The Leadership Lab with Asbel Montes

Asbel Montes
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Hosted by Asbel Montes, The Leadership Lab explores bold ideas, tough conversations, and real solutions shaping the future of healthcare and public service. Join leaders from across the industry as they share insights, stories, and strategies that inspire action and elevate impact.

  1. 5d ago

    When "Stable" Becomes the Wrong Finish Line with Dr. Nicholas Cozzi

    Watch the video: https://youtu.be/NJ0Pmyc-z_g "Stabilization, to me, is the wrong word." In this Team Summit Special Edition of The Leadership Lab, recorded in Chicago, Asbel Montes sits down with returning guest Dr. Nicholas Cozzi, emergency physician and EMS Medical Director at Rush University Medical Center, for a conversation about a question that sounds simple and isn't: what actually counts as an emergency, and when is a patient truly safe? Dr. Cozzi starts at the bedside. He walks through a shift where he saw 70 to 80 patients in eight hours, a patient he heard wheezing before he ever saw her, and why a final diagnosis can't decide after the fact whether someone was having an emergency. Then the conversation turns personal for both of them: behavioral health patients waiting hours, days, even weeks in the ER for a bed, a 22-year-old who was stable at hour 11 and in restraints by hour 30, and why Asbel wants to retire the "cage car" for good. You'll Learn: ✅ Why EMTALA was written in 1986, and why the ER looks very different almost 40 years later ✅ What a medical screening exam is, and how an emergency physician sorts dozens of patients an hour ✅ The prudent layperson standard, and why insurance can't use a final diagnosis to deny an emergency ✅ Why "stable" doesn't mean safe, and how your zip code can decide where you get transferred ✅ What happens when behavioral health patients have nowhere to go but the emergency department ✅ Why transportation is part of treatment, from psychiatric care to dialysis This conversation isn't finished. Asbel and Dr. Cozzi are planning a round two on behavioral health, and Dr. Cozzi invited Asbel to shadow him in the ER to see it firsthand. If this episode made you think, subscribe to The Leadership Lab and share it with someone who needs to hear it. About Dr. Nicholas Cozzi: Dr. Cozzi is a board-certified Emergency Medicine and EMS physician with an MBA. He is EMS and Disaster Medicine Medical Director at Rush University Medical Center, Assistant Professor of Emergency Medicine at Rush Medical College, and a physician medical consultant for the Chicago Fire Department. He completed his EMS fellowship with FDNY and Northwell Health. Chapters: 00:00 Cold open 01:03 Welcome back to Chicago, Dr. Nicholas Cozzi 01:45 What counts as an emergency? 03:36 Dr. Cozzi's background 04:41 Why EMTALA exists 06:03 80 patients in 8 hours: the medical screening exam 10:12 When minutes mean life or death 12:47 The prudent layperson standard 15:00 When the ER can't provide the care 17:15 Your zip code can change your care 18:40 Why "stable" is the wrong word 21:31 Sponsor: Solutions Group Services 22:41 Behavioral health transfers and state law 24:37 The mental health access failure 28:49 Cage cars and the humanity of transport 34:01 Rethinking behavioral health transportation 35:54 Why "get them out of the ED" is the wrong goal 36:44 A 22-year-old, 30 hours in the ER 38:16 Transportation is part of treatment 39:32 Round two, and an invitation to the ER 40:47 Closing thoughts Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 Asbel Montes Book (In Plain Sight) - https://asbelmontes.com/store/ Asbel Montes Website - https://asbelmontes.com Dr. Nicholas Cozzi LinkedIn - https://www.linkedin.com/in/nicholaspcozzi/ Dr. Nicholas Cozzi at Rush - https://doctors.rush.edu/details/19379 Dr. Cozzi's first episode, The Economics of Care - https://youtu.be/s1zuc-Rb4yU The Leadership Lab: X - https://x.com/leadershiplabam Instagram - https://www.instagram.com/leadershiplabam/ Sponsored by: Solutions Group Services - https://www.solutionsgroup.com/?utm_source=podcast&utm_medium=audio&utm_campaign=ll-ep47-nicholas-cozzi Black Ink - https://www.discoverblackink.com

