a turnkey solution designed for primary care and women’s health physicians. Concert Health’s exceptional team of clinicians deliver Collaborative Care Management, an evidenced-based model proven to treat anxiety, depression, and other behavioral health conditions.

Prior to Concert, Spencer co-founded Reflexion Health, where he served as CEO for three years. Spencer also previously served as Senior Director at West Health, where he helped source and support investments in innovative companies such as Humedica, Change Healthcare, and goBalto. Spencer has also served as a member of the founding healthcare team at the Federal Communications Commission during the Obama administration.

Spencer received an MBA from Yale School of Management and BA from Colby College.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#136: A Modern Solution to One of Medicine’s Oldest Problems with Dr. Noam Emanuel

dyllen@grippimedia.com (John Marchica) — Fri, 21 May 2021 07:00:00 +0000

Dr. Emanuel has over 26 years of research and development, marketing and management experience in biotechnology projects, including development of drug delivery systems and immunology. His extensive expertise includes immunotherapy, vaccines, immunodiagnostics, systemic and local drug-delivery, and medical devices. Dr. Emanuel has a number of approved patents in the field of drug delivery and diagnostics. Dr. Emanuel is a co-founder of PolyPid and served as its CEO during the company’s first three years. He received his Ph.D. from the Faculty of Medicine at the Hebrew University of Jerusalem.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#135: ENCORE Rethinking the ‘Moral Hazard’ Approach to Structuring Health Insurance, with Christopher Robertson

dyllen@grippimedia.com (John Marchica) — Fri, 14 May 2021 07:00:00 +0000

Christopher Robertson joined the Boston University law school faculty in 2020 as a tenured professor and an N. Neal Pike Scholar in health and disability law. Prior to that, he served as associate dean for research and innovation and professor of law at the University of Arizona. He is also a principal at Hugo Analytics, a firm that provides scientific services to litigators. In 2019, Harvard University Press published his book, Exposed: Why Our Health Insurance Is Incomplete and What Can Be Done About It. Chris has also co-edited three books, Nudging Health: Behavioral Economics and Health Law (2016,) Blinding as a Solution to Bias: Strengthening Biomedical Science, Forensic Science, and Law (2016), and Innovation and Protection: The Future of Medical Device Regulation (2021). Chris graduated magna cum laude from Harvard Law School and earned a doctorate degree at Washington University in St. Louis. He has taught at Harvard Law School, NYU Law, and the London School of Economics.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#134: ENCORE Shifting the PBM Paradigm From Volume and Cost Savings to Customer Alignment, with Karthik Ganesh

dyllen@grippimedia.com (John Marchica) — Fri, 7 May 2021 07:00:00 +0000

Karthik Ganesh is the CEO of EmpiRx Health, the industry’s only value-based PBM, with a clinically focused, technology-enabled approach to bending the Rx cost curve. Prior to EmpiRx Health, Karthik was the founding operations leader of CareAllies. He is a senior health care executive with a solid track record of comprehensively scaling, transforming, and maximizing value at tech-enabled health service companies while driving dramatic before-and-after results across all facets of the organization. Karthik is recognized as a thought leader on health care, leadership, and resilience. He is a published author and has been featured in leading industry journals.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

133: Challenges to, and Solutions for, Better Integrating Behavioral Health and Primary Care, with Dr. Tom Young

dyllen@grippimedia.com (John Marchica) — Fri, 30 Apr 2021 07:00:00 +0000

Dr. Thomas Young is a board-certified family physician with more than 35 years of medical experience. He is recognized as an innovator and thought leader in the fields of consumer-directed health care and population health care management. Dr. Young is the founder and chief medical officer of nView Health, an innovative software company that helps providers better identify, treat, and monitor patients with behavioral health conditions.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#132: Pairing AI and Virtual Technology with a Patient-Centered Delivery Model to Transform Health Care, with Dr. Thomas Hale

dyllen@grippimedia.com (John Marchica) — Fri, 23 Apr 2021 07:00:00 +0000

Dr. Hale is the chief medical officer at VirtuSense Technologies, a health care company that uses proprietary technology and artificial intelligence to reduce adverse events within hospitals, skilled nursing facilities, and senior living communities. He previously was the senior vice president for care solutions at Navvis Healthcare, after a 37-year career at Mercy Health, where he was the leader and clinical architect of the world’s first virtual care center. As the executive medical director of Mercy Virtual, Dr. Hale led the development of new ways to effectively and efficiently deliver health care to Mercy communities.

Prior to his current position, Dr. Hale maintained a general internal medicine practice for 23 years. He was a founder of Mercy Medical Group and served as its first president for 15 years.

Dr. Hale holds a Ph.D. in pharmacology from Saint Louis University. He received his medical degree from the University of Missouri-Columbia Medical School, subsequently completing his internal medicine internship and residency at Mercy Hospital St. Louis leading to board certification in 1983. In 2011, he earned a master’s degree in medical informatics from Northwestern University.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#131: Post-COVID Partnerships Between Pharma and Integrated Delivery Networks, with Sean Brusky

dyllen@grippimedia.com (John Marchica) — Fri, 16 Apr 2021 07:00:00 +0000

Sean Brusky, health care entrepreneur, executive advisor, strategist, and former head of health care delivery innovation at Genentech/Roche

Sean’s career has developed around a central theme: How can we innovate to help Pharma become true partners in value-based care? Over the course of 15 years in various leadership roles with Genentech/Roche, Sean has lived experience attempting to solve the problems at the core of this challenge, directly engaging key market stakeholders from the seat of one of the world’s largest integrated health care companies, focused on both innovative new medicines and novel diagnostics, and real-world data solutions.

Sean has built and led teams responsible for brand-focused marketing and sales, managed care marketing, channel contracting and engagement, integrated health system engagement, government and commercial payer engagement and, most recently, digital health partnerships and novel approaches to health care delivery. He spearheaded Genentech’s efforts to execute value-based pricing models in collaboration with health systems and group practices. He has directly initiated and executed more than 20 novel commercial and medical partnerships in the personalized medicine, digital health, and value-based contracting space.

This unique blend of business development, commercial, managed care, medical affairs, and strategy experience has contributed to Sean’s unique perspective on what is broken about the current pharmaceutical pricing, purchasing, and partnership model and how we can fix it.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#130: How the Pandemic Has Accelerated the Role of Home Health Care, with Paul VerHoeve

dyllen@grippimedia.com (John Marchica) — Fri, 9 Apr 2021 07:00:00 +0000

Paul VerHoeve is CEO and a board member for Mission Healthcare. With more than 20 years of health care leadership experience, he has been recognized as a driver of healthy workplace culture. Prior to his involvement with Mission Healthcare, Paul was president of the west region with Louisville, Ky.-based Kindred Healthcare, one of the largest post-acute care systems in the country. Before joining Kindred Healthcare, he served in several leadership positions with Gentiva Health Services (now part of Kindred Healthcare), Haven Healthcare, and VITAS Healthcare.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#129: Successfully Growing an Independent Physician Practice, with Dr. Kyle Guyton

dyllen@grippimedia.com (John Marchica) — Fri, 2 Apr 2021 07:00:00 +0000

Dr. Kyle Guyton is a pediatrician, CFO and co-founder of SouthernMED Pediatrics, a multi-site pediatric and counseling practice with 10 locations throughout South Carolina. In addition to caring for his patients, he serves his local community as a member of the Lexington County School District One School Board. Dr. Guyton attended the Medical University of South Carolina, where he earned his medical degree, and furthered his training at the University of South Carolina in pediatric residency. Dr. Guyton has a passion to see that regions with a need for accessible, exceptional pediatric care are provided for.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#128: Transforming the Delivery of Care with Dr. Daniel Durand

dyllen@grippimedia.com (John Marchica) — Fri, 26 Mar 2021 07:00:00 +0000

Daniel J. Durand, M.D. serves as the chief innovation officer and chairman of radiology for LifeBridge Health. He led the LifeBridge Health ACO, LLC, and previously served as the first director of accountable care for Johns Hopkins Medicine. Prior to Hopkins, Dr. Durand was a vice president and member of the executive leadership team at Evolent Health, a health care IT startup. He also worked as an associate with McKinsey & Co. out of the firm's Washington, D.C., office. Dr. Durand earned his medical degree at The Johns Hopkins University School of Medicine and has more than 20 years of experience in health care, science, and technology.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

# 127: Improving the Patient Experience with Compassionate Communication in Medicine with Dr. Anthony Orsini

dyllen@grippimedia.com (John Marchica) — Fri, 19 Mar 2021 07:00:00 +0000

Dr. Anthony Orsini is a practicing physician, author and frequent speaker on the topic of compassionate communication in medicine. He is a Level II Medical Director at one of the largest Neonatal Intensive Care Units in the world. He also serves as Chief of Patient Experience and Palliative Care Liaison for his neonatal practice, and is a frequent keynote speaker at various medical and business events, including an upcoming TEDx presentation entitled-Improving Healthcare Starts with a Single Conversation.

In 2011, he founded The Orsini Way, a company that provides communication training to healthcare and business professionals. Dr. Orsini received his BS in Biochemistry and Molecular Biology at Rutgers University and his D.O. in Medicine at Philadelphia College of Osteopathic Medicine. He has authored several papers on the topics of communication in medicine, enhancing the patient experience and delivering tragic news. His recently published book titled “It’s All in the Delivery – Improving Healthcare Starting With a Single Conversation” is now available on Amazon. His weekly podcast “Difficult Conversations – Lessons I Learned as an ICU Physician” hit the Top 100 podcasts on Apple in 2020.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#126: Using Technology to Advance Care for an Aging Population, with Jon Warner

dyllen@grippimedia.com (John Marchica) — Fri, 12 Mar 2021 07:00:00 +0000

Jon Warner, CEO and Board Chair Decision-support Architect for Innovation, Technology, DigitalHealth, Aging populations

Five-time company CEO Jon Warner is a widely respected entrepreneurship expert. His career started in the corporate world with Air Products, working in the US and across Europe before joining Exxon-Mobil. At Exxon, Jon worked in the UK, the US, Australia, and Nigeria, ending his career there as deputy CEO. He is the founder of The Worldwide Center for Organizational Development, a management consulting business, and CEO of Silver Moonshots, a research organization and “virtual incubator” for startups focused on health technology and innovation aimed at the 50+ population. He is also a noted author and speaker at businesses, colleges and conferences around the world. A graduate of Warwick University in the UK, Jon has a double bachelor’s degree in philosophy and politics, an MBA, and a Ph.D. in psychology, specializing in neuroscience. He’s on the board of St. Barnabas and is co-chair of the annual “Aging into the Future” conference in Los Angeles, California. Jon is also an adjunct professor at Redlands University, where he teaches entrepreneurship.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#125: Discussing the Past, Present, and Future with Scott Becker

dyllen@grippimedia.com (John Marchica) — Fri, 5 Mar 2021 07:00:00 +0000

2:07 - 2:13 Scott: “It was originally sort of a hobby and a marketing effort to develop a brand in health care.”

16:22 - 16:25 Scott: “So I understood the niche marketing concept, being in a niche within health care.”

19:10 - 19:18 Scott: “It wasn’t until 7-8 years ago when we started, you know, really thinking about this as a serious business, where somebody said, ‘Oh, you’re in business-to-business media.’”

24:28 - 24:51 John: “I just get the sense that there’s still this antagonistic relationship between pharmacy and Pharma. … Pharma has not been able to demonstrate the value that they bring to the table.”

26:02 - 26:14 Scott: “There’s this constant issue with pharmacy officers of, ‘Are we getting the right drugs, or ... is somebody pushing us drugs that don’t really make a difference but have a huge impact on the cost?’”

27:59 - 28:03 John: “I think people are willing to pay for the game changers, [but] not so much for the ones where there’s that marginal benefit.”

32:58 - 36:16 Scott: "How do you mix in your strategy some of the things that were sort of ignored or not brought to the front as strong as they were before, like health equity and making sure that you’re a lead on health equity, not just in revenue on fee for service and your five great service lines?”

Scott Becker is the publisher and founder of Becker’s Healthcare and Becker’s Hospital Review. He is also a CPA and a partner and former board member of the law firm McGuireWoods, where he served as chair of the national health care practice for more than 12 years. Scott is a graduate of Harvard Law School.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and an active member of the American College of Healthcare Executives.

About Darwin Research Group

#124: Powering Precision Health with Kevin Hrusovsky

dyllen@grippimedia.com (John Marchica) — Fri, 26 Feb 2021 07:00:00 +0000

Kevin Hrusovsky, Precision Health Visionary, Chairman & CEO, Quanterix

Kevin Hrusovsky is a biotech entrepreneur and healthcare visionary who has dedicated his career to transforming medicine into preventative and personalized healthcare. Hrusovsky currently serves as the President, Chairman and CEO of Quanterix, a company digitizing biomarker analysis to advance Precision Health, and is the founder of Powering Precision Health (PPH). He holds an M.B.A. from Ohio University and a B.S. in Mechanical Engineering from The Ohio State University. He received an Honorary Doctorate from Framingham State University and helped build the competitive strategy curriculum at the Institute for Strategy & Competitiveness at Harvard Business School. Hrusovsky lends his business expertise on the boards of several innovative technology companies, and was most recently named Chairman of the Board of Directors for Quanterix. He also serves on the Educational Board of the Massachusetts Biotech Council, the JALA Editorial Board, and the Strategy Committee of Children’s Hospital Boston.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#123: Exploring the Future of Health Care Delivery with Dr. Elliott Fisher

Fri, 13 Nov 2020 07:00:00 +0000

Elliott S. Fisher, M.D., M.P.H., is director of the Dartmouth Institute for Health Policy & Clinical Practice and Professor of Medicine, Community and Family Medicine and Health Policy at Dartmouth University’s Geisel School of Medicine. As a recognized leading health care researcher and advocate for improving health system performance, Dr. Fisher previously contributed to the concept of the “accountable care organizations” (ACOs) and has influenced research within the development of the Affordable Care Act. His research areas of expertise focus on Medicare, payment reform, and community health with an overall goal to deliver health care value. In his recent article, he focuses on the exploration of elements to success in health care reformation. Dr. Fisher is a well-known supporter of locally organized and operated community health collaboratives, leading to his role as co-founder of ReThink Health, an initiative designed to employ transformative change in order to deliver an improved well-being for all. Dr. Fisher earned his BA from Harvard College, his MD from Harvard Medical School, and his MPH from the University of Washington, now serving as a member of the Institute of Medicine of the National Academy of Sciences.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#122: Investing in Social Determinants of Health with John Gorman

dyllen@grippimedia.com (John Marchica) — Fri, 30 Oct 2020 07:00:00 +0000

John Gorman is the founder and Chairman of Nightingale Partners, the first Opportunity Zone fund to invest in social determinants of health interventions with health insurers, states, and provider organizations. He is the Founder and former Executive Chairman of Gorman Health Group. John’s work focuses on Medicare, Medicaid, and Affordable Care Act strategy, governance, and turnaround of distressed health plans. Prior to founding his firm, John served as Assistant to the Director of Health Care Financing Administration’s (HCFA, now CMS) Office of Managed Care, where he provided day-to-day management and served as the external liaison for the Medicare and Medicaid managed care programs.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#121: Value Creation in Health Care with Dr. Bill Weeks

dyllen@grippimedia.com (John Marchica) — Fri, 23 Oct 2020 16:06:19 +0000

William B. Weeks, MD, PhD, MBA, is a Principal Researcher at Microsoft Healthcare NExT. Dr. Weeks has published a book and over 200 peer-reviewed manuscripts examining economic and business aspects of health care services utilization and delivery, physicians’ return on educational investment, health care delivery science, and healthcare value. Dr. Weeks has been honored with the 2009 National Rural Health Association Outstanding Researcher Award, the 2016 Jerome F McAndrews award for excellence in research from the National Chiropractic Medical Insurance Corporation Group, and the 2016 Fulbright-Tocqueville Distinguished Chair at Aix-Marseille University.

