Value Health Voices

Dr. Amar Rewari and Dr. Anthony Paravati
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We discuss the most impactful health policy and healthcare finances developments shaping the US Healthcare system now and in the future. We also discuss personal development for physician executives. Co-hosts Dr Anthony Paravati and Dr Amar Rewari.

  1. The Three Words AI Won't Say: Inside Mednet's Bet on Honest Medicine

    May 28

    The Three Words AI Won't Say: Inside Mednet's Bet on Honest Medicine

    Can AI replace physicians? Dr. Nadine Housri explains why Mednet merges AI in medicine with human expertise to solve the most complex patient cases. Episode Resources: Official Platform for MednetPeter Densen Study on the Acceleration of Medical KnowledgeJAMA Oncology Study on AI Accuracy vs. NCCN GuidelinesAnalysis of Evidence Levels within NCCN GuidelinesGenerative AI is rapidly entering healthcare, but even the most advanced models struggle to answer medicine's most nuanced, patient-specific questions. In this episode, Dr. Nadine Housri, co-founder of Mednet, joins Dr. Amar Rewari and Dr. Anthony Paravati to discuss how her platform bridges the gap between limited clinical guidelines and real-world patient care. You’ll discover how scaling expert wisdom not only solves impossible clinical cases but also prevents the dangerous de-skilling of modern physicians. Dr. Housri explains how Mednet evolved from a niche tool for oncologists into a nationwide digital hallway that allows clinicians to crowdsource expert clinical reasoning when traditional data falls short. The conversation tackles the vital difference between a confident AI hallucination and a human expert's willingness to admit "I don't know," exploring why large language models excel on board exams but often fail in complex clinical decision-making. The group also unpacks a growing debate surrounding ambient AI scribes and medical education: does automating documentation destroy a trainee's critical thinking, or does it pave the way for better adaptive problem-solving? Find out how hard-coding humility into artificial intelligence might be the key to upskilling the next generation of doctors. If you enjoyed this deep dive into the intersection of technology and clinical practice, please subscribe and leave us a five-star review!

    56 min

  2. May 7

    The Value-Based Care Illusion: Consolidation and the Future of Specialist Medicine

    Discover how health system consolidation impacts specialist stipends and care costs. Dr. Eric Bricker reveals how physicians can reclaim their market power. Episode Resources: AHealthcareZDOJ Antitrust Lawsuits Against NY-Presbyterian and OhioHealthKFF Issue Brief on Provider ConsolidationOverview of the No Surprises Act Dispute Resolution ProcessWhen it comes to negotiating healthcare payments, fairness is an illusion. It is entirely a game of market power. In this episode, Dr. Eric Bricker returns to unpack the massive impact of health system consolidation on specialist stipends, facility fees, and the everyday reality of patient care. You’ll walk away with a crystal-clear understanding of the hidden financial levers driving up healthcare costs and how recent Department of Justice lawsuits could disrupt the entire industry. Dr. Anthony Paravati and Dr. Amar Rewari join Dr. Bricker to examine the aggressive all-or-nothing contracting tactics that mega hospital systems use to monopolize markets and artificially inflate facility fees. The trio dissects the controversial world of specialist stipends, revealing how workarounds to the Stark Law and the influx of private equity are radically transforming physician compensation. They also debate whether the push for value-based care within Medicare Advantage is a genuine cost-control solution or just a cynical strategy by the government to shift the burden of rationing care to insurance carriers. You won't want to miss Dr. Bricker’s surprisingly radical framework for how doctors can collectively reclaim their agency and finally outmaneuver corporate administrators.  If you want to stay ahead of the curve on the business of medicine, be sure to subscribe to the podcast and leave a review!

    54 min

  3. Apr 16

    Do Hospitals "Launder" Billions in Medicaid Fraud? ft. Brian Blase

    Discover how government policies distort U.S. healthcare. Brian Blase exposes Medicaid gimmicks, ACA exchange flaws, and healthcare policy reforms. Episode Resources: The Great Obamacare Enrollment Fraud ReportReport on Medicaid Financing Reform and Provider GimmicksU.S. healthcare spending accounts for nearly a fifth of our GDP, yet systemic failures and physician burnout continue to reach historic highs. In this episode of Value Health Voices, Dr. Amar Rewari and Dr. Anthony Paravati sit down with Brian Blase, President of the Paragon Health Institute, to unpack the massive legislative shifts inside the newly passed One Big Beautiful Bill Act. Clinicians and healthcare leaders will walk away with a clear understanding of how new federal policies are fundamentally altering healthcare economics, Medicaid funding, and everyday clinical practice. We explore the structural forces driving hospital consolidation, examining how government-subsidized demand and restricted supply have inadvertently inflated costs across the entire sector. Brian breaks down the controversial "legalized money laundering" of Medicaid provider taxes and reveals why enforcing site neutrality and Medicare payment reform could be the ultimate weapons against hospital monopolies. The conversation also tackles the heated debate over Medicaid work requirements, exposing staggering data on ACA exchange "phantom enrollees" that challenges the structural integrity of subsidized coverage. Will pushing for consumer-driven healthcare and expanding HSAs finally force high-priced providers to compete, or simply shift the burden to vulnerable patients? If you want to stay ahead of the curve on healthcare policy and economics, be sure to subscribe to Value Health Voices and leave us a review.

