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The ACO Show

Aledade Inc

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The ACO Show explores the latest developments in the U.S. health care system, with a focus on value-based care and accountable care organizations (ACOs). Join co-hosts Josh Israel, MD, senior medical director of Quality, and Sean Cavanaugh, chief of Policy at Aledade, in conversations with experts, policymakers and clinicians to understand how value-based care is good for patients, practices and society. The ACO Show is produced by Aledade.
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I built MDCalc 20 years ago because I wanted to save myself and other doctors time and make it easy for them to integrate more evidence into their medical care. Now I’ve launched Offcall to tackle something even bigger: giving doctors back our autonomy — through salary and workload transparency. These ideas shouldn’t be radical…but here we are. I still practice emergency medicine, but I’ve spent my career breaking out of the cookie cutter version of “what a doctor looks like” or “what a doct ...
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Independent primary care isn’t a relic of the past — it’s becoming the future of American medicine. In this episode of How I Doctor, Dr. Graham Walker talks with two leaders helping drive that shift: Dr. Umar Bowers, an internist who left a major health system to build the practice he always envisioned, and Dan Bowles, General Manager of Practice H…
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David Rhew has spent his career at the intersection of frontline medicine and cutting-edge technology. An infectious disease physician by training and now Global Chief Medical Officer at Microsoft, David brings a rare perspective shaped by decades of clinical work, health system leadership, and early research on AI in healthcare. In this episode of…
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Merry Christmas! Today we are re-releasing one of our favorite episode of the year. We'll be back next week with a brand new interview to kickoff 2026. Mark Cuban is a business mogul, the “Shark” every entrepreneur wants to make a deal with, the former owner of the Dallas Mavericks, and, most recently, an online pharmacy CEO. In 2022, Mark co-found…
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Dr. Eric Topol is one of the most influential voices in modern medicine. Founder of the Scripps Research Translational Institute and author of Deep Medicine and Super Agers, Eric has spent decades interrogating medical dogma, calling out hype, and pushing the profession toward evidence, prevention, and humanity. Dr. Graham Walker sits down with Eri…
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AI is already shaping how physicians practice. And for the release of The 2025 Physicians AI Report, Graham is taking a different kind of episode: a deep-dive mailbag where he answers the questions doctors are actually asking about AI, grounded in one of the largest physician surveys of its kind. More than 1,000 physicians were polled in this proje…
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Shawn Martin, executive vice president and CEO of the American Academy of Family Physicians (AAFP), joins Josh Israel, MD, and Sean Cavanaugh to discuss challenges with the future of primary care, particularly independent primary care practices. Martin believes that value-based care has helped sustain rural health care practices and that the Medica…
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This Thanksgiving, we’re pressing pause on the chaos of clinical life to honor the physicians, nurses, and healthcare workers who keep showing up tired, hopeful, frustrated,and inspired. In this special “Best Of” episode, Dr. Graham Walker revisits five conversations that have sparked the most messages, DMs, forwarded links, and late-night reflecti…
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Dr. Kalie Dove-Maguire is an emergency physician, health-tech leader, and the President and Chief Product Officer at Evidently — a physician-founded company building clinical decision support tools designed to earn trust, not replace judgment. After years on the frontlines, Kalie saw firsthand how critical information gets lost in the noise, how cl…
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Dr. Shiv Rao is a cardiologist, entrepreneur, and the CEO and co-founder of Abridge, the physician-founded AI company transforming how clinical conversations become care. Built on the belief that healthcare is about people, not paperwork, Abridge is now embedded in more than 200 major health systems, processing millions of encounters each week and …
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Dr. Jackie Gerhart is a family physician, clinical informaticist, and Chief Medical Officer at Epic — the company whose software powers much of American healthcare. From ambient documentation and AI scribes to patient-facing AI assistants like Emmy, Epic is now redefining how data, technology, and the human touch coexist in clinical care. Few physi…
