Medicare Advantage Changes: From PPO’s to Value-Based Care

🎧🎙️ New podcast episode is live! I sat down with Insurance 360 hosts Bob & Rob to dig into why value-based care (VBC) isn’t just the future—it’s survival.

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What we cover (and why it matters now):
• 2030 inevitability: Nearly everyone will be in some form of VBC by 2030—readiness beats reactivity.
• Brokers/agents = first touch: You hold the member’s trust and set the tone for proactive care (not crisis care).
• Consolidation & shrinking PPOs: How to navigate plan design while keeping members’ needs front and center.
• Quality + total cost of care: Prevention, condition control, and using site-of-care decisions to avoid avoidable ER admits.
• Telehealth’s durable role: Access, after-hours options, rural reach—used judiciously alongside in-person care.
• Quintuple Aim: Right care, right time, right place—while supporting clinicians and equity.
• CSNP momentum: Why condition-specific plans (e.g., diabetes, CHF, COPD) will expand—and how brokers can guide fit.
• Data + AI: Better standardization and engagement tools to help members take up their own health—responsibly.

To every broker and agent out there: your work is hard, vital, and central. You’ve earned the member’s trust, and you treat that responsibility as sacred. That’s the foundation VBC needs to actually work.

Huge thanks to Bob & Rob for a thoughtful, fun conversation—and for my very own Insurance 360 mug ☕😄. Looking forward to coming back to raise a glass (or a mug) as we keep building a system that works for everyone.

🫰 Quick note on the photo: I’m a PhD (not an MD)—my lane is improving the health of healthcare through organizational management and behavior change, in partnership with our clinician colleagues. Immense respect for the MDs and care teams who make the clinical magic happen—we build the systems so your work can shine.

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