MedCity Pivot

Breaking Media
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  • Medicine
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We are at a watershed moment in healthcare. The entire industry is being compelled to question old assumptions and chart a new path forward - in a word, we need to pivot. This podcast hosted by the editorial team at MedCity News will highlight the strategies, the companies and the personalities spearheading this monumental transformation.

  1. Aug 10

    Deploying Agentic AI with Aetna's Chief Digital Officer

    Executive Summary Insurance companies are moving fast on agentic AI, and Aetna is one of the clearest examples of what that looks like in production. In this episode, Nathan Frank, Chief Digital and Technology Officer at Aetna, the insurance business of CVS Health, explains how AI agents are cutting administrative burden for nurses, why Aetna refuses to use AI for care denials, and what it will take to give every member their own AI health agent within the year. Key Takeaways Aetna's AI agents pull data from multiple platforms, providers, and EHRs to prepare clinical notes automatically, giving the company's 12,000 care management nurses 90 minutes back per day. Aetna does not use AI to deny care. Nathan Frank draws a hard line here: AI supports auto-approvals and administrative work, but clinicians review any case with missing information. 84% of providers in Aetna's annual survey believe AI and agentic AI will lead to better outcomes, a signal the company is using to justify deeper investment in interoperability and clinical data exchange. An early version of an AI scheduling agent is already in production, handling the "homework" of booking appointments. Nathan expects a fully autonomous AI health agent for members within the next year. Model cost management is becoming a core discipline: Aetna is routing workflows to lower-cost models where possible instead of defaulting every task to frontier AI. Links and Resources Connect with Arundhati Parmar aparmar@medcitynews.com Arundhati Parmar (@aparmarbb) on X — https://twitter.com/aparmarbb?lang=en MedCity News — https://medcitynews.com/ Keywords agentic AI healthcare, Aetna AI, Nathan Frank Aetna, CVS Health AI, AI in health insurance, ambient listening healthcare, AI care management, administrative burden AI, health insurance AI trust, AI claims processing, AI appointment scheduling, health plan AI agents, payer AI strategy, CVS Health Ventures, AI model cost management, interoperability healthcare AI, AI care denials, MedCity Pivot podcast, healthcare AI startups, member experience AI Episode Highlights [00:03:00 - 00:04:00] How Aetna's AI agents pull data from multiple EHRs to prepare clinical notes for nurses before patient visits [00:04:00 - 00:04:30] The result: 90 minutes back per day for clinicians, redirected to patient care, not homework [00:06:00 - 00:07:00] Aetna's 10-plus years of AI and machine learning history, and its 3,000 data scientists [00:12:00 - 00:12:30] Nathan Frank's direct statement: Aetna does not use AI to deny care [00:13:00 - 00:13:30] The provider survey finding that 84% believe agentic AI will lead to better outcomes [00:16:00 - 00:17:00] How Aetna sorts signal from noise among healthcare AI startups [00:21:00 - 00:22:00] An early version of the AI scheduling agent is already live, with a fully autonomous member health agent expected within the year

