TCN Talks

Hosted by Chris Comeaux

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Episodes

222

Latest episode

Nov 2026

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EN-US

About the show

Welcome to TCNtalks / Anatomy of Leadership.

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60 recent

November 6, 202635 min

Hospice SSVI Explained: What Your Score Isn’t Telling You | Part Two

Your hospice SSVI score raises questions. Does your leadership team know what’s driving the answers? In Hospice SSVI Explained: What Your Score Isn’t Telling You | Part Two, Chris Comeaux welcomes back Lindsay Doak to examine hospice SSVI, CMS oversight, and the leadership decisions behind the data. Discover why understanding your score requires a closer look at non-hospice spending, visit-minute reporting, staffing capacity, and access to general inpatient care (GIP) and continuous home care (CHC). Chris and Lindsay also discuss how fraud enforcement could affect comparison benchmarks—and why measures alone cannot tell the full story of hospice quality. Looking ahead, Lindsay shares her perspective on potential value-based hospice reimbursement and how HOPE, caregiver experience measures, and SSVI might help inform a stronger quality framework. At the center of the conversation is a fundamental leadership challenge: ensuring patients and caregivers receive consistent, compassionate care while demonstrating hospice’s value across the healthcare system. For hospice CEOs, nonprofit executives, clinical leaders, and quality teams, this conversation offers practical ways to turn data into better decisions. Continue the conversation with your team: What does your SSVI score reveal—and what needs a closer look? Subscribe to TCNtalks / Anatomy of Leadership, share this episode with a colleague, and leave a comment with the leadership insight you’re taking into practice. Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

November 4, 2026Episode 1027 min

Hospice SSVI Explained: What Your Score Isn’t Telling You | Part One

Your hospice SSVI score may leave out the context your leadership team needs most. In “Hospice SSVI Explained: What Your Score Isn’t Telling You | Part One,” Chris Comeaux welcomes HealthPivots’ Lindsay Doak to TCNtalks / Anatomy of Leadership for a closer look at the Service and Spending Variation Index (SSVI). What do hospice utilization and non-hospice spending reveal about care delivery? Where can the measures identify troubling patterns—and where might they raise questions about legitimate providers? Drawing on her experience in home health and hospice analytics, Lindsay explores unexpected spending outside the Medicare hospice benefit, care coordination in skilled nursing facilities, and the risks of letting score management drive clinical decisions. In this episode: • Why avoiding SSVI points does not establish exceptional hospice quality • What non-hospice spending can reveal about gaps in visibility and coordination • Why skin allograft spending raised concerns in the discussion • How utilization measures can help flag concerning patterns • Why live discharge measures and nursing facility demographics deserve context • How leaders can keep patient and family needs central to performance improvement Bring this conversation to your next clinical, quality, or executive team meeting: What does our SSVI score reveal, and what do we still need to investigate? Subscribe for Part Two and more conversations on healthcare leadership, hospice quality, and leading with cause and purpose. Share your perspective in the comments: Which SSVI measure raises the biggest question for your team? Thank you to Netsmart for sponsoring this podcast. Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

November 2, 2026Episode 91 hr 3 min

Full Episode | The Debate: Vertical Integration, Payvider, or World-Class Care—Which Path Forward?

FULL EPISODE of “The Debate: Vertical Integration, Payvider or World-Class Care—Which Path Forward?” This video brings together the complete discussion behind the previously released segments on hospice strategy, palliative care, and the future of healthcare leadership. What if the greatest threat to hospice is succeeding at the wrong strategy? In this special episode of TCNtalks / Anatomy of Leadership, host Chris Comeaux plays three distinct characters, each defending a different vision for the future of hospice and serious illness care: • Paul — Vertical Integration: Build a broader care continuum that reaches patients earlier and supports them through changing needs. • Christopher — Payvider Strategy: Align care delivery and financial responsibility to influence how care is funded and delivered. • Comeaux — World-Class Hospice and Palliative Care: Make specialty excellence, measurable outcomes, and patient trust the foundation of strategy. Each strategy offers opportunities. Each introduces risks. Through the story of Mary, an older adult living with serious illness, and her overwhelmed caregiver, Chris examines what these organizational decisions mean for patients and families. For healthcare leaders, nonprofit executives, hospice professionals, and business leaders, this full episode explores how to navigate workforce shortages, reimbursement pressure, population health, and changing baby boomer expectations while protecting clinical excellence and meaningful patient choice. Host: Chris Comeaux, President / CEO of TELEIOS, Author of the Anatomy of Leadership JOIN THE CONVERSATION Which perspective—Paul’s, Christopher’s, or Comeaux’s—best fits your organization’s capabilities and your community’s needs? Share your reasoning in the comments.o is about The Debate - Full Episode Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

