Advertise on podcast: The Surgical Journey Podcast

What are hospital leaders really focused on in 2026? In this episode of The Surgical Journey, Lisa Miller speaks with Hayes Waldrop, founder and president of the Institute of Healthcare Executives and Suppliers, about the pressures shaping healthcare leadership today. Drawing on more than two decades of conversations with hospital executives, Hayes discusses capital constraints, slow implementation, AI adoption, and the growing responsibility for care beyond the hospital walls. They also explore how technology, home-based care, and stronger organizational alignment could change the way health systems manage patients across the surgical journey.   0:00 Introduction to NovaNav 0:55 Guest Introduction: Hayes Waldrop 2:15 What Hospital CEOs Are Most Concerned About Right Now 3:57 Value-Based Care and the CFO's Growing Role in Post-Acute Outcomes 6:30 The Power of Peer Networks and Closed-Door Executive Conversations 8:00 How the Strongest C-Suite Leaders Make Big Decisions Differently 9:36 The $25 Million Problem: How Implementation Lag Kills ROI 11:00 Accountability Structures, Incentive Misalignment, and the Forcing Function Gap 13:25 Where the C-Suite Stands on AI Adoption Today 14:36 The IT Barrier, Epic's Roadmap, and Healthcare's Easy No on AI 15:44 Open-Source AI, Local Sandboxes, and Where Healthcare Is Headed 17:56 What Leadership Looks Like in 2026 vs. Five Years Ago 19:38 Hospital-at-Home, Side-of-Care Shifts, and the Role of Technology in Recovery 22:00 Managing the 30-Day Surgical Window and Post-Op Care Accountability 22:40 Robotics, Humanoids, and the Future of Home-Based Care 25:10 Closing Remarks and How to Connect with Hayes Waldrop

In this episode of The Surgical Journey, NovaNav's Lisa T. Miller speaks with board-certified vascular surgeon Dr. Chopra about the unusually complex recovery period vascular patients face after leaving the hospital. Many are managing multiple chronic conditions, strict antiplatelet or anticoagulation regimens, wound-care requirements, mobility limitations, and ongoing surveillance, often while also navigating transportation barriers, medication costs, limited health literacy, and fragmented access to specialty care. Dr. Chopra explains why the first two weeks after surgery are such an important intervention window and how serious complications often begin with subtle, manageable changes rather than an obvious emergency. Mild incision redness, a gradual decline in walking tolerance, new calf discomfort, or an interruption in medication may be easy for a patient to dismiss, even when those changes indicate that a wound, bypass graft, or broader recovery plan is beginning to fail. The conversation also examines the limits of a follow-up model built primarily around scheduled office visits. Routine surveillance remains essential, but long intervals between appointments can leave care teams without visibility into gradual deterioration, particularly when patients do not recognize that a symptom warrants earlier attention. Lisa and Dr. Chopra discuss what more reliable post-discharge support should accomplish for this population: give patients clearer context for interpreting changes in recovery, reinforce medication and surveillance requirements, reduce the burden of knowing when to call, and help care teams identify emerging risk while there is still time for a limited course correction. The episode offers a practical look at why vascular recovery requires sustained clinical awareness beyond the procedure itself, and why preserving the opportunity to intervene depends on what happens between discharge and follow-up. Episode Contents 0:00 Introduction to NovaNav 0:55 Guest Introduction: Dr. Chopra 2:04 What Concerns Vascular Surgeons Most in the First Two Weeks Post-Op 3:09 Wound Healing Complications in High-Risk Patients 4:44 Acute Limb Ischemia and the Cost of Waiting 5:12 Medication Adherence as a Silent Failure Point 6:17 Modifiable Risk Factors and the Intervention Window 7:12 Addressing Medication Cost Barriers Proactively 9:16 Why Vascular Follow-Up Is Uniquely Difficult 10:29 Transportation and Mobility Barriers to Surveillance 11:35 Comorbidity Overload and Health Literacy Gaps 12:58 Silent Graft Failure and the Surveillance Paradox 15:28 How Technology Must Be Designed for Rural and Elderly Patients 16:36 Low-Friction Design and the NovaNav Approach 19:10 Medication Understanding and Health Literacy 21:01 What One Change Would Most Improve Vascular Post-Op Support 22:16 The Case for a Single Clear Line of Communication Across the Care Team

