{"podcast":{"title":"Turn on the Lights Podcast","slug":"turn-on-the-lights-podcast-6307880","podcast_index_feed_id":6307880,"rss_url":"https://feeds.megaphone.fm/NSSMO6501171747","website_url":"https://www.ihi.org/","image_url":"https://megaphone.imgix.net/podcasts/03eaaad0-d23e-11ed-9e41-e33b9cfb8f4d/image/73706558b12b7a1c50e00a6d60e66830.png?ixlib=rails-4.3.1&max-w=3000&max-h=3000&fit=crop&auto=format,compress","author":"IHI","episode_count":143,"summary":"Hosted by Dr. Philip McAdoo, Director of Internal Equity and Workplace Well-Being at the Institute for Healthcare Improvement (IHI), Turn on the Lights is a podcast that aims to improve health care worldwide by shedding light on health care issues through thought-provoking, patient-centered conversations. By demystifying health care problems, we hope to activate both the public and health care professionals to help accelerate changes leading to health and health care improvements worldwide. Our discussions cover various topics such as health care delivery, health equity, quality, and social justice. The podcast features solutions from around the world and encourages listeners to take action. Brought to you by the Institute for Healthcare Improvement (IHI).","last_synced_at":"2026-07-17T20:19:37.731848+00:00","page_url":"https://stenobird.com/podcast/turn-on-the-lights-podcast-6307880"},"episode":{"title":"The Cost Shifting Cycle Behind Your Rising Premiums with Chris Van Gorder","slug":"the-cost-shifting-cycle-behind-your-rising-premiums-with-chris-van-gorder","published_at":"2026-02-20T11:00:00+00:00","page_url":"https://stenobird.com/podcast/turn-on-the-lights-podcast-6307880/the-cost-shifting-cycle-behind-your-rising-premiums-with-chris-van-gorder","show_page_url":"https://stenobird.com/podcast/turn-on-the-lights-podcast-6307880","url":"https://traffic.megaphone.fm/NSSMO5406490075.mp3?updated=1771374076","audio_url":"https://traffic.megaphone.fm/NSSMO5406490075.mp3?updated=1771374076","summary":"Leading a major health system today means juggling patient-first ethics with a financing model that keeps tightening the screws. In this episode, Chris Van Gorder, President and Chief Executive Officer of Scripps Health, explains why health care is becoming structurally unaffordable amid soaring premiums, uncompensated emergency care, and rising input costs. He describes how hospitals have become the default safety net as county systems disappear, while underpayment by Medicare and Medicaid forces cost shifting onto employers and commercially insured patients. Van Gorder also highlights California’s seismic rebuilding mandates, which create massive capital pressure without matching reimbursement. He critiques managed care, value-based care, and Medicare Advantage for pushing risk onto providers through prior authorization and denials, recounting Scripps’ difficult decision to exit several Medicare Advantage contracts after heavy losses and the downstream impact on patients. Tune in and learn how payment design, intermediaries, and regulation shape what hospitals can sustain and what patients can access. Resources: Connect with and follow Chris Van Gorder on LinkedIn. Follow Scripps Health on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices","meta_description":"Leading a major health system today means juggling patient-first ethics with a financing model that keeps tightening the screws. In this episode, Chris Va…","key_points":[],"chapters":[],"topics":[],"duration_seconds":2324,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/turn-on-the-lights-podcast-6307880/episodes/the-cost-shifting-cycle-behind-your-rising-premiums-with-chris-van-gorder/transcription-requests","description":"Idempotently request low-priority transcript generation for this episode."},{"name":"read_markdown","method":"GET","url":"https://stenobird.com/podcast/turn-on-the-lights-podcast-6307880/the-cost-shifting-cycle-behind-your-rising-premiums-with-chris-van-gorder.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}