October 30, 2026Episode 830 min

The Debate: Vertical Integration, Payvider, or World-Class Care—Which Path Forward? | Part Four

The future of hospice and palliative care demands difficult choices about growth, financial responsibility, and clinical excellence. How can leaders build a sustainable organization while keeping patients and families at the center? Part Four brings those choices into sharp focus. Three characters. Three competing healthcare strategies. One host putting every approach to the test. In The Debate: Vertical Integration, Payvider or World-Class Care—Which Path Forward? | Part Four , Chris Comeaux plays all three characters in a debate about the future of hospice, palliative care, and serious illness care: • Paul — Vertical Integration: Build a broader care continuum that reaches patients earlier and supports them through changing needs. • Christopher — Payvider Strategy: Align care delivery and financial responsibility to influence how care is funded and delivered. • Comeaux — World-Class Hospice and Palliative Care: Make specialty excellence, measurable outcomes, and patient trust the foundation of strategy. In this installment of TCNtalks / Anatomy of Leadership , all three voices face difficult questions. Can Paul expand the continuum without sacrificing quality? Can Christopher align financial incentives while protecting clinical decisions and patient choice? Can Comeaux turn exceptional care into meaningful access when others control referral pathways? Their cross-examination points toward a sequenced approach: build world-class care at the core, strengthen continuity through services and partnerships, and pursue appropriate financial participation when the organization is ready. For healthcare leaders, nonprofit executives, hospice professionals, and business leaders, this episode explores: • What world-class hospice and specialty palliative care require • Why clinical excellence needs a market access strategy • How vertical integration and partnerships can improve continuity • Where payvider models and value-based care create conflicts • Why patient choice and changing baby boomer expectations must shape strategy Subscribe to TCNtalks / Anatomy of Leadership for thoughtful conversations about healthcare strategy and leadership. Share this episode with your team, and tell us in the comments: Which argument resonates most—Paul’s, Christopher’s, or Comeaux’s—and why? Explore Chris Comeaux’s book, The Anatomy of Leadership , on Amazon. Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

October 28, 2026Episode 713 min

The Debate: Vertical Integration, Payvider, or World-Class Care—Which Path Forward? | Part Three

Who controls the healthcare dollar—and how does that control shape patient care? In Part Three of The Debate: Vertical Integration, Payvider or World-Class Care—Which Path Forward? , Chris Comeaux examines whether aligning healthcare financing and care delivery can help hospice and palliative care organizations better serve patients—or introduce new conflicts between financial performance and mission. "Christopher" presents the payvider case: providers need a voice in the flow of risk, capital, data, and decision-making to invest earlier in prevention, home-based care, and caregiver support. Chris tests that argument against the realities of financial risk, organizational scale, patient choice, and clinical independence. Using Mary’s care as a practical example, this conversation asks what healthcare leaders must put in place to ensure that better financial alignment produces better care. In this episode: • How value-based care can support proactive, interdisciplinary services • Different ways providers can participate in accountable care and financial risk • Why becoming a payer requires capabilities beyond excellent care delivery • How integrated networks can affect access and patient choice • Governance safeguards that protect quality of life and organizational mission Whether you lead a hospice, palliative care program, nonprofit, or healthcare organization, this debate offers questions to bring into your next strategic planning conversation. Join the conversation: What safeguards would your organization require before taking on financial risk for patient care? Share your perspective in the comments. Subscribe to TCNtalks / Anatomy of Leadership and continue the conversation in Part Four. Share this episode with a colleague navigating healthcare strategy, value-based care, or the future of hospice. Host: Chris Comeaux Full Episode Characters: Paul: Vertical Integration / Frail-Elder Practice Christopher: Payvider Strategy Comeaux: World-Class Hospice and Palliative Care Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

