Advertise on podcast: Claims Denied: A Hospitalogy Podcast

Hospitalogy’s Blake Madden sits down with Dr. Shiv Rao, CEO and co-founder of Abridge, two hours before Rao was going on call at the hospital.  They talk about how Abridge has taken its playbook from ambulatory to the ER and now inpatient, and what’s different about engineering for that setting, why AI should rethink the claims process rather than be sprinkled on it, and how Abridge is working to help health systems avoid unpredictable token costs.  Also in this episode: What happens to a claim after a doctor types “shortness of breath” into a note? Rao says the whole loop adds up to roughly $300 billion of waste. What separates real products from “party trick” prototypes? A University of Vermont case shows the value-add of context engineering, guardrails, and knowing what good looks like. One payor told Abridge it approves well over 90% of the prior auths it initially denies and would welcome automation. Rao says scale earned Abridge a seat with payors, and he wants to avoid a future of “agents fighting agents.” --- Assort Health’s AI agents complete the work that turns patient demand into care, including scheduling, intake, referrals, forms, medication refills, and payments. Customers have increased appointment volume by 5%, expanded staff capacity by 115%, and captured up to $4.3 million in new annual revenue per 100 providers. To learn more, check them out today at ⁠⁠https://www.assorthealth.com/hospitalogy⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 80K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Like our podcast? Listen to previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Which model won after Jefferson Health and Lehigh Valley Health Network merged? Dr. Baligh Yehia says that’s not the question Jefferson asks. Blake sits down with Dr. Yehia, President of Jefferson Health, to talk about running a 33-hospital system that wants to be an operating company, not a collection of hospitals. He breaks down how Jefferson is integrating LVHN, why the team lets AI-era rebuilds replace the usual model bake-off, and what it takes to align incentives when a payvider only covers part of your patients. In this episode: Why “standard as possible, different as necessary” is the default Jefferson is building around, and why quality came before back office in the LVHN integration Why payviders are one of the few models that can truly align incentives, even with no commercial book (Medicaid, Medicare Advantage, and ACA only), and how Jefferson still removes friction, like skipping prior auth for plan members moving to the next site of care The goal of handing 10 million hours back to clinicians in 3 years “Nursing out loud”: ambient for nurses is in 3 pilots, and the early wins are nurses eating lunch and clocking out on time Why AI won’t fix misaligned payment models, and will just run automated denials and automated appeals at machine speed --- Assort Health’s AI agents complete the work that turns patient demand into care, including scheduling, intake, referrals, forms, medication refills, and payments. Customers have increased appointment volume by 5%, expanded staff capacity by 115%, and captured up to $4.3 million in new annual revenue per 100 providers. To learn more, check them out today at ⁠https://www.assorthealth.com/hospitalogy⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 80K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠ Like our podcast? Listen to previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Claims Denied is back for a new season, and Blake kicks it off by driving down from Dallas to Austin, and sits in-studio with Will Johnson, co-founder and CEO of AI startup Gyde (http://gydehealth.ai/). Will is 17 months post-incorporation with a decade at Oscar behind him, and he brought a thesis Blake hadn't heard anyone articulate this cleanly: Healthcare's real front door isn't the carrier or the PCP. It's the broker, and there are fewer of them every year while the job gets harder every year. They get into why Will thinks commission rates stay flat while ACA premiums rip 14%, why an AI founder calls himself "a huge software bear," why roll-up is a banned word inside his own M&A shop, and the Capstone deal he thought was dead until a February coffee in Austin. Healthcare keeps trying to go around the broker. This episode makes the case for going through them. --- Assort Health’s AI agents complete the work that turns patient demand into care, including scheduling, intake, referrals, forms, medication refills, and payments. Customers have increased appointment volume by 5%, expanded staff capacity by 115%, and captured up to $4.3 million in new annual revenue per 100 providers. To learn more, check them out today at https://www.assorthealth.com/hospitalogy --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 80K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠⁠⁠⁠ Like our podcast? Listen to previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Second time's the charm! Blake welcomes back Navvis CEO, Tim Elliott, for a new conversation that goes deeper than round one. Blake and Tim get into why CMS finally ditched its "voluntary" posture on value-based care, what actually happens in the first 60 days when a mandatory bundle lands on a health system, and why specialists, not just primary care, are now squarely in CMS's crosshairs. They also cover physician enterprise 2.0, where AI is actually moving the needle on burnout (spoiler: it's not just ambient scribes), and Tim's read on what health systems get wrong heading into 2027. Genuinely one of Blake's favorite VBC conversations this season. And if you missed Tim's first appearance on Claims Denied from June 2026, be sure to check out that episode here. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠⁠⁠⁠https://navvishealthcare.com/vbc⁠⁠⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Tim Elliott on LinkedIn: https://www.linkedin.com/in/tim-elliott-b246aa151/ Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠⁠

Blake sits down with Dr. Ramon Lizardo, ER doc turned three-time operator turned investor, and former CEO of Tele911. This one goes places Blake didn't plan for. Ramon shares his impressive journey: Getting into medical school on a single borrowed application he found in his backpack a month later. He left a $300K+ clinical job for $40K base and a $25K bonus, with debt. Then he built a company that turned Baltimore, Fort Worth, and San Francisco into cities where calling 911 puts a physician on your screen in 37 seconds. When the Key Bridge collapsed, the city called him at 3 a.m. and asked him to go live early. Blake pushed him on the physician hierarchy, on why nobody teaches doctors how money works, and on the digital health profitability problem. He also told Blake, on the record and before anyone else, where he's going next. Ramon even suggested a working title for the episode: "Health Tech Physician-founder Can't Control His Children" (His five-year-old and eight-year-old were negotiating a treaty in the next room the whole time.) This is the best kind of episode. Genuine, honest, and one not to miss! --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠⁠⁠⁠https://navvishealthcare.com/vbc⁠⁠⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Ramon Lizardo on LinkedIn: https://www.linkedin.com/in/ramonlizardomd Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠⁠

We're doing something special with this latest episode of Claims Denied. Blake packed up and drove out to Plano, TX on a 100 degree August morning to record this one live on site, and the location is half the story: Matic's team works out of a suite inside Catalyst Health Group's headquarters. That's not a real estate footnote. That's the business model. Blake sits down with Calvin Carter, CEO and co-founder of Matic (https://maticinside.ai/), and Dr. Chris Crow, CEO and co-founder of Catalyst Health Group (https://www.catalysthealthgroup.net/). Calvin spent 15 years at Bottle Rocket building consumer apps for Chick-fil-A, Southwest, and half the news networks in America before an algorithmic trading side project put him next to Dr. Alex Shepherd, an engineer with a PhD in adversarial training for hallucinations who decided to go to medical school because "finance is a zero-sum game." The group gets into why Dr. Crow thinks every lab-built AI product is just the EMR story repeating, why he called direct primary care a cottage industry born of burnout rather than a model worth scaling, and what happens to a physician's panel when you stop making them the bottleneck. Dr. Crow also went on record with "Natty or bust" for the Texas Longhorns, and Blake is ready to hold him to it! --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Calvin Carter on LinkedIn: https://www.linkedin.com/in/calvincarter/ Follow Dr. Chris Crow on LinkedIn: https://www.linkedin.com/in/drcrow/ Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠

Blake sits down with Ahmed Marmoush, CEO and co-founder of Handl Health, fresh off their Series A funding, and this one covers the full arc of where employer-sponsored insurance is heading. Ahmed's path is unlike any guest we've seen on Claims Denied: From a clinical pharmacist in New Zealand's single-payer system, to a consultant alongside the country's former Director General of Health, to an $800 bill for a routine physical in LA that turned into a company. (They offered him 50% off if he paid within a few days. He compared it to haggling in an Egyptian street market. He's not wrong.) They get into why cost shifting is dead, how variable copay plans really work, what's inside Handl's value index, and why Ahmed is betting on being the enablement layer between brokers and carriers instead of building yet another health plan. If you touch benefits strategy, brokerage, or health plan ops, this one's worth the commute. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠⁠⁠https://navvishealthcare.com/vbc⁠⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Ahmed on LinkedIn: https://www.linkedin.com/in/ahmed-marmoush-25169961/ Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠⁠

Blake sits down with Nick Stefanizzi, CEO of Northwell Direct (https://northwelldirect.northwell.edu/) — the man running the most ambitious direct-to-employer play in the country. Since going live in 2022, his team has built a platform serving 70+ employers and unions, 300K members, and $2.5B in medical spend, with 97% retention. Then they landed 32BJ: 20% validated savings, $46M in year one, live as of April. Blake and Nick get into all of it — why Northwell runs Direct as a standalone company (Nick literally negotiates rates against his own parent system), what they rented instead of built, how the 32BJ deal came together in 10 weeks, and what happens to managed care when health systems stop asking permission. If you're a health system exec, benefits leader, or union fund trustee, this one's required listening. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠⁠https://navvishealthcare.com/vbc⁠⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Nick on LinkedIn: https://www.linkedin.com/in/nickstefanizzi/ Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠⁠

This episode hits the affordability crisis head-on, as Blake sits down with Ali Diab, CEO and co-founder of Collective Health (https://collectivehealth.com/). Ali started the company after his own hospital claim got denied, and has spent the decade since building what he calls the “Stripe” of healthcare benefits — for employers today, and potentially insurers and health systems tomorrow. In this episode, Ali makes the case that health insurance itself is the real inflationary catalyst in American healthcare.  Ali doesn't do the polite version. He calls the MLR a cost-plus contract, compares network "discounts" to markdowns off the Neiman Marcus price, and told me about the time he was charged $340 in coinsurance for a $125 knee brace on his own company's plan.  We dig into why self-insurance and direct contracting are eating the fully-insured market alive, why small employers are legally boxed out of self-funding, and why he thinks healthcare pricing needs an SEC. Also: World Cup takes. Ali's a winger-turned-number-nine and I broke two leg bones playing this sport, so we earned the tangent. Follow Ali Diab on LinkedIn: https://www.linkedin.com/in/alidiab/ Follows Collective Health on LinkedIn: https://www.linkedin.com/company/collectivehealth/home/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠https://navvishealthcare.com/vbc⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠ Like our podcast? Check our previous episodes of Claims Denied here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠

For this week's episode, Hospitalogy's Blake Madden puts two people on opposite ends of the same handshake into one virtual room: Travis Messina, CEO of Regent Surgical, and Niyum Gandhi, CFO of Mass General Brigham (MGB), who runs one of the most-watched integrated systems in the country. Nominally, this episode is about ASCs. Really, it's about what a system does when it could build anything itself — and chooses to partner instead. Blake walked in carrying a grudge from his valuation days, when every ASC cap table he cracked open had physician ownership baked in like it was law. Niyum spent 20 minutes calmly arguing the opposite. They also get into MGB's $3B insurance arm (don't call it a provider-sponsored plan to his face), a 25,000-patient endoscopy wait list, robots doing oncology, and the best AI adoption framework Blake's heard a CFO articulate. Travis also reminded Blake that his Geogia Bulldogs bounced Blake's Texas Longhorns during the College World Series — which Blake is choosing to forgive. Follow Travis Messina on LinkedIn: https://www.linkedin.com/in/travis-messina-4460565/ Follow Niyum Gandhi on LinkedIn: https://www.linkedin.com/in/niyum-gandhi/ Follow Mass General Brigham on LinkedIn: https://www.linkedin.com/company/mass-general-brigham/ Follow Regent Surgical on LinkedIn: https://www.linkedin.com/company/regent-surgical/ Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. ⁠https://navvishealthcare.com/vbc⁠ --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠⁠https://hospitalogy.com/⁠⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠⁠

Featuring: Elliott Rapaport (Founder of Birches Health) and Dr. Doug Nemecek (Senior advisor with Birches Health and former Cigna/Evernorth CMO) --- This episode with two experts in the mental health space (Elliott Rapaport, Founder of Birches Health, and Dr. Doug Nemecek, a senior advisor with Birches Health and former Cigna/Evernorth CMO for behavioral health) was one of the more eye-opening conversations Hospitalogy’s Blake Madden has had on payor behavioral spend. Think about this: 39 states + DC have legalized online gambling, FanDuel and DraftKings are sponsoring everything that moves, and yet payors will tell you they don't "see" the gambling disorder volume in their claims data. That's because it's getting coded as depression or anxiety. F63.0 never makes it to the bill. Blake, Doug, and Elliott get into the real prevalence numbers (a recent Pennsylvania study puts roughly a third of the state somewhere on the gambling-risk spectrum), why specialty networks for behavioral process addictions are about to follow the same pattern Equip ran in eating disorders, and what AI actually does in this model (spoiler: it's not replacing the therapist). Blake also pushed Elliott on the "anti-capitalism" of building a clinical model that explicitly wants patients to use you less over time. Elliott’s answer was sharp. Follow Birches Health on LinkedIn: ⁠https://www.linkedin.com/company/bircheshealth/⁠ Follow Doug on LinkedIn: https://www.linkedin.com/in/douglasnemecek/ Follow Elliott on LinkedIn: https://www.linkedin.com/in/er1/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

Hospitalogy's Blake Madden sits down with Yair Saperstein, MD MPH — co-founder and CEO of AvoMD — fresh off the company's Series A close in Q1. Yair makes the case that the real prize in clinical AI isn't the AI scribe, it's the operating system living inside the EHR itself, and why he thinks most of primary care ultimately gets replaced by AI voice chatbots, at-home labs, and wearables. Blake also pushes Yair on the Open Evidence valuation question (politely sidestepped), how AvoMD sells differently to academic systems versus rural hospitals, and the "avoid the 800-pound gorilla" go-to-market strategy against Epic. Plus: what Dr. Oz told a ViVE crowd about agentic AI being in front of every patient by 2028 — and a closing piece of life advice that somehow involves Frogger. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. --- Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