Dr. Weeks’ research that has been funded by CMMI, NIH, the Commonwealth Fund, the National Chiropractic Medical Insurance Corporation Group, the VA, AHRQ, and Bupa.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#120: Integrating Patient-Centered Care with Dan Pelino

dyllen@grippimedia.com (John Marchica) — Fri, 16 Oct 2020 07:00:00 +0000

Dan Pelino is an innovator, thought leader and author. He is a regular contributor to the discussion on healthcare, citizen-based services and Smarter Cities having appeared on CNN, Bloomberg, the BBC and other media outlets. He serves as a moderator and host to the current healthcare debate and is an adjunct professor lecturing on Leadership at Western Kentucky University. He has worked for IBM for 36 years, leading its global Healthcare and Life Sciences Business for 10 years. On behalf of IBM, Dan and Dr. Paul Grundy both accepted the 2012 National Committee for Quality Assurance (NCQA) award for Leadership in Healthcare.

Now Co-founder with Anne Altman of Everyone Matters, Inc., Dan has served on the Executive Committee for the Patient-Centered Primary Care Collaborative (PCPCC) and on the Board of Directors of the Healthcare Executive Network. His many honors include being an inaugural member of the IBM Industry Academy.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#119: Improving Health Care Affordability Through PBM Optimization with Eric Levin

dyllen@grippimedia.com (John Marchica) — Fri, 9 Oct 2020 18:11:15 +0000

Eric Levin is CEO of Scripta Insights. Eric is a seasoned executive and serial entrepreneur who has created and managed products that have sold well in excess of $5 billion. He has been involved in more than 32 mergers and acquisitions and helped to grow several companies from startup through large-scale global success.

After beginning his career at a market-leading consumer electronics retailer, Eric joined Kevin O’Leary (of TV’s Shark Tank fame) in the consumer technology business as part of the executive management team responsible for growing The Learning Company from $60m to over $1.2 billion in sales in just six years, ultimately selling for $3.6 billion.

He has held several high-level roles at both large and small companies in both the consumer and the B2B space, including SVP, Mattel; Chief Marketing Officer, Frictionless Commerce; CEO & Co-President, Techno Source; and Division President and Corporate SVP, Li & Fung Ltd., and CEO of M5 Consulting, Inc.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#118: The Developing World of Wound Care with John Sory

dyllen@grippimedia.com (John Marchica) — Fri, 2 Oct 2020 07:00:00 +0000

John Sory is the President of Vohra Wound Physicians. Sory has been an integral part of Vohra since March 2018 and brings 25 years of extensive expertise in healthcare management. Today, he is responsible for managing Vohra’s core operations and key strategic initiatives.

Formerly, he served as the Chief Executive, UHealth Regional Alliance for the University of Miami Health System (UHealth) where he oversaw affiliations and expansion, health plan relationships, and new reimbursement models. He also led the organization’s entry into population health and the transformational steps from fee for service to value-based health outcomes. Sory expanded the health system through affiliations with physician groups, ACOs, employers, pharmacies, and foreign health entities. Prior to that role, he led Pfizer Health Solutions (PHS), a wholly owned, global subsidiary of Pfizer Inc. which developed and sold health information technologies, designed employer-based health services, and operated risk-based population health programs across the U.S. and Europe.

Sory received his MBA from the Tuck School of Business at Dartmouth College and earned his B.A. from Vanderbilt University. He also completed an executive management program at the Harvard Business School.

John Marchica, CEO, Darwin Research Group

John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#117: Breaking Down Benefits Design with David Contorno

dyllen@grippimedia.com (John Marchica) — Fri, 25 Sep 2020 12:00:04 +0000

David Contorno is a nationally recognized thought leader and author on disrupting health care and delivering better care at lower costs for employers and their employees. David spends much of his time educating the industry, including his competition, on how to bring these cost-effective healthcare solutions to the masses. In 2016, Forbes named David as “One of America’s Most Innovative Benefits Leaders.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#116: Digital Success in Health Care with Stewart Gandolf

dyllen@grippimedia.com (John Marchica) — Fri, 18 Sep 2020 07:00:14 +0000

Stewart Gandolf, MBA

Stewart Gandolf, is Chief Executive Officer of Healthcare Success, one of the nation’s leading healthcare and digital marketing agencies. Over the past 20 years, Stewart has marketed and consulted for over 1,000 healthcare clients, ranging from practices and hospitals to multi-billion dollar corporations. A frequent speaker, Stewart has shared his expertise at over 200 venues nationwide. As an author and expert resource, Stewart has also written for many leading industry publications, including the 21,000 subscriber Healthcare Success Insight blog. Stewart also co-authored, “Cash-Pay Healthcare: Start, Grow & Perfect Your Cash-Pay Healthcare Business.” Stewart began his career with leading advertising agencies, including J. Walter Thompson, where he marketed Fortune 500 clients such as Wells Fargo and Bally’s Total Fitness.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#115: Dissecting the PBM Model with Karthik Ganesh

dyllen@grippimedia.com (John Marchica) — Fri, 11 Sep 2020 07:00:09 +0000

Karthik Ganesh is the CEO at EmpiRx Health, the industry’s only value-based PBM, with a clinically- focused and tech-enabled approach to bending the Rx cost curve. Prior to EmpiRx Health, Karthik was the founding operations leader of CareAllies. Karthik is a senior health care executive with a solid track record of comprehensively scaling, transforming and maximizing value at tech-enabled health service companies while driving dramatic before-and-after results across all facets of the organization. Karthik is recognized as a thought leader on healthcare, leadership, and resilience. He is a published author and has been featured in leading industry journals.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#114: Building a Stronger Future for Health Care with Stefan Behrens

dyllen@grippimedia.com (John Marchica) — Fri, 4 Sep 2020 07:00:29 +0000

Stefan Behrens the CEO and co-founder of GYANT. GYANT creates digital assistant for healthcare – the software helps triage, navigate, and inform patients along the continuum of care. Prior to GYANT, Stefan has had great success as an entrepreneur. As Co-Founder and COO of Invincible Brands, he oversaw the launch and development of two lifestyle brands (Natural Mojo and Hello Body) in the healthy living space. Stefan also spent a decade in strategy consulting, driving large-scale transformation programs for international telco companies. Stefan guided multiplayer gaming company Aeria Games from humble beginnings to acquisition by ProSiebenSat.1, Europe's leading media company.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#113 : A New Perspective in Health Care with Twila Brase

dyllen@grippimedia.com (John Marchica) — Fri, 28 Aug 2020 07:00:06 +0000

Twila Brase is President and Co-Founder of Citizens’ Council for Health Freedom (CCHF), a

national patient-centered nonprofit established 25 years ago in Minnesota to support health care choices, individualized patient care and medical and genetic privacy. She is author of the eight-time award-winning book Big Brother in the Exam Room: The Dangerous Truth About Electronic Health Records, which was published in July 2018.

Modern Healthcare named her #75 on their 2009 “100 Most Powerful People in Healthcare”

list. Last year, Twila Brase was selected as one of 18 leaders to participate in the U.S.

Department of Health and Human Services Quality Summit, which met three times at the end of 2019. Their discussions will be used to provide the President of the United States with a roadmap for restructuring federal quality measurement programs.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#112: The Growing Role of the Health System Specialty Pharmacy with Ameet Wattamwar, PharmD

dyllen@grippimedia.com (John Marchica) — Fri, 21 Aug 2020 07:00:08 +0000

Ameet Wattamwar, PharmD, is the Director of Specialty Pharmacy for the NYU Langone Hospitals System. Prior to this role, he was Vice President of Client Strategies for PHS, AmerisourceBergen’s health system facing consulting arm where he specialized in specialty & ambulatory pharmacy development, 340b optimization, and other pharmacy centric cost savings, and efficiency-focused initiatives. Ameet has also consulted for pharmaceutical manufacturers in addition to practicing pharmacy across various care settings.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#111: Redesigning Value in Health Care with Brian Paradis

dyllen@grippimedia.com (John Marchica) — Fri, 14 Aug 2020 07:00:07 +0000

Brian Paradis is a senior partner with CSuite Solutions, a national strategic advisory firm. CSuite Solutions is led by former healthcare industry CEOs focused on the transition and practical strategies to move healthcare industry from “volume to value.”

Previously, Paradis was president of Florida Hospital’s Central Region, a $4billion enterprise with over 25,000 employees and 2,000 physicians. Under his leadership, Florida Hospital was the #1 ranked hospital in Florida by the US News and World Report for three years. Paradis’s understanding of the role of immigration in organizational leadership helped develop a creative, results-oriented team based on a shared vision driven by a Strategic Innovation Agenda (SIA).

Paradis earned a BA in Business Administration from Southern College, Chattanooga, TN, is a CPA, and is a Certified Management Accountant. He is married, father of five, and the unexpected owner of three dogs.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#110: ENCORE LifeBridge Health’s Focus on the Community with Neil Meltzer

dyllen@grippimedia.com (John Marchica) — Fri, 7 Aug 2020 07:00:05 +0000

Neil Meltzer, President and CEO of LifeBridge Health since 2013. Meltzer joined Sinai Hospital of Baltimore as Vice President of Operations in 1988, and a decade later became Sinai’s President and Chief Operating Officer.

Meltzer has a background in public health and brings a community-focused approach to every health care decision. He serves on the boards of the Greater Baltimore Committee, Notre Dame of Maryland University, the Maryland Hospital Association, the Hippodrome Foundation and Everyman Theatre. Additionally, Meltzer serves on the advisory board of the University of Maryland School of Public Health. On the national level, he continues to work with the American Heart Association after serving as national chairman. He was also one of 15 national workforce health care champions appointed by former president Barack Obama.

Meltzer earned his Master of Public Health and Health Administration from Tulane University School of Public Health and Tropical Medicine in Louisiana, and his undergraduate degree in public health from the University of Massachusetts Amherst.

John Marchica, CEO, Darwin Research Group

John Marchica is a veteran health care strategist and COO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#109: ENCORE Breakthroughs in Cancer Research with Dr. David Hong

dyllen@grippimedia.com (John Marchica) — Fri, 31 Jul 2020 07:00:17 +0000

Dr. David S. Hong is deputy chair of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center. He also serves as associate vice president for Clinical Research and clinical medical director of the Clinical Center for Targeted Therapy. Dr. Hong received a bachelor’s degree in biology from Yale University and a medical degree from Albert Einstein College of Medicine. He then completed an internship and residency at Thomas Jefferson University Hospital and a medical oncology fellowship at MD Anderson, during which time he was appointed chief medical oncology fellow. In 2005, he joined MD Anderson’s faculty.

Dr. Hong is the recipient of the 2004 Young Investigator Award from the American Society of Clinical Oncology, the Jesse H. Jones Fellowship in Cancer Education, MD Anderson’s Best Boss Award, the Irwin H. Krakoff Award for Excellence in Clinical Research, the Gerald P. Bodey Award for Excellence in Education and a research training fellowship from Howard Hughes Medical Institute. He has published more than 270 articles in prestigious journals.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#108: ENCORE The Aging Population with Bob Roth

dyllen@grippimedia.com (John Marchica) — Fri, 24 Jul 2020 07:00:33 +0000

Bob Roth founded Cypress with his family in 1994 and has been at the helm as Managing Partner since December 2003. Experienced in consumer products, healthcare and software since 1984, Bob is considered an innovator of technologies used to enhance communication and effectively support customers and peers in the health and home care industries.

Bob was a finalist for the 2015 Phoenix Business Journal’s prestigious Healthcare Heroes award. In 2013 Cypress was awarded the Better Business Bureau’s Business Ethics Award, the only home care agency to be nominated let along win this coveted award. His community involvement includes hosting a weekly radio show, writing publications, serving on various boards and advisory committees, representing Cypress at networking events and attending conferences.

Nationally, Bob serves on the Home Care Association of America (HCAOA), locally; he serves on the Board of Directors for the Banner Alzheimer’s Foundation, DUET Partners in Aging and is on the ambassador committee for Aging 2.0 – Phoenix Chapter. When he’s not working, Bob enjoys playing golf, tennis, hiking and walking with Lacey, our pet therapy dog.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#107: ENCORE Three Dartmouth Guys Talk Health Care

dyllen@grippimedia.com (John Marchica) — Fri, 17 Jul 2020 07:00:15 +0000

David Radley

David Radley is a senior scientist for The Commonwealth Fund’s Tracking Health System Performance program. Dr. Radley and his team develop national, state, and substate regional analyses on health care system performance and related insurance and care system market structure analyses. He is also a senior study director at Westat, a research firm that supports the Scorecard project. He joined the Commonwealth Fund in July 2010 from Abt Associates where he was associate in Domestic Health Policy with responsibility over a number of projects related to measuring long term care quality and evaluation of various Health Information Technology initiatives. His methodological expertise is in small-area analysis and in the design, implementation, and interpretation of observational studies that take advantage of large administrative and survey-based datasets.

Dr. Radley received his bachelors from Syracuse University, a masters in public health from Yale, and a PhD from Dartmouth College in Health Policy and Clinical Epidemiology.

Trafford Crump, PhD

Dr. Crump is part of a University of British Columbia-led research team – which includes strong collaboration from the Vancouver Coastal Health Authority and the B.C. Ministry of Health – that has undertaken one of the largest systematic collections of patient-reported outcomes (PROs) in Canada.

Dr. Crump received his doctorate from Dartmouth College in the field of Evaluative Clinical Sciences followed by a postdoctoral fellowship at The University of British Columbia.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#106: ENCORE Behavioral Economics with Dr. Allen Weiss

dyllen@grippimedia.com (John Marchica) — Fri, 10 Jul 2020 07:00:14 +0000

Dr. Allen Weiss graduated from Columbia University’s College of Physicians and Surgeons and is board certified in Rheumatology, Internal Medicine, and Geriatrics. He is a Fellow of the American College of Physicians and the American College of Rheumatology.

In 2017, Dr. Weiss became an Assistant Professor of Medicine at the Mayo Clinic School of Medicine and was also elected to the American Hospital Association Board. He’s been named to Becker’s Top 100 Outstanding Physician leaders of healthcare systems several times now.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#105: ENCORE Partnering with IDNs and ACOs, with Scott Hylla

dyllen@grippimedia.com (John Marchica) — Fri, 26 Jun 2020 07:00:06 +0000

Scott Hylla, Director; Health Systems

Scott Hylla is the Director of Health Systems for Sunovion Pharmaceuticals Inc. He has served in various roles spanning a 28 year career in the pharmaceutical industry, most recently in leading the Sunovion Health Systems team in the development and execution of collaborative strategies in the transformational IDN marketplace.

