Bright Spots in Healthcare: Recent Episodes
Eric Glazer
Each episode, I interview innovators in the healthcare industry to extract the strategies, tactics, tools, and/or routines they utilize to generate extraordinary, positive outcomes. We highlight and breakdown these bright spots so you can apply them at your organization. "See a bright spot .... and clone it!"
What does it really take to challenge the status quo in healthcare, and win? Dr. Imamu “Mu” Tomlinson, CEO of Vituity and author of Less Than One Percent: How Disruptors Defy the Odds, joins host Eric Glazer to share hard-won lessons on leadership, resilience, and breaking barriers. In this energizing conversation, Mu discusses: How to […]
In this Bright Spots in Healthcare episode, host Eric Glazer brings together health plan and specialty care leaders to examine a challenge becoming increasingly important to healthcare organizations: how to make sure the right specialty expertise reaches the right patient at the right moment without simply adding another disconnected program. The discussion explores what happens […]
In this Bright Spots in Healthcare episode, host Eric Glazer brings together health plan and specialty care leaders to examine a challenge becoming increasingly important to healthcare organizations: how to make sure the right specialty expertise reaches the right patient at the right moment without simply adding another disconnected program.
The discussion explores what happens when organizations rethink specialty care as a pathway rather than an isolated episode. Across health plans and specialty care organizations, the conversation looks at how earlier identification, better triage, care navigation, workflow integration, physician engagement, and technology can help organizations improve access while making better use of limited specialist capacity.
This is a practical discussion for health plan and provider leaders navigating rising specialty costs, growing demand, limited specialist capacity, and increasingly complex member needs.
Our guests include:
- Shantanu Agrawal, MD, Chief Health Officer, Elevance Health
- Lora Council, MD, Chief Medical Officer, Fallon Health
- Sunil Shivaram, MD, Chief Medical Officer, Elite Health Plan
- Jessica Landin, CEO, Vori Health
Together, they explore:
- How organizations can improve specialty access by identifying, triaging, and routing patients earlier, rather than simply adding specialist capacity
- How health plans and specialty organizations are redesigning care pathways to better connect primary care, specialists, behavioral health, navigation, and community resources
- How AI, predictive analytics, digital screening, and asynchronous care can extend clinical capacity while helping specialists focus on patients who need their expertise most
- What it takes to build more connected specialty care models that improve access, reduce fragmentation and unnecessary utilization, and deliver better outcomes and experiences for patients
This episode offers an inside look at how leading organizations are rethinking specialty care not by adding more disconnected solutions, but by improving how expertise is allocated, coordinated, and delivered across the patient's journey.
Panelist Bios here: https://www.brightspotsinhealthcare.com/events/rethinking-specialty-care-new-opportunities-to-improve-outcomes-experience-and-affordability/
Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/07/Episode-Guide-Bright-Spots-in-Health-Care-07-30-26.pdf
Key Insights Summary: Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation.
Thank You to Our Episode Partner, Vori Health Vori Health helps health plans and provider organizations rethink musculoskeletal care through an integrated, physician-led model that brings physicians, physical therapists, health coaches, and technology together around the patient. Rather than treating specialty care as an isolated episode, Vori's approach is designed to provide coordinated, longitudinal support while helping patients access the right care at the right time.
The model also reflects a broader shift discussed throughout this episode: using technology to extend the care team, identify patients earlier, support engagement between visits, and connect patients to the resources they need across the healthcare system. Vori's digital and AI-enabled tools can support asynchronous care, provide feedback to clinicians, and help identify patient needs before they escalate into higher-cost settings or worse outcomes.
Learn more about Vori Health - http://vorihealth.com.
Schedule a Meeting with Jessica Landin, CEO, Vori Health To explore how Vori Health can help your organization rethink MSK care, improve access, reduce fragmentation, and build a more coordinated specialty care model, reach out to show producer Vekonda Luangaphay at vluangaphay@brightspotsventures.com to schedule a conversation with Jessica Landin, CEO, Vori Health.
About Bright Spots Ventures:
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the "bright spots" in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
Recorded live at HLTH, this episode of Bright Spots in Healthcare features Dr. Carolyn Jasik, Associate Chief Clinical Officer at Verily, an Alphabet company focused on precision health innovation at scale.
Carolyn shares how Verily has evolved through multiple "moonshot" phases, from devices and research to its current focus on precision health, combining AI, data science, and clinical expertise to deliver the right intervention to the right person at the right time.
Drawing from her background as a pediatrician, behavioral scientist, and former digital health executive, Carolyn explains why healthcare transformation must move beyond the clinic and into people's daily lives, meeting them in moments that actually matter.
In this conversation, you'll hear about:
- What precision health really means beyond the buzzword, and why timing and context are everything
- How Verily Me enables consumers to interact with their health records, ask questions, and identify gaps in care
- The role of AI coaches and human clinicians working together, not in competition
- Why Verily is taking a direct-to-consumer-first approach to crack the engagement problem in healthcare
- How licensed nurses, HIPAA-protected AI, and real-time support can transform patient experience
- Carolyn's long-term vision for AI agents like Violet to meaningfully extend care teams and reduce clinician burden
This episode offers a thoughtful, human-centered look at how AI can help people feel seen, supported, and cared for while laying the foundation for scalable, enterprise-grade precision health.
If you're building, buying, or deploying digital health solutions, this conversation provides a grounded blueprint for what consumer trust, engagement, and impact really require.
Bio: https://hlth.com/speakers/2024/carolyn-bradner-jasik
References:
Verily Me - https://www.verilyme.com/
Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email hkrish@brightspotsventures.com
About Bright Spots Ventures:
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation. We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the "bright spots" in healthcare—proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
Visit our website: www.brightspotsinhealthcare.com. Follow Bright Spots in Healthcare: https://www.linkedin.com/company/shared-purpose-connect/
Duration: 1 hr In this episode of Bright Spots in Healthcare, host Eric Glazer brings together leaders from Johns Hopkins Medicine, Northwell Health, WVU Medicine, and TytoCare to explore one of healthcare’s biggest challenges: how to move beyond isolated AI pilots and operationalize AI in ways that genuinely improve specialty care. While AI continues to […]
What happens when the founder of Mint.com takes on one of healthcare’s most broken experiences—patient communication? In this episode of Bright Spots in Healthcare, Eric Glazer sits down with Aaron Patzer, Founder and CEO of Vital, to explore how simplicity, clarity, and human-centered design can drive real impact in healthcare. Drawing from his journey building […]
GLP-1 therapies are transforming pharmacy benefits, and Express Scripts is leading the way. Harold Carter, PharmD, SVP of Trade Relations, joins host Eric Glazer to discuss how one of the nation’s largest PBMs is navigating this disruptive moment in healthcare. Harold shares how Express Scripts is: Capping costs of GLP-1 therapies to expand patient access […]
Recorded live at the AHIP 2026 Conference, Eric Glazer sits down with Dr. Hector de Leon, Board Chair of the Kaiser Permanente Medical Foundation and practicing pediatrician, for a conversation about one of healthcare’s biggest challenges: Not discovering what works, but scaling what already does. For more than 80 years, Kaiser Permanente has built its […]
A lot of digital health pilots do not fail because the idea is bad. They fail because the care model, workflow, staffing, and financial design were never fully built. This episode features a presentation from the ROI-Centered Care Summit, produced by Bright Spots Ventures in partnership with TytoCare and the American Telemedicine Association (ATA). In […]
In oncology, performance is not just about getting patients in the door. It is about getting them to the right specialist, at the right time, with less friction across every handoff. This episode features a presentation from the ROI-Centered Care Summit, a half-day virtual summit produced by Bright Spots Ventures in partnership with TytoCare and […]
Emergency department performance is often shaped long before a patient is admitted, or discharged. This episode features a presentation from the recently held ROI-Centered Care Summit, a half-day virtual summit produced by Bright Spots Ventures in partnership with TytoCare and the American Telemedicine Association (ATA). In this episode, Robert Sumter, PhD, FACHE, EVP / Market […]
The healthcare system we’ve built is remarkably good at treating disease. The question is whether it’s designed to create health. In this episode of Bright Spots in Healthcare, Eric Glazer sits down with Dr. John D’Angelo, President and CEO of Northwell Health, one of the largest health systems in the country, for a candid conversation […]
What happens after a patient leaves the emergency department is often where performance is won, or lost. This episode features a presentation from the recently held ROI-Centered Care Summit, a half-day virtual summit produced by Bright Spots Ventures in partnership with TytoCare and the American Telemedicine Association (ATA). In this episode, Albert Villarin, MD, MBA, […]
Why do so many healthcare innovation efforts stall after pilots? In this Bright Spots in Healthcare episode, host Eric Glazer sits down with leaders from Healthworx, the investment and innovation arm of CareFirst, for a candid discussion on what actually allows innovation to scale inside complex healthcare organizations. As health plans invest heavily in AI, […]
n this Bright Spots in Healthcare episode, host Eric Glazer brings together Medicare Advantage and operational leaders to explore a growing challenge facing health plans: why identifying risk is no longer enough to improve outcomes. As organizations invest heavily in HRAs, predictive analytics, and member insight platforms, many still struggle to convert those insights into […]
What if the most effective care model isn’t built inside the hospital at all? This episode features the opening presentation from the recent Home Care Innovation Summit, a half-day virtual summit produced by Bright Spots Ventures in partnership with TytoCare, focused on how leading organizations are redesigning care to reach patients where they are. Kelly […]
In this episode of Bright Spots in Healthcare, recorded live at the ViVE 2026 conference, Eric Glazer sits down with Dr. Pavitra Krishnamani from MD Anderson Cancer Center to explore what it actually takes to build scalable digital health systems. As both a practicing emergency physician and digital health innovator, Dr. Krishnamani brings a frontline […]
In this Bright Spots in Healthcare episode, host Eric Glazer brings together payer and strategy leaders to explore a fundamental challenge in Medicare Advantage: why improving experience is not about measuring more, but managing better. This conversation focuses on where performance is actually being lost across the member journey, not within individual programs, but in […]
In this Bright Spots in Healthcare episode, host Eric Glazer brings together payer leaders to explore a fundamental challenge in Medicare Advantage: why strong strategies often fail to translate into sustained performance. This conversation focuses on the gap between intention and execution, where plans invest heavily in programs, outreach, and data, yet still struggle to […]
Chronic care isn’t failing because of strategy. It’s breaking down in execution. In this episode of Bright Spots in Healthcare, host Eric Glazer brings together provider leaders to explore a critical issue: the loss of time, attention, and clinical capacity to inefficient workflows instead of patient care. This conversation highlights how organizations are making structural […]
In this Bright Spots in Healthcare episode, host Eric Glazer brought together payer and provider leaders to examine a major shift underway in specialty care. Historically, specialty models have been built around episodic intervention, stepping in after a condition has progressed. But as organizations take on greater accountability for outcomes and cost, that model is […]
In this Bright Spots in Healthcare episode, host Eric Glazer convenes provider and health system leaders working at the front lines of rural healthcare transformation across Texas. The conversation explores what it actually takes to extend clinical expertise across distance, workforce shortages, and infrastructure gaps, and how organizations are redesigning care delivery to meet patients […]
In this episode of Bright Spots in Healthcare, recorded live at the ViVE 2026 conference, Eric Glazer sits down with Dr. Reshma Gupta from UC Davis Health to explore how health systems can translate artificial intelligence and predictive analytics into real operational improvement. As Chief of Population Health and Accountable Care, Reshma focuses on turning […]
In this Bright Spots in Healthcare episode, host Eric Glazer convenes health plan leaders who are focused on what happens beyond the clinic visit, the moments between care where behavior, adherence, and risk quietly take shape. The conversation centers on how plans are operationalizing care without proximity by extending support into daily life, redesigning benefit […]
Guests: Louis DeStefano, Chief Growth Officer, Oscar Health Jon Van Der Veer, DO, Founder & CEO, Hy-Vee Health In this special HLTH interview, Bright Spots in Healthcare host Eric Glazer speaks with two leaders shaping one of the most innovative payer–provider–retail collaborations in the country: Louis DeStefano, Chief Growth Officer, Oscar Health Jon Van Der […]
In this episode of Bright Spots in Healthcare, recorded live at the HLTH 2025 conference in Las Vegas, Eric Glazer sits down with Scott Arnold from Tampa General Hospital, one of the nation’s leading academic health systems, to explore their ambitious digital transformation journey. The conversation dives deep into how TGH built a unified digital […]
In this Bright Spots in Healthcare episode, host Eric Glazer brings together health system leaders transforming how care continues beyond the hospital stay—using digital coordination, subspecialization, and AI-enabled virtual care to reduce readmissions and improve patient experience. Our guests include: Matthew Sakumoto, MD, Medical Director, Connected Care Clinic, and Regional Chief Medical Informatics Officer, Sutter […]
In this Bright Spots in Healthcare episode, host Eric Glazer sits down with three leaders reshaping one of healthcare’s most overlooked — yet mission-critical — functions: provider credentialing. Credentialing is the quiet infrastructure of trust in healthcare. When it’s done right, patients get timely access to high-quality care, providers get paid faster, and health plans […]
Host Eric Glazer convenes senior leaders from Humana, Noom, and Blue Shield of California to explore how payers are integrating GLP-1 therapies into comprehensive cardio-metabolic care strategies. The conversation outlines how digital, behavioral, and...
In this Bright Spots in Healthcare episode, host Eric Glazer brings together an all-star panel of leaders who are reshaping the future of Medicaid and social care.
Our guests include:
- Vanita Pindolia, Vice President, Medicare Star Ratings, Emergent Holdings (BlueCross BlueShield Michigan)
- Jason Merola, MD, Chief Medical Officer, MVP Health Care
- Charlotta Eriksson, Lead Director, National VBC Partnerships (Specialty), Aetna
- Mary O’Connor, MD, Chief Medical Officer & Co-Founder, Vori
Together, they explore:
- How Medicare Advantage plans are embedding Stars, CAHPS, and adherence metrics directly into provider contracts to drive accountability, improve quality, and sustain year-over-year performance gains.
- How payers like Aetna are expanding value-based care into specialty domains—from CKD and oncology to musculoskeletal and cardiology—by partnering with specialty-aligned organizations rather than converting individual specialists to risk models.
- How MVP Health Care is designing hybrid incentive structures that reward specialists for closing quality gaps and improving outcomes, without requiring full downside risk.
- Why MSK care is becoming pivotal to Stars success, as physical and mental health measures grow in weight through 2027, and how holistic, physician-led models are improving activity, satisfaction, and cost savings simultaneously.
- How digital-first specialty networks are solving access challenges, reducing “ghost network” exposure, and creating new opportunities for plans to meet CMS adequacy standards while improving the member experience.
- How collaboration across utilization management, Stars, and member experience teams helps avoid trade-offs, ensuring that cost controls don’t come at the expense of satisfaction or CAHPS performance.
Panelist Bios: https://www.brightspotsinhealthcare.com/events/stars-savings-and-satisfaction-unlocking-msk-and-specialty-care-strategies-for-medicare-advantage-success/
Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://drive.google.com/file/d/1a_rX23Ev5VRrJKqb8_UwAYBd9tUBIfWA/view?usp=sharing
Resources:
Maximizing 2026 Medicare Advantage Performance with Physician-Led MSK Care This report outlines how Vori’s physician-led, virtual-first musculoskeletal (MSK) model helps Medicare Advantage plans:Improve up to 12 Star measures across preventive care, chronic condition management, and member experience
- Deliver faster access to care—appointments available within 48 hours
- Enhance outcomes for pain, fall prevention, and osteoporosis care while achieving an NPS of 87
- Align with the new 2026 Star measures for Improving and Maintaining Physical and Mental Health
To request your copy, email nroberts@brightspotsventures.com.
Clinical Quality Performance of Value-Based and Fee-for-Service Models for Medicare Advantage: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2839238 This JAMA Health Forum article compares clinical quality outcomes for Medicare Advantage patients whose care is delivered under value-based payment (VBP) models versus traditional fee-for-service (FFS). It finds that VBP arrangements, especially those with two-sided financial risk—in general are associated with better performance on standardized clinical quality measures than FFS.
Thank you to our Episode Partner, Vori:
Vori partners with health plans and providers to improve musculoskeletal (MSK) care through data-driven, physician-led solutions. Their approach helps reduce unnecessary surgeries, improve recovery outcomes, and enhance patient satisfaction—supporting plans in achieving better Stars performance and overall member experience. To learn more, visit vorihealth.com.
Schedule a meeting with Mary O’Connor Chief Medical Officer, Vori: To dive deeper into how Vori can help your plan improve outcomes, reduce costs, and strengthen Medicare Advantage Star Ratings,or to schedule a meeting with Mary O’Connor. Reach out to nroberts@brightspsotsventures.com to schedule the meeting.
About Bright Spots Ventures:
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
GLP-1 therapies are transforming pharmacy benefits, and Express Scripts is leading the way. Harold Carter, PharmD, SVP of Trade Relations, joins host Eric Glazer to discuss how one of the nation’s largest PBMs is navigating this disruptive moment in healthcare.
Harold shares how Express Scripts is:
- Capping costs of GLP-1 therapies to expand patient access while keeping plan spending predictable.
- Redesigning funding models to strike a balance between affordability, predictability, and outcomes.
- Leveraging digital tools and AI to reduce friction in the member experience and support long-term adherence.
- Rethinking formularies not just as cost-control tools but as part of a broader population health and behavioral change ecosystem.
You’ll also hear his forward-looking perspective on how PBMs will evolve over the next three to five years, and the key questions health plans and employers should be asking today to prepare for the future of pharmacy benefits.
About Dr. Harold Carter:
Harold Carter, PharmD, is responsible for leading all interactions and contracting with pharmaceutical manufacturers and oversees strategy and management of Express Scripts’ drug formularies, data & insights, client underwriting, and product strategy and development. In his nearly 14 years with the organization, Harold has held numerous leadership roles oriented around critical efforts to lower the cost of prescription drugs and ensuring medication access for Express Scripts clients and members. Harold’s previous responsibilities include oversight of the organization’s medical pharma contracting and drug procurement teams, as well as leading the strategy, development and execution of Express Scripts’ wholesale market, value-based solutions and generic strategy, and development of Express Scripts’ advanced utilization management solutions.
In addition to his work at Express Scripts, Harold serves on numerous boards including LifeWise Stl Board of Directors, St. Louis University High School Board of Trustees and IVI Board of Directors. Harold earned his doctorate in pharmacy from St. Louis College of Pharmacy.
Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email hkrish@brightspotsventures.com
About Bright Spots Ventures:
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
In Part Two of our special HLTH 2025 series, Bright Spots in Healthcare host Eric Glazer continues his conversation with Rich Scarfo, President of HLTH, to explore how the event has become a true growth engine for healthcare solution providers.
Rich shares why HLTH is more than a conference - it’s a platform intentionally designed to foster meaningful connections, drive measurable ROI, and accelerate innovation across the ecosystem. He breaks down how Market Connect and Investor Connect differ from traditional conference networking, best practices for making the most of those high-value 15-minute meetings, and strategies for effective follow-up that turn introductions into lasting partnerships.
You’ll also hear how HLTH creates an environment that blends serious business with immersive, memorable experiences ensuring that startups, investors, payers, and providers leave with actionable opportunities.
With HLTH 2025 taking place October 19–22 in Las Vegas, this episode is a must-listen for solution providers and innovators looking to maximize their presence and impact at the year’s most influential healthcare event.
Resources:
Take a look at what’s in store at HLTH 2025 - https://hlth.com/events/usa
Attend HLTH using discount code H25_BSV for $250 off the General Attendee ticket - https://hlth.com/events/usa/register/
Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email hkrish@brightspotsventures.com
About Bright Spots Ventures:
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
In this first episode of a special two-part series, Bright Spots in Healthcare host Eric Glazer sits down with Rich Scarfo, President of HLTH, to explore how one of the most influential healthcare events in the world continues to evolve.
With HLTH 2025 taking place this October 19–22 in Las Vegas, Rich reveals what’s new this year—from immersive zones on AI and diagnostics, to physician and nurse engagement programs, to the expanded startup pavilions and Investor Connect opportunities. He also shares a blueprint for payers, providers, pharma, and innovators on how to get the most value out of their time at HLTH, including can’t-miss sessions, networking strategies, and hidden gems across the show floor.
Whether you’re a health plan executive, provider leader, startup founder, or healthcare innovator, this episode offers a practical guide to navigating HLTH 2025 and turning conversations into action.
Stay tuned for Part Two, where the discussion shifts to how HLTH serves as a growth engine for solution providers.
Resources:
Take a look at what’s in store at HLTH 2025 - https://hlth.com/events/usa
Attend HLTH using discount code H25_BSV for $250 off the General Attendee ticket - https://hlth.com/events/usa/register/
Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email hkrish@brightspotsventures.com
About Bright Spots Ventures:
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
In this episode of Bright Spots in Healthcare, we explore The Next Frontier in Self-Funded Benefits. Don Antonucci, CEO of Providence Health Plan and Ali Diab, CEO of Collective Health share how their new partnership is reshaping the employer-sponsored benefits landscape. The conversation dives into:
Why aligning provider and member needs is essential for a truly seamless healthcare experience
How transparency and simplicity can unlock smarter healthcare decisions
The role of innovation and technology in reducing complexity for both employers and employees
How strategic partnerships can accelerate growth and deliver more affordable, high-quality care
This discussion offers practical insights for health plans, employers, and healthcare leaders looking to design benefits that drive satisfaction, savings, and long-term success.
Panelist Bios: https://www.brightspotsinhealthcare.com/events/the-next-frontier-in-self-funded-benefits-inside-providence-health-plans-new-partnership-with-collective-health/
Resources & References Start with Why by Simon Sinek (Book) - https://simonsinek.com/books/start-with-why/
How Great Leaders Inspire Action – TED Talk by Simon Sinek - https://www.ted.com/talks/simon_sinek_how_great_leaders_inspire_action
Healthcare Models to Explore: Kaiser Permanente (U.S.) – cited as effective at integrating coverage and care into one user experience Israel – highlighted as having a national health service with user-friendly, electronic front doors for care and transparency in costs Japan – also noted for its efficient, transparent national health service with easy access and clear financial responsibility for patients
Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email hkrish@brightspotsventures.com About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
In this Bright Spots in Healthcare episode, host Eric Glazer brings together an all-star panel of leaders who are reshaping the future of Medicaid and social care.
Our guests include:
- Laurie Stradley, CEO, Impact Health
- Lori Andrade, EVP, Health Equity Alliance of Long Island (HEALI)
- Joneigh Khaldun, MD, President & CEO, Public Health Accreditation Board (PHAB)
- Evan Jones, Chief Strategy Officer, Vircho
Together, they explore:
- How community-based organizations (CBOs) are evolving into trusted healthcare partners
- Practical strategies for bridging healthcare and social care at scale
- The role of technology, data, and community health workers in building sustainable Medicaid networks
- Real-world success stories—from disaster recovery in North Carolina to integrated care models in New York and beyond
You’ll hear how leaders are overcoming compliance, billing, and operational challenges while keeping people, not just systems, at the center of care.
If you’re looking for bright spots you can replicate to drive innovation, equity, and efficiency in Medicaid, this episode is packed with lessons and inspiration.
Panelist Bios: https://www.brightspotsinhealthcare.com/events/doubling-down-on-medicaid-innovation-in-a-post-obbb-world/
Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://www.brightspotsinhealthcare.com/wp-content/uploads/2025/09/Episode-Guide_Doubling-Down-on-Medicaid-Innovation.pdf
Resources:
2025 HRSN Innovations Learning Lab Conference, Oct. 23-24, 2025, Asheville NC Guided by Impact Health and the WNC Health Policy Initiative, participants will navigate hands-on workshops, build teams through peer networking, and discover practical paths to success beyond Medicaid—all while connecting with trailblazing experts from across the country. Learn more and register here - https://ihorg.jotform.com/251884444887979
Check out PHAB’s new podcast In Service of Health with Dr. Joneigh Khaldun, which explores what it really takes to build healthier communities. Learn more and subscribe here - https://in-service-of-health.podcastpage.io/
Thank you to our Episode Partner, Vircho:
Vircho partners with health plans, Government, and Community Care Hubs to connect healthcare with the social needs that impact health. Their tools make it easier to deliver community-based services efficiently and improve outcomes for the people we all serve.
To learn more, visit https://vircho.com/
Schedule a meeting with Evan Jones, Chief Strategy Officer, Vircho: To dive deeper into how social care networks are optimizing capacity and outcomes, schedule a meeting with Evan Jones. Reach out to hkrish@brightspotsventures.com to schedule the meeting.
About Bright Spots Ventures:
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
What does it really take to challenge the status quo in healthcare, and win? Dr. Imamu “Mu” Tomlinson, CEO of Vituity and author of Less Than One Percent: How Disruptors Defy the Odds, joins host Eric Glazer to share hard-won lessons on leadership, resilience, and breaking barriers.
In this energizing conversation, Mu discusses:
- How to turn “you can’t” into the fuel that drives innovation.
- Why being disagreeable, optimistic, and relentless are the core traits of true disruptors.
- Lessons healthcare can borrow from sports icons like Steph Curry and leaders in entertainment.
- Why moments of victory - not defeat - are the best opportunities to spark lasting change.
You’ll come away with a fresh perspective on leadership, culture, and how to build teams that defy expectations and achieve more.
About Dr. Imamu (Mu) Tomlinson:
Imamu Tomlinson, MD, MBA, is the Chief Executive Officer at Vituity, a physician-led and -owned multispecialty partnership. With decades of clinical leadership and practice management experience, Dr. Tomlinson brings deep operational and clinical knowledge to foster Vituity’s mission to be at the heart of better care.
In his role, Dr. Tomlinson oversees Vituity’s 500+ communities, focusing on clinical and cultural integration, and strategies that improve patient satisfaction and drive operational efficiency. Since his appointment as CEO in 2017, Vituity has doubled its footprint.
Additionally, during his tenure, Dr. Tomlinson formalized two disciplines within Vituity to support improved patient care: an innovation team, including the appointment of the organization’s first Chief Innovation Officer, and a community impact initiative. He also champions physician engagement initiatives, including fellowship programs and innovation grants, to further empower Vituity’s healthcare providers to deliver exceptional care and collaborate across the care continuum.
Prior to Vituity, Dr. Tomlinson was the Chief of Staff for the Adventist Health Central Valley Network, where he continues to practice as an emergency physician. He previously served as Medical Director for Adventist Health's Hanford and Selma Emergency Departments. At Adventist Health, he spearheaded an effort to create the network's Department of Emergency and Diagnostic Medicine and later served as the department’s chair.
Outside of his work at Vituity, Dr. Tomlinson is devoted to making a difference in his local community through the 24/7 Foundation, which works with kids in the Central Valley Youth to inspire mental toughness, athletic competition, and resilience through basketball.
Dr. Tomlinson is the author of Less Than One Percent: How Disruptors Defy the Odds. In this book, he thoughtfully explores the lives of those who dare to defy the odds and disrupt a world of contradictions. Through vivid narratives and deep insights, he reveals powerful strategies for challenging the status quo and driving transformative change.
Order your copy today.
About Bright Spots Ventures:
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
Artificial intelligence is no longer just a buzzword, it’s a practical tool transforming how healthcare organizations prepare for the future. From evaluating and pricing risk with greater accuracy to identifying rising-risk members and strengthening long-term financial strategies, AI is reshaping the very foundations of forecasting in healthcare.
In this episode, leaders from Florida Blue, Premera Blue Cross, Blue Shield of California, and Prealize Health share how they’re applying AI across actuarial, clinical, and data science domains to optimize decisions, improve outcomes, and drive organizational sustainability.
In this episode, you’ll learn:
- How health plans are evaluating and scaling AI models to improve accuracy in forecasting and underwriting
- Real-world examples of AI identifying rising-risk populations and transforming engagement strategies
- Why “next best action” models are becoming central to member engagement and population health
- How generative AI and workflow optimization are streamlining operations and reducing costs
- What it takes to embed AI into financial planning, provider contracting, and long-term ROI strategies
Panelists:
- Romilla Batra, MD, MBA, SVP & Chief Medical Officer, Premera Blue Cross
- Ratnik Gandhi, Senior Director, AI, Florida Blue
- Emily Allred, Senior Director & Actuary, Large Group Pricing, Blue Shield of California
- Dean Noble-Tolla, PhD, Chief Product & Analytics Officer, Prealize Health
Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here.
Learn how AI is already working to close the member engagement gap, transforming intent into impact, personalizing care at scale, and creating the connected experiences members now expect. Leaders from Highmark Health, Ovatient, Cigna, and League share proven strategies, bright spots, and lessons learned in applying AI to drive measurable outcomes, lower costs, and improve the member experience.