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Margaret E. O’Kane, CEO, president and founder of the National Committee for Quality Assurance (NCQA), joins Joshua Israel, MD and Sean Cavanaugh to discuss how the organization has helped transform quality measurement in the American health care system. Over the past 35 years, O'Kane and the NCQA have developed quality measurement standards for cl…
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We're releasing a Physicians AI Whitepaper and need your help! Calling all MDs: Help us shape the future of what AI looks like in medicine. Participate Here! Dr. Sean Codier is an emergency physician at Salem Hospital within Mass General Brigham and one of the leaders behind the first successful physician unionization effort in the system’s history…
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Dr. Vineet Arora is the Dean for Medical Education at the University of Chicago and one of the nation’s leading voices on equity, leadership, and physician well-being. Her groundbreaking research has exposed how gender bias and pay inequity continue to shape medicine—from how residents are evaluated to how faculty are promoted and paid. But more im…
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Dr. Ali Chaudhary is an emergency physician, entrepreneur, and one of the leading voices helping doctors reclaim control over their careers. After leaving a traditional W-2 job, he built Locums United and LocumOS - two platforms designed to bring transparency, fairness, and autonomy to how physicians are staffed and compensated. Having lived both s…
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Dr. Alison Haddock is an emergency physician, educator, and past president of the American College of Emergency Physicians (ACEP). She’s spent her career fighting for physician autonomy and building a sustainable future for emergency medicine. One where doctors aren’t just surviving shift to shift, but leading the systems that shape their work. A n…
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Join Josh Israel, MD, and Sean Cavanaugh, along with Brittney Anderson, MD, family physician and podcaster (“Physicians Hanging a Shingle”) and Dan Bowles, general manager of practice health at Aledade, to discuss Anderson’s journey to owning her own private practice, and how she supports other physicians seeking independence. Both Anderson and Bow…
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Dr. Brian Dixon is a psychiatrist, entrepreneur, and one of the boldest physician voices pushing for salary transparency and fairness in medicine. He’s the founder of Simply Psych and Mindful, and he’s built his career by pulling back the curtain on contracts, compensation, and the hidden math of how health systems profit off physicians. With radic…
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This episode is sponsored by Abridge - the leading AI platform that drafts structured, clinically useful notes at the point of conversation. MDCalc turns 20 this year. What began as a scrappy side project in med school grew - without outside funding - into one of the most-used, most-trusted clinical references in the world. In this episode of How I…
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Ethan Nkana spent over a decade as a hospital executive negotiating contracts on behalf of health systems. He knew the inside playbook: how administrators calculated physician value, what mantras they used behind closed doors, and the quiet ways hospitals exploited physician professionalism. Then he switched sides. In this episode of How I Doctor, …
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Join Josh Israel, MD and Sean Cavanaugh in their video debut as they discuss the Medicare Shared Savings Program (MSSP) results for 2024 released by CMS with Aledade CEO Farzad Mostashari, MD They explore how Aledade Accountable Care Organizations (ACOs) earned more than $1 billion in total savings and continue to improve performance year over year…
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Dr. Danielle Ofri is an internist at Bellevue Hospital, clinical professor at NYU, and one of the most widely read physician-writers of our time. Through her books, essays, and New York Times op-eds, she has given voice to the emotional realities of medical work and exposed the ways the business of healthcare exploits the professionalism of doctors…
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Dr. Hillary Lin is a Stanford-trained internist and longevity entrepreneur who is cutting through the hype to bring evidence-based clarity to one of medicine’s buzziest frontiers. As co-founder and CEO of Carecore and host of The Longevity Show, she’s built her career at the intersection of clinical skepticism and innovation, challenging what’s rea…
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Dr. Gita Pensa is an emergency physician and nationally recognized advocate who knows firsthand the toll malpractice takes on doctors. After enduring a 12-year legal battle that included two jury trials, she emerged determined to break the silence around litigation and its hidden impact on physicians’ identity, mental health, and careers. Today, sh…
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Dr. Paulius Mui is a family physician, technologist, and community builder who refuses to fit into a single box. Instead of choosing between clinic shifts and tech projects, he’s built a portfolio career that blends patient care, experimentation, and creativity. Most recently, Paulius is reimagining what primary care looks like by launching a direc…
