The Disrupted Podcast

What if the most powerful person on your care team isn't a nurse, a doctor, or a specialist — but someone showing up at 8:00 AM to check blood pressure, eat lunch with residents, and play vital signs bingo?

In this episode, we go deep on the Community Health Worker role: what it is, what it isn't, and why most organizations are dramatically underusing it. Scott pulls no punches on the disconnect between what CHWs are doing and what...

What does it actually take to say yes in healthcare when the system is wired to say no?

In this episode of The Disrupted Podcast, Scott takes you straight into the field — from a brand-new administrator in Marietta, Georgia who's already revolutionizing her building eight days in, to a 190-patient facility in Charleston where the real conversation isn't about hospice referrals, it's about whether you have the staff to back it up.

S...

Healthcare didn’t get expensive because patients got worse — it got expensive because the system got fragmented. In this episode of The Disruptive Podcast, Scott Middleton breaks down why hospice can’t live “over there,” separate from primary care, nursing, therapy, and care management.

Scott explains the Your Health Hospice rollout, the staffing reality that determines whether integration is real, and the math behind a new model: c...

In this episode, Jamie and Scott discuss a simple leadership posture that changes outcomes: default to “yes” when it protects patients—then solve the obstacles. Scott shares real examples from winter-storm outreach, hospice and palliative care misconceptions, and operational “rules” that block care (often driven by language, software, or habit—not true limitations). They dig into how patient-centered thinking, clearer communication...

In this episode of The Disrupted Podcast, Scott Middleton returns from the JP Morgan healthcare conference with a blunt takeaway: the future of care is not a magic pill, another telehealth platform, or a clever financial structure — it’s showing up. Scott breaks down why healthcare has become unnecessarily complicated, how fee-for-service incentives distort decision-making, and why “easy-entry” models won’t hold up long-term.

He mak...

In this first Disrupted Podcast episode of 2026, Jamie and Scott unpack the reality of a new “High Needs ACO” and what it demands from frontline care teams. Scott explains why spending more in primary care reduces total cost, how care management codes are expanding, and why the real win is keeping patients out of the hospital through proactive, consistent engagement.

The centerpiece is a clear operational playbook for facilitated vi...

In this episode of The Disrupted Podcast, Jamie and Scott break down what’s really happening inside healthcare facilities—and why the problem isn’t complexity, but misalignment. Through a real-world walkthrough of one provider’s experience, Scott unpacks the Facility Model, explaining how proper staffing, proactive care, and smarter use of hospice, telehealth, and community health workers can radically improve outcomes for patients...

In this episode of The Disrupted Podcast, Jamie sits down with Chief Disruption Officer Scott Middleton to unpack what’s really holding healthcare organizations back from sustainable growth — and it’s not demand. From inefficient scheduling and fragmented care teams to missed opportunities in behavioral health, hospice, and regional expansion, Scott lays out a candid blueprint for how ownership thinking, smarter systems, and physic...

KEY TAKEAWAYS

• The new ACO model increases funding for high-risk Medicare patients but requires disciplined execution.
• Visits — frequent, short, meaningful ones — are the #1 driver of reduced hospitalizations and better outcomes.
• The target is four visits per patient per month for those with a 2.4–2.8 risk score.
• Current numbers show only 2.5 visits per patient per month — leaving savings and outcomes on the table.
• Facilitators are e...

00:00 – Welcome & Atlanta Traffic Humor
03:12 – Why Atlanta’s Senior Healthcare System Is “Almost Nonexistent”
09:15 – Hospitals begging for help & broken discharge processes
14:00 – Upcoming cuts to home health and rehab penalties
18:45 – Why therapy services need massive, immediate expansion
23:18 – The dementia support group story and the power of proactive care
30:52 – How storytelling improves patient and family understanding
36:44 –...

Show Notes / Summary

• Why launch hospice now: continuity, fewer hospitalizations, value-based alignment
• Clarifying myths: CNA hours on hospice, attending provider still leads care
• RAF & staffing logic: ~$6k/mo hospice per diem ↔ RAF ~5; translating RAF → weekly CNA/CHW hours
• Nurse incentives: $150 per admission; double telehealth-assist credit on hospice patients
• Software + workflow: Athena ↔ WellSky (care plans, documentation, pull-...

Key Takeaways (for on-air recap & social)

• Presence prevents: Being in the building daily beats any remote administrative stack.
• Rituals > heroics: Small, repeatable actions (exercise + vitals + lunch checks) compound.
• Caregivers stabilize: A modest weekly schedule creates 40 hours of reliable on-site support.
• Therapy cadence matters: Spread the care; keep people moving longer to reduce falls.
• Document to decide: Specific behavioral ...

Show Notes

Why transitional care is at the heart of Your Health’s model

How incentives for early post-hospital visits worked (and why they didn’t)

Why in-person care matters more than telehealth alone

The growing role of respiratory therapists, physical and occupational therapists, and community health workers

The challenge of patient perception: “too many visits” vs. “too many calls”

Why insurance companies trying to become pro...

Key Topics:

• How sudden insurance and policy changes disrupt patients and providers
• The importance of prevention and primary care in lowering long-term costs
• What fully staffed care teams look like and why they matter
• Balancing productivity and patient-centered care
• Why disruption is necessary for a healthier future
• Takeaway: Healthcare continues to be shaped more by profit and red tape than by prevention and patient outcomes. But wit...

Episode Notes

• What Health Connectors are and why they matter.
• The danger of a provider-centered workflow—and how to avoid it.
• Real examples of how proactive home visits catch problems early.
• Why vital signs can be the key to preventing 50% of heart attacks.
• The culture shift needed: salaried roles with responsibility, not clock-in/clock-out mindsets.
• Scott’s challenge to all healthcare workers: “Go see your damn patients.”

Episode Notes

• Scott shares a story about meeting a compliance pharmacist who unexpectedly became the solution to a major organizational challenge.
• The importance of pharmacy compliance and direct-to-manufacturer drug purchasing.
• Why God’s timing plays a role in healthcare growth and leadership decisions.
• The danger of miscommunication across facilities and how to “season” a team for long-term effectiveness.
• How leaders can ...

Episode Notes

• Why disruption in healthcare often means simplifying, not complicating.
• The critical role of Senior Solutions Advisors as navigators, educators, and advocates.
• Real-world stories: from a weight loss patient’s experience to common Medicare misunderstandings.
• How word-of-mouth becomes the best marketing strategy when patients feel truly cared for.
• Scott’s challenge to SSAs: prioritize patient contact, ask deeper...

Episode Notes

• Why each patient-facing role at Your Health was created and the specific problems they solve
• How Medicare’s new Community Health Worker reimbursement is shaping care delivery
• The bonus structures that align staff incentives with patient outcomes
• Real-world examples of how metrics reveal opportunity — and lost income — for staff
• The difference between “helping” and staying focused on core role responsibilities
• H...

Episode Notes

• Behind-the-scenes look at Your Health’s move to a High-Needs Accountable Care Organization (ACO)
• How Medicare calculates risk scores and allocates funding for high-risk patients
• Why Your Health is delivering a 32% savings over Medicare’s projected spend — at scale
• The flaw in most investment-backed healthcare models (and why they’re losing millions)
• The urgency of same-day or next-day post-hospital visits to prevent re...