Which model won after Jefferson Health and Lehigh Valley Health Network merged? Dr. Baligh Yehia says that’s not the question Jefferson asks. In this week's Claims Denied episode, I sat down with Dr. Yehia, President of Jefferson Health, to talk about running a 33-hospital system that wants to be an operating company, not a collection of hospitals. He breaks down how Jefferson Health is integrating LVHN, why the team lets AI-era rebuilds replace the usual model bake-off, and what it takes to align incentives when a payvider only covers part of your patients. Listen on Apple: Listen on Spotify: In this episode: • Why “standard as possible, different as necessary” is the default Jefferson is building around, and why quality came before back office in the LVHN integration • Why payviders are one of the few models that can truly align incentives, even with no commercial book (Medicaid, Medicare Advantage, and ACA only), and how Jefferson still removes friction, like skipping prior auth for plan members moving to the next site of care • The goal of handing 10 million hours back to clinicians in 3 years • “Nursing out loud”: ambient for nurses is in 3 pilots, and the early wins are nurses eating lunch and clocking out on time • Why AI won’t fix misaligned payment models, and will just run automated denials and automated appeals at machine speed @TJUHospital @LVHN @Hospitalogy_HC