  2. Sep 24

    Follow the Data, Not the Narrative: What's Really Driving Healthcare Costs with Dr. Vivian Ho

    "There's upcoding, but the bigger problem is the price increases." In this episode of The Leadership Lab podcast, Asbel Montes sits down with Dr. Vivian Ho, health economist and James A. Baker III Institute Chair in Health Economics at Rice University, for a conversation about what the data actually says is driving American healthcare costs. Dr. Ho has studied the economics of healthcare for four decades. When she started, most hospitals were independent. Today close to 70 percent belong to a larger system, and most physicians are employed by a hospital or a corporate owner. She walks through what that shift has done to prices, why price transparency data has gotten worse instead of better, and the simple, practical reforms she recently shared with the Texas House Select Committee on Health Care Affordability. For physicians, hospital leaders, employers, and policymakers, this is a conversation about following the data even when you don't like where it leads. You'll Learn: ✅ Why hospital consolidation and facility fees keep pushing prices up ✅ What her research found actually drives nonprofit hospital CEO pay ✅ Why today's price transparency files are still so hard to use, and why enforcement is the real gap ✅ How a simple tiered copay model in Massachusetts cut spending per hospital stay by 8.5 percent ✅ Whether upcoding or price increases are driving emergency department spending Before we try to fix healthcare costs, we have to understand what's actually driving them. Better policy starts with better questions, and better data. If this conversation was valuable, subscribe to The Leadership Lab and share it with someone who is shaping healthcare policy. About Dr. Vivian Ho: Dr. Vivian Ho is the James A. Baker III Institute Chair in Health Economics at Rice University, a professor in the Department of Economics at Rice, and a professor of medicine at Baylor College of Medicine. She is an elected member of the National Academy of Medicine, and her research examines how economic incentives and regulation shape the quality and cost of care. Chapters: 00:00 Preview 01:02 Welcome, Dr. Vivian Ho 03:33 Four decades of consolidation 07:30 Facility fees and why hospitals buy physician practices 12:47 What drives nonprofit hospital CEO pay 16:55 Testifying before the Texas House Select Committee 19:31 How far should price transparency go? 22:06 If I can price a car, why not healthcare? 24:05 Ghost rates and the enforcement gap 27:21 Sponsor: Solutions Group Services 28:07 Legal vs. reasonable 31:47 The Massachusetts tiered hospital experiment 37:23 Should employers take back control? 41:39 Upcoding vs. price increases in the ED 44:12 AI and health economics research 46:58 What keeps Dr. Ho up at night 51:03 Life outside the numbers Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 Asbel Montes Book (In Plain Sight) - https://asbelmontes.com/store/ Asbel Montes Website - https://asbelmontes.com Dr. Vivian Ho LinkedIn - https://www.linkedin.com/in/vivian-ho-11b3771a2/ Dr. Vivian Ho at the Baker Institute - https://www.bakerinstitute.org/expert/vivian-ho Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices Instagram - https://www.instagram.com/solution_sgroup/ Facebook - https://www.facebook.com/solutionsgroupservices Website - https://www.solutionsgroup.com/?utm_source=podcast&utm_medium=audio&utm_campaign=ll-ep46-vivian-ho

