How Health Systems Work

HHSW
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Interviews with the U.S Health Systems Brightest Minds. Over the years, Jim Burke has had the privilege of engaging in deep, insightful conversations with some of the brightest minds in healthcare. These leaders possess invaluable perspectives that could offer solutions to many of the challenges facing the U.S. health Systems today. Driven by his curiosity and passion for learning, Jim created this podcast to amplify these voices and share their stories. This series invites healthcare leaders to tune in, learn from these mental models, and be inspired to collaborate and challenge the status

  1. Todd Nova: Aligning 340B Optimization with Health System Strategy

    12/17/2025

    Todd Nova: Aligning 340B Optimization with Health System Strategy

    In this episode of How Health Systems Work, Jim Burke and Steve Pratt talk with Todd Nova, a nationally recognized attorney at Hall Render and one of the foremost legal experts on the 340B drug pricing program. Todd brings his two decades of experience advising hospitals, health systems, and safety-net providers to help unpack the complex reality of 340B — its origins, its current pressures, and how health systems can navigate it responsibly and strategically. The conversation spans a wide range of topics, including how 340B savings impact financial sustainability, why program participation is often misunderstood, and the operational and legal risks of aggressive optimization tactics. Todd explains the practical link between Medicaid reimbursements, disproportionate share hospital (DSH) thresholds, and the survival of inpatient psychiatric and maternal health programs in underserved communities. He also lays out what hospital leadership must understand about compliance, strategy, and governance when engaging with 340B. Whether you’re at the start of your 340B journey or already deeply involved, this episode is a valuable roadmap for aligning compliance with mission — and ensuring your organization doesn’t leave critical value untapped.

    31 min
  2. Abigail Kaericher John Williams: Inside DC, What Hospitals Need to Know

    11/26/2025

    Abigail Kaericher John Williams: Inside DC, What Hospitals Need to Know

    From cyber‑risk and patient privacy to post‑shutdown policy drama — this episode brings together regulatory insight from a privacy lawyer and legislative specialists to help health systems anticipate what’s next.

    34 min
  3. Mark Swearingen: Protecting Patient Data in a Digital World

    11/13/2025

    Mark Swearingen: Protecting Patient Data in a Digital World

    As healthcare becomes more digital and data-driven, the risks around privacy and cybersecurity grow. In this episode, privacy and security attorney Mark Swearingen joins Jim Burke and Steve Pratt to unpack how health systems can protect themselves from breaches, ransomware, and vendor risk — while navigating the next frontier of data use in AI and analytics.

    30 min
  4. From Bedside to Boardroom: When Caring Becomes Leadership

    11/05/2025

    From Bedside to Boardroom: When Caring Becomes Leadership

    How does a small rural hospital maintain five-star performance for six straight years?In this episode, Carthage Area Hospital CEO Ada Bair joins hosts Jim Burke and Steve Pratt to share how strong culture, creative workforce strategies, and deep community partnerships are helping rural health systems not just survive—but thrive.

    28 min
  5. Pamela Jones: Managing Risk, Reimbursement, and Real-Life Care

    10/16/2025

    Pamela Jones: Managing Risk, Reimbursement, and Real-Life Care

    In this episode of How Health Systems Work, Jim Burke and Steve Pratt sit down with Pamela Jones, Vice President & General Counsel at Reed Health and former long-time GC at Franciscan Health. Pamela brings a unique blend of legal insight, rural health experience, and a deep commitment to community-driven care. Pam shares the challenges and opportunities she’s tackled moving from a large, urban hospital system to a rural one—where recruitment, behavioral health, and reimbursement dynamics are persistent headwinds. Among other topics, she talks about: How Reed Health is addressing “frequent flyers” in the emergency department through integrated community services, patient navigation, and value-based physician incentives The complexities of involuntary psychiatric commitments, guardianship processes, and statute-driven decisions that can make or break patient care Strategies for engaging state legislators and telling the hospital’s story amid financial pressures The importance of physician governance in small systems, and how to meaningfully involve physicians in strategic decisions Advice for young lawyers aiming for in-house roles, rooted in both law firm rigor and servant leadership If you serve in legal, operational, or leadership roles at rural or mid-sized health systems, this conversation is full of hard-earned wisdom and real-world strategies you can use.

    35 min
  6. Doug Long: From Law Firm to General Counsel, lessons from SSM Health's Legal Leadership

    09/25/2025

    Doug Long: From Law Firm to General Counsel, lessons from SSM Health's Legal Leadership

    Former SSM Health General Counsel Doug Long joins hosts Jim Burke and Steve Pratt to discuss the economic pressures reshaping healthcare today. From AI implementation and behavioural health challenges to hospital-at-home services and new Medicare payment models, Doug shares insights from leading legal operations at a $12 billion health system. The conversation covers essential leadership lessons for healthcare CEOs and practical advice for in-house counsel navigating an increasingly complex regulatory landscape.

    29 min

  7. 07/30/2025

    Unlocking Value-Based Enterprises in Healthcare

    In this episode, Jim Burke and Steve Pratt discuss the intricacies of Value-Based Enterprises (VBEs) in healthcare, focusing on their regulatory framework, key components, and practical applications. They explore the differences between Stark Law and AKS Safe Harbor, the importance of risk models, and how to effectively engage physicians in these initiatives. The conversation also highlights common mistakes in implementing VBEs and emphasizes the need for credible data and physician leadership to ensure success.

    32 min
  8. Gwen Sandefur: Rebuilding Trust by Listening to Patients

    07/16/2025

    Gwen Sandefur: Rebuilding Trust by Listening to Patients

    In this episode of How Health Systems Work, hosts Jim Burke and Steve Pratt sit down with Gwen Sandifer, interim president at Henry Ford Genesis Hospital and founder of Loud Minds. Gwen brings over 25 years of experience in healthcare administration and a deeply personal perspective shaped by her upbringing in a small rural town. She shares powerful stories—from a near-paralyzing injury in high school to her mother’s struggles accessing mental health services—that inspired her mission to improve healthcare systems. Gwen discusses how the sector has evolved, what’s stayed the same, and why relationships and real conversations remain at the core of progress. We dive into everything from the loss of informal collaboration spaces to the challenge of truly centering the patient in a fragmented system. Gwen offers bold ideas for healthcare transformation, including radically shifting incentives to put consumers in control of their care. Her perspective is rooted in deep compassion, operational experience, and a clear-eyed view of what’s not working.

    24 min
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Interviews with the U.S Health Systems Brightest Minds. Over the years, Jim Burke has had the privilege of engaging in deep, insightful conversations with some of the brightest minds in healthcare. These leaders possess invaluable perspectives that could offer solutions to many of the challenges facing the U.S. health Systems today. Driven by his curiosity and passion for learning, Jim created this podcast to amplify these voices and share their stories. This series invites healthcare leaders to tune in, learn from these mental models, and be inspired to collaborate and challenge the status

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