Shows / Medsolve Dynamics
Medsolve Dynamics
Short, operator-level strategy for radiation oncology and cancer program leaders navigating margin pressure, capital decisions, and AI reality. No fluff. No pitch. Just what the vendor isn't telling you.
Episodes
- Medsolve Dynamics
Know the number before the denial.
On November 5 eviCore's new radiation oncology guideline takes effect, and it lists osteoarthritis and plantar fasciitis as not medically necessary. The…
- Medsolve Dynamics
Two different things
"I use AI every single day." The opening minute of the SROA 2026 session Yoel Bakas gave with Heather Turner, on the difference between a chatbot a team can…
- Medsolve Dynamics
Two clocks: the rule moves, your budget doesn't.
Two clocks run underneath every capital decision made this fall. One of them can still move. The other one locks. From "Protecting Program Margin, Part Two,"…
- Medsolve Dynamics
The machine passes. The plan is not tested.
Acceptance proves the machine is what was bought. It says nothing about the volume the purchase was approved on. Yoel Bakas of Medsolve Dynamics, twenty years…
- Medsolve Dynamics
Benchmark what you own
Before asking for another treatment machine, establish what limits the ones already in service. Yoel Bakas of Medsolve Dynamics explains why a capital review…
- Medsolve Dynamics
It Would Have Been My Machine: The Oncology Operator, Issue 007
Twenty years on the vendor side, and an honest answer about which machine to buy would still have been his machine. Yoel Bakas on where a vendor's physicist…
- Medsolve Dynamics
LINAC Service Contract Rate vs Service Cost: One Number to Check Before You Sign
One flat service rate on a one-year-old linear accelerator and a twenty-year-old one means the LINAC service contract price is not built from parts, labor…
- Medsolve Dynamics
The Alternative Does Not Have to Win (AMAC Summer Seminar 2026)
Yoel Bakas on why a competing bid earns its keep even when everyone knows which vendor wins, and what one question did for a vault budget. From Yoel Bakas's…
- Medsolve Dynamics
The Number With No Counterparty
Every hospital-based cancer program pays its own institution for space, lab and IT, and almost none can show how the figure was built. Yoel Bakas on why the…
- Medsolve Dynamics
The Escalator Nobody Argues About
Every service agreement has one clause that grows on its own, and it is almost never the clause that gets negotiated. Yoel Bakas on what a five percent annual…
- Medsolve Dynamics
Sixteen Months of Ordinary Course
The radiopharmaceutical supply chain consolidated on paper on August 3, 2026, when Curium and Lantheus signed a definitive merger agreement. Yoel Bakas on why…
- Medsolve Dynamics
The Half-Million-Dollar Anchor
A radiation oncology capital price that has not moved in twenty years. Onboard imaging, arc delivery, the next iteration of arc delivery, a couch upgrade — all…
- Medsolve Dynamics
Price the AI, Not the Demo: Two Questions Before You Buy Theranostics Response-Monitoring Software
Yoel Bakas, computer science and an MBA in artificial intelligence, twenty years configuring and pricing this class of technology from the vendor side, on the…
- Medsolve Dynamics
Running the Theranostics Plan at Drug Margin Zero
The CY 2027 OPPS proposed rule puts the 340B drug spread underneath hospital theranostics programs on the table. Two drugs carry the category, Pluvicto and…
- Medsolve Dynamics
Why a One-Hour LINAC downtime Becomes a Three-Hour Day in Radiation Oncology
Parts lead time and field-engineer coverage, not the uptime percentage in your contract, decide how long a LINAC is actually down. A vendor-side look at how…
- Medsolve Dynamics
The Tell in a LINAC Service Contract: Same Rate on a New Machine and a Twenty-Year-Old One
A radiation oncology service contract that quotes the same rate on a one-year-old LINAC and a twenty-year-old one was never priced on the cost to serve the…
- Medsolve Dynamics
What Every New Radiation Oncology Administrator Should Know Before Their First Vendor Meeting
Your first capital negotiation is against someone who runs forty a year. This explains where the vendor puts the leverage and how a new administrator levels…
- Medsolve Dynamics
Why a Discount Off List Is Not a Number You Can Trust in Radiation Oncology Capital
A percentage off a list price the vendor set themselves tells you very little. This explains why the value package matters more than the discount in a LINAC…
- Medsolve Dynamics
Why AI Efficiency Disappears Between the Demo and the Staffing Model.
Vendor AI demos show real efficiency that never reaches the staffing model. The workflow redesign and oversight cost behind AI value in radiation oncology…
- Medsolve Dynamics
Why a Radioligand No-Show Costs Differently Than a Missed Fraction.