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Dr. Annie Andrews is a pediatric hospitalist, public health advocate, and U.S. Senate candidate in South Carolina taking on incumbent Lindsey Graham. Known for her unapologetic advocacy for children’s health, Annie has spent over 15 years caring for sick and injured kids, only to realize that many of their challenges stemmed from broken policies fa…
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Dr. Shoshana Ungerleider is an internal medicine physician, a public health advocate, and one of the most trusted voices translating science for the real world. Whether she’s hosting th TED Health podcast, advising Netflix on end-of-life storytelling, or calling out hype and misinformation in the media, her work is reshaping how clinicians show up …
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Dr. Josh Green is an emergency physician who’s done what many doctors only talk about. He’s taken a seat at the table and turned it into a platform for real change. After two decades practicing rural medicine in Hawaii and witnessing firsthand the systemic failures that lead to poor outcomes, he ran for office in his scrubs - and won. Today, as Gov…
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Abe Sutton, director of the Center for Medicare and Medicaid Innovation (CMMI), sits down with Aledade CEO Farzad Mostashari, M.D., and Sean Cavanaugh to unpack the new strategic framework for CMMI models. Sutton explores CMMI’s focus on three pillars: promoting evidence-based prevention, improving patient access to their health data and driving ch…
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Rebecca Mitchell is a physician, product strategist, and founding partner at Scrub Capital - a new kind of venture fund built from first principles to fix what’s broken in health tech investing. Alongside her co-founders, Rebecca is working to make sure that healthcare startups aren’t just built for clinicians, they’re built with them. In this epis…
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Join Josh Israel and Sean Cavanaugh for part two of their most recent road trip visiting primary care practices from Los Angeles to Washington D.C. First, they visited Dr. Arvinder Bir and Dr. Seema Bir, Aledade partners in California, to discuss how Aledade has helped enable their practice to reduce patient hospitalizations and remain independent.…
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Attorney Dennis Hursh has reviewed more than 3,500 physician contracts and has seen the same patterns again and again - doctors being underpaid, overworked, and legally trapped by language they didn’t know to question. In this episode, Dr. Graham Walker talks with Dennis about how RVUs and non-competes are often used against physicians, and how to …
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Dr. Jay Parkinson is a pediatrician and founder who’s been reinventing healthcare from the outside in for nearly two decades. From launching one of the first tech-enabled house call services in Brooklyn to pioneering virtual primary care with Sherpaa, Jay has always believed that doctors can design better systems. Now he’s back with Automate Clinic…
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Aledade CEO Farzad Mostashari, M.D., and Mat Kendall, president, join Josh Israel and Sean Cavanaugh to share insights from their recent road trip to primary care practices from Los Angeles to Washington D.C. They reflect how conversations about value-based care have evolved over the past 11 years — and what organizations are trying to learn when d…
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Dr. Ami DeWaters is a hospitalist, medical educator, and one of the leading voices reimagining how we prepare residents for the realities of modern medicine. She’s an associate professor at Penn State College of Medicine that’s known for her sharp insights and deep commitment to building physicians who are not just clinically excellent, but also fi…
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Dr. Greg Murphy is a practicing urologist and four-term Republican Congressman representing North Carolina’s third district—and the only physician in Congress who still actively sees patients, entirely pro bono. Before entering politics, he served as an affiliate professor, urology group president, and chief of staff at a Level 1 trauma center in G…
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Dr. Paul Tran is a pediatric gastroenterologist, award-winning medical educator, and the creator behind Alimentary School — an online platform using storytelling, mentorship, and dad jokes to make medicine more human. He’s on a mission to break down outdated hierarchies and rebuild medical education around trust, real-time feedback, and genuine con…
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The world of medicine is entering a new era. One where AI isn’t just a buzzword, but a daily presence in the lives of physicians. That’s why Offcall recently hosted a live webinar We're Sharing AI Secrets for Clinicians, featuring Dr. Graham Walker, ER physician and co-founder of Offcall, and Dr. Sarah Gebauer, anesthesiologist and founder of Valar…
