<p>Welcome back to another episode of The Healthcare STARcast! In this powerful conversation, Subbu Ramalingam is joined by industry thought leader and serial entrepreneur John Gorman for an unfiltered deep dive into the seismic policy changes shaking up Medicare Advantage and the healthcare landscape at large. Recorded on August 19th, this episode tackles head-on the fallout from recent legislation, what John refers to as the “biggest change in 35 years”, and explores its sweeping impact on health plans, providers, and, most importantly, vulnerable seniors and dual eligibles.</p><p>From discussions about the devastating effects of Medicaid cuts and looming Medicare sequestration to urgent warnings about the future of social services, John offers a frank, expert perspective on the “war on the poor” and why health plan leaders need to rethink benefit design, focusing on the real needs of members, like food, housing, and transportation. Subbu and John also dig into the operational pressures facing plans, the inefficiencies of prior authorization, the coming storm of risk adjustment audits, and what leaders at every level should be doing now to prepare.</p><p>If you’re a health plan executive or boots-on-the-ground operator, this is essential listening for navigating one of the most challenging periods in American healthcare. Get ready for actionable insights, candid advice, and a rallying call for courageous leadership and member-centric innovation as we step into uncharted territory together.</p><p><br></p><p><b>Timestamps:</b></p><p>00:00 "Health Bill's Impact on Medicare"</p><p>05:30 Severe Cuts Impact Seniors and Disabled</p><p>08:28 Doge Effect Alters Social Security</p><p>12:17 PPO Retreat Signals Industry Worries</p><p>14:53 Reimagining Administrative Benefits for 2026</p><p>20:01 Improving Provider Network Accuracy</p><p>22:48 Risk Adjustment Data Accuracy Focus</p><p>27:20 Impact of Costs on Mid-Tier Plans</p><p>28:58 "Challenges in Health Equity Measures"</p><p>31:29 Audit of Supplemental Benefits Use</p><p>35:18 Prioritizing Member Outreach Roles</p><p>40:22 "Enhancing Member Experience Returns"</p><p>42:42 Connect on LinkedIn: John Gorman</p><p><br></p><p>Show Website - <a href="https://healthcarestarcast.com/">https://healthcarestarcast.com/</a></p> <p>Subbu Ramalingam - Show Host - Linkedin - <a href="https://www.linkedin.com/in/subburamalingam/">https://www.linkedin.com/in/subburamalingam/</a></p> <p>FloWise Leadership - <a href="https://flowiseleadership.com/">https://flowiseleadership.com/</a></p> <p>ViVega Business Services - <a href="https://www.vivega.co/">https://www.vivega.co/</a></p> <p>Media Partner - TopHealth - <a href="https://tophealth.care/">https://tophealth.care/</a></p>

<p>Welcome to The HEALTHCARE STARcast, the show that breaks down the complex world of healthcare to reveal the real strategies and mindsets driving excellence. In this episode, host Subbu Ramalingam sits down with Charles Baker, Vice President at ATTAC Consulting Group and an expert who has worn many hats in the industry, from clinical social work to executive compliance roles. Charles shares his unique journey from the hospital floor to the executive suite, offering fresh perspectives on population health, risk management, and how healthcare organizations can break out of silos to tackle today's biggest challenges.</p><p>Together, Subbu and Charles dig into the realities of compliance, quality improvement, Medicare Advantage pressures, and the evolving landscape of risk adjustment and RADV audits. You'll hear actionable insights for health plan leaders and providers, a no-nonsense approach to regulatory changes, and practical ideas for bridging the gaps between compliance, operations, and patient care. </p><p>Whether you’re leading a health plan, driving quality initiatives, or reimagining care delivery, this conversation is packed with timely advice and big-picture thinking to help you navigate change and deliver real value for patients and communities.</p><p><br></p><p><b>Timestamps:</b></p><p>00:00 Rethinking Community-Focused Mental Health</p><p>05:53 "Insurance's Role in Community Health"</p><p>10:05 Breaking Silos in Compliance Strategies</p><p>11:18 Proactive Data Management for Medicare Advantage</p><p>16:17 Regulatory Compliance Cadence Analysis</p><p>19:32 "Medicare Advantage and RADV Focus"</p><p>21:24 HMO Cost Control Evolution</p><p>27:50 Healthcare Consulting & RADV Support</p><p>30:54 Ensuring Audit-Ready Clinical Documentation</p><p>35:10 Policy Presentation: Key Opportunity</p><p>36:49 Holistic Teamwork for Data-Driven Decisions</p><p>Show Website - <a href="https://healthcarestarcast.com/">https://healthcarestarcast.com/</a></p> <p>Subbu Ramalingam - Show Host - Linkedin - <a href="https://www.linkedin.com/in/subburamalingam/">https://www.linkedin.com/in/subburamalingam/</a></p> <p>FloWise Leadership - <a href="https://flowiseleadership.com/">https://flowiseleadership.com/</a></p> <p>ViVega Business Services - <a href="https://www.vivega.co/">https://www.vivega.co/</a></p> <p>Media Partner - TopHealth - <a href="https://tophealth.care/">https://tophealth.care/</a></p>