Lutetium-177 has a half-life of about 6.6 days, so a radioligand therapy no-show is a paid dose decaying in your department. The dose economics behind…
- Medsolve Dynamics
Why AI Is Not a One-Time Purchase in Radiation Oncology
AI purchasing differs fundamentally from traditional capital and software decisions. The cost is not the license, it is the recurring monitoring as the model…
- Medsolve Dynamics
Why a Theranostics No-Show Hurts Differently Than an IMRT One
In radiation oncology, a curative no-show is a slot you backfill. In theranostics, the Lu-177 dose is a fixed amount with about a five-day shelf life…
- Medsolve Dynamics
A Guideline Says It Is Appropriate. The Next Question Is Whether Your Program Can Deliver It.
A society guideline on low-dose radiation for osteoarthritis makes benign disease a real service-line conversation in radiation oncology. Clinical…
- Medsolve Dynamics
The Service Contract Renewal Conversation Most Rad Onc Programs Have Already Lost
Most rad onc programs walk into a service contract renewal with no independent numbers on the table. The vendor brings their performance data. The program…
- Medsolve Dynamics
The Vendor Landscape Just Widened. Your Capital Conversation Changed Whether You Know It Or Not.
At ESTRO 2026, United Imaging showed a CE-marked uRT-linac 506c on the show floor. Diagnostic-CT integrated with a linear accelerator on a single platform…
- Medsolve Dynamics
The Hospital Math Says Build. The Physician Math Says Do Not. That Gap Is The wRVU Trap.
Most rad onc programs sitting on soft Q2 numbers are looking outside the building for offsetting revenue. The infrastructure for radioligand therapy is already…
- Medsolve Dynamics
Ask The Vendor What The Same Software Costs Without The AI. The Unbundled-Price Question
From 20 years on the vendor side of oncology software sales, the one question that exposes the AI price premium baked into software renewal quotes in 2026…
- Medsolve Dynamics
When I Was On The Vendor Side: The AI Demo That Skipped The Workflow Question
A vendor-side story Yoel Bakas has watched play out dozens of times in radiation oncology. A software demo runs without anyone asking what is actually broken…
- Medsolve Dynamics
Why Your LINAC's Unbooked Hours Are The Cheapest Margin Audit You Will Run In 2026
From 20 years on the vendor side of LINAC capital and service negotiations, the data point most radiation oncology programs do not see with the same precision…
- Medsolve Dynamics
What Does This Commit Us To In Year Five? The Question Every Oncology Capital Decision Needs
Capital decisions hold up when the year-five reality is considered before the signature. They break when only year-one numbers are. From 20 years on the vendor…
- Medsolve Dynamics
The Proforma Altitude Problem In 2026 Oncology Capital Decisions
From 20 years on the vendor side and now on the program side, the math that wins capital approval is not the math the program runs in year two. The…
- Medsolve Dynamics
Adding Benign Disease Is A Referral Decision, Not An Equipment Decision
Benign disease radiation uses LINAC capacity that is already paid for in most programs. The growth question is referral pathway, not capital. From 20 years of…
- Medsolve Dynamics
Theranostics Capital Decisions Are Build-Or-Partner Decisions, Not Product Decisions
From 20 years on the vendor side and now on the program side, the capital form decision that gets skipped on most theranostics service-line additions. Build or…
- Medsolve Dynamics
Capital Is A 7-10 Year Commitment: The Math Most Proformas Skip
Capital decisions in radiation oncology are not point-in-time decisions. The proforma that wins approval at signature is not the proforma that runs the program…
- Medsolve Dynamics
After 20 Years Selling LINACs, This Is What I Saw From The Vendor Side
A moment from the AMAC Spring Symposium 2026 talk on the day I told a room of oncology administrators that I have watched programs lose margin on contracts I…
- Medsolve Dynamics
Why The Old Capital Math Does Not Survive The 2026 Reimbursement Environment
A short clip from the AMAC Spring Symposium 2026 talk on the discipline programs need to apply to every capital decision in the current environment…
- Medsolve Dynamics
Why Vendor Proformas Don’t Survive Year Two: A Capital Decision Reality Check
The capital case in a vendor proforma is usually solid. The operating case is rarely modeled. From 20 years on the vendor side selling these programs, here is…
- Medsolve Dynamics
Where Volume Responsibility Belongs in an Oncology Program | Jeff Siupik
Jeff Siupik, 35 years in oncology operations, on where volume responsibility actually belongs in a healthy program. The C-suite looks at P&L. The clinical team…
- Medsolve Dynamics
Running a Cancer Program in 2026: Capital, Operations, and the Job Behind the P&L
Yoel Bakas sits down with Jeff Siupik, a healthcare executive with 35 years in oncology operations and 25 years in oncology leadership. Jeff has put in eight…
- Medsolve Dynamics
Staff Is The Soul Of Your Program: Capital Discipline For Oncology Hiring And AI Tools