October 23, 2026Episode 614 min

The Debate: Vertical Integration, Payvider, or World-Class Care—Which Path Forward? | Part Two

Can vertical integration help hospice organizations deliver better care earlier—and sustain the investment required? In Part Two of “The Debate: Vertical Integration, Payvider or World-Class Care—Which Path Forward?” , Chris Comeaux examines the case for extending hospice expertise into palliative care and home-based primary care for frail elders. Paul presents a vision of care built around lasting relationships, interdisciplinary teams, and support that follows patients as their needs change. Chris tests that vision against the realities of capital, reimbursement, workforce shortages, organizational culture, rural access, and patient choice. The central question: Can healthcare organizations build a connected continuum while protecting world-class quality and every patient’s freedom to choose? In this episode: • Why hospice organizations are considering moving upstream • How home-based care can support patients and caregivers earlier • Why fee-for-service reimbursement may fall short • The financial and operational risks of expanding services • How ethical integration can support timely hospice transitions For healthcare leaders, nonprofit executives, hospice professionals, and business leaders evaluating vertical integration, payvider strategies, population health, and value-based care. Listen, share this episode with your leadership team, and tell us in the comments: What must an integrated care model do to earn patients’ trust? Host: Chris Comeaux Characters: Paul: Vertical Integration / Frail-Elder Practice Christopher: Payvider Strategy Comeaux: World-Class Hospice and Palliative Care Subscribe for more conversations from TCNtalks and Anatomy of Leadership. Join us next Wednesday as THE Debate continues. Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

October 21, 2026Episode 513 min

The Debate: Vertical Integration, Payvider, or World-Class Care—Which Path Forward? | Part One

What if hospice succeeds at the wrong strategy? Chris Comeaux explores three paths for the future of hospice and palliative care: vertical integration, the payvider model, and world-class specialty care. In Part One of THE Debate: Vertical Integration, Payvider or World-Class Care—Which Path Forward? , Chris sets the stage for an unusual conversation—playing three characters, Paul, Christopher and Comeaux, who represent competing visions for serious illness care. Should organizations build a coordinated continuum of hospice, palliative care, and home-based primary care? Should they also participate in healthcare financing and risk? Or should they focus on becoming indisputably world class in their specialties? This opening installment introduces eight challenges shaping those choices, from reimbursement and workforce pressures to changing patient expectations, artificial intelligence, and caregiver strain. It also establishes the question at the heart of the debate: Which strategy best serves patients and families, and under what conditions? For healthcare leaders, nonprofit executives, hospice professionals, and business leaders navigating change, this episode provides a starting point for a deeper strategic conversation. Which path best fits your organization—and what would need to be true for it to work? Share your perspective in the comments, send this episode to your leadership team, and subscribe for Part Two. *** Referenced Podcast: https://www.teleioscn.org/tcntalkspodcast/future-proofing-care-the-challenges-we-face-in-hospice-and-palliative-care-part-one Host: Chris Comeaux Characters: Paul: Vertical Integration / Frail-Elder Practice Christopher: Payvider Strategy Comeaux: World-Class Hospice and Palliative Care Thank you to Netsmart for sponsoring this podcast. Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