    45 min

  4. Apr 2

    The Truth Behind Health Insurance Denials with Warris Bokhari

    Claimable founder Warris Bokhari exposes the truth behind medical insurance denials. Learn how to successfully appeal claims and win life-saving patient care. Episode Resources: Official Website for ClaimableMarshall Allen’s Official Website and "Never Pay the First Bill"NBC News: How AI Helps Patients Fight Insurance DenialsSTAT News: Investigation into UnitedHealth’s "nH Predict" AlgorithmWhen a health insurance company denies life-saving medical care, it isn’t just a bureaucratic hurdle—it’s a hidden public health crisis that costs lives. In this episode of Value Health Voices, Dr. Amar Rewari and Dr. Anthony Paravati sit down with Time 100 Health List honoree Warris Bokhari, founder of Claimable, to expose the shocking reality behind the nearly one billion medical denials issued every year. Listeners will learn exactly how to fight back against predatory insurance tactics and successfully overturn wrongful claim rejections, especially in high-stakes fields like oncology. Drawing from his insider experience at Anthem and Apple Health, Warris pulls back the curtain on how insurers use proprietary AI algorithms and fabricated terms like "medically unnecessary" to boost profits at the expense of patient care. The conversation explores the heavy toll of prior authorization and utilization management, the disturbing conflict between fiduciary responsibility and clinical ethics, and how Claimable operates as the "TurboTax for health insurance appeals" to wage asymmetric warfare against corporate giants. Warris also reveals a brilliant, legally-backed framework for using ERISA laws and employer liability to force insurers into approving delayed treatments, but you'll have to listen to find out the single most important step every patient must take within 48 hours of receiving a denial letter. Don't let a devastating insurance denial dictate your health journey. Hit play to arm yourself with these essential medical advocacy tools. Be sure to subscribe to Value Health Voices, leave us a review, and check the show notes for a direct link to Claimable and other critical resources mentioned in this episode.

    59 min

  5. Mar 23

    The Real Crisis Destroying US Healthcare ft. Sachin Jain

    Dr. Sachin Jain reveals why healthcare faces a leadership crisis, not a payment crisis. Learn how SCAN Health Plan is transforming Medicare Advantage. Episode Resources: Healthcare in Action Official WebsiteDr. Sachin Jain on The Ethical Erosion of American HealthcareDetails on SCAN Health Plan’s $250 Million Legal VictorySCAN Affirm Member Guide for LGBTQ+ SeniorsAmerican healthcare doesn’t have a payment crisis; it has a profound leadership crisis. In this episode, Dr. Sachin Jain, President and CEO of SCAN Group, dismantles the broken culture of modern medicine and reveals how his non-profit Medicare Advantage organization is successfully flipping the script on senior care. Tune in to discover actionable strategies for aligning clinical integrity with financial sustainability, empowering you to drive meaningful change within your own health system.  Dr. Jain takes us under the hood of SCAN’s explosive growth, explaining why delegating full financial risk to provider groups is the ultimate antidote to the toxic cycle of traditional utilization management. He introduces his fascinating framework of "soft UM," challenging the industry's obsession with superficial quality metrics and exposing the "ethical erosion" plaguing profit-driven hospital boards. From designing hyper-targeted health plans for diverse populations to navigating the controversial debate over health systems dropping Medicare Advantage contracts, this conversation pushes boundaries and redefines the social determinants of health. Can we rely on corporate giants to save value-based care, or does the true solution lie in the hands of courageous, disruptive physician leaders?  If you’re ready to stop accepting the status quo and start leading with impact, hit subscribe and leave us a five-star review. Be sure to check the show notes for more information on SCAN Health Plan and additional resources on the future of healthcare innovation.