  3. Sep 16

    Healthcare by the Fine Print with Pati McCandless

    "You would go to the same provider, same service, same facility, and the cost variation is going to be drastically different." In this episode of The Leadership Lab podcast, Asbel Montes sits down with Pati McCandless, Shareholder at Maynard Nexsen and a healthcare policy attorney with more than 30 years inside health plans, law firms, and government relations, for a conversation about the difference between what is legal in American healthcare and what is actually reasonable. The same knee replacement can be paid at 100 percent of Medicare one week and 900 percent the next, depending only on the patient's birthday. The No Surprises Act took patients out of the middle of balance billing, and then opened a door that some free-standing emergency rooms are now walking through with six-figure arbitration awards for minor emergencies. One health plan has 400 full-time employees doing nothing but processing No Surprises Act disputes. If you are a provider, a payer, an employer, or a taxpayer, this is your money. You'll Learn: ✅ Why your coverage, and what your doctor gets paid, depends on your age, income, employer, and state ✅ The knee replacement example: how the same surgery at the same hospital is priced differently at 64 and 65 ✅ Whose money is really at stake when a health plan negotiates (hint: 8 out of 10 patients are on someone else's dime) ✅ How the No Surprises Act came to be, and what it fixed for patients ✅ Where the Independent Dispute Resolution process is being exploited, from San Antonio's $40 million overrun to $100,000 awards for an eye infection ✅ Pati's solutions: a regulated benchmark payment, guardrails for the fringe, and more people at the table Asbel and Pati do not agree on everything, and that is the point. This is a living-room conversation between a provider-side leader and a payer-side attorney who both want the same thing: a system that works for the patient, the provider, and the people paying the bill. Don't miss future episodes that equip you to lead systemic change in healthcare. Subscribe to The Leadership Lab with Asbel Montes and share this episode with your team and network. About Pati McCandless: Pati McCandless is a Shareholder in the Insurance practice group at Maynard Nexsen in Austin, Texas, and the former Vice President of State Government Relations at Health Care Service Corporation. She began her career at the Texas Department of Insurance during the Richards administration and has spent more than 30 years moving between law firm practice and in-house government relations work for health plans, including testimony before the Texas Legislature on surprise billing dating back to 2005. Chapters: 00:00 Cold open 00:55 Meet Pati McCandless 06:26 Why coverage and provider pay vary so much 12:44 The same knee, two different prices 20:46 Whose money is it? Fully insured vs. self-funded 26:14 How the No Surprises Act came to be 30:02 A word from Solutions Group Services 31:17 Inside the IDR process 36:17 San Antonio and the free-standing ER problem 40:38 Solutions 49:17 Supply and demand, primary care, and the free-standing ER business model 54:16 What Congress should do next 59:17 What keeps Pati up at night Watch this episode on YouTube: https://youtu.be/asfmhrm3Ccs Listen on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-leadership-lab-with-asbel-montes/id1810035183 Listen on Spotify: https://open.spotify.com/show/4rNhvQ6DRA2i8f0IDPwgRv Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 Asbel Montes Book (In Plain Sight): https://asbelmontes.com/store/ Asbel Montes Website: https://asbelmontes.com/ Pati McCandless LinkedIn - https://www.linkedin.com/in/pati-mccandless/ Maynard Nexsen - https://www.maynardnexsen.com/professionals-pati-mccandless Solutions Group Services LinkedIn - https://www.linkedin.com/company/solutionsgroupservices Solutions Group Services Instagram - https://www.instagram.com/solution_sgroup/ Solutions Group Services Facebook - https://www.facebook.com/solutionsgroupservices Solutions Group Services Website - https://www.solutionsgroup.com/