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Dr. Caroline Fife and Dr. Christopher Apostol join us to explore the rising cost of skin substitutes in wound care, which Aledade data suggests is a tenfold increase in the last three years. Dr. Fife explains that rising costs are due to an increase in both cost of the product and increased usage and she addresses the real concerns such as the way …
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Shawna Butler is a nurse, economist, and creator of the EntrepreNURSE movement — but above all, she’s a force for rethinking how healthcare systems are built and who gets a say. In this episode of How I Doctor, Dr. Graham Walker talks with Shawna about what we lose when we treat nurses like costs instead of collaborators. They unpack the deep roots…
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Aniq Rahman is a two-time tech founder, but when he turned his attention to healthcare he did something most disruptors don’t - he shut up and listened. Aniq embedded himself in hospitals, shadowed physicians, and absorbed the daily frustrations that don’t show up in EMR logs or admin dashboards. In this episode of How I Doctor, Dr. Graham Walker t…
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Dr. Amelia Bond and Dr. Dhruv Khullar join us to discuss the long-term savings of accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP). Their recent study in JAMA found that ACOs generate increasing savings over time, with physician-led ACOs demonstrating more significant savings. Learn about their study’s methodology…
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Dr. Kaveh Hoda is a practicing gastroenterologist and longtime podcaster. He’s part of a cohort of doctors who trained on paper charts, watched the rise of EHRs, and now find themselves navigating mid-career questions that older generations rarely asked. Questions about purpose, burnout, and identity beyond the white coat. In this episode of How I …
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Natalie Davis, CEO of United States of Care, joins us to talk about the challenges of discussing value-based care with patients and policymakers. Through extensive research with over 30,000 individuals, Davis shares that the term "value-based care" often evokes negative connotations of low-quality care. When presented with the benefits of value-bas…
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Dr. Farzad Mostashari is the former National Coordinator for Health IT, the CEO and co-founder of Aledade, and a longtime champion for independent primary care. He’s spent his career trying to answer one question: how do we fix American healthcare by paying doctors to prevent illness—not just treat it? In this episode of How I Doctor, Dr. Graham Wa…
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Dr. Tiffany Moon is a board-certified anesthesiologist, entrepreneur, mother of twins, and former cast member on The Real Housewives of Dallas. She is a deeply thoughtful physician who is working to reclaim joy in a system that often seems designed to extinguish it. In this episode of How I Doctor, Dr. Graham Walker talks with Tiffany about her jou…
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Dr. Sanjay Divakaran is a cardiologist, educator, and Associate Chief at Brigham and Women’s Hospital. He’s also one of the most thoughtful voices when it comes to guiding the next generation of physicians. Not just in clinical medicine, but in career strategy, mentorship, and personal growth. In this episode of How I Doctor, Dr. Graham Walker sits…
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Dr. Craig Joseph is a pediatrician, informaticist, and the Chief Medical Officer at Nordic Global. He’s also the author of Designing for Health and a former Epic employee, with decades of experience at the intersection of clinical care and health IT. On this episode of How I Doctor, Dr. Graham Walker talks with Craig about what’s actually broken in…
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A majority of those with behavioral health challenges lack access to high-quality care. Gabe Diop, co-founder of Rula, a behavioral health physician group, joins the ACO Show to discuss how Rula is making behavioral health care more accessible by partnering with primary care practices to connect patients with the care they need. Dr. Samantha Cotler…
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Michael Johnson is an attorney and the founder of Michael Johnson Legal, a firm that works exclusively with physicians and physician groups to review contracts, negotiate fair compensation, and protect career freedom. In this episode of How I Doctor, Dr. Graham Walker sits down with Michael to unpack one of the most overlooked yet high-stakes parts…
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Last week’s interview with Mark Cuban generated a huge response — thank you to everyone who listened, commented on, or shared the episode. New guests will debut next week, but this week, we’ve rounded up some of the show’s most inspiring and thought-provoking moments to date to help all the new listeners get acquainted with How I Doctor and Offcall…
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