# EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD Page: https://stenobird.com/podcast/relentless-health-value-872220/ep505-the-death-of-the-what-is-value-guessing-game-for-clinical-and-plan-decision-makers-ready-to-move-on-with-ahilan-sivaganesan-md Text version: https://stenobird.com/podcast/relentless-health-value-872220/ep505-the-death-of-the-what-is-value-guessing-game-for-clinical-and-plan-decision-makers-ready-to-move-on-with-ahilan-sivaganesan-md.md Podcast: [Relentless Health Value](https://stenobird.com/podcast/relentless-health-value-872220) Published: 2026-04-02T09:30:00+00:00 Episode link: https://cc-lnk.com/EP505 Audio file: https://traffic.libsyn.com/secure/healthvalue/RHV_EP505_Ahilan_Sivaganesan1.mp3?dest-id=197686 Processing state: not_requested JSON: https://stenobird.com/v1/public/podcasts/relentless-health-value-872220/episodes/ep505-the-death-of-the-what-is-value-guessing-game-for-clinical-and-plan-decision-makers-ready-to-move-on-with-ahilan-sivaganesan-md Duration seconds: 2618 ## Resource Stacey Richter interviews neurosurgeon Dr. Ahilan Sivaganesan (Dr. Siva) about replacing vague healthcare "value" claims with quantified outcomes and unit-level costs, introducing his Operative Value Index (OVI). They discuss how hospitals often lack true internal episode costs and how common quality metrics miss patient-reported outcomes and appropriateness across the full care journey. Using time-driven activity-based costing (TDABC) and condition- or procedure-specific patient-reported outcomes, OVI creates a common mathematical language to compare surgeons, practices, or health systems, risk-adjust for confounders, and support steering/tiering and direct contracting for self-funded employers. Siva describes transparency via bubble charts that spur clinician behavior change without new incentives and argues this infrastructure is essential as bundled payments and risk-based arrangements expand, framing a "Yahoo vs Google" shift from fee-for-service volume to measurable value. === LINKS === πŸ”— Show Notes with all mentioned links: https://cc-lnk.com/EP505 βœ‰οΈ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe πŸ«™ Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎀 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls= 🎀 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b πŸ“Ί Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitte… ## Actions - request_transcript: `POST https://stenobird.com/v1/public/podcasts/relentless-health-value-872220/episodes/ep505-the-death-of-the-what-is-value-guessing-game-for-clinical-and-plan-decision-makers-ready-to-move-on-with-ahilan-sivaganesan-md/transcription-requests` β€” Idempotently request low-priority transcript generation for this episode. - read_markdown: `GET https://stenobird.com/podcast/relentless-health-value-872220/ep505-the-death-of-the-what-is-value-guessing-game-for-clinical-and-plan-decision-makers-ready-to-move-on-with-ahilan-sivaganesan-md.md` β€” Read the agent-friendly Markdown representation of this episode resource. A page view does not enqueue transcription. Agents should invoke `request_transcript` explicitly when they need this episode processed. ## Transcript Full transcripts are not published on public pages unless there is a clear rights basis.