Featuring: Emily Rash (COO) and Dr. Neil Gheewala (CMO of Value-Based Care), US Heart and Vascular --- Is 3-6 weeks really how long patients should have to wait to see a cardiologist? That's the national average — and it's the exact inefficiency Emily Rash (COO) and Dr. Neil Gheewala (CMO of Value-Based Care) at US Heart and Vascular are betting they can fix. Blake Madden sat down with them for a refreshingly candid conversation about what actually separates an integrated cardiology platform from a bunch of practices bolted onto a cap table. In this episode: The Ares + Rubicon Founders dual capital structure — arguably the sharpest specialty-VBC sponsor pairing out there The "AIR" framework (autonomy, independence, representative governance), and why the third leg is the one most rollups get wrong Why cardiology might be the cleanest specialty fit for value-based care, full stop (no structural fee-for-service conflict the way a hospital has) Neil's actual pitch to RFK Jr. for a "Level 6" reimbursement category for ambulatory IV diuretics (CMMI, this one's free) Where cardiology bifurcates in the next five years: outpatient access groups vs. hospital-based acute care If specialty VBC, physician governance, or the cardiology rollup wave are anywhere on your radar, this one's worth the listen. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

This episode covers something Claims Denied hasn't touched before: the world's first passive gut health monitoring device. Blake sits down with Scott Hickle, co-founder of Throne Science, for a deep dive into the tech behind hands-free gut health, hydration, and urinary health monitoring — and yes, that means talking about poop for an hour. It turns out to be one of the most fascinating conversations on the pod yet, covering real technology, wild behavior-change data, and a long-term vision for cancer screening. Listen to hear: How Throne's monitor clips onto your toilet, identifies users via Bluetooth, and runs entirely in the background with no sample collection and no manual logging How Whoop's former CTO ended up joining the team after a hospital stay with ulcerative colitis What three years of obsessive product development looks like when building a camera for the most intimate room in someone's home What longitudinal gut health data reveals that elimination diets and manual stool logs can't How Oura Ring's decade-long arc — from 2,400 Kickstarter units to an $11 billion valuation — shapes Throne's own go-to-market patience The roadmap toward detecting microscopic blood in stool, and why that could make Throne a smoke detector for colon cancer, bladder cancer, and more Follow Scott Hickle on LinkedIn: https://www.linkedin.com/in/scotthickle/ Follow Throne Science on LinkedIn: https://www.linkedin.com/company/thronescience/ --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠

In this latest episode of Claims Denied, Blake sits down with Tim Elliott, CEO of Navvis, for one of the most clear-eyed conversations he's had on where value-based models are actually headed. Tim doesn't deal in buzzwords or wishful thinking. He deals in what's actually working, what operators are getting wrong, and where the puck is going — whether you're ready for it or not. Here were some gems from the discussion which makes the broader convo worth your time: Payment innovation will always come out of the government. Tim's conviction is that DRGs came from CMS, and the next durable models, commercial and governmental alike, will too. Not the private market. Tim is a fan of moving more into mandatory risk models. While most operators are bracing against mandatory, Tim thinks the mandatory direction is exactly where we need to go and would tell CMMI to keep pushing. LEAD is a no-go right now for most systems. Navvis' analysis with their partners anticipates very few of them will move to LEAD as it stands today. Benchmarking and settlement math doesn't pencil yet, so it's enhanced-track MSSP until they get a few more reps. Stop leading with the comp model. Popular belief (that Blake asked Tim about) is that nothing changes in healthcare until physician comp changes. Tim pushed back on this notion hard. At SSM Health, he led with culture first and comp later, and argued you can get pretty darn far before you ever touch the RVU. FTEs are becoming FTAs, meaning full-time equivalent agents. His advice was to start drawing your org chart with agents on it. Pretty interesting mental model and paradigm shift. --- Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models. https://navvishealthcare.com/vbc --- For expert analysis on healthcare M&A, strategy, finance, and markets, join 68K+ readers of Blake Madden’s Hospitalogy newsletter. Subscribe here: ⁠⁠⁠https://hospitalogy.com/⁠⁠⁠ Like our podcast? Listen to previous episodes here: ⁠⁠⁠https://hospitalogy.com/podcast/⁠⁠⁠ Be sure to leave us a review, and share our podcast with colleagues. Follow Tim Elliott on LinkedIn: https://www.linkedin.com/in/tim-elliott-b246aa151/  Follow Blake Madden on LinkedIn: ⁠⁠⁠⁠⁠https://www.linkedin.com/in/blakecmadden/⁠⁠⁠⁠⁠