PopHealth Week: Ghost Rates, Anchor Events and the Real Cost of Care with David Muhlestein, PhD, JD, founder & CEO. Simple Healthcare

Join host Beth Friedman and Dr. Alex Ding, Chief Medical and Public Affairs Officer at DataSpring, for a conversation on the state of provider data, its impact across the ecosystem, and the path toward industry standardization. Dr. Ding breaks down why provider data matters, how industry leaders are convening to build unified standards, and how eliminating administrative friction directly benefits clinicians and patients. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

How do you know whether your healthtech company needs a classic demand gen campaign or a full ABM program? On this episode host Adam Turinas is joined by his colleague Paul Vandre, Account Director and Digital Marketing Specialist at Health Launchpad. Paul has two decades of experience in digital marketing, spending more than five years building paid media strategy for about 30 Health Launchpad clients. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Dr. Nick and Dr. Craig discuss a range of topics including: (1) vaccines, COVID and flu shots may come with a rough day, but there's a payoff reducing the risk of serious illness, hospitalization and worse; (2) AI-enabled documentation can capture care that was previously missed, but there’s a fine line between accurate coding and genuine upcoding; (3) whenever technology creates new revenue opportunities, someone will inevitably find a way to game the system; (4) OpenEvidence and its Doximity lawsuit raises questions about legal strategy; and (5) Orthosomnia and Sleep trackers can reveal useful trends, but obsessing over the numbers may actually make sleep worse.

Revenue Cycle Management and the Role of AI with Ritesh Ramesh On this episode host Tome Foley invites Ritesh Ramesh the CEO of MDaudit to discuss the recent benchmark report, highlighting trends such as payer reimbursement pressures, the strategic importance of revenue integrity, and the increasing use of AI to drive operational efficiency and ROI. Ritesh emphasizes that AI should be used with human oversight, as it cannot replace human judgment. The discussion covers challenges like medical necessity denials, the complexity of payer policies, and the need for cross-functional collaboration within health systems. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”.

Why hasn't a decade of value-based care bent the cost curve? On this episode host Fred Goldstein talks with David Muhlestein, PhD, JD, founder and CEO of Simple Healthcare, about the variable health reform has largely left alone: price. Drawing on years of ACO research and on federal price transparency data, Muhlestein explains how the same provider can be paid very different amounts for the same billing code depending on the insurer, why episode-level analysis beats claim-level repricing, and how self-insured employers can act on the gap through steerage, reference-based pricing, direct contracting and centers of excellence. He also unpacks "ghost rates," the negotiated prices listed for services providers never perform, which make up the large majority of insurer transparency files, and previews a consumer tool that uses AI to translate plain-language questions into total episode prices. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listenTo stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio.

Medical Device Security: From Alert to Action On this episode host Jessica Davis invites Tara Lansing-Deis, Principal Security Consultant of First Health Advisory to talk about tactical, reactive approaches to medical device security in the clinical setting, as well as training needs for health tech management teams. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”.

On this episode Jim welcomes Mitesh Kumar (SVP of Claims) and Christian Bass (SVP of Payment Integrity) of Sagility, a technology-led healthcare operations partner for payers and providers. Kumar and Bass provide insight into the challenges and solutions of modern day claim payment. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Is Healthcare Vulnerable to Runaway AI? To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Host Adam Russo invites Keith Smith, M.D, Medical Director at Surgery Center of Oklahoma to discuss transparent healthcare pricing and market-driven reforms. Dr. Smith discusses the founding of the Surgery Center of Oklahoma and its pioneering approach to posting all-inclusive, bundled prices online, which initially faced skepticism but eventually led to increased quality and lower costs in the local market. The model attracted self-funded employers and uninsured patients, and described the growth of the Free Market Medical Association (FMMA), which he co-founded to connect healthcare buyers and sellers. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Securing the Machine Workforce: Identity, Zero Trust, and the Recovery Plan for When It Still Goes Wrong with Ben Smith of SailPoint Zero trust sounds simple until you try to implement it in a hospital where clinicians share devices, legacy systems can't be segmented, patients access care virtually across state lines, and AI agents are multiplying faster than you can inventory them. Add ambient AI documenting patient encounters, remote patient monitoring streaming data 24/7, and third-party algorithms making clinical recommendations, and suddenly "healthcare everywhere" becomes a CISO's nightmare. This panel cuts through the theory to reveal what actually works when you're securing distributed care, AI-powered workflows, and thousands of identities, human and non-human, that don't fit traditional security models. • Implementing zero trust without disrupting patient care or alienating clinicians • Taking control of AI agent identities • Medical device segmentation when legacy won't retire • Adaptive identity for clinicians and patients • Measuring security success in healthcare everywhere To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/