Scott has a BS in Biology from St. John’s University and an MBA in Healthcare Management from the Opus College of Business, University of St. Thomas. He is a member of American College of Healthcare Executives and is a corporate participant in the Health Management Academy and Advisory Board.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#104: ENCORE Commonwealth Primary Care ACO with Dr. Curtis Page

dyllen@grippimedia.com (John Marchica) — Fri, 19 Jun 2020 07:00:22 +0000

Dr. Curtis Page is quite invested in health care reform and currently serves as the CEO & president of the Commonwealth Primary Care Accountable Care Association, an entity that represents over 50 primary care practices in Maricopa County and Flagstaff. The Commonwealth ACO is primarily focused on redesigning the healthcare delivery system to place primary care and their patients at the center of the healthcare paradigm.

Dr. Page went to Harvard Medical School and is double board certified in Family Practice and Addiction Medicine. In 2001, Dr. Page returned to Tempe and joined his father’s practice, then known as Tempe Primary Care Associates. Along with his ACO, to further engage in community health, Dr. Page has also developed AAFP sponsored Group Visit/Educational programs covering Smoking Cessation, Diabetes, COPD, CHF and Cardiovascular disease.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#103: ENCORE Functional Wellbeing with Sean Sullivan

dyllen@grippimedia.com (John Marchica) — Fri, 12 Jun 2020 07:00:05 +0000

Sean Sullivan, JD

Sean Sullivan is the Co-Founder, President and CEO of the Institute for Health and Productivity Management, as well as the WorkPlace Wellness Alliance which was created by the World Economic Forum, now managed and sustained by the Institute. Founded in 1997, the Institute is a global enterprise that serves as a catalyst and champion for a growing international movement to establish health as the new “human capital asset” and source of competitive workforce advantage for the 21st century economy.

Sean speaks regularly at Forums in Europe and the United Kingdom and has held training and certification academies in Brazil, China and the United Arab Emirates. Prior to founding the Institute with two physicians, Mr. Sullivan was the original President and CEO of the National Business Coalition on Health for five years, and spent ten years as a Washington-based health economist and policy analyst – as a fellow at the American Enterprise Institute (AEI) for Public Policy Research, and as Executive Vice President of New Directions for Policy. Mr. Sullivan holds degrees in economics from Harvard and law from Stanford.

John Marchica, CEO, Darwin Research Group

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#102: ENCORE Social Determinants of Health with Dr. Joshua Lenchus

dyllen@grippimedia.com (John Marchica) — Fri, 5 Jun 2020 07:00:32 +0000

Joshua Lenchus, DO, RPh, FACP, SFHM

Joshua Lenchus holds a pharmacy degree from the University of Florida, and graduated from Nova Southeastern University College of Osteopathic Medicine in 2000. He currently works as a hospitalist at Jackson Memorial Hospital for the University of Miami Miller School of Medicine.

In 2012, was elected as the youngest and the first osteopathic President of the Jackson Health System medical staff and chairman of its medical executive committee. He was subsequently re-elected in 2014 and 2016. In 2007 he developed a novel curriculum centered about simulation-based invasive bedside procedural instruction. Now in its eleventh year, the program has transformed the way procedures are taught and performed, decreasing complications thereby leading to safer patient care.

Outside the hospital, Dr. Lenchus is incredibly involved, serving as a leader, in multiple county, state and national medical associations, including as the newly elected President of the Florida Osteopathic Medical Association, the Florida Medical Association, the American College of Physicians, and the Society of Hospital Medicine.

About Darwin Research Group

#101: ENCORE Northwell Health’s Successful Rebranding with Ramon Soto

dyllen@grippimedia.com (John Marchica) — Fri, 29 May 2020 17:07:56 +0000

About Darwin Research Group

#100: A Recap of Our Last 3 Seasons

dyllen@grippimedia.com (John Marchica) — Fri, 8 May 2020 05:23:10 +0000

This week on Health Care Rounds, as we wrap up our third season, we are celebrating our 100th episode! Tune in as John and podcast producer Kim Ascuitto share highlights from some of our best episodes, covering topics like Big Pharma, our aging population, care management, value-based care, and the changing health care delivery environment.

In this episode, we include clips from the following guests:

Ramon Soto, Chief Marketing and Communications Officer, Northwell Health
Dr. Curtis Page, CEO, Commonwealth Primary Care ACO
Scott Hylla, Director, Health Systems - Market Access, Sunovion Pharmaceuticals
A.J. Loicano, CEO, Capital Rx
Dr. David Hong, Associate Vice President of Clinical Research, MD Anderson Cancer Center
Bob Roth, Managing Partner, Cypress Homecare Solutions
Dr. Andy Lazris, Personal Physician Care
Suzanne Delbanco, Executive Director, Catalyst for Payment Reform
Dr. Neil Meltzer, President and CEO, Lifebridge Health
Dr. Joshua Lenchus, Regional Chief Medical Officer, Broward Health
Rosemarie Day, Founder and CEO, Day Health Strategies
Dr. Robert Pearl, Forbes Contributor, Author, Stanford Faculty, former CEO, Permanente Medical Group
Dr. Mark Briesacher, Senior Vice President, Chief Physician Executive, Intermountain Healthcare

We hope that you enjoy sharing this milestone episode with us.

Kim Asciutto, Podcast Manager and Producer, Health Care Rounds

Kim Asciutto is the podcast manager and producer for Health Care Rounds and marketing associate for Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. Kim is graduating from Arizona State University, W.P. Carey School of Business with an undergraduate degree in Business Marketing.

John Marchica, CEO, Darwin Research Group

John Marchica is a veteran health care strategist and COO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

About Darwin Research Group

#99: Closing Gaps in Health Care with Debbie Welle-Powell

dyllen@grippimedia.com (John Marchica) — Fri, 1 May 2020 07:00:07 +0000

This week, John speaks with Debbie Welle-Powell, Chief Population Health Officer with Essentia Health. They discuss what it means to be a value-based organization and what services bring value to patients. They also identify opportunities for bending the cost curve for future value-based contracts and recognizing the need for coordinated care. Debbie shares some of her experiences in managing provider value to patients as well as maintaining patient engagement. She also touches on the positive impacts of telehealth during a global pandemic.

#98: Simplifying Value-Based Care with Kyle Swarts and Dr. Matt Lambert

dyllen@grippimedia.com (John Marchica) — Fri, 24 Apr 2020 07:22:17 +0000

Today on Health Care Rounds, John speaks with Kyle Swarts and Dr. Matt Lambert. They discuss their journey to simplify value-based care with Curation Health, an advanced clinical decision support platform serving the health care community in improving overall performance. In this episode, Swarts and Dr. Lambert emphasize their aim to navigate a strategy to close care gaps between providers and patients while maintaining overall satisfaction. They also discuss the high demand of value-based care in the industry as well as some major shifts happening in health care in the wake of the Covid-19 pandemic.

#97: Women Transforming Health Care with Rosemarie Day

dyllen@grippimedia.com (John Marchica) — Fri, 17 Apr 2020 07:00:05 +0000

Today on Health Care Rounds, John sits down with Rosemarie Day, founder and CEO of Day Health Strategies. Rosemarie talks about her passion for health care reform and introduces her new book, Marching Toward Coverage: How Women Can Lead the Fight for Universal Healthcare. Rosemarie emphasizes the power that women bring to the health care reform movement and why women need to be at the forefront of change.

#96: Shaping Payment Reform in Health Care with Suzanne Delbanco

dyllen@grippimedia.com (John Marchica) — Fri, 10 Apr 2020 07:00:09 +0000

This week, Health Care Rounds welcomes Suzanne Delbanco, executive director of Catalyst for Payment Reform. Suzanne shares her experiences in improving the health care system and gives an outlook on payment reform and thought leadership. In this episode, Suzanne notes that employers and other health care purchasers focus on the importance of integrated care, overall value, and the main cost drivers in health care. Suzanne reveals the relevance in addressing social determinants of health and seeks a solution on how to make drugs both available and affordable for patients.

#95: Recognizing True Value in Health Care with Gail Zahtz

dyllen@grippimedia.com (John Marchica) — Fri, 3 Apr 2020 07:00:04 +0000

This week, John speaks with Gail Zahtz about the intersection of system’s design and value in healthcare. They discuss what health systems can learn from Covid-19, the true meaning of value, and what it takes to achieve better patient outcomes. At Centers Healthcare — one of the largest post-acute providers in New York — Zahtz leads their efforts to improve care by executing better designed solutions. Zahtz shares her positive outlook on how our health care professionals are responding to the recent COVID-19 pandemic and recognizes their dedicated, hard work during this time. Zahtz also talks about her personal experiences in health care, which has uncovered her true passion for the industry.

#94: Using AI to Improve Clinical Outcomes with Stefan Behrens, PhD

dyllen@grippimedia.com (John Marchica) — Fri, 27 Mar 2020 07:00:15 +0000

This week, John sits down with Stefan Behrens, PhD, co-founder and CEO of GYANT, an artificial intelligence (AI) driven chat tool to help steer patients to the appropriate site of care. Stefan talks about how AI can improve clinical outcomes, and can help health systems and payers lower costs. Most recently, the GYANT architecture is helping triage patients suspected of contracting COVID-19 at some of the nation’s prominent health systems, including Intermountain.

#93: A True Outlook on American Health Insurance with Christopher Robertson

dyllen@grippimedia.com (John Marchica) — Fri, 20 Mar 2020 16:55:34 +0000

Today on Health Care Rounds, we welcome Christopher Robertson, Associate Dean for Research and Innovation and Professor of Law at the University of Arizona. With his diverse background in law and economics, Chris offers a unique and thoughtful perspective on the American health care system. In this episode, he offers unique insights about the unwarranted effects of co-pays and co-insurance on health care utilization and quality of care. John and Chris also discuss COVID-19 and the economic impact of the coronavirus pandemic here and abroad. Chris is the author of Exposed: Why Our Health Insurance is Incomplete and What can be Done About It, recently published by Harvard University Press.

#92: A Reliable Home Health Care with Assaf Shalvi

dyllen@grippimedia.com (John Marchica) — Fri, 13 Mar 2020 07:00:01 +0000

This week, John speaks with Assaf Shalvi, CEO and co-founder of Swift Shift. In creation of his business, Shalvi focuses on the demand for efficiency in home health care. He strives to improve the management and quality of the industry through partnerships of Homecare providers and Health Plans. This episode recognizes the common barriers of low caregiver presence in home health care while uncovering the arising opportunities in recreating a more reliable one. Shalvi talks about the efforts Swift Shift makes toward employee experience and driving success with data and analytic approaches.

#91: What it’s Like to be an American Physician Practicing in Canada, with Dr. Peter Cram

dyllen@grippimedia.com (John Marchica) — Fri, 6 Mar 2020 07:00:12 +0000

In this week’s Health Care Rounds, John sits down with Dr. Peter Cram, Director of General Internal Medicine and Geriatrics at Sinai Health System in Toronto. John and Peter discuss the similarities and differences between the U.S and Canada in health care delivery. Having trained and practiced in both the U.S. and Canada — and as a leading health care services researcher — Dr. Cram offers key insights and lessons about health care delivery and payment reform that health care leaders on both sides of the border will appreciate.

#90: Preventing Physician Burnout through Improved EHRs with Dr. Scott Weingarten

dyllen@grippimedia.com (John Marchica) — Fri, 28 Feb 2020 07:00:11 +0000

Today on Health Care Rounds, John speaks with Dr. Scott Weingarten, CEO of Stanson Health and former Chief Clinical Transformation Officer for Cedars-Sinai Medical Center. He discusses the future of improving patient satisfaction and the prevention of physician burnout with new technology in electronic health records. Dr. Weingarten also touches on the development of next generation clinical decision support with an emphasis on creating valuable patient-provider relationships in order to improve overall patient quality.

#89: Driving Success in Population Health with Dr. Arshad Rahim

dyllen@grippimedia.com (John Marchica) — Fri, 21 Feb 2020 07:00:02 +0000

Today, John speaks with Dr. Arshad Rahim, a practicing physician and expert in population health and quality improvement at Mount Sinai Health System. He shares with us critical success factors in population health and value based care, and demonstrates his passion for driving patient quality. Dr. Rahim also speaks on the topics of physician engagement and the relationship between centralizing costs and utilization..

#88: Solutions in Digital Communications with Brian Peet & Dr. Christian Annese

dyllen@grippimedia.com (John Marchica) — Fri, 14 Feb 2020 07:00:06 +0000

This week, John speaks with Brian Peet, the CEO and Co-Founder of DocCom, a digital platform teaching online communication skills for health care providers, to discuss the barriers in health care communication. Along with Peet, Dr. Christian Annese explains the motivation behind DocCom and reveals the born inspiration behind StatChat, a new application that enables health care providers to instantly and securely communicate information through mobile and desktop devices. Peet and Annese both express their passions for the future of health care while bringing overall value into the field. To track the launch of StatChat, visit StatChat.com.

#87: Health Care Affordability and High-Quality Care with Dr. Mark Briesacher

dyllen@grippimedia.com (John Marchica) — Fri, 7 Feb 2020 14:00:17 +0000

This week’s guest is Dr. Mark Briesacher, Senior Vice President and Chief Physician Executive for Intermountain Healthcare and President of Intermountain Medical Group. Dr. Briesacher talks about Intermountain’s core values and explains the critical success factors behind becoming a leading integrated health system in the United States. He also discusses the future affordability of health care and reveals Intermountain’s aspirational role to provide high-value care at lower costs. Dr. Briesacher also leads Intermountain’s podcast, and in the interview he addresses how Intermountain uses podcasts as a successful vehicle for employee engagement.

#86: Innovations in Health Care Communications with Chris Cullmann

dyllen@grippimedia.com (John Marchica) — Fri, 31 Jan 2020 08:00:12 +0000

John hosts an intriguing discussion with special guest Chris Cullmann, an expert strategist in digital marketing for health care and pharmaceutical brands, and Head of Digital and General Manager with RevHealth. Cullmann speaks on the demands of EHR systems as well as the wide variety of value concepts in healthcare. Chris’ expression for innovation in health care communication is unmatched, and shares with us his advice for implementing a successful digital communication strategy.

#85: Discussing VA Health Care with Dr. David Shulkin

dyllen@grippimedia.com (John Marchica) — Fri, 24 Jan 2020 07:00:03 +0000

This week John speaks with Dr. David Shulkin, former US Secretary for Veterans Affairs and Chief Innovation Officer for Sanford Health. Dr. Shulkin shares with us his passion for the advocacy of veterans and the importance of public transparency. He speaks on the impact of behavioral health in veterans and shares what he worked on to address this problem. He also discusses his new book, It Shouldn’t Be This Hard to Serve Your Country; Our Broken Government and the Plight of Veterans.

#84: Driving Value Through Perioperative Medicine with Dr. Zeev Kain

Fri, 17 Jan 2020 14:49:41 +0000

If you're like most people, you probably don't know the first thing about perioperative medicine. We didn't either, until John sat down with Dr. Zeev Kain, the founder and president of the American College of Perioperative Medicine. We learned that this emerging field of medicine holds a lot of promise for improving surgical outcomes, lowering costs, and increasing patient satisfaction.