In this episode, you’ll learn:
- How AI is turning digital intent into meaningful health actions
- Real-world examples of personalized engagement that improved outcomes and savings
- Why the future of digital health is shifting from mobile-first to AI-first
- What it takes to build a scalable, purpose-built AI platform for healthcare
- How payers and providers can unite around the member with AI-powered engagement
Panelists:
Ian Blunt, VP Advanced Analytics, Highmark Health
Michael Dalton, Founder & CEO, Ovatient
Charles DeShazer, MD, Former Chief Quality Officer, The Cigna Group
Andrew Dubowec, Chief Growth Officer, League
Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here.
Resources
Here’s the podcast Eric Glazer referenced during the show: Acquired/ACQ2 Episode: How is AI Different Than Other Technology Waves? (With Bret Taylor and Clay Bavor), August 18, 2025
Thank you to League for supporting this episode. League is the leading healthcare consumer experience platform, reaching more than 40 million people around the world and delivering the highest level of personalization in the industry. Payers, providers, and consumer health partners build on League’s platform to deliver high-engagement healthcare solutions proven to improve health outcomes. Learn more at www.league.com.
How to Engage: Chat with Us: Share your thoughts with Producer Jessica Tenzer at jtenzer@brightspotsventures.com
With member engagement driving everything from Star Ratings to care gap closures, health plans are rethinking how they connect with members—pairing rich data with human-centered strategies to create real moments of influence.
In this episode, we explore how payers are:
- Combining multiple assessments, social risk data, and AI to build actionable member profiles
- Using empathy-driven outreach and concierge-style service to build trust
- Leveraging real-time insights to engage members at the right moment
- Aligning cross-functional teams to accelerate innovation and close gaps
- Turning clinical, social, and behavioral signals into measurable quality gains
Whether you focus on Stars, Medicaid quality, or member experience, you’ll walk away with practical strategies to engage more effectively and improve outcomes.
Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here.
Download the Episode Notes and KPI’s: Get the moderator notes and the Key Points of Interest from the episode. Download here.
Icario Client Summit Information: Additional details about the Icario Summit - Moments of Influence - taking place October 21-23, 2025, can be found here.
Thank you to Icario for supporting this episode. Icario is a leading health action platform that helps payers connect with members in ways that drive measurable results. By combining behavioral science, data-driven personalization, and omnichannel outreach, Icario motivates members to complete critical health actions—closing gaps in care, improving Star Ratings, and reducing avoidable costs—while delivering an experience that feels relevant, human, and engaging. Learn more at www.icariohealth.com.
How to Engage: Chat with Us: Share your thoughts with Producer Nicole Roberts at nroberts@brightspotsventures.com
With adherence measures playing a major role in Star Ratings, Medicare Advantage plans are rethinking how they engage members—moving beyond transactional reminders to personalized, story-driven content that inspires real behavior change.
In this episode, leaders from Zing Health, Horizon Blue Cross Blue Shield of New Jersey, and SmartStory share how they're using storytelling, data, and behavioral insights to:
- Improve medication adherence and close gaps at scale
- Design culturally relevant, human-centered messaging
- Translate member engagement into measurable Star Rating gains
- Avoid common pitfalls in content strategy and execution
Whether you lead pharmacy, Stars strategy, or member engagement, this discussion offers actionable insights to improve performance heading into the 2026 Star Ratings year.
Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here.
here. Thank you to SmartStory for supporting this episode. SmartStory delivers secure, app-like digital experiences that help health plans improve medication adherence, member satisfaction, and quality performance—without requiring downloads or logins. Learn more at https://www.smartstory.com/
How to Engage: Chat with Us: Share your thoughts with Producer Vekonda Luangaphay at vluangaphay@brightspotsventures.com
Episode Description: In this episode, League, Vori Health, and Fitzroy International unpack how healthcare organizations are rethinking growth, partnerships, and go-to-market strategies in a rapidly shifting environment.
Learn how leading innovators are:
- Designing scalable, digitally enabled experiences to meet evolving consumer expectations
- Adapting sales and billing models amid policy and reimbursement uncertainty
- Attracting long-term, “patient capital” to fuel innovation in mission-driven organizations
From enterprise partnerships to nimble, virtual-first care models, this discussion delivers fresh perspectives and actionable strategies for leaders navigating transformation across health plans, health systems, and digital health.
How to Engage:
- Chat with Us: Share your thoughts with Head of Production Strategy and Operations, Haritha Krishnarathnam at hkrish@brightspotsventures.com
Episode Description: How can healthcare leaders expand access and improve equity at scale without further burdening overstretched systems?
In this Bright Spots in Healthcare episode, senior leaders from leading provider organizations explore how remote-first, tech-enabled primary care models are transforming access for diverse and underserved populations.
Through real-world examples, clinical, innovation, and strategy experts will highlight how they’re leveraging data, team-based care, and smart technology to:
- Expand access to historically marginalized communities
- Improve care continuity and build patient trust
- Reduce avoidable utilization and enhance system efficiency
- Deliver sustainable, equitable outcomes at scale
Panelists:
- Michael Cui, MD, Associate Chief Medical Informatics Officer, Rush University Medical Center
- Amanda Parsons, MD, MBA, Vice President, Clinical Management, Healthfirst
- Emily Young, MBA, President, Tufts Medicine Integrated Network, Tufts Medicine
- Gabriella Lawrence, Senior Director, Clinical Solutioning, TytoCare
Download the Episode Guide: Summarizing key insights and speaker highlights, this guide is your companion to the discussion. Download it to follow along and take away actionable strategies.
Thank you to TytoCare for supporting this episode. TytoCare is transforming primary care with a smart, remote-first approach that connects patients and clinicians to deliver equitable, efficient healthcare, anytime, anywhere. Learn more here: https://www.tytocare.com
How to Engage:
- Chat with Us: Share your thoughts with Producer Jessica Tenzer at jtenzer@brightspotsventures.com
Episode Description: In this episode, Atlantic Health System, Intermountain Health, and Navina explore how AI is transforming value-based care by boosting financial resilience and improving outcomes.
Learn how these organizations are:
- Enhancing risk adjustment and closing care gaps
- Reducing administrative burden through AI-augmented workflows
- Equipping teams with real-time insights to drive performance under VBC models
From virtual medical assistants to smarter financial planning, this discussion offers actionable strategies for leaders across clinical, operational, and financial roles.
Download the Episode Guide: Summarizing key insights and speaker highlights, this guide is your companion to the discussion. Download it to follow along and take away actionable strategies.
Thank you to Navina for supporting this episode. Navina helps physicians thrive in value-based care with an AI-powered platform that turns data into actionable clinical insights. Learn how they’re enabling smarter decisions, better care, and less burnout at www.navina.ai.
How to Engage:
- Chat with Us: Share your thoughts with Producer Vekonda Luangaphay at vluangaphay@brightspotsventures.com
Scaling AI across a healthcare system takes more than just good technology—it requires effective governance, operational focus, and the right data foundation.
In Part 2 of our conversation with Kiran Mysore, Chief Data & Analytics Officer at Sutter Health, he explores how Sutter is operationalizing AI across its 24 hospitals and hundreds of care sites.
You’ll hear:
- How the AI Council—a cross-functional governance body—ensures alignment, safety, and momentum
- What makes the “Sutter Navigator” platform a game-changer for operational visibility
- Why “speed of business” and “speed of foundation” must be balanced to move fast and responsibly
- How Sutter is applying lessons from finance and retail to transform healthcare
This episode is a masterclass in AI implementation at scale—perfect for health system leaders, innovators, and data executives alike.
About Kiran
Kiran is the Chief Data Analytics Officer at Sutter Health, a leading not-for-profit healthcare network in America. With over 25 years of experience, Kiran has been instrumental in driving digital transformation and leveraging data and AI to generate business value across various sectors, including healthcare, technology, and consulting.
Before joining Sutter Health in September 2023, Kiran held significant roles at prestigious organizations such as Medtronic, GE, Apple, and St. Jude Medical. His expertise includes optimizing operations, developing real-time insights, and modernizing technology infrastructures. Known for his commitment to fostering data-driven cultures and championing diversity and ethical practices in data, Kiran’s leadership at Sutter Health focuses on making data and insights meaningful to improve healthcare outcomes, operational efficiency, and patient care. His work exemplifies the transformative power of technology in advancing healthcare.
About Bright Spots Ventures
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
How can health systems move from AI experimentation to AI execution at scale, without losing sight of what matters most: patients and providers?
In this two-part episode of Bright Spots in Healthcare, Kiran Mysore, Chief Data and Analytics Officer at Sutter Health, joins host Eric Glazer to explore how Sutter is turning the promise of AI into measurable impact.
In Part 1, Kiran Mysore, Chief Data & Analytics Officer at Sutter Health, shares how his team is building clinical AI solutions that actually work—because they’re built with empathy, trust, and a clear focus on impact.
He walks us through:
- The strategic approach Sutter takes to choosing AI use cases
- How the team launched an ambient documentation program that reduced charting time by up to 30%
- The keys to earning clinician trust and enabling adoption
- Why ROI isn't always about dollars—but about doing the right thing for providers and patients
Whether you’re just starting your AI journey or looking to scale, this episode offers lessons on building a human-centered AI strategy that providers will actually embrace.
About Bright Spots Ventures
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
Brindha Sridhar, Vice President, Customer Experience Strategy, MetroPlusHealth, discusses how one of New York City’s largest public health plans is transforming the healthcare experience for its diverse and underserved populations. Brindha shares how her team is working to improve member and provider engagement across a city where 90% of members are Medicaid beneficiaries and 30% report a preferred language other than English.
Brindha dives into initiatives aimed at addressing care disparities, including multilingual communication strategies, culturally aligned member onboarding, and integrated provider support. She also outlines how MetroPlusHealth is using real-time member feedback to fuel continuous improvement and why building a high-touch, relationship-driven experience, especially for vulnerable communities, requires both systemic change and frontline empathy.
This conversation offers practical ideas and replicable strategies for any health plan seeking to improve equity, access, and engagement.
This session was recorded as part of the Healthcare Engagement Virtual Summit: Strategies for Plans to Engage Consumers and Providers on May 8, 2025, co-sponsored by Bright Spots in Healthcare, TytoCare and Navina.
For more information on the summit and to see the full video, please go to: https://www.tytocare.com/virtual-summit-healthcare-engagement-strategies-for-plans-to-engage-consumers-and-providers/
About Bright Spots Ventures
Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.
We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
In this insightful episode, Kim Barrus, AVP of Quality and Accreditation at Select Health, shares three compelling case studies showcasing how her team is improving care access, streamlining provider engagement, and addressing health disparities across four states.
Kim walks us through:
- A groundbreaking hybrid clinic model in rural Nevada, created in partnership with the city of Wells and Intermountain Health, to bring primary, urgent, and behavioral care to medically underserved communities.
- The development of Select Health’s Quality Provider Plus Program, which consolidates risk adjustment and quality initiatives into a unified, less burdensome experience for provider partners—improving data sharing, reporting, and overall engagement.
- A remote blood pressure monitoring initiative targeting rural members with hypertension, using disparity analytics to identify high-need populations and improve outcomes through education, mailed BP cuffs, and clinician collaboration.
If you're exploring ways to improve access to care, streamline provider relationships, and address social and geographic health disparities—this session is a must-listen.
This session was part of the the Healthcare Engagement Virtual Summit: Strategies for Plans to Engage Consumers and Providers on May 8, 2025, co-sponsored by Bright Spots in Healthcare, TytoCare and Navina.
For more information on the summit and to see the full video, please go to: https://www.tytocare.com/virtual-summit-healthcare-engagement-strategies-for-plans-to-engage-consumers-and-providers/
In this episode of Bright Spots in Healthcare, host Eric Glazer explores how leading healthcare organizations are transforming specialty care in Medicare Advantage through physician leadership and AI innovation. Hear from Julia McDowell (Highmark Health), Chuck Palermo (HAP), Dr. Mary O’Connor (Vori Health), and Dr. Krystal Revai (Health Alliance) as they share pragmatic strategies for improving care quality, enhancing member engagement, reducing administrative burden, and delivering meaningful clinical outcomes. Discover how AI is being used to streamline prior authorization, enable real-time gap closure, personalize care management, and deepen shared decision-making between providers and patients.
Thank you to Vori Health for supporting this episode. Vori Health is the only nationwide MSK medical practice with doctor-led care teams – driving better outcomes. Vori helps with pain reduction in MSK issues, through their holistic approach, and by creating a personalized treatment plan from the convenience of your own home through their virtual-first platform. Their doctor-led team tailors care programs to reduce surgery by as much as 78%, avoiding pain, imaging, and injections and saving your organization the cost burden of unnecessary surgeries and increasing productivity. And all from the comfort of home! Vori is on a mission to empower humanity to lead a healthier life. Visit them at www.vorihealth.com/
In this standout episode, three healthcare leaders unpack how they're transforming regulatory pressure into real-world impact. Melissa Skelton Duke (Banner Health), Dina Homer (HealthTeam Advantage), and Bita Farrokhroo (MedWatchers) share practical strategies for driving medication adherence, optimizing Part D performance, and bridging digital and cultural gaps to better serve diverse member populations. Learn how Banner is reframing adherence through member empathy, how HealthTeam Advantage aligns every employee to Stars performance, and how MedWatchers is consolidating fragmented workflows for a 29% lift in gap closure. With an NPS of 93, this is one of our highest-rated episodes in over 11 years.
Download the Episode Guide: We’re piloting a brand-new Episode Guide summarizing key insights and speaker highlights. Download the Guide to follow along and deepen your understanding of today’s discussion.
Thank you to MedWatchers for supporting this episode. With 180 pharmacists on staff, they’re a trusted clinical partner to more than 300 health plan contracts—delivering over 2.7 million pharmacist-led interventions annually across Medicare, Medicaid, and Commercial populations. Learn how they’re helping plans improve adherence, reduce readmissions, and scale Stars-aligned strategies at www.medwatchers.com.
In this engaging session, Eric Glazer sits down with Jessica Vander Zanden, VP of Operations at Network Health, a Wisconsin-based plan known for its top-tier CMS ratings and commitment to exceptional provider and member experiences. Jessica shares two standout strategies driving the organization’s success: a unique approach to treating providers as valued customers and transforming their call center into a powerful engine for improving CAHPS and Star Ratings. Discover how Network Health redefines healthcare engagement through operational excellence, provider partnership, and member-centric service design.
This session was part of the the Healthcare Engagement Virtual Summit: Strategies for Plans to Engage Consumers and Providers on May 8, 2025, co-sponsored by Bright Spots in Healthcare, TytoCare and Navina.
For more information on the summit and to see the full video, please go to: https://www.tytocare.com/virtual-summit-healthcare-engagement-strategies-for-plans-to-engage-consumers-and-providers/
The most powerful person in the world is the storyteller. Steve Jobs believed this, and it's never been more accurate, especially in healthcare.
Renowned storytelling expert Craig Wortmann—Professor at Northwestern’s Kellogg School of Management and CEO of Sales Engine joins Eric Glazer to discuss one of the most underutilized leadership tools in healthcare: storytelling.
During the episode, Craig shares a practical framework—Collect, Categorize, Construct, Convey—to help healthcare leaders use storytelling to drive action, inspire change, and connect more deeply with teams and stakeholders.
You’ll learn:
- Why stories persuade better than data
- The four types of stories every leader should tell
- How to embed storytelling into your leadership routine
Plus, Craig explains how failure stories can actually build trust—and why storytelling is a leadership discipline, not just an art.
About Craig
One of the most respected voices in storytelling and leadership, Craig Wortmann is an award-winning educator, three-time entrepreneur, author and CEO. Craig is also Clinical Professor of Innovation & Entrepreneurship at Northwestern’s Kellogg School of Management and the Founder & Academic Director of the Kellogg Sales Institute.
He founded Sales Engine, a tools and services firm founded on the principle that leaders should treat sales as the engine of their business, in 2009. Craig and his team consult to the world’s largest and most successful companies, as well as some of the world’s fastest-growing entrepreneurial companies.
Craig is author of What’s Your Story™? a book that helps people tell the right story at the right time for the right reasons. You can learn more about Craig here: https://www.linkedin.com/in/craigwortmann/
About Bright Spots in Healthcare
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
Visionary healthcare leaders from The Permanente Medical Group, UC Davis Health, UNC Health, Summit Medical Group and Navina joined Eric Glazer to explore how artificial intelligence transforms clinical workflows and enables better value-based care.
Discover how AI-driven chart prep, ambient scribe technology, and risk models streamline provider workflows, improve patient outcomes, and reduce clinician burnout. From overcoming implementation roadblocks to building cross-functional frameworks that promote trust and equity, this episode is packed with strategic insights and real-world success stories you can apply at your organization.
Panelists Include:
- Brian Hoberman, MD, EVP & CIO, The Permanente Medical Group
- Reshma Gupta, MD, Chief of Population Health and Accountable Care, UC Davis Health
- Ram Rimel, Manager of Data Science Engineering, UNC Health
- Eric Penniman, D.O. Executive Medical Director, Summit Medical Group
- Dana McCalley, VP of Value-Based Care, Navina
https://www.brightspotsinhealthcare.com/events/the-new-physician-playbook-ai-workflows-value-based-care-in-action/#url
This episode is sponsored by Navina Navina is the clinician-first AI copilot for value-based care. Recently named Best in KLAS for clinician digital workflows, Navina turns fragmented patient data into actionable clinical insights right at the point of care. Natively integrated into the clinical workflow, their AI copilot helps improve risk adjustment, quality metrics, and population health – while significantly easing the administrative burden. Navina has earned the trust of more than 10,000 clinicians and care team members across 1,300 clinics, from some of the leading value-based care organizations in the country like Privia Health, Agilon Health, and Millennium Physician Group.
About Bright Spots in Healthcare
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
As CMS regulations shift, how can you continue to impact complex members? Join us as we explore innovative approaches to member engagement that drive better health outcomes and reduce costs. In this episode, we will hear how plans are leveraging social support, in-home care, and tailored services to reach vulnerable members. Don’t miss this timely conversation: hear how you can be reaching the unreachable and personalizing Medicare engagement in a shifting CMS landscape.
Panelists:
Sheila Yahyazadeh, Chief External Operations Officer, CareFirst Community Health Plan Maryland
Eve Gelb, Chief Innovation Officer, Gold Coast Health Plan
Andrew Parker, Founder & CEO, Papa
This episode is sponsored by Papa:
Papa is your trusted partner in the home. Since 2017, its vetted Papa Pals has completed millions of companion care visits across 7,300 cities — 10x that of Lyft. Papa Pals come from the same communities as the members they serve, build trust in person, and provide tailored support proven to reduce hospitalizations and emergency department visits, increase preventive care trends, and lower costs. But that’s not all Papa Pals do... As an extension of your care team in the home, Papa Pals can now conduct in-home assessments, educate and help members learn new skills, like digital health literacy, and so much more.
Visit papa.com to learn more.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
Welcome to the debut episode of Executive Briefs—a new short-form series from Bright Spots in Healthcare designed to deliver fast, actionable insights for healthcare leaders.
In under 10 minutes, host Eric Glazer shares 10 powerful storytelling takeaways from bestselling author Michael Lewis (Moneyball, The Big Short, The Blind Side) from his keynote address at League Connect 2025.
Whether you're a health plan executive, provider leader, or innovator in digital health, these tips will help you better engage your team, inspire change, and drive results.
Takeaways 00:50 – Why Michael Lewis and storytelling matter to healthcare leaders 01:42 – 1: Start with a question 02:15 – 2: Stories are about people 02:45 – 3: Good characters are great teachers 03:18 – 4: Find a fresh angle 03:55 – 5: Make data emotional 04:30 – 6: Tension drives the narrative 05:10 – 7: Keep it moving 05:50 – 8: Authenticity over polish 06:25 – 9: End with meaning 07:00 – 10: Tell stories that move people 08:10 – How leaders can apply these lesson
🔗Register for the League Connect Digital Summit 2025 on May 7 at https://connect.league.com/digital-summit/ to see the Michael Lewis keynote.
Learn more about League’s digital-first healthcare platform: https://league.com
About Bright Spots in Healthcare
Bright Spots in Healthcare spotlights real-world “bright spots” from health plans and providers to help leaders scale innovation and drive measurable improvement. We believe that finding and replicating bright spots is the most effective strategy to improve healthcare in our lifetime. Produced by Bright Spots Ventures. Learn more: brightspotsinhealthcare.com.
Traditional approaches to closing care gaps in Medicare Advantage often fail to reach the members who need it most. This episode goes beyond conventional strategies to explore how innovative, remote, and community-driven solutions are transforming chronic care management—particularly for cardiometabolic conditions like diabetes, hypertension, and heart disease. Learn how health plans are leveraging proactive outreach, virtual engagement, and data-driven interventions to improve HEDIS scores, boost Star Ratings, and drive better long-term outcomes. Through real-world case studies and expert insights, we’ll uncover scalable, cost-effective approaches that enhance care access, reduce avoidable hospitalizations, and deliver measurable impact for both members and plans.
Panelists:
Michael Harris, CEO, HealPros
Tejaswita Karve, Ph.D. - Healthcare Quality and Innovation Leader, Stars Leader, Mass General Brigham Health Plan
Mike Rapach, SVP Government Programs, President & CEO, CareFirst Community Health Plan Maryland
Daniel Weaver, SVP Stars and Quality, Zing Health
Bios: https://www.brightspotsinhealthcare.com/podcast-episodes/
This episode is sponsored by HealPros:
HealPros helps health plans find and address missed care opportunities in member’s homes, at events in their communities, and remotely. Our team specializes in helping polychronic members access the care they need, from anywhere. HealPros’ Care Access Pros completed over 70,000 in-home visits in 2024 and is committed to engaging even more members in 2025 - including those that are hard-to-reach – as we work towards our vision of transforming millions of live each year. Our Care Connection Specialists make over 4,000,000 calls to members each year. With a sophisticated logistics operation, national footprint, and national network of providers, HealPros is available to work in all 50 states and the US Virgin Islands. For more information, visit www.healpros.com.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
What if AI could guide every patient through their healthcare journey—nudging them toward better choices, anticipating their needs, and adapting in real time?
We talk a lot about engagement in healthcare, but too often, the digital tools we use fail to improve outcomes. AI and data-driven personalization hold incredible promise, yet many health plans and providers still struggle with low participation rates.
Dr. Erich Huang, Associate Chief Clinical Officer for Informatics and Technology at Verily, an Alphabet company leading the charge in precision health, joins Eric to discuss what’s next for AI in healthcare. The conversation touches on how AI is redefining patient engagement, the delicate balance between automation and human touch, and how platforms like Verily’s Lightpath are pioneering a new model for chronic care management.
If you’re a health plan or hospital leader looking to unlock the next generation of patient engagement, you won’t want to miss this conversation.
About Erich
Erich leads a team focused on structuring clinical-grade data that integrates with the clinical research and healthcare data ecosystems and is optimized for precision medicine, analysis, and artificial intelligence.
Erich was previously at Duke University where he served as the Chief Data Officer for Quality at Duke Health, Director of Duke Forge, Director of Duke Crucible, and Assistant Dean for Biomedical Informatics for Duke University School of Medicine. There, he led and deployed machine learning capabilities for complex care management in Duke Health’s Accountable Care Organization, led health data science initiatives, and helped develop Duke Health’s new institutional governance process for algorithmic decision support.
He earned his MD and PhD from Duke University, trained and was a Chief Resident in the Duke General Surgery Residency Program. Erich is previously a Burroughs Wellcome Fund Innovations in Regulatory Science Award recipient, received a Sidney Kimmel Cancer Research Foundation Translational Scholar Award, and is twice a recipient of an IBM Faculty Award.
About Verily
Verily is an Alphabet health technology company focused on research, care, and health financing to deliver on the promise of precision health and help people live healthier lives. We are uniquely positioned at the intersection of technology, data science, and healthcare to create tools to accelerate evidence generation, products to enable more personalized care, and approaches to make costs more predictable.
What if your health plan’s biggest opportunity to improve outcomes wasn’t in a hospital or clinic—but in a home, a grocery store, or a child’s support system?
Mark Rakowski, President of Chorus Community Health Plans (CCHP) and Senior Vice President of Children's Wisconsin, joins Eric to explore the plan’s innovative approach to social determinants of health.
From its Housing Navigator Program and Foodsmart initiative to its groundbreaking mental health strategy, CCHP is driving better health, lowering costs, and achieving remarkable results—including a 70% treatment adherence rate among Medicaid members.
If you’re a healthcare leader looking for scalable, high-impact strategies to address social determinants of health and improve member outcomes, this episode is a must-listen!
About CCHP
Chorus Community Health Plans, which is owned by Children’s Wisconsin – the state’s only health care system dedicated 100% to children and teens, is focused on improving the health and well-being of its members by providing access to a broad network of health services and providers, as well as prevention programs. CCHP is the second-largest Medicaid health plan in the state. The plan serves 150,000 Medicaid members in 28 counties in eastern Wisconsin. In 2017, CCHP began offering individual and family plans in the Marketplace in southeastern Wisconsin, and the plan has now expanded to 15 counties in eastern Wisconsin, covering 15,000 members in 2022.
About Mark
Mark is responsible for the health plan's overall operation. He directs the development of strategies and budgets, negotiates contracts and ensures compliance. In addition to these roles, Mark oversees the contractual relationship with the Wisconsin Department of Health Services and monitors and influences state and local healthcare policy.
Mark is also actively involved in the Children’s Wisconsin strategic plan to improve children’s health in Wisconsin. The plan focuses on increasing access to preventive services, addressing social drivers of health, and partnering with providers to improve care coordination.
Mark joined Children’s Wisconsin and the CCHP team in 1999 as director of managed care.
Before that, he had 11 years of experience in healthcare-managed care roles. Mark earned a bachelor’s degree in finance from the University of Wisconsin–Whitewater and a master’s in accounting from the University of Wisconsin – Milwaukee.
In 2010, Mark was recognized as a notable health care hero by BizTimes Milwaukee, which was an advancement in healthcare.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
What if I told you that in 2025, the way we access and exchange healthcare data will be fundamentally different?
For years, we've talked about interoperability—but now, we’re seeing it take shape. Nearly 40% of the CommonWell network and most Q-HINs are responding to patient access requests, opening the door to a new era of seamless, secure, and patient-driven data exchange.
Paul L. Wilder, Executive Director of CommonWell Health Alliance, joins Eric to explore the future of healthcare data and the evolving landscape of healthcare interoperability. Learn about the CommonWell Marketplace, how patient access to data is improving, the increasing role of FHIR, and the critical aspects of trust and AI in healthcare. Paul provides key insights to help you and your organization position yourself for success.
This episode was recorded live at ViVE 2025 in Nashville.
About CommonWell
CommonWell is a not-for-profit interoperability advocate and Qualified Health Information Network under the Trusted Exchange Framework and Common Agreement (TEFCA), which facilitates the secure exchange of patient data across more than 36,000 provider sites, representing over 238 million individuals nationwide. CommonWell has enabled the exchange of more than 7.7 billion healthcare records. Visit https://www.commonwellalliance.org/.
About Paul
Paul is leading the organization as it enters a new chapter in its pursuit of empowering clinicians, practitioners and individuals with interoperability services via its robust, nationwide network. With more than two decades of experience in health IT, Paul has held various roles focusing on imaging, clinical informatics, and interoperability.
Before joining CommonWell, Paul was Vice President of Strategy & Business Development for Philips Interoperability Solutions. He also spent close to 10 years with one of the largest regional HIE networks in the world, the New York eHealth Collaborative (NYeC)—serving as its Chief Information Officer, Vice President of Product Management and Program Director for NYeC’s Regional Extension Center. During his time with the NYeC, he helped nearly 10,000 primary care providers attest to Meaningful Use and solidified the state’s status as one of the national leaders in health IT adoption. Each role enabled him to work and hear directly from providers and end-users of Electronic Health Records (EHRs)—which gives him an important perspective as a leader in health IT adoption and execution.
Paul received his Master of Business Administration from New York University, with a concentration in Finance and Operations. He also holds two bachelor’s degrees from the University of Pennsylvania: one from the College of Arts and Sciences in Economics and the other from the School of Engineering and Applied Science in Biomedical Science. Paul lives in the New York area with his wife, two daughters and their newest family member, their dog Penny.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
Highmark Health, Mass General Brigham Health Plan, SCAN, and TytoCare leaders discuss strategies for creating innovative, high-impact healthcare products.
Tune in to learn:
- How traditional health plans are rethinking product design in the face of growing competition from direct-to-consumer models
- Strategies for creating more personalized, flexible, and transparent offerings that resonate with today’s healthcare consumers
- The role of data, technology, and innovation in modernizing health insurance products
- Real-world success stories from leading organizations who are successfully navigating this evolving market
Panelists:
- Maria Baker, VP, Health Strategy & Delivery, Highmark Health
- Lena Perelman, VP, Medicare Product Operations, SCAN Health Plan
- Roni Mansur, Vice President of Product Management, Mass General Brigham Health Plan
- Suzi Pigg, Vice President, Payers, TytoCare
https://www.brightspotsinhealthcare.com/events/innovating-product-design-for-growth-and-member-engagement/
This episode is sponsored by TytoCare:
TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are six times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for the successful deployment and adoption of the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 250 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
Health plan leaders from Cambia Health Solutions, Highmark Health and League share strategies for driving consumer engagement, improving health outcomes, and optimizing payer-provider relationships. Learn how health plans can shift from broad segmentation strategies to truly personalized, member-centric healthcare by harnessing data, AI, and digital transformation.
