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The Disrupted Podcast

The Disrupted Podcast

By: James Preston Scott Middleton
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Entrepreneur and Chief Disruption Officer Scott Middleton share's his experiences of how he uses disruption to innovate and keep an organization moving forward and growing. Scott shares these weekly stories on The Disrupted Podcast with Scott Middleton.James Preston Economics Hygiene & Healthy Living Leadership Management & Leadership Personal Development Personal Success Physical Illness & Disease
Episodes
  • A Value-Based Merger
    Jun 29 2026

    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

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    46 mins
  • We NOT Them
    Jun 22 2026

    What if the fastest way to grow your healthcare organization is to slow down? In this episode of The Disrupted Podcast, Scott Middleton returns from Scotland straight into the thick of a merger — and what he's learning is reshaping how he thinks about change itself.

    Scott takes us inside the integration of TCPA and Providence Care into Your Health, where two very different models are colliding. One organization built 640 billing codes last year; the other built 40. One puts a single nurse practitioner in a building with no support; the other surrounds providers with nurses and community health workers. The opportunity is enormous — but so is the risk of moving too fast and scaring everyone away.

    What if the fastest way to grow your healthcare organization is to slow down? In this episode of The Disrupted Podcast, Scott Middleton returns from Scotland straight into the thick of a merger — and what he's learning is reshaping how he thinks about change itself.

    Scott takes us inside the integration of TCPA and Providence Care into Your Health, where two very different models are colliding. One organization built 640 billing codes last year; the other built 40. One puts a single nurse practitioner in a building with no support; the other surrounds providers with nurses and community health workers. The opportunity is enormous — but so is the risk of moving too fast and scaring everyone away.

    In this conversation, Jamie and Scott explore:

    • Why a nurse practitioner alone is a "single source of failure" — and how staffing changes everything
    • How to enter a building without threatening the provider they already love
    • Why billing isn't bureaucracy — it's how Medicare knows you made a difference
    • The art of giving people what they think they need now, and the rest over time
    • Advanced care planning, DNRs, and why the right message sometimes needs a different voice

    This is a masterclass in change management disguised as a healthcare conversation. Listen now — and rethink what "disruption" really requires.

    • Why a nurse practitioner alone is a "single source of failure" — and how staffing changes everything
    • How to enter a building without threatening the provider they already love
    • Why billing isn't bureaucracy — it's how Medicare knows you made a difference
    • The art of giving people what they think they need now, and the rest over time
    • Advanced care planning, DNRs, and why the right message sometimes needs a different voice

    This is a masterclass in change management disguised as a healthcare conversation. Listen now — and rethink what "disruption" really requires.

    www.YourHealth.Org

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    41 mins
  • If You Didn't Document It, Medicare Thinks It Never Happened
    Jun 8 2026

    It was 3 o'clock in the morning when Scott Middleton finally signed the papers. The merger was official. And within days, he was already on the road — visiting facilities, riding along with providers, and spotting the same gap everywhere he went: brilliant clinicians doing real work that was completely invisible to the system.

    In this episode of The Disrupted Podcast, Jamie sits down with Scott Middleton, calling in from Boston, to unpack what he's discovering on the ground in the newly merged Your Health organization — and why tracking your time isn't about paperwork. It's about protection, proof, and getting paid for every minute of care you're already delivering.

    What you'll hear in this episode:

    • The Dr. Jeeve story: a high-producing doc who managed a nursing home crisis by phone, saved a patient from an unnecessary ER visit — and never billed for it, leaving Medicare with no record of his intervention
    • Why not documenting a visit before a hospitalization doesn't just cost you revenue — it makes you look like a bad provider, even when you did everything right
    • How insurance companies like United Healthcare boldly take 15% off the top of every healthcare dollar — and why that math means providers can't afford to give their time away for free
    • The TCPA pattern Scott keeps seeing: 15,000–18,000 visits a month, almost entirely in nursing homes, with zero follow-up once patients go home
    • The new post-discharge standard: every patient leaving a nursing home gets a telehealth visit within 48 hours, then weekly follow-up for four weeks — no one gets left in the gap

    This episode is a masterclass in understanding that documentation isn't bureaucracy — it's how you tell your story, protect your reputation, and keep the care you've already given from disappearing.

    www.YourHealth.Org

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    33 mins
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