#83: The Future of Health Care with Dr. Robert Pearl

dyllen@grippimedia.com (John Marchica) — Fri, 10 Jan 2020 07:00:10 +0000

It’s the question on everyone’s mind — at least those in health care — what’s wrong with our health care system and how do we fix it? This week, John sits down with Dr. Robert Pearl, host of the popular health care podcast, Fixing Healthcare, for a fascinating discussion. Dr. Pearl was formerly CEO of Permanente Medical Group, one of the largest physician practices in the U.S. and which consistently ranks in the top 10 programs for clinical quality by the National Committee for Quality Assurance (NCQA).

#82: Curing Medicare with the Running Doc Unhinged

dyllen@grippimedia.com (John Marchica) — Fri, 15 Nov 2019 07:00:07 +0000

This week, we close out Season 2 of Health Care Rounds with Dr. Andy Lazris. A board-certified internist, Dr. Lazris’ private practice, Columbia, Md.-based Personal Physician Care, is dedicated to providing individualized and comprehensive care for its patients. We found Dr. Lazris on YouTube where he’s better known as the Running Doc Unhinged. Listen today and learn about common sense medical practice reforms and why aging patients need to be cared for differently — and better — than they are today.

#81: Our Take, November 11, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 11 Nov 2019 07:00:04 +0000

Other briefs include:

Stryker signed a definitive agreement to acquire Wright Medical Group.
Amgen will pay $2.7 billion for a 20.5% ownership stake in BeiGene, a research-based, oncology-focused biotech company headquartered in Beijing.
The University of Louisville announced that it has completed the acquisition of KentuckyOne Health’s Louisville-area assets from CommonSpirit Health.
HealthPartners is closing its mail order and all 30 retail pharmacy locations, and will lay off 300 workers.
Dr. Philip Ozuah will become Montefiore Medicine’s new CEO.
Dr. Stephen Hahn has been nominated as the FDA’s new commissioner.
Several updates from CMS.

About Darwin Research Group

#80: Our Take, November 4, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 4 Nov 2019 07:00:01 +0000

Other briefs include:

Insurers will receive $1.59 billion in unpaid subsidies if the federal government follows through on a judge’s order.
California’s attorney general put the kibosh on the Adventist-St. Joseph merger.
UPMC has begun building a network of hospitals in China.
Fifteen drug companies settled an Illinois Medicaid fraud suit for $242 million.
An Oregon insurer has filed an antitrust lawsuit against three health systems.
Thomas Zenty, the CEO of Cleveland-based University Hospitals for almost 18 years, will retire in January 2021.

About Darwin Research Group

#79: Strategies for Health Care Innovation with Naomi Fried, Ph.D.

dyllen@grippimedia.com (John Marchica) — Fri, 1 Nov 2019 20:00:05 +0000

This week on Health Care Rounds, Darwin Research Group CEO John Marchica sits down with Naomi Fried, Ph.D., founder and CEO of Health Innovation Strategies. Dr. Fried brings a wealth of experience in understanding how companies affect change, from her tenure as vice president of innovation and external partnerships at Biogen to heading up innovation and technology efforts at Kaiser Permanente. CONNECT WITH US: 🌐 Visit us on the web 🌐 Follow Health Care Rounds on LinkedIn 🌐 Follow Darwin Research Group on LinkedIn 📺 Watch Health Care Rounds on YouTube 🎧 Listen on Apple Podcasts 🎧 Listen on Spotify ⚙️ Health Care Rounds is produced by Grippi Media

#78: Our Take, October 28, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 28 Oct 2019 07:00:07 +0000

In this week’s Our Take, we’re covering the latest events in Biogen, involving their second life for aducanumab. To sign up for the weekly email brief, click here.

Other briefs include:

California releases its first report on drug pricing, in an effort to improve transparency.
Bristol-Myers Squibb-Pfizer Alliance is collaborating with Fitbit for atrial fibrillation detection.
Amazon is partnering with City of Hope to provide cancer support services to U.S. Amazon employees and their families.
Hackensack Meridian Health and Englewood Health have signed a definitive merger agreement.
RWJBarnabas Health has signed a non-binding letter of intent to acquire Trinitas Regional Medical Center and its affiliates.
Drug distributors McKesson, AmerisourceBergen, and Cardinal Health are discussing an agreement with state and local authorities to settle thousands of opioid-related lawsuits for $18 billion.

About Darwin Research Group

#77: Our Take, October 21, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 21 Oct 2019 07:00:06 +0000

In this week’s Our Take, we’re covering the latest events in the Sutter Health antitrust trial. To sign up for the weekly email brief, click here.

Other briefs include:

California releases its first report on drug pricing, in an effort to improve transparency.
Bristol-Myers Squibb-Pfizer Alliance is collaborating with Fitbit for atrial fibrillation detection.
Amazon is partnering with City of Hope to provide cancer support services to U.S. Amazon employees and their families.
Hackensack Meridian Health and Englewood Health have signed a definitive merger agreement.
RWJBarnabas Health has signed a non-binding letter of intent to acquire Trinitas Regional Medical Center and its affiliates.
Drug distributors McKesson, AmerisourceBergen, and Cardinal Health are discussing an agreement with state and local authorities to settle thousands of opioid-related lawsuits for $18 billion.

About Darwin Research Group

#76: High-performing organizations with Brian Klepper, EVP, The Valuation Institute

Fri, 18 Oct 2019 16:00:06 +0000

Everyone says that they are a high-performing organization, but which ones really are? Which health care organizations have proven to deliver better outcomes at lower costs? This week, John sits down with the dynamic Brian Klepper, Ph.D., executive vice president of The Valuation Institute. Brian offers examples of unusually high-performing health care organizations and the secrets to their success. CONNECT WITH US: 🌐 Visit us on the web 🌐 Follow Health Care Rounds on LinkedIn 🌐 Follow Darwin Research Group on LinkedIn 📺 Watch Health Care Rounds on YouTube 🎧 Listen on Apple Podcasts 🎧 Listen on Spotify ⚙️ Health Care Rounds is produced by Grippi Media

#75: Our Take, October 14, 2019

Mon, 14 Oct 2019 07:00:05 +0000

In this week’s Our Take, we’re covering the proposed rules to ease restrictions imposed by Stark Law, anti-kickback statute. To sign up for the weekly email brief, click here.

Other briefs include:

Dartmouth-Hitchcock Health and GraniteOne Health signed an agreement to merge.
Walmart is testing new health benefits to help employees receive appropriate care.
ICER pulled a draft evidence report it released in late September on three new rheumatoid arthritis drugs.
UPS is set to expand its drone delivery service to hospital campuses nationwide.
Civica Rx’s first drug has been administered to patients.
Dr. Patrick Conway has stepped down as CEO of Blue Cross Blue Shield of North Carolina.

About Darwin Research Group

#74: Our Take, October 7, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 7 Oct 2019 07:00:05 +0000

In this week’s Our Take, we’re covering the latest results from the Medicare Shared Savings Program ACO data, just released last week. To sign up for the weekly email brief, click here.

Other briefs include:

Dartmouth-Hitchcock Health and GraniteOne Health signed an agreement to merge.
Walmart is testing new health benefits to help employees receive appropriate care.
ICER pulled a draft evidence report it released in late September on three new rheumatoid arthritis drugs.
UPS is set to expand its drone delivery service to hospital campuses nationwide.
Civica Rx’s first drug has been administered to patients.
Dr. Patrick Conway has stepped down as CEO of Blue Cross Blue Shield of North Carolina.

About Darwin Research Group

#73: Our Take, September 30, 2019

dyllen@grippimedia.com (John Marchica) — Sun, 29 Sep 2019 21:00:02 +0000

In this week’s Our Take, we’re covering the antitrust trial for Sutter Health, and implications for future health system mergers. To sign up for the weekly email brief, click here.

Other briefs include:

Lafayette General Health to merge with Ochsner Health System.
CMS finalized a rule for implementing Medicaid DSH payment cuts.
Connecticut is working to create the state’s first network of Centers of Excellence.
Amazon is piloting a virtual health clinic called Amazon Care.
RWJBarnabas Health and St. Luke’s University Health Network signed a three-year clinical affiliation agreement.
CVS is launching a new pharmacy solution designed to give patients quicker access to specialty drugs.

About Darwin Research Group
Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

#72: Reinventing the PBM Model with A.J. Loiacono

dyllen@grippimedia.com (John Marchica, A.J. Loiacono) — Fri, 27 Sep 2019 20:31:42 +0000

Several weeks ago we reported on Capital Rx, a new PBM with a “clearinghouse model” designed to eliminate spread pricing and price variability — and promote greater transparency. This week, John sits down with A.J. Loiacono, a veteran entrepreneur and CEO of Capital Rx. Listen in and learn about what’s wrong with pharmaceutical pricing and how A.J. intends to fix it.

Speaker Bios
A.J. Loiacono, CEO, Capital Rx
A.J. is a successful entrepreneur, with 20 years of experience in pharmacy benefits and software development. As the CEO of Capital Rx, his mission is to change the way pharmacy benefits are priced and administrated in the US. Prior to Capital Rx, A.J. was a co-founder of Truveris, where he served for eight years as CEO, Chief Innovation Officer, and Board Member, leading the company to record growth (Deloitte FAST 500 and Crain’s Fast50). Prior to Truveris, A.J. co-founded SMS Partners, a joint venture with Realogy (RLGY), and in 2010 exited the partnership with a buyout. In his first venture, A.J. started Victrix, a pharmaceutical supply chain software consultancy, and successfully sold the company to Chrysalis Solutions in 2007.

John Marchica, CEO, Darwin Research Group
John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade. John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

#71: Our Take, September 23, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 23 Sep 2019 07:00:16 +0000

In today’s Our Take read-in, we discuss hospital market concentrations and their association with DOJ investigations and inpatient prices. To sign up for the weekly email brief, click here.

Other briefs include:

Novo Nordisk announced that Rybelsus has been approved by the FDA for the treatment of type 2 diabetes.
NUW Medicine, MultiCare Health System, and LifePoint Health have partnered to form a clinically integrated network known as Embright.
Sanofi and Abbott are collaborating to integrate their diabetes-related technologies.
Blue Shield of California is testing rideQ, a ride-share program launched by the Blue Cross Blue Shield Institute last year, in the Sacramento area.
Tennessee has proposed switching its Medicaid funding to a block grant.

#70: Our Take, September 16, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 16 Sep 2019 07:00:06 +0000

In today’s Our Take read-in, we review value-based payment models in oncology. If this is your field, this episode is one you don’t want to miss. To sign up for the weekly email brief, click here.

Other briefs include:

Capital Rx, a startup pharmacy benefit manager, launches its Clearinghouse Model.
The owners of Purdue Pharma, maker of OxyContin, tentatively agreed to pay $3 billion to settle opioid-related lawsuits.
Cigna introduced a new program to make expensive gene therapies more accessible.
370 health care organizations signed a letter to Congress in support of bipartisan legislation to reform prior authorization requirements.
Insurers will owe a record $1.3 billion in medical loss ratio rebates this year.
Several executive moves.

#69: Our Take, September 9, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 9 Sep 2019 07:00:04 +0000

In today’s Our Take read-in, here’s the lead: “A judge ordered Johnson & Johnson to pay $572 million to Oklahoma for creating a ‘public nuisance.’ The state had sought $17.5 billion in a lawsuit against J&J, contending that the company had engaged in misleading marketing and contributed to the opioid epidemic that has claimed the lives of more than 6,000 Oklahomans. J&J plans to appeal, and the company’s shares rose in after-hours trading on the day of the ruling, suggesting that investors believed the outcome could have been much worse.” To sign up for the weekly email brief, click here.

Other briefs include:

Capital Rx, a startup pharmacy benefit manager, launches its Clearinghouse Model.
A federal judge officially approves the merger between CVS Health and Aetna.
Michigan-based insurers Priority Health and Total Health Care will merge.
Amgen will buy Celgene’s Otezla (apremilast), a psoriasis drug, for $13.4 billion.
CMS rejects Idaho’s request for a waiver for Medicaid expansion.
Blue Cross and Blue Shield of Minnesota announcea 5-year, value-based agreement with Minnesota Oncology.

#68: Our Take, August 26, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 26 Aug 2019 07:00:21 +0000

In today’s Our Take read-in, here’s our lead story: Good Neighbor Pharmacy tops the list of chain drugstores in customer satisfaction, according to a new survey by J.D. Power and Associates. The network of independent pharmacies received the highest overall score among brick-and-mortar chain store pharmacies, with a score of 914 out of 1,000 possible points, followed by Health Mart (893), Rite Aid Pharmacy (865), Walgreens (840), and CVS (834). To sign up for the weekly email brief, click here.

Note that we’re not uploading a read-in next week due to the Labor Day holiday.

Other briefs include:

CMS announced that quality star ratings for qualified health plans offered on the Health Insurance Marketplace will be available in 2020.
Signify Health and Remedy Partners signed a definitive agreement to merge.
SSM Health formed a joint venture with Denver-based Paladina Health to offer direct-to-employer primary care in the St. Louis area.
Three new drug approvals for AbbVie, Genentech, and Nabriva Therapeutics.

#67: Our Aging Crisis with Bob Roth

dyllen@grippimedia.com (John Marchica) — Thu, 22 Aug 2019 07:00:10 +0000

This week, Bob Roth returns to Our Take to discuss America’s growing aging population and implications for ignoring what he calls the Aging Crisis. Bob’s passion for caring for the elderly stems from his personal experience with his own mother, which led to the creation of Cypress HomeCare Solutions, the Roth family business. Listen to the elder care issues Bob is calling out—and what we need to do about it.

Speaker Bios
Bob Roth, Managing Partner, Cypress HomeCare Solutions
Bob Roth founded Cypress with his family in 1994 and has been at the helm as Managing Partner since December 2003. Experienced in consumer products, healthcare and software since 1984, Bob is considered an innovator of technologies used to enhance communication and effectively support customers and peers in the health and home care industries.

Bob was a finalist for the 2015 Phoenix Business Journal’s prestigious Healthcare Heroes award. In 2013 Cypress was awarded the Better Business Bureau’s Business Ethics Award, the only home care agency to be nominated let alone win this coveted award. His community involvement includes hosting a weekly radio show, writing publications, serving on various boards and advisory committees, representing Cypress at networking events and attending conferences.

#66: Our Take, August 19, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 19 Aug 2019 07:00:07 +0000

In today’s Our Take read-in, we discuss Commercial Accountable Care Organizations, including updates on programs from UnitedHealthcare, Aetna, Cigna, Humana, and Anthem. To sign up for the weekly email brief, click here.

Other briefs include:

Harvard Pilgrim Health Care and Tufts Health Plan have signed a definitive agreement to merge.
Humana files a lawsuit against Mallinckrodt plc.
The FDA has approved Pretomanid Tablets, a game changer in the treatment of treatment-resistant tuberculosis.
Centene is expanding its health exchange offerings to ten more states.

#65: Our Take, August 12, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 12 Aug 2019 00:00:04 +0000

In today’s Our Take read-in, “The FDA announced Tuesday that Novartis submitted the drug application for Zolgensma, the company’s novel gene therapy treatment for spinal muscular atrophy, with manipulated data. The FDA said it is assessing the matter and ‘remains confident’ that the gene therapy will continue to be available to patients.” To sign up for the weekly email brief, click here.