Learn how health plans are using AI-driven insights to deliver tailored interventions.
📈 Discover how personalization can enhance member satisfaction and retention.
🔍 Hear real-world examples of digital transformation in action.
Panelists:
Karen Hanlon, EVP & COO, Highmark Health
Laurent Rotival (EVP & CIO, Cambia Health Solutions)
Michael Serbinis, Founder & CEO, League
Bios: https://www.brightspotsinhealthcare.com/podcast-episodes/
This episode is sponsored by League:
Founded in 2014, League is the leading healthcare consumer experience platform, reaching more than 20 million people worldwide and delivering the highest level of personalization in the industry. Payers, providers, and consumer health partners build on League’s platform to deliver high-engagement healthcare solutions that improve health outcomes. To date, League has raised $235 million in venture capital funding, powering the digital experiences for some of healthcare’s most trusted brands, including Highmark Health, Manulife, Medibank, and Shoppers Drug Mart.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
Top healthcare leaders from HAP, Independent Health, Johns Hopkins Health Plans and Prealize Health explore how predictive analytics and artificial intelligence (AI) revolutionize risk management and care delivery. The discussion delves into real-world applications of AI-driven predictive analytics to enhance patient engagement, improve outcomes, and reduce costs.
Learn how leading health plans use AI to identify high-risk populations earlier, optimize care pathways, and improve patient outcomes. If you’re interested in the future of healthcare innovation, this is a must-listen!
Key Takeaways:
- How health plans are leveraging AI to transition from segmentation to personalization
- The role of unified data lakes in driving insights and improving member experiences
- Real-world examples of AI in chronic disease management, risk stratification, and end-of-life care
- The power of AI-driven predictive models in enhancing underwriting accuracy
- How Generative AI is transforming customer service and operational efficiency
Our expert panel includes: Bethany McAleer – Chief Actuary & Chief Analytics Officer, Johns Hopkins Health Plan Amin Serehali – SVP & Chief Data & Analytics Officer, Independent Health Mike Treash – SVP & COO, Health Alliance Plan Dean Noble-Tolla – Chief Product Analytics Officer, Prealize Health
https://www.brightspotsinhealthcare.com/events/predictive-analytics-proactive-healthcare-leveraging-ai-to-transform-risk-management-and-care-management/
This episode is sponsored by Prealize Health
Founded by two industry thought leaders from Stanford University and through continuous partnership with Stanford, Prealize is a leading provider of AI-driven predictive analytics and insights to health plans, specialty care management companies, healthcare technology companies, employers, and providers across the nation. Committed to transforming healthcare from reactive to proactive, reducing healthcare costs and enabling more people to live healthier lives, Prealize and its partners positively influence the health trajectory of millions of people. www.prealizehealth.com
Marc Willard, CEO, Icario, joins Eric to discuss Icario’s new, innovative platform and how it improves member engagement and health outcomes. The conversation also touches on the challenges health plans face in adapting to changing member needs, the importance of data integration and organization, and the potential impact of AI-driven solutions on healthcare delivery and cost reduction.
Here are some key takeaways from the conversation:
The Power of Personalization – Health plans are lagging in using AI and data-driven insights to create truly personalized member experiences. Icario’s approach focuses on knowing the member through data to improve engagement and outcomes.
Beyond Transactions to Long-Term Engagement – Many health plans operate in silos, leading to disconnected member experiences. Icario’s platform shifts from one-time interactions to continuous, AI-driven engagement that adapts to member behaviors and preferences.
Smart Outreach Strategies – Effective member engagement requires understanding preferences (text, email, phone, or mobile apps), timing communication to when members are most responsive, and avoiding member abrasion through excessive outreach.
Leveraging AI and Machine Learning – Icario’s new platform, Aivella, goes beyond rules-based engines to incorporate machine learning. Based on member responses, it dynamically adjusts outreach strategies in real time.
About Marc
Marc Willard is responsible for Icario’s overall strategy, growth, and operations. Marc has over three decades of experience leading digital transformation and technology in the digital health sector. Marc is passionate about improving lives with industry-leading, cloud-first digital health platforms.
Marc brings a unique and highly relevant set of abilities, operational experiences, and industry relationships to Icario at the perfect time in the company’s development. Before joining Icario, Marc founded Certify, where he pioneered the first cloud-based data and interoperability platform connecting providers and payors at scale. Marc founded Transcend Insights at Humana, the merger of three Humana acquisitions, including Certify. Transcend developed and launched an innovative cloud-based population health platform. At Humana Corp, as SVP, he led all member, patient, and provider digital engagement initiatives. These initiatives were focused on data and analytics to improve care delivery and quality and lower healthcare costs. In addition, Marc holds several board member positions.
Marc studied Electronic Engineering at Farnborough College of Technology and in classic entrepreneurial style, left to focus on his first start-up. Outside work, he enjoys spending time with his wife and family, collecting classic cars, and being on the water. He also mentors entrepreneurs while supporting the start-up community, which he finds very rewarding.
Find Marc on LinkedIn: https://www.linkedin.com/in/marcwillard/
About Icario
Icario serves health plans using robust whole-person data, predictive behavioral science, and a proprietary engagement platform to offer personalized experiences that meet members where they are in their health journey. Icario combines the industry's largest member data repository with unparalleled industry expertise to implement health action programs that deliver personalized member engagement, reduce abrasion and encourage positive health behaviors. Visit Icariohealth.com.
Follow Bright Spots in Healthcare on LinkedIn: https://www.linkedin.com/company/shared-purpose-connect/
Check our YouTube page: https://www.youtube.com/@BrightSpotsinHealthcare
Ted Rath, former VP of Player Performance for the Philadelphia Eagles and two-time “NFL Strength and Conditioning Coach of the Year,” joins Eric to share the most effective approaches to creating a Super Bowl contender in the NFL and provide insights on goal setting, mindset shifts, and building sustainable habits. These lessons can be applied directly to your approach to lifestyle modification programs and value-based care strategies.
Links:
Extreme Ownership: How U.S. Navy SEALs Lead and Win by Jocko Willink
Beyond Comfort, Master a Growth Mindset with Excellence through Urgency
Ted Rath's YouTube Channel
Atomic Habits by James Clear
tedrath.com
About Ted Rath
Ted Rath is the author of Beyond Comfort, Master a Growth Mindset with Excellence through Urgency and the former Vice President of Player Performance for the Philadelphia Eagles.
He has two decades of experience working with athletes, almost all of them in the NFL …his resume beyond the Eagles job includes the LA Rams, Miami Dolphins, Detroit Lions and his alma mater, the University of Toledo.
Rath was voted “NFL Strength and Conditioning Coach of the Year” not once but twice and was elected as the inaugural President to represent the Professional Football Performance Coaches Association (PFPCA) in early 2023. Before Detroit, Rath was an Assistant Strength and Conditioning Coach at The University of Toledo, where he directed the strength and conditioning programs for all fifteen of the school’s Olympic sports.
Richard Feifer, MD, Chief Medical Officer of InnovAge, joins Eric to explore the transformative potential of the PACE (Program of All-Inclusive Care for the Elderly) model. Richard shares compelling stories and strategies showcasing how PACE integrates medical, physical, social, and emotional care to improve outcomes for seniors and individuals with complex needs.
Listeners will gain insights into:
- The unique interdisciplinary care team (IDT) approach and how it delivers personalized, efficient care.
- Innovations in reducing hospitalizations and shifting care to home-based settings.
- Lessons on advanced care planning and end-of-life support that prioritize patient goals. Operational strategies for managing costs while maintaining exceptional patient experiences.
Richard explores the economic and practical sustainability of the PACE model, providing actionable insights for healthcare leaders aiming to replicate its success.
Link to DC Bipartisan Report on PACE mentioned in podcast: https://bipartisanpolicy.org/press-release/improving-access-to-and-enrollment-in-programs-of-all-inclusive-care-for-the-elderly-pace/
About Richard
As a physician executive with broad healthcare industry experience, Dr. Richard Feifer helps organizations achieve their fullest potential in an ever-changing environment. Rich is a board-certified internist with clinical experience in primary care, geriatrics, and urgent care medicine. As a health system leader, he has also developed expertise in population health management, value-based payment models, clinical analytics, and technology-driven healthcare transformation.
Rich has dedicated his career to improving the quality and efficiency of healthcare and the health of populations he has served. Most recently, as executive vice president and chief medical officer of Genesis HealthCare, he led one of the nation's largest skilled nursing and long-term care providers, operating over 400 facilities in 25 states in 2019. As president of Genesis Physician Services, a Genesis subsidiary with over 450 physicians, nurse practitioners, and physician assistants in 2019, he navigated the successful transition to value-based care delivery. In that capacity, he also launched and served as chief medical officer of the only national accountable care organization focused on nursing home residents, LTC ACO.
Prior to joining Genesis, Rich was Aetna’s chief medical officer of National Accounts, leading the department of Clinical Consulting, Strategy, and Analysis, which helped large employers improve the health and productivity of their employees and dependents. Before Aetna, Rich served as vice president of Clinical Program Innovation and Evaluation at Medco, where he was responsible for the organization’s portfolio of care enhancement programs.
A graduate of Brown University and the University of Pennsylvania School of Medicine, Rich received his master’s in health services management from Columbia University. He is an assistant clinical professor at the University of Connecticut and a board member of the Accreditation Commission on Health Care.
About InnovAge
Our passion and mission is to help frail seniors age in their own homes with dignity. InnovAge has done this through PACE for more than 30 years.
As the largest provider of the Program of All-inclusive Care for the Elderly (PACE) based on participants served, InnovAge is dedicated to expanding this successful program to serve as many seniors as possible nationwide. In some communities, like Philadelphia, PACE is known as Living Independence for the Elderly.
With InnovAge's Program of All-inclusive Care for the Elderly (PACE), older individuals have a team of healthcare professionals focused on providing all the connected care they need. This helps seniors live at home for as long as possible, instead of going to a nursing home or other care facility.
Kenneth Harper, VP & GM of Dragon at Microsoft, joins Eric to discuss how health systems are deploying AI to help busy clinicians. He explains how Microsoft’s AI tool, DAX Copilot, improves access to care by streamlining administrative tasks and lightening clinicians' documentation workloads. Ken shares several examples of health systems successfully using the tool with positive results. The conversation also covers overcoming implementation challenges, including clinician adoption and the future of AI in healthcare.
About Kenn
Kenn Harper has been working in the conversational AI industry for 15+ years, helping to shape virtual assistant solutions across mobile phones, TV’s, cars, wearables, robotics, and most recently healthcare systems. He is currently responsible for running the Healthcare Virtual Assistant business at Dragon, a divisionof Microsoft ( formerly Nuance), which leverages an advanced suite of technologies combined with purpose-built hardware to streamline interactions with the EHR and creation of clinical documentation, allowing physicians to remain 100% focused on the patient without technology getting in the way. Kenn holds a B.S. in human factors engineering from Cornell University and a M.S. in human factors from Bentley University
About DAX Copilot
Serving as an AI assistant for automated clinical documentation, the Dragon Ambient eXperience (DAX) Copilot solution enables physicians to do more with less and improve clinical efficiency, physician and patient satisfaction and financial outcomes. Amplified by the power and scale of the Microsoft Cloud for Healthcare, it combines Nuance’s proven conversational and ambient AI with the newest and most capable generative AI model.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
Michael Serbinis, CEO and Founder of League, sits down with Eric to for a compelling discussion on how digital innovation is reshaping healthcare.
Discover how League’s platform empowers health plans like Highmark to deliver personalized, data-driven experiences that simplify navigation, improve engagement, and enhance member satisfaction. Mike shares fascinating insights on:
- The power of a unified digital front door for healthcare consumers
- Real-world examples of how League amplifies care access and reduces costs
- The role of personalization in creating Amazon-like experiences for healthcare
Mike also reflects on lessons from his entrepreneurial journey, including his time working with Elon Musk and how it inspired his vision to transform healthcare.
Listen in for actionable strategies on leveraging technology to meet evolving consumer expectations and drive better outcomes.
About Mike
Michael Serbinis founded League in 2014. League accelerates the digital transformation of the healthcare consumer experience (CX). Serbinis has led the company since its inception, raising over $235 million in funding and driving exponential growth as League powers healthcare’s biggest brands.
Mike has had a long and distinguished career as a serial entrepreneur, rocket scientist, engineer and investor. Most recently, Serbinis was the founder and CEO of Kobo, a digital reading company that rivals Amazon’s Kindle worldwide. Before that, he founded cloud storage pioneer DocSpace and then built Critical Path, a messaging service that handled one-third of the world’s email. Serbinis is also Chair of the Board of Directors for the Perimeter Institute, the world’s leading center for scientific research in theoretical physics.
Now, as the CEO of League, Serbinis is focused on healthcare transformation. Payers, providers and pharmacy retailers build on the League platform to accelerate digital transformation and deliver high-engagement, personalized digital experiences. Millions worldwide use and love solutions powered by League to access, navigate and pay for care.
About League
Founded in 2014, League is the leading healthcare consumer experience platform, reaching more than 20 million people around the world and delivering the highest level of personalization in the industry. Payers, providers, and consumer health partners build on League’s platform to deliver high-engagement healthcare solutions that improve health outcomes. To date, League has raised $235 million in venture capital funding, powering the digital experiences for some of healthcare’s most trusted brands, including Highmark Health, Manulife, Medibank, and Shoppers Drug Mart.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
Shereef Elnahal, MD, MBA Under Secretary for Health at the Department of Veterans Affairs, joins Eric to discuss the transformative potential of psychedelic-assisted therapies for veterans.
The conversation explores the VA's groundbreaking initiatives, including their funding of studies on MDMA and psilocybin, and how these therapies address conditions like PTSD, depression, and addiction.
Dr. Elnahal highlights the VA's role as a leader in mental health research and shares a vision for how these breakthrough therapies could revolutionize care for millions. Learn how veterans themselves have driven this agenda, the promising outcomes from early studies, and the significant hurdles in bringing these therapies to scale.
Tune in for a thought-provoking discussion on the future of mental health treatment for veterans and how the integration of psychedelic-assisted therapies could revolutionize care and improve the quality of life for those who have served.
About Dr. Elnahal
Dr. Shereef Elnahal is Under Secretary for Health at the United States Department of Veterans Affairs (VA). He was nominated by President Joseph R. Biden and confirmed by the United States Senate on July 21, 2022. As the Under Secretary for Health, Dr. Elnahal directs a health care system with an annual budget of approximately $102.2 billion, overseeing the delivery of care to more than 9 million enrolled Veterans. The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at over 1,300 health care facilities, including 171 VA Medical Centers and 1,120 outpatient sites of care of varying complexity (VHA outpatient clinics). VHA is the nation's largest provider of graduate medical education and a major contributor to medical and scientific research. More than 73,000 active volunteers, 127,000 health professions trainees, and more than 362,000 health care professionals and support staff are an integral part of the VHA community.
Dr. Elnahal is physician leader who previously served as President and Chief Executive Officer of University Hospital in Newark, NJ from 2019 through 2022. Dr. Elnahal led University Hospital through the COVID-19 public health emergency. The hospital has served as a model for urban hospital and regional response efforts. In addition to his leadership during the pandemic, Dr. Elnahal oversaw substantial improvements in care quality and patient safety at University Hospital, leading to improvements against national benchmarks.
Prior to his time at University Hospital, Elnahal served as New Jersey’s 21st Health Commissioner, appointed to the Cabinet post by Governor Phil Murphy and confirmed unanimously by the New Jersey Senate. During his nearly two years as Commissioner, he expanded the New Jersey Health Information Network, an interoperability platform that allows for electronic exchange of patient health information among healthcare providers. He worked closely with New Jersey First Lady Tammy Murphy on her Nurture NJ campaign to help improve infant and maternal health outcomes and reduce health disparities—a mission he continued at University Hospital, with its top tier maternal health services. He also made strides in curbing the opioid epidemic, granting funding to institutions to facilitate data sharing and public health reporting, and marked NJ as the first state in the nation to allow EMS responders to use buprenorphine in the field to prevent withdrawal after naloxone.
Dr. Elnahal previously served as VA’s Assistant Deputy Under Secretary for Health for Quality, Safety, and Value from 2016 through 2018, overseeing national policies around quality of care for the VHA, and as a White House Fellow in the VA from 2015-16. During that time, he co-founded the VHA Innovation Ecosystem, a program that continues to foster the spread of innovation and best practices that improve Veteran care across the nation.
Dr. Elnahal holds an M.D. from Harvard Medical School and an M.B.A. with Distinction from Harvard Business School.
Press Release from VA New research would determine the benefit of psychedelics for treating PTSD and depression in Veterans: https://news.va.gov/press-room/to-improve-care-for-veterans-va-to-fund-studies-on-new-therapies-for-treating-mental-health-conditions/
VA Health: https://www.va.gov/health-care/
VA Mental Health Resources: https://www.mentalhealth.va.gov/index.asp
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.
Visit our website at www.brightspotsinhealthcare.com
Vega Shah, PhD, Product Marketing Manager Lead for Healthcare & Life Sciences, NVIDIA, joins Eric to explore the evolution of generative AI in healthcare and how harnessing the technology will transform the future of patient care. Vega delves into the cutting-edge ways NVIDIA’s AI tools are enhancing clinician-patient relationships and optimizing the healthcare experience for everyone.
Get real-world examples of AI in action, insights into overcoming common challenges, and strategies for implementing AI effectively in healthcare organizations. This episode is packed with valuable takeaways for anyone looking to understand the transformative potential of AI in reshaping patient care.
Don’t miss it!
This episode was recorded live on October 22, 2024 at HLTH 2024 in Las Vegas.
About Vega
Vega leads go-to-market strategies for Healthcare & Life Sciences Solutions at NVIDIA, collaborating with a diverse range of partners including cloud service providers, biotech, and digital health companies. Her expertise in biotech software stems from her previous role as a product manager at Dotmatics, where she developed cloud-based tools for research analytics. Her career trajectory also includes shaping product strategies for drug discovery at Benchling, a prominent lab data management company. Outside of her professional life, Vega is passionate about building scientific communities in the Bay Area. She is founder of Techbio Transformers - a community of operators working at the intersection of biology and AI.
About NVIDIA
NVIDIA’s invention of the GPU sparked the PC gaming market. The company’s pioneering work in accelerated computing—a supercharged form of computing at the intersection of computer graphics, high-performance computing, and AI—is reshaping trillion-dollar industries like healthcare and fueling the growth of many others. NVIDIA Clara – a healthcare application framework for imaging, genomics, smart hospitals, and drug discovery – is accelerating the journey to precision medicine.
About NVIDIA Healthcare & Life Sciences Solutions
To meet the need for personalized medicine, next-generation clinics, enhanced quality of care, and biomedical breakthroughs to treat disease, the healthcare industry has to embrace new computing capabilities. With NVIDIA, institutions can harness the power of AI and high-performance computing (HPC) to define the future of medicine.
NVIDIA Healthcare & Life Sciences: https://www.nvidia.com/en-us/industries/healthcare-life-sciences/
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized, peer events along with sales and go-to-market consulting. We believe that finding a bright spot, and cloning it, is the most effective strategy to improve healthcare in our lifetime.
Visit our webiste: www.brightspotsinhealthcare.com
Doug Henry, PhD, Vice President and Medical Director of Enterprise Behavioral Health at Highmark Health, and Mari Vandenburgh, Vice President of Health Programs and Solutions at Highmark Health, join Eric to share Highmark’s innovative approaches to transforming care delivery through digital and hybrid solutions.
Topics include:
- Post-Acute Care Innovations: AHN At-Home Care program’s multidisciplinary approach integrates mental health support to reduce readmissions and save $600 PMPM in total care costs.
- Addressing Network and Access Gaps: Highmark’s strategic initiatives to expand access through geo-analysis, virtual-first strategies, and enhanced provider partnerships.
- Virtual Mental Health: A closer look at Highmark’s partnership with Spring Health to provide personalized, outcome-driven mental health care, achieving symptom remission in six weeks or less for 70% of patients with moderate to severe conditions.
- Living Health Strategy: Leveraging personalized nudges and integrated digital platforms to boost member engagement, with 79% receiving their first mental health care through the program.
- Innovation for Loneliness and Beyond: Doug shares groundbreaking grant projects, such as using technology and social prescriptions to address loneliness and improve senior care outcomes.
This episode is packed with actionable insights for health plans seeking to close access gaps, enhance member experience, and drive measurable outcomes in mental health and beyond.
Tune in to learn from Highmark’s bright spots and discover strategies to replicate their success.
About Doug and Mari
- Doug is a clinical psychologist licensed in Pennsylvania and California and brings over 20 years of experience in professional applied psychology, including inpatient, outpatient, and administrative assignments. Attracted by the integrated payer-provider model and emphasis on patient-centered treatment, he joined the Allegheny Health Psychiatry and Behavioral Health Institute in 2017 as vice president. In addition to his role at the enterprise, he continues to serve as a leadership dyad for the Institute.
Before joining AHN, Dr. Henry served as clinical administrator at Western Psychiatric Institute and Clinic for UPMC Child and Adolescent Behavioral Health Services, the UPMC Center for Autism and Developmental Disorders, and the UPMC Center for Eating Disorders.
- Mari is responsible for identifying and managing best-in-class healthcare solutions to improve Quadruple Aim outcomes related to chronic and episodic clinical conditions and validating multi-year business case value drivers and ROI. She has been with Highmark in various roles since 2005. Mari has a Bachelor of Science from Duquesne and a Master of Health Administration from the University of Pittsburgh.
About Highmark Health
Highmark Health is a $27 billion national, blended health organization with one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health’s 44,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, including Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, enGen, and Helion.
We’d love to hear from you!
Send your comments, suggestions and ideas to hello@brightspotsinhealthcare.com
Bright Spots in Healthcare is produced by Bright Spots Ventures.
Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized, peer events along with sales and go-to-market consulting. We believe that finding a bright spot, and cloning it, is the most effective strategy to improve healthcare in our lifetime.
Visit our website to learn more about the show!
www.brightspotsinhealthcare.com
Leaders from Arkansas Blue Cross and Blue Shield, CVS Caremark, Independent Health and Vori Health explore how healthcare leaders tackle members’ weight management challenges by creating comprehensive programs that responsibly integrate GLP-1 medications while controlling costs.
Key Discussion Topics:
- Benefit Design and Prior Authorization Programs: Crafting strategies to balance access and affordability.
- Integrated, Whole-Person Care: Addressing weight management holistically to improve outcomes.
- Leveraging Bright Spots: Applying successful approaches from other areas to optimize GLP-1 management.
- Future Innovations: Exploring emerging opportunities to enhance weight management programs.
Panel:
Ryan A. Grant, MD, MS, MBA, FAANS, CEO and Co-Founder, Vori Health
Martin Burruano, Vice President, Pharmacy Services, Independent Health
Mark T. Jansen, M.D., Vice President, Chief Medical Officer, Arkansas BlueCross BlueShield
Ilona Smith, SVP of Employer, Government and Coalitions, CVS Caremark
Bios: https://www.brightspotsinhealthcare.com/events/responsible-glp-1-strategies-structuring-benefits-for-economic-viability-and-proven-member-results
Request Whitepaper
To request the whitepaper, Integrating GLP-1s into the Future of MSK Care, from our partner Vori, please submit this form: https://www.brightspotsinhealthcare.com/request-a-copy-of-the-integrating-glp-1s-into-the-future-of-msk-care/
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized, peer events along with sales and go-to-market consulting. We believe that finding a bright spot, and cloning it, is the most effective strategy to improve healthcare in our lifetime.
Visit our website: www.brightspotsinhealthcare.com
We’d love to hear from you!
Send your comments, suggestions and ideas to hello@brightspotsinhealthcare.com
Megan Antonelli, Founder & CEO of HealthIMPACT and HealthIMPACT Chairperson Shahid Shah, Publisher & CEO, Medigy, join Eric to give Bright Spots in Healthcare listeners a sneak preview of the HealthIMPACT Forum 25, taking place on January 22-23, 2025, in New York City.
Megan and Shahid share what makes their event different from other healthcare conferences – purposeful content that creates conversations that lead to meaningful connections.
They also discuss the theme, Powering the Patient-Led Revolution for Healthcare Anywhere and mention some key things to look forward to at the event, including Keynote Speaker Chelsea Clinton, who will lead a panel discussion on digital innovation.
In addition to Clinton, the conference's speakers include hospital leaders from top health systems, including Atrium Health, Mayo Clinic, Northwell Health, and Oschner Health.
Megan also discusses how HealthIMPACT partners with Road Recovery, which has been changing lives through music since 1998 by combining music industry mentorship with mental health support for young people battling addiction and adversity.
About HealthIMPACT
HealthIMPACT isn't just another conference—it's a catalyst for change. For a decade, we've been the no-PowerPoint, no-BS platform where healthcare providers, payers, pharma, and patients converge to drive digital health implementation and adoption because you have to have both to make an IMPACT.
Join C-suite IT and clinical executives at the forefront of healthcare transformation as we explore how to deliver superior outcomes, enhance experiences, and achieve operational excellence in the new era of healthcare anywhere.
To register for the event, go to https://impactnyjan25.healthimpactlive.com/ Use the code BRIGHTSPOTSVIP to receive a 20% discount on the registration fee.
About Shahid Shahid N. Shah is an internationally recognized and influential healthcare IT thought leader who is known as “The Healthcare IT Guy” across the Internet. He is a consultant to various federal agencies on IT matters and winner of Federal Computer Week’s coveted “Fed 100” award given to IT experts that have made a big impact in the government. Shahid has architected and built multiple clinical solutions over his almost 20-year career. He helped design and deploy the American Red Cross’s electronic health record solution across thousands of sites; he’s built two web-based EMRs now in use by hundreds of physicians; he’s designed large groupware and collaboration sites in use by thousands; and, as an ex-CTO for a billion dollar division of CardinalHealth he helped design advanced clinical interfaces for medical devices and hospitals. Shahid also serves as a senior technology strategy advisor to NIH’s SBIR/STTR program helping small businesses commercialize their healthcare applications. Shahid runs three successful blogs. At http://shahid.shah.org he writes about architecture issues, at http://www.healthcareguy.com he provides valuable insights on how to apply technology in health care, at http://www.federalarchitect.com he advises senior federal technologists, and at http://www.hitsphere.com he gives a glimpse of the health-care IT blogosphere as an aggregator.
About Megan
A relentless creator and knowledge seeker who brings people together to solve big problems, Megan believes face-to-face meetings give everyone a shared focus, bringing forth new insights, a clearer sense of purpose, and solutions that impact long-term performance.
An experienced event executive with extensive knowledge of healthcare, technology, and corporate management strategy. Developed and managed hundreds of events for health system, physician, health plan, pharmaceutical, digital marketing, and technology executives. A creative and passionate leader interested in how technology is transforming healthcare delivery, the way people work, and global market dynamics.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized, peer events along with sales and go-to-market consulting. We believe that finding a bright spot, and cloning it, is the most effective strategy to improve healthcare in our lifetime.
Visit our website: www.brightspotsinhealthcare.com
We’d love to hear from you!
Send your comments, suggestions and ideas to hello@brightspotsinhealthcare.com
This episode was recorded on Monday, October 21, 2024, at HLTH 2024 in Las Vegas
Natalie Davis, co-founder and CEO of United States of Care, joins Eric to share her thoughts on the current healthcare system and how her organization is advocating for a more affordable, dependable, personalized and understandable healthcare system.
In addition, Natalie shares insights from the USofCare’s recent research and the policy solutions her organization is advancing to deliver the healthcare experience people want and ensure our healthcare system works better for everyone.
About Natalie
Natalie believes that making our healthcare system work better for everyone has never been more critical. She is dedicated to bringing together leaders and advocates nationwide who can help create meaningful change in our nation’s inequitable health care system. She brings all her personal and professional experiences to the fight for better health care, working to expand access to quality, affordable health care to help people right now while working towards durable federal policies centered on the needs of people to provide real and lasting solutions for everybody.
Natalie Davis has spent nearly two decades shaping American healthcare policy to ensure that all people have access to affordable, quality care. In 2018, she co-founded United States of Care with Andy Slavitt, focusing on a person-centered approach to healthcare solutions and forging partnerships with organizations, advocacy groups, and communities to drive systemic change.
Her prior roles include serving as Senior Advisor at CMS, where she supported a major healthcare expansion, and as Director at the Bipartisan Policy Center, where she launched reform initiatives to develop innovative, politically viable healthcare solutions.