    Deploying Agentic AI with Aetna's Chief Digital Officer

  2. Jun 30

    The Evolution of At-Home Care

    SUMMARY Arundhati Parmar speaks with Jill Schwartz-Chevlin, Chief Medical Officer at Vinca, about the evolution of palliative care from a hospital-based, end-of-life service to a community and home-based model for patients living with serious illness. Jill explains how Vinca grew from an advanced care planning platform into a value-based palliative care company serving patients across five states, primarily through Medicaid and Medicare Advantage plans. The conversation covers the critical distinction between palliative care and hospice, the cost savings data that health plans are paying attention to, and what it will take for Medicare to finally build a sustainable reimbursement model for the specialty. KEY TAKEAWAYS Palliative care is not hospice. It is symptom management and whole-person support for patients still pursuing active treatment for serious illness, including cancer, COPD, and advanced heart failure. More than 75% of hospitals now have palliative care teams, but their positioning around end-of-life discussions has created a widespread misconception that palliative care equals dying. Home-based palliative care through Vinca produces a 42% reduction in ER admissions and a 53% reduction in hospitalizations. Only three states (California, Hawaii, and New Jersey) have established a Medicaid benefit specifically for palliative care. Traditional Medicare offers no such benefit. The current fee-for-service model for palliative care is not sustainable. Most palliative care programs linked to hospices survive only because the hospice subsidizes them. KEYWORDS palliative care at home, home-based palliative care, serious illness management, palliative care vs hospice, Vinca health, value-based palliative care, Medicaid palliative care benefit, Medicare Advantage palliative care, community palliative care, advanced care planning, hospice length of stay, ER reduction palliative care, whole-person care, serious illness, home health palliative care, CMO interview healthcare, palliative care reimbursement, MedCity Pivot podcast Links and resources  Connect with Arundhati Parmar  aparmar@medcitynews.com  Arundhati Parmar (@aparmarbb) on X MedCity News EPISODE HIGHLIGHTS [00:02:04 – 00:02:36]  Jill defines palliative care: symptom relief, patient wishes, team-based approach [00:03:11 – 00:03:46]  Why hospital palliative care teams created the end-of-life association [00:06:13 – 00:07:06]  Vinca's 15-year journey from advanced care planning to full palliative care services [00:11:43 – 00:12:07]  The data: 42% ER reduction, 53% hospitalization reduction [00:12:52 – 00:13:31]  Patient story: metastatic pancreatic cancer, golf one month ago, ER the next [00:18:47 – 00:19:29]  Jill clarifies the hospice misconception: 90% of hospice care happens at home [00:22:50 – 00:24:10]  Why Medicare's fee-for-service model for palliative care is failing and what should replace it

    The Evolution of At-Home Care

  3. May 20

    Interoperability with CEO of Particle Health

    Episode Summary Particle Health CEO Jason Prestinario joins MedCity Pivot to assess the state of U.S. healthcare interoperability with clear-eyed candor. He grades the technical infrastructure a B — data can move — but gives access governance a C, because the rules around who uses data, and how, remain murky and poorly enforced. Jason draws a direct line between true interoperability and the viability of value-based care: without frictionless data access, accountability for patient outcomes is impossible. The conversation also covers Particle's antitrust lawsuit against Epic, now past its first major legal hurdle, and the broader wave of litigation challenging Epic's market dominance. Jason urges nuance: there's a meaningful difference between patients authorizing their own data use and bad actors harvesting records without consent — and conflating the two risks setting back the entire data-sharing ecosystem. Key Takeaways The data infrastructure gets a B — but access governance is still a C. The technical pipes for moving health records exist, but who can use them, when, and for what purpose remains the critical unsolved problem. Interoperability is a 'nice to have' in fee-for-service care — but it's a hard requirement for value-based care. When a provider is accountable for outcomes that happen outside their four walls, they need data from outside those walls. Information blocking penalties need teeth. Until healthcare organizations believe violations will result in real consequences, the rules won't change behavior — just like speed limits only work when drivers believe tickets are real. There's a critical distinction between patients authorizing their own data use and third parties accessing data without consent. The current Epic lawsuit debate conflates two very different scenarios that deserve separate legal and regulatory treatment. True patient data ownership is still largely a myth. Despite portals and progress, patients still face significant barriers — forgotten logins, provider-controlled systems — to accessing their own medical records programmatically. Links and Resources Connect with Arundhati Parmar aparmar@medcitynews.com Arundhati Parmar (@aparmarbb) on X MedCity News Keywords healthcare interoperability, Particle Health, Jason Prestinario, Epic lawsuit, antitrust healthcare, value-based care, CMS interoperability, TEFCA, Carequality, health data access, information blocking, 21st Century Cures Act, patient data ownership, HIPAA compliance, health information exchange, payer interoperability, digital health data, EHR data sharing, CommonWell, ONC rules Episode Highlights [00:04:22 - 00:05:16] Jason grades the interoperability 'pipes' a B-plus but gives data access governance a C at best. [00:10:56 - 00:12:37] Interoperability shifts from 'nice to have' in fee-for-service to a hard requirement in value-based care. [00:17:05 - 00:19:27] Jason explains why Particle sued Epic and what the case means for the broader healthcare data ecosystem. [00:25:11 - 00:27:11] A key distinction: patient-authorized data use versus unauthorized third-party data harvesting. [00:28:34 - 00:32:44] Why patients still can't easily access their own records — and what it would take to change that. [00:29:02 - 00:29:41] Information blocking penalties only work when organizations believe the consequences are real.

