The Disrupted Podcast

Hosted by James Preston, Scott Middleton

Business Health Fitness Education

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Episodes

154

Latest episode

Oct 2026

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About the show

Entrepreneur and Chief Disruption Officer Scott Middleton share's his experiences of how he uses disruption to innovate and keep an organization moving forward and growing. Scott shares these weekly stories on The Disrupted Podcast with Scott Middleton.

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60 recent

October 26, 202632 min

Group Therapy Reimagined

What if the thing keeping your grandmother out of the hospital isn’t a new drug, but a circle of chairs and a story about sharing lunch? Behavioral health is tangled up in a striking share of hospital stays. Scott cites data that nearly a third involve a mental health or substance use condition, and “altered mental status” is one of the most common reasons older adults get admitted. On this episode of The Disrupted Podcast, Your Health founder and Chief Disruption Officer Scott Middleton walks Jamie Preston through a model he calls “therapy in a box.” It’s a facilitated group session that turns a weekly gathering into early detection, real connection and a billable encounter. In this episode: Why senior living facilities keep asking for bingo, and what Your Health can offer instead How a chaplain’s take on the feeding of the 5,000 becomes a lesson in gratitude and generosity Using AI dictation to identify each speaker and document every resident’s participation Bringing a nurse practitioner, physician or psych NP into the room by phone or video each week Why a missed session should trigger a knock on the door, not a note in the chart If you lead a care team, run a community or care for someone aging in place, this conversation will change what you think an “activity” can do. Press play, then go disrupt something. www.YourHealth.Org

October 19, 202632 min

The Like Me Trap Part 2

Healthcare has been cut into pieces, with a specialist here and a hospital there, and nobody holding the whole patient. Scott Middleton says the same problem shows up inside our own teams. In Part 2 of this conversation, host Jamie Preston and Scott Middleton, owner and Chief Disruption Officer of Your Health, move from hiring philosophy to the frontline care team. Scott explains why clinical teams lean heavily toward C and S personalities, what that meant when Your Health launched hospice, and why the people who coordinate the team need a different wiring altogether. In this episode: Why a hospice launch stalled when the care team was built for a different job How Medicare’s care management and care coordination codes put the provider at the center of the patient’s care Why a primary care provider often can’t see their own patient in the hospital, and why that makes no sense “What does a care manager do?” “Scheduling!” Why that answer is the problem A nurse practitioner who bought EKG strips with her own money, and the D and I behind that decision Scoring a whole team’s DISC mix, and why talent acquisition and engagement leaders should be DISC certified If you lead a care team or have ever renamed a role and wondered why nothing changed, this one’s for you. www.YourHealth.Org

October 12, 202620 min

The Like Me Trap Part 1

We hire the people we like. And we like the people who are like us. That’s exactly the problem. In Part 1 of this two-part conversation, host Jamie Preston sits down with Scott Middleton, owner and Chief Disruption Officer of Your Health, to talk about putting the right people in the right seats. Scott explains why Your Health has an unwritten rule against hiring your own direct reports, and Jamie breaks down what happens when a team is built from a single DISC personality type. In this episode: Why leaders should let others hire their direct reports, and what bias that rule protects against What an all-D, all-I, all-S, or all-C team looks like in practice, and why each one stalls Why your real team is four or five people, not twenty “You’ll never get fired for arguing with me”: building a circle that will call you out How to read the clues behind someone’s personality, and why a blunt C often gets mistaken for a D The cost of pigeonholing people by their job title If you’re hiring right now or wondering why your team keeps hitting the same wall, start here. Part 2 takes these ideas straight into the care team. www.YourHealth.Org

October 5, 202647 min

Scott's Coaching Playbook

The best golfers in the world have a swing coach, a putting coach, and a mental coach. So why do so many leaders think they've outgrown one? Jamie Preston sits down with Scott Middleton, owner and Chief Disruption Officer of Your Health , to talk about where his coaching culture came from: opening his first assisted living facility the month he turned 40, scaling to more than 600 employees, and finally admitting he didn't know what he was doing. Scott makes the case that anyone with "leader," "director," or "president" in their title is a coach, and that real coaching starts with data, not guesses. In this episode: Why a team call about who's visiting Mrs. Smith today is a scheduling meeting, not coaching How fewer visits connect directly to more hospitalizations, and what the numbers reveal Why collecting vital signs 12 times a month could catch sepsis up to five days sooner How a passing comment turned into a workplace "rule," and why coaches have to verify before they repeat Why the hospitalist model broke continuity of care, and how palliative consults could help restore it If you lead people, this conversation will change what you bring to your next team call. Listen now, then go coach. www.YourHealth.Org