About the United States of Care
United States of Care is a non-profit organization focused on building a healthcare system that serves everyone. Its mission is to ensure people can access affordable, quality care that meets their needs regardless of their background or circumstances. Working with leaders, communities, and individuals nationwide, the United States of Care focuses on developing innovative, non-partisan solutions to healthcare challenges, emphasizing policy, patient experience, and health equity.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized, peer events along with sales and go-to-market consulting. We believe that finding a bright spot, and cloning it, is the most effective strategy to improve healthcare in our lifetime.
Visit our website: www.brightspotsinhealthcare.com
We’d love to hear from you!
Send your comments, suggestions and ideas to hello@brightspotsinhealthcare.com
OSF HealthCare, Providence, UMass Memorial Medical Center, and TytoCare share actionable strategies and best practices to transform hybrid care and offer patients personalized, flexible and accessible care. Our expert panel also explores how virtual care reduces costs and addresses healthcare challenges like staff shortages.
Key topics include:
- Maximizing Hybrid Care Models: Panelists explore how hybrid and home-based care models – supported by technology, are revolutionizing how providers deliver care – making it more accessible, efficient, and impactful.
- Home-Based Healthcare Innovations: Real-world success stories highlighted how providers make healthcare accessible from the comfort of home, schools, and community centers.
- Technology-Driven Solutions: Technical tools enable immersive primary care experiences remotely, enhancing connectivity and care delivery for families.
Highlights:
- Providence: Kate Baars shared how remote patient monitoring helps achieve compelling clinical and financial outcomes
- OSF OnCall: Jennie Van Antwerp walked us through innovations in acute and digital care delivery at OSF.
- UMass Memorial Medical Center: Dr. John Broach discussed how the medical center utilizes technology to drive efficient responses and care, eliminating ED visits.
- TytoCare: Tina Nelson highlighted strategic partnerships that enable healthcare access for underserved communities through remote technology.
Panelists:
Kate Baars, Executive Director, Product Development, Virtual Care & Digital Health, Providence
Jennie Van Antwerp, MSN, RN, Director, Digital Acute Care/ Digital Care Division, OSF OnCall
(Colleen Reynolds)
John Broach, MD, Division Direction for EMS and DIsaters Medicine, UMASS Medical Center Christina (Tina) Nelson, Strategic Partnership Manager, TytoCare
https://www.brightspotsinhealthcare.com/events/how-providers-are-maximizing-hybrid-care-and-home-based-interventions
This episode is sponsored by TytoCare
TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are six times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for the successful deployment and adoption of the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 250 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.
Healthfirst, myPlace Health and Wellsky share their successful strategies for reducing readmissions, improving health outcomes and reducing costs through post-acute and home care.
Topics covered include:
Building your provider partnerships beyond the traditional transition of care program
Reducing readmissions among higher-risk Medicare Advantage members?
Ensuring members receive high-quality home health care after being discharged from skilled nursing facilities, and what made this approach stand out in terms of impact
- Susan J. Beane, MD FACP, Executive Medical Director, Health System Transformation, Healthfirst
- Robert Schreiber, MD, Vice President & National Medical Director, myPlace Health
- Andy Eilert, President, Payer & Emerging Markets, WellSky
Bios: https://www.brightspotsinhealthcare.com/events/how-to-create-more-bright-spots-in-post-acute-and-home-care/
This episode is sponsored by Wellsky
WellSky is one of America’s largest and most innovative healthcare technology companies leading the movement for intelligent, coordinated care. Our proven software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations scale processes, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care. WellSky serves more than 20,000 client sites — including the largest hospital systems, blood banks, cell therapy labs, home health and hospice franchises, post-acute providers, government agencies, and human services organizations. Informed by more than 40 years of providing software and expertise, WellSky anticipates clients’ needs and innovates relentlessly to build healthy, thriving communities.
AmeriHealth Caritas, Health Alliance Plan, Highmark Health and Icario discuss how AI transforms healthcare by creating personalized experiences that drive performance improvements and enhance member engagement. Learn how high-ranking health plans reinvent their approach to member experience to elevate your HEDIS scores, improve health outcomes and streamline data processes.
Guests:
- Vandna Bhrany, MPH, Vice President, HEDIS Strategy and Analytics, AmeriHealth Caritas
- Tracy Saula. Senior Vice President, Chief Product and Experience Officer, Highmark Health
- Cory Busse, VP, Strategy, Icario
- Mike Treash, Senior Vice President and Chief Operating Officer, Health Alliance Plan
Bios: https://www.brightspotsinhealthcare.com/events/a-new-era-for-consumer-engagement-and-hedis-combining-the-human-touch-with-ai/
This episode is sponsored by Icario
Icario serves health plans by using powerful whole-person data, predictive behavioral science, and a proprietary engagement platform to offer personalized experiences that meet members where they are in their health journey. Icario combines the industry's largest member data repository with unparalleled industry expertise to implement health action programs that deliver personalized member engagement, reduce abrasion and encourage positive health behaviors.
Banner|Aetna, Blue Shield of California, Healthfirst and TytoCare explore innovative strategies that health plans can leverage to drive meaningful lifestyle modifications among members, improve health outcomes and reduce the rising costs of chronic disease.
Our expert panel also discusses the role of primary care in empowering members to adopt healthier behaviors.
Topics include:
- Building a culture that fosters habit formation for long-term success
- Supporting members using GLP-1s for weight management
- Addressing Social Determinants of Health (SDOH) to improve outcomes
- Leveraging technology to encourage sustainable lifestyle modifications
Panelists:
Joe Brennan, Vice President, TytoCare
Robert Groves, MD, Executive Vice President and Chief Medical Officer, Banner|Aetna
Eric Glazer, Host (moderator)
Angie Kalousek, Senior Director, Lifestyle Medicine, Blue Shield of California
Amanda Parsons, MD, MBA, Vice President, Clinical Management, Healthfirst
Bios: https://www.brightspotsinhealthcare.com/events/innovations-in-lifestyle-change-the-role-of-primary-care-2/
This episode is sponsored by TytoCare
TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are six times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for the successful deployment and adoption of the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 250 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.
Value-based care leaders from Kaiser Permanente, Premera, UnitedHealthcare and TailorCare discuss the evolving landscape of specialty value-based care. They explain how their plans drive success with innovative approaches designed to optimize care and improve outcomes—even with their most complex, high-cost members.
Our expert panelists share practical strategies for navigating the most effective treatment pathways, from leveraging predictive data and the latest evidence-based guidelines to assessing members’ symptoms and goals.
Topics covered include:
- Strategie Planning
- Technology Enablement
- Solutions in Action
Featured Guests
- Romilla Batra, MD, Senior Vice President, Chief Medical Officer – Clinical Strategy & Solutions, Premera Blue Cross
- Hemant Keny, MD, Lead for Senior Surgical Care Program, Kaiser Permanente Northern California
- Donna Laliberte O’Shea, MD, MBA, CPE, National Vice President, Operations and Chief Medical Officer, UCS Population Health and VBC, UnitedHealthcare
- Rachel Winokur, Chief Executive Officer, TailorCare
Guest Bios: https://www.brightspotsinhealthcare.com/events/unlocking-success-through-specialty-value-based-models/
This episode is sponsored by TailorCare
TailorCare is a risk-based care navigation program that provides deeply personal support to patients living with joint, back, and muscle pain. By combining a careful assessment of patients’ symptoms, health history, preferences and goals with predictive data and the latest evidence-based guidelines, TailorCare helps patients choose—and navigate—the most effective treatment pathway for them, every step of the way. Website: www.tailorcare.com
Alec Peterson, MD, Chief Medical Officer of Acute and Specialty Care at Devoted Health, joins Eric to explore the innovative care delivery model that sets Devoted Health apart from other Medicare Advantage plans. Devoted Health uniquely integrates healthcare coverage with its in-house, virtual, and in-home care provider, Devoted Medical, in partnership with leading healthcare providers to offer comprehensive care for older Americans.
Alec shares the key strategies behind Devoted Health’s impressive success and delves into how Devoted Medical’s groundbreaking model has driven high member satisfaction and improved clinical outcomes. He also unveils the roadmap for achieving a 5-star rating from CMS for their Medicare Advantage plans in Florida and Ohio.
About Alec
Alec Petersen, MD, is an internal medicine physician and Chief Medical Officer, Acute & Specialty Care with the Devoted Medical team of Devoted Health. In his role, Petersen leads Devoted Health’s Care on Demand program and focuses on maximizing the potential of innovative at-home care delivery without overstressing an already maxed-out healthcare workforce.
After receiving his medical degree from Vanderbilt University School of Medicine, Alec completed a clinical fellowship and MBA at Harvard. Before his career in medicine, he served as a military intelligence officer.
About Devoted Health
Founded in 2017 by brothers Todd and Ed Park, Devoted Health is a new kind of healthcare company providing all-in-one care for older Americans. Members of the company’s best-in-class insurance plans can receive care through their trusted PCP and complementary preventative care services through Devoted Medical, the first virtual and in-home medical group built from the ground up to serve the specific needs of the Medicare population. The Devoted Medical team of mission-oriented clinicians works closely with members’ primary care physicians and Devoted’s full-service Guides to deliver a new model of advanced primary care, powered by deeply specialized clinical programs and proprietary technology that enables intensive care coordination.
Rachel Winokur, CEO, TailorCare and Alex Bateman, CEO, United Musculoskeletal
Partners (UMP) join Eric to discuss the evolution and adoption of specialty value-based care, highlighting the significant improvements in patient care, customer satisfaction scores, cost reduction and value creation.
Hear how their two organizations partner with a commercial payer to manage musculoskeletal cases, ensuring they assess patients, understand their needs, and match them with the best providers in the market.
Rachel and Alex also touched on the keys to implementing a successful value-based care strategy and underscored the transformative power of data analytics in shaping the future of healthcare.
Segments
- Origin Story
- Payer Experience
- Patient Experience
- Pitfalls
- Strategy/Building
An episode of The Bear, is referenced in the interview. Here is a link to a summary of the episode (Season 2, Ep. 2) https://www.imdb.com/title/tt26230348/
About Alex
Alex is an accomplished, results-driven healthcare leader with 20 years of development and operations experience in multi-state, multi-site healthcare services organizations. He is a proven talent and team builder who adapts and thrives in the changing healthcare space. He is analytical, confident in challenging environments, and regarded as a top company performer in both leadership and growth/development.
About Rachel
Rachel is the co-founder and CEO of TailorCare, a risk-based care navigation and health management company that provides deeply personal, data-driven support and clinical access to patients living with joint, back, and muscle pain. Prior to founding TailorCare, Rachel launched Bright Health Group, a value-based healthcare company committed to managing population risk. She served as Chief Business Officer of Bright before serving as the CEO of NeueHealth, the risk-based primary care delivery, provider enablement, and network management company she created within Bright. Rachel built her career in executive and leadership roles at Aetna, where she helped start the health plan’s population health management division, The Carlyle Group, as a healthcare investor, and at Datascope, a public medical device company she helped take private. Rachel has previously held positions at Bertelsmann and Goldman Sachs.
About United Musculoskeletal Partners
United Musculoskeletal Partners (UMP) was formed in December 2021 by Resurgens Orthopaedics, one of the nation's largest orthopedic practices. UMP partners with entrepreneurial, physician-owned orthopedic practices to deliver exceptional clinical care to patients around the country while simplifying the management functions of the practices under one umbrella company. Website: www.umpartners.com
This episode is sponsored by TailorCare
TailorCare is a risk-based care navigation program that provides deeply personal support to patients living with joint, back, and muscle pain. By combining a careful assessment of patients’ symptoms, health history, preferences and goals with predictive data and the latest evidence-based guidelines, TailorCare helps patients choose—and navigate—the most effective treatment pathway for them, every step of the way. Website: www.tailorcare.com
BlueCross BlueShield of Tennessee, Cambia Health Solutions, Health Plan of San Joaquin/Mountain Valley Health Plan and Pager Health discuss how technology and innovation transform the member experience, improving clinical outcomes and consumer engagement.
- Laurent Rotival, EVP & CIO, Cambia Health Solutions
- Victoria Worthy, CIO, Health Plan of San Joaquin | Mountain Valley Health Plan
- Sherri Zink, SVP, Chief Data & Engagement Officer, BlueCross BlueShield of Tennessee
- Rita Sharma, Chief Product Officer, Pager Health
https://www.brightspotsinhealthcare.com/events/revolutionizing-health-plans-the-connected-member-experience/#url
This episode is sponsored by Pager Health
Pager Health is a connected health platform company that enables healthcare enterprises to deliver high-engagement, intelligent health experiences for their patients, members and teams through integrated technology, AI and concierge services. Our solutions help people get the right care at the right time and in the right place and stay healthy while simultaneously reducing system friction and fragmentation, powering engagement, and orchestrating the enterprise. Pager Health partners with leading payers, providers and employers representing more than 28 million individuals across the United States and Latin America.
Former NFL general manager and three-time Super Bowl winner Mike Lombardi joins Eric to share what he learned working with coaching legends Bill Walsh of the 49ers, Al Davis of the Raiders, and Bill Belichick of the Patriots, among others, during his three decades in football and how those core leadership lessons directly translate to managing health plans and hospital systems.
He discusses building a winning team, handling high-pressure situations, adapting to change, decision-making under uncertainty, and cultivating a winning culture.
https://www.brightspotsinhealthcare.com/events/from-the-sidelines-to-the-boardroom-leadership-lessons-from-the-nfl/
CareSource, Independent Health, and AdhereHealth outline strategies for the upcoming Medicare Advantage Star Rating changes, focusing on medication adherence and the Health Equity Index (HEI) starting in measurement years 2024-2025 for the 2027 Medicare Advantage Star Rating Period.
Under HEI, plans must identify disparities in populations with social risks and create intervention strategies to address these inequities. Tune in and gain insights on leveraging policy changes, predictive analytics, and strategic implementation to meet these new standards and reach or maintain 4+ Stars.
Panelists:
Amin Serehali, Senior Vice President, Chief Data & Analytics Officer, Independent Health
Logan Fox, PharmD, MBA, Director, Enterprise Quality
Improvement, Programs, CareSource
Kempton Presley, MPH, MS, Chief Strategy Officer, AdhereHealth
https://www.brightspotsinhealthcare.com/events/convergence-of-pharmacy-the-health-equity-index-in-2024-and-beyond/
This episode is sponsored by AdhereHealth
AdhereHealth is at the forefront of delivering purpose-built, innovative technology solutions designed to elevate pay-for-performance achievement for government-sponsored lines of business. This includes improved Star Ratings for Medicare, plus enhanced patient experience scores, improved patient health outcomes, and optimized cost outcomes for clients. The company’s pioneering efforts are particularly noteworthy for addressing social determinants of health (SDOH) and significantly improving patient experiences as a mechanism for improved Star Ratings performance through multi-modal outreach capabilities.
Powered by the industry-leading Adhere Platform™, AdhereHealth integrates predictive analytics, intelligent clinical workflow software, and proactive multi-channel outreach. This combination, executed by a nationwide team of licensed clinicians, effectively drives health equity and adherence outcomes that improve quality of care for patients and boost financial results for clients.
The impact of AdhereHealth's comprehensive solutions is far-reaching, touching tens of millions of patients across over 100 health plans, self-insured employers and other risk-bearing entities. Since its inception in 2006, AdhereHealth, headquartered in Franklin, Tennessee, has grown into a robust organization with hundreds of dedicated professionals nationwide, all committed to their mission of improving healthcare outcomes. Visit www.adherehealth.com for more information.
Fred Turner, co-founder and chief executive officer of Curative, joins Eric to discuss how Curative is reinventing health insurance by adopting a more preventative approach to drive better results and lead to a more affordable delivery of plans.
Fred shares Curative’s journey from a pandemic testing company to a health insurance provider with a first-of-its-kind plan that eliminates copays and deductibles and advocates that the most effective approach to promote early preventive care is ensuring accessible and cost-free access to top-tier healthcare providers.
Fred underlines the significance of simplifying the healthcare system and the positive impact of Curative's approach. The innovative health insurance plan offers unmatched transparency into healthcare costs, providing reassurance to both employees and employers about the affordability and accessibility of healthcare.
Tune in and learn what makes Curative different from other plans and how it makes health care affordable, accessible and engaging for members.
About Fred
Fred Turner is the Chief Executive Officer and co-founder of Curative. A British scientist from West Yorkshire, Turner attended the University of Oxford. Fred was named one of the top 100 practicing scientists in the UK by the Science Council in 2013. Turner was included in Forbes “30 Under 30” list and ranked first in the European Union Contest for Young Scientists.
About Curative
Curative has been critical and a national leader in bringing COVID-19 testing and vaccine-administration resources in response to the pandemic, providing more than 32 million tests and two million vaccines across thousands of locations in 40+ states. Concurrently, Curative has created and launched a first-of-its-kind health insurance plan offering that offers unmatched transparency into health care costs.
Leading healthcare investors and strategists discuss how to rethink capital in healthcare and share unique ways to grow and scale companies to improve health outcomes, cost savings, and operational efficiencies.
Topics include:
- Components investors look for in 2024
- Healthcare sectors with the highest growth projections
- Human capital strategies
- Growth strategies to scale your company
- Bright spots that have been attracting people and capital
Anna Haghgooie, Managing Director at Valtruis, a WCAS Company
Steven Klopfer, Founder & Managing Partner, Kamyn Search
Shayan Masoudpour, Director, Bow River Capital
Naimish Patel, President, Healthcare Practice, Red Cell Partners
https://www.brightspotsinhealthcare.com/events/investor-insights-strategies-to-drive-transformative-growth-in-healthcare
Feedback survey: https://www.surveymonkey.com/r/VGMVMWB
Katherine Gergen Barnett, MD, Vice Chair of Primary Care Innovation and Transformation in the Department of Family Medicine at Boston Medical Center (BMC) and Cheryl Harding, patient and community advocate, join Eric to share how Boston Medical Center is utilizing storytelling to build trust and connection between the hospital and its community partners. Katherine and Cheryl discuss the impact medical mistrusts has on health outcomes and health disparities.
They also tell how Storytelling to Build Medical Trust project was born out of the desire of BMC to improve the health and well-being of Black and brown community members. The project puts a face to the statistics and allow community members to explain why they lack trust in the overall healthcare system.
Hear how this unique project has brought the medical and local communities together and how empathy and trust can help advance health equity and narrow health disparities.
About Katherine
Katherine Gergen Barnett, MD, is a family medicine physician and the Vice Chair of Primary Care Innovation and Transformation in the Department of Family Medicine at Boston Medical Center (BMC). Dr. Gergen Barnett is also a clinical associate professor at Boston University Chobanian & Avedisian School of Medicine. Her primary clinical interests are behavioral health, preventive medicine, nutrition, trauma informed care, gender affirming care, women’s health, reproductive care, mindfulness-based stress reduction, and group medical care. Dr. Gergen Barnett’s research focuses on innovative models of care to address chronic medical conditions, physician burnout, and engaging community partners in creating feasible solutions to increase health and wellness and to address medical distrust in traditionally marginalized communities. Dr. Gergen Barnett is involved in local and state health policy addressing health inequities, national policy addressing primary care delivery, and is a regular contributor to The Boston Globe, Boston Public Radio, and various television outlets.
About Cheryl
The founder of a Boston nonprofit, From Roots to Wings, Cheryl continues to be a strong voice for the underserved and underrepresented to ensure that everyone gets access to information, services and opportunities.
About the Project
“Storytelling to Build Medical Trust” focuses on highlighting the experience and wisdom of community members, who shared in video interviews their negative interactions with the healthcare system in the hope that the healthcare industry would finally listen. The project is jointly led by Boston Medical Center, Everyday Boston, and the B.L.A.C Project, in partnership with Transformational Prison Project, We Got Us, and EmVision Productions. The project was funded by Boston University Clinical and Translational Science Institute and MA-CEAL.
https://www.storiesformedicaltrust.org/
Elevance Health, Blue Cross Blue Shield of South Carolina, and the Business Group on Health and Socially Determined discuss how plans can provide a more holistic and effective healthcare journey for members by gaining insight into all barriers to caring for your members, including social risks such as food insecurities, housing instabilities, financial strain, health literacy challenges, and lack of transportation.
Our expert panel explores the value of quantifying the impact of social risks and shares strategies and actions that health plans can take to improve health outcomes, reduce health disparities, decrease costs, and track measurable results.
Guests:
Shantanu Agrawal, MD, MPhil, Chief Health Officer, Elevance Health
April Richardson, MD, Vice President, Clinical Services, Blue Cross Blue Shield of South Carolina
Ellen Kelsay, President & CEO, Business Group on Health
Trenor Williams, MD, CEO & Co-Founder, Socially Determined
https://www.brightspotsinhealthcare.com/events/innovative-strategies-for-health-plans-to-mitigate-social-risk/
This episode is sponsored by Socially Determined
Socially Determined provides social risk data, analytics, and expertise to healthcare organizations seeking to understand how Social Determinants of Health and social risk factors impact the communities they serve. Our analytics platform, SocialScape, provides actionable insights into community-level SDOH risk exposure and individual-level social risk factors, and their impact on health care utilization, cost, outcomes, and equity.
Allison Bryant, MD, MPH, Associate Chief Health Equity Officer, Mass General Brigham (MGB), joins Eric to discuss how the health system ensures its innovations are accessible to everyone, particularly those from marginalized communities. Allison elaborates on MGB's unique approach, viewing its mission as providing healthcare and as a catalyst for improving equity of outcomes for patients and the communities it serves.
Topics covered include:
- Community health
- Bridging the digital divide
- Equity in maternal health
- United Against Racism (MGB’s Diversity, Equity and Inclusion statement)
About Allison
In her role at MGB, Allison works to eliminate longstanding inequities in patient care and outcomes. She is a maternal-fetal medicine subspecialist, an associate professor of obstetrics, gynecology and reproductive sciences at Harvard Medical School and is the Frederic D. Frigoletto, MD Endowed Chair in the Department of Obstetrics and Gynecology at Massachusetts General Hospital. She received degrees in biology, public health and medicine from Harvard University, where she also completed residency training in obstetrics and gynecology and fellowships in maternal/fetal medicine and the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy. She previously served as the vice chair for quality, equity and safety for the Department of Obstetrics and Gynecology at Mass General.
About Mass General Brigham
Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals.
Mass General Brigham
https://www.massgeneralbrigham.org/
United Against Racism: https://www.massgeneralbrigham.org/en/about/diversity-equity-and-inclusion/united-against-racism
Esteemed leaders from CVS Health, Florida Blue, Highmark, and Vori Health delved into the impact of health equity on chronic care. They not only shared strategies and solutions to enhance healthcare accessibility but also shed light on specific programs they have successfully implemented to bridge the health equity gap in chronic disease prevention and treatment.
Guests:
- Joneigh S. Khaldun, MD, MPH, FACEP, Vice President and Chief Health Equity Officer, CVS Health
- Kelli Tice, MD, Vice President, Medical Affairs & Chief Health Equity Officer, Florida Blue
- Nebeyou Abebe, Senior Vice President, Social Determinants of Health, Highmark Health
- Mary O'Connor, MD, Co-Founder & Chief Medical Officer, Vori Health
https://www.brightspotsinhealthcare.com/events/navigating-the-intersection-of-health-equity-and-chronic-care/
Links to programs mentioned during the episode
- Advancing Health Equity | CVS Health: https://www.cvshealth.com/impact/health-equity.html
- CVS Health launches Community Equity Alliance to improve health outcomes in underserved communities: https://www.cvshealth.com/news/health-equity/cvs-health-launches-community-equity-alliance-to-improve-health-outcomes.html
- Spoken Rx - Prescription Reader | CVS Pharmacy: https://www.cvs.com/content/pharmacy/spoken-rx
- Highmark Community Support Platform: https://highmark.findhelp.com/
This episode is sponsored by our partner, Vori Health
Vori Health is a specialty medical practice delivering a virtual-first musculoskeletal (MSK) solution to help members get back to their lives faster. As the only nationwide MSK practice with doctor-led care teams, Vori Health is the most convenient way to access appropriate care for back, neck, and joint pain without bouncing around the healthcare system. Whether members need a diagnosis, non-opioid prescription, personalized physical therapy, or health coaching, they can turn to Vori Health for evidence-based care and effective end-to-end support. This holistic model reduces unnecessary surgeries, enables faster recoveries, and lowers MSK spend with up to a 4:1 ROI. For more information, visit www.vorihealth.com.
Dan Fishbein, President of Sun Life U.S., joins Eric to discuss Sun Life’s commitment to supporting holistic care for mental health and how it leverages digital technology to enhance the overall delivery of mental health and caregiver support to all clients.
The conversation also touches on how Sun Life is helping patients navigate a challenging healthcare system. It’s using data and analytics to identify trends and unmet needs and AI to summarize health records quickly to improve health outcomes.
In addition, Dan elaborates on Sun Life’s redefined role as a healthcare benefits provider and its collaborations with various healthcare organizations to help promote health and well-being.
About Dan
As president of Sun Life U.S., Dan has transformed the company into a leader in health-related benefits and services that connect to the broader healthcare ecosystem to help people access the care and coverage they need.
Since joining Sun Life in 2014, Dan has overseen several successful acquisitions that have grown the company and its capabilities, including DentaQuest (2022), PinnacleCare (2021), Maxwell Health (2018), and Assurant Employee Benefits (2016). Since 2014 Sun Life U.S. has grown three-fold to $8 billion in revenues, offering more than 50 million Americans group benefits and services through employers, partners and government programs. It serves a block of in-force individual life insurance policyholders.
Before Sun Life, he served as Aetna’s President, Specialty Businesses and held several other senior leadership positions during his 16-year tenure. He previously served in leadership posts at New York Life and MassMutual.
Dan earned a bachelor’s degree and a Doctor of Medicine from Boston University. He is a member of the Massachusetts Medical Society and Maine Medical Association. Dan is also a past chair and active board member of Spurwink Services in Portland, Maine, and serves in an advisory capacity on the board of Collective Health, an insurtech start-up based in San Francisco.
About Sun Life
Sun Life is a leading financial services company that helps clients achieve lifetime financial security and live healthier lives. Sun Life has operations in a number of markets worldwide, including Canada, the United States, the United Kingdom, Ireland, Hong Kong, the Philippines, Japan, Indonesia, India, China, Australia, Singapore, Vietnam, Malaysia and Bermuda.
Leaders from Ballad Health, Baystate Health, Stony Brook Medicine and Purple Lab share how health systems can take a more sophisticated and consumer-focused approach to attracting new patients.
Our expert panel leads a thought-provoking discussion on the importance of seeing patients as healthcare consumers and understanding how they make decisions, what motivates them, and how, where, and why they engage with the broader healthcare system.
You will discover innovative patient acquisition strategies and best practices you can implement in your organization to break through the market clutter, differentiate your health system’s offerings and create a message that resonates with customers.
Themes covered:
- Consumer Centricity & The Patient Journey
- Personalized, Data-Driven Marketing
- Health Equity
Guests:
- Ebrahim Barkoudah, MD, MPH, MBA, System Chief of Hospital Medicine and Regional Chief Medical Officer/Regional Quality Officer, Baystate Health
- Timothy Brown, Chief Communications and Marketing Officer, Stony Brook Medicine
- Molly Luton, Chief Marketing and Communications Officer, Ballad Health
- Ted Sweetser, Vice President, Strategy, Healthcare, Purple Labs
Bios: https://www.brightspotsinhealthcare.com/events/how-top-hospital-systems-are-capturing-new-patients/
We are proud to have Purple Lab as the sponsor of this event. Their support is Instrumental in bringing you this insightful discussion.
PurpleLab is a health tech company that puts valuable healthcare insights in customers' hands, enabling the healthcare industry to drive better outcomes through access to real-world data. https://purplelab.com/
Leaders from Independence Blue Cross, Oscar Health and TytoCare explore
how health plans can leverage various solutions effectively to optimize pricing structures; exploring technology adoption, cost-effectiveness, and market competitiveness. Our panel of industry experts will share successful strategies and real-world examples you can implement in your organization.
Topics covered include:
- Matching benefits with member personas
- Evolving virtual care beyond video
- Various innovations in product design
- Bringing price transparency to ACA and Medicare Advantage products
- How to penetrate new, highly competitive markets
Guests:
Jonathan Stump, Vice President, Product Services, Independence Blue Cross
Bill Bradley, Vice President, Insurance Product Development, Oscar Health
Meni Shikhman, Vice President, TytoCare
Bios: https://www.brightspotsinhealthcare.com/events/differentiating-your-product-in-the-healthcare-insurance-marketplace/
This episode is sponsored by TytoCare
TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are five times higher than traditional telehealth services, reduces the total cost of care by an average of five percent, diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for successfully deploying and adopting the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 220 major health systems and plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.
Kody Kinsley, Secretary of North Carolina’s Department of Health and Human Services, joins Eric to discuss how his state is improving the lives of families and children by expanding Medicaid and improving the mental health system.