October 16, 2026Episode 437 min

The Workforce Crisis Healthcare Leaders Can’t Afford to Ignore | Part Two

What happens when the demand for care grows faster than the workforce available to provide it? Ron Hetrick joins host Chris Comeaux on TCNTalks / Anatomy of Leadership to explore the healthcare workforce crisis—and the decisions leaders can make today to prepare for tomorrow’s staffing challenges. In Part Two, the conversation moves into practical workforce planning: improving care jobs, developing talent pipelines, strengthening employee retention, and understanding how an aging population could reshape competition for caregivers. They also examine AI in healthcare, the limits of robotics, and why technology’s greatest contribution may be giving people more time and capacity for meaningful care. In this episode, discover: • How to make healthcare careers more attractive to new workers • Why training and retention require sustained investment • Where AI could reduce administrative burdens and support learning • How private home care could change competition for talent • Why local workforce data belongs in every expansion decision • How collaboration among providers could help protect access to care Take the conversation into your next leadership meeting: What workforce decision can you make this quarter that will strengthen your organization’s ability to deliver care in 2030? Subscribe to TCN Talks / Anatomy of Leadership, share this episode with your team, and leave a comment about the staffing challenge your organization is working to solve. Featured Guest: Ron Hetrick , Principal Economist with Lightcast Host: Chris Comeaux , President / CEO of TELEIOS and author of The Anatomy of Leaderships about The Workforce Crisis Part Two Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

October 14, 2026Episode 331 min

The Workforce Crisis Healthcare Leaders Can’t Afford to Ignore | Part One

The healthcare workforce crisis is bigger than unfilled jobs. What happens when demand for care keeps growing while the pool of available workers shrinks? In “ The Workforce Crisis Healthcare Leaders Can’t Afford to Ignore | Part One ,” Chris Comeaux welcomes Ron Hetrick, principal economist at Lightcast , to TCNtalks / Anatomy of Leadership for a candid conversation about healthcare staffing shortages, demographic change, and the future of work. Hetrick explains how baby boomer retirement, smaller younger generations, and an aging population are reshaping the labor supply—and why he expects the pressure to intensify between 2030 and 2035. Together, Chris and Ron explore what these shifts could mean for hospice, palliative care, home health, and the essential workers who keep organizations running. This conversation also examines the interaction of demographics, artificial intelligence, and geopolitical uncertainty, along with Hetrick’s case for treating immigration as a strategic workforce resource. Whether you lead a healthcare organization, nonprofit, hospice team, or business, this episode offers a starting point for examining the assumptions behind your workforce planning. IN THIS EPISODE • Why healthcare staffing challenges extend beyond COVID-19 • How an aging population changes the demand for care • Why retirements and smaller graduating classes matter • How education choices affect essential workforce availability • The role of immigration in addressing labor shortages Featured Guest : Ron Hetrick, Principal Economist with Lightcast Host: Chris Comeaux, President / CEO of TELEIOS and author of The Anatomy of Leadership JOIN THE CONVERSATION What workforce challenge is putting the most pressure on your organization? Share your perspective in the comments. Subscribe to TCNtalks / Anatomy of Leadership , share this episode with your leadership team, and watch Part Two for the next conversation: the battle plan. Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

October 9, 2026Episode 229 min

Hospice at a Crossroads: The Top News Stories Leaders Can’t Ignore | Part Two

Hospice’s future is being shaped by the headlines leaders cannot afford to overlook. In Hospice at a Crossroads: The Top News Stories Leaders Can’t Ignore | Part Two , Chris Comeaux and Cordt Kassner examine the hospice news and healthcare leadership questions that deserve your attention—from fraud and public trust to caregiver support, workforce sustainability, and AI in healthcare. Drawing on articles featured in Hospice and Palliative Care Today , they explore what these developments could mean for hospice and palliative care organizations, nonprofit executives, and the leaders supporting frontline teams. In this episode: • How hospice fraud threatens public confidence and patient access • Why caregiver support and workforce sustainability demand attention • How AI, interoperability, and predictive tools are entering leadership conversations • What Netflix, software implementation, and branding can teach hospice leaders • Why policy headlines need careful interpretation The conversation also considers consolidation, private equity, outside-of-hospice spending, and the enduring importance of mission as organizations adapt. Which issue deserves the most attention in your organization? Share your perspective in the comments, send this episode to a colleague, and subscribe to TCN Talks / Anatomy of Leadership for more conversations about the decisions shaping care. Host: Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of Leadership Co-Host: Cordt Kassner, PhD, Publisher of Hospice & Palliative Care Today & CEO and Founder of Hospice Analytics Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast