Turn on the Lights Podcast

Vivek Garg, a physician and health care leader focused on primary care, value-based care, and measurement. He shares how personal experience and innovative “edge” roles shaped his drive for patient-centered improvement. Conversation covers NCQA’s role in standards and accreditation. Focuses on critiques of the bloated measurement system and the push for digital, interoperable metrics that deliver real-time, clinically meaningful results.

Millions of Americans could lose health coverage in the coming years, and the consequences may be more profound than most people realize. In this episode, Dr. Ben Sommers, the Huntley Quelch Professor of Health Care Economics at the Harvard T.H. Chan School of Public Health, and professor of medicine at Harvard Medical School and Brigham & Women’s Hospital, talks about how new federal policies, including Medicaid work requirements and the rollback of Affordable Care Act subsidies, are reshaping access to health insurance in the U.S. Drawing on extensive research, he explains why these changes are expected to increase uninsured rates without meaningfully boosting employment. Dr. Sommers also shares evidence from prior state experiments showing that administrative red tape, not a lack of willingness to work, drives coverage loss. He outlines the ripple effects on patient health, safety-net providers, and hospitals, especially in rural and underserved communities. Tune in to understand what these policy shifts mean for patients, providers, and the future of the U.S. health care system. Resources: Follow the Harvard T.H. Chan School of Public Health on LinkedIn and explore their website! Learn more about the One, Big, Beautiful Bill here! Learn more about your ad choices. Visit megaphone.fm/adchoices

Trust in health care AI won’t happen by hype. It will be earned through transparent standards, independent evaluation, and real-world performance monitoring. In this episode, Dr. Brian Anderson, President & CEO and Co-Founder of the Coalition for Health AI (CHAI), discusses why health care needs a technically specific, use-case-by-use-case definition of “good” AI and how CHAI is building voluntary consensus-driven guidelines around fairness, transparency, safety, robustness, and privacy. He shares how his frustration with bloated EHR workflows pushed him into digital health innovation, then into pandemic-era public-private coordination during Operation Warp Speed, where rapid collaboration revealed what’s possible when incentives align. Brian explores CHAI’s “AI nutrition labels” (model cards), an emerging registry, and why vendors may opt into scrutiny to speed sales cycles and prove value. He also digs into ambient clinical documentation, performance metrics that matter to clinicians, cost pressure through apples-to-apples comparisons, agentic AI to expand rural access, and the alignment and biosecurity risks that demand vigilance. Tune in and learn how to build and verify AI that improves care without sacrificing safety, equity, or trust! Resources Connect with and follow Brian Anderson on LinkedIn. Learn more about the Coalition for Health AI (CHAI) on LinkedIn. Explore CHAI’s website. Learn more about your ad choices. Visit megaphone.fm/adchoices

What happens when a health system decides that quality comes first? In this episode, Dr. Gary Kaplan, who retired as the longtime CEO of Virginia Mason and currently serves on the Board of Stewardship Trustees of CommonSpirit Health, discusses leading one of America’s most influential physician-led health systems through a radical transformation focused on quality, safety, and patient-centered care. He reflects on Virginia Mason’s roots as a Mayo Clinic–style group practice and why shared purpose and clinician leadership created a fundamentally different culture of care. Dr. Kaplan explains how adopting Lean management principles reshaped chaotic health care systems, reduced waste, and supported clinicians in delivering safer, more reliable care. He also discusses why fee-for-service medicine drives unsustainable costs, his advocacy for value-based and capitated payment models, and how market consolidation ultimately led to Virginia Mason's merger, despite its strong performance and independence. Tune in to explore what it truly takes to redesign health care systems around patients, clinicians, and value, rather than volume. Resources: Connect with and follow Dr. Gary Kaplan on LinkedIn. Follow CommonSpirit Health on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices

The energy is electric at the IHI Forum, even before the forum officially begins. In this episode, co-hosts Kedar Mate and Don Berwick discuss how AI, patient safety, and administrative waste are shaping the future of health care. They explore the excitement and uncertainty around AI’s growing role in diagnostics, coordination, and clinical decision-making. They discuss why clinicians need real training to use AI safely and effectively, and how learning health networks are driving continuous improvement. They also delve into the persistent administrative burdens, especially in Medicaid and fee-for-service systems, that hinder true efficiency in health care. Tune in to hear how innovation, policy, and technology are colliding at this year’s IHI Forum! Resources Connect with and follow Kedar Mate on LinkedIn or reach out via email!  Connect with and follow Don Berwick on LinkedIn or reach out via email! Check out the Turn on the Lights podcast! Learn more about your ad choices. Visit megaphone.fm/adchoices

