{"podcast":{"title":"Relentless Health Value","slug":"relentless-health-value-872220","podcast_index_feed_id":872220,"rss_url":"https://healthvalue.libsyn.com/rss","website_url":"https://relentlesshealthvalue.com","image_url":"https://static.libsyn.com/p/assets/6/6/4/4/66448feffdf62b8940be95ea3302a6a1/22-RHV-0008_1400_pixel_web_art.jpg","author":"Stacey Richter","episode_count":645,"summary":"American Healthcare Entrepreneurs and Execs you might want to know. Talking. Relentless Health Value is a weekly interview podcast hosted by Stacey Richter, a healthcare entrepreneur celebrating fifteen years in the business side of healthcare. This show is for leaders in pharma, devices, payers, providers, patient advocacy and healthcare business. It's for health industry innovators, entrepreneurs or wantrepreneurs or intrapreneurs. Relentless Healthcare Value is the show for you if you want to connect with others trying to manage the triple play: to provide healthcare value while being personally and professionally fulfilled.","last_synced_at":null,"page_url":"https://stenobird.com/podcast/relentless-health-value-872220"},"episode":{"title":"EP510: The Impact on You of Medicare Advantage Goings-on (2026 Edition), With Betsy Seals","slug":"ep510-the-impact-on-you-of-medicare-advantage-goings-on-2026-edition-with-betsy-seals","published_at":"2026-05-07T09:30:00+00:00","page_url":"https://stenobird.com/podcast/relentless-health-value-872220/ep510-the-impact-on-you-of-medicare-advantage-goings-on-2026-edition-with-betsy-seals","show_page_url":"https://stenobird.com/podcast/relentless-health-value-872220","url":"https://cc-lnk.com/EP510","audio_url":"https://traffic.libsyn.com/secure/healthvalue/RHV_EP510_Betsy_Seals.mp3?dest-id=197686","summary":"Medicare Advantage 2026: Stabilization, Retrenchment, and a Back-to-Basics Playbook with Betsy Seals In Episode 510, Stacey Richter interviews Medicare Advantage (MA) consultant Betsy Seals about the 2026 state of MA and its broader impact, including taxpayer value, seniors' access to care, and cost shifting to commercial employers when vertically integrated carriers negotiate MA rates while employers pay higher ASO rates. Seals describes MA as in a stabilization/retraction phase with market exits, regulatory and administration shifts, and benefit pullbacks that can affect beneficiaries depending on whether plans cut \"flashy\" enrollment perks versus outcome-focused care. Her \"back to basics\" guidance emphasizes avoiding profiteering and compliance risks (e.g., upcoding, problematic AI-driven prior authorization), focusing on populations a plan can truly serve well (including chronic SNP strategies), and improving STARS through real health outcomes rather than box-checking. They discuss high prior-authorization denial overturn rates on appeal, downstream provider incentives, and the need for stronger process reform and regulatory \"teeth,\" while noting confidence in MA's long-term viability. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP510 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 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=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV T…","meta_description":"Medicare Advantage 2026: Stabilization, Retrenchment, and a Back-to-Basics Playbook with Betsy Seals In Episode 510, Stacey Richter interviews Medicare Ad…","key_points":[],"chapters":[],"topics":[],"duration_seconds":2130,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/relentless-health-value-872220/episodes/ep510-the-impact-on-you-of-medicare-advantage-goings-on-2026-edition-with-betsy-seals/transcription-requests","description":"Idempotently request low-priority transcript generation for this episode."},{"name":"read_markdown","method":"GET","url":"https://stenobird.com/podcast/relentless-health-value-872220/ep510-the-impact-on-you-of-medicare-advantage-goings-on-2026-edition-with-betsy-seals.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}