The Disrupted Podcast

Hosted by James Preston, Scott Middleton

Business Health Fitness Education

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147

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Aug 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

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

August 17, 202641 min

Presence vs. Popping In: Why Most Facility Relationships Are Failing Patients

Most nursing homes think they're measuring success by how many patients move through their building. What they're not measuring is how many of those same patients end up right back in the hospital — and who pays the price when they do. In this episode of The Disrupted Podcast, Scott Middleton — Owner of Your Health and Chief Disruption Officer — pulls back the curtain on the facility partnership model Your Health is rolling out across the Southeast. It's a model that doesn't just serve patients in skilled nursing facilities; it pays those facilities for the care coordination work their staff is already doing, while creating the kind of presence that actually moves the needle on outcomes. Scott and Jamie cover the mechanics, the competitive landscape, and the cultural shift required to make it all work: Why Your Health is contracting with nursing homes to pay up to $20,000 a month for care coordination — and what that's worth annually to a facility with 200 Medicare patients The difference between "popping in" and genuine presence — and why only one of them drives real cost savings and keeps patients from bouncing back to the hospital Why physicians working in isolation are the biggest liability in a team-based care model, and how a September 1st bonus restructure is designed to change that culture How 80% of what used to require an in-person visit can now happen via telehealth — and the one thing technology will never replace: the relationship that makes a patient actually follow through Scott's 10-year urgency: why Your Health is already three steps ahead of the competition — and why that lead only matters if the model scales fast enough If you work in a nursing facility, lead a care team, run a healthcare organization, or believe the system needs a fundamentally better architecture — this is what building it actually looks like. Press play. www.YourHealth.Org

August 10, 202641 min

Medicare Is Already Paying for This — Your Facility Just Isn't Collecting It

Most nursing home administrators don't realize they're sitting on one of the most underutilized revenue streams in all of Medicare — and until someone shows up and tells them what it's worth, they never will. In this episode, Scott Middleton — founder and Chief Disruption Officer of Your Health — calls in from the road as he travels across rural Georgia on a multi-day facility tour, fresh off completing a major merger with TCPA. What follows is an unfiltered, on-the-ground breakdown of two transformational opportunities Scott is actively building: chronic care management (CCM) reimbursement and ACO cost savings — and the very specific reasons most of the industry is getting both wrong. In this episode, you'll hear: Why Medicare already pays $65/hour for care management performed by nurses, community health workers, and social workers — and how Your Health is now contracting with nursing home facilities to perform it, paying them up to $100 per patient per month The "Fuse" platform — a communication and documentation tool that routes care management notes directly into billing-ready buckets, syncing with point-of-care software so the minutes get captured and billed automatically How ACO risk scores work, why Your Health's scores have grown 30% under their current plan, and what failing to see hospice patients could cost the organization — up to $22 million in a single year The $4,800 per patient per year problem: how one physician in their network was quietly rated one of the worst under the ACO model simply because his patients were going home without any follow-up Scott's announcement that SSAs and TCPs are being restructured to report directly to peer group administrators — and why the confusion about their roles has cost the company If you lead a nursing home, an assisted living facility, a physician group, or any organization inside the long-term care ecosystem, this episode will change how you look at what you're already doing — and what you're leaving behind. www.YourHealth.Org

August 3, 202630 min

Closing The Merger

What does it look like the day a healthcare merger closes — not in a press release, but in real life? Scott Middleton was still signing DocuSign documents from his car when Jamie Preston hit record, and what followed is one of the most honest conversations yet about what it takes to grow a healthcare organization without losing the soul of why you started. Scott Middleton, Owner of Your Health and Chief Disruption Officer, joins the show to break down the just-completed acquisition of TCPA and Providence Care — and what it means to suddenly be responsible for 32 nursing home buildings, 900 new patients, and the enormous operational lift of pulling it all together under one roof. In this episode, Scott and Jamie cover: Why Your Health is immediately deploying two nurses and two community health workers per building — and how the revenue model makes them essentially self-funding from day one The continuous care hospice strategy: how night nurses on call can simultaneously generate $67/hour in Medicare reimbursement and ensure no patient dies alone The critical failure Scott discovered — hospice patients who haven't been seen by a provider since January, and the financial and human cost of letting that slide Why strategic planning lives in the field, not the boardroom — and what happens when leaders stop getting out from behind their desks The 30-day integration sprint: switching all providers to Athena, connecting hospice nurses to nurse practitioners, and getting risk scores captured before it's too late This is what disruption actually sounds like — not a keynote, not a case study, but a leader in motion, making decisions in real time, building something the healthcare system has never seen. If you're in healthcare, business, or just believe the way things have always been done is not good enough — this one's for you. www.YourHealth.Org

July 27, 202637 min

Presence & Consistency

What if the most powerful growth strategy in hospice and primary care had nothing to do with your clinical protocols, your technology stack, or your marketing budget — and everything to do with who shows up, and how often ? In this episode of The Disrupted Podcast, Scott Middleton — founder and Chief Disruption Officer of Your Health — unpacks the real-world lessons shaping how your Health is staffing, growing, and rebuilding trust as it integrates the newly merged TCPA and Providence Care organizations. Scott spent the week in the field — Monroe, Georgia; Beaufort, South Carolina; Atlanta and beyond — sitting in care team meetings, talking to nurses, watching exercise classes, and rethinking everything from staffing ratios to personality matching. What he found is both a warning and a blueprint. In this episode: Why minor service failures — a nurse who didn't show up once — can cost you an entire facility relationship, and what it actually takes to earn it back The strategic case for pulling a nurse off a shared caseload and planting her full-time in a single building — even when the numbers don't fully justify it yet The story of a nurse so embedded in one facility that an administrator told Your Health: "I will cut you if you move her" How DISC personality profiles should determine which staff member walks into which building — and why getting it wrong creates friction that kills referrals Why the best talent you'll ever hire is already living in the community you serve — and why your recruiters will never find them on Indeed The centralize-then-decentralize model Your Health deploys every time it launches something new — and why it's the only way to scale without losing quality If you lead a care team, run a hospice program, manage a building, or are trying to grow in any direction in healthcare right now — this episode is your field guide. www.YourHealth.Org