Scott Becker, founder of Becker's Healthcare and partner at McGuire Woods, joins the Surgical Journey to discuss what separates genuinely great health systems from merely large ones, how the best CEOs navigate policy noise without losing clinical focus, and why patient navigation remains a chronically underinvested gap even in top-ranked systems. This conversation is for healthcare CEOs, CMOs, and CNOs navigating strategic growth decisions, workforce pressures, and the expanding accountability for post-acute outcomes under episode-based payment models.   Episode Chapters 0:00 Introduction to NovaNav 0:55 Guest Introduction: Scott Becker 1:30 Scott's background and new book overview 2:03 How hospital CEOs should think about niche and strategic expansion 3:53 Being great versus being big: the strategic clarity imperative 5:18 Profit from the Core and adjacent growth strategy 6:12 Jack Welch's number one or two rule applied to healthcare 8:09 Transitioning to overcoming setbacks and building momentum 8:43 Filtering noise: how the best leaders stay focused under pressure 9:31 Jenny Spiesel and UCLA Health as a model for leadership clarity 11:59 Jim Collins, great teams before strategy, and loving your 90 percenters 12:27 The evolution of a founder and building teams that outrun leadership 14:08 Why beating up 90 percenters is the core of organizational stupidity 16:57 The three strategic priorities for hospital leaders in the next six to twelve months 18:46 Technology adoption: the case for being a second mover 21:14 Last question: post-acute care, CMS episodes, and patient navigation 22:36 Why even top-10 systems are often awful at patient navigation 23:27 The reimbursement gap that explains chronic underinvestment in navigation 24:33 Closing remarks

In this episode of The Surgical Journey, Lisa Miller is joined by Dr. Mallika L. Mendu and Dr. Kathryn M. Corelli of Mass General Brigham for a practical discussion on what it takes to manage the full surgical episode under value-based care and the CMS TEAM model. Dr. Mendu is Chief Population Health Officer at Mass General Brigham, Vice President of Clinical Operations and Care Continuum at Brigham and Women's Hospital, and Associate Professor at Harvard Medical School. Dr. Corelli is Associate Medical Director of Strategy and New Program Development within MGB Population Health and an Instructor in Medicine at Harvard Medical School. The conversation moves beyond policy and into the operational work required to support patients across preoperative optimization, the hospital stay, post-acute care, and recovery at home. Dr. Mendu explains why patient-centeredness is central to value-based care, and why episode accountability requires a more connected infrastructure across surgeons, primary care, specialists, home health, post-acute partners, pharmacists, social workers, and care navigators. Dr. Corelli shares how Mass General Brigham is building these programs in practice, including stakeholder interviews, data-driven opportunity analysis, caregiver coaching, physical therapy navigation, post-acute collaboratives, and risk stratification. The discussion also covers what moves the needle in the post-discharge window, why readmission prevention depends on both human touchpoints and scalable technology, and how Healthcare at Home and Home Hospital models may shape the future of surgical recovery. For health system leaders preparing for mandatory episode-based payment, this episode offers a grounded look at the infrastructure needed to support safer recoveries, better patient experiences, and more coordinated care after surgery. Timestamps / Contents 00:00 Welcome to The Surgical Journey 00:54 Introducing Dr. Mallika Mendu and Dr. Kathryn Corelli 01:49 How the CMS TEAM model changes surgical accountability 02:17 Why MGB sees TEAM as an opportunity to improve care delivery 03:45 The challenge of building new workflows for episode-based care 04:16 Dr. Corelli's framework: preoperative optimization, hospitalization, and recovery 05:24 Using stakeholder interviews and data to design better workflows 06:15 Why caregiver coaching matters after surgery 07:42 Patient-centered value-based care across surgery, primary care, and post-acute care 10:04 Surgeon engagement and shared ownership of outcomes 11:02 Physical therapy, case management, and preparing patients for home recovery 13:17 The practical details that make recovery at home safer 13:53 Designing programs that align primary care, surgeons, and post-acute partners 14:22 SNF and home health collaboratives, shared learning, and quality standards 15:10 Using benchmark data to identify post-acute utilization opportunities 15:56 Readmissions and the critical 30-day post-discharge window 17:04 Navigation, medication reconciliation, home services, and care team coordination 18:52 MGB's post-discharge follow-up work and readmission reduction 19:51 Where technology fits into scaling navigation 20:15 Risk scores, frailty measures, FLEX score, and predictive modeling 21:22 Healthcare at Home and Home Hospital in surgical recovery 22:10 Why home-based care aligns with patient-centeredness 23:03 Building workflows for appropriate surgical patients at home 23:40 Neuro spine pilots, SNF at Home, and future care models 24:23 Advice for health systems building TEAM infrastructure 25:01 The need for real-time data and actionable risk identification 25:35 Benchmarking, culture change, patient feedback, and frontline insights 26:20 Why TEAM is a signal for where care delivery is headed 27:21 Closing remarks

