"What happens when healthcare stops rewarding volume and starts rewarding value?"

Dr. Anna Chacon, board-certified dermatologist and host of Skin Deep, welcomes Jonathan Gruner, CEO of Salud Healthcare. With over 15 years of healthcare experience, Gruner leads a premier Managed Service Organization supporting independent primary care physicians transitioning from fee-for-service to value-based care. This father of four married at 21 and built a 75-person company while staying true to his Orthodox Jewish values. "We are all created in God's image," Gruner explains.

Gruner breaks down fee-for-service medicine's problems and presents compelling alternatives. The conversation explores Medicare Advantage mechanics, capitation rates, and risk-sharing arrangements. How can independent physicians survive the mandated 2030 transition to value-based care? Gruner offers practical solutions, explaining how his company serves as "the backbone for primary care practices." As he puts it: "The future of healthcare must be within a value-based care setting."

Jonathan Gruner is CEO of Salud Healthcare, revolutionizing how independent primary care physicians transition to value-based care. Originally from Far Rockaway, New York, this Orthodox Jewish entrepreneur leads a 75-person team while raising four children in Miami. His leadership philosophy centers on treating all people equally, bringing both innovation and values-driven leadership to healthcare transformation.

In This Episode:

• (00:00) Introduction - the young generation, value-based care
• (01:08) Growing up in Far Rockaway and journey to Miami healthcare
• (05:13) Value-based care versus fee-for-service healthcare models
• (08:42) Understanding Medicare Advantage and Government Insurance
• (12:31) How doctors and capitation rates work in value-based care
• (17:15) Jonathan's entry into healthcare transformation
• (19:37) Orthodox Jewish values in business leadership

About Skin Deep: A podcast for dermatology professionals. Host Dr. Anna Chacon shares insights on dermatology's future, telemedicine, and serving underserved communities.

About Dr. Chacon: Board-certified dermatologist, founder of Indigenous Dermatology, specializing in remote/rural communities. First dermatologist serving Alaska's Bush region, licensed in all 50 states.

Resources:

LinkedIn: linkedin.com/in/jonathan-gruner
Salud Healthcare: saludhealthcare.com
Dr. Chacon: drannachacon.com
Social: @miamiderm (Instagram, Facebook, Twitter, TikTok)

• (00:00:00) - Skin Deep: Value-
• (00:00:58) - How Married People Balance Their Lives
• (00:05:13) - What is Value-Based Care in Healthcare?
• (00:07:50) - Medicare Advantage vs. Straight Medicare
• (00:15:27) - Health Insurance Companies' Capitations
• (00:17:11) - How Microsoft is helping primary care doctors navigate the value-based care
• (00:18:37) - How big is your team at your company?
• (00:19:37) - Importance of treating everyone equally in the workplace

How did a young man from a Cuban immigrant family in Miami navigate his way to becoming a successful medical entrepreneur in the Florida Keys?

Welcome to another episode of Skin Deep with Dr. Anna Chacon. Today we’re joined by Dr. Miguel Diaz, M.D. a Board-Certified Family Medicine Physician. Today’s discussion is focused on medical practice management. Dr. Diaz shares his remarkable journey from humble beginnings as a Cuban-American in Miami to becoming a successful multi-practice owner and family medicine residency program director. His path was anything but conventional – starting as a 16-year-old orderly in the ER, serving in the Navy, completing nursing school, and eventually attending medical school in the Dominican Republic where he met his wife. Dr. Diaz's story emphasizes the importance of having backup plans and being willing to take calculated risks, illustrated by his transition from ER medicine to private practice ownership in the Florida Keys.

You’ll hear valuable insights into the business aspects of medical practice, particularly regarding SBA loans, practice acquisition, and scaling operations. Dr. Diaz details how he grew from a small 1,000-square-foot office to managing four clinics, emphasizing the importance of keeping overhead low and reinvesting in the business. He shares candid advice about the advantages of private practice ownership over hospital employment, including greater autonomy, better work-life balance, and more financial opportunities through real estate and business expansion. The episode concludes with his perspectives on exit strategies and the importance of balancing business success with family time, offering practical wisdom for physicians considering private practice ownership.

Dr. Miguel Diaz, M.D., is a board-certified Family Medicine physician with over 11 years of experience and a passion for both healthcare and practice management. Born in Miami to Cuban parents, his early exposure to the mechanics of business and structure shaped his career. Dr. Diaz's journey into medicine began at 16, and after serving in the Navy and completing nursing school, he earned his medical degree in 2011. As an entrepreneur, he grew his practice in the Florida Keys from one to four clinics. Dr. Diaz is also the Director of the Larkin Residence Program and a strong advocate for physician-owned practices.

In This Episode:

• (00:00) Introduction of guest Dr. Miguel Diaz, his life growing up in Miami with Cuban parents who immigrated in 1962, including influence of grandfather - who participated in the Cuban Revolution
• (04:57) Dr. Diaz’ path to medicine, working in an ER at age 16, joining the Navy, attending nursing school, family pressures
• (08:06) Medical school in Dominican Republic, meeting his wife in medical school, having five children, attempting adoption, and balancing family with medical career
• (14:35) Buying & building a practice in the Florida Keys, sharing expenses with previous owner, growing the business
• (31:30) The ease of obtaining SBA loans, starting an LLC, expanding to new buildings, scaling up patient capacity, journey from teaching medical students to becoming a family medicine residency program director
• (37:00) Becoming a teacher after residency, selling a practice, growing fro...

Great skin doesn’t stop at the face—your scalp and hair deserve just as much attention. In this episode of Skin Deep, Dr. Anna Chacón sits down with Todd Da Silva, an elite L6 stylist and the Senior Technical Trainer for Bellus Academy in San Diego, CA, to talk all things scalp health, haircare science, and how dermatology and hairstyling go hand in hand. From preventing scalp conditions to maintaining luscious, healthy locks, Todd shares expert insights on the connection between skincare and haircare, the biggest myths in the industry, and pro tips for keeping your scalp and strands at their best.