  4. Sep 3

    Smarter Data. Stronger Healthcare. with Dave O'Reilly

    "I don't think EMS has a data creation problem. It has a data connectivity and a context issue." In this episode of The Leadership Lab podcast, Asbel Montes sits down with Dave O'Reilly, CEO of Traumasoft, to talk about what it actually takes to make EMS data useful: connecting it, putting the patient at the center of it, and using AI to catch documentation gaps while the crew still remembers the call. Dave came to EMS from outside the industry, and Asbel admits he was not a fan of Traumasoft when they first met. That changed. Dave walks through the culture shift he led, why EMS customers will not accept a vendor that refuses to integrate, and the story behind Huly, the AI documentation platform Traumasoft acquired after an EMT saved a life and got yelled at for an incomplete chart the same day. You'll Learn: ✅ Why EMS has plenty of data and still loses the outcome: the record does not follow the patient, and the crew never hears what happened next ✅ Why "you don't get to build a walled castle" in this industry, and what interoperability pressure looks like from a CEO's chair ✅ What Huly does: an AI agent that watches the ePCR in near real time, checks 100% of charts instead of a sample, and flags what is missing before the chart closes ✅ What it does not do: maximize what you can bill, or write the narrative for you ✅ Why the real documentation risk is the QA call weeks later, and what changes when the check happens while the call is fresh ✅ Why Traumasoft kept Huly independent, so agencies on ESO, Zoll, or ImageTrend can use it too ✅ Human in the loop: "someone in the cab who'll tap you on the shoulder and ask you, are you sure? Not somebody in the cab who's taking the keyboard from you" ✅ Where Traumasoft is headed: FHIR integration with hospitals, smaller barriers between systems, and no ambition to become an EHR ✅ What keeps Dave up at night, and why a patient with low blood sugar should not have to be transported for anyone to get paid Asbel closes with the case he keeps making on this show: healthcare is a business, the current trajectory is not sustainable, and providers, technologists, physicians, payers, and regulators have to get in the same room with the patient in the middle. Don't miss future episodes that equip you to lead systemic change in healthcare. Subscribe to The Leadership Lab with Asbel Montes and share this episode with your team and network. About Dave O'Reilly: Dave O'Reilly is CEO of Traumasoft, an EMS and NEMT operations platform covering dispatch, CAD, ePCR, billing, fleet, and workforce management. Named CEO in November 2024 after more than 20 years in software and healthcare technology, including serving as COO of CivicPlus, he led Traumasoft's acquisition of Huly, the AI-native pre-billing and QA/QI platform it runs as an independent company. Watch this episode on YouTube: https://youtu.be/JAM51BSLvX0 Listen on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-leadership-lab-with-asbel-montes/id1810035183 Listen on Spotify: https://open.spotify.com/show/4rNhvQ6DRA2i8f0IDPwgRv Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 Asbel Montes Book (In Plain Sight): https://asbelmontes.com/store/ Asbel Montes Website: https://asbelmontes.com/ Dave O'Reilly LinkedIn - https://www.linkedin.com/in/daveoreilly/ Traumasoft Website - https://traumasoft.com/ Huly Website - https://www.huly.ai/ Solutions Group Services LinkedIn - https://www.linkedin.com/company/solutionsgroupservices Solutions Group Services Instagram - https://www.instagram.com/solution_sgroup/ Solutions Group Services Facebook - https://www.facebook.com/solutionsgroupservices Solutions Group Services Website - https://www.solutionsgroup.com/

  5. Aug 25

    Healthcare's Hardest Problems: 7 Leaders on CMS Fraud, EMS Data, Rural Care, and AI