Secretary Kinsley shares strategies for improving behavioral healthcare access and benefit design for North Carolina’s Medicaid and Medicare members, including peer support programs, mental health crisis lines, and data systems to track the availability of beds and individuals in need.
The conversation also explores the importance of improving healthcare infrastructure through Medicaid, focusing on preventative measures and addressing social determinants of health.
About Secretary Kinsley
Kody Kinsley serves as North Carolina’s Secretary of Health & Human Services, overseeing a department with over 18,000 staff and a $38 billion budget.
With experience centered on health policy and operations, Kinsley worked on digital healthcare transformation, national education, and labor policies and served as the COO and CFO of the U.S. Treasury.
Secretary Kinsley’s three priorities for the department include Investing in behavioral health and resilience, improving child and family well-being, and building a solid and inclusive workforce. Under his leadership, North Carolina expanded Medicaid and received the most significant investment to bolster the mental health system in over a decade.
Kinsley grew up in Wilmington, earning his bachelor’s degree from Brevard College and his master’s in Public Policy from the University of California at Berkeley.
Leaders from Humana, Blue Cross, and Blue Shield of Rhode Island delve into the dynamic landscape of specialty value-based care, sharing valuable insights and actionable strategies for navigating its complexities.
Show Guests:
Alexander Ding, MD, MS, MBA, Associate Vice President for Physician Strategy and Medical Affairs, Humana
Nick Lefeber, Senior Vice President, Value-Based Care, Contracting, Data & Analytics, Blue Cross Blue Shield of Rhode Island
Rachel Winokur, Chief Executive Officer, TailorCare
https://www.brightspotsinhealthcare.com/events/the-evolution-of-specialty-value-based-care/
This episode is sponsored by TailorCare
TailorCare is a risk-based care navigation program that provides deeply personal support to patients living with joint, back, and muscle pain. By combining a careful assessment of patients’ symptoms, health history, preferences and goals with predictive data and the latest evidence-based guidelines, TailorCare helps patients choose —and navigate—the most effective treatment pathway for them, every step of the way.
Melissa Newton Smith, Founder of Newton Smith, and Keslie Crichton, Chief Sales Officer of BeneLynk, join Eric to discuss the introduction of the CMS Health Equity Index, which will replace the reward factor within the Medicare Advantage Star Rating program measurement. The Health Equity Index will be a seismic change for Medicare Advantage plans and impact revenue associated with Star Ratings. Melissa and Keslie share success stories from plans preparing for the change.
Links
"Associations Between Annual Medicare Part D Low-Income Subsidy Loss and Prescription Drug Spending and Use": https://jamanetwork.com/journals/jama-health-forum/fullarticle/2814604
Book Links
$2.00 a Day: Living on Almost Nothing in America: https://www.amazon.com/2-00-Day-audiobook/dp/B012E8RDS2/ref=sr_1_1?crid=29MW28TUOFAG0&keywords=%242+a+day&qid=1708126201&s=books&sprefix=2+a+day%2Cstripbooks%2C125&sr=1-1
Because I Said I Would: https://store.becauseisaidiwould.org/store/thebook/?_gl=1qfwy3p_gaOTY3NTIzNTYzLjE3MDgxMjYyNDc._ga_9YFXHXM1VK*MTcwODEyNjI0Ny4xLjAuMTcwODEyNjI1NC41My4wLjA.
The Ethical Case Manager: https://www.amazon.com/dp/194388918X/ref=cm_sw_r_apin_dp_GVBYY6XZGAK9RK9VRHE8
About Melissa
Melissa is the founder of Newton Smith. She brings over 25 years of experience in Star Ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. Most recently, she served as Chief Consulting Officer at Healthmine.
Melissa is a well-known healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, quality performance, health outcomes, and the member experience.
About Keslie
Keslie has worked in managed care for over 25 years, focusing on SDoH solutions that improve members' lives and provide a return on investment for our clients.
Keslie drives enterprise growth and innovative partnerships to improve outreach strategies and health outcomes for our client’s members. Keslie works closely with BeneLynk’s product team to offer differentiated services and capabilities to maintain its market leader position.
This episode is sponsored by BeneLynk
BeneLynk is a national provider of Social Care solutions for Medicare Advantage and Managed Medicaid health plans. They serve plans and their members by creating a human-to-human connection and providing the assistance a member needs to get the benefits they deserve.
Leaders from Independence Blue Cross, Banner| Aetna, and Scene Health share exclusive insights on successfully accomplishing chronic condition management success with fewer resources.
Our expert panel explores patient-centered and technology-enabled approaches that elevate chronic care management efficiency and effectiveness. Don't miss the opportunity to learn about strategic solutions tailored to the unique challenges of Medicaid and Medicare health plans.
Panelists:
Robert Groves, MD, Chief Medical Officer & Executive Vice President, Banner| Aetna
Reetika Kumar, MD, FACP, Vice President, Market Clinical Solutions and Pharmacy Services, Independence Blue Cross
Sebastian Seiguer, CEO & Co-Founder, Scene Health
Bios: https://www.brightspotsinhealthcare.com/events/meeting-goals-for-chronic-condition-management-with-fewer-resources/
This episode is sponsored by Scene Health
Meet Scene Health, the industry leader in MedEngagement. They are going beyond traditional medication adherence to transform disease management.
Scene’s MedEngagement approach uses 1:1 async video to deliver medication support at scale.
Scene helps members get better fast—getting to the doctor, getting their meds, taking them as prescribed, and getting labs and vitals—driving cost-effective utilization and improving multiple clinical and quality measures in as little as 90 days.
Scene was commercialized out of Johns Hopkins, and has developed the most extensive catalog of peer-reviewed publications among medication adherence companies. Visit its website at www.scene.health for more information.
Leaders from Blue Cross and Blue Shield of Illinois, Independent Health, Evry Health and Vori Health
discuss GP-1s and their role in addressing the global challenge of obesity. The panel shares innovative, multidisciplinary strategies you can implement to complement lifestyle interventions and other therapeutic approaches in your organization.
-
Improving outcomes by pairing GLP-1s with evidence-based behavior change
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Considering musculoskeletal (MSK) health in obesity treatment
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Understanding the role of GLP-1s in delivering value-based care
Panelists:
Shelley Turk, Divisional Senior Vice President of Health Care Delivery, Blue Cross and Blue Shield of Illinois
Martin Burruano, Vice President, Pharmacy Services, Independent Health
Mamata Majmundar, MD, Chief Medical Officer, Evry Health
Mary O'Connor, MD, FAAOS, Co-Founder & Chief Medical Officer, Vori Health
https://www.brightspotsinhealthcare.com/events/how-innovators-are-addressing-glp-1s-obesity-and-msk/
This episode is sponsored by Vori Health
Vori Health is a specialty medical practice delivering a virtual-first musculoskeletal (MSK) solution to help members get back to their lives faster. As the only nationwide MSK practice with doctor-led care teams, Vori Health is the most convenient way to access appropriate care for back, neck, and joint pain without bouncing around the healthcare system. Whether members need a diagnosis, non-opioid prescription, personalized physical therapy, or health coaching, they can turn to Vori Health for evidence-based care and effective end-to-end support. This holistic model reduces unnecessary surgeries, enables faster recoveries, and lowers MSK spend with up to a 4:1 ROI. For more information visit www.vorihealth.com.
Seema Kumar, CEO of Cure, an innovation campus in New York City, joins Eric to discuss how artificial intelligence can positively impact healthcare and lead to more innovation. She shares how AI has been used in healthcare and the promise it holds for the future.
The conversation also highlights the Cure Xchange Challenge: Health AI For Good, an initiative to incubate innovations by healthcare startups and entrepreneurs across disciplines and sectors to use artificial intelligence (AI) responsibly and equitably. Cure collaborated with MIT Solve for the Challenge and an independent board of judges selected the ten finalists. The winners will be announced later in the First Quarter of 2024.
Seema shares the stories of several finalists, including Oben Health, an AI-enabled platform that facilitates the delivery of healthcare screenings, education, and treatment via barbershops and salons, and Nutrible, artificially intelligent social workers.
This episode is part of a series of episodes featuring the Clinton Global Initiative Commitments to Action from the Clinton Global Initiative. Please listen to the previous episode, Safe Babies Safe Moms: Rethinking Equitable Access and Maternity Care.
About Cure
Cure is an innovation campus in NYC boasting laboratories, lecture, and office space, as well as technology and other amenities to set up innovators for success across the healthcare industry, including academic institutions and other nonprofits. Visit the website at: https://cure.345pas.com/
Blue Shield of California, Highmark, Intellihealth and NourishedRX discuss how they are mitigating the high costs of GLP-1s with lifestyle interventions such as behavior change, physical exercise, nutritional counseling and coaching to optimize outcomes for members living with obesity and diabetes.
Hear real-life examples and best practices to equip your members with the tools and strategies to achieve lasting success in managing obesity and diabetes beyond the limitations of GLP-1s.
This episode is sponsored by NourishedRX
NourishedRx is a leading digital health and nutrition company specializing in comprehensive nutrition solutions for consumer and health plan members living with diabetes, obesity and other diet-related conditions.
NourishedRx recognized food's healing and connective power, and partners with healthcare organizations nationwide to address the nutritional needs of their most vulnerable populations.
The NourishedRx B:B:C health and nutrition platform facilitates and optimizes personalized, culturally concordant food in addition to the tools necessary to drive lasting behavior change – leveraging technology so YOU can all deliver at scale.
Beyond diet, NourishedRx engages with health plan members and patients to support their whole health and lifestyle more broadly. They engage consumers with omnichannel wrap-around support and education, enabling individuals to make informed choices and gain a deeper understanding of the impact of their diet and lifestyle on their overall well-being, empowering them for the long term.
NourishedRx is well suited as an early alternative and/or companion therapy to specialized obesity treatment, including GLP-1 and other Anti-Obesity Medication therapies.
Blue Shield of California, Highmark, Intellihealth and NourishedRX discuss how they are mitigating the high costs of GLP-1s with lifestyle interventions such as behavior change, physical exercise, nutritional counseling, coaching to optimize outcomes for members living with obesity and diabetes.
Hear real-life examples and best practices to equip your members with the tools and strategies to achieve lasting success in managing obesity and diabetes beyond the limitations of GLP-1s.
PANELISTS Angie Kalousek Ebrahimi, Senior Director of Lifestyle Medicine, Blue Shield of California
Timothy Law, DO, Chief Medical Officer, Highmark Health
Katherine H. Saunders, M.D., Executive Vice President & Co-Founder, Intellihealth
Lauren Driscoll, Founder & CEO, NourishedRx
https://www.brightspotsinhealthcare.com/events/lifestyle-modification-strategies-to-support-those-living-with-obesity-and-diabetes/
This episode is sponsored by NourishedRX
NourishedRx is a leading digital health and nutrition company specializing in comprehensive
nutrition solutions for consumer and health plan members living with diabetes, obesity and other
diet-related conditions.
NourishedRx recognized food's healing and connective power, and partners with healthcare
organizations nationwide to address the nutritional needs of their most vulnerable populations.
The NourishedRx B:B:C health and nutrition platform facilitates and optimizes personalized,
culturally concordant food in addition to the tools necessary to drive lasting behavior change –
leveraging technology so YOU can all deliver at scale.
Beyond diet, NourishedRx engages with health plan members and patients to support their
whole health and lifestyle more broadly. They engage consumers with omnichannel wrap-around support and education, enabling individuals to make informed choices and gain a deeper understanding of the impact of their diet and lifestyle on their overall well-being, empowering them for the long term.
NourishedRx is well suited as an early alternative and/or companion therapy to specialized obesity treatment, including GLP-1 and other Anti-Obesity Medication therapies.
Leaders from Blue Cross and Blue Shield of Michigan, Highmark and Quest Analytics discuss how health plans are examining and reimagining their provider strategies to stay competitive and meet their members' evolving needs. By focusing on areas such as compliance, network adequacy, data integrity, and performance metrics, plans are redefining their own roles and enhancing quality and affordability for their members.
Our panel of experts will share their insights and experiences. Possible topics of discussion:
- Compliance
- Network adequacy
- Data integrity
- Performance metrics & goals
https://www.brightspotsinhealthcare.com/events/differentiating-your-health-plan-reimagining-your-provider-network-strategy/
Quest Analytics sponsors this episode
Quest Analytics’ software platform empowers you to analyze, expertly manage meticulously, and impeccably report on your provider network‘s adequacy and the provider data accuracy across your entire organization and all lines of business. You can trust them! CMS does, and they are among eight of the nation’s largest health plans that leverage its software and services, not to mention multiple state regulatory agencies and many of the nation’s leading health systems and provider groups. They manage, measure and monitor health plan network performance so that together, we can elevate the health of communities nationwide. They also enable health plans to differentiate their position in the marketplace through a vastly superior provider network. My words, not theirs, and I know I am simplifying things a bit …but think of them as the Kayak for physician quality and accessibility data. For more information, please visit the Quest Analytics website at http://www.questanalytics.com./
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Sonny Goyal, Senior Vice President of Diversified Business Group and Chief Strategy Officer of Blue Cross Blue Shield of North Carolina (Blue Cross NC), joins Eric to share some of Blue Cross NC’s successful initiatives to help members live their best lives. Sonny discussed Blue Cross NC’s approach to mitigating social determinants of health, explaining the insurer is utilizing test-and-learn models to build quantifiable evidence, scale up successful models and, eventually, expand those ideas through its benefit offerings across the state. Sonny and Eric touch on several topics, including Blue Cross NC’s recent food insecurity pilot program, value-based care, provider relationships and community health initiatives. After listening, you’ll have many bright spots to consider implementing in your organization!
Links to articles mentioned during the discussion:
https://www.bluecrossnc.com/blog/expert-takes/transforming-health-care/food-is-medicine
https://catalyst.nejm.org/doi/full/10.1056/CAT.22.0351
https://mediacenter.bcbsnc.com/news/blue-cross-nc-donates-500-000-to-the-forward-fund-established-to-support-transition-efforts-following-mill-closure
About Sonny
Sonny leads the diversified business group at Blue Cross and Blue Shield of North Carolina (Blue Cross NC) while also serving as their chief strategy officer, He is responsible for thoughtfully guiding the company as it seeks to achieve sustainable long-term growth by enhancing its existing business and identifying opportunities to expand beyond via inorganic growth.
Among other responsibilities, Sonny is accountable for managing and maturing the company’s best-in-class business partnerships and assets, shaping Blue Cross NC’s short-term goals and long-term strategy, portfolio planning and prioritization, corporate development and utilizing strategic intelligence to improve the experience of key stakeholders across the state.
Before joining Blue Cross NC, Sonny served in leadership roles at several other leading companies in the healthcare, venture capital and finance sectors. Most recently, he was Executive Director for Corporate Strategy and Development for the Advisory Board Company in Washington, DC. Before that, Sonny led Mergers and Acquisitions for Highmark Blue Cross and Blue Shield; brokered acquisitions, divestitures and capital raises ranging from $250 million to $12 billion at Wells Fargo; and assisted in assessing venture capital investments for Garage Technology Ventures in Silicon Valley.
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Former New Jersey Congressman and Health Transformation Alliance (HTA) CEO, Robert Andrews, joins Eric to discuss how HTA – a cooperative of more than 60 of America’s leading employers –and its members employers are fixing our broken healthcare system by sharing data, challenging the status quo and implementing innovative solutions. Robert shares many bright spots from HTA, including initiatives in medication management and infant mortality. He explains how the cooperative has saved its member companies well over $2 billion in healthcare costs to date.
About Robert
As CEO of the HTA, Robert oversees the strategic direction of approximately 60+ major corporations that have come together in an alliance to fix the broken healthcare system. He is also the Chairman of the Board of Lolo Health, a health tech company that connects consumers to a high-value health experience. Andrews previously led the Government Affairs practice at Dilworth Paxson law firm for two years before joining the HTA.
Before private practice, Andrews served as a Member of the United States House of Representatives for nearly 24 years. Upon his departure from Congress, President Barack Obama praised Andrews’ service as “an original author of the Affordable Care Act…and a vital partner in its passage and implementation” and cited his “tenacity and skill” in representing the people of New Jersey.
About HTA
The Health Transformation Alliance (HTA) is a cooperative of more than 60 of America’s leading employers coming together to fix the broken healthcare system. Formed by four founding members in September 2015, the HTA member companies collectively are responsible for over 8 million employees, dependents, and retirees with an annual healthcare spend of $30+ billion.
Some members include Walgreens, 3M, Marriott, Shell, Coca-Cola and NextEra Energy.
Angela D. Thomas, DrPH, MPH, MBA, Vice President, Healthcare Delivery Research, MedStar Health Research Institute, joins Eric to discuss D.C. Safe Babies Safe Moms, a community-driven collaborative launched in 2020 to improve the health and well-being of mothers and infants in Washington, D.C., and reduce racial disparities in maternal and infant health outcomes – one of the most urgent challenges facing the District of Columbia.
Combining the expertise of MedStar Health, evidence-based healthcare, and proven community-centric support services, Safe Babies Safe Moms offers services to support birthing individuals before, during, and after pregnancy and until their child reaches age three.
Angela shares success stories from families supported by the initiative and discusses the program's impact. For health systems interested in implementing a similar program, she outlines MedStar Health's steps in building and sustaining the initiative.
She also speaks about the role technology plays in the initiative. Safe Babies and Safe Moms recently launched a Clinton Global Initiative (CGI) Commitment to Action project to use artificial intelligence and machine learning to help reduce disparities in maternal and infant health.
About Safe Babies Safe Moms
Made possible by the A. James & Alice B. Clark Foundation, D.C. Safe Babies Safe Moms is a partnership between MedStar Health, Community of Hope, and Mamatoto Village to address critical maternal and infant care disparities in Washington, D.C., which has among the highest rates of maternal and infant mortality in the nation. In FY22, 15,346 mothers and babies received care through the program.
Services offered include on-site mental health support during prenatal and postpartum visits, assessments for high-risk or complicated pregnancies, social support services for mothers and families who may be experiencing food or housing insecurity, pro-bono legal services, and other counseling on securing public benefits, transportation to and from appointments, infant care supplies, culturally-aware breastfeeding support, and more.
About Angela
Angela is responsible for leading a team of experts to apply rigorous scientific methods to enable next-generation healthcare delivery through quality, safety, innovation, health economics, payment reform, outcomes, health services research, data science, and health equity. She also ensures that these research activities leverage the collective leadership and unique strengths of MedStar Health and Georgetown University.
Her research interests focus on health equity and patient safety. As the Executive Leader of Safe Babies Safe Moms, Angela is responsible for ensuring the development, implementation, and evaluation of an evidence-based program that will reduce disparities in maternal and infant mortality in Washington, DC. In addition, she contributes her research expertise in disparities, health equity, and patient safety to the initiative to uncover the contributing factors leading to disparities in maternal and infant harm.
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Leaders from CareFirst, CareSource, UPMC Health Plan and Scene Health explore how proper medication adherence ensures a higher quality of life, improves health outcomes and reduces healthcare costs.
Many health plans saw their overall Medicare Star Ratings drop this year due to one particular area – medication adherence. Our expert panel from top-rated plans shares innovative and actionable strategies for overcoming barriers to medication adherence.
Topics for discussion include:
- Reasons traditional approaches to medication adherence are not effective
- Best ways to speed up intervention with a personalized, member-centric approach
- Financial and ratings impacts of medication adherence measures
Confirmed Panelists
Tom Manetti, Associate Vice President, Quality Products, CareSource
Molly McGraw, PharmD, BCPS, Manager, Clinical Pharmacy, UPMC Health Plan
Suzanne Moxham, Director, Quality, Accreditation, & Government Programs at CareFirst BlueCross BlueShield
Sebastian Seiguer, CEO & Co-Founder, Scene Health
Bios: https://www.brightspotsinhealthcare.com/events/how-medication-adherence-can-be-much-more-than-medication-adherence/
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This episode is sponsored by Scene Health
Meet Scene Health, the medication engagement company that's taking on the colossal $500 billion problem of medication nonadherence. But here's the twist – they're doing it in a novel way by leveraging asynchronous video engagement.
Scene's model of care enhances the CDC-endorsed gold standard for ensuring medication adherence, Directly Observed Therapy. Their team of pharmacists, nurses, and health coaches engage with members via back-and-forth videos to build trust through person-to-person connections and empower every patient to take every dose of medication properly.
And they're not just all talk. Scene Health has been clinically validated in 20 peer-reviewed publications and is already teaming up with Medicaid and Medicare health plans, public health departments, and life science organizations to tackle a range of conditions, from diabetes & asthma to sickle cell disease.
Kim Barrus, MSN, RN, PMP, Director, Clinical Outcomes Management of SelectHealth, joins Eric to discuss how her plan reinvented the consumer experience for ACA Marketplace health plans.
With almost half of ACA Marketplace customers complaining about making appointments with providers and other process challenges, SelectHealth committed to reversing the trend and implementing a complete, end-to-end consumer experience.
Kim shares the results of SelectHealth’s efforts and outlines the plan’s strategy giving members the seamless experience they want. Listen and get the roadmap for remaking your plan’s ACA consumer experience!
About Kim
Kim Barrus began her career with SelectHealth 26 years ago and has worked in various capacities. She developed the SelectHealth Advanced Primary Care (a.k.a. patient-centered medical home) program. She facilitated the initial pilots of the program in 2010. Today the program has 1,240 participating providers at 222 participating clinics. In her current role, Kim oversees quality, medical home, NCQA accreditation, HEDIS and CMS Stars.
Kim is a registered nurse who received her Bachelor of Science in Computer Information Systems and maintains a Project Management Professional (PMP) certification from the Project Management Institute (PMI).
This episode is sponsored by ReferWell
Health plans must be acutely aware of their progress towards achieving their Care Gap Closure targets. Their most significant obstacle is to directly impact those specific areas, even though they have limited capabilities to do so.
ReferWell helps health plans improve access to care by efficiently scheduling members for the care they need.
ReferWell care navigators find the "Perfect Match" provider right at the referable moment when the member is saying yes to their care. They then seamlessly schedule the member's appointment while still on the call. It’s a proven process that provides better access, experience and outcomes for members and better quality performance, which affects the health plan’s bottom line.
Leaders from Humana, Healthfirst, Health Leads and Vesta Healthcare join Eric to discuss the future of home healthcare for Medicare Advantage plans. As care delivery strategies evolve, the home is critical in achieving clinical and customer satisfaction ratings that drive business success. Home health is also vital to providing equitable care to all members. Our expert panel lays a blueprint for implementing a successful home care model that your plan can use.
Confirmed Panelists:
Susan Beane, MD, FACP, Executive Medical Director, Clinical Partnerships, Healthfirst
Chase Dailey, Principal, Home Solutions, Humana
Randy Klein, CEO, Vesta Health
Dominique Morgan, Chief Operating Officer, Health Leads
https://www.brightspotsinhealthcare.com/events/medicare-advantage-and-the-next-generation-in-home-health-strategies/
This episode is sponsored by Vesta Healthcare
Vesta Healthcare is a specialized virtual medical group providing high-touch medical support to patients with chronic conditions. Our program uses technology and patient and caregiver engagement to act on insights gleaned from the first mile of patient care: the home.
We connect the entire care team - patients, family, caregivers, insurance plans, agencies, doctors, and nurses - to support the best care at home. The ancient Roman goddess of hearth and home inspired our name, Vesta, because our mission is to ensure that people stay in the comfort of their homes as long as possible.
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Leaders from Network Health, UPMC Health Plan, Healthmine and Benelynk explore how Medicare Advantage plans can attain 5-Stars and share bright spots on improving outcomes for members with social risk factors. Learn how closing gaps in care and reducing health disparities can help your plan reach 5 Stars!
Topics include:
- CMS Health Equity Index
- Product Enhancement
- Member Activation and Engagement
- Payer/Provider Collaboration
- Social Care Strategy Blueprint
Panelists:
- Andre Bliss, Ph.D., MBA, Director, Medicare STARs, UPMC Health Plan
- Mallory Mueller, (she/her/hers) Director Quality Health Integration, Network Health
- Cherie Shortridge, Senior Advisor, Healthmine
- Sean Libby, President, BeneLynk
Bios: https://www.brightspotsinhealthcare.com/events/evolution-of-sdoh-2024-and-beyond/
BeneLynk sponsors this episode
BeneLynk is a national provider of Social Care solutions for Medicare Advantage and Managed Medicaid health plans. We serve plans and their members by creating a human-to-human connection and providing the assistance a member needs to get the benefits they deserve.
We build stronger human connections supported by innovative technology by employing one dynamic conversation that flows organically to meet Social Determinants of Health challenges.
All of our services are customized to the specific geography, where we provide the members with the specific information they need to keep their benefits in place.
Our mission is to improve lives and positively impact Social Determinants of Health barriers by providing our healthcare partners with the information they need and people with the advocacy they deserve.
Healthcare leaders from Humana, myPlace Health, Mom’s Meals, and SCAN explore the latest product and benefit design trends for the aging population. Our expert panel shares strategies and best practices your plan can implement to bridge the social and clinical care gap and empower seniors to create a lifetime of healthy habits.
Topics include:
- Product Segmentation
- SDOH/Supplemental Benefits
- Care Models
- Payer and Provider Collaboration
Panelists:
- Catherine Macpherson, MS, RDN, Senior Vice President of Healthcare Strategy & Development, Mom’s Meals
- Erika Pabo, MD, MBA, Chief Transformation Officer & Central Operations, Centerwell & Conviva, Humana
- Lena Perelman, Senior Director, Product Development, Market Expansion, SCAN Health Plan
- Robert Schreiber, MD, AGSF, Vice President and National Medical Director, myPlace Health
Bios: https://www.brightspotsinhealthcare.com/events/the-future-of-senior-health-equitable-access-open-enrollment/
The Episode is Sponsored by Mom’s Meals
Getting the right nutrition is essential to achieving and maintaining good health – yet accessing balanced meals that also support health challenges and fulfill personal tastes is not always as easy as it should be.
At Mom’s Meals, our passion is to provide nourishment and deliver wholesome meals to the homes of those who need better nutrition to support their health and wellness, no matter where they live. It’s the reason we’ve built our business from our own personal roots, caring for our clients as we do our own family and loved ones.
Our menus are designed by professional chefs and registered dieticians to taste great and support the nutritional needs of common chronic conditions. Clients get to choose every meal, every order. Meals are delivered to any address, no matter how remote.
To learn more visit momsmeals.com.
Senior healthcare leaders from AmeriHealth Caritas, AvMed, HealthTeam Advantage, and ReferWell share strategies health plans can use to understand gaps in care throughout the member journey.
For health plans participating in risk-based agreements, gaps in care have severe implications for members' health outcomes and their ability to attain higher quality scores necessary to receive financial bonuses and drive member enrollment.
Hear how plans leverage data and real-time analytics to effectively and efficiently close time-sensitive care gaps to improve HEDIS, Stars and other quality scores.
Topics covered include:
- Provider Plan Partnerships
- Building a Relationship with Members
- Identification & Targeting
- Systems & Incentives
Confirmed Panelists
- Marsha Barlocker, RN, BSN, MS, Senior Director, Quality & Case Management, HealthTeam Advantage
- Chad Baugh, Chief Strategy Officer, ReferWell
- Vandna Bhrany, Vice President, HEDIS Strategy & Analytics, AmeriHealth Caritas
- Frank Izquierdo, Senior Vice President Provider Solutions and Strategic Alliances,
- AvMed
Bios: https://www.brightspotsinhealthcare.com/events/last-minute-gaps-in-care-strategies/
This episode is sponsored by ReferWell
Health plans must be acutely aware of their progress towards achieving their Care Gap Closure targets. Their most significant obstacle is to directly impact those specific areas, even though they have limited capabilities to do so.
ReferWell helps health plans improve access to care by efficiently scheduling members for the care they need.
ReferWell care navigators find the "Perfect Match" provider right at the referable moment when the member is saying yes to their care). They then seamlessly schedule the member's appointment while still on the call. It’s a proven process that provides better access, experience and outcomes for members and better quality performance, which affects the health plan’s bottom line.
Nashville General Hospital CEO Joseph Webb,D.Sc., MSHA, FACHE, joins Eric to discuss how the hospital is using innovation to fulfill its mission and vision to improve the health and wellness of Nashville – one neighbor at a time.
During the conversation, Dr. Webb shares details on two innovative initiatives Nashville General implemented to address health equity and transform care delivery.
- Food Pharmacy - In 2018, Nashville General launched the Food Pharmacy to provide access to food for individuals living with food insecurity and to educate those individuals about which foods best fit within the care plan based on their chronic conditions.
- Congregational Health and Education Network (CHEN) - Launched in 2017, CHEN is a 501(c)(3) faith-based initiative with local churches and educational institutions with a primary focus on reducing health disparities for communities of color through education attainment, access to healthcare, and health literacy. Currently, CHEN includes 100 faith-based organizations of all denominations throughout Nashville.