September 28, 202640 min

Interpreting The Regs

Most healthcare providers assume that if a regulatory agency approved it, they're protected. A recent court ruling just dismantled that assumption entirely — and if you haven't heard about it yet, this episode is your wake-up call. In this episode of The Disrupted Podcast, host Jamie Preston sits down with Scott Middleton, Chief Disruption Officer of Your Health, for one of the most practically important conversations in the show's history. Scott has three full-time healthcare attorneys on staff, has been investigated by the federal government — and won — and is now rolling out a care management compensation program that he's been legally stress-testing for six months. He knows how this world works, and he's not keeping it to himself. What you'll hear in this episode: Why courts can no longer defer to regulatory agencies to interpret the law — and what that means for every provider in America who's been operating under that assumption How chronic care management (CCM) is actually billed and why families and even some providers fundamentally misunderstand what they're paying for The real distinction between enticement and antitrust law — and why it's one $12 bottle of water away from a federal investigation How Scott's organization beat the federal government in court over proactive hospice placement — and how that single case dropped hundreds of similar cases across the country Why radical transparency, including open Power BI dashboards that anyone can examine, has become their most powerful legal defense The risk score gap that could unlock $100 million in additional annual Medicare revenue — and what providers are leaving on the table If you're in healthcare and you've ever assumed following regulatory guidance means you're safe, this episode will change how you think about compliance, courage, and what it actually means to do this work right. Press play. www.YourHealth.Org

September 21, 202633 min

Know Your Vital Signs

If your doctor prescribes you medication without first asking about your diet, your sleep, your stress, or your vital signs — you don't have a doctor. You have a drug dealer. That's the provocation Scott Middleton brought to this episode of The Disrupted Podcast, and it's one that cuts straight to the heart of everything wrong — and everything possible — in modern healthcare. Scott is the Founder and Chief Disruption Officer of Your Health, a healthcare organization built on the radical idea that prevention is cheaper, smarter, and more humane than reaction. In this conversation, Scott unpacks: Why most doctors have become de facto salespeople for pharmaceutical companies — and how to change that The staggering math of remote patient monitoring: how vital signs three times a week could prevent 50% of heart attacks and hospitalizations The GLP-1 opportunity hiding in plain sight — and why missing a patient's height is costing thousands of people access to life-changing care How self-insured employers are bleeding money on avoidable hospitalizations — and what accountability actually looks like Scott's mission beyond the bottom line: a United Methodist minister who got into healthcare to save souls, not just bodies If you've ever left a doctor's appointment feeling like a transaction rather than a patient, this episode is for you. The data already exists to change that — we just have to decide to use it. www.YourHealth.Org

September 14, 202636 min

Specialty Care At Your Health, Use it!

Most healthcare organizations know specialty care matters. Almost none of them are actually using it at the level their patients need. In this episode of The Disrupted Podcast, Jamie Preston sits down with Scott Middleton — Founder and Chief Disruption Officer of Your Health — for an unfiltered look at one of the most critical gaps in care delivery: specialty services. Your Health currently routes about 10% of its patient appointments through specialty providers. The national average is 20%. Scott makes the case — with real stories from nursing homes, lawsuits, and the road across South Georgia — that closing that gap isn't just a clinical priority, it's a survival strategy. What you'll hear in this episode: Why a 400-pound patient in a nursing home had never been offered a GLP-1 for weight loss — and what that reveals about how providers think about specialty The exact communication chain (DPH → EDCS → Care Manager → Provider) and precisely where it breaks down How 80% of Your Health patients have behavioral health needs while psych providers sit with open schedules — and how to fix that paradox Why texts and emails don't cut it in care coordination — and why voice-to-voice is the only real standard The lawsuit that should have been prevented with a single chest x-ray, and what it means for provider accountability going forward Why Scott banned the word "no" inside Your Health — and the mindset shift that comes with replacing it Specialty is what separates Your Health from every other provider in the market. If you're a DPH, a care manager, or a provider inside this system — this episode is for you. If you're a healthcare leader watching specialty care fall through the cracks anywhere, it might be for you too. www.YourHealth.Org