<p>Welcome to the inaugural episode of The HEALTHCARE STARcast, where your host Subbu Ramalingam invites you to go beyond the usual healthcare metrics to uncover the heart - and the purpose - behind the people leading change in the industry. In this episode, we get to know Subbu, a seasoned leader in star ratings and risk adjustment, whose journey spans continents and roles, from fintech innovations in India to driving population health initiatives and nonprofit work in the US and abroad.</p><p>Subbu shares his personal stories of how diverse backgrounds, challenges, and values have shaped his passion for healthcare. You’ll hear about the profound impact of combining data, technology, and mission-driven leadership to improve both the business and human side of medicine. Subbu opens up about the principles that guide his work, the importance of clarity and prioritization, and why true transformation in healthcare requires collaboration across silos.</p><p>Whether you’re a healthcare operator, an executive, or just fascinated by the stories of those making a real difference, this episode sets the stage for thoughtful conversations on leadership, clarity, and the ongoing evolution of healthcare.</p><p><br></p><p><b>Timestamps:</b></p><p>00:00 From Finance to Healthcare Transition</p><p>04:15 Medicare Advantage Evolution & Skills</p><p>08:28 "Journey from Veterans to Tech Healthcare"</p><p>12:26 Balancing Local and Global Healthcare</p><p>17:28 Pioneering Yoga's Western Influence</p><p>19:14 "Mastering Time Management & Clarity"</p><p>22:20 Star Ratings and Population Health Management</p><p>26:09 Culture and Strategy in Health Systems</p><p>31:32 Medicare Star Ratings Timeline</p><p>32:49 CMS Risk Adjustment Audits Intensify</p><p>37:31 Streamlining Healthcare for Better Outcomes</p><p>41:34 Preparing for Audits and Budgeting</p><p>44:30 "Medicare Audits and AI Insights"</p><p>48:25 "Healthcare Star Cast Launch"</p><p><br></p><p>Show Website - <a href="https://healthcarestarcast.com/">https://healthcarestarcast.com/</a></p> <p>Subbu Ramalingam - Show Host - Linkedin - <a href="https://www.linkedin.com/in/subburamalingam/">https://www.linkedin.com/in/subburamalingam/</a></p> <p>FloWise Leadership - <a href="https://flowiseleadership.com/">https://flowiseleadership.com/</a></p> <p>ViVega Business Services - <a href="https://www.vivega.co/">https://www.vivega.co/</a></p> <p>Media Partner - TopHealth - <a href="https://tophealth.care/">https://tophealth.care/</a></p>

<p>Welcome to the very first episode of The Healthcare STARcast! In this kickoff conversation, host Subbu Ramalingam dives deep into Subbu’s fascinating journey from growing up in an entrepreneurial household in Chennai, India, to becoming a thought leader in the U.S. healthcare industry. Subbu shares how his early experiences in technology and finance ultimately led him to discover his true purpose in healthcare, using data and analytics to make a tangible difference for patients.</p><p>Throughout their discussion, Subbu unpacks the philosophy of "Vivega" — the art of discerning the right priorities amid the chaos of modern healthcare — and explains why it’s crucial to break down silos between star ratings, risk adjustment, quality, and cost. He reflects candidly on building high-performing teams, the importance of ethical leadership, and why even metrics-driven healthcare is fundamentally about people, not just numbers.</p><p>If you’re a healthcare leader, operator, or someone interested in transforming managed care, this episode delivers practical guidance, inspiring stories, and a preview of what’s to come in future deep dives. Get ready to reimagine what’s possible at the intersection of clarity, compassion, and value-based care!</p><p><b>Timestamps:</b></p><p>00:00 Healthcare Consultant & Executive Coach Journey</p><p>05:02 Early Healthcare Analytics Success</p><p>09:06 "Vivega: Personalized Healthcare Prioritization"</p><p>11:32 Integrating US Health Care Measures</p><p>14:47 Optimizing Patient Care Delivery</p><p>18:53 Building a High-Performing Team</p><p>21:14 Tailoring Success Strategies by Market</p><p>25:18 Essential Executive Tasks for Team Success</p><p>30:07 Risk Adjustment Strategy and Communication</p><p>35:19 Adapting to Change as Leaders</p><p>39:34 Align Ethics with Organizational Goals</p><p>41:58 Value-Based Care Quality Measures</p><p>45:02 Healthcare STARcast: Technical Deep Dives</p><p><br></p><p>Show Website - <a href="https://healthcarestarcast.com/">https://healthcarestarcast.com/</a></p> <p>Subbu Ramalingam - Show Host - Linkedin - <a href="https://www.linkedin.com/in/subburamalingam/">https://www.linkedin.com/in/subburamalingam/</a></p> <p>FloWise Leadership - <a href="https://flowiseleadership.com/">https://flowiseleadership.com/</a></p> <p>ViVega Business Services - <a href="https://www.vivega.co/">https://www.vivega.co/</a></p> <p>Media Partner - TopHealth - <a href="https://tophealth.care/">https://tophealth.care/</a></p>