What really happens after a patient leaves the hospital—and why does so much still break down in the first 10 days? In this episode, Dr. Robert Cunningham, a fellowship-trained bariatric and metabolic surgeon, shares what it takes to build a surgical program from the ground up in one of the most underserved regions in the Midwest. From launching a de novo bariatric program at Methodist Jennie Edmundson to navigating real-world access challenges, he offers a candid look at the operational and human realities behind growth. The conversation goes beyond program building. Dr. Cunningham breaks down how GLP-1 medications are reshaping—and in some cases complicating—the surgical pipeline, and why the biggest gaps in care still happen after discharge. Despite advances in technology, the first week at home remains one of the most vulnerable periods for patients. This is a practical, on-the-ground discussion for health system leaders, surgeons, and operators focused on access, outcomes, and the parts of recovery that clinical pathways and digital tools still struggle to solve. 0:00 Introduction to NovaNav 0:55 Guest Introduction: Dr. Robert Cunningham 1:00 Dr. Cunningham's background: Ireland, MGH, and UNMC 3:40 Fellowship training at Geisinger and entering practice during COVID 4:15 Launching the bariatric program at Methodist Jenny Edmondson 5:52 Technology's impact on surgical safety: AI image overlays and intraoperative guidance 7:21 Bile duct injury and the holy grail of cholecystectomy safety 9:07 Molecules and nerve identification for inguinal hernia repair 10:25 Patient-facing technology: what patients actually experience 12:13 Immediate result release in patient portals and the cancer diagnosis problem 15:48 The host's personal experience: discharge instructions and post-op confusion 17:55 Where perioperative navigation platforms fit into the care continuum 20:46 Building the bariatric program: institutional support and proforma negotiation 23:55 Program components: dietitians, physical therapy, psychiatric evaluation 26:07 First surgical outcomes and the role of the program coordinator 27:32 Post-discharge follow-up, phone calls, and the literature on outcomes 29:13 GLP-1 medications and their effect on bariatric volume 35:20 Cost analysis: surgery versus lifelong GLP-1 therapy 36:41 Rural healthcare, critical access hospitals, and workforce challenges 39:06 The limits of AI and the risks of removing human interaction from care 43:00 Loneliness, social isolation, and surgical logistics for older patients 44:17 Advice for surgical residents: communication as the defining non-technical skill 48:40 The full spectrum of communication: bad news, colleagues, and conflict 50:30 Malpractice data and surgeons who communicate well 51:44 Closing remarks

