Health Tech Nerds Radio

Kevin O'Leary, Martin Cech
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Where we share our weekly news debriefs and discussions with industry experts. These are lo-fi recordings aimed at giving our readers more opportunities to engage with our analysis and a view into some of the conversations that shape it.

  1. Why medically integrated dispensing is gaining traction amid PBM reform | Denali Cahoon & Tamiko Yamatani (House Rx)

    2D AGO

    Why medically integrated dispensing is gaining traction amid PBM reform | Denali Cahoon & Tamiko Yamatani (House Rx)

    A little noticed aspect of the bipartisan PBM reform bill is strengthening of the “any willing pharmacy” provisions of Medicare. To talk about what “any willing pharmacy” means in practice, why it was included in the PBM reform bill, and broader discussion on medically integrated dispensing and the policy environment, we’re joined by two pharmacist-leaders at House Rx: Denali Cahoon, Chief Pharmacy & Operations Officer, and Tamiko Yamatani, VP, Client Operations.

    34 min
  2. How state Medicaid programs are preparing for cell and gene therapies | Bruce Greenstein (Louisiana DoH) and Will Shrank (Aradigm)

    4D AGO

    How state Medicaid programs are preparing for cell and gene therapies | Bruce Greenstein (Louisiana DoH) and Will Shrank (Aradigm)

    In this episode of Health Tech Nerd Radio, Kevin speaks with Bruce Greenstein, the Secretary of the Louisiana Department of Health, and Will Shrank, the Co-Founder and CEO of Aradigm, about how state Medicaid programs are preparing for the coming wave of cell and gene therapies. The conversation covers state and federal roles, innovative payment models (including Louisiana’s earlier “Netflix model” for Hep C), operational challenges for providers and manufacturers, and the need for ecosystem-level public-private partnerships while warning against other payers shifting risk onto Medicaid.

    25 min
  3. Why preventative care is hard to finance and how Truemed is trying to fix it | Justin Mares (Truemed)

    5D AGO

    Why preventative care is hard to finance and how Truemed is trying to fix it | Justin Mares (Truemed)

    In this episode, Justin Mares, CEO of Truemed, discusses why preventative care is widely supported but hard to finance due to limited ROI data compared to pharmaceuticals. He explains TruMed’s mission and business model: infrastructure that helps qualified individuals use tax-free HSA/FSA dollars for evidence-backed lifestyle interventions—such as fitness, sleep products, and medically tailored programs—through partnerships with merchants like Eight Sleep, Peloton, Lifetime Fitness, and Garmin, plus a direct-to-consumer eligibility flow. The conversation covers how TruMed decides what qualifies (clinical evidence in reputable journals), the role of letters of medical necessity via a compliant telemedicine process, and the goal of building a more “formulary-like” system for prescribing lifestyle interventions based on biomarkers and outcomes tracking. Justin also addresses criticisms that HSAs favor higher earners, argue for prevention as a tool to reduce chronic disease costs, and compare U.S. healthcare incentives with Singapore’s Medisave approach, emphasizing that fixing lifestyle and environmental drivers of chronic disease is essential.

    25 min
  4. The Grand Roundup: March 2nd, 2026

    5D AGO

    The Grand Roundup: March 2nd, 2026

    After spending about as much time on the State of the Union as the President spent on health care in the speech, Kevin and Martin talked about a busy week in the health care public markets including some analyst skepticism around Humana’s 2026 margin guidance and MA MLR dynamics; Hims financial results and burgeoning investor distrust; and GoodRx’s role as a pharma channel. They touch on Option Care’s Stelara biosimilar-driven margin compression, Fresenius’s improving value-based kidney care amid regulatory headwinds, and VBC updates from Agilon, Evolent, Privia, Clover, and Alignment, focusing on recontracting and risk transfer.  Plus, UHS price-driven growth, skepticism about AI ROI, an Allina–Innovaccer/Story Health cardiology partnership, and rising attention to 340B financing and HHS’s rebate pilot.