    Interoperability with CEO of Particle Health

  4. Apr 23

    Modernizing Prior Authorization to Boost Transparency

    Episode Summary In this episode of the MedCity Pivot Podcast, host Arundhati Parmar sits down with Javier Gonzalez (Abarca Health) and Tanvi Patel (Amazon Pharmacy) to unpack one of healthcare's most frustrating processes: prior authorization. The conversation explores how outdated systems, lack of transparency, and fragmented communication are eroding patient trust and delaying care. From policy complexity and data gaps to operational risks, the guests break down why prior authorization remains such a challenge—and what it will take to modernize it at scale. They also highlight the critical role of transparency, interoperability, and consumer expectations in shaping the future of healthcare. With insights from both payer and pharmacy perspectives, this episode paints a clear vision of a more patient-centered system where access to medication is faster, clearer, and more trustworthy Links & Resources Connect with Arundhati Parmar aparmar@medcitynews.com  https://twitter.com/aparmarbb?lang=en https://medcitynews.com/ Keywords prior authorization healthcare transparency patient trust interoperability digital pharmacy healthcare innovation medication adherence health tech ePA patient experience healthcare systems PBM reform Amazon Pharmacy Abarca Health Episode Highlights 00:00–00:25 – Introduction to prior authorization challenges and patient frustration 00:01–00:49 – Overview of modernization efforts in healthcare systems 00:01:27–00:03:31 – The three core challenges: policy complexity, data quality, operational risk 00:04:11–00:04:29 – Real-life impact: delays in critical care (cancer case) 00:04:36–00:05:22 – How prior authorization erodes patient trust 00:05:59–00:07:00 – Medication adherence begins before the first dose 00:07:00–00:07:18 – 20–30% drop-off due to prior authorization failures 00:07:18–00:07:39 – Transparency as the key to patient engagement 00:08:20–00:09:45 – Benefits of electronic workflows (60–70% efficiency gains) 00:11:18–00:12:24 – What should be eliminated in a redesigned system 00:12:47–00:13:55 – Employers' role in improving benefit transparency 00:15:23–00:16:21 – Rise of modular PBM models and industry shifts 00:20:46–00:22:11 – Misaligned incentives across healthcare stakeholders 00:23:51–00:24:45 – Consumer expectations reshaping healthcare timelines 00:25:14–00:26:11 – The future: invisible, frictionless prior authorization

