In this episode of the Regional Hospital Voice, Mark interviews Scott Ellsworth, a former health plan executive who spent 30 years on the payer side, including Market President at Excellus BlueCross BlueShield and President and CEO of Centene's seven-state western region. In 2022 he left the payer side and built a firm that works only for providers, after a health system brought him in to help undo a bad Blue Cross contract.

Scott explains how hospitals can use price transparency data to anchor rate requests and why he targets the 75th percentile of the market. He lays out the payer playbook of “start late, go slow, run the clock out.” He describes how dropping the bottom half of Medicare Advantage plans can lift yields by 200 to 300 basis points, and shares his view on why value-based contracts favor payers.

Scott’s message to hospital leaders is that every hospital has leverage. The key is knowing how to use it.

Learn more about Scott's work HERE

Connect with Scott on LinkedIn HERE

Apply to be a guest on the show HERE

In this episode of the Regional Hospital Voice, host Mark Craig speaks with Marc Mertz, CEO of Kaweah Health in Visalia, California.

Mertz discusses the mounting pressures facing regional hospitals, including surging emergency department volumes, nursing shortages, and the devastating financial impact of Medicaid cuts under H.R. 1, projected to cost Kaweah $40 million annually. He highlights innovative solutions like launching an in-house nursing school, reducing vacancies from 270 to under 60. Mertz also addresses unfunded state mandates, OB care deserts, and his commitment to community health, emphasizing that sustainable Medicaid reimbursement is critical to keeping regional hospitals operational.

Learn more about Marc's work at Kaweah Health HERE.

Connect with Marc on LinkedIn HERE.

Apply to be a guest on the show HERE.

In this episode of the Regional Hospital Voice podcast, your host Mark Craig sits down with healthcare advisor Nathan (N8) Kaufman, Managing Director of Kaufman Strategic Advisors, to discuss the dire state of American healthcare.

Kaufman describes the system as "designed to fail," driven by political dysfunction, insurance company abuses, and misaligned incentives. He addresses the financial struggles of independent community hospitals, the predatory practices of insurers, flawed Medicare Advantage programs, and the devastating impact of poorly informed policymakers. Kaufman offers potential solutions, including standardized reimbursement rates and contract reforms, while warning that without meaningful change, hospital closures and reduced patient access will worsen.

Learn more about Nathan's work at Kaufman Strategic Advisors HERE.

Connect with Nathan (N8) on LinkedIn HERE.

Apply to be a guest on the show HERE.