Dr. Robert Cerfolio, Chief of Clinical Thoracic Surgery at NYU Langone and former COO of an $11 billion academic health system, joins The Surgical Journey to discuss what nearly 20,000 operations have taught him about the difference between technical excellence and true episode management. Drawing on decades of surgical and executive leadership experience, he explains why better outcomes depend not only on what happens in the operating room, but on what happens before surgery, after discharge, and across the recovery journey at home. Exploring direct physician access, wearable-based remote monitoring, pre-op home assessment, and the structural barriers that keep health systems from adopting approaches already shown to reduce readmissions and improve recovery, Dr. Cerfolio makes the case that extending surgical accountability beyond the hospital is not simply a patient experience initiative. It is a quality, operational, and financial imperative. He also reflects on the cultural changes required to make this model work: physician transparency, personalized recovery goals, stronger continuity after discharge, and a willingness to redesign care around the patient's actual environment rather than the assumptions of the inpatient setting. For surgical service line leaders, CMOs, CNOs, and operators building infrastructure beyond the hospital walls, it's all about what it takes to manage the full episode well. Episode Contents 0:00 Introduction to NovaNav 0:55 Guest Introduction: Dr. Robert Cerfolio 2:27 Why Cerfolio Gives Every Patient His Cell Phone Number 3:44 Accessibility as a Clinical Standard, Not a Personal Quirk 4:52 How Residents Respond and Whether This Model Scales 5:34 Leveraging Digital Technology: Telemedicine and Pulse Ox Papers Rejected Before COVID 6:37 Innovation Resistance and Hiding Behind the Safety Card 7:52 The Three-Month Standardization and Continuous Improvement Cycle 9:10 Consumer Wearables in Post-Op Monitoring: Whoop, Apple Watch, and Actionable Data 10:09 The Pneumonia Catch: How Remote Metrics Prevented a Potential Death 11:43 Care as a Spectrum: Before Admission Through Long After Discharge 13:18 Scaling Post-Op Visibility and Where AI Fits 14:25 Video Navigation for Surgical Patients: A Practice Started in 1996 16:00 Barriers to Scaling Across Education, Technology Access, and Demographics 19:44 Accountability, Culture, and Ownership Across Surgical and Medical Teams 20:08 The Efficiency Quality Index: Physician-Defined Metrics That Stick 22:47 Building the Ideal System-Wide Perioperative Infrastructure 23:05 Pre-Op Virtual Home Walkthroughs and Environmental Safety 24:19 Personalized Post-Op Goals and Real-Time Metrics at Home 25:00 Why Getting Home Faster Produces Better Outcomes 26:25 Pre-Op Home Visits, Fall Prevention, and Leading Before the Adverse Event

Dr. Nizar Wehbi, physician, health policy expert, and former North Dakota State Health Officer, joins the NovaNav Surgical Journey to examine why perioperative outcomes are decided far more by what happens outside the hospital than inside it. He breaks down fragmented episode-of-care ownership, misaligned post-acute incentives, and how tiered alert systems can function as a genuine workforce capacity lever. The conversation closes on the Rural Health Transformation Program and why the real opportunity is not self-sufficiency for rural hospitals but connectivity to regional and urban hubs. His expertise and insights are perfectly framed for CMOs, CNOs, CFOs, and health system strategists who are accountable for what happens after discharge.   Episode Contents 0:00 Introduction to NovaNav 0:55 Guest Introduction: Dr. Nizar Wehbi 6:11 Biggest Gaps Between Discharge and Full Recovery 10:25 Social Determinants and the Case for Navigation Support 14:46 CMS Bundled Payments and Outpatient Shift: How Leaders Should Prepare 19:15 Process Mapping the Episode of Care and Cross-Team Accountability 22:42 Standardizing Patient Management Across Sites and Teams 25:30 Policy Opportunities to Improve Patient Experience at the System Level 29:38 Fragmentation as a Design Problem and the Role of Incentive Alignment 32:48 30-Day Readmission and the Misaligned Incentives Across Post-Acute Facilities 35:24 Risk Stratification, Yellow and Red Flag Alerts, and Clinical Escalation 36:50 Workforce Shortage, AI, and the 80-20 Principle in Post-Discharge Monitoring 41:45 The $50 Billion Rural Health Transformation Program and Infrastructure Investment 48:51 Hub-and-Spoke Models, Rural-Urban Connectivity, and Community-Based Recovery 51:37 Closing Thoughts and Full Circle on the Process Map

