<![CDATA[The Outer Shell]]>The Outer Shell podcast from Covalence Health, hosted by Mike Rawaan, where we peel back the layers on issues that drive healthcare in the U.S. Covalence Health is a Washington, DC - based consulting firm that partners with organizations across the US healthcare industry to navigate complex challenges and unlock sustainable growth. From policy change and compliance to accelerating market expansion and optimizing the patient journey, Covalence Health relies on over 250 years of collective experience to deliver actionable solutions that drive real results.

]]>https://anchor.fm/s/113f33680/podcast/rssRiverside.fm (https://riverside.com)Mon, 12 Oct 2026 20:34:16 GMTMon, 15 Jun 2026 15:49:51 GMT60Covalence Health<p>The Outer Shell podcast from Covalence Health, hosted by Mike Rawaan, where we peel back the layers on issues that drive healthcare in the U.S. Covalence Health is a Washington, DC - based consulting firm that partners with organizations across the US healthcare industry to navigate complex challenges and unlock sustainable growth. From policy change and compliance to accelerating market expansion and optimizing the patient journey, Covalence Health relies on over 250 years of collective experience to deliver actionable solutions that drive real results.</p>episodicCovalence Healthmike@covalencehealth.comno<![CDATA[Episode 6: Independent Providers & the Business of Healthcare]]>Physicians train for a decade to practice medicine and rarely learn to run the business. Dr. Eric Mann, ophthalmologist and founder of Lucens, joins Mike Rawaan to unpack payer contracts, vendor risk, and why independent providers need both peer community and paid expertise. Season 1 finale of The Outer Shell.

]]>2fa4b55a-88c6-41a1-b2eb-3497a9f1c8a8Mon, 05 Oct 2026 13:39:34 GMT<p>Physicians train for a decade to practice medicine and rarely learn to run the business. Dr. Eric Mann, ophthalmologist and founder of Lucens, joins Mike Rawaan to unpack payer contracts, vendor risk, and why independent providers need both peer community and paid expertise. Season 1 finale of The Outer Shell.</p>no00:31:3816Episode 6: Independent Providers & the Business of Healthcarefull<![CDATA[Episode 5: Real-Time Data in Healthcare ]]>In Episode 5, Effie Carlson, CEO of Watershed Health - a healthcare technology company that provides a care coordination and interoperability platform to connect different medical and community providers during patient care transitions - joins Mike to discuss why  American healthcare has spent twenty years and billions of dollars making data available - and almost nothing making data actionable.

]]>7bd250e6-747b-4daa-b240-ba93b545609dThu, 17 Sep 2026 14:05:45 GMT<p>In Episode 5, Effie Carlson, CEO of Watershed Health - a healthcare technology company that provides a care coordination and interoperability platform to connect different medical and community providers during patient care transitions - joins Mike to discuss why  American healthcare has spent twenty years and billions of dollars making data available - and almost nothing making data actionable.</p>no00:47:3415Episode 5: Real-Time Data in Healthcare full<![CDATA[Episode 4: Advocacy, Enablement, and Partnership in VBC]]>In this episode, Mike sits down with Nicole Bradberry — a veteran operator who has built management companies, run ACOs, and founded a partner-aggregation company — to unpack why partner selection in value-based care isn't a procurement decision. It's an existential one.

We get into:

  • The "risk pool game" — how some aggregators' algorithms sort providers into a pool built to win and a pool built to "learn," before the provider sees a single patient under the contract
  • Why you can do everything right clinically and still walk away with nothing
  • The questions providers should ask before signing with any ACO or MSO
  • How to vet a partner and figure out who's actually doing the work

Providers weighing VBC options — or aggregators wondering why providers are getting smarter about diligence — this one's for you.


The Outer Shell is produced by Covalence Health: covalencehealth.com

#ValueBasedCare #ACO #HealthcareStrategy #VBC

]]>865e867a-86b8-4785-8361-1e716ba850d8Thu, 27 Aug 2026 13:15:33 GMT<p>In this episode, Mike sits down with Nicole Bradberry — a veteran operator who has built management companies, run ACOs, and founded a partner-aggregation company — to unpack why partner selection in value-based care isn't a procurement decision. It's an existential one.</p><p>We get into:</p><ul><li>The "risk pool game" — how some aggregators' algorithms sort providers into a pool built to win and a pool built to "learn," before the provider sees a single patient under the contract</li><li>Why you can do everything right clinically and still walk away with nothing</li><li>The questions providers should ask before signing with any ACO or MSO</li><li>How to vet a partner and figure out who's actually doing the work<p></p></li></ul><p>Providers weighing VBC options — or aggregators wondering why providers are getting smarter about diligence — this one's for you.</p><p><br />The Outer Shell is produced by Covalence Health: <a rel="noopener noreferrer nofollow" href="http://covalencehealth.com" target="_blank">covalencehealth.com</a></p><p>#ValueBasedCare #ACO #HealthcareStrategy #VBC</p>no00:31:49Episode 4: Advocacy, Enablement, and Partnership in VBCfull<![CDATA[Episode 3: Medical Economics & Data Modeling in Healthcare]]>Just about every move in the U.S. Healthcare is driven by analytics and data models. Risk scores, predictive analytics, and actuarial projections drive the industry ... And we treat the outputs like gospel because the math looks rigorous and the dashboards look clean.

However, the models used today are flawed - especially those used in value-based care.

