You Can’t Escape the Economics: The Role of AI in Value-Based Care

Описание: In this episode of The Akros Advantage, Demi Radeva sits down with Rachael Jones, CEO of Syntax Health (now part of Lightbeam) to unpack how reimbursement models, contract design, and healthcare economics shape real financial outcomes. If you work with payers, providers, or risk-based models, this conversation will help you understand what is happening beneath the surface and why so many value-based arrangements struggle to deliver on their promise.

If you work with payers, providers, or risk-based models, this conversation will help you understand what is happening beneath the surface and why so many value based arrangements struggle to deliver on their promise.
What you will learn:

✅ The true definition of Value-Based Care (VBC)
✅ Where value based care adoption actually stands today and why true downside risk is still limited
✅ VBC Contracting failure points
✅ Where AI can meaningfully reduce administrative burden
✅ What it looks like for payers and providers to have more transparent conversations about goals and accountability

This is a down-to-earth discussion about risk, incentives, and the math behind value based care.

For more information on the topics mentioned in today’s conversation, check out these links:

Health Care Payment Learning & Action Network (HCPLAN) - https://hcp-lan.org/workproducts/apm-...

CMS Medicare Advantage Star Ratings Program - https://www.cms.gov/medicare/health-d...

HEDIS (NCQA Quality Measures) - https://www.ncqa.org/hedis/

Centers for Medicare & Medicaid Services (CMS) - https://www.cms.gov/

Elevance Health (formerly Anthem) - https://www.elevancehealth.com/

Health First - https://hf.org/

Redesign Health - https://www.redesignhealth.com/

Lightbeam Health Solutions - https://lightbeamhealth.com/

This podcast is part of the series The Akros Advantage
Learn more here: https://www.akrosadvisory.com/

The Experts:
Demi Radeva — CEO & Founder, Akros Advisory
Rachael Jones — CEO, Syntax Health (now part of Lightbeam)

👍 If this episode added value, like, subscribe, and share it with someone working in Medicare Advantage, Medicaid, commercial risk, or digital health strategy. If you'd like to join us in future episodes or know someone who would be great for us to feature, contact us at: [email protected].

We are headed to HLTH Europe next and would love to feature founders and experts who scaled through payer partnerships and/or have expertly navigated GTM strategy!