The Policy Stack

Duncan Reece, a health care operator and entrepreneur who helped build value-based care organizations like Iora and Liza Health. He discusses the surge of simultaneous CMMI models and why focusing on relevant pilots matters. He talks about tech barriers, why Iora built its own EHR, and how AI and cheaper connectivity are reshaping care delivery and operational complexity.

Kristen Valdes from b.well reflects on building CMS's voluntary Health Technology Ecosystem framework after discovering that, despite a decade of interoperability policy, live demos showed only 1 out of 30+ providers could return data automatically. She shares lessons on community organizing when 500+ companies need coordination, but the government can't lead, why the real barriers are business and liability issues rather than technology, and how to prevent legacy players from relitigating settled policy when the goal is implementation, not debate.

Most healthcare decisions happen far from the headlines. The Policy Stack, hosted by Lisa Bari, reveals the people and processes shaping how American healthcare really works. From state leaders to industry innovators, each episode examines the laws, funding, and political realities behind the policies that shape care.

In this live episode from Innovaccer’s Mini-Xccelerate conference in DC, Blair Childs and Dave Johnson examine the sweeping policy and market shifts transforming U.S. healthcare. They discuss the move from government-designed systems toward market accountability, how “liberating data” is key to real value-based care, and why structural incentives, not funding, determine the pace of reform. With their deep experience in health policy and strategy, they offer a grounded look at where healthcare is heading, and what it will take to finally realign incentives for better outcomes.

Timi Leslie, a health IT and policy practitioner who leads BluePath Health and built cross-sector data-sharing programs, discusses implementing California’s new data exchange framework. She talks about bringing healthcare and social services together. She explores technical interoperability limits, workflow and trust-building across organizations. She shares design studios, surprises from street-medicine pilots, and pragmatic steps that move policy into practice.

Dan O'Neill reflects on 15 years in health technology, services, and policy after discovering that most healthcare administrative problems could have been solved decades ago. He shares lessons on why business model problems masquerade as technology challenges, how organizational inertia perpetuates inefficiency, and why "slapping AI on it" won't fix structural issues rooted in misaligned incentives.

Nikita Singareddy reflects on building technology for America's most complex healthcare system after discovering that 20% of Medicaid enrollees lose coverage due to bureaucratic failures. She shares lessons on why every government case is an "edge case," solving policy problems before building tech solutions, and maintaining an enrollee-first approach across 56 different state systems.

Kody Kinsley speaks with Lisa Bari to reflect on leading North Carolina’s $26 billion health agency through COVID-19, Medicaid expansion, and a behavioral health crisis. He shares lessons on making impossible choices, driving reform under pressure, and turning crises into opportunities.