In Episode 11 of The Surgical Journey, Fred Neis — best-selling author of The Disciplined Leader, registered nurse, and healthcare executive — joins the show to discuss what makes the surgical experience feel coordinated, reliable, and well designed. Patients may not use those exact words, but they know when care feels predictable and when it does not. Neis explains why stronger follow-up, better coordination, and more consistent standard work are essential to perioperative operations. He also makes the case that high reliability requires leadership that is willing to reduce unnecessary variation across teams and build a more dependable experience for both patients and staff. Episode Contents 00:00 NovaNav Introduction 00:51 Guest Introduction: Fred Meese 02:16 What patients really want: service, predictability, and tailored interactions 07:35 The biggest disconnect after surgery: what happens once patients go home 11:41 High reliability, standardization, and reducing variation in care 16:20 Value-based care, risk-based contracts, and where AI can improve outcomes 20:49 Nurse coordinators, workforce strain, and using AI to extend clinical capacity 24:41 Why healthcare technology adoption fails and how to build trust 30:18 Fred's book: The Discipline Leader 33:49 Referrals, reputation, and preventing network leakage 37:21 Where to find Fred and his book 38:25 Closing Remarks

Most cancer patients experience their worst anxiety not during surgery, but in the days between diagnosis and treatment. Dr. Lisa Atterbury, a board-certified breast surgical oncologist with 18 years of experience, and Dr. Dupree, a breast radiologist, walk through the specific operational breakdowns that turn clinical delays into worse outcomes. They explain why the standard discharge instruction model fails, how 48-hour biopsy windows correlate with patient outcomes, and why post-operative ER visits often signal gaps in structured follow-up rather than true emergencies. This episode offers a clinical operations perspective on patient navigation, caregiver coordination, and the friction points that health systems can address without adding headcount. If you manage cancer programs or surgical services, this is a rare look at how two clinicians think about the space between appointments. Episode Contents 00:00 NovaNav Introduction 01:02 Guest Introduction: Dr. Lisa Attebery 02:43 What clinicians often miss between appointments 06:40 Common post-op issues patients face at home 08:52 How technology can support patients before and after surgery 11:54 Why delays in care can worsen outcomes 15:43 Reducing unnecessary ER visits with better guidance 18:18 Redesigning the space between appointments 20:33 The first days after diagnosis: delivering news with hope 22:05 Biggest friction points in the cancer journey 24:58 Access challenges, workforce strain, and rural care realities 28:08 Mobile mammography and meeting patients where they are 29:13 The role of families and caregivers in cancer care 32:27 What it means to care for breast patients for life 35:11 Closing Remarks

