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Care Decoded

Care Decoded

By: TopHealth Media
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Care Decoded is the go-to podcast for clinicians, health plan leaders, and quality champions navigating the evolving world of risk adjustment, value-based care, and smarter documentation. Hosted by Inferscience, this show takes you inside the workflows, decisions, and technologies that turn clinical complexity into clarity. From demystifying HCCs and RAF scores to decoding CMS changes and exploring the impact of AI, we help you understand the data behind every diagnosis.


This show isn't about theory. It's about impact. Not about compliance. But confidence. Not about more clicks. But clarity at the point of care.


If you're building the future of care – one chart, one visit, one code at a time – Care Decoded is your ultimate guide.

© 2025 Care Decoded
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Episodes
  • Transforming Clinical Care with AI: How Physicians Can Lead the Healthcare Revolution
    Jan 14 2026

    Welcome back to Care Decoded, the podcast where we break down the complexities of documentation, coding, and clinical AI to empower better care. In this episode, host Dr. Sunil Nihalani, CEO of Inferscience, sits down with Dr. Hassan Bencheqroun, critical care pulmonary specialist, creator of Med AI Academy, and host of the AI Ready Doctor podcast, to explore how artificial intelligence is reshaping healthcare.

    Together, they dive deep into why AI is entering exam rooms faster than it’s entering medical training, and how physicians can move from feeling lost and overwhelmed to becoming proactive leaders in the AI revolution. They discuss the critical difference between AI tools that truly support patient care and those that just create extra noise, the importance of AI literacy (without needing to code), and the ethical challenges of bias, responsibility, and decision-making in an AI-driven world.

    If you’re a clinician, educator, or just curious about how AI will impact the doctor-patient relationship, this episode covers practical steps for developing a “tech mindset,” advocating for ethical guardrails, and harnessing AI as an empowering tool. Tune in for a thoughtful conversation on how physicians can shape tomorrow’s medical landscape by asking informed questions and keeping compassion at the center of care.


    Timestamps:

    00:00 "Bridging AI and Medical Training"

    06:09 "AI Stages for Physicians"

    09:34 "Spotting Good vs. Bad AI"

    13:53 "Ethical Challenges of AI in Healthcare"

    17:39 "Understanding AI to Question It"

    19:07 "Redefining Medical Education"

    21:50 "AI Empowering Physicians and Patients"


    Podcast's Website - https://caredecoded.com/

    Dr. Sunil Nihalani - CEO and Founder at Inferscience - https://www.linkedin.com/in/sunil-nihalani-a6983a5/

    Inferscience - https://www.inferscience.com/

    Podcast Powered by TopHealth - https://tophealth.care/

    “Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”

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    25 mins
  • Navigating Healthcare Interoperability: Tailwinds, Headwinds, and the Human Impact
    Dec 16 2025

    Welcome back to Care Decoded! In this episode, host Dr. Sunil Nihalani, CEO of Inferscience, sits down with interoperability expert Brendan Keeler, better known as the “health API guy.” Together, they tackle one of health tech’s biggest promises: interoperability. You’ll hear a down-to-earth exploration of what interoperability really looks like in practice, from the daunting challenges of connecting healthcare systems and sharing patient data, to the recent regulatory pushes trying to bridge the gaps.

    Dr. Sunil Nihalani and Brendan Keeler dive into the evolution of healthcare data exchange, discuss the real progress and persisting pain points, and unpack both the tailwinds and headwinds shaping the future of seamless data sharing. With candid stories from the front lines and practical insights, this episode cuts through the industry buzz, spotlighting where we’re at and where we need to go to make interoperability meaningful for providers, patients, and everyone in between. If you care about the future of healthcare, data access, and smarter care, you won’t want to miss this conversation!


    Timestamps:

    00:00 "Healthcare, Consolidation, and Frustration"

    03:57 "Progress and Continuous Improvement"

    07:15 EHR Data Sharing Challenges

    11:23 AI Modernizing EHRs and Visit Prep

    15:59 "TEFCA Driving Patient Data Access"

    18:03 "Boost for Tech-Enabled Care"

    21:03 "Trust Strain Threatens Care Networks"

    25:01 Illegal Loopholes Exploiting Patient Data

    27:46 Identity Proofing vs Scribble Debate

    31:42 "EPIC's Dominance in Vertical SaaS"

    34:57 EHR Integration and Antitrust Rulings

    39:04 EHRs, APIs, and Information Blocking

    41:11 "Ubiquity Over Structured Data"

    46:16 "Optimism Through AI and Interoperability"

    47:40 "Driving Interoperability Through Advocacy"


    Podcast's Website - https://caredecoded.com/

    Dr. Sunil Nihalani - CEO and Founder at Inferscience - https://www.linkedin.com/in/sunil-nihalani-a6983a5/

    Inferscience - https://www.inferscience.com/

    Podcast Powered by TopHealth - https://tophealth.care/

    “Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”

    Show More Show Less
    49 mins
  • The Future of Risk Adjustment: Preparing for CMS Audits, Extrapolation, and AI Technology
    Nov 18 2025

    Welcome back to Care Decoded, the podcast where we make sense of the fast-evolving world of documentation, coding, and clinical AI to power better patient care. In today’s episode, host Michael Lesnik welcomes healthcare innovation and policy leader Dr. Shannon Decker for a deep dive into the major changes facing risk adjustment as we approach 2026.

    You’ll hear Michael Lesnik and Dr. Shannon Decker tackle the ripple effects of a recent court ruling that vacated CMS’s RADV final rule and what that means for audit compliance, health plans, and provider groups. As the landscape shifts, they’ll explore how AI is revolutionizing regulatory oversight, the urgent need for data accuracy, and why quality and total cost of care matter more than ever in the value-based care era.

    This episode is packed with practical insights for health plan leaders and providers alike, including firsthand stories, strategies to shore up documentation workflows, and tips for staying competitive as technology and compliance expectations accelerate. If you want to be ready for the future of risk-based contracting and avoid common blind spots, you won’t want to miss it.


    Timestamps:

    00:00 "CMS Compliance Pause Insights"

    06:26 AI in Medical Data Challenges

    07:12 "Good Data is Essential"

    10:16 "Risk Adjustment Impacts Provider Groups"

    14:15 AI Advancements and Hiring Delay

    17:27 Improving Claims & Patient Care

    22:15 Optimize Documentation and Systems Effectively

    24:49 Risk Improvement Strategies

    31:18 Renegotiating Contracts and Data Strategy

    32:16 Streamlining Medical Record Management

    35:24 Unfair CAHPS Survey Impact

    41:05 Advancing Physician Support Effectively

    44:30 Investing for Growth and Healthcare Challenges

    46:13 "Thoughtful System Implementation Strategy"

    49:12 "Risk Adjustment: Accuracy Matters"


    Podcast's Website - https://caredecoded.com/

    Dr. Sunil Nihalani - CEO and Founder at Inferscience - https://www.linkedin.com/in/sunil-nihalani-a6983a5/

    Inferscience - https://www.inferscience.com/

    Podcast Powered by TopHealth - https://tophealth.care/

    “Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”

    Show More Show Less
    50 mins
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