    Seven conversations. One summit. And a room full of leaders who agreed the system is not working the way it should. We took The Leadership Lab on the road to Clarity 2026 in Laguna Beach, and this is the recap: the moments that stopped the room, pulled from seven special edition episodes recorded live at the summit. CMS stopping more than $2.5 billion before it went out the door. A paramedic in 2026 still faxing a patient record into a hospital that owns the ambulance. A rural blood program in Mississippi that has transfused more than 60 patients and wasted exactly one unit. An economist whose own mother got a surprise bill. An attorney explaining why the AI chat you used to prep your legal argument is not privileged. If you work in EMS, healthcare finance, or health policy, start here. Then go listen to the full conversations linked below. Data. Doctors. Leadership. Through the eyes of the patient. CHAPTERS 00:00 Cold open: the lines that stopped the room 01:21 Kim Brandt, CMS: the fraud war room, the chili cook-off, and $2.5B stopped before payment 07:20 Fred Wilkins, VLI Tech: why EMS is still faxing patient records in 2026 12:55 Dr. Lisa Grabert: a surprise bill in her own family, and AI as a research assistant 17:44 Dr. Eric Beck, ESO: modernization, unmeasured EMS value, and the courage to be transparent 21:47 Dr. Hawnwan "Phil" Moy: get EMS out of the Department of Transportation 25:54 Dr. Damon Darsey: whole blood in rural Mississippi, and a $4 antibiotic 30:26 Scott Moore: AI, privilege, and the policy you will be rewriting monthly THE FULL EPISODES The War on Waste: CMS Priorities in a New Era with Kimberly Brandt https://www.youtube.com/watch?v=4EFsliL2fl4 Improving Outcomes & Efficiency Through Data Insight with Fred Wilkins https://www.youtube.com/watch?v=ims5tqkUBhQ Part II: An Economist's Take on Surprise Billing and Healthcare Payment Reform with Dr. Lisa Grabert https://www.youtube.com/watch?v=FyN-6INjZQ8 The Strategic Value of EMS Data in Modern Healthcare with Dr. Eric Beck https://www.youtube.com/watch?v=BQt8nO5VZt0 Physician Leadership in the Next Era of Healthcare with Dr. Hawnwan Moy https://www.youtube.com/watch?v=cEoPZoXvlQg When Physicians Lead: Transforming Rural Care Delivery with Dr. Damon Darsey https://www.youtube.com/watch?v=wGAKj4_g5a4 AI, Privacy & the Law: What EMS Leaders Must Know with Scott Moore https://www.youtube.com/watch?v=N6rP5KOEU2Q ABOUT THE LEADERSHIP LAB I'm Asbel Montes, founder of Solutions Group, where we tackle the challenges of healthcare revenue cycles head on. In this podcast we break down complex reimbursement processes, explore practical strategies, and bring you actionable insights from industry leaders to help you transform healthcare finance. SUBSCRIBE AND CONNECT Watch this episode on YouTube: https://www.youtube.com/watch?v=Ik9mWwOz4WI Apple Podcasts: https://podcasts.apple.com/us/podcast/the-leadership-lab-with-asbel-montes/id1810035183 Spotify: https://open.spotify.com/show/4rNhvQ6DRA2i8f0IDPwgRv YouTube: https://www.youtube.com/@AsbelMontes Asbel Montes LinkedIn: https://www.linkedin.com/in/asbel-montes-31027634 Asbel Montes Book (In Plain Sight): https://asbelmontes.com/store/ Asbel Montes Website: https://asbelmontes.com/ Clarity User Summit: https://www.solutionsgroup.com/clarityusersummit Solutions Group Services LinkedIn: https://www.linkedin.com/company/solutionsgroupservices Solutions Group Services Instagram: https://www.instagram.com/solution_sgroup/ Solutions Group Services Facebook: https://www.facebook.com/solutionsgroupservices Solutions Group Services Website: https://www.solutionsgroup.com/ Stay focused, stay innovative, and keep leading the way.

  6. Aug 6

    Physicians as Leaders: Grace, Policy, and Transforming Healthcare with Dr. Rebekah Gee

    "It was taken away, but we're taking it back." In this episode of The Leadership Lab podcast, Asbel Montes sits down with Dr. Rebekah Gee, OBGYN, former Louisiana Secretary of Health, and Founder and CEO of Nest Health, to explore what happens when physicians stop giving their voice away and start leading the transformation of American healthcare. Dr. Gee has led at every level of the system: at the bedside, in state government, and now as a value-based care entrepreneur delivering whole-family primary care in the home. She shares why half of America's children are on Medicaid yet only 25% of Medicaid patients receive the recommended primary care, what it takes to lead with grace when politics and patient care collide, and why every physician needs to understand healthcare economics. You'll Learn: ✅ How Nest Health brings the fullness of primary care into the home for the whole family, now serving 50,000 lives across Louisiana and Arizona ✅ What value-based care really means: getting paid for outcomes, not for doing more ✅ How the Rural Health Transformation Program can marry care teams, technology, and workforce investment in communities that need care, not another app ✅ The glass ceiling is real: only 1.5% of venture funding goes to female-founded companies ✅ Why physicians must engage in policy, because wherever there is money, there is politics ✅ Where AI belongs in healthcare: let AI handle everything that doesn't require person-to-person care, and let people take care of people ✅ What keeps Dr. Gee up at night: Medicaid work requirements, the rising cost of care, and who really benefits from the AI revolution This conversation blends hard truths with hope, challenging physicians, policymakers, and healthcare executives to step beyond traditional roles, lead with grace, and keep the patient at the center of every decision. Don't miss future episodes that equip you to lead systemic change in healthcare. Subscribe to The Leadership Lab with Asbel Montes and share this episode with your team and network.   About Dr. Rebekah Gee: Dr. Rebekah Gee is a practicing OBGYN who served as Louisiana Secretary of Health from 2016 to 2020, where she led the state's Medicaid expansion and a first-in-the-nation subscription model for hepatitis C treatment. She went on to serve as CEO of LSU Health Care Services and is now the Founder and CEO of Nest Health, the first company in the U.S. to deliver the fullness of primary care to children and their families in the home, in partnership with Medicaid managed care. She is a member of the National Academy of Medicine. Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 Asbel Montes Book (In Plain Sight): https://asbelmontes.com/store/ Asbel Montes Website: https://asbelmontes.com/ Dr. Rebekah Gee LinkedIn - https://www.linkedin.com/in/rebekahgeemd/ Nest Health Website - https://www.nesthealth.com/ Solutions Group Services LinkedIn - https://www.linkedin.com/company/solutionsgroupservices Solutions Group Services Instagram - https://www.instagram.com/solution_sgroup/ Solutions Group Services Facebook - https://www.facebook.com/solutionsgroupservices Solutions Group Services Website - https://www.solutionsgroup.com/