Dr. Vamsi Ithapu has spent his career studying how people process information and building technology that reduces cognitive overload. His work is grounded in a deceptively simple question: how much information can people actually process in critical moments? During his PhD at the University of Wisconsin-Madison, he built predictive models for Alzheimer's disease. Later, at Meta Reality Labs, he led teams building systems designed to reduce cognitive overload for millions of users. In this episode, he brings that perspective into healthcare and makes a compelling case for why patient communication should be designed with cognitive load in mind. This conversation explores why discharge instructions so often fail, what healthcare gets wrong about information delivery, and how systems can be built around what patients are actually able to absorb in vulnerable moments. Vamsi also breaks down the difference between prediction, reasoning, and planning in AI, where large language models are useful in clinical settings, and where leaders should be far more skeptical. We also discuss what it takes to move from research to real-world product, what healthcare can learn from consumer-scale technology, and why defining an ideal recovery state may be the most important starting point in designing better surgical journeys. The Surgical Journey is sponsored by NovaNav, the surgical patient journey platform designed to reduce readmissions, coordinate post-surgical care, and support patients from the OR through full recovery. Learn more at NovaNav.ai. In this conversation, we discuss: Dr. Ithapu shares four lessons from Meta's product experience that translate directly to health system AI strategy The three core things AI systems actually do: prediction, reasoning, and planning, plus where healthcare expectations often go wrong The reality of large language models in clinical environments: where they are useful, where they hallucinate with dangerous confidence, and what hospital leaders should be asking vendors right now A different way to think about discharge instructions. Cognitive overload is a design problem as much as it is a technology problem. We talk about what "minimum viable information" might look like for a surgical patient going home The idea of a "North Star" recovery state: defining what ideal recovery actually looks like for a patient, then designing the entire surgical journey backward from that point Throughout the episode, Dr. Ithapu disvusses where these systems help, where they fail, and what healthcare leaders need to understand before adopting them in clinical workflows. The discussion is especially relevant for anyone thinking seriously about discharge, recovery, and the gap between technical capability and patient reality. The Surgical Journey is sponsored by NovaNav, the surgical patient journey platform designed to reduce readmissions, coordinate post-surgical care, and support patients from the OR through full recovery. Learn more at NovaNav.ai. Episode Timestamps 0:00 Introduction to NovaNav 0:58 Introduction to Dr. Ithapu 4:38 From Alzheimer's research to Meta Reality Labs 5:52 Why "AI" is an overloaded term 6:03 The three functions of AI: prediction, reasoning, and planning 7:40 What AI is actually good at today, and where it still struggles 10:16 What hospital executives should ask AI vendors 11:42 Why personalization in healthcare is different from consumer tech 18:49 Where LLMs are genuinely useful in clinical settings 19:45 Hallucinations, opacity, and why failure is hard to detect 25:57 Discharge instructions and cognitive overload 29:40 "Minimum viable information" for patients going home 32:17 What it takes to move from research to real-world product 33:10 Four product lessons healthcare can borrow from Meta 41:23 Why not every healthcare problem needs an AI solution 47:26 The "North Star" framework for recovery and care design 48:11 Closing

Dr. Thomas Tsai, Associate Professor of Surgery at Harvard Medical School and Medical Director of Health Policy Research at the American College of Surgeons, joins The Surgical Journey to discuss what it actually takes to redesign surgical care around where patients recover today. Drawing on his work leading the first randomized controlled trial of home hospital for surgical patients at Brigham and Women's Hospital, and an enhanced recovery initiative that achieved same-day discharge rates above 90 percent for bariatric surgery, Tsai makes the case that better outcomes require more coordination, not less, and that the infrastructure most hospitals rely on was built for the team, not the patient. He addresses the counterintuitive reality of CMS TEAM: that reducing utilization requires more effort and more investment, not less. And he lays out what it takes to move a protocol from pilot to sustained execution at scale, including a year-long culture and buy-in effort that he describes as the real secret sauce. Topics covered include pre-habilitation, workflow redesign, gain-sharing under bundled payment, patient-reported outcomes, and the growing gap between where care happens and where the infrastructure to support it currently exists. EPISODE CONTENTS 00:00 Introduction and guest background 02:22 Redesigning surgical workflow around the patient, not the team 03:35 Why clinical workflows are built for the medical team, not the patient 05:02 Team-based and technology-enabled approaches to home recovery 08:24 How bundled payment models align incentives across the episode 09:55 Pre-habilitation and setting shared expectations before surgery 11:18 The counterintuitive reality: less utilization requires more effort 12:55 Achieving 90 percent same-day discharge for bariatric surgery 14:55 The year-long culture and buy-in effort behind protocol adoption 16:20 What it takes for digital health tools to move beyond a pilot 19:20 Redesigning the full surgical patient journey end to end 21:18 The burden of recovery shifts to patients and caregivers at discharge 23:24 Patient connection to the surgical team does not end at discharge 24:10 Patient-reported outcomes and the future of post-acute measurement