In addition, Dr. Webb provides a blueprint to help other health organizations implement similar, innovative programs to promote healthy communities and reduce health disparities.
About Dr. Webb
Since joining Nashville General in 2015, Dr. Webb has successfully led efforts to improve patient outcomes, enhance the patient experience and grow revenues.
Before joining Nashville General Hospital, Dr. Webb served as chief operating officer for Common Table Health Alliance in Memphis, Tennessee. As a former chief executive operating officer for Methodist Le Bonheur South Hospital in Memphis, Tennessee, he held additional chief executive roles for Healthcare Services of America at Coastal Carolina Hospital and Northwest Mississippi Regional Medical Center.
Dr. Webb is board certified in Healthcare Management and is a Fellow of the American College of Healthcare Executives. Nationally, he serves as a board member of America’s Essential Hospitals and as chairman of the Governance Committee. He serves on the board of the Nashville chapter of the American Heart Association and as a board member of NashvilleHealth. Dr. Webb is a member of Omega Psi Phi, Incorporated.
Dr. Webb earned a Doctorate of Science in Health Services Administration and a Master of Science in Hospital and Health Services Administration from the University of Alabama at Birmingham. He also holds a Bachelor of Science and Master of Science in Health and Physical Education from Tennessee State University.
About Nashville General Hospital
A leading safety net hospital with 150 beds and more than 22 clinics. Nashville General Hospital serves as the index teaching hospital for the historic Meharry Medical College.
Nashville General has earned multiple accreditations for its evidence-based measures and practices that provide quality healthcare. These include The Joint Commission’s Gold Seal of Approval accreditation, NCQA PatientCentered Medical Home accreditation, the NCQA Diabetes Recognition Program, accreditation by the Commission on Cancer for Nashville General’s Robert E. Hardy Cancer Center, and Level 3 TNCPE Performance Excellence Award.
The hospital also has increased its revenue sources through expanded healthcare services and launched initiatives to attract new commercially insured patients. These efforts ensure that every patient receives high-quality care at Nashville General Hospital regardless of their ability to pay.
Healthcare leaders from Geisinger, Intermountain Health, UNC Health and TytoCare join Eric to discuss how AI and machine learning transform the member journey and empower members to take a more active role in their health. Our experts share successful strategies and best practices your healthcare organization can implement to change the member experience.
Hear the following case studies and learn how:
- Intermountain Health physicians use AI to diagnose pneumonia
- Geisinger leverages AI and machine learning to identify patients at higher risk for colon cancer to ensure they go for a colonoscopy
- UNC Health determines which patients are best suited for home health care vs. the hospital with AI and machine learning
- TytoCare drives better patient adoption of virtual care technologies with AI
Panelists:
Nathan Dean, MD, Section Chief of Pulmonary and Critical Care Medicine, Intermountain Medical Center
Rachini Moosavi, Chief Analytics Officer, UNC Health
Karen M. Murphy, PhD, RN, EVP/Chief Innovation and Digital Transformation Officer, Geisinger Ohad Pollak, Chief Marketing Officer, TytoCare
Bios: https://www.brightspotsinhealthcare.com/events/how-ai-is-changing-patient-engagement
This episode is sponsored by TytoCare
TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are five times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for successfully deploying and adopting the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 220 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.
Healthcare leaders from Health Net, Horizon Blue Cross Blue Shield of New Jersey and Socially Determined shared successful Medicaid Redetermination strategies and best practices to help ensure your plans’ most vulnerable populations do not lose essential health coverage.
With the end of the Public Health Emergency and the Medicaid continuous coverage provision in April, Redetermination could cause 18M Americans to lose health coverage, creating care gaps for the most vulnerable & widening health disparities. Our expert panel provides you with important information about navigating the disenrollment storms ahead.
- Mildred Menos, Director, Medicaid Product Administration, Horizon Blue Cross and Blue Shield of New Jersey
- Darrel Ng, Vice President, Communications & Marketing, Health Net
- Trenor Williams, MD, Co-Founder & CEO, Socially Determined
Bios: https://www.brightspotsinhealthcare.com/events/the-disenrollment-tsunami-how-to-fix-your-medicaid-redetermination-strategy/
This episode is sponsored by Socially Determined
Socially Determined is leading the transformation of health care delivery and payment through social risk analytics and solutions. Our SocialScapeⓇ SaaS platform, data and industry-leading expertise empower health systems, plans and other risk-bearing organizations to better manage risk, improve outcomes and advance equity at scale. Recently named by Fierce Healthcare as one of the 15 most promising healthcare companies, Socially Determined is headquartered in Washington, DC. Visit: www.sociallydetermined.com
Phylicia Schroeder, Manager, Provider Engagement and Quality Analytics at Blue Cross Blue Shield of Arizona Medicare Advantage and Janine Wakim, Head of Operations at ReferWell, join Eric to discuss how the plan is transforming the member journey by instituting a cultural shift putting the member’s needs above the plan’s needs, adding that to accomplish this goal, the plan uses data and predictive analytics to learn about what makes its members unique.
Topics covered during the episode include:
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Member journey mindset
-
Navigation and physician scheduling
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Data integration, risk mitigation (as it relates to CAHPS) and
-
Provider engagement.
Phylicia and Janine share many bright spots your plan can implement to provide a tailored experience for your members!
About Phylicia
Phylicia is a highly skilled Medicare Stars quality (HEDIS, CAHPS, HOS) analyst and strategist who specializes in data analysis, extrapolation and visualization through building dashboards in Power BI, technology implementation, provider engagement and clinical workflows, project management, process improvement and documentation.
She is a true innovator who never says “No” and sees obstacles as opportunities to apply creative problem-solving to find a solution.
About Janine
As Head of Client Operations, Janine Wakim is keenly focused on the success and satisfaction of ReferWell’s customers.
Janine leads the team that works with some of the largest healthcare systems and payers in the United States from onboarding to growth to ongoing support.
She is an operations leader with over 20 years of experience in strategic planning and process improvement, leading client experience and business analytics teams. At Gartner, she served as the lead in building the offshore center of excellence for Business Analysis to provide insights into the Research and Advisory business to grow its footprint and retain its client base. She also served in leadership roles at Datto and Potoo Solutions.
Janine earned a Bachelor of Science in Finance from Lehigh University, an MBA from Columbia Business School, and an MPH in Hospital Administration from Columbia University Mailman School of Public Health.
This episode is sponsored by ReferWell
Health plans are acutely aware that they are measured and graded on quality, experience and health equity more so than ever before. Their biggest challenge is to impact those areas directly.
ReferWell helps health plans advance health equity by scheduling underserved members for the care they need, be it medical, care gap appointments or — through your community partnerships — appointments for transportation assistance, nutritional counseling, mental health services and other community-based organization offerings.
Data shows that ReferWell’s solution directly impacts the members who need it most.
ReferWell care navigators find the Perfect Match right at the referable moment (when the member is leaning into their care) and schedule the member while on the phone. It’s a proven process that provides better access, experience and outcomes for members, and better quality performance, which affects the health plan’s bottom line. For more information, visit www.referwell.com.
Psychedelic Researcher and Psychologist Alex Belser, PhD, joins Eric to discuss the efficacy and safety of psychedelics, how they are being applied in practice and the potential pharmacoeconomic or business impact this category of medications can have. Alex also shares information on the latest research and developments in psychedelics.
About Alex
Dr. Alex Belser is a licensed psychologist and researcher focused on psilocybin, MDMA, and DMT therapies. At Yale, Dr. Belser is investigating a psychedelic treatment for OCD. He is the Chief Clinical Officer of Cybin, where he is the co-creator of a new model of psychedelic-assisted psychotherapy called EMBARK.
Leaders from Humana, SCAN and NourishedRx discuss the link between food, nutrition security and health and the idea that food and nutrition programs can improve health. Many Americans lack access to nutritious food due to food insecurity, contributing to high rates of chronic disease, poor health outcomes and health disparities, especially among underserved communities.
Our expert panel will share solutions and strategies health plans can adopt to improve health equity, reduce healthcare costs and alleviate the adverse impact of limited access to healthy food among your most vulnerable populations.
Panelists
Romilla Batra, MD, MBA, Chief Medical Officer, SCAN
Leah Brucchieri, Director of Medicare Growth and Innovation at Humana
Lauren Driscoll, Founder and CEO of NourishedRx
Bios: https://www.brightspotsinhealthcare.com/events/equity-engagement-nutrition-innovations-empowering-the-underserved/
This Episode is sponsored by NourishedRx
NourishedRx aims to eradicate poor diet and nutrition insecurity as top drivers of death, disease, and disparities. Founded in 2019 by Lauren Driscoll, NourishedRx is a digital health and nutrition company that helps people live healthier lives and supports health equity. Leveraging the healing and connective power of food, NourishedRx partners with healthcare organizations nationally to nourish their most vulnerable members, build healthy relationships, and support health equity. NourishedRx delivers highly personalized, culturally relevant meals and groceries to members, along with wrap-around whole health support and nutrition education. The NourishedRx solution delights and engages members and promotes connection that enables NourishedRx not only to support dietary health and glean actionable insights regarding gaps in care and health-related social needs. Through this solution, NourishedRx can drive better health outcomes and lower overall costs at scale. Visit the website at nourishedrx.com
Psychedelic Researcher and Psychologist Alex Belser, PhD, joins Eric to discuss the efficacy and safety of psychedelics, how they are being applied in practice and the potential pharmacoeconomic or business impact this category of medications can have. Alex also shares information on the latest research and developments in psychedelics.
About Alex
Dr. Alex Belser is a licensed psychologist and researcher focused on psilocybin, MDMA, and DMT therapies. At Yale, Dr. Belser is investigating a psychedelic treatment for OCD. He is the Chief Clinical Officer of Cybin, where he is the co-creator of a new model of psychedelic-assisted psychotherapy called EMBARK.
Healthcare leaders from AmeriHealth Caritas, Cigna Healthcare, Highmark, Reliant Medical Group and Corporate Insight share innovations in mental health, including how their organizations are incorporating and maximizing digital mental health tools and platforms. Learn strategies and approaches you can implement in your organization.
Panelists
Yavar Moghimi, MD, Chief Psychiatric Medical Officer, AmeriHealth Caritas
Sam Nordberg, PhD, Chief of Behavioral Health, Reliant Medical Group
Demetrios C. Marousis, MA, MBA, LPC, Director, Behavioral Health, Highmark
William M. Lopez, MD, CPE, National Medical Director-Virtual Care, Senior Medical Director-Behavioral Health, Cigna Healthcare
Lauren Roncevic, Senior Director of Healthcare Research, Corporate Insight
Bios: https://www.brightspotsinhealthcare.com/events/how-digital-mental-health-is-making-an-impact/
Want more information about our Executive Roundtable Summit on August 24 & 25 in Boston? Visit our website for more information: https://www.brightspotsinhealthcare.com/summit/
This episode is sponsored by Corporate Insight.
Corporate Insight delivers competitive intelligence, user experience research and consulting services to the nation’s leading healthcare, financial services and insurance institutions. As the recognized industry leader in customer experience research for over 30 years, Corporate Insight has been the trusted partner to corporations seeking to improve their digital capabilities and user experience. Their best-in-class research platform and unique approach of analyzing the actual customer experience helps corporations advance their competitive position in the marketplace. Visit their website at: www.corporateinsight.com
G.T. Sweeney, Chief Information Officer, Healthfirst and Sami Boshut, Chief Information Officer, MediSys Health Network, Inc., join Eric to discuss how their organizations collaborated with a technology company to create a cloud-based platform that enables seamless sharing of patient data across the care continuum.
The platform connects longitudinal data from claims, quality measures and electronic health records (EHRs) to identify gaps in care, making it easier for providers to address patient needs in real-time. The two discuss how the platform supports the next phase of value-based care by ensuring providers have the right information at the right time to address the needs of patients.
Sweeney and Boshut also provide a blueprint to help other organizations implement similar provider-centric technology systems.
About Our Guests:
G.T. Sweeney has been Healthfirst’s Chief Information Officer since 2014, leading the Information Services department to help transform the insurer's business and tightly integrate information systems to further strategic goals. Sami Bosurt has a demonstrated history of working in the hospital & healthcare industry with a proven track record and expertise in Healthcare Consulting, Infrastructure Installations, Software Implementation and Vendor Management.
John Petito, Corporate Vice President, Transformation, SCAN Health and Ashish V. Shah, CEO, Dina, discuss the power of benefits navigation in attracting and retaining members for Medicare Advantage plans and other government programs.
The average Medicare beneficiary has access to over 43 Medicare Advantage plans, and offering supplemental benefits such as home-centered care enables plans to compete and differentiate in the marketplace. But plans must ensure members understand the benefits and that the navigation experience is seamless – and painless.
John and Ashish share successful strategies and best practices plans can implement to improve member experience and ensure members receive the care they need.
Topics include:
- How the Medicare Advantage market is shifting
- New opportunities for risk-bearing entities
- Why navigation is so hard and how to enhance it
- Measuring navigation strategy
- Improving CAHPS and STAR Ratings through enhanced benefit navigation
This episode is sponsored by Dina
Dina provides benefits and care coordination solutions to support health plans and providers as they extend care management into the home. Customers use our SaaS technology to digitize their network of community and home-centered providers; transform coordination workflows so they spend less time with phone calls and faxes; collect performance data to improve their network continuously; and capture meaningful data directly from home. Last year, Dina was named to the Inc. 5000 list of fastest-growing companies and CB Insights Digital Health 150 list of companies transforming healthcare with digital technology.
Healthcare leaders from Blue Shield of California, CareSource, UT Health Austin and Vori Health discuss the importance of adopting a whole-person approach across the broader healthcare experience to maximize value, drive healthy behavior change and ensure more equitable care.
Learn how to develop an integrated whole-person solution framework and implement strategies to support members with chronic and high-risk conditions. Topics include:
- Adopting self-service digital tools and applications to engage members
- Providing access to resources, health coaches, medication, and mental/behavioral health support
- Leveraging medical and SDoH data to determine unique needs, tailor care, and sustain healthy behavior change
Panelists: Judith Davis, Vice President Clinical Operations, Ohio Market, CareSource, Angie Kalousek Ebrahimi, Senior Director, Lifestyle Medicine, Blue Shield of California, Karl Koenig, M.D., M.S., Executive Director, Musculoskeletal Institute; Division Chief of Orthopaedic Surgery, Associate Professor of Surgery and Perioperative Care, Dell Medical School, Ryan A. Grant, MD, MBA, FAANS, Founder and Chief Executive Officer, Vori Health
Bios: https://www.brightspotsinhealthcare.com/events/reduce-total-cost-of-care-innovative-whole-person-models-for-high-cost-conditions/
Request discount code for our Payer & Provider Summit: https://www.brightspotsinhealthcare.com/summit-promo/
This episode is sponsored by Vori Health
Vori Health is a specialty medical practice delivering a virtual-first musculoskeletal (MSK) solution to help members return to their lives faster. As the only nationwide MSK practice with doctor-led care teams, Vori Health is the most convenient way to access appropriate care for back, neck, and joint pain without bouncing around the healthcare system. Whether members need a diagnosis, non-opioid prescription, personalized physical therapy, or health coaching, they can turn to Vori Health for evidence-based care and effective end-to-end support. This holistic model reduces unnecessary surgeries, enables faster recoveries, and lowers MSK spending with up to a 4:1 ROI, for more information, visit www.vorihealth.com.
CDPHP, Johns Hopkins Medicine, Priority Health, ATRIO Health Plans and Vatica Health share successful strategies and best practices for provider-centric risk adjustment programs, which enable health plans to enjoy higher compliance, enhanced quality of care, improved risk score accuracy, higher Star and quality ratings and better financial performance. Learn how your plan can empower physicians to close care gaps, avoid common pitfalls and maintain compliant record documentation proactively.
Panelists: Gregg Kimmer, President & CEO, ATRIO Health Plans; Michelle Ilitch, MPH, Vice President, Vice President of Network Solutions and Value-Based Programming, Priority Health,; Colleen Gianatasio MHS, CPC, CPC-P, CPMA, CRC, CPCO, CDEO, CPPM, CCDS-0, CCS, and AAPC Approved Instructor, Director Clinical Documentation Integrity and Coding Compliance, Capital District Physician’s Health Plan (CDPHP); Frank Shipp, FACHE, MBA, Executive Director, Johns Hopkins Clinical Alliance, Johns Hopkins Medicine; Hassan Rifaat, MD, CEO, Vatica
https://www.sharedpurposeconnect.com/events/boosting-plan-performance-improving-provider-centric-risk-adjustment-staying-compliant/
For more information on our Payer & Provider Roundtable Summit:
https://brightspotssummit.eventbrite.com
This episode is sponsored by Vatica Health
Vatica Health is the #1 rated risk adjustment and quality of care solution for health plans and health systems. By pairing expert clinical teams with cutting-edge technology, Vatica increases patient engagement and improves coding accuracy and completeness. It helps identify and facilitate closure of care gaps and enhances communication and collaboration between providers and health plans. The company’s unique provider-centric solution helps payers, providers and patients achieve better outcomes, together.
Vatica is trusted by many leading health plans and thousands of providers nationwide. Healthcare research firm KLAS named Vatica “Best in KLAS” for risk adjustment in 2023. KLAS also named Vatica to its Emerging Solutions Top 20 list for innovative companies that have the greatest potential to impact and disrupt the healthcare market. For more information, visit VaticaHealth.com.
AmeriHealth Caritas, Blue Cross Blue Shield, Optum at Home & Reema Health share bright spots and novel tactics for engaging dual eligible beneficiaries. Discussion topics include: building a foundation of trust through a community approach, engaging hard-to-reach or historically unreachable members, and addressing health-related social needs to improve clinical outcomes
Panelists Include:
Christopher McDade, Vice President, Medicare Integrated Health Plans and Revenue Management, AmeriHealth Caritas,
Leanna Moran, Managing Director of the Duals Market, Blue Cross Blue Shield of Rhode Island
Catherine Mitchell, Chief Strategy Officer, Optum at Home
Melissa Kjolsing, Head of Engagement Strategy, Reema Health
Bios: https://www.sharedpurposeconnect.com/events/unique-approaches-to-building-trust-with-dual-eligible-members/
This episode is sponsored by Reema Health
Reema is transforming how people navigate the gaps between health care and social care using technology and Community Guides who share their identity with the members they serve. Reema’s approach improves healthcare experiences, leading to higher member engagement and reduced costs.
Reema’s breakthrough health platform uses proprietary technology and predictive data modeling to identify people with the highest level of unmet social needs, power Community Guides with the right information to engage them meaningfully, connect them with the most relevant resources, and improve their health and lives. Because they believe in guiding all members to better health. Learn more at reemahealth.com
Joanne Mizell, Chief Operating Officer, Banner|Aetna – a joint venture between CVS Health’s insurance arm, Aetna, and health system Banner Health – joins Eric to discuss what makes Banner|Aetna unique from other health insurers and its approach to whole person care.
She shared how the company uses MultiDisciplinary Care Teams to provide high-risk patients with a localized, high-touch, intensive care management strategy with a unique care approach to meet patients face-to-face.
In addition to sharing numerous bright spots, including a Type 2 Diabetes Reversal program, Joanne lays out a blueprint for building innovative, whole person care programs.
About Joanne
Joanne joined Banner|Aetna in February 2018 with over 20 years of Aetna experience and nearly 30 years in the Employee Benefits industry. In this role, and as a member of the executive leadership team, Joanne oversees the organization's operations. She supports the execution of the strategic goals set by Banner|Aetna’s Board of Directors and Chief Executive Officer.
Bright Spots in Healthcare has a new website! Please visit: https://www.brightspotsinhealthcare.com/
Register for our Payer & Provider Executive Summit on August 24 & 25 in Boston.: https://www.eventbrite.com/e/469644799237
Healthcare leaders from Alignment Health, SCAN, ATI Advisory and Dina discuss the importance of MA plans to ensure members understand available non-medical benefits. Making the experience painless is essential to attracting and retaining members – and improving CAHPS and Star Ratings. Learn successful strategies and best practices your plan can implement to improve member experience and ensure members receive the care they need. Topics include: Humanizing the navigation process; creating a culture of customer service; using technology to streamline benefit navigation, and leveraging home-centered care
Panel:
Dawn Maroney, CEO of Alignment Health Plan and President, Markets of Alignment Health
John Petito, Corporate Vice President of Strategy & Transformation, SCAN Health Plan
Ashish V. Shah, CEO, Dina
Anne Tumlinson, CEO, ATI Advisory
Bios: https://www.sharedpurposeconnect.com/events/maximizing-the-impact-of-supplemental-benefits-to-increase-star-ratings/
Payer & Provider Executive Roundtable Summit Registration: https://www.eventbrite.com/e/payer-provider-roundtable-summit-engagement-clinical-bright-spots-registration-469644799237
This episode is sponsored by Dina
Dina provides benefits and care coordination solutions to support health plans and providers as they extend care management into the home. Customers use our SaaS technology to digitize their network of community and home-centered providers; transform coordination workflows so they spend less time with phone calls and faxes; collect performance data to improve their network continuously; and capture meaningful data directly from home. Last year, Dina was named to the Inc. 5000 list of fastest-growing companies and CB Insights Digital Health 150 list of companies transforming healthcare with digital technology.
Healthcare leaders from United Health Group, Blue Shield of California, Highmark, Oklahoma Complete Health (Centene) and TytoCare share real-world, virtual care success stories. Gain insight into how virtual care boosts outcomes improves equity and reduces costs. Hear case studies, lessons learned, and best practices you can implement in your organization.
Topics include:
- Engagement, Experience and Equity
- Plan Design
- Local as a Strategy and Hybrid Care
Industry Experts: Nina Birnbaum, Medical Director, Innovation Acceleration, Blue Shield of California; Barbara Koch, Senior Vice President, Office of Health Equity, UnitedHealth Group;
Timothy Law, DO, Chief Medical Officer, Highmark; Douglas Olivo, Director of Rural Care and Telehealth Services, Oklahoma Complete Health, a subsidiary of Centene; Si Yahav Tirosh, Director of Engagement Labs, TytoCare
Bios: https://www.sharedpurposeconnect.com/events/success-stories-in-virtual-care-enrollment-engagement/
This episode is sponsored by TytoCare
TytoCare allows users to access quality medical care anytime, anywhere, enabling providers to conduct a comprehensive examination of the ears, lungs, heart, throat, heart rate, temperature, skin, abdomen, and more ..all remotely. TytoCare’s handheld exam kit and app connect users with a clinician or specialist for a medical exam and telehealth visit no matter where they are. Clinicians can access clinical-quality exam data to help ensure patients receive the best remote diagnosis and treatment possible. Health providers, insurers, hospitals, clinics, businesses, and schools worldwide are leveraging TytoCare’s remote exam system to deliver on the full promise of telehealth. And when it comes to product design and the consumer experience, no one has them beat. Companies who are already leveraging their knowledge and platform include Kaiser, Elevance, Amazon and the NHS to name a few. TytoCare is fully compliant and cleared with regulatory bodies, including FDA, CE, HealthCanada, ISO medical, HIPAA, HITRUST, and GDPR.
Visit: www.tytocare.com
Senior leaders from Cigna, Independent Health, Regence, and Socially Determined join Eric to discuss how minimizing social risk helps plans garner higher quality and performance scores. Learn successful strategies for identifying, engaging, and addressing members with elevated social risks to drive gap closure and member retention. The session is full of bright spots you can implement in your organization!
Panel:
- Kathleen Faulk, Senior Vice President &
- Dawn Odzywolski, Vice President, Medicare Programs, Independent Health
- Ashley Perry, MPH, Chief Strategy & Solutions Officer, Socially Determined
- Angela Kloepfer-Shapiro, MD, MBA, Regional Medical Executive, Northeast and West Regions, Cigna Medicare Advantage
Bios: https://www.sharedpurposeconnect.com/events/mitigating-social-risk-to-achieve-higher-star-ratings/
Summit Registration:
https://www.eventbrite.com/e/469644799237
This episode is sponsored by Socially Determined
Socially Determined is leading the transformation of healthcare delivery and payment through social risk analytics and solutions. Our SocialScapeⓇ SaaS platform, data and industry-leading expertise empower health systems, plans and other risk-bearing organizations to manage risk better, improve outcomes and advance equity at scale. Recently named by Fierce Healthcare as one of the 15 most promising healthcare companies, Socially Determined is headquartered in Washington, DC. Visit the website at www.sociallydetermined.com.
A well-crafted story can pack the emotional punch to turn routine presentations into productive relationships. Organizational storytelling expert and author Paul Smith joins Eric to share his popular and proven formula for telling a story. Paul discusses the following:
- What is the optimal structure of a story?
- What different types of stories should we all have at our fingertips for our meetings with health plans and provider organizations?
- How do we leverage these stories to make a sales pitch?
- How do we use storytelling to close a sale?
At the end of the episode, you’ll have a blueprint for a new storytelling strategy for their sales organization!
About Paul
Paul Smith is one of the world’s leading experts on organizational storytelling. He’s one of Inc. Magazine’s “Top 100 Leadership Speakers of 2018” and the author of three Amazon #1 bestsellers: Lead with a Story (now in its 11th printing, and published in 7 languages around the world), Sell with a Story, and The 10 Stories Great Leaders Tell; in addition to Parenting with a Story and his newest work, Four Days with Kenny Tedford. He’s a former executive at The Procter & Gamble Company and a consultant with Accenture before that.
Buy Paul’s book, Sell with a Story: https://www.amazon.com/Sell-Story-Capture-Attention-Build/dp/0814437117
Paul’s website: https://leadwithastory.com/
As health equity initiatives play an increasingly important role in CMS programs, Medicare Advantage plans must commit to addressing social factors hindering access to care and driving members to take action to improve their health, such as scheduling a preventive care visit or completing a missed screening. Industry leaders from 4 & 5-Star plans discuss strategies to advance health equity and improve care access to achieve higher Star Ratings.
Topics include:
- Creating a true health equity strategy
- Using a personalized approach to reaching the unreachable members
- Creating a trustworthy, comfortable approach to care access
- Navigation and scheduling
- Partnering with CBOs
Panelists:
Elizabeth Benz, Vice President of Quality and Clinical Integration, Network Health; Gene Huang, Executive Chairman, ReferWell; Brindha Sridhar, Vice President, Customer Experience Strategy, MetroPlusHealth; Alexandria Tusek, Director, HEDIS & Data Analytics, Priority Health
Panelist Bios:
https://www.sharedpurposeconnect.com/events/equity-timely-access-as-a-stars-strategy/
Bright Spots in Healthcare is hosting our first in-person event on August 24 & 25, 2023, in Boston. The Executive Roundtable Summit is a unique and transformative gathering, bringing together like-minded leaders from health plans, ACOs, health systems, hospitals, government agencies and community-based organizations for large-scale conversations that matter to the future of healthcare.
Payer & Provider Roundtable Summit brochure: https://images.magnetmail.net/images/clients/SPC_/attach/SPCEventBrochure3.pdf
Summit Registration:
https://brightspotssummit.eventbrite.com
This episode is sponsored by ReferWell
ReferWell helps health plans advance health equity by scheduling underserved
members for the care they need, be it medical, care gap appointments or — through
your community partnerships — appointments for services like transportation
assistance, nutritional counseling, mental health services and other community-based
organization offerings.
The residual impact of the COVID-19 pandemic is a change in the way care is delivered in the U.S. With a growing demand for post-acute care, coupled with staffing challenges, providers face challenges and opportunities in care transition and coordination along the continuum of care. Hear our panel of experts discuss innovative and novel approaches to care coordination. Topics include: real-time transparency, streamlining and improving communication, and Interoperability between partner organizations
Panelists: Cynthia Deculus, Chief Population Health Officer and Vice President, Population Health, Cedars Sinai; Margie Zeglen, MBA, RHIA, Vice President, Population Health, Carle Health; Jessica Hohman, MD, MSc, MSc, President and Medical Director, Cleveland Clinic Medicare Accountable Care Organization; Lissy Hu, M.D., MBA, President, Connected Networks, CarePort, powered by WellSky
Bios: https://www.sharedpurposeconnect.com/events/novel-approaches-to-care-coordination-the-key-to-profitable-risk-models/
This episode is sponsored by CarePort, powered by WellSky
CarePort is the leading care coordination network of 2,000 hospitals and 130,000 post-acute and community providers. The end-to-end platform bridges acute and post-acute EHRs, providing visibility into the patient journey for providers, physicians, payers and risk-bearing entities.
With CarePort, healthcare professionals can efficiently and effectively coordinate patient care with visibility and intelligence to manage patients as they move through the continuum. Visit website at: www.careporthealth.com
CMS replaced the Global and Professional Direct Contracting (GPDC) Model with the redesigned ACO Realizing Equity, Access, and Community Health (REACH) Model in 2023. ACO REACH is the first accountable care model to directly address health equity and access to care, with a specific directive to meet the needs of patients from marginalized and underserved communities.