    51 min

  6. Feb 26

    The $200 Billion Healthcare Cartel Destroying Your Doctor: The MultiPlan Lawsuit with Matt Lavin

    What is the MultiPlan lawsuit? Attorney Matt Lavin exposes how commercial insurers allegedly use price fixing to underpay out-of-network healthcare claims. Episode Resources Free Case Evaluation Form for Interested Providers and Physicians to Connect with an AttorneyGilbert LLPMultiPlanCMS: No Surprises ActDepartment of Labor: ERISAUnitedHealthcareA single intermediary company touches an estimated 80% of all out-of-network medical claims in the United States, yet most doctors have never even heard of it. To help us understand the massive MultiPlan lawsuit, we sit down with Matt Lavin, a partner at Gilbert LLP and the lead antitrust attorney at the center of the battle. He breaks down how this obscure pricing system might be quietly draining hundreds of billions of dollars from American medicine. Throughout the episode, Lavin explains the exact mechanics of how commercial health insurance companies process out-of-network claims and why the system is drawing scrutiny from the Department of Justice. He reveals how proprietary algorithms are allegedly used to aggressively suppress healthcare reimbursement rates, creating massive fees for insurers while leaving providers struggling and patients stuck with the balance. We also unpack the hub-and-spoke cartel theory that forms the foundation of this case, detailing the real-world financial impact on rural hospitals and private practices. If you are an independent physician dealing with unpredictable revenue or a practice manager trying to make sense of mysteriously slashed payments, this episode is for you. You will walk away with a clear understanding of the hidden corporate forces driving down your revenue and practical advice on how to audit your past claims to protect your business. About Matt Lavin: Matt Lavin is a partner at Gilbert LLP’s Washington, D.C. office. He has successfully resolved countless reimbursement disputes with commercial payors such as Aetna, Anthem, AmeriHealth, Ambetter, Beacon, Centene, HealthNet, Humana, Cigna, UnitedHealthcare, HealthNet, Magellan, and many Blue Cross Blue Shield entities and Blue Card Network plans. Matt has experience with practically every aspect of the business of healthcare and revenue cycle management and has handled suits against “cost-containment” vendors, like MultiPlan, that egregiously underprice the value of out-of-network claims.

    1h 3m

  7. Jan 29

    The Business of Diagnostics: Reimbursement, PAMA & Innovation with Quest CMO Dr. Yuri Fesko

    Quest Diagnostics CMO Dr. Yuri Fesko joins Value Health Voices to decode the Clinical Laboratory Fee Schedule, the impact of PAMA and SALSA, and the future of precision medicine. Episode Resources: Learn more about Quest DiagnosticsExplore Quest's Consumer-Initiated TestingHow does a flawed government policy threaten the very foundation of modern medicine? Nearly every clinical decision, from a routine check-up to advanced cancer treatment, begins with data from a lab test. But the system that determines the value and payment for these critical services is under threat. In this episode, we explore the complex world of clinical laboratory services policy and payment with an unparalleled expert, Dr. Yuri Fesko, Chief Medical Officer of Quest Diagnostics. We uncover how a poorly designed law could cripple patient access to testing, especially in rural communities, and stifle the life-saving innovation happening in diagnostics. This deep-dive conversation with Dr. Yuri Fesko breaks down the most pressing issues facing clinical laboratories today. We start with the Clinical Laboratory Fee Schedule (CLFS) and the disastrous impact of the Protecting Access to Medicare Act (PAMA). Dr. Fesko explains how PAMA’s flawed data collection, which surveyed only the largest, most efficient labs, has led to proposed reimbursement cuts of up to 15% annually, threatening the viability of smaller hospital and independent labs across the country. We then discuss the bipartisan RESULTS Act, a proposed solution to create a more accurate and equitable system. The discussion also tackles the immense administrative burden of prior authorization for lab testing, a major friction point for clinicians that delays diagnoses and care. We explore how technology, like Quest’s adoption of the Epic EMR system, aims to streamline this broken process. A significant portion of our conversation focuses on the challenges surrounding reimbursement for advanced diagnostics. Dr. Fesko provides a fascinating look into cutting-edge innovations like Minimal Residual Disease (MRD) testing in oncology, a revolutionary tool that can detect trace amounts of cancer DNA in the blood to help guide treatment decisions and avoid unnecessary, toxic chemotherapy. We also navigate the intricate landscape of laboratory-developed tests (LDT) regulation, weighing the pros and cons of proposed FDA oversight versus the existing accreditation framework. Finally, we touch on patient-centric improvements like price transparency, the power of lab data in public health initiatives, and the critical importance of interoperability in ensuring patients own and control their health records. This episode is an essential guide to understanding the policy, payment, and innovation that will define the future of diagnostic medicine. About Our Guest: Dr. Yuri Fesko is the Chief Medical Officer of Quest Diagnostics. With a background in internal medicine, hematology, and oncology, Dr. Fesko leads Quest's medical groups, payer access and reimbursement strategies, and research activities. He brings a unique perspective from the front lines of both clinical practice and the leadership of one of the world's largest laboratory services companies, offering deep insights into the regulatory and financial pressures impacting patient care and diagnostic innovation. Timestamps: (00:00) Why Lab Testing is the Foundation of Medicine (05:43) The Clinical Laboratory Fee Schedule (CLFS) Explained (09:22) PAMA: A Flawed Law Threatening Lab Services (14:51) The RESULTS Act: A Bipartisan Fix for PAMA (18:24) The Burden of Prior Authorization for Lab Testing (26:07) Improving the Patient Experience with Price Transparency (30:56) Innovation: Reimbursement for Minimal Residual Disease (MRD) Testing (41:52) The Complex Regulation of Laboratory-Developed Tests (LDTs) (46:15) Big Data: How Lab Results Shape Public Health (55:49) Future Risks & Opportunities for Clinical Labs