Other briefs include:

Allscripts Healthcare Solutions reached a tentative $145 million settlement agreement with the Department of Justice.
CMS has agreed to reimburse any FDA-approved chimeric antigen receptor (CAR) T-cell therapies.
SSM Health is introducing an individual health plan in the St. Louis market this fall.
Provention Bio’s teplizumab received the FDA’s Breakthrough Therapy Designation.
New York City launched NYC Care, a program that offers health care to uninsured residents.
CVS has expanded its CarePass program to participating CVS pharmacies throughout the U.S.
Walgreens customers can soon get select prescription Bausch Health dermatology products for a flat rate.

#64: Our Take, August 5, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 5 Aug 2019 00:00:29 +0000

In today’s Our Take read-in, we discuss several CMS initiatives announced last Monday. The email version of Our Take includes several important links to other final and proposed rules from CMS. To sign up for the weekly email brief, click here.

Other briefs include:

Pfizer signed a definitive agreement to merge its Upjohn division with Mylan.
HHS is working on a plan to allow the legal importation of prescription drugs.
CMS denies Utah’s request for partial Medicaid expansion.
Cigna and Memorial Sloan Kettering (MSK) sign a value-based agreement.
Philadelphia’s Temple University will sell its Fox Chase Cancer Center to Thomas Jefferson University.

#63: Our Take, July 29, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 29 Jul 2019 03:53:41 +0000

In today’s Our Take read-in, we discuss a bipartisan bill to lower drug prices that cleared a Senate committee. On Thursday, the Senate Finance Committee voted 19-9 to advance a bill proposed by Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., that includes numerous provisions to lower drug prices. The bill, called the Prescription Drug Pricing Reduction Act (PDPRA) of 2019, is likely to undergo considerable changes before it reaches the Senate floor for a full vote — if it gets that far.

Over the span of a decade, the PDPRA as it currently stands would save $85 billion in Medicare spending and another $15 billion in Medicaid spending. Further, the Congressional Budget Office estimated that Medicare beneficiaries would save $27 billion in out-of-pocket costs and $5 billion in premiums during that same time period.

Other briefs include:

New research on ACOs with two-sided risk suggests lower costs and improved health outcomes.
Tenet Healthcare Corp. is spinning off its Conifer business unit.
CVS is testing a coordinated care pilot for Aetna beneficiaries requiring knee replacements.
Civica Rx signs a five-year agreement with London-based Hikma, a generic drug manufacturer.
Advocate Aurora Health names former Advocate CEO Jim Skogsbergh as president and CEO.
Paula Steiner leaves her post as CEO of Health Care Services Corp.
CVS Health names Dr. Sree Chaguturu as chief medical officer for CVS Caremark.
Dr. Reshma Kewalramani is being elevated to CEO of Vertex Pharmaceuticals.

#62: Behavioral Health & Mobile Apps with Dr. Julie Kinn

dyllen@grippimedia.com (John Marchica) — Thu, 25 Jul 2019 00:00:14 +0000

In this week’s episode, John sits with military psychologist Dr. Julie Kinn to talk about the latest behavioral health mobile apps and online resources developed by the Defense Health Agency (DHA). Dr. Kinn discusses how DHA’s technology combats the stigma present around behavioral health issues so that both veterans and civilians are more inclined to seek care. Check out some of their free mobile apps: Virtual Hope Box, Breathe2Relax, and T2 Mood Tracker. For more resources, go to www.health.mil/connectedhealth.

Speaker Bios
Dr. Julie Kinn is a licensed clinical psychologist with over 15 years of experience researching and implementing health technology for suicide prevention and other behavioral health promotion. At the Department of Defense (DoD), Defense Health Agency (DHA), Julie oversees the development and implementation of health technology for the military and veteran community and leads the DHA Usability Lab. She also initiated the Military Health Podcast program and produces/hosts three DoD podcasts: A Better Night’s Sleep, The Military Meditation Coach, and Next Generation Behavioral Health. Julie received her B.A. in psychology from Indiana University, an M.A. in clinical psychology from the University of North Carolina at Charlotte, and her Ph.D. in clinical and community psychology from the University of Illinois at Chicago.

John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade. John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.

#61: Our Take, July 22, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 22 Jul 2019 00:00:02 +0000

In this week’s episode, we focus on Intermountain Healthcare’s announcement that it has formed a “comprehensive health platform company focused on elevating value-based care capabilities.” The new organization, named Castell, will be led by Rajesh Shrestha as president and CEO. Shrestha will continue to serve as vice president and chief operating officer of Community Based Care for Intermountain.

Other briefs include:

Gilead Sciences’ research and development collaboration with Belgian biopharmaceutical company Galapagos NV, valued at more than $5 billion.
Genentech’s recent spate of research agreements.
John Muir Health is forming “a comprehensive relationship” with Optum.
The closing of Michigan’s Together Health Network.
Physician participation in CMS’ Advanced Alternative Payment Models doubles in 2018.
Care New England withdraws from merger discussions with Lifespan and Brown University.
Memorial Hermann names Dr. David Callender as its new president and CEO, effective September 1.

#60: Our Take, July 15, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 15 Jul 2019 00:43:05 +0000

Last Tuesday, three judges from the federal appeals court in New Orleans heard oral arguments regarding the ruling made last December in Texas v. United States. The district judge overseeing the case ruled that the Affordable Care Act (ACA)’s individual mandate is unconstitutional and, therefore, the entire ACA must be overturned. This week’s Our Take discusses what happened during oral arguments and what’s expected next.

Other briefs include:

A federal judge has blocked a Trump administration rule stipulating that drug manufacturers include wholesale prices in television advertising.
President Trump signed an executive order designed to transform kidney care in the U.S.
Boston-based Partners HealthCare announced that its Biobank has surpassed 100,000 participants.
Evanston, lll.-based NorthShore University HealthSystem is merging with Swedish Covenant Health.
Southfield, Mich.-based Beaumont Health System signed a letter of intent to acquire Akron, Ohio-based Summa Health.

#59: Improving Healthcare Through Grassroots Initiatives with Craig Brammer

dyllen@grippimedia.com (John Marchica) — Thu, 11 Jul 2019 00:00:01 +0000

CMS’ Innovation Center has, through federal grants, helped states address specific population health needs. But what happens when entrepreneurs take healthcare improvement seriously, and are able to find innovative ways to align partnerships to effect change? This week, John sits down with Craig Brammer, CEO of The Health Collaborative and President & CEO of the Network for Regional Healthcare Improvement. Craig is an inspirational leader—helping to create change at the national level driven by grassroots efforts of local healthcare leaders.

Speaker Bios
Craig Brammer serves as President & CEO of the Network for Regional Healthcare Improvement (NRHI) & The Health Collaborative, a regional health improvement collaborative in Cincinnati. In these concurrent roles, he is responsible for helping leaders set a shared strategic direction and execute on a broad agenda of improving health and healthcare across the country.

At NRHI, Craig oversees a membership base of over 30 members/state partner regional health improvement collaboratives that are working to improve health, reduce price, and eliminate waste in their communities. At The Health Collaborative, Craig manages a $15 million annual budget and leads a team of 65 health professionals focused on the organization’s three work streams: Healthcare Improvement, Population Health, and Clinical Informatics. He previously served on the leadership team at the Office of the National Coordinator for Health Information Technology in Washington, DC, where he focused on the intersection of technology and payment policy and led a $260 million Federal technology innovation program.

#58: Our Take, July 1, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 1 Jul 2019 00:00:08 +0000

In this week’s episode, we focus on the Supreme Court’s decision to hear arguments from health insurers, who claim $12.3 billion in losses after the federal government reneged on payments owed to certain payers under provisions in the Affordable Care Act (ACA). Business leaders, including the Chamber of Commerce, had urged the court to review an appellate court ruling in June 2018 that Health and Human Services is not obligated to make risk corridor payments to insurers.

Other briefs include:

AbbVie is set to acquire Allergan for approximately $63 billion.
President Trump’s executive order on health care pricing transparency.
Sanford Health and UnityPoint Health signed letter of intent to merge.
CityMD and Summit Medical Group agree to merge.
City of Hope will invest more than $1 billion to create a comprehensive cancer campus in Irvine, Calif.
North Memorial Health and Blue Cross and Blue Shield of Minnesota create joint venture.

#57: Frontiers in International Medicine with Dr. Heitham Hassoun

dyllen@grippimedia.com (John Marchica) — Thu, 27 Jun 2019 00:00:07 +0000

Why are integrated health systems and academic medical centers increasing their focus on international medicine? What lessons can we learn from our colleagues abroad? Find out this week as John sits down with Dr. Heitham Hassoun, vice president and medical director for Cedars-Sinai International Health and Telemedicine.

Speaker Bios
Heitham Hassoun, MD, a leading international health expert, is vice president and medical director of Cedars-Sinai's Center for International Health and Telemedicine. Dr. Hassoun was previously medical director for Global Healthcare at Johns Hopkins Medicine International and an associate professor in the Department of Surgery at Johns Hopkins School of Medicine. Prior to his work at Johns Hopkins, Hassoun served as medical director for Methodist International in Houston and was an associate professor of cardiovascular surgery at Weill Cornell Medical College In New York. He completed his fellowship training in vascular surgery at Northwestern University in Chicago and earned his medical degree at the Baylor College of Medicine in Houston.

#56: Our Take, June 24, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 24 Jun 2019 15:07:43 +0000

In this week’s episode, John shares some of the results from our fifth annual ACO Executive Survey.

Results discussed include:

ACO priorities
2019 initiatives
Operational issues
Factors affecting quality and cost
Electronic health record interoperability
Partnering activity

#55: Our Take, June 17, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 17 Jun 2019 07:00:06 +0000

In this week’s episode, John reviews some of the lessons learned from ExL’s 13th Partnering with ACOs & IDNs Summit, which took place in Boston, June 10-11.

Briefs include:

Anthem signed a definitive agreement to acquire Beacon Health Options.
Washington state proposal to pay for hepatitis C drugs using a “subscription” model approved by CMS.
Penn Medicine has created a clinical alert app that reduces stays in the intensive care unit.
Ascension’s leadership lineup will undergo several changes, beginning July 1.
New York Proton Center has opened its doors.

#54: Building an in-house specialty pharmacy within an IDN with Brett McClain

dyllen@grippimedia.com (John Marchica) — Thu, 13 Jun 2019 07:00:16 +0000

This week, John sits down with Brett McClain, chief operating officer for Dignity Health’s St. Joseph’s Hospital and Medical Center, where he recently oversaw the launch of Dignity’s systemwide specialty pharmacy. Brett speaks to the development of the specialty pharmacy through a strategic partnership, how pharma engages with his health system, the Dignity-CHI merger, and more.

Speaker Bios
Brett McClain is the Chief Operating Officer for Dignity Health’s St. Joseph’s Hospital and Medical Center, and St. Joseph’s Westgate Medical Center. Brett has been with Dignity Health since 2008. His career spans nearly 25 years of health care management experience overseeing various hospital and medical clinic operations. He is an active leader within St. Joseph’s Hospital and Medical Center with roles in a variety of operational and strategic committees and councils. Brett earned degrees in both finance and marketing from the University of Arizona and an MBA from Regis University. He is a Fellow of the National Association of Public Hospitals and board member of Catholic Charities.

#53: Our Take, June 10, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 10 Jun 2019 07:00:04 +0000

In this week’s episode, John reviews CVS’ move to expand its HealthHub stores to 1,500 by the end of 2021. HealthHub stores have expanded space for health-related products and larger health clinics with a lab for blood testing and screening. They also have a general wellness room used for yoga classes and educational events.

We also have our first subscriber feedback, which addresses John’s editorial from last week on Novartis’ new gene therapy priced at $2.1 million.

Briefs include:

Supreme Court ruling on CMS payments to disproportionate-share hospitals.
Partners canceling its agreement to acquire Care New England.
Bon Secours Mercy Health selling its majority share in Ensemble Health.
Connecticut’s withdrawal of a bill to offer a public health insurance option.

#52: Our Take, June 3, 2019

dyllen@grippimedia.com (John Marchica) — Mon, 3 Jun 2019 07:00:11 +0000

In this week’s episode, John reviews Novartis’ new gene therapy for spinal muscular atrophy, priced at more than $2.1 million. ICER, a nonprofit research institute that evaluates the cost effectiveness of pharmaceuticals, said Novartis’ price is within the upper bound of the organization’s value-based price benchmark range.

Briefs include:

A broad bipartisan draft health care legislation package containing dozens of provisions was recently released by the Senate Health Committee.
Forcing oncology practices to take on downside risk in CMS’ Oncology Care Model in July could result in more than half of them owing the government.
UnitedHealth Group pointed to price variations for diagnostic tests as a potential way to reduce overspending.
Mallinckrodt plans to spin off its specialty generics business to shareholders.
The FDA’s recent approval of Novartis’ Piqray (alpelisib).
FDA clears a new wearable device to treat migraine.
Biogen is scrapping its investigational treatment for Alzheimer’s disease, and is canceling its Phase III ENGAGE and EMERGE clinical trials.

#51: Three Dartmouth Guys Talk Health Care

dyllen@grippimedia.com (John Marchica) — Thu, 30 May 2019 07:00:08 +0000

This week, John sits down with Dr. David Radley, senior scientist for The Commonwealth Fund, and Dr. Trafford Crump, assistant professor at the University of Calgary. Trafford and Dave welcomed John to Dartmouth’s PhD program in health economics and clinical epidemiology back in 2005, and have remained good friends ever since.

In this episode, they talk about the politicization of health care, health system performance, what's driving healh care cotsts, patient-reported outcomes, and more.

Speaker Bios
David Radley is a senior scientist for The Commonwealth Fund’s Tracking Health System Performance program. Dr. Radley and his team develop national, state, and substate regional analyses on health care system performance and related insurance and care system market structure analyses. He is also a senior study director at Westat, a research firm that supports the Scorecard project. He joined the Commonwealth Fund in July 2010 from Abt Associates where he was associate in Domestic Health Policy with responsibility over a number of projects related to measuring long term care quality and evaluation of various Health Information Technology initiatives. His methodological expertise is in small-area analysis and in the design, implementation, and interpretation of observational studies that take advantage of large administrative and survey-based datasets. Dr. Radley received his bachelors from Syracuse University, a masters in public health from Yale, and a PhD from Dartmouth College in Health Policy and Clinical Epidemiology.

Trafford Crump, PhD is a health services researcher and assistant professor at the University of Calgary’s Department of Surgery with an interest in patient-centered measures. Dr. Crump's earlier research involved developing the methods for eliciting health care preferences from community-dwelling Medicare beneficiaries in the United States. Dr. Crump's more recent research has expanded into linking primary data collected from patients with large administrative data sets maintained by regional and provincial health authorities. Dr. Crump is part of a University of British Columbia-led research team – which includes strong collaboration from the Vancouver Coastal Health Authority and the B.C. Ministry of Health – that has undertaken one of the largest systematic collections of patient-reported outcomes (PROs) in Canada. Dr. Crump received his doctorate from Dartmouth College in the field of Evaluative Clinical Sciences followed by a postdoctoral fellowship at The University of British Columbia.

#50: Our Take May–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 23 May 2019 07:00:06 +0000

In this week’s episode, John talks about the latest bombshell lawsuit filed by 44 states accusing Teva and other generic drugmakers of price fixing.