    Modernizing Prior Authorization to Boost Transparency

  5. Mar 30

    Tackling Existential Crisis

    Summary In this episode of the Med City Pivot Podcast, host Arundhati Parmar speaks with Lars Petersen about one of the most remarkable corporate transformations in modern business history. Facing a catastrophic collapse of its core film business in the mid-2000s due to the rise of digital photography, Fujifilm executed a bold and strategic pivot into healthcare and life sciences. The company diversified aggressively, leveraging its deep expertise in materials science, imaging, and innovation to build a thriving biotechnology and medical technology ecosystem. Today, Fujifilm operates as a global Contract Development and Manufacturing Organization (CDMO), partnering with leading pharmaceutical companies and startups alike. The conversation explores how strategic investment, diversification, long-term thinking, and innovation—including AI—enabled Fujifilm not just to survive, but to lead in a completely new industry. Links & Resources Connect with Arundhati Parmar aparmar@medcitynews.com  https://twitter.com/aparmarbb?lang=en https://medcitynews.com/ Keywords Fujifilm Pivot Healthcare CDMO Biotechnology Biologics digital transformation business strategy Innovation AI in healthcare Pharma Manufacturing monoclonal antibodies gene therapy cell therapy Diversification corporate strategy MedTech Episode Highlights  00:00–00:23 – Introduction to the concept of "pivot" and Fujifilm's survival story 00:00–00:47 – The collapse of the film industry and existential crisis 00:00–01:15 – Fujifilm's transformation into a healthcare company 00:02:39–00:03:28 – 2006: the pivotal year and 60% revenue loss 00:03:28–00:03:45 – Strategic decision to diversify long-term 00:04:22–00:05:08 – Why Fujifilm succeeded while competitors failed 00:05:35–00:06:26 – Key investments and acquisitions (including Biogen assets) 00:06:52–00:07:30 – Why healthcare is a stable, long-term growth industry 00:07:53–00:08:29 – Expansion into medical devices and imaging technologies 00:09:42–00:10:34 – Core therapeutic focus: biologics, gene therapy, cell therapy 00:10:49–00:11:22 – Serving both startups and global pharma giants 00:12:39–00:13:40 – Competitive positioning vs. Samsung Biologics & Lonza 00:15:08–00:15:44 – "Partners for life" philosophy and long-term trust 00:17:52–00:18:49 – AI integration across manufacturing ecosystems 00:18:54–00:19:42 – Final takeaway: building shared ecosystems for the future of medicine

    Tackling Existential Crisis

  6. Feb 22

    Should Testosterone Replacement Therapy Be Less Regulated?

    EPISODE SUMMARY In this episode, Arundhati Parmar interviews Shalin Shah, CEO of Marius Pharmaceuticals, about Testosterone Replacement Therapy (TRT) and the long-standing regulatory classification that places testosterone as a Schedule III controlled substance. Shah explains that testosterone was scheduled in 1990 following Olympic doping scandals — despite opposition at the time from the FDA, DEA, and the American Medical Association. More than 30 years later, he argues that the regulatory framework no longer reflects current clinical evidence and may be doing more harm than good. The conversation explores: The scientific evidence surrounding cardiovascular and prostate safety The differences between injectable and oral testosterone therapies The stigma and logistical barriers created by controlled substance status How GLP-1 drugs intersect with hormone health and muscle preservation The possibility of expanding testosterone therapy access to women Whether the current regulatory environment may revisit testosterone scheduling At its core, this episode examines whether testosterone is being regulated based on outdated controversy rather than modern clinical science — and what that means for patients navigating care today. Episode Resources Connect with Arundhati Parmar aparmar@medcitynews.com  https://twitter.com/aparmarbb?lang=en https://medcitynews.com/ KEYWORDS Testosterone Replacement Therapy TRT regulation Schedule III classification Controlled substances Hormone therapy stigma Men's health Women's hormone therapy TRAVERSE study Cardiovascular risk Prostate cancer risk Oral testosterone Injectable testosterone Hematocrit levels GLP-1 muscle loss Hypogonadism FDA regulation Healthcare policy Hormone optimization   EPISODE HIGHLIGHTS 00:00–01:40 - Why testosterone became a Schedule III controlled substance in 1990 01:40–02:30 - Political backlash after Olympic doping scandals 02:30–03:56 - Testosterone as the only controlled hormone 03:56–04:58 - The physiologic role of testosterone across multiple organ systems 04:58–06:19 - Cardiovascular and prostate cancer risk: What the TRAVERSE study showed 06:19–07:04 - Physiologic vs. supraphysiologic dosing 07:04–08:49 - How controlled status creates stigma and access barriers 08:49–10:10 - Provider tracking, pharmacy hurdles, and patient friction 10:10–11:48 - Would deregulation increase abuse or doping? 11:48–13:20 - GLP-1 drugs, rapid weight loss, and muscle preservation 13:20–15:08 - Testosterone in women: The overlooked half of the population 15:08–16:22 - Injectable vs oral TRT: Mimicking natural diurnal rhythms 16:22–17:40 - Hematocrit elevation differences between injections and oral therapy 17:40–19:07 - Side effect profiles and hormone signaling differences 19:07–20:32 - Go-to-market strategy: Cash pay vs insurance coverage 20:32–21:24 - Stigma among payers and barriers to reimbursement 21:24–22:43 - Expanding label indications and idiopathic hypogonadism 22:43–22:22 - Could the current administration reconsider testosterone scheduling?