What happens when bundled payments stop being optional? In this episode of The Surgical Journey, host Lisa Miller sits down with Dr. David Shulkin, the 9th Secretary of the U.S. Department of Veterans Affairs and former health system CEO, to examine the implications of CMS's new mandatory bundled payment program: TEAM (Transforming Episode Accountability Model). Beginning in 2026, 780 hospitals will be required to participate in TEAM, a Medicare value-based care model that ties hospital reimbursement to outcomes across the full surgical episode — including the 30 days after discharge. Dr. Shulkin explains why this shift from voluntary to mandatory bundled payments could fundamentally change how hospitals manage surgical care, why many health systems are unprepared for episode-based accountability, and where the greatest clinical and financial risk actually occurs after surgery. The conversation explores the future of value-based reimbursement, surgical episode management, Medicare payment reform, and the operational challenges hospitals face when managing outcomes beyond their walls. If you work in hospital leadership, surgical care, bundled payments, value-based care strategy, or healthcare policy, this episode provides a clear view into how mandatory episode accountability may reshape the economics of surgery in the United States.   EPISODE CONTENTS  00:00 — Introduction to The Surgical Journey Overview of the podcast and its focus on improving surgical outcomes through better coordination, communication, and data. 00:51 — Introducing Dr. David Shulkin Background on the former VA Secretary and his leadership experience across health systems and federal healthcare policy. 04:30 — Shulkin's Path from Physician to Health System Leader How clinical training led to executive roles in major health systems and eventually national healthcare leadership. 08:45 — The Evolution of Value-Based Care in the U.S. Why payment reform has progressed slowly and what structural barriers health systems face. 13:50 — Why Bundled Payments Emerged in Surgical Care The rationale behind episode-based payment models and their role in aligning incentives across the surgical journey. 18:35 — CMS TEAM and the Shift to Mandatory Participation 780 hospitals received notice that they will participate beginning in 2026, marking a departure from voluntary bundle programs. 19:30 — Why TEAM Matters Financially Procedures included in TEAM can represent 15–20% of hospital revenue, making performance under the program financially significant. 19:42 — Are Hospitals Ready? Shulkin argues that many hospitals are not operationally prepared to manage surgical episodes under mandatory accountability. 23:10 — Managing Outcomes Beyond the Hospital Walls Why the post-discharge recovery period represents the highest risk for complications, readmissions, and episode costs. 26:00 — What Hospitals Must Do Differently How health systems will need to rethink care coordination and episode management to succeed under TEAM.

In this episode of The Surgical Journey, NovaNav Chief Strategy Officer Lisa Miller sits down with Dr. Albert Hakaim, pioneering vascular and endovascular surgeon and one of the foundational surgical leaders at Mayo Clinic Florida, to discuss what truly drives outcomes after a patient leaves the hospital. Drawing from decades of surgical leadership, Dr. Hakaim shares practical insights on post-discharge risk, why many recovery issues are invisible in traditional quality metrics, and how health systems can reduce avoidable readmissions through better communication, triage, and standardization across teams. The conversation explores why aligning surgeons on consistent readmission criteria is harder than most people realize, and why patient experience is often shaped by one simple factor: how quickly questions get answered after discharge. Key topics include: Post-op follow-up calls and why proactive outreach matters The hidden drivers of readmissions across surgical specialties CABG recovery and why anxiety and uncertainty increase ER utilization The tradeoff between length of stay vs readmission costs How technology, wearables, and automation can improve triage without adding staff burden Lessons from home-based recovery and the patient experience   EPISODE CONTENTS 0:00 NovaNav Introduction 0:54 Guest Introduction: Dr. Albert Hakaim 2:26 Decisions with the biggest positive impact on outcomes 3:28 Automating triage to reduce communication delays and readmissions 4:24 Streamlining post-operative care coordination support amidst workforce challenges 7:25 Patterns in post-discharge struggles that traditional metrics miss 10:21 Cross-team alignment: creating uniform readmission criteria 12:02 CABG readmissions and post-discharge variability in care 16:02 Longer length of stay vs readmission risk: what actually costs more under CMS TEAM 16:59 Managing accountability, data, and outliers across divisions 22:50 Episode wrap-up