Other briefs include:

A house bill introduced to address surprise medical billing.
CMS’ guidance designed to eliminate spread pricing.
Advent International to acquire AccentCare.
Civica Rx announces first two drugs in production.
A hearing is set to review CVS-Aetna merger.

#49: Our Take May–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 16 May 2019 07:00:07 +0000

In this week’s episode, John talks EHRs and physician burnout, prescription drug prices in TV ads, and more.

Highlights include:

Gundersen Health System and Marshfield Clinic talk merger.
Bon Secours Mercy Health signs letter of intent to acquire Dublin, Ireland-based Bon Secours Health System.
UnitedHealthcare’s new bundled payment program for maternity care.
U.S. District Court judge struck down the 340B rate cut.
Washington becomes the second state to announce a subscription-based payment model for HCV drugs.

#48: John Takes the Mic

dyllen@grippimedia.com (John Marchica) — Thu, 9 May 2019 07:00:11 +0000

Analysts and consultants often make predictions about where markets are headed. In this week’s episode, John goes back five years and reviews what he first wrote about accountable care organizations and the value-based care movement. What did he get right? Where was he wrong? What lessons have we learned?

Highlights include:

What the Affordable Care Act was designed to address.
How markets reacted to events related to policy announcements.
Harvard Business School’s Clay Christensen and why ACOs will fail.
Prescriptive advice for partnering with ACOs.

#47: Our Take April–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 2 May 2019 07:00:08 +0000

In this week’s episode, John reviews Humana’s new oncology payment model, several important announcements from the Centers for Medicare and Medicaid Services, and more.

Highlights include:

CMS is offering five new payment models for primary care practices
CMS is inviting state Medicaid directors to test new ways to approach dual-eligibles
FDA cleared the first medical device to treat attention-deficit/hyperactivity disorder (ADHD)
Amazon rolled out its PillPack at-home prescription drug delivery service
Sutter and UPMC partner with DNAnexus to develop personalized treatments for multiple sclerosis

#46: Breakthroughs in Cancer Research with Dr. David Hong Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 25 Apr 2019 07:00:29 +0000

In today’s episode, John returns to his conversation with renowned cancer researcher Dr. David S. Hong. Dr. Hong is deputy chair of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center. He also serves as associate vice president for Clinical Research and clinical medical director of the Clinical Center for Targeted Therapy. Dr. Hong has published more than 270 papers in leading academic journals.

Topics include:

Go/No-go decisions in clinical trials.
Interchangeability of oncology drugs and biosimilars.
Rising drug prices and declining trust in pharmaceutical companies.
Health care delivery in the United States.

Speaker Bios
Dr. David S. Hong is deputy chair of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center. He also serves as associate vice president for Clinical Research and clinical medical director of the Clinical Center for Targeted Therapy. Dr. Hong received a bachelor’s degree in biology from Yale University and a medical degree from Albert Einstein College of Medicine. He then completed an internship and residency at Thomas Jefferson University Hospital and a medical oncology fellowship at MD Anderson, during which time he was appointed chief medical oncology fellow. In 2005, he joined MD Anderson’s faculty.

#45: Our Take April–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 18 Apr 2019 07:00:08 +0000

In this episode, John discusses Our Take on health care news in the first half of April 2019. He covers the Times/ProPublica report on Memorial Sloan Kettering Cancer Center, the proposed merger between Atrium Health and Wake Forest Baptist Health, and other top stories through April 15.

A new report by The New York Times and ProPublica says leadership at Memorial Sloan Kettering Cancer Center (MSK) “repeatedly violated policies on financial conflicts of interest,” resulting in an environment in which “profits appeared to take precedence over research and patient care.”
Charlotte, N.C.-based Atrium Health signed a memorandum of understanding with Winston Salem, N.C.-based Wake Forest University and Wake Forest Baptist Health to create a “transformative academic health care system.” The organizations said they have entered into a period of exclusive negotiations to agree on terms, and intend to arrive at a final agreement later this year.

#44: Breakthroughs in Cancer Research with Dr. David Hong

dyllen@grippimedia.com (John Marchica) — Thu, 11 Apr 2019 07:00:14 +0000

In today’s episode, John has a fascinating conversation with renowned cancer researcher Dr. David S. Hong. Dr. Hong is deputy chair of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center. He also serves as associate vice president for Clinical Research and clinical medical director of the Clinical Center for Targeted Therapy. Dr. Hong has published more than 270 papers in leading academic journals.

Topics include:

The rise of immunotherapy and the Golden Age of cancer treatment.
The role of clinical pathways and personalized medicine in improving patient care.
Industry-researcher collaborations and investments in clinical trials.
How physicians balance research with providing clinical care.

Speaker Bios
Dr. David S. Hong is deputy chair of Investigational Cancer Therapeutics at The University of Texas
MD Anderson Cancer Center. He also serves as associate vice president for Clinical Research and clinical medical director of the Clinical Center for Targeted Therapy. Dr. Hong received a bachelor’s degree in biology from Yale University and a medical degree from Albert Einstein College of Medicine. He then completed an internship and residency at Thomas Jefferson University Hospital and a medical oncology fellowship at MD Anderson, during which time he was appointed chief medical oncology fellow. In 2005, he joined MD Anderson’s faculty.

#43: Our Take March–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 4 Apr 2019 07:00:05 +0000

In this week’s episode, John reviews some pharma breakthroughs—along with one major setback—and discusses the bold statement by the Department of Justice (DOJ) regarding the Affordable Care Act (ACA).

Highlights include:

The Department of Justice issued a letter stating that it agrees with a federal judge who struck down the entire ACA as unconstitutional.
The FDA approved the first drug to treat postpartum depression: Sage Therapeutics’ Zulresso (brexanolone).
Amarin Corp. presented updated results for its ongoing Vascepa (icosapent ethyl) clinical trial, REDUCE-IT, at the American College of Cardiology Annual Meeting.
Biogen is scrapping its investigational treatment for Alzheimer’s disease, and is canceling its Phase III ENGAGE and EMERGE clinical trials.

#42: JeffConnect, On-Demand Telehealth with Frank Sites

dyllen@grippimedia.com (John Marchica) — Thu, 28 Mar 2019 07:00:07 +0000

In today’s podcast, John Marchica sites down with the Director of Telehealth and of JeffConnect at the Thomas Jefferson University Hospitals, Mr. Frank Sites. Frank has decades of experience in this space and shares with us just what it took to get JeffConnect to become the robust telehealth program that it is today.

Here are some of the interview highlights:

Specifics about Jefferson Health’s telehealth program, JeffConnect, and the “buckets” it fills for the end users.
Adoption by Jefferson providers, successes and challenges with that, as well as how reimbursement plays out.
Frank’s advice to persons and organizations looking to starting and growing a successful telehealth program.

Speaker Bios
Frank D. Sites, MHA, BSN, RN is the Director of Telehealth & JeffConnect at Thomas Jefferson University Hospitals in Philadelphia. In this role Mr. Sites is responsible for leading all internal and external growth initiatives including all clinical, technical, support and regulatory activities impacting the enterprise wide telehealth program. Previously, Frank has served as the Operations Director a tele-ICU in a large academic health system that provided tele-critical care services to several hospitals. Frank has served in a variety of nursing leadership roles including Chief Nurse Executive of Good Shepherd Penn Partners and served as a Clinical Director of Emergency Nursing and Patient Progression at Pennsylvania Hospital, and as the Division Director of Critical Care at Reading Health System. Frank graduated from Holy Family University with a bachelor’s of science in nursing and earned his master’s degree in Healthcare Administration from Saint Joseph’s University.

John Marchica is a veteran health care strategist and CEO of Darwin Research Group. He was the founder and CEO of FaxWatch, a leading business intelligence and medical education company and two-time member of the Inc. 500 list of America's fastest growing companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade. John earned his B.A. in economics from Knox College, an MBA and M.A. in public policy from The University of Chicago, and completed his Ph.D. coursework and doctoral exams in clinical epidemiology and health economics at The Dartmouth Institute for Health Policy and Clinical Practice. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University.

#41: Our Take March–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 21 Mar 2019 07:00:17 +0000

In this episode, John reviews what happened in the world of health care this past week, specifically the results of a study published on March 11 in the JAMA Internal Medicine on Home Health and how it can provide a significant amount of savings when compared to other discharge locations.

Home health care agencies save Medicare millions of dollars compared with skilled nursing facilities, despite higher readmission rates, according to the study. Researchers used Medicare claims data from 2010 through 2016 to compare the results of more than 17 million hospitalizations, where 39% were discharged to home health and 61% to skilled nursing.
This massive study—17 million cases over a seven-year period—demonstrates the enormous potential value home health care can bring to Medicare and other payers.

#40: Partnering with IDNs and ACOs, with Scott Hylla, Sunovion Pharmaceuticals

dyllen@grippimedia.com (Scott Hylla, John Marchica) — Thu, 14 Mar 2019 07:00:00 +0000

Welcome to Season 2 of Health Care Rounds. In this episode, John Marchica speaks with Scott Hylla, Director of Health Systems and Managed Markets with Sunovion Pharmaceuticals. Scott and John discuss the state of pharma-IDN partnerships, pharma attitudes toward ACOs, and the future of industry-provider relations.

Key questions include:

How does pharma align with integrated health systems (IDNs), and what are IDNs looking for in a partnership?
Should pharma partner with ACOs, and if so, why?
What are the key trends in health care delivery that drive pharma toward higher-level partnerships?

Speaker Bios
Scott Hylla is the Director of Health Systems for Sunovion Pharmaceuticals Inc. He has served in various roles spanning a 28 year career in the pharmaceutical industry, most recently in leading the Sunovion Health Systems team in the development and execution of collaborative strategies in the transformational IDN marketplace. Scott has a BS in Biology from St. John’s University and an MBA in Healthcare Management from the Opus College of Business, University of St. Thomas. He is a member of American College of Healthcare Executives and is a corporate participant in the Health Management Academy and Advisory Board.

#39: Our Take December–Part 3

dyllen@grippimedia.com (John Marchica) — Thu, 20 Dec 2018 07:00:00 +0000

In this episode, John takes a look back on the year of 2018 and gives you his top five health care stories of the year, as well as a few honorable mentions and a few of the worst health policy ideas.

#38: Our Take December–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 13 Dec 2018 07:00:00 +0000

In this episode, John gives his insight on recent developments on one of this year’s trending healthcare topics, pharmacy benefit managers (PBM) and pharmaceutical rebates.

CVS announced that it is launching a new pharmacy benefits plan that returns 100 percent of drug rebates to its clients. In a statement, CVS said its new Guaranteed Net Cost pricing model “more closely aligns PBM incentives with plan sponsors’ objectives” by offering more predictability and transparency.

#37: Our Take December–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 6 Dec 2018 07:00:00 +0000

In this episode, John walks us through the recent flurry of mergers and acquisitions that are coming to a close and only recently announced at the end of 2018.

The biggest news is that CVS Health completed its acquisition of Aetna last Wednesday in a deal that valued Aetna at $212 per share, or approximately $70 billion, not including debt.

#36: Our Take November–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 29 Nov 2018 07:00:00 +0000

In this episode, John discusses our take specifically on the news of the results from the Johns Hopkins care management program, Johns Hopkins Community Health Partnership.

A Johns Hopkins community intervention is associated with reductions in admissions, readmissions and emergency department visits, netting $113.3 million in savings, according to new research in JAMA Network Open.

#35: Happy Thanksgiving, 2018!

dyllen@grippimedia.com (John Marchica) — Wed, 21 Nov 2018 22:00:00 +0000

Have a festive Thanksgiving from all of us at Health Care Rounds Podcast!

We will be back next week with a new episode, the Season 1 closing, so stay tuned for our take on the first season of Health Care Rounds.

In the meantime, enjoy your week!

#34: Our Take November–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 15 Nov 2018 07:00:00 +0000

In this episode, John discusses our take on health care news surrounding the midterm elections and how this will affect health care going forward.

At the end of October, Senate Majority Leader Mitch McConnell, R-Ky., told Reuters that if given the chance—that is, if Republicans remained in control of both chambers of Congress—we could expect another attempted repeal of Obamacare.
But this last week, referring to an ACA repeal, McConnell told reporters, “I think it’s pretty obvious, the Democratic House is not going to be interested in that,” adding that he was willing to work on health policy issues on a bipartisan basis.

#33: A Review on exl's 12th Partnering with ACOs and IDNs Summit

dyllen@grippimedia.com (John Marchica) — Thu, 8 Nov 2018 07:00:00 +0000

John is taking the helm this week to share his experience presenting at a conference last week, and the lessons he learned from two days of sessions. We will return to our regular format next week. The conference, exl’s 12th Partnering with ACOs and IDNs Summit, included about 100 people, mostly represented by pharma, ACOs and health systems.

The first part of his presentation covered what we learned from our annual ACO Executive survey, which includes what are their most pressing problems.
The second part delved into the partnering, or lack thereof, of pharma companies with ACOs.

#32: Our Take October–Part 3

dyllen@grippimedia.com (John Marchica) — Thu, 1 Nov 2018 07:00:00 +0000

Hoping all of our listeners had a wonderful and safe Halloween!
In this episode, John discusses our take on health care news in the last week of October. He covers President Trump’s proposed change on how Medicare pays for certain drugs, based on an international pricing index of drugs.

HHS Secretary Alex Azar referenced a report his agency recently completed—which compared U.S. prices for 27 drugs with prices for the same drugs in 16 other countries—tweeting that “Among these drugs, on average, the US pays 180% more than the international price.” HHS said the rule would include most of the drugs in Medicare Part B, which covers injectables and many specialty medications.

#31: Our Take October–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 25 Oct 2018 07:00:00 +0000

John discusses our take on health care news in the second half of October. He covers how CVS and Aetna have made a big step towards completing their merger, as well as a new proposed rule by CMS regarding transparency of pricing in drug advertisements.

The U.S. Department of Justice (DOJ) has cleared the way for the $69 billion merger between CVS Health and Aetna Inc., with the stipulation that Aetna divests its Medicare Part D individual prescription drug plan business.
CMS proposed a rule requiring prescription drug manufacturers to post the wholesale acquisition cost (WAC) of Medicare- and Medicaid-approved drugs in direct-to-consumer television advertising.

#30: Northwell Health’s Successful Rebranding with Mr. Ramon Soto

dyllen@grippimedia.com (John Marchica) — Thu, 18 Oct 2018 07:00:00 +0000

In this episode, John Marchica speaks with Mr. Ramon Soto, Northwell Health’s Chief Marketing and Communications Officer. Mr. Soto came to what was formerly known as the North Shore-Long Island Jewish Health System after several years of unsuccessful deliberations on how to rebrand the system. In the interview, he touches upon how marketing is much more than “what looks good” and how to use market analytics as a driver to a more consumer-centric health system.
Here are some of the interview highlights:

The thought behind Northwell Health’s recent rebranding strategy
How Northwell Health uses marketing analytics to understand customer needs
Using storytelling to stand out in the highly competitive market of New York

Speaker Bios
Ramon Soto is a skilled marketing executive with deep healthcare and financial services experience. Ramon is the senior vice president, chief marketing and communications officer for Northwell Health. He is responsible for the development and execution of Northwell’s brand strategy, as well as for all aspects of marketing and communications including public relations, digital engagement, strategic marketing, clinical marketing and customer acquisition. Ramon was formerly the chief marketing officer for Magellan Health, a healthcare services company focused on the unmet needs of individuals in the fast growing, highly complex and high cost areas of healthcare. Prior to Magellan, Ramon was a senior vice president with Aetna, managing the commercial marketing function for the Aetna enterprise. In 2006, Ramon was admitted into Yale School of Management’s MBA program for executives. Ramon is also a graduate of GE Capital’s Leadership Interchange, a high potential manager training program. He is Six Sigma certified, was awarded a U.S. government patent for co-development of GE Capital’s product development process and was an instructor at GE’s Small Business College. Ramon received his B.A. from the State University of New York at Binghamton in 1988.