The flaw isn't in the arithmetic. It's in the assumptions buried underneath it. Bad inputs, biased training data, and models built for one population deployed on another.

Dr. Aaron Wells, PhD, joins Mike to dissect the problem.

Aaron takes us inside the statistical models that drive billions in healthcare decisions — and shows us exactly where they break.

]]>77c545ae-7c35-4f87-a23b-feb25fbea118Fri, 07 Aug 2026 12:33:13 GMT<p>Just about every move in the U.S. Healthcare is driven by analytics and data models. Risk scores, predictive analytics, and actuarial projections drive the industry ... And we treat the outputs like gospel because the math looks rigorous and the dashboards look clean.</p><p></p><p>However, the models used today are flawed - especially those used in value-based care.</p><p></p><p>The flaw isn't in the arithmetic. It's in the assumptions buried underneath it. Bad inputs, biased training data, and models built for one population deployed on another. <br /></p><p>Dr. Aaron Wells, PhD, joins Mike to dissect the problem.<br /></p><p>Aaron takes us inside the statistical models that drive billions in healthcare decisions — and shows us exactly where they break.</p>no00:41:5513Episode 3: Medical Economics & Data Modeling in Healthcarefull<![CDATA[Episode 2: Success in CMMI LEAD with Becki Baker]]>Guest Rebecca Baker, BSN, RN, BS Ed, ACHE, joins Mike Rawaan to dive deep into what it takes to succeed in value-based care. Becki breaks down the operational changes - including tools, staff, and workflows - necessary for primary care providers to succeed in value-based care (VBC).

You don't want to miss these insights if you are ...
👉 A physician or physicians' group considering getting into VBC
👉 An existing ACO considering expanding its footprint
👉 An #investor looking for #investment opportunities in VBC
👉 A healthtech vendor looking to deliver greater value to VBC organizations

]]>c2e1ab34-fa3e-42c0-a711-7e493332b5abFri, 19 Jun 2026 10:27:17 GMT<p>Guest Rebecca Baker, BSN, RN, BS Ed, ACHE, joins Mike Rawaan to dive deep into what it takes to succeed in value-based care. Becki breaks down the operational changes - including tools, staff, and workflows - necessary for primary care providers to succeed in value-based care (VBC).<br /><br />You don't want to miss these insights if you are ...<br />👉 A physician or physicians' group considering getting into VBC<br />👉 An existing ACO considering expanding its footprint <br />👉 An <a rel="noopener noreferrer nofollow" href="https://www.youtube.com/hashtag/investor">#investor</a> looking for <a rel="noopener noreferrer nofollow" href="https://www.youtube.com/hashtag/investment">#investment</a> opportunities in VBC<br />👉 A healthtech vendor looking to deliver greater value to VBC organizations</p>no00:37:0612Episode 2: Success in CMMI LEAD with Becki Bakerfull<![CDATA[Episode 1: Healthcare Lobbying (Guest: Gary Jacobs)]]>Gary Jacobs⁠, a lobbyist, a healthcare executive, and the author of ⁠The Zen Lobbyist⁠, joins ⁠Mike Rawaan⁠ to discuss how lobbying actually works: who lobbyists represent, what a win looks like, and why mindfulness and compassion aren't soft concepts; they're strategic ones. Using real examples, including the creation of the ⁠CMMI LEAD⁠ model and the ⁠Medicare Advantage ⁠Reimbursement Final Rule, to show how advocacy shapes policy from first draft to final rule.

]]>https://podcasters.spotify.com/pod/show/mike-rawaan/episodes/Episode-1-Healthcare-Lobbying-Guest-Gary-Jacobs-e3k2g784c03745d-73a9-463c-ab52-993cba2cd42aFri, 29 May 2026 12:36:18 GMT<p><a href="https://garymjacobs.com/" rel="noopener noreferrer nofollow" target="_blank"><strong>Gary Jacobs</strong></a>⁠, a lobbyist, a healthcare executive, and the author of <a href="https://garymjacobs.com/the-book/" rel="noopener noreferrer nofollow" target="_blank">⁠<strong>The Zen Lobbyist</strong>⁠</a><strong>, </strong>joins <a href="https://www.covalencehealth.com/team-members/1" rel="noopener noreferrer nofollow" target="_blank">⁠<strong>Mike Rawaan</strong>⁠</a> to discuss how lobbying actually works: who lobbyists represent, what a win looks like, and why mindfulness and compassion aren't soft concepts; they're strategic ones. Using real examples, including the creation of the <a href="https://www.cms.gov/priorities/innovation/innovation-models/lead" rel="noopener noreferrer nofollow" target="_blank">⁠<strong>CMMI LEAD</strong>⁠</a> model and the <a href="https://www.linkedin.com/posts/mike-rawaan_cy-2027-medicare-advantage-part-d-proposed-activity-7450151831789297664-xAdj?utm_source=share&amp;utm_medium=member_desktop&amp;rcm=ACoAACeoJgoBAJLXYRyW8GmEEgbmUrZ2ZuGEqM4" rel="noopener noreferrer nofollow" target="_blank">⁠<strong>Medicare Advantage </strong>⁠</a>Reimbursement Final Rule, to show how advocacy shapes policy from first draft to final rule.</p><p></p> no00:44:2911Episode 1: Healthcare Lobbying (Guest: Gary Jacobs)full