A Value-Based Merger
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What if the patient you discharged three years ago is still costing you money today? In this episode of The Disrupted Podcast, Scott Middleton pulls back the curtain on the mechanics of value-based care most providers never see — and the merger bringing it all into focus.
With the July 15th closing date approaching, Scott walks through what the merger of Your Health with TCPA and Providence Care actually means on the ground: new contracts, new provider numbers, a reimbursement model built on RAF scores and revenue rather than guesswork, and a technology stack — from the Clini app to QR-coded patient wristbands — designed to capture what was previously left on the table.
In this episode:
- Why patient attribution under value-based contracts follows you for years — and what hospice discharges are really costing the organization
- How the new bonus structure ties pay to billing, RAF scores, and quality measures (and why you can never be paid to put someone on hospice)
- The difference between care management, facilitated visits, and what providers have been under-billing all along
- How skilled nursing facilities became the highest-leverage opportunity in the entire model
- Why advanced care plans aren't just clinical — they're a 30% income increase hiding in plain sight
If you've ever wondered why the "why" behind a process matters more than the process itself, this episode is the answer. Press play.
www.YourHealth.Org