#29: Our Take October–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 11 Oct 2018 07:00:00 +0000

John discusses our take on health care news in the first half of October, specifically commenting on the recent movements of multiple significant health systems.

University Health Network (UHN) and Vanderbilt Health Affiliated Network (VHAN) announced a partnership for value-based health care that reaches throughout the state of Tennessee.
Baylor Scott & White Health (BSW) and Memorial Hermann Health System have signed a letter of intent to merge. In a statement, the organizations said their next step is to complete a due diligence and regulatory review prior to signing a definitive agreement, which is expected to occur in 2019.

#28: LifeBridge Health’s Focus on Community with Neil Meltzer

dyllen@grippimedia.com (John Marchica) — Thu, 4 Oct 2018 07:00:00 +0000

What’s it like competing for business as an integrated delivery system—sandwiched eight miles between the University of Maryland Medical System and Johns Hopkins Health System—in a global budget environment within the state of Maryland? Find out this week in John’s conversation with LifeBridge Health CEO Neil Meltzer, a dynamic and inspirational leader serving his community and the stakeholders of LifeBridge with purpose. Interview highlights include:

What sets LifeBridge apart from the steep competition in the Baltimore market
How LifeBridge hotspots community needs through patient data analysis
Where LifeBridge is looking to expand in the future

Speaker Bios
Neil Meltzer is president and CEO of LifeBridge Health, a position he has held since 2013. Mr. Meltzer joined Sinai Hospital of Baltimore as vice president of operations in 1988, and a decade later became Sinai’s president and chief operating officer. Mr. Meltzer has a background in public health and brings a community-focused approach to every health care decision. He serves on the boards of the Greater Baltimore Committee, Notre Dame of Maryland University, the Maryland Hospital Association, the Hippodrome Foundation and Everyman Theatre. Additionally, Mr. Meltzer serves on the advisory board of the University of Maryland School of Public Health. On the national level, he continues to work with the American Heart Association after serving as national chairman. He was also one of 15 national workforce health care champions appointed by former president Barack Obama. Mr. Meltzer earned his Master of Public Health and Health Administration from Tulane University School of Public Health and Tropical Medicine in Louisiana, and his undergraduate degree in public health from the University of Massachusetts Amherst.

#27: Our Take September–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 27 Sep 2018 07:00:00 +0000

John discusses our take on the important health care news that occurred in the second half of September. Our main stories this episode include the creation of OneOncology, a merger of three oncology groups, and a suit on the alleged illegal kickbacks regarding the prescription of Humira.

Three large cancer practices have teamed up to create OneOncology. Announced Wednesday, OneOncology includes Tennessee Oncology, New York Cancer & Blood Specialists and Memphis-based West Cancer Center, comprising more than 225 providers and over 60 locations.
California Insurance Commissioner Dave Jones filed suit against AbbVie, alleging that the drugmaker gave illegal kickbacks to physicians to prescribe Humira (adalimubab). In court filings, the state alleges that AbbVie “systematically and repeatedly has violated the Insurance Frauds Prevention Act by providing kickbacks to health care providers throughout California.”

#26: Medumo, a Novel Patient Portal, with Dr. Adeel Yang

dyllen@grippimedia.com (John Marchica) — Thu, 20 Sep 2018 07:00:00 +0000

In this podcast, John Marchica has Dr. Adeel Yang at the table to discuss his newest venture, Medumo. Medumo’s CareTours™ are digital "instructional pathways" that healthcare providers can rapidly customize to guide patients throughout treatments and procedures in the most effective, scalable way possible. Medumo was highlighted at the Connected Health Conference in 2017, looking at “Digital Health Startups Working with Large Health Systems - Lessons Learned.”

Here are some of the interview highlights:

What is Medumo and how does it help both the patients and their providers?
Current key gaps in health care along the patient’s health care journey and how Medumo addresses these through its digital platform.
How the Medumo team has managed to succeed in the health start-up world.

Speaker Bios
Dr. Yang is the co-founder and CEO of Medumo, a PULSE MassChallenge digital health startup offering an intelligent patient navigation platform that creates value for hospitals by improving operational efficiency and patient outcomes through validated clinical algorithms. Prior to Medumo, Dr. Yang co-founded Picmonic, a venture-backed e-learning company addressing the needs of students in the healthcare profession. He raised venture funding and built an online community of over 250,000 learners in over 100 countries. He has been an active investor and worked with a medical technology focused venture capital firm. He completed his medical degree at the University of Arizona with research distinction and holds multiple patents and publications. Through Medumo, Dr. Yang hopes to leverage his experience in education technology to dramatically improve patient adherence, lower healthcare cost, and improve health outcomes.

#25: Our Take September–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 13 Sep 2018 07:00:00 +0000

John shares a special our take on the trove of changes that occurred in the world of ACOs this past week.

In late August, the National Opinion Research Center at the University of Chicago released the results of the first performance year (2016) for CMS’ Next Generation ACO model.
Also in late August, CMS released its MSSP ACO public-use data file for 2017, which includes financial performance and quality scores for 472 ACOs, representing nearly 9 million beneficiaries.
According to a new study published in The New England Journal of Medicine by Harvard Medical School researchers, physician-group ACOs outperformed hospital-integrated ACOs during the first three years of the MSSP (2013–2015).

#24: Our Take August–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 6 Sep 2018 07:00:00 +0000

John shares our take on what happened in health care at the end of August including the NYU at the frontier of offering free tuition to medical students, as well as how a few Republican senators have introduced legislation to protect Affordable Care Act’s provisions for people with pre-existing conditions.

The New York University School of Medicine announced that it is now offering free tuition for medical students, becoming the first major medical school in the U.S. to offer tuition-free education. “Our full-tuition scholarships make it possible for aspiring physicians to choose a specialty based on their talent and inclinations to better serve the communities who need it most, and to more easily pursue scientific breakthroughs that improve how we care for patients.”
Ten Republican senators have introduced legislation that purports to protect the Affordable Care Act’s provisions for people with pre-existing conditions. The language offering protections would be effected by amending the Health Insurance Portability and Accountability Act.

#23: Happy Labor Day

dyllen@grippimedia.com (John Marchica) — Thu, 30 Aug 2018 07:00:00 +0000

Happy Labor Day from all of us at Health Care Rounds Podcast!

We will be back next week with a new episode. In the meantime, enjoy your week!

#22: Insights into Canadian Health Care with Trafford Crump, PhD and Dr. Paul Woods

dyllen@grippimedia.com (John Marchica) — Thu, 23 Aug 2018 07:00:00 +0000

In this podcast, John Marchica discusses the intricacies of Canadian health care with his old colleagues, Trafford Crump, PhD and Paul Woods, MD, MS. Canada’s health care system is about 70% federally funded and is experiencing the same health care trends of an aging population and attempts to move towards a value-based care model.

Here are some of the interview highlights:

How health care is structured in Canada, and its similarities and differences to health care in the U.S.
The increasing costs of health care in Canada, and delving into why this is becoming a trend.
The reasonings behind looking to the province of Ontario to lead the way to value-based care in Canada.

Speaker Bios
Trafford Crump, PhD is a health services researcher and assistant professor at the University of Calgary’s Department of Surgery with an interest in patient-centered measures. Dr. Crump's earlier research involved developing the methods for eliciting health care preferences from community-dwelling Medicare beneficiaries in the United States. Dr. Crump's more recent research has expanded into linking primary data collected from patients with large administrative data sets maintained by regional and provincial health authorities. Dr. Crump is part of a University of British Columbia-led research team – which includes strong collaboration from the Vancouver Coastal Health Authority and the B.C. Ministry of Health – that has undertaken one of the largest systematic collections of patient-reported outcomes (PROs) in Canada. Dr. Crump received his PhD from Dartmouth College in the field of Evaluative Clinical Sciences followed by a postdoctoral fellowship at The University of British Columbia.

Paul Woods, MD, MS is the President and CEO of London Health Sciences Centre in London, Ontario, Canada. Dr. Woods began his career as a practicing Family Medicine physician in the United States. After finishing his graduate degree in Evaluative Clinical Sciences from Dartmouth College in 2007, he served in several health care executive positions including as the Medical Director at Essentia Health, Department Chief of Primary Care at Spectrum Health Medical Group, and the interim Medical Director for the Michigan Center for Clinical Systems Improvement. Most recently, from 2014 to 2017, Dr. Woods was the Senior Vice President, Provider Network Organization for Trinity Health – a multi-institutional health care organization comprised of over 120,000 people, including over 7,000 physicians and advanced practice providers, across more than 1,700 sites in the United States. In this role, Dr. Woods had clinical, operational and financial accountability for medical practices in primary care, specialty care and hospital-based physician practices. Dr. Woods received his M.D. from Western University.

#21: Our Take August–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 16 Aug 2018 07:00:00 +0000

John shares our take on what happened in health care at the beginning of August including extended coverage through the Affordable Care Act, as well as a new direct-to-employer contract between Henry Ford Health System and General Motors.

The Trump administration issued a final rule concerning short-term health plans. Consumers can now extend coverage for up to a year, with the option to renew for up to three years.
Henry Ford Health System announced that it signed its first direct-to-employer contract with General Motors. Starting in 2019, Henry Ford will provide health care management and wellness services to 24,000 salaried GM employees and their families in southeast Michigan.

#20: Our Take July–Part 3

dyllen@grippimedia.com (John Marchica) — Thu, 9 Aug 2018 07:00:00 +0000

John shares our take on what happened in health care at the end of July, including how the Centers for Medicare and Medicaid Services is proposing both a rule for site-neutral payments, as well as potentially more 340B cuts.

The Centers for Medicare and Medicaid Services (CMS) has proposed a rule to move toward “site neutral” payments for clinic visits, under the 2019 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. Clinic visits are “essentially checkups with a clinician,” CMS said, and are the most common service billed under OPPS.
CMS proposed to reduce 340B payments in 2019 to non-excepted off-campus departments of hospitals that are paid under the physician fee schedule. Earlier this year, CMS had already reduced $1.6 billion in Medicare outpatient drug payments to some 340B hospitals.

#19: Functional Wellbeing with Sean Sullivan

dyllen@grippimedia.com (John Marchica) — Thu, 2 Aug 2018 07:00:00 +0000

In this podcast, John Marchica has a conversation with Sean Sullivan, JD on the need to address not just physical wellness in the workforce, but also its wellbeing. Sean and John speak on the growing trend of value-based care, not just in the United States, but also internationally.

Here are some of the interview highlights:

What are the definitions of wellness and wellbeing in the workforce, and where are we currently?
How do companies measure and address wellness? How do they tackle the harder task of workforce wellbeing?
The changing outlook of seeing employees as human capital, their wellbeing as an investment rather than a cost.

Speaker Bios
Sean Sullivan is the Co-Founder, President and CEO of the Institute for Health and Productivity Management, as well as the WorkPlace Wellness Alliance which was created by the World Economic Forum, now managed and sustained by the Institute. Founded in 1997, the Institute is a global enterprise that serves as a catalyst and champion for a growing international movement to establish health as the new “human capital asset” and source of competitive workforce advantage for the 21st century economy. Sean speaks regularly at Forums in Europe and the United Kingdom and has held training and certification academies in Brazil, China and the United Arab Emirates. Prior to founding the Institute with two physicians, Mr. Sullivan was the original President and CEO of the National Business Coalition on Health for five years, and spent ten years as a Washington-based health economist and policy analyst – as a fellow at the American Enterprise Institute (AEI) for Public Policy Research, and as Executive Vice President of New Directions for Policy. Mr. Sullivan holds degrees in economics from Harvard and law from Stanford.

#18: Our Take July–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 26 Jul 2018 07:00:00 +0000

John shares our take on the second half of July, including how the Trump administration continues to take aim at Obamacare, and that Stark and other anti-kickback laws may be obsolete in a value-based world.

On July 7, the Trump administration said it was temporarily withholding $10.4 billion in risk adjustment payments to insurers, citing a district court ruling from earlier this year in New Mexico. On Tuesday July 10th, 340B Health released an analysis of a bill introduced by Rep. Joe Barton, R-Texas, that would raise the minimum disproportionate share hospital (DSH) adjustment percentage that hospitals must meet to qualify for the 340B drug discount program.
Kathleen Sebelius, Health and Human Services (HHS) secretary under President Barack Obama, and Tommy Thompson, HHS secretary under President George W. Bush, wrote in an op-ed for The Hill that “Stark and anti-kickback laws are a remnant of the fee-for-service world and harm the very patients they are supposed to protect by deterring more comprehensive patient-centered, coordinated care. While well intentioned, these laws have not been sufficiently updated to reflect the transformation in health care payment and delivery or account for the rapid emergence of new treatments and innovative technologies.”

#17: Social Determinants of Health with Dr. Joshua Lenchus

dyllen@grippimedia.com (John Marchica) — Thu, 19 Jul 2018 07:00:00 +0000

In this podcast, John Marchica discusses with Dr. Joshua Lenchus the challenges that come with running a safety net hospital, and the role that social determinants of health play in managing population health initiatives.

Topics include:

Managing population health in a safety net system
Social determinants of health and medical compliance
Why we should avoid integrating social determinants of health into the EMR.

Speaker Bios
Joshua Lenchus, DO, RPh, FACP, SFHM, holds a pharmacy degree from the University of Florida, and graduated from Nova Southeastern University College of Osteopathic Medicine in 2000. He currently works as a hospitalist at Jackson Memorial Hospital for the University of Miami Miller School of Medicine. In 2012, was elected as the youngest and the first osteopathic President of the Jackson Health System medical staff and chairman of its medical executive committee. He was subsequently re-elected in 2014 and 2016. In 2007 he developed a novel curriculum centered about simulation-based invasive bedside procedural instruction. Now in its eleventh year, the program has transformed the way procedures are taught and performed, decreasing complications thereby leading to safer patient care. Outside the hospital, Dr. Lenchus is incredibly involved, serving as a leader, in multiple county, state and national medical associations, including as the newly elected President of the Florida Osteopathic Medical Association, the Florida Medical Association, the American College of Physicians, and the Society of Hospital Medicine.

John Marchica is a veteran health care strategist and CEO of Darwin Research Group. Previously, he was the founder and CEO of FaxWatch, a leading business intelligence and medical education company and two-time member of the Inc. 500 list of America's fastest growing companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade. John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and serves as an active member of the American College of Healthcare Executives.

#16: Our Take July–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 12 Jul 2018 07:00:00 +0000

John shares our take on the first half of July, including CMS’s decision to green-light a Medicaid value-based drug plan, and how JJMDC added a collaboration with Mercy to its list of partnerships designed to improve patient care.