September 7, 202638 min

Wellness Wins

A hundred million Americans don't have a primary care provider. For most healthcare systems, that's a problem. For Scott Middleton, it's proof that the whole model needs to change. Scott, founder and Chief Disruption Officer at Your Health, joins Jamie for an unfiltered conversation about what wellness actually is — and why it's not the same as primary care. Your Health's wellness program has exploded from zero to 4,100 patients in just two years, and Scott is just getting started. From GLP-1s and hormone replacement to peptides and the controversial South Carolina ruling that tried to silence physicians, Scott holds nothing back — and makes clear he's willing to take the fight to court. In this episode: Why wellness is a specialty — not an alternative to primary care — and why the distinction changes everything about how patients should seek care The South Carolina Board of Medical Examiners' peptide ruling, why Scott believes it violates the First Amendment, and what he plans to do about it How clinical pharmacists and nurse practitioners are filling the gaps physicians are being pressured to leave Scott's own transformation: from 425 pounds to 216, cholesterol from 280 to 189, and what specific peptides and protocols drove those results Why employers like Bank of America — spending $2 billion a year on employee health — are the sleeper stakeholders in the wellness revolution If you've been told to "come back when something's wrong," this episode is the permission slip to demand something better. www.YourHealth.Org

August 31, 202640 min

Log Your CCM

What if the single biggest lever on your paycheck wasn't a raise, a promotion, or a new contract — but three minutes a day of logging? Scott Middleton returns to break down the real math behind Your Health's bonus structure, and why so many care managers, CNAs, and nurses are unknowingly walking away from serious money every month. Scott, Owner of Your Health and its Chief Disruption Officer, walks through a live coaching conversation he had with a team member confused about how hospice bonuses actually get calculated — and turns it into a masterclass on incentive design, healthcare economics, and why "showing your work" is the whole game. In this episode, you'll hear: How the hospice bonus pool is actually calculated, from raft scores to the $6,000-a-month billing baseline per patient A simple system for logging care management minutes in under five minutes a day — and why skipping it quietly shrinks every bonus check on the team Why 600+ patients on competitor hospices represent a multi-million-dollar opportunity Your Health is leaving on the table The uncomfortable truth about physician ego, referral economics, and why hospitals actually lose money in the ER Why some healthcare incentives are secretly built to keep patients sicker longer — and one patient's remarkable recovery story that exposes it If you've ever wondered why the system pays for what it pays for, or you're leaving money on the table because you're not tracking your own work, this conversation will change how you think about both. Press play — and then go log your hours. www.YourHealth.Org

August 24, 202645 min

The Bundled Payment Bomb: CMS Is About to Blow Up Orthopedic Care

What if your hospital billed $90,000 for your surgery — and no one on the surgical team had any idea what it cost, or whether you were okay after you went home? That's not a hypothetical. That's the system Scott Middleton walked into at a Boston conference of hospital administrators and orthopedic surgeons — and what he found will change how you understand every hip replacement, every knee surgery, and every nursing home stay on Medicare. In this episode, Scott unpacks the incoming CJX bundled payment program — the sweeping CMS policy set to take effect January 1, 2028, that will hold hospitals financially accountable for everything that happens to a Medicare surgical patient from 30 days before the OR to 90 days after they go home. And the hidden detail that changes everything: the risk score that determines how much a hospital gets paid is captured 180 days before the surgery even happens. Why the 180-day risk score window means proactive patient management isn't just good medicine — it's now a financial imperative How orthopedic surgeons will be incentivized to cherry-pick healthy patients and avoid complex ones under the new bundled model Why excluding social determinants of health from the risk score formula is a disaster waiting to happen — and who pays for it The "studies" hospitals are using to eliminate physical therapy after hip and knee surgery — and why they're comparing apples to 88-year-olds How Your Health is already positioning itself as the value-based care partner that orthopedic surgeons and hospitals are going to desperately need The system that's coming will reward the organizations that have been doing the right thing all along — and penalize everyone who's been gaming fee-for-service. Press play to find out which side you're on. www.YourHealth.Org

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