What happens when clinicians stop hearing the very people they’re trying to help? In this episode, Dr. Rageshri Dhairyawan, a Consultant Physician in Sexual Health and HIV Medicine at Barts Health NHS Trust and Deputy Director of the SHARE Collaborative at Queen Mary University of London, discusses how patients are often disbelieved or dismissed in healthcare. She shares her own experience of being ignored during a painful hospitalization, which revealed how difficult it can be for even a senior doctor to speak up when vulnerable. Dhairyawan argues that medicine has a long-standing culture of skepticism toward patient testimony, which harms trust, exacerbates inequities, and undermines care. She urges systemic and educational reforms, more time, continuity, staff wellbeing, training in true listening, and structural support for patient voices. While acknowledging resource constraints, she emphasizes that listening is both therapeutic and essential to restoring humanity in healthcare. Tune in to hear Dr. Rageshri Dhairyawan unpack why patients often feel unheard, and how listening might be healthcare’s most powerful, yet overlooked, tool. Resources Connect with and follow Dr. Rageshri Dhairyawan on LinkedIn and visit her website! Follow Barts Health NHS Trust on LinkedIn and explore their website! Follow Queen Mary University of London on LinkedIn and discover their website! Check out Dr. Dhairyawan’s book, Unheard: The Medical Practice of Silencing, here! Learn more about your ad choices. Visit megaphone.fm/adchoices

The collapse of a major hospital system set off one of the most complex healthcare emergencies Massachusetts has ever faced. In this episode, Dr. Gregg Meyer, Incident Manager for the Massachusetts Department of Public Health, discusses how the state responded to the unprecedented Steward Health Care crisis and worked to protect patients, communities, and hospital staff. He explains how years of debt, real estate deals, and private equity extraction destabilized the system and pushed it into bankruptcy. He shares what it took to manage a months-long VUCA public health emergency, including on-site monitoring, emergency closures, and the transfer of six hospitals to new nonprofit operators. He also reflects on the human and financial toll the crisis left behind, as well as why stronger oversight and policy reform are urgently needed. Tune in to learn how Massachusetts led one of the most challenging hospital rescue operations in U.S. history! Resources Follow the Massachusetts Department of Public Health on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices

Medicaid is a massive, life-sustaining program whose new work requirements and funding cuts risk stripping coverage from millions of people who can’t afford to lose it. In this episode, Cindy Mann, partner at Manatt Health and former director of the Center for Medicaid and CHIP Services, explains how Medicaid was created alongside Medicare in 1965 and has grown into the nation’s largest public coverage program, serving nearly 80 million people across diverse populations. She details the state–federal financing structure, explains why match rates vary, and highlights how Medicaid remains foundational to the Affordable Care Act’s coverage continuum. Cindy breaks down the proposed Medicaid cuts in HR1 and the impact of work requirements, illustrating how administrative barriers lead to people losing coverage and increasing uncompensated care costs without improving employment outcomes. She also challenges the “deserving versus undeserving poor” narrative and highlights efforts by states and providers to protect coverage gains. Tune in and learn how Medicaid’s design, politics, and future will shape health, budgets, and justice in America! Resources Follow Cindy Mann on LinkedIn. Follow Manatt Health on LinkedIn and explore their website! Learn more about the Medicaid program here. Learn more about your ad choices. Visit megaphone.fm/adchoices

What if the biggest threat to our survival isn’t the next virus, but our failure to learn from the last one? In this episode, Dr. Michael Osterholm, Regents Professor and Director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, explains why America’s public health system is dangerously underprepared for the next major outbreak. He shares how misinformation and political interference have eroded confidence in science, leaving critical institutions like the CDC and NIH struggling to fulfill their missions. Dr. Osterholm discusses lessons from COVID-19 and why failing to apply them could cost millions of lives in the future. He also explores the promise of universal vaccines, the need for sustained investment in pandemic defense, and how rebuilding public trust starts with humility, transparency, and truth-telling. Tune in to hear what it will really take to prepare for “the big one. Resources Connect with and follow Dr. Michael Osterholm on LinkedIn. Follow the University of Minnesota on LinkedIn! Follow the Center for Infectious Disease Research and Policy (CIDRAP) on LinkedIn and visit their website! Learn more about the Vaccine Integrity Project here! Pick up any of Dr. Osterholm’s books here! Check out the Osterholm Update podcast! Learn more about your ad choices. Visit megaphone.fm/adchoices

A nation’s promise to those who served becomes a lesson in how health care can truly heal. In this special Veterans Day episode, Dr. David Shulkin, the ninth Secretary of the U.S. Department of Veterans Affairs in the Trump Administration and VA’s Under Secretary of Health in the Obama Administration, talks about the mission, history, and transformation of the Veterans Health Administration, one of the nation’s largest and most innovative health systems. He shares how his time leading the VA changed his perspective on what effective, compassionate care looks like, highlighting the system’s holistic, population-based approach and its groundbreaking medical research. Dr. Shulkin also reflects on the challenges of government service, the importance of protecting the VA from privatization, and his continued advocacy for veterans and the workforce that serves them. Tune in to hear how the VA’s model offers vital lessons for the future of American health care! Resources: Connect with and follow Dr. David Shulkin on LinkedIn. Get a copy of Dr. Shulkin’s book, It Shouldn't Be This Hard to Serve Your Government, Our Broken Government and the Plight of Veterans, here! Learn more about your ad choices. Visit megaphone.fm/adchoices