The Centers for Medicare and Medicaid Services (CMS) has approved the nation’s first value-based purchasing agreement for Medicaid, by approving Oklahoma’s request to allow the state to negotiate supplemental rebate agreements with drug manufacturers.
Mercy announced a research collaboration with Johnson & Johnson Medical Devices Cos. (JJMDC). In a press release, JJMDC said it would utilize Mercy's data infrastructure to inform and improve regulatory decision making and health outcomes for medical devices.

#15: Fourth of July

dyllen@grippimedia.com (John Marchica) — Wed, 4 Jul 2018 07:00:00 +0000

Happy 4th of July from all of us at Health Care Rounds Podcast!

We will be back next week with a new episode. In the meantime, enjoy your week!

#14: Our Take June–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 28 Jun 2018 07:00:00 +0000

John shares our take on the second half of June, including the decision of a federal appeals court regarding risk corridor payments, and the announcement of the new CEO for the Amazon-Berkshire-JPMorgan health care venture.

A federal appeals court Thursday ruled that the Health and Human Services Department is not obligated to pay insurers the more than $12 billion in risk corridor payments that have accrued to date. The U.S. Court of Appeals for the Federal Circuit reversed a previous decision in a suit brought by Moda Health, in which the company argued that it was owed risk corridor payments as stipulated by the Affordable Care Act (ACA).
Amazon, Berkshire Hathaway and JPMorgan Chase appointed Dr. Atul Gawande as chief executive officer of their newly formed health care company. In a press release, the companies announced that the new company will be headquartered in Boston and will “operate as an independent entity that is free from profit-making incentives and constraints.”

#13: Advantages of Telehealth with Dr. Suzanne Shugg

dyllen@grippimedia.com (John Marchica) — Thu, 21 Jun 2018 07:00:00 +0000

In this podcast, John Marchica speaks with the CEO and Co-Founder of Teleplus Healthcare, Dr. Suzanne Shugg Teleplus is a medical information technology company that combines comprehensive telemedicine and tele-educational services with the leading treatment technology, focusing on the areas of Sleep Apnea, Congestive Heart Failure, Obesity, Chronic Care, and COPD. Teleplus has an exclusive global partnership with the University of Pennsylvania called the UPENN Sleep Disorder Certificate program that distributes sleep disorder education. Here are some of the interview highlights:

What do telehealth and telemedicine mean, and what are their differences?
The advantages of bringing telehealth for managing chronic care and rural health.
The motivations behind the creation of the telehealth company and its continued success.

Speaker Bios
Suzanne Shugg, DNP, has over 20 years of experience in multiple healthcare sectors. She has developed a new, innovative health insurance company, implemented and expanded preventive cardiovascular clinics, assisted in the management of hospital systems, and remains a hands-on health care provider. Suzanne continues to teach all aspects of Adult Medicine and Future Technology in Medicine at Rutgers University, where her program is ranked 7th in the U.S. She was elected as a Fellow of the National Lipid Association, one of the highest and most prestigious rankings in the organization. Suzanne currently heads a preventive clinic at a partner of the largest hospital system in New Jersey, Saint Barnabas Medical Center and New Jersey Cardiology Associates. She has served across the United States as a consultant for telemedicine, starting independent telemedicine clinics both in and out of hospitals. She has been published in numerous peer-reviewed journals, sits on multiple medical boards and is a highly sought-after speaker in the field of preventive cardiology and telemedicine.

#12: Our Take June–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 14 Jun 2018 07:00:00 +0000

John shares our take on the first half of June which includes how New Jersey recently mandated health insurance starting in 2019, and what the increase in payer-provider partnerships means.

New Jersey became the second state to mandate health insurance into law, through the New Jersey Health Insurance Market Preservation Act. The law was signed by Gov. Phil Murphy on May 30 and takes effect Jan. 1, 2019.
According to a new report by Oliver Wyman, a health care consulting firm, nearly three-quarters of the 22 payer-provider partnerships reported in the first quarter of this year were co-branded or joint venture insurance products. Wyman reports that the number of payer-provider partnerships was the most the company had seen in the six years it has been tracking them.

#11: The Aging Population with Bob Roth

dyllen@grippimedia.com (John Marchica) — Fri, 8 Jun 2018 07:00:00 +0000

In this podcast, John Marchica speaks with Cypress HomeCare Solutions’ Managing Partner, Bob Roth. The Better Business Bureau serving Central, Northern and Western Arizona (BBB) announced on May 16, 2018 that Cypress HomeCare Solutions was the winner of its 2018 BBB Torch Awards for Ethics for companies with more than 150 employees. This is the first time a home care company has been nominated regionally, let alone won this award. Here are some of the highlights we cover:

The differences between the terms of home health care, home care, and private duty, and how Cypress HomeCare Solutions fits in with them.
The difficulties that Home Care organizations have with partnering with Integrated Delivery Networks (IDN) and Accountable Care Organizations (ACO).
Bob’s opinion on how the nation currently scores for caring for the aging, quoting renowned Dr. Ken Dychtwald.
Moving forward, how do we both gain more caregivers and integrate technology with caring for the growing aging population?

Speaker Bios
Bob Roth founded Cypress with his family in 1994 and has been at the helm as Managing Partner since December 2003. Nationally, Bob serves on the Home Care Association of America (HCAOA), locally; he serves on the Board of Directors for the Banner Alzheimer’s Foundation, DUET Partners in Aging and is on the ambassador committee for Aging 2.0 – Phoenix Chapter. Bob hosts a radio show called “Health Futures, Taking Stock in You.” This program airs every Friday from Noon to 1:00 pm on Money Radio 1510 AM, 105.3 FM. The talk show is about how to live a healthier happier life with a focus on our aging adult community and is in its 5th year. He writes a monthly column called “Aging Today” for the Jewish News of Greater Phoenix, and Lovin Life after 50 newspapers. Bob is a graduate of Ithaca College with a B.S. in Business Management, and a minor in Marketing.

#10: A Discussion on Home Health Care

dyllen@grippimedia.com (John Marchica) — Thu, 7 Jun 2018 07:00:00 +0000

A century ago, all health issues were tended to in the home, whether by a physician house call or by another family member. Yet, as modern medicine evolved in the early 20th century—along with important economic social changes, such as urbanization, industrialization and immigration—care transferred to hospitals and physician offices.

With rising health care costs in mind, by 2050 an estimated 27 million Americans will need some form of long-term care, with the bulk of that care being provided through home health providers and hospice care. Who receives health care in the home is not only a crucial policy question to be addressed but also can be a significant business opportunity for the industry and its suppliers.

In this episode, John walks us through how home health care came to be, the differences between home health care, private duty, and hospice, and the impending importance it has for the future as we live longer lives.

#9: Our Take May–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 31 May 2018 07:00:00 +0000

To all of our listeners, we hope you had a wonderful Memorial Day Weekend! In this episode, John shares an an abbreviated our take on the second part of May focused on FDA and The Centers for Medicare and Medicaid Services' (CMS) take on lowering drug prices.

Steps are being taken to lower drug prices—but which, if any, will work? The FDA posted a list of more than 50 drugs for which generic drugmakers have been unable to obtain samples of certain branded products from the manufacturers. CMS also weighed in last week by announcing enhanced “drug dashboards” that include year-over-year pricing changes for drugs reimbursed by Medicare Part B and Part D and Medicaid.

#8: Our Take May–Part 1

dyllen@grippimedia.com (John Marchica) — Wed, 23 May 2018 07:00:00 +0000

John shares our take on the first half of May which includes the proposal by The Centers for Medicare and Medicaid Services (CMS) to scale back its quality measures for fiscal year 2019 and the current administration’s “blueprint” to tackle soaring prescription drug prices.

CMS is looking to reduce the number of quality measures across the five quality and value-based purchasing programs for its FY 2019 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System.
President Trump announced his much anticipated proposal to control prescription drug pricing. In his remarks in the White House Rose Garden, Trump said, “The drug lobby is making an absolute fortune at the expense of American consumers.”

#7: Behavioral Economics with Dr. Allen Weiss–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 17 May 2018 07:01:00 +0000

In this two-part podcast, John Marchica speaks with NCH Healthcare System’s president and CEO, Dr. Allen Weiss. Dr. Weiss breaks down how they have changed the mindset of community health at the health system level with astounding statistics and fruitful outcomes. Here are some of the highlights we cover:

Part 1 - 17 min.

Present day history of NCH Healthcare System
Focus on community health with Blue Zones project
Behavioral economics for reducing health care costs

Part 2 - 13 min.

Health System trends
Other health care systems going the same path as NCH Healthcare
Advice to new physician residents

Speaker Bios
Dr. Allen Weiss graduated from Columbia University’s College of Physicians and Surgeons and is board certified in Rheumatology, Internal Medicine, and Geriatrics. He is a Fellow of the American College of Physicians and the American College of Rheumatology. In 2017, Dr. Weiss became an Assistant Professor of Medicine at the Mayo Clinic School of Medicine and was also elected to the American Hospital Association Board. He’s been named to Becker’s Top 100 Outstanding Physician leaders of healthcare systems several times now.

#6: Behavioral Economics with Dr. Allen Weiss–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 17 May 2018 07:00:00 +0000

Part 1 - 17 min.

Present day history of NCH Healthcare System
Focus on community health with Blue Zones project
Behavioral economics for reducing health care costs

Part 2 - 13 min.

Health System trends
Other health care systems going the same path as NCH Healthcare
Advice to new medical residents

#5: Our Take April–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 10 May 2018 15:01:00 +0000

John shares our take on the second half of April highlighting the health of ACA under the current administration and Humana’s statement to acquire and merge Curo Health with Kindred Healthcare.

The Centers for Medicare and Medicaid Services provided enrollment statistics for Healthcare.gov and the state-run exchanges created by the Affordable Care Act (ACA). In its last tax package, the Republican-led Congress zeroed out the individual mandate penalty—a cornerstone of the ACA. The Congressional Budget Office (CBO) estimated that 13 million people will lose or drop coverage as a result of this move over the next decade.
Reuters reported that Humana, along with two private equity firms, will acquire Mooresville, N.C.-based Curo Health Services for $1.4 billion. Humana will merge Curo Health with the hospice business of Kindred Healthcare, which Humana agreed to acquire in December 2017.

Of Note: Our Take Narrations will be twice monthly after these inaugural episodes.

#4: Our Take April–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 10 May 2018 15:00:00 +0000

John shares our take on the first half of April highlighting Walmart’s talks to acquire Humana, and California's suit against Sutter Health.

Reuters and The Wall Street Journal independently reported that
Walmart is considering an acquisition of health insurer Humana.
Citing people familiar with the matter, Reuters said the companies
are in early talks about developing closer ties, with one possibility
being an acquisition.
The state of California has filed an antitrust suit against Sutter
Health, alleging anticompetitive behavior. Among other complaints,
the suit alleges that the Sacramento-based health system imposes gag
clauses on prices and in some cases charges “punitively high” amounts
for out-of-network services.

Of Note: Our Take Narrations will be twice monthly after these inaugural episodes.

#3: Commonwealth Primary Care ACO with Dr. Curtis Page & Lance Donkerbrook–Part 3

dyllen@grippimedia.com (John Marchica) — Thu, 3 May 2018 22:03:00 +0000

In this three-part podcast, John Marchica speaks with Commonwealth Primary Care ACO president and CEO, Dr. Curtis Page, and Lance Donkerbrook, chief information officer. Last year, Commonwealth Primary Care ACO was Darwin's Western Region ACO of the Year. Here are some of the highlights we cover:

Part 1 - 20 min. (Page)

Accountable Care Organizations defined
How to deliver high-quality patient care
Origins and growth of the Commonwealth Primary Care ACO

Part 2 - 20 min. (Donkerbrook)

Impact of policy changes on ACOs
Lessons from the 2018 HIMMS conference
Patient attribution and self-selection
Application of quality metrics
How to improve physician engagement

Part 3 - 18 min. (Page and Donkerbrook)

Commonwealth’s use of technology, challenges
Partnering with Pharma, other suppliers and providers
Strategic priorities
Wrap-up

Speaker Bios
Dr. Curtis Page is quite invested in health care reform and currently serves as the CEO & president of the Commonwealth Primary Care Accountable Care Association, an entity that represents over 50 primary care practices in Maricopa County and Flagstaff. The Commonwealth ACO is primarily focused on redesigning the healthcare delivery system to place primary care and their patients at the center of the healthcare paradigm.

Lance Donkerbrook is the Chief Information Officer for Commonwealth Primary Care ACO. He is a health care executive with over 20 years of diversified experience in strategic planning, program management, client management, information systems project implementations, project proposal, financial management and contracting for payer and provider operations. Mr. Donkerbrook has a bachelor’s degree in Economics from Arizona State University, as well as an MBA from Texas Christian University Fort Worth.

#2: Commonwealth Primary Care ACO with Dr. Curtis Page & Lance Donkerbrook–Part 2

dyllen@grippimedia.com (John Marchica) — Thu, 3 May 2018 22:02:00 +0000

Part 1 - 20 min. (Page)

Accountable Care Organizations defined
How to deliver high-quality patient care
Origins and growth of the Commonwealth Primary Care ACO

Part 2 - 20 min. (Donkerbrook)

Impact of policy changes on ACOs
Lessons from the 2018 HIMMS conference
Patient attribution and self-selection
Application of quality metrics
How to improve physician engagement

Part 3 - 18 min. (Page and Donkerbrook)

Commonwealth’s use of technology, challenges
Partnering with Pharma, other suppliers and providers
Strategic priorities
Wrap-up

#1: Commonwealth Primary Care ACO with Dr. Curtis Page & Lance Donkerbrook–Part 1

dyllen@grippimedia.com (John Marchica) — Thu, 3 May 2018 22:01:00 +0000

Part 1 - 20 min. (Page)

Accountable Care Organizations defined
How to deliver high-quality patient care
Origins and growth of the Commonwealth Primary Care ACO

Part 2 - 20 min. (Donkerbrook)

Impact of policy changes on ACOs
Lessons from the 2018 HIMMS conference
Patient attribution and self-selection
Application of quality metrics
How to improve physician engagement

Part 3 - 18 min. (Page and Donkerbrook)

Commonwealth’s use of technology, challenges
Partnering with Pharma, other suppliers and providers
Strategic priorities
Wrap-up

#0: Health Care Rounds – Trailer

dyllen@grippimedia.com (John Marchica) — Thu, 3 May 2018 22:00:00 +0000

From Darwin Research Group HQ, we welcome you to our table to discuss health care policy and issues, our take, and the opinions of today’s leading health care experts. Darwin Research Group provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care.

Your host for this podcast is John Marchica, a veteran health care strategist and CEO of Darwin Research Group. He was the founder and CEO of FaxWatch, a leading business intelligence and medical education company and two-time member of the Inc. 500 list of America's fastest growing companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.

John earned his B.A. in economics from Knox College, an MBA and M.A. in public policy from The University of Chicago, and completed his Ph.D. coursework and doctoral exams in clinical epidemiology and health economics at The Dartmouth Institute for Health Policy and Clinical Practice. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University.

We will have new interviews every other week. Subscribe on your favorite podcast app.

In this brief episode, John spends a few minutes talking about why we're launching a podcast and what to expect in future installments.