The Value Shift by Protera Health

The Value Shift by Protera Health

di Protera Health
Medicina
Stagione 2
Fixing MSK: How Health Plans Can Recognize and Reduce Imaging and Surgery Overspend | Featuring Clem Foltz, FSA
What happens when an Actuary and a Surgeon look at the same claims data? In our latest episode of The Value Shift, we’re joined by Clem Foltz, FSA, an expert in specialty value-based care. While doctors see patients, actuaries see the "sequences" and "intensity" of care journeys—and that’s where the opportunity for true value lies.
S2 · E2
9 apr 2026
44:26
How Can We Get Surgeons to Value Value-Based Care? | Featuring Dr. Ahilan Sivaganesan
Welcome to the Season 2 premiere of The Value Shift. We’re kicking off the new season with a deep dive into one of the biggest hurdles in modern medicine: aligning surgical incentives with patient outcomes. In this episode, host Eric sits down with neurosurgeon Dr. Ahilan Sivaganesan to tackle the fundamental question: How can we get surgeons to value value-based care? The current fee-for-service model often rewards volume over value, leading to "CPT Envy" and misaligned incentives. Dr. Sivaganesan shares his firsthand experience navigating these hurdles—from his viral advocacy on LinkedIn to resolve insurance denials to his work with Mishe Health and Mark Cuban’s Cost Plus Wellness to build a direct, transparent healthcare ecosystem.
S2 · E1
24 feb 2026
34:56
Stagione 1
The Powerhouse Dyad Behind Intermountain's Payor/Provider Specialty Collaboration | Featuring Dr. Aaron Chamberlain & Casey Leavitt
In Episode 11 of the Value Shift Podcast, we sit down with Dr. Aaron Chamberlain & Casey Leavitt of Intermountain Health to discuss payor/provider speciality collaboration.
S1 · E11
18 nov 2025
45:42
Ep 10: How AI and Innovation Are Transforming Musculoskeletal Health | Featuring Dr. Christian Pean
Ever wondered how AI is changing orthopedic care? We sat down with Dr. Christian Pean of Revel AI Health and Duke University to talk: Scaling high-quality care without breaking the system Making healthcare more equitable and accessible Value-based care and longitudinal bundles for joint health A must-listen for anyone curious about the future of clinical technology and population health.
S1 · E10
28 ott 2025
44:02
Ep 8: From Surgery to Systems: How an IPU Improves Outcomes and Reduces Costs | Featuring Dr. Kelton Burbank
In this episode of our podcast, Dr. Makhni sits down with Kelton Burbank, MD, a nationally recognized orthopedic shoulder surgeon and value-based care expert. Kelton shares how his unique path from family medicine to orthopedics shaped his passion for high-value, patient-centered care and how his team built an Integrated Practice Unit (IPU) model that: Coordinates orthopedics, behavioral health, nutrition, and PT Reduces unnecessary procedures and costs Boosts PROM scores and patient engagement If you’re a healthcare leader or innovator looking to replicate a proven value-based care model, this episode is a must-listen.
S1 · E8
23 set 2025
36:44
Ep 7: Digital MSK and Embedded PT: Emplify Health's Visionary Approach to Value-Based Care | Featuring Dr. Joe Kucksdorf
How do you scale value-based musculoskeletal care inside a competitive market? Dr. Joe Kucksdorf of Bellin Health (now Emplify) shares how embedding physical therapists in primary care, offering free PT for employees, and layering in virtual care creates measurable ROI. From reducing unnecessary surgeries to boosting retention and patient satisfaction, this episode is a blueprint for payers and providers looking to bend the MSK cost curve.
S1 · E7
10 set 2025
34:32
Ep 6: When Physical Therapy Meets Policy: Lessons for Value-Based Specialty Care | Featuring Dr. Dana Strauss
What happens when a frontline clinician turns into a policy leader? Dr. Dana Strauss, PT, shares her journey from inpatient rehab to shaping national value-based care policy. We dive into bundled payments, CMS’s new TEAM model, and how aligning incentives can transform musculoskeletal care — for patients, providers, and payers alike.
S1 · E6
19 ago 2025
53:00
Ep 5: Value-based Care Begins in the ER: Strategic Advice from a Health Plan CMO | Featuring Dr. Charles Bloom
In the fifth episode of The Value Shift podcast, we are excited to welcome Dr. Charles Bloom, Chief Medical Officer of Health Alliance Plan (HAP) of Michigan. Dr. Bloom discusses his career transition from an emergency department physician to a health plan executive and his passion for value-based care. He explains how HAP, a regional health plan owned by Henry Ford Health, is working to align incentives between payers, providers, and patients to improve quality of care and patient outcomes while managing costs.
S1 · E5
30 lug 2025
41:30
Ep 4: Growing Growth in Medicaid Managed Care: An Executive’s Perspective | Featuring Dave Thomas
In the fourth episode of The Value Shift podcast, we are excited to welcome Dave Thomas, a seasoned health plan executive with 25 years of experience at Fidelis and Centene. Thomas details his career, rising from director to CEO of Fidelis, growing it from under 70,000 members to 1.7 million by 2018, and ultimately overseeing 32 health plans across 31 states as CEO of Medicaid and Markets for Centene.
S1 · E4
17 lug 2025
35:11
Ep 3: Building Culture, Trust, and a Better Health Plan from the Ground Up | Featuring Dr. David Lee
In the third episode of The Value Shift podcast, we are excited to welcome Dr. David Lee. Dr. Lee is the President of OhioHealthy, a value-driven health plan operated in partnership with OhioHealth, Ohio’s largest not-for-profit healthcare system. From medical school to coffee entrepreneur to health plan president - Dr David Lee has established himself as a leading health plan executive. Lee sits down with Dr. Eric Makhni of Protera Health to discuss his fascinating professional development journey and what he is most excited about in the days ahead.
S1 · E3
26 giu 2025
36:10
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