    59 min

  8. Jan 8

    The Clinical Case for Sunlight Therapy to Reduce Hospital Stays with Dr. Roger Seheult

    Dr. Roger Seheult makes the clinical case for sunlight therapy. Discover the evidence for using infrared light to reduce hospital stays by 30% and cut costs. Episode Resources: Learn from Dr. Seheult on his YouTube ChannelExplore MedCram's Health Optimization Courses (CME available)Watch the Guy Foundation's Autumn Series on Light & HealthRead the Glen Jeffery study in Nature Scientific ReportsExplore the Swedish study on sun exposure and all-cause mortalityCould a simple, free resource dramatically reduce hospital stays and save the healthcare system billions? In this episode, we explore the powerful clinical case for sunlight therapy with one of the most respected medical educators online, Dr. Roger Seheult. He begins with the astonishing story of a 15-year-old boy given two days to live due to a flesh-eating fungal pneumonia, who made a miraculous recovery after one simple request: to go outside. This episode confronts the "magical thinking" skepticism head-on, presenting a data-driven argument that hospitals and policymakers can't afford to ignore. We're joined by Dr. Roger Seheult - a quadruple board-certified physician in pulmonary, critical care, and sleep medicine, and the founder of Medcram - to dissect the science behind sunlight and infrared light. Dr. Seheult breaks down the groundbreaking randomized controlled trials, including recent studies in Nature, that demonstrate the profound link between infrared light and mitochondrial function. Learn how specific wavelengths of light can pass through the human body, making our cellular batteries (mitochondria) more efficient, boosting ATP production, and impacting the root cause of many chronic diseases. This robust photobiomodulation evidence suggests we've overlooked a fundamental element of human health. The discussion pivots from cellular mechanics to systemic impact, focusing on the staggering potential for reducing hospital length of stay. Dr. Seheult cites multiple studies showing that patients exposed to more sunlight or targeted infrared light are discharged 3-4 days earlier - a reduction of over 30%. We analyze the immense financial implications, calculating potential savings of $5,000-$7,500 per admission for hospitals operating on bundled DRG payments. The episode tackles the practical and bureaucratic hurdles, from the inertia of hospital administration to the need for a new light therapy reimbursement policy. We explore actionable pathways for change, including updates to CPT codes, integration into CMMI value-based care models, and the power of the HCAHPS patient satisfaction survey to drive adoption. This conversation makes a compelling case that adopting light therapy isn't just good medicine; it's a financial and ethical imperative. About Our Guest: Dr. Roger Seheult is a quadruple board-certified physician (Internal Medicine, Pulmonary Diseases, Critical Care Medicine, and Sleep Medicine) and an Associate Clinical Professor at the UC Riverside School of Medicine and on faculty at Loma Linda University. As a critical care doctor, he sees the sickest patients in the hospital, which pushed him to explore foundational health principles that could pull patients back from the brink. He is the co-founder of MedCram, a leading online medical education platform with millions of viewers, where he excels at explaining complex medical topics in a clear and accessible way. Timestamps: (00:00) A Miraculous Recovery: The Case of the Boy with a Flesh-Eating Fungus (02:49) The Science and Finance of Light Therapy (03:55) Deep Dive: A 15-Year-Old's Fight Against Fungal Pneumonia (11:10) The Clinical Case for Light Therapy: Examining the Evidence (15:22) How Infrared Light Boosts Mitochondrial Function (19:51) Sunlight Exposure, All-Cause Mortality, and Global Health Patterns (26:40) The Financial Impact: Reducing Hospital Length of Stay by 30% (31:28) Practical Implementation: How to Prescribe Light Therapy in a Hospital (34:40) Overcoming Barriers: The Financial and Logistical Case for Change (44:14) Pathways to Reimbursement: New Policy and Payment Models (47:35) Rediscovering Old Wisdom: The History of Heliotherapy (56:21) Actionable Resources & How to Get Involved

    1h 1m
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About

We discuss the most impactful health policy and healthcare finances developments shaping the US Healthcare system now and in the future. We also discuss personal development for physician executives. Co-hosts Dr Anthony Paravati and Dr Amar Rewari.

Information

  • Creator
    Dr. Amar Rewari and Dr. Anthony Paravati
  • Years Active
    2024 - 2026
  • Episodes
    35
  • Rating
    Clean
  • Copyright
    © 2025
  • Show Website
    Value Health Voices

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