Whether you are participating in ACO REACH, the model provides vital insights into the future of value-based care and care collaboration. This panel will discuss the incentives and requirements laid out by the new ACO REACH model and how organizations can develop action plans to identify differences or disparities in their members' health status.
Panelists: Gary Jacobs, Executive Director, Center for Government Relations and Public Policy, VillageMD; Kate Casaday, MPH, Director of Market Operations, CareMount Health Solutions; Ashley Perry, MPH, Chief Solutions Officer, Socially Determined
Bios: https://www.sharedpurposeconnect.com/events/aco-reach-advancing-equity-and-optimizing-performance/
This episode is sponsored by Socially Determined
Socially Determined is leading the transformation of healthcare delivery and payment through social risk analytics and solutions. Our SocialScapeⓇ SaaS platform, data and industry-leading expertise empower health systems, plans and other risk-bearing organizations to manage risk better, improve outcomes and advance equity at scale. Recently named by Fierce Healthcare as one of the 15 most promising healthcare companies, Socially Determined is headquartered in Washington, DC. Visit the website at www.sociallydetermined.com.
Dr. Errol L. Pierre, Senior Vice President, State Programs at Healthfirst, joins Eric to discuss how health plans, providers and other organizations can create a culture of health equity. He notes the challenges of obtaining the data necessary to understand where to start. Errol advises organizations to gain the patient's or member's trust to get the information. He also touches on setting ROI expectations for health equity programs, defining terms to normalize the discussion of health disparities within the organization and the business imperative of diversity.
Errol shares his identity-defining moments and experience as an executive of color in the healthcare industry. He talks about his new book, The Way Up: Climbing the Corporate Mountain as a Professional of Color, which profiles Errol’s career journey from working in a beauty salon warehouse to being a health insurance executive. The book also offers guidance from prominent executives of color and delivers a pragmatic and actionable guide to help underrepresented individuals from all ethnic backgrounds uncover their passion to achieve their professional goals and elevate their careers.
About Errol
Dr. Errol L. Pierre is a business executive, healthcare strategist, public speaker, professor, and author. He currently serves as a senior executive of Healthfirst, the largest nonprofit health plan in New York. He is also the former Chief Operating Officer of Empire BlueCross BlueShield, the largest for-profit health plan in New York.
Errol graduated from Fordham University with a bachelor’s degree in Business Administration. He later obtained a master’s degree in Health Policy and Financial Management from New York University. He completed his Doctorate in Business Administration from the Zicklin School of Business at Baruch College, focusing on Health Economics.
Errol is a professor at Baruch College, Columbia University, and New York University, teaching Health Economics and Health Transformation and serves on several boards, including the Arthur Ashe Institute for Urban Health and MediNova.
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As we turn the page from 2022, health plans are facing new challenges impacting member experience, retention, and, most importantly, their member’s health. This panel will offer insights on the priorities to focus on as we enter 2023. Topics include: the new reality health plans and members will face once the PHE ends and how getting ahead will avoid significant membership losses; CMS’ increased weight on CAHPS surveys will lead to more focus on member satisfaction; New Social Need Screening and Intervention (SNS-E) requirement means that plans will need to get more serious about members’ social needs by 2025
Panel: Mikal Sutton, Managing Director, Medicaid Policy, Blue Cross Blue Shield Association; Mildred Menos, Director of Member Advocacy and Community Outreach Transformation, Horizon Blue Cross Blue Shield of New Jersey; Steve Wigginton, CEO, Icario
Link to bios: https://www.sharedpurposeconnect.com/events/2023-strategy-session-member-redetermination-cahps-and-social-needs/
This Bright Spots in Healthcare episode is sponsored by Icario
Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through extrinsic and intrinsic motivations. Learn more at icariohealth.com.
Healthcare is moving to a whole-person approach, and rapid innovation connects the dots. Healthcare leaders from Blue Cross NC, KC Blue, Blue Cross MN and MOBE explore how leading health plans can leverage innovations in clinical, wellness and medication management to build and expand a whole-person care framework. Topics include: building digital care models for Whole-Person Care, developing an integrated whole-person solution; Leveraging pharmacy and medical claims data; and coordinating physical, behavioral and SDOH care
Panelists: Angela Lynn, Director of Care Management, NC Blue Cross; Laurie Gehrt, MSN, MBA, RN, CSMC, FACHE, Department Vice President, Care Management, KC Blue; Amy Bloomquist, Director of Population Health Design, Blue Cross MN; and Leslie Helou, PharmD, Vice President, Medication Strategies, MOBE
This episode is sponsored by MOBE
MOBE is a health outcomes company. They improve health by providing a high-touch one-to-one coaching program focused on lifestyle, emotional well-being, and comprehensive medication management. Using advanced analytics, MOBE identifies populations where they can make a real difference in both individual health status and expense reduction for large employers and health plans.
For more information, visit www.mobeforlife.com.
Health leaders from Network Health, Health Net, Priority Health, and Health.io discuss how top health plans improve risk assessment and quality measures through innovations and at-home testing.
Topics include:
- Strategies for deploying novel solutions to drive member engagement and reduce costs for members, especially among traditionally unengaged populations
- Why removing barriers to testing with at-home solutions is a boon to health equity
- How accurate staging improves health outcomes for members with chronic conditions
- Working with provider networks for better management of members’ health
Panelists: Pooja Mittal, MD, Vice President, Chief Health Equity Officer, Health Net, Inc.; Megan Schmidt, Sr. Vice President, Employer Solutions, Priority Health; Mushir Hassan, MD, Chief Medical Officer, Network Health; Jonah Mink, MD, Medical Director, Healthy.io
This episode is sponsored by Healthy.io
Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for an at-home urinalysis and digital wound management.
Their at-home kidney test, Minuteful Kidney, aids in the early detection of chronic kidney disease and helps close gaps in access and care for over 500,000 patients worldwide. It is the first and only smartphone-powered home kidney test to receive FDA clearance and the first digital health test to obtain FDA clearance across all smartphone devices.
Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high completion rates, and huge potential savings.
They are the first company to convert your smartphone into a clinical-grade medical device to allow patients to take the test – and receive results – in the comfort of their homes.
Motivating Medicare Advantage members to take the clinical actions needed to promote and support their care is a high priority for health plans. Data shows that talking to peers with whom they can relate and share common health issues benefits members and engages them more in their health
Our panel of experts from Humana, Regence, SCAN Health Plan and Wisdo discuss how incorporating peer support programs in your MA plans can improve clinical outcomes, lower costs and boost engagement for members with chronic diseases, behavioral health issues and other social determinants of health. Hear "bright spots" and practical strategies you can implement in your health plan.
Panelists: Mike Franz, MD, Senior Medical Director of Behavioral Health, Regence; Lisbeth Briones-Roberts, Chief Togetherness Officer, SCAN Health Plan; Jennifer Spear, Associate Director, Population Health, Humana; Boaz Goan, Founder & CEO, Wisdo Health.
This episode is sponsored by Wisdo
Wisdo is a peer support and clinical referral platform designed to address the harmful consequences of loneliness, social isolation, and lack of engagement on health and medical costs.
Founded in 2018, over 500,000 adults ages 18-80 have joined Wisdo, making it one of the market's largest and most diverse peer support platforms. Wisdo clients include health plans, gov’t agencies, behavioral health providers, and SDOH services. https://www.wisdo.com/
Julianne Eckert, Senior Director of Clinical Quality, Clover Health, Andre Bliss, Director of Medicare STARs, UPMC Health Plan and Marisa Howard, Senior Director, MA Operations, Evolent Health,
share practical strategies and best practices to help Medicare Advantage plans to execute a successful star rating strategy. Learn significant trends and gain critical insights to help your plan earn and sustain a 4+ star rating in an era of rapid change!
This episode is sponsored by Evolent Health Services
Evolent Health Services is disrupting healthcare administration, generating exceptional clinical efficacy and better risk adjustment for health organizations while simplifying the overall administration process. Similar to what Tesla did with automobiles and Amazon did with retail, Evolent Health Services is helping to transform our healthcare industry from antiquated to innovative. The uniqueness of Evolent is
- TECH: they have the industry’s only trustworthy end-to-end integrated platform, along with
- TOUCH: some of the most innovative people in the business know how to operate the solution for and with every type of health plan.or risk-bearing provider org
Omolara Thomas Uwemedimo, MD, MPH joins Eric to discuss place-based interventions and how they are used to address health inequities. The place-based model focuses on improving health that aligns with community members, businesses, schools, churches and other institutions in a specific geographic location (a specific community or zip code).
Omolara is a healthcare social entrepreneur, board-certified pediatrician, community health equity consultant, career transition & business coach, public health researcher & health justice advocate. She is CEO & co-founder of Strong Children Wellness, a multi-award-winning healthcare practice network in NYC, providing integrated physical, mental, and social health services for low-income communities of color.
This Episode of the Bright Spots in Healthcare is sponsored by Socially Determined
Socially Determined is leading the transformation of healthcare delivery and payment through social risk analytics and solutions. Their social risk analytics platform, SocialScape, social risk data and industry-leading expertise empower health plans, providers, and other risk-bearing organizations to manage risk, improve outcomes, and advance equity at scale. To learn more, visit sociallydetermined.com
Omolara Thomas Uwemedimo, MD, MPH joins Eric to discuss place-based interventions and how they are used to address health inequities. The place-based model focuses on improving health that aligns with community members, businesses, schools, churches and other institutions in a specific geographic location (a specific community or zip code).
Omolara is a healthcare social entrepreneur, board-certified pediatrician, community health equity consultant, career transition & business coach, public health researcher & health justice advocate. She is CEO & co-founder of Strong Children Wellness, a multi-award-winning healthcare practice network in NYC, providing integrated physical, mental, and social health services for low-income communities of color.
This Episode of the Bright Spots in Healthcare is sponsored by Socially Determined
Socially Determined is leading the transformation of healthcare delivery and payment through social risk analytics and solutions. Their social risk analytics platform, SocialScape, social risk data and industry-leading expertise empower health plans, providers, and other risk-bearing organizations to manage risk, improve outcomes, and advance equity at scale. To learn more, visit sociallydetermined.com
Hybrid care models provide a more personalized, flexible, and seamless patient journey, improving the in-person experience and giving patients more autonomy over their own care.
Our expert panel discusses leveraging hybrid-care models to improve access to care, close gaps in care and improve outcomes. Learn successful strategies and best practices you can implement in your organization.
Panel:
Tracy Rico, Director, Virtual Care Services, Superior HealthPlan (Centene Corporation); Erika Pabo, MD, MBA, Vice President Transformation & Central Operations, Centerwell/Humana; Donna O’Shea, Chief Medical Officer of Population Health Management, UnitedHealthcare;; Elizabeth Hyatt, Director of Payer Solutions,TytoCare
This episode is sponsored by TytoCare
TytoCare is one of the world leaders in enabling providers to practice healthcare virtually. Imagine remote physician exams from your home. TytoCare has a consumer friendly, remote exam system to deliver on the full promise of telehealth. https://www.tytocare.com/
The delivery of social care services in connection with healthcare requires new systems to organize the relationships and activities of healthcare payers, providers, community-based organizations (CBOs), and community members.
This panel will discuss integrating social care into healthcare delivery and the need for the organized delivery of social care services, including care coordination, through a multi-stakeholder health and social care ecosystem, as part of a whole-person approach to health.
Ji Im, MPH, Senior Director for Community and Population Health, CommonSpirit
Sherry Novick, Community Health Lead, Social Health Practice, Kaiser Permanente
June Simmons, MSW, CEO, Partners in Care Foundation
Tim McNeil, COO & Founder, Freedmen’s Health
This episode is sponsored by the Partnership to Align Social Care
Personal and community health outcomes significantly depend on our social, economic, and community conditions. Meeting our communities' social care and health care needs requires strengthening our systems of care and aligning health and social care. The Partnership to Align Social Care aims to achieve precisely this goal. We are a national collaborative that brings together healthcare and community leaders to co-design systems of care that will better meet the health and social care needs of individuals and communities. Learn more and join our efforts by visiting our website, www.partnership2asc.org.
The delivery of social care services in connection with healthcare requires new systems to organize the relationships and activities of healthcare payers, providers, community-based organizations (CBOs), and community members.
This panel will discuss integrating social care into healthcare delivery and the need for the organized delivery of social care services, including care coordination, through a multi-stakeholder health and social care ecosystem, as part of a whole-person approach to health.
Ji Im, MPH, Senior Director for Community and Population Health, CommonSpirit
Sherry Novick, Community Health Lead, Social Health Practice, Kaiser Permanente
June Simmons, MSW, CEO, Partners in Care Foundation
Tim McNeil, COO & Founder, Freedmen’s Health
This episode is sponsored by the Partnership to Align Social Care
Personal and community health outcomes significantly depend on our social, economic, and community conditions. Meeting our communities' social care and health care needs requires strengthening our systems of care and aligning health and social care. The Partnership to Align Social Care aims to achieve precisely this goal. We are a national collaborative that brings together healthcare and community leaders to co-design systems of care that will better meet the health and social care needs of individuals and communities. Learn more and join our efforts by visiting our website, www.partnership2asc.org.
Motivating Medicare members to take action to improve their health is a high priority for health plans. Our panel explores how health plans can meet members where they are at the right time and with the right message. Hear success stories and “bright spots” you can implement in your organization!
Panel:
- Nathan Adams, CEO & President, Linkwell Health
- Bob Crawford, Vice President, Corporate Marketing and Customer Experience, Blue Cross Blue Shield of Michigan
- Monett Jackson, Medicare Sales Strategy Manager, Blue Cross and Blue Shield of Kansas City
- Marketa Wills, MD, Chief Medical Officer, Johns Hopkins HealthCare
This panel is sponsored by Linkwell Health
Linkwell Health is a consumer engagement technology company that creates healthy experiences for consumers by guiding them to take action to improve their health. Linkwell ’s world-class content and engagement programs are seamlessly delivered via their technology platform, designed to drive health engagement, activations, retention, and business results for some of the largest health plans and health services providers.
Motivating Medicare members to take action to improve their health is a high priority for health plans. Our panel explores how health plans can meet members where they are at the right time and with the right message. Hear success stories and “bright spots” you can implement in your organization!
Panel:
- Nathan Adams, CEO & President, Linkwell Health
- Bob Crawford, Vice President, Corporate Marketing and Customer Experience, Blue Cross Blue Shield of Michigan
- Monett Jackson, Medicare Sales Strategy Manager, Blue Cross and Blue Shield of Kansas City
- Marketa Wills, MD, Chief Medical Officer, Johns Hopkins HealthCare
This panel is sponsored by Linkwell Health
Linkwell Health is a consumer engagement technology company that creates healthy experiences for consumers by guiding them to take action to improve their health. Linkwell ’s world-class content and engagement programs are seamlessly delivered via their technology platform, designed to drive health engagement, activations, retention, and business results for some of the largest health plans and health services providers.
The impending need for state Medicaid agencies and plans to administer redeterminations for Medicaid beneficiaries poses a risk of lost coverage for nearly 15 million individuals, especially for the vulnerable D-SNP population. Our expert panel provides insights into the groundwork needed to educate members about the requirements.
Panelists: Marty Janssen, Senior Program Director, Colorado Access; Errol Pierre, Vice President, State Programs, Healthfirst; Andrey Ostrovsky, MD, FAAP, Former US Medicaid Chief Medical Officer, Managing Partner, Social Innovation Ventures; Aanchal Falken, Vice President, Strategy & Business Development, Icario
Bios: https://www.sharedpurposeconnect.com/events/redetermination-strategies-to-maximize-continuous-medicaid-coverage/
This Bright Spots in Healthcare episode is sponsored by Icario
Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through extrinsic and intrinsic motivations. Learn more at icariohealth.com.
Landmark Health CEO Chris Johnson joins Eric to share his vision for the aging health system of tomorrow and his organization’s mission to help seniors age in place by extending primary and urgent care into the homes of patients with challenging illnesses. Finally, Chris talks about the shift to value-based care and how providers can navigate the new landscape by leveraging technology to create and execute the most effective care plan for each individual.
Launched in 2014, Landmark currently is in 25 states with around 300,000 patients. By the end of next year, the integrated health provider will be in about 40 states with just over half a million patients. A fully mobile medical group, Landmark brings medical care into the homes of seniors and chronically ill patients. These home-based visits are conducted by doctors, advanced practitioners, and care team members to supplement the care patients receive from their primary care providers and specialists – at no additional cost.
Chris joined Landmark in 2017 as Vice President and General Manager, responsible for launching the New England market. Most recently, Chris has served as Landmark’s Head of Corporate Development, responsible for the company’s growth strategy, strategic partnerships, mergers and acquisitions, and public policy. In this position, Chris was integral in spearheading Landmark’s merger with Optum and leading the company’s integration into Optum’s Home and Community platform. He was named one of Aging Media Network’s 2022 Vision Series Leaders.
Before Landmark, Chris was a Principal at Innosight, a healthcare-focused growth strategy consultancy and Co-founder of Predilytics, a healthcare analytics business. Chris holds a Bachelor of Arts in economics from Harvard College. He also received his M.B.A. from Harvard Business School.
Healthcare leaders from Avera, Blue Shield of California, Renown Health and the Partners in Care Foundation discuss solving the last mile In healthcare, the link between the consumer and where care is delivered. When consumers can’t pass through the last mile connection to the healthcare delivery system, they never even get an opportunity to engage with healthcare up close.
Our panel will share success stories and best practices for improving access, creating a new business model and engaging consumers in their care.
Panelists:
Mitchell Fong, Vice President of Virtual Care, Renown Health
Daniel Rivas, Senior Manager, Community Health, Blue Shield of California
Rhonda Weiring, Vice President, Clinical Innovation, Avera @Home
Dianne Davis, Vice President, Community Wellness, Partners in Care Foundation
Bios: https://www.sharedpurposeconnect.com/events/novel-approaches-to-last-mile-care/
This episode of Bright Spots in Healthcare is sponsored by Partners in Care Foundation.
The Partners in Care Foundation aligns social care and health care to address the “Social Determinants of Health” that routinely affect diverse, under-served, and vulnerable populations.
PICF serves as a bridge between medical care and what individuals can accomplish on their own at home, achieving greater equity of conditions and effectiveness of care.
Partners’ evidence-based programs and services have been demonstrated to improve quality of life, help participants avoid suffering, and reduce costly hospital readmissions, Emergency Department visits, and nursing home placements.
For over two decades, the Partners in Care Foundation has been innovating and improving SDOH solutions and driving life-changing, life-saving alignment between social care and health care for those we serve. Please visit https://www.picf.org for more information.
Dina CEO Ashish V. Shah joins Eric to discuss the advantages and challenges in transitioning care from the hospital to the home. He shares what it takes to replicate the facility-based experience outside of the hospital and deliver measurable quality improvements cost-effectively.
Ashish provides a step-by-step blueprint for creating an exceptional transition-to-home care model you can replicate at your own organization.
Our Guest
Ashish V. Shah is CEO of Dina
Ashish leads the Dina (Dena) team on its mission to power the healthcare industry’s transition to virtual and in-home care. He founded the company in 2015 and remains passionate about empowering care teams with the tools they need to help people age. A recognized thought leader, Shah previously served as CTO at Medicity, the market leader for vendor-neutral Health Information Exchange solutions (acquired by Aetna in 2011).
This episode is sponsored by Dina
Dina powers the future of home-based care with its care-at-home platform and network that can activate and coordinate multiple home-based service providers, engage patients directly, and unlock timely home-based insights that increase healthy days at home. Dina works with many leading health systems, ACOs and health plans to extend their reach into the home to help people live their best lives.
The platform creates a virtual experience for the entire healthcare team so they can communicate with each other--and help patients and families stay connected--even though they may not physically be under the same roof. Dina helps professional, and family caregivers capture rich data from the home, using artificial intelligence to recommend evidence-based, non-medical interventions.
Dina CEO Ashish V. Shah joins Eric to discuss the advantages and challenges in transitioning care from the hospital to the home. He shares what it takes to replicate the facility-based experience outside of the hospital and deliver measurable quality improvements cost-effectively.
Ashish provides a step-by-step blueprint for creating an exceptional transition-to-home care model you can replicate at your own organization.
Our Guest
Ashish V. Shah is CEO of Dina
Ashish leads the Dina (Dena) team on its mission to power the healthcare industry’s transition to virtual and in-home care. He founded the company in 2015 and remains passionate about empowering care teams with the tools they need to help people age. A recognized thought leader, Shah previously served as CTO at Medicity, the market leader for vendor-neutral Health Information Exchange solutions (acquired by Aetna in 2011).
This episode is sponsored by Dina
Dina powers the future of home-based care with its care-at-home platform and network that can activate and coordinate multiple home-based service providers, engage patients directly, and unlock timely home-based insights that increase healthy days at home. Dina works with many leading health systems, ACOs and health plans to extend their reach into the home to help people live their best lives.
The platform creates a virtual experience for the entire healthcare team so they can communicate with each other--and help patients and families stay connected--even though they may not physically be under the same roof. Dina helps professional, and family caregivers capture rich data from the home, using artificial intelligence to recommend evidence-based, non-medical interventions.
Josh Weisbrod from Network Health and Keslie Crichton and Sean Libby from BeneLynk join Eric to discuss opportunities and challenges in identifying and converting members to full dual status, including specific examples and an outlined roadmap into this additional revenue stream.
After listening to this episode, you will understand:
- Why identifying members as “full or partial” matters
- How much revenue you may be leaving on the table
- What components need to be in place to convert members
Our Guests
Josh Weisbrod, Vice President, Risk Adjustment, Network Health
Over 20 years of healthcare, health insurance, healthcare analytic and human service experience working with local and national companies, and state and federal agencies. Specializing in health plan operations and data analytics.
Sean Libby, President and Co-founder, Benelynk
Sean has worked at the intersection of managed care and government benefit programs for the past 19 years. Prior to BeneLynk, Sean served as the President of Freedom Disability and Alpha Disability, one of the nation’s largest Social Security Disability and Veterans Advocacy companies. Before that, Sean served as Vice President, Sales for SSC Disability, providing government program benefit services for Managed Care Organizations.
Keslie Crichton, Chief Revenue Officer, Benelynk
Keslie has over 25 years of comprehensive managed care and healthcare technology experience.Prior to Benelynk She spent 13 years as Vice President of Sales at Change Healthcare and its predecessor companies Altegra Health and Social Service Coordinators, helping plans improve risk-adjusted revenue and quality performance scores through dual enrollment and retention, as well as health education campaigns.
Acronym Glossary
MSP - Medicare Savings Programs
ABD- Age Blind and Disabled
MAPP - Medicaid Purchase Plan
SSI - Supplemental Security Income
QMB - Qualified Medicare Beneficiary
SLMB - Specified Low-Income Medicare Beneficiary
QI-1 - Qualifying Individual
SNAP - Supplemental Nutrition Assistance Program
LIS - Low-Income Subsidy
SSA - Social Security Administration
CMS - Center for Medicare and Medicaid Services
MAO - Medicaid Add On
MA - Medicare Advantage
HCC - Hierarchical Condition Category
FPL - Federal Poverty Level
MAGI - Modified Adjusted Gross Income
PMPM - Per Member Per Month
HRA - Health Risk Assessment
D-SNPs - Dual Eligible Special Needs Plans
This Episode of Bright Spots in Healthcare is sponsored by BeneLynk
BeneLynk is arguably the most innovative Dual Advocacy organization in the country. Benelynk’s mission is to improve people’s lives and positively impact social determinants of health barriers by granting their healthcare partners the necessary information while providing healthcare consumers with the advocacy they deserve. They use innovative technology that enables their people to have a dynamic conversation that flows organically to meet social determinants of health challenges and, as such, can build stronger human connections. This carefully planned combination generates exceptional results. Visit their website at www.benelynk.com
Preventable hospital readmissions cost the healthcare system approximately $25 billion annually, and it is estimated that one of every five Medicare patients is readmitted to the hospital within 30 days of discharge. Our panel of experts shares insights and best practices on lowering readmission rates for patients with chronic health conditions through proven prevention and discharge programs and follow-up plans.
Panelists:
- Troy Garland, MBA, RN, Vice President, Clinical and Quality Operations, Equality Health
- Sarah Keenan, RN, BSN, MSIHM, Chief Clinical Officer/President, Integrated Care, Bluestone Physician Services
- Michelle Nelson, Director, Health Improvement, United Regional Health Center
- Ashish V. Shah, CEO, Dina
This episode is sponsored by Dina
Dina powers the future of home-based care with its care-at-home platform and network that can activate and coordinate multiple home-based service providers, engage patients directly, and unlock timely home-based insights that increase healthy days at home. Dina works with many leading health systems, ACOs and health plans to extend their reach into the home to help people live their best lives.
The platform creates a virtual experience for the entire healthcare team so they can communicate with each other--and help patients and families stay connected--even though they may not physically be under the same roof. Dina helps professional and family caregivers capture rich data from home, using artificial intelligence to recommend evidence-based, non-medical interventions. Visit their website at dinacare.com
Digital technology can give organizations more data so that they have visibility not only into patients’ clinical profiles but also population health profiles and socioeconomic profiles.
Our panel of experts will discuss how health plans can effectively tap the potential of digital technologies to improve care delivery, outcomes and equity for traditionally underserved populations. Learn strategies and best practices you can implement in your own organization!
how health plans can use digital tools to close gaps in care and advance health equity.
Panelists:
- Paula Gutierrez, Director, Health Equity, Director of Health Equity for CVS Kidney Care, a CVS Health Company
- Seun O. Ross, Executive Director, Health Equity, Independence Blue Cross
- Paula LeClair, US General Manager, Healthy.io
Panelist bios: https://www.sharedpurposeconnect.com/events/health-equity-how-digital-technologies-are-reshaping-healthcare/
This episode is sponsored by Healthy.io
Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for at-home urinalysis and digital wound management
Their smartphone-powered home kidney test (pause) aids in the early detection of chronic kidney disease and helps close gaps in access and care for over 500,000 patients worldwide. Beyond being recently featured by CNBC, Fast Company and the Financial Times, Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high completion rates, and the huge potential savings.
They are the first company to convert your smartphone into a clinical-grade medical device to enable at-home testing with instant results.
Risk adjustment is much more than a regulatory requirement for Medicare Advantage plans – it can improve the quality of care by providing an accurate picture of each member’s health status and ensuring each member receives the right interventions and treatment.
Providers play an important role in risk adjustment, too. An engaged partnership between health plans and providers is vital to ensure beneficiaries receive valuable benefits.
Our panel of experts from Blue Cross Blue Shield of Illinois, CommuniCare Health Centers, Priority Health, SelectHealth and Vatica Health will share successful strategies and best practices for payers and providers to work in partnership to close gaps in care, achieve better clinical and financial performance, and support value-based care. Hear both payer and provider perspectives on building a successful relationship.
Confirmed Panelists:
Jeslie Jacob, Divisional Vice President, Provider Analytics, Reporting & Connectivity, Blue Cross and Blue Shield of Illinois.
Rebecca Welling, Associate Vice President, Risk Adjustment & Coding, SelectHealth
Lisa Wigfield, RN, BSN, CCM, CRC, CDEO, Clinical Advisor, Risk Management, Priority Health
Janie Reddy, DNP, FNP-BC, Director of Family Medicine, CommuniCare Health Centers
Hassan Rifaat, MD, CEO, Vatica Health
Bios: https://www.sharedpurposeconnect.com/events/elevating-risk-adjustment-by-activating-physician-participation/
This episode is sponsored by Vatica Health
Founded in 2011, Vatica Health is the leading provider-centric risk adjustment and quality of care solution for health plans and health systems. By pairing expert clinical teams with cutting-edge, HITRUST-certified technology at the point of care, Vatica increases patient engagement and wellness, improves coding accuracy and completeness, facilitates the identification and closure of gaps in care, and enhances communication and collaboration between providers and health plans. The company’s unique solution helps providers, health plans, and patients achieve better outcomes together. Vatica Health is trusted by many of the leading health plans and thousands of providers nationwide. Vatica Health is a portfolio company of Great Hill Partners. For more information, visit www.vaticahealth.com/.
Engaging high-needs Medicare and Medicaid members can be a huge barrier to better health and a consistent challenge for even the most innovative health plans. In order to successfully engage these members, health plans must meet them in the communities they live and work and provide the right solutions and resources. Our expert panel of leaders from UnitedHealth Group, UPMC Health Plan, and Reema Health along with the former mayor of Wahington D.C. share how using personalized, community-based solutions helps plans identify member needs, build meaningful relationships, establish trust, navigate care gaps and boost outcomes.