Hiring and retention decisions are landing on the same desks as AI tool decisions, often in the same week. After 20 years on the vendor side, here is the…
- Medsolve Dynamics
The Service Contract Autopilot Problem: A 14-Year Veteran Explains
From the Medsolve Dynamics conversation with Heather Turner, radiation oncology operator with 14 years from therapist to director. The contracts are not the…
- Medsolve Dynamics
I Loved Selling Bundles: 20 Years On The Vendor Side Of LINAC Capital
The economic case for a LINAC purchase rarely fails at signature. It fails in years two through eight, when the bundled add-ons start collecting service…
- Medsolve Dynamics
Negotiating Inside a Structure the Vendor Built Before You Arrived
Most oncology capital and service negotiations are decided before anyone sits down. Vendor teams map your budget range, rehearse responses to your objections…
- Medsolve Dynamics
After 20 Years on the Vendor Side, What Medsolve Does for Cancer Programs
After 20 years on the vendor side of oncology at GE HealthCare, ViewRay, and Varian, Yoel Bakas launched Medsolve Dynamics to work from your program side. In…
- Medsolve Dynamics
Why Most Oncology Service Contracts Quietly Cost Programs Money
Most oncology service contracts renew automatically unless a specific window is used to renegotiate. Yoel Bakas, founder of Medsolve Dynamics, walks through…
- Medsolve Dynamics
AI Procurement Accountability in Healthcare: 3 Questions Before You Sign
The conversation highlights the pitfalls of AI procurement, the consequences of procurement failure, misleading claims in AI sales, and key questions for…
- Medsolve Dynamics
Can you afford it at 80% of the current reimbursement?
The conversation explores the critical question of whether decisions hold up at 80% of the current reimbursement, emphasizing the importance of considering…
- Medsolve Dynamics
The allure of new technology without a clear problem to solve!
A physicist's excitement about a new tool without a clear problem to solve. Takeaways Tool adoption without a clear problem The allure of new technology…
- Medsolve Dynamics
Preparation and Anticipation in Vendor Negotiations
Preparation and Anticipation in Negotiations Takeaways Preparation is key Anticipate objections medsolvedynamics.com team@medsolvedynamics.com
- Medsolve Dynamics
Key provisions that can have a significant financial impact.
The conversation explores the impact of contracts on margins and highlights the importance of paying attention to contract details, especially key provisions…
- Medsolve Dynamics
Defining the problem before pricing is crucial.
The conversation emphasizes the importance of answering key questions before requesting a quote from a vendor, highlighting the vendor's influence on…
- Medsolve Dynamics
Inside Oncology Operations: What Programs Are Dealing With Right Now | Heather Turner
Heather Turner has 14 years of experience in radiation oncology. Radiation therapist, operations manager for a new cancer center build, director. In this…
- Medsolve Dynamics
Getting beyond price in vendor negotiations.
In the context of radiation oncology capital conversations, the focus on price often overshadows other critical factors such as service coverage, software…
- Medsolve Dynamics
How to avoid financial losses and unexpected escalations from your service contract.
Understanding the key provisions in a service contract is crucial to avoid financial losses and unexpected escalations. Four common provisions, including the…
- Medsolve Dynamics
The asymmetry in sales conversations & the need for program leaders to have support.
The conversation delves into the asymmetry in sales conversations, the structural information asymmetry, and the need for program leaders to have support when…
- Medsolve Dynamics
Programs that document performance gaps can negotiate from a position of strength.
Customer experience drives 53% of purchase decisions, not clinical superiority. This is particularly relevant for radiation oncology programs. Programs that…
- Medsolve Dynamics
The importance of defining success and the problem before engaging in pricing discussions.
The conversation delves into the misconceptions and limitations of requesting a quote from a vendor, highlighting the importance of defining success and the…
- Medsolve Dynamics
The margin structure of LINAC service contracts and its impact on negotiations.
Understanding the margin structure of LINAC service contracts and its impact on negotiations. Takeaways Service contracts are highly profitable for vendors…
- Medsolve Dynamics
Leveraging contracts and KPI tracking is essential for program success.
Oncology programs often have service contracts with major vendors, but lack active tracking of vendor performance. Key performance indicators (KPIs) such as…
- Medsolve Dynamics
Reevaluate assumptions and review budget numbers in response to budget cuts.
The conversation highlights the significant impact of budget cuts on oncology programs, particularly on capital decisions, pre-approved purchases, and service…