Concierge Medicine and the Law: Insights for Full and Hybrid Practices

The newly signed One Big Beautiful Bill Act is reshaping the healthcare landscape, with ripple effects for providers, payers, and patients. From Medicaid coverage shifts and rural hospital funding challenges to stricter ACA rules, expanded value-based care, and mandatory risk models, the implications are broad and far-reaching. In this episode of Value-Based Care Insights, host Daniel J. Marino speaks with Ben Sparks, President of Bryan Health Connect, a clinically integrated network, to examine four critical areas leaders must prepare for: projected Medicaid losses, financial pressures on hospitals, new insurance access rules, and the wider fiscal and political fallout across states. Drawing on Bryan Health Connect’s experience, Ben shares practical takeaways to help leaders adapt to the new law.

In this episode of Value-Based Care Insights, host Daniel Marino is joined by Christina Kuta, a healthcare attorney specializing in regulatory and transactional healthcare law. Together, they explore the growing shift toward concierge medicine and address common misperceptions surrounding full and hybrid concierge models. They discuss key legal and contractual considerations—ranging from commercial insurance implications to the Medicare opt-out process and membership agreements—that providers must understand before transitioning to concierge practices. Tune in to gain insights into how physicians can successfully navigate regulatory requirements, protect patients, and build sustainable concierge practices.

In this episode of Value-Based Care Insights, host Daniel Marino explores the potential impact of new federal legislation, including One Big Beautiful Bill Act of 2025, which is set to reshape healthcare delivery and payment models. He is joined by Natalie Davis, a nationally recognized health policy leader who has spent nearly two decades shaping and implementing initiatives to improve access to affordable, high-quality care for all. In 2018, Natalie co-founded United States of Care, an organization dedicated to advancing health equity and ensuring care is accessible regardless of health status, social needs, or income. She also played a key role in launching Town Hall Ventures and The Medicaid Transformation Project. Together, they examine the implications of the legislation for hospitals across the country, highlighting both the opportunities to advance value-based care and the challenges of adapting to new funding and operational requirements. Tune in to gain insights into how hospitals can proactively prepare for change, navigate evolving financial pressures, and sustain access and quality of care particularly in resource-limited settings. Strategies are explored to help organizations achieve success while maintaining strong community impact.

In this episode of Value-Based Care Insights, host Daniel Marino tackles one of healthcare’s most persistent challenges: physician burnout. Joining him are two experts who bring both clinical and research perspectives to the conversation. First, Dr. Stephen Hippler, a retired Chief Clinical Officer at OSF HealthCare, oversaw more than 1,500 physicians and advanced practice providers and has led initiatives to support provider well-being and a thriving work culture. Second, Dr. Laurence Weinzimmer, an endowed research professor at Bradley University, is a nationally recognized healthcare researcher and advisor to Fortune 100 companies.  Together, they share insights from their latest study on “physician fortitude” examining the deeper, human roots of burnout, the organizational and cultural factors at play, and the strategies needed to drive meaningful change. Listeners will gain an understanding of why burnout persists, and what leaders can do to better support clinicians, build resilience, and improve workforce well-being over the long term. 

In this episode of Value-Based Care Insights, host Daniel Marino explores the evolving role of operating room (OR) nurse leaders within the perioperative service line. As perioperative services become an increasingly important strategic and financial focus for hospitals and health systems, the demand is growing for leaders who can combine clinical expertise with business and operational acumen. Joining the conversation is Cheryl Barratt, a seasoned healthcare consultant with over 30 years of experience in surgical services operations, system integration, and performance improvement. Cheryl discusses how perioperative nurse leaders, while strong clinically, frequently lack the training needed to manage the broader responsibilities of these roles. She shares practical insights into how organizations can support their development with leadership, financial, and strategic competencies that enable them to lead more effectively and drive long-term performance.

In this episode of Value-Based Care Insights, host Daniel Marino continues the conversation on CMS’s mandatory TEAM Model (Transforming Episode Accountability Model) — a five-year episode-based pricing initiative impacting 741 hospitals across the country. Joining the discussion is Dr. Christian Pean, a board-certified orthopedic trauma and reconstruction surgeon at Duke University School of Medicine, executive director of AI and Innovation for Duke Orthopedic Surgery, and co-founder/CEO of Revel AI Health. Together, they unpack the clinical and operational impacts of TEAM, with a focus on five key surgical procedures. Dr. Pean highlights how emerging technologies — including conversational AI platforms — are enhancing episode management and streamlining outreach, triage, and documentation to help providers improve care coordination and succeed under TEAM. 

In this episode of Value-Based Care Insights, host Daniel Marino explores the evolving role of artificial intelligence (AI) in population health. As AI continues to dominate industry conversations and drive vendor offerings, healthcare leaders are faced with questions: What is real, what is hype, and where does the value lie? Dr. David Nash, Founding Dean Emeritus of Jefferson College of Population Health and a nationally recognized thought leader in value-based care and population health, join the conversation. Additionally, Rick Howard, a seasoned Chief Data Officer and AI Strategist contributes to the conversation with his deep expertise in driving data-driven innovation across healthcare organizations. Together, they break down common misconceptions, highlight the most promising AI applications in care delivery, and offer practical insights into how health systems, providers, and payers can responsibly integrate AI to drive meaningful outcomes and return on investment (ROI).

In this episode of Value-Based Care Insights, host Daniel Marino explores the newly introduced the CMS Transforming Episode Accountability Model (TEAM)—a mandatory five-year, episode-based pricing model, informed by earlier initiatives from the CMS Innovation Center. Designed to cover high-volume, high-cost surgical procedures, TEAM represents a significant shift in how hospitals and providers approach bundled payments. Join Daniel and special guest Lucy Zielinski, an expert in value-based programs and HCC coding , as they unpack what the TEAM model entails and what participating hospitals must do to prepare for the January 1, 2026 implementation. Gain insights how this model influences financial performance, drives care coordination redesign, and introduces new incentives and penalties. Whether you are a healthcare leader, provider, or payer, don’t miss this overview of one of CMS’s initiatives shaping the future of value-based care.

As hospitals and health systems continue to evolve in value-based care, optimizing the post-acute recovery process has become a top priority. In this episode of Value-Based Care Insights, Diane Shifley, Assistant Vice President of Population Health and Post-Acute Services at a major Chicago health system joins us to discuss how robust transitions-in-care programs can drive better patient outcomes. She shares insights on the critical role of early patient evaluation—whether at hospital admission or pre-surgery—in shaping effective transitions. We explore how transitional care models that include post-acute facilities and home care can reduce readmission rates, improve patient satisfaction, and control post-acute costs. This episode offers actionable strategies to strengthen your transitions-in-care to support patients through successful recovery.

In this episode of Value-Based Care Insights, host Daniel Marino explores one of the most pressing issues in healthcare today—workforce engagement and retention. Since the COVID-19 pandemic, healthcare organizations have faced unprecedented levels of burnout, turnover, and staffing shortages. Daniel is joined by Tanya Allee, Vice President of Patient Experience at Campbell County Health, a rural health system that is making meaningful strides in workforce development. Tanya shares practical strategies and initiatives to boost staff satisfaction, improve retention, and create a healthy culture of support and engagement. Tune in for valuable insights on how health systems can navigate workforce challenges and create a healthy organizational culture resulting in better patient care.