    55 min
  5. The clinical model behind Alignment Healthcare’s success in Medicare Advantage | John Kao (Alignment Health)

    FEB 28

    The clinical model behind Alignment Healthcare’s success in Medicare Advantage | John Kao (Alignment Health)

    Kevin interviews John Kao, CEO of Alignment Health, after the company reported earnings that beat the high end of guidance across membership, revenue, gross profit, and EBITDA.  Kao explains Alignment’s provider-alignment model: guaranteeing PCP revenue via monthly payments, stratifying members so an interdisciplinary “Care Anywhere” team manages the highest-risk 10% at home, and sharing data back to physicians to improve outcomes and reduce avoidable hospitalizations. He discusses California-specific dynamics with IPAs, shared-risk arrangements, and global capitation, and contrasts these with expansion into new markets via clinically integrated networks and hospital systems.  They address oncology as a specialty risk area, health system tensions around MA payment and claim edits, and CMS’s MA advance notice, emphasizing program integrity and the potential advantage for low-cost, clinically driven plans amid V28 and policy changes.

    38 min
  6. Reengineering ACOs for competition and better outcomes | Liz Fowler and Purva Rawal (ex-CMMI)

    FEB 25

    Reengineering ACOs for competition and better outcomes | Liz Fowler and Purva Rawal (ex-CMMI)

    Purva Rawal and Liz Fowler, along with their co-authors, have written a several recent forefront articles in Health Affairs that are timely given all the attention to Medicare and MA right now. The one that’s been on our mind lately is “Reengineering ACOs to Make Medicare Competitive,” and we're excited to welcome them to share their thoughts on improvements to the program and recent developments like CMS’s Long-term Enhanced ACO Model (LEAD) and CMS Administered Risk Arrangements (CARA) Additional ContextChris Klomp, the Medicare Director, made an interesting comment at the J.P. Morgan Healthcare conference earlier this year, sharing that CMS wants two types of Medicare: 1. Original Medicare in accountable care relationships; 2. Medicare Advantage, with Klomp noting that they renamed the internal team at CMS from Fee for Service Medicare to Original Medicare last month as a symbol of the focus. Medicare Advantage has been getting most of the attention in healthcare policy worlds after the jaw-dropping Advance Notice from CMS, but in Martin's opinion what’s going on with Accountable Care Organizations deserves more attention. While MedPAC and the Better Medicare Alliance argue about whether MA actually saves money, the Medicare Shared Savings Program has a consistent track-record of real, albeit modest, savings.

    33 min
  7. Designing and delivering home-based care for dual-eligible populations | Oren Shatken + Romanos Fessas (Jukebox Health)

    FEB 24

    Designing and delivering home-based care for dual-eligible populations | Oren Shatken + Romanos Fessas (Jukebox Health)

    Oren Shatken and Romanos Fessas, co-founders of Jukebox Health, join us to discuss how home-based interventions can improve outcomes and reduce costs for long-term services and supports (LTSS) populations. They explain the economics of LTSS and dual-eligible members, why keeping people safely at home matters, and how occupational therapist–led assessments and home modifications can drive measurable ROI for health plans. The conversation covers Jukebox’s operational model — building OT and contractor networks, partnering with plans on outcomes-based contracts, and delivering interventions that improve independence while preventing costly utilization. They also share real-world examples, lessons from working with Medicaid populations, and what’s next, including proactive monitoring and AI tools for care managers.

    39 min
  8. The Grand Roundup: February 23rd, 2026

    FEB 23

    The Grand Roundup: February 23rd, 2026

    Martin and Kevin discuss three ways the government has tried to spend less money on healthcare: the Inflation Reduction Act, The No Surprises Act, and ACCESS.  They highlight what we learned from public companies this week including Grail’s stock drop after an NHS study missed its primary endpoint and reimbursement concerns; Talkspace’s shift from consumer to B2B; and Community Health Systems’ divestitures while also previewing Hims’ earnings and its acquisition of Eucalyptus.  They discuss Scripps exiting Medicare Advantage after losing ~$75M and moving patients to traditional Medicare plus MedSup, contrasted with Cleveland Clinic expanding global cap lives.  Looking ahead, they previewed upcoming earnings (Option Care, Fresenius, Acadia, Agilon, Teladoc, GoodRx, Privia, UHS, Clover, Alignment), flag HRSA’s renewed 340B rebate model discussions, and close with Inhabit Home Health & Hospice being acquired by Kinderhook for ~$1.1B amid MA contracting challenges and a broader theme of healthcare services companies considering going private.

    1h 1m
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About

Where we share our weekly news debriefs and discussions with industry experts. These are lo-fi recordings aimed at giving our readers more opportunities to engage with our analysis and a view into some of the conversations that shape it.

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  • Creator
    Kevin O'Leary, Martin Cech
  • Years Active
    2K
  • Episodes
    20
  • Rating
    Clean
  • Copyright
    © 2026 Kevin O'Leary, Martin Cech
  • Show Website
    Health Tech Nerds Radio

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