  7. Jul 16

    The Future of EMS at Scale with Nick Loporcaro

    What if the industry that saves your life doesn't believe in itself? That's the challenge Nick Loporcaro walked into when he joined Global Medical Response as Chairman and CEO in 2023. In this episode of The Leadership Lab, Asbel Montes sits down with the leader of the nation's largest EMS organization for a candid conversation about what it actually takes to transform an industry from the inside out. From GMR's landmark transition to the only publicly traded EMS company in the United States, to the hard truth about how Wall Street misread emergency care, Nick brings a perspective few have: an outsider who fell in love with the mission and joined the company to prove that EMS is healthcare, not transportation. In this episode: Why Wall Street discounted GMR at its IPO and what that reveals about how EMS is misunderstood The "you call, we haul, that's all" problem and why it starts from within the industry How GMR is integrating AI across 80 million patient records to free up clinicians and improve care The case for moving EMS out of the transport benefit and into a Part B construct What population health and Nurse Navigation could mean for 100 million covered lives Why Nick believes the industry must disrupt itself before someone else does This is a conversation for EMS leaders, healthcare finance professionals, policymakers, and anyone who wants to understand the real business of saving lives.

  8. Jul 9

    Scott Becker on Healthcare Costs, Transparency, and the Future of the US Healthcare System

    Is American healthcare headed toward a breaking point? Scott Becker,  founder and publisher of Becker's Healthcare and partner at McGuireWoods LLP, joins Asbel Montes for a candid conversation about why the current cost trajectory is unsustainable, who's actually responsible for the administrative crisis, and what it would take to build a healthcare system that truly centers the patient. From the staggering math behind administrative waste to AI's role in giving patients back control, this episode covers the structural forces reshaping American healthcare and what leaders, payers, providers, and patients need to understand right now. In this episode: Why healthcare costs $30,000–$35,000 per year for the average family of four, and why that number is unsustainable The real story behind prior authorization, denials, and the "greatest hypocrisy" in healthcare policy How $500 billion to $1 trillion is spent annually on administrative costs alone inside a $5 trillion system Why the era of physician-driven primary care is coming to an end How AI is shifting power back to patients, and where the human in the loop still matters most What it would take for payers and providers to move from adversarial relationships to shared accountability What gives Scott Becker hope that American healthcare can still get this right About Scott Becker: Scott Becker is the founder, publisher, and chief content officer of Becker's Healthcare, the leading news, conference, and podcast platform in the industry. He is also a longtime partner at McGuireWoods LLP, one of the nation's largest law firms, where he focuses on healthcare law, transactions, private equity, hospitals, and physician organizations. Scott is also a Certified Public Accountant. Connect with Scott Becker on LinkedIn: https://www.linkedin.com/in/scottbeckermw/  Connect with Becker's Healthcare on LinkedIn: https://www.linkedin.com/company/asc-communications Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634  Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices  Instagram - https://www.instagram.com/solution_sgroup/  Facebook - https://www.facebook.com/solutionsgroupservices  Website -  ​​https://www.solutionsgroup.com/

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Hosted by Asbel Montes, The Leadership Lab explores bold ideas, tough conversations, and real solutions shaping the future of healthcare and public service. Join leaders from across the industry as they share insights, stories, and strategies that inspire action and elevate impact.

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