{"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":"EP511: The Tension When Clinical Teams Take On Risk for Policymakers and Others Looking to Rustle Up Future Perverse Incentives, With Dr. Siva and Monica Lypson, MD, MHPE","slug":"ep511-the-tension-when-clinical-teams-take-on-risk-for-policymakers-and-others-looking-to-rustle-up-future-perverse-incentives-with-dr-siva-and-monica-lypson-md-mhpe","published_at":"2026-05-14T14:50:00+00:00","page_url":"https://stenobird.com/podcast/relentless-health-value-872220/ep511-the-tension-when-clinical-teams-take-on-risk-for-policymakers-and-others-looking-to-rustle-up-future-perverse-incentives-with-dr-siva-and-monica-lypson-md-mhpe","show_page_url":"https://stenobird.com/podcast/relentless-health-value-872220","url":"https://cc-lnk.com/EP511","audio_url":"https://traffic.libsyn.com/secure/healthvalue/RHV_EP511_Dr_Siva_and_Monica_Lypson2.mp3?dest-id=197686","summary":"In this episode, Dr. Monica Lypson and Dr. Ahilan Sivaganesan join the conversation to dissect the complexities of value-based payment models and the \"perverse incentives\" that often follow. By examining the parallels between Medicare Advantage upcoding and sliding-scale bundled payments, Dr. Lypson and Dr. Sivaganesan provide a masterclass on the systemic friction between financial risk and clinical equity. Key Discussion Themes - The Upcoding/Downcoding Tug-of-War: An analysis of how Medicare Advantage plans and health systems navigate risk adjustment, and why current models often incentivize \"grading your own homework.\" - The TDABC Solution: Dr. Sivaganesan explains why physicians cannot truly manage risk without Time-Driven Activity-Based Costing (TDABC) to identify condition-specific costs. - Selection Bias in Care: A deep dive into the \"cherry picking\" (selecting low-risk patients) and \"lemon dropping\" (avoiding high-risk patients) dilemmas that threaten healthcare's moral compass. - Equity vs. Efficiency: Dr. Lypson explores how value-based care can either bridge the gap for underserved populations or inadvertently widen disparities through structural barriers. - The Path Forward: Why \"whole-person health\"—including non-clinical factors like housing—is the ultimate cost-saver, and the necessity of neutral, third-party risk scoring. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP511 ✉️ 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 Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://…","meta_description":"In this episode, Dr. Monica Lypson and Dr. Ahilan Sivaganesan join the conversation to dissect the complexities of value-based payment models and the \"per…","key_points":[],"chapters":[],"topics":[],"duration_seconds":1777,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/relentless-health-value-872220/episodes/ep511-the-tension-when-clinical-teams-take-on-risk-for-policymakers-and-others-looking-to-rustle-up-future-perverse-incentives-with-dr-siva-and-monica-lypson-md-mhpe/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/ep511-the-tension-when-clinical-teams-take-on-risk-for-policymakers-and-others-looking-to-rustle-up-future-perverse-incentives-with-dr-siva-and-monica-lypson-md-mhpe.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}