    Should Testosterone Replacement Therapy Be Less Regulated?

  7. Jan 13

    Separating Hype from Reality in AI

    Summary  Tune into MedCity Pivot Podcast with host Arundhati Parmar as three healthcare tech leaders—Serge Perras, Ton Roelandse, and Bertil Chappuis—decode AI's true potential in healthcare. Explore its role in enhancing efficiency and busting myths about AI supremacy.   Episode Highlights 00:00:19 - The high bar for AI safety in healthcare. 00:01:29 - AI's current hype and exaggerated promises. 00:03:57 - Misconceptions about AI replacing healthcare roles. 00:05:51 - Meaningful AI use cases: Prior authorization automation. 00:06:52 - AI in triage and its capacity enhancements. 00:08:10 - AI's role in modernizing healthcare infrastructure. 00:10:46 - Clarifying AI vs. RPA in tech solutions. 00:13:30 - Importance of governance and guardrails in AI. 00:16:38 - Humanizing healthcare through AI. 00:18:27 - AI's potential and challenges in medical coding. 00:21:31 - AI's impact on job roles and productivity boosts. 00:24:25 - Use of AI in personal life for everyday tasks.   Episode Resources Connect with Arundhati Parmar aparmar@medcitynews.com  https://twitter.com/aparmarbb?lang=en https://medcitynews.com/   Keywords Artificial Intelligence   Healthcare Innovation   AI Applications   Healthcare Safety   Technology Hype   Serge Perras   Abarca Health   Ton Roelandse   Trexin Consulting   Bertil Chappuis   Xtillion   Machine Learning   Generative Media   Super Agents   Risk and Reliability   Clinical Prediction Models   Automation Bias   Prior Authorization Process   Agentic Systems   Healthcare Infrastructure   Modernization   Robotic Process Automation (RPA)   Data Quality   Governance and Guardrails   Human vs AI Roles   Healthcare Workforce Transition   AI Augmentation   Patient Care   Medical Coding   Electronic Health Records (EHR)   AI Ethics   Data Fragmentation   AI Engineering   Healthcare Economics   AI's Net New Jobs   AI Sounding Board

    Separating Hype from Reality in AI

  8. 12/16/2025

    How Emergency Departments Are Using Real-Time Data to Improve Outcomes with Dr. Hamad Husainy and Dr. Barbara Bond

    During the episode, MedCity News Associate Editor Katie Adams interviews Dr. Hamad Husainy, chief medical officer at PointClickCare, and Dr. Barbara Bond, a physician at Sutter Health, about how AI can help improve patient outcomes in the emergency department.   Episode Resources Connect with Arundhati Parmar aparmar@medcitynews.com  https://twitter.com/aparmarbb?lang=en https://medcitynews.com/   Review, Subscribe and Share If you like what you hear please leave a review by clicking here   Make sure you're subscribed to the podcast so you get the latest episodes. Click here to subscribe with Apple Podcasts  Click here to subscribe with Spotify Click here to subscribe with Podbean Click here to

    How Emergency Departments Are Using Real-Time Data to Improve Outcomes with Dr. Hamad Husainy and Dr. Barbara Bond
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About

We are at a watershed moment in healthcare. The entire industry is being compelled to question old assumptions and chart a new path forward - in a word, we need to pivot. This podcast hosted by the editorial team at MedCity News will highlight the strategies, the companies and the personalities spearheading this monumental transformation.

Information

  • Creator
    Breaking Media
  • Years Active
    2020 - 2026
  • Episodes
    84
  • Rating
    Clean
  • Copyright
    © 2023 Breaking Media
  • Show Website
    MedCity Pivot