In this episode of The Surgical Journey, NovaNav Chief Strategy Officer Lisa Miller interviews Dr. Hans Van Lancker, Chair of Orthopedics (and Bone & Joint services) at Cambridge Health Alliance and an orthopedic trauma surgeon, for a practical conversation on what CMS's TEAM model is changing in orthopedics and post-acute care. Dr. Van Lancker explains why success under CMS TEAM must be measured across the full episode of care, not just surgical performance, and why the highest-cost and highest-risk portion of the bundle often occurs after discharge. He discusses the challenge of accountability when surgeons and hospitals are financially responsible for outcomes that depend heavily on post-acute settings, care coordination, and patient adherence. The conversation also explores the future of home recovery, including how health systems can reduce post-operative variability, strengthen patient advocacy, and build workflows that help patients and caregivers succeed at home. Dr. Van Lancker shares why nurse navigation, standardized education, and real-time patient visibility are critical, and how technology can support recovery without increasing clinician cognitive burden. The episode highlights the role of digital care pathways, patient-reported outcomes, and "top-of-license" work as healthcare organizations adapt to value-based care and new CMS reimbursement models.   EPISODE CONTENTS 0:00 Introduction to NovaNav 1:10 Guest Introduction: Dr. Hans Van Lancker 5:10 Orthopedics under CMS TEAM: defining success across the full episode of care 10:59 CMS TEAM care coordination: aligning the team beyond the surgeon and reducing post-op variability 14:02 Home care and workflows that mimic patient advocacy 17:45 Building a culture around patient advocacy 19:16 Post-op home care: supporting caregivers and increasing patient confidence with technology 23:10 Using technology to free up time for top-of-license work 27:55 Episode wrap-up

In this episode of The Surgical Journey, NovaNav Chief Strategy Officer Lisa Miller speaks with Dr. Robert Hymes, Chairman of Orthopedic Surgery at Inova Fairfax Medical Center and a fellowship-trained orthopedic trauma surgeon, about the impact of CMS's TEAM model on orthopedic departments in 2026. Dr. Hymes shares how the shift from "excellent surgery" to total episode accountability is reshaping day-to-day leadership, requiring orthopedic teams to own not just the procedure, but 30 days of outcomes and spend. He explains why the biggest risk under TEAM is failing to redesign post-discharge recovery, especially discharge disposition, patient engagement, readmissions, and complications. The conversation explores the cultural shifts required for success, including aligning surgeons, reducing variation, and rounding as a true multidisciplinary team. Dr. Hymes also introduces a powerful concept for measuring navigation effectiveness: events avoided, not just calls made. Finally, he discusses the role of technology in the TEAM era and why the best solutions must function as a quiet, scalable early-warning system that supports navigators and care teams without increasing clinician cognitive burden.   EPISODE CONTENTS 0:00 Introduction to Nova Nav 1:06 Guest introduction: Dr. Robert Hymes 2:05 CMS TEAMS overview 7:30 Post-discharge accountability in CMS TEAMS 13:04 Cultural shifts required for CMS TEAMS success 18:21 Reframing outcomes through events avoided 21:44 The importance of care navigation 23:20 How to succeed with CMS in 2026 25:15 The role of technology in CMS TEAMS 28:30 Episode wrap-up