Panelists: Cyrus Batheja, National Vice President, UnitedHealth Group; Kendra J. White, Senior Manager, Medicare Community Relations, UPMC for Life; Adrian Fenty, Former Mayor District of Columbia; Justin Ley, Co-Founder & CEO, Reema Health
View Panelist Bios on our website
This episode is sponsored by Reema Health
Reema uses technology to power human relationships with the goal of improving health outcomes for people who are hardest to reach. Reema’s breakthrough health platform uses proprietary technology and predictive data modeling to identify people with the highest level of unmet social needs, power Community Guides with the right information to engage them meaningfully, connect them with the most relevant resources, and improve their health and their lives. For more information visit ReemaHealth.com.
Socially Determined Co-Founder and CEO Trenor Williams, MD, talks with Eric about the importance of accessing and unlocking the potential of member demographic data, including race, ethnicity and language, to identify social risk.
Specifically, he shared details of his organization’s partnership with CareFirst Blue Cross Blue Shield to optimize interventions for populations with complex health needs.
CareFirst’s objective is to understand what drives the decisions people make regarding their health and healthcare but a lack of visibility into data and insights outside of the traditional healthcare setting makes it challenging.
To meet the objective, Socially Determined is helping CareFirst identify social risks at the social domain level including financial strain, food insecurity, housing instability, transportation barriers, and health literacy challenges, enabling CareFirst to build personalized interventions for individuals with elevated health risks due to social drivers of health.
Access to these actionable insights supports CareFirst’s mission to advance health equity and advocate for affordable, accessible, and quality care for members, employers and the communities they serve.
Here’s a link to the press release announcing the partnership: https://www.sociallydetermined.com/carefirst-partnership
About Trenor Williams
Trenor co-founded Socially Determined in 2017 and is responsible for leading the company’s mission and fundraising activities with strategic investors as well as providing executive oversight to clients. As the son of a social worker, Trenor saw firsthand how the insights his mother gleaned during in-home client visits provided a more holistic story of a person than he ever got as a family physician. Inspired by this experience, he created the company to give organizations full visibility into social risk factors so they could understand its impact on the people and communities they serve and strategically intervene.
Prior to Socially Determined, Trenor was the Medical Director of Family Practice at Mammoth Hospital in California. He went on to serve as Lieutenant Commander in the United States Naval Reserve.
This Episode of the Bright Spots in Healthcare is sponsored by Socially Determined
Socially Determined is a physician-founded, Social Risk Intelligence and solutions company, providing risk analytics, data, and advisory services to industry-leading organizations committed to assessing and addressing Social Determinants of Health (SDOH) and social risk among the communities and populations they serve – and bear risk for. Visit their website at https://www.sociallydetermined.com/
Loneliness is associated with worsening health-related quality of life, increased mortality, higher risk for a variety of physical and mental health conditions, and other poor health outcomes. While loneliness is typically applied to seniors, it can apply at any age. Michelle Bentzien-Purrington, SVP, Senior Vice President, MLTSS, Molina Healthcare and Cindy Jordan, Co-founder & CEO of PYX Health, share strategies and best practices tied to reducing the impact of loneliness on Medicare and Medicaid populations.
This episode is sponsored by PYX Health
Founded pre-pandemic, Pyx Health is the first proven solution used to treat loneliness. The Pyx Health platform combines a friendly technology application with a call center staffed with certified, compassionate humans. We work with health insurers who have demonstrated improving loneliness improves cost (57% reduction in medical spending), health (82% improved loneliness and depression) and engagement (73% feel more connected to care teams).
Featuring: David Shulkin, MD, Former U.S. Secretary of Veterans Affairs
Kacey L. Serrano, MPA, CPC, CRC, Director, Medicare Stars and Risk Adjustment, Arkansas Blue Cross and Blue Shield
Sean Libby, President, BeneLynk
Today, 22% of Medicare Advantage members are veterans of the United States Armed Forces and 5% of Medicare Advantage members use the Department of Veterans Affairs (VA) for some of their healthcare needs. However, many health plans don’t have a full understanding of the care their veteran population needs. Panelists share how Medicare Advantage plans can address social determinants of health (SDOH) for its veteran members by identifying their veteran populations and coordinating care with the VA. Topics for Discussion include: Identifying your Medicare Advantage veterans, discovering the value of documenting VA care and understanding military service as a Social Determinant of Health.
This episode is sponsored by BeneLynk, a national provider of social determinants of health (SDoH) solutions for Medicare Advantage and Managed Medicaid health plans. We serve plans and their members by creating a human-to-human connection and providing the assistance a member needs to get the benefits they deserve. By employing one dynamic conversation that flows organically to meet social determinants of health challenges, we build stronger human connections that are supported by innovative technology. We help Medicaid members to retain their benefits through a comprehensive outreach campaign providing information and assistance. All of our services are customized to the specific geography where we provide services and provide the members with the specific information they need to keep their benefits in place. Our mission is to improve lives and positively impact social determinants of health barriers by providing our healthcare partners with the information they need, and people with the advocacy they deserve.
Panelist bios available at: https://www.sharedpurposeconnect.com/events/medicare-quality-and-risk-knowing-your-veteran-population/
Reaching hard-to-reach populations takes heart, determination, and support. And it’s hard. Just because you’re communicating, doesn’t mean you’re connecting. Our panel explores ways health plans can make sure they meet their members where they're at and how to navigate the complicated outreach process.
Panelists: Merrill Friedman, RVP, Inclusive Policy and Advocacy, Anthem; Ben Line, SVP, Complex Member Services, UnitedHealthcare; Traci Massie, Director, Government Programs, Optima Health; Sara Ratner, SVP, Government Markets & Strategic Initiatives, Icario
https://www.sharedpurposeconnect.com/events/creating-a-more-human-holistic-approach-to-sdoh-reaching-the-unreachable/
This Bright Spots in Healthcare episode is sponsored by Icario. Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com
In order to implement an effective SDOH strategy, healthcare organizations must develop an infrastructure to integrate both clinical and social interventions. Our panel of experts from Melanin & Medicine, MetroPlus Health, Priority Health, ProMedica, and Socially Determined shares best practices, lessons learned, and key considerations to help you design a roadmap to address social determinants of health (SDOH), social risk factors and social needs among the communities, populations and individuals you serve.
Panelist bios: https://www.sharedpurposeconnect.com/events/your-new-sdoh-roadmap-integrating-social-care-into-healthcare/
This episode is sponsored by Socially Determined
Socially Determined is a Social Risk IntelligenceTM and solutions company, providing risk analytics, data, and advisory services to industry-leading organizations committed to assessing and addressing Social Determinants of Health (SDOH) and social risk among the communities and populations they serve – and bear risk for. To that end, we offer a purpose-built analytics platform, SocialScape®, to quantify, visualize, and mitigate the impact of SDOH and social risk – at scale.
SocialScape generates community-level SDOH risk exposure indices, individual-level social risk factor scores, and advanced analytics that empower organizations to understand how SDOH and social risk impacts key business metrics, including suboptimal utilization, total cost of care, quality measure attainment, and health equity, as well as member engagement, satisfaction, and retention. Our platform and expertise are trusted by organizations across the healthcare ecosystem including health plans, health systems, life science companies, non-profits, and foundations.
Dr. Jonah Mink, Medical Director of Health.io discusses how health plans can convert data into actionable insights by leveraging focused chronic care service providers with at-home or last-mile care or diagnostics. Jonah also shares how health plans are generating clinical results and revenue from partnerships with service providers and offers guidance on what plans should consider when thinking about a partnership. He also discusses how partnerships with chronic care-focused service providers help reduce health disparities in the community.
Jonah cares deeply about health equity and social justice and has expertise in new models of technology and relationship-based care delivery that address access gaps and improves care quality. Jonah completed his residency training in Family Medicine and Community Health at the University of Pennsylvania works as a family medicine doctor in the U.S. and Israel.
To receive a copy of the Healthy.io whitepaper, Actionable Approaches to Population Health, please complete this form: https://www.sharedpurposeconnect.com/population-health/
This episode is sponsored by Healthy.io
Healthy.io is an innovative healthcare company that uses smartphone technology to make remote clinical testing possible. Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for at-home urinalysis and digital wound management. Their home urinalysis kits aid in the diagnosis of chronic kidney disease, urinary tract infections and prenatal testing and serves over 500,000 patients worldwide. Beyond being recently featured by CNBC, Fast Company and the Financial Times, Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high patient adherence and the huge potential savings
Achieving health equity begins with an ability to identify health disparities and their causes Without adequate data and measures, inequities remain unseen and unaddressed. Our expert panel discusses the importance of leveraging data and analytics to understand, measure, and support equity improvement efforts. They will share successful strategies and best practices you can bring back to your organization.
Panelists: R.J. Briscione, Senior Director, Social Determinants of Health Strategy & Execution, Aetna, a CVS Health Company, Merrill Friedman, RVP, Inclusive Policy and Advocacy, Anthem, Inc., Amy Riegel, Senior Director, Housing, CareSource, Nick Jones, Director, Healthy Neighborhoods Healthy Families, Nationwide Children's Hospital, Katie McKillen, Regional President, Market Operations, Evolent Health
This episode is sponsored by Evolent Health Services
Evolent Health Services provides modern administrative and clinical capabilities along with managed
services to health plans and risk-bearing organizations. We drive operational efficiency through higher levels of automation, enhance member engagement using a modern, fully integrated end-to-end platform, and leverage AI to convert data into actionable insights. visit:evolenthealthservices.com
Eric goes one-on-one with Chris Delaney, Founder, and CEO of Insignia Health. During the episode, Chris talks about consumer centricity and the importance of the patient activation measure (PAM) for health plans and providers. He provides various case studies and overall guidance on how to successfully implement activation programs that work.
This episode is sponsored by Insignia Health
Insignia Health provides the only empirically derived and quantifiable model for healthcare organizations, professionals and consumers to co-create personalized healthcare strategies to improve health self-management. By continuously measuring and increasing patient activation, our clients empower individuals to unlock their potential, leading to better health outcomes, lower costs and improved well-being.
And now, as part of Phreesia, Insignia Health further expands the spectrum of organizations that can leverage patient activation to achieve their strategic objectives and connect with patients before, during and after their healthcare encounters.
Their partners include hospitals and health systems, health plans and insurers, pharmaceutical companies and government health programs around the world, including direct contracts with leading healthcare organizations like the Centers for Medicare and Medicaid Services (United States) and the National Health Service (England).
In order to improve a consumer’s health, we have to meet them where they are. The Patient Activation Measure® (PAM®) is a 10- or 13-item survey that measures a patient’s current knowledge, skills and confidence to manage their own health and healthcare. PAM’s design and results are validated by hundreds of published studies from researchers around the world. Visit: insigniahealth.com
Experts from Cigna, SCAN Health Plan and UPMC Health plan share strategies and best practices for generating higher HEDIS and STAR ratings by advancing a holistic approach to their members’ care including “last mile” strategies and caregiver support coupled with physical, behavioral and social needs.
Panelists include Ellen Bjeckford, PhD, MPH, Associate Vice President, Population Health and Clinical Transformation, UPMC Health Plan, Evan Falchuk, Chairman & CEO, Family First, Sophie Howlett, Manager, Population Health, SCAN Health Plan Grant Tarbox, DO, Regional Medical Executive, West/Northeast Region, Cigna Medicare, Kendra White, Senior Manager, Community Relations, UPMC for Life, UPMC Health Plan.
Bios:https://www.sharedpurposeconnect.com/events/medicare-advantage-novel-approaches-to-whole-person-care/
This episode is sponsored by Family First
More than ever, Americans are struggling with the complex realities of caregiving. Family First is the first expert-led and technology-powered caregiving solution for Medicare members. By integrating clinical data and social determinants of health, our multi-disciplinary Care Teams craft and implement comprehensive care plans to solve Medicare members’ most urgent caregiving needs, close care gaps, increase member satisfaction and decrease the intensity of care needed. To learn more, visit www.Family-first.com.
Dr. Cynthia Brandt joins Eric to discuss her mission to unlock philanthropy to improve health for children and mothers around the world through the foundation, which directs all fundraising for the Lucile Lucile Packard Children’s Hospital Stanford and for the maternal and child health programs at Stanford University School of Medicine. Cynthia shares some“bright spots” in children’s healthcare today. In addition to the foundation’s mission, the discussion also touches on topics from health equity to the evolution of philanthropy in healthcare.
Cynthia Brandt is Chief Executive Officer & President of the Lucile Packard Foundation for Children’s Health. Since 2018 she has been on a mission—with the outstanding team at the Foundation—to unlock philanthropy to improve health for all kids and moms, in Silicon Valley and around the world.
During 20+ years in fundraising and communications, Cynthia has contributed to important missions and great teams as Campaign Director for the Smithsonian Institution, VP for Advancement at Mills College, and Associate Dean for External Relations at Stanford University’s School of Humanities & Sciences. She is grateful and motivated to give back because others’ generosity allowed her to pursue a PhD and MA in sociology at Stanford and a BA in English and fine arts at Vanderbilt.
Cynthia is passionate about the potential for science to heal humanity and the planet. She is emphatic that this work must be grounded in empathy and a commitment to lift up all people equally.
Our panel of experts from Commonwealth Care Alliance, Molina Healthcare of Ohio and BeneLynk share best practices for addressing the SDOH needs of your dual eligible members. Walk away with ideas you can implement in your own organization to close gaps in care, improve outcomes, and reduce costs. Topics include: Topics include: Combining technology with the human touch; Segmenting your population by key determinants; Using SDOH Z-Codes to prioritize patient outreach; Designing programs to change behavior; Determining ROI
Panelists:
Pamela Tropiano, RN, BSN, MPA, CCM, Vice President, Healthcare Services, Molina Healthcare of Ohio, Inc.
Lauren Easton, MSW, L.I.C.S.W. Vice President, Integrative Program Development and Clinical Innovation, Commonwealth Care Alliance
Sean Libby, President, BeneLynk
Panelist Bios
https://www.sharedpurposeconnect.com/events/leveraging-sdoh-to-increase-dual-eligible-penetration/
This episode is sponsored by BeneLynk, a national provider of social determinants of health (SDoH) solutions for Medicare Advantage and Managed Medicaid health plans. We serve plans and their members by creating a human-to-human connection and providing the assistance a member needs to get the benefits they deserve.
By employing one dynamic conversation that flows organically to meet social determinants of health challenges, we build stronger human connections that are supported by innovative technology. We help Medicaid members to retain their benefits through a comprehensive outreach campaign providing information and assistance. All of our services are customized to the specific geography where we provide services and provide the members with the specific information they need to keep their benefits in place.
Our mission is to improve lives and positively impact social determinants of health barriers by providing our healthcare partners with the information they need, and people with the advocacy they deserve.
Anthem’s Chief Health Officer Shantanu Agrawal, MD, talks to Eric about what the insurer is doing to lessen the effect of social determinants of health (SDOH). He shares the results from Anthem’s recently released report, Driving Our Health: A study exploring health perceptions in America, a national survey of 5,000 U.S. adults. Anthem conducted the study to raise awareness of the impact social drivers such as housing, transportation, and food insecurity have on our health outcomes. View the report at: https://www.thinkanthem.com/wp-content/uploads/Anthem-SDOH-Results-Report.pdf
Shantanu discusses some of the programs Anthem has implemented to ensure its members get the resources they need to live healthy lives. One example he cited was the opening of a locally owned grocery store, Indy Fresh Market, in a food desert in Indianapolis, Indiana. The store was funded by a grant from the Anthem Foundation and the Local Initiatives Support Corp. of Indianapolis.
This episode is the first in a short series of episodes where we will be highlighting bright spots in the community. This grassroots, bottom-up, local approach to health is rapidly gaining momentum as a way to take innovations in technology data collection and analytics, and combine it with the foundational elements of personal, high quality, high touch primary care that Americans received in the 50s and 60s.
Health plans today are facing simultaneous pressures to improve member experience, increase healthcare quality and reduce costs. Hear how leading health plans are designing and implementing exceptional member experiences, boosting quality rating and helping members achieve better health outcomes! Also, learn how looking at the member experience through a financial services lens yields powerful insights about targeting members with a data-centric approach.
Expert panelists: Cynthia Weiss, RN, MSM, BSN, Director, Quality, Accreditation, and Wellness, AvMed Health Plans; Topher Wurts, Partner, and CMO, Chief Outsiders and Louise Briguglio, SVP, Integrated Experience Group, Icario. View their bios at: https://www.sharedpurposeconnect.com/events/demystify-the-member-experience-to-make-your-health-plan-more-competitive-and-improve-quality-ratings/
This Bright Spots in Healthcare episode is sponsored by Icario. Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com
As healthcare works toward value-based care, closing care gaps and engaging consumers in preventive health is a high priority among payers and providers as it reduces costs and improves health outcomes. In this podcast, leaders from Blue Cross Blue Shield of Illinois, Clover Health, Health.io and Humana share successful strategies for closing gaps in care, improving health outcomes and reduce costs. Topics include preparing for the 2022 and 2023 HEDIS measures, analyzing data, measuring provider performance and the impact of SDOH.
Panelists:
- Nicole Lowery, Director of Population Health Strategy, Office of Health Affairs and Advocacy, Humana
- Jeslie Jacob, Divisional Vice President, Provider Performance | Provider Analytics, Reporting and Connectivity, Blue Cross Blue Shield of Illinois
- Julianne Eckert, Director of Quality Improvement, Clover Health
- Paula Leclair, U.S. General Manager, Healthy.io
This podcast is sponsored by Healthy.io.
Healthy.io is an innovative healthcare company that uses smartphone technology to make remote clinical testing possible. Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for an at-home urinalysis and digital wound management
Their home urinalysis kits (pause) aids in the diagnosis of chronic kidney disease, urinary tract infections and prenatal testing and serves over 500,000 patients worldwide. Beyond being recently featured by CNBC, Fast Company and the Financial TImes, Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high patient adherence and the huge potential savings
In this episode, UnitedHealth Group National Vice President Cyrus Batheja joins Eric to share his inspirational personal story and how it motivates his desire to break down the barriers to healthcare.
During the conversation, it becomes clear Cryus is a remarkable individual. He details his family’s journey to America and his experience growing up in this country as a first-generation immigrant. We all get to understand how Cyrus’s background provides him a unique perspective that enables him to be exceptional at his work.
Cyrus advises us on the importance of utilizing empathy as a strategy by driving meaningful cultural change within the workplace. He discusses tactics like poverty simulation, motivational interviewing and special training.
This episode is full of thought-provoking concepts and ideas. Cyrus’s journey reminds us to be thankful for being born in this country and inspires us to improve the quality of life for the consumers we serve.
This Bright Spots in Healthcare episode is sponsored by Icario. Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com
In this episode, Lisa Davis, Senior Vice President and Chief Information Officer at Blue Shield of California (BSC) sits down with Eric to talk about BSC's overall Health Reimagined strategy, BSC's Portfolio Product Models, and their new partnership with Google Cloud.
In addition, Lisa dives into criminal and counterintelligence and how the overall data strategies at the Department of Defense and U.S. Marshals Service influenced BSC’s current data strategy.
A jam-packed conversation full of strategies, tactics, and bright spots!
This episode is sponsored by MedorionMedorion created the first and only Health Behavior engine, based on 50 years worth of Behavioral Science expertise integrated into a revolutionary AI Software as a Service (SaaS), focused on "Behavioral Persuasion". The Behavioral Persuasion platform solves healthcare management challenges by understanding the decision barriers members face when taking a decision regarding their health, with the goal of bettering healthcare management and improving the well-being of millions of individuals. Visit www.medorion.com for more information about the platform.
Our panel of experts from Banner Health, BlueCross BlueShield of South Carolina, SCAN Health Plan and other leading healthcare organizations share case studies and best practices for engaging consumers in decision-making and behavior change to improve health outcomes.
Find out why a human-centric approach may help persuade consumers to actively participate in their healthcare. Learn how AI technology and behavior science principles can improve health delivery by pinpointing the underlying psychological, environmental, and economic drivers and barriers behind people’s health decisions.
Panelists:
- William (Tripp) Jennings MD, FACEP, Vice President, Clinical Innovation Officer, BlueCross BlueShield of South Carolina
- Alexandra Morehouse, Chief Marketing Officer, Banner Health
- Eve Gelb, Senior Vice President, Member & Community Health, SCAN Health Plan
- Shai Levi, Co-Founder, and COO, Medorion Technologies
- Andrea Wallace, Manager, Product Development, Business Lab, Emergent Holdings
This episode of Bright Spots in Healthcare is sponsored by Medorion Technologies
Medorion aims to help organizations manage the entire process of health management more efficiently, and take strides that will change medical behavior across entire populations and improve the lives of millions of individuals. Medorion's behavioral intelligence software provides health insurers with an in-depth understanding of members and their concerns, enhancing health plans in all areas pertaining to human behavior. Utilizing behavior-based insights, the Medorion EBR™ platform enables payors to personalize and automate one-on-one member conversations at scale, based on health decision barriers. Medorion's SaaS facilitating proactive interactions that improve health delivery and financial outcomes.
Leaders from Humana, ProMedica, Health Plan of San Mateo, Alliance of Community Health Plans, and Insignia Health share case studies and best practices for leveraging health data to drive consumer activation, improve health outcomes and reduce costs. Topics include:
- Using AI, machine learning, and language processing to drive more effective communication and activation
- Engaging providers in consumer activation and engagement
- Measuring ROI of data investments
- Utilizing social needs data to engage consumers in underserved communities
This episode of Bright Spots in Healthcare is sponsored by Insignia Health
Insignia Health empowers healthcare organizations and health professionals around the world to assess patient activation and develop strategies for the efficient application of healthcare resources. As activation increases and individuals become better managers of their health, utilization costs decline and patient satisfaction improves. The Patient Activation Measure® (PAM®) and over 15 years of health activation research form the cornerstone of a complementary suite of solutions that help clinicians, coaches and population health providers improve health outcomes and lower costs. Today, Insignia Health supports the health activation efforts of more than 250 organizations touching the lives of millions of patients in dozens of countries.
Panelists:
Cara McNulty, President, Behavioral Health & EAP, CVS | Aetna
Claire Neely, MD, FAAP, President & CEO, Institute for Clinical Systems Improvement
The mental health experience can be daunting and lonely with the stigma attached preventing many people from getting the care they need. With the COVID-19 pandemic exacerbated mental health issues at an astonishing rate, the need for more accessible care has increased significantly. This panel explores new approaches to reduce the stigma around mental health and make it easier for people to get the treatment they need. The discussion covers the collaborative care model of integrating mental and physical health as well as the components of a new care model being piloted in select CVS HealthHUB locations in partnership with Minute Clinic.
This Bright Spots in Healthcare episode is sponsored by Icario
Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.
Drawing on his decades of interviewing some of the biggest names in sports, business, politics and pop culture, author and Esquire Writer-at-Large Cal Fussman shares how the power of storytelling can help hospitals and health plans make better connections with patients and members.
Experts from Mass General Hospital, Excellus BlueCross BlueShield, AvMed and Appnovation discuss bright spots in consumer engagement and how to reinvent your patient engagement strategies.
Panelists:
- Ana Eberhard, Vice President, Member Experience, AvMed
- Susie Hume, Director of Digital Strategy, Experience and Delivery at Excellus BCBS
- Susan Edgman-Levitan, PA, Executive Director of the John D. Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital
- Steve Peretz, Director, Health Experience & Product Strategy, Appnovation
This episode is sponsored by Appnovation
Appnovation is a global digital consultancy that combines strategy, user experience and design, technology and managed services to deliver human-centered digital experiences.
Their award-winning team creates standout digital experiences by collaborating with brands to understand the individual challenges and goals for every initiative.
With extensive experience throughout the Life Sciences industry, they work alongside providers and payers to provide the framework to define, execute, and validate digital concepts with their intended patient and caregiver audiences.
To find out more, visit them at www.appnovation.com
How Payers and Providers Can Drive Better Health Literacy in Underserved Communities
Dr. Lisa Fitzpatrick, MD, MPA, MPH, CEO and Founder of Grapevine Health has dedicated her life to improving Health Literacy and diffusing the distrust around healthcare in our underserved communities. During this interview, Lisa shares strategies and tactics to help for payers and providers better address health literacy to reduce avoidable healthcare costs and inspire healthy behaviors.
About Dr. Lisa
Lisa Fitzpatrick, MD, MPA, MPH is the Founder, and CEO of Grapevine Health, an organization that engages and collaborates with patients and the community to improve health literacy and engagement on their terms. improve health literacy and health care engagement by learning and deeply understanding motivations and factors influencing medical decision-making.
Dr. Lisa is a medical doctor who has also worked at the Centers for Disease Control and Prevention. Her career has spanned research, clinical medicine, global health, community health education and patient advocacy. She recently served as the medical director for Washington DC’s Medicaid program. She is also a clinical professor and professorial lecturer for the George Washington University School of Medicine and Milken Institute School of Public Health. A member of the Aspen Institute Global Leadership Network, she was selected as a 2017 Aspen Institute Health Innovator Fellow. Dr. Lisa has a Masters in Public Health from the University of California-Berkeley School of Public Health and a Masters in Public Administration from the Harvard Kennedy School of Government.
Dr. Talya Schwartz, President & CEO of MetroPlus Health Plan joins Eric on the podcast!
Talya and Eric discuss overall strategy and approaches a CEO must consider and how to manage relations with both local municipalities and community--based organizations (CBOs). Talya shares specific examples around how to more effectively build roots within your community and how to implement successful incentive programs for the Medicaid population. Eric asks her about the “how tos” and “how local is local?” when health plans are revisiting their overall community-based strategy.
About Talya Schwartz
Dr. Talya Schwartz was appointed President & CEO of MetroPlus Health Plan in 2019. During her tenure, MetroPlusHealth has achieved a 20% growth in membership, a five-star rating from New York State’s Consumer Guide, and an increase in overall net worth. Prior to her appointment, Dr. Schwartz served as the Chief Medical Officer at MetroPlusHealth She was a postdoctoral researcher at the University of Pennsylvania and served as a Fellow at the National Institutes of Health. Dr. Schwartz earned her medical degree from the Sackler School of Medicine, completed her residency in Pediatrics at (may-mon-i-dees) Maimonides Medical Center in Brooklyn, New York, and practiced at the Children’s National Medical Center in Washington, DC.
About MetroPlus Health Plan
MetroPlusHealth is the plan of choice for over 600,000 New Yorkers. It was recently ranked the #1 health plan among all 15 New York State Medicaid plans in overall quality. The health plan’s robust network of primary care doctors and specialists includes many independent community providers. Culturally sensitive, and fluent in more than 40 languages.
Interesting in extending your thought leadership, content market and networking? Consider partnering with Shared Purpose Connect, producers of the Bright Spots in Healthcare podcast. For information on how we can integrate your marketing goals into our programming, please contact Tony Flynn, head of business development & partnerships, at aflynn@sharedpurposeconnect.com.
View our upcoming shows, and past guests and episodes, at www.sharedpurposeconnect.com.
As new solutions emerge to help overcome common SDoH barriers, considering how health plans fit into the larger picture comes into focus. Our panel of healthcare leaders share new ideas and approaches to health equity in government programs, including broadband access, food access programs, and more.
Panelists include:
- R.J. Briscione, Senior Director, Social Determinants of Health Strategy & Execution, CVS | Aetna
- Creshelle Nash, MD, MPH, CHIE, Medical Director for Health Equity and Public Programs, Arkansas Blue Cross and Blue Shield
- Tejaswita Karve, Ph.D., Director, Quality Improvement, Johns Hopkins HealthCare
- Lora Alexander, Vice President, Engagement & Design, Icario
This Bright Spots in Healthcare episode is sponsored by Icario
Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.
Value-based care requires new thinking in both how we pay for care (i.e. alternative payment models) and how we engage consumers to seek care (i.e. benefit design). During this podcast, A. Mark Fendrick, MD, Director of the Center for Value-Based Insurance Design at the University of Michigan, discusses the origins and evolution of V-BID and why he believes designing health benefit plans to reduce financial barriers to essential, high-value clinical services is the answer to lowering healthcare costs.
Mark, who is also a professor in medicine and public health at the University of Michigan, and shares real-world examples of V-BID implementation and how it has helped public and private payers increase the use of high-value services, lower consumer out-of-pocket costs, and reduce health care disparities. Hew also talks about incorporating digital into V-BID, the differences between V-BID and Value-Based Care, and the challenges of implementing V-BID and how to overcome them.
This episode of Bright Spots in Healthcare is sponsored by Healthy.io.
Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for an at-home urinalysis and digital wound management. Their home urinalysis kit aids in the diagnosis of chronic kidney disease, urinary tract infections, and prenatal testing and is used by leading healthcare systems worldwide.
When intrinsic motivation isn't enough, a different approach to close gaps and increase satisfaction is needed. We know that rewards are effective, particularly with Medicaid members, but what's the magic number, reward, or incentive that sparks action? Our panel of experts - MaryAnn Faralli, Highmark Health Options - Deleware, Marty Janssen, Colorado Access, Daniel Weaver, Gateway Health and Cory Busse, Icario - offer real-life examples of leveraging rewards and incentives to drive Medicaid beneficiaries to take action to improve their health. Learn everything you need to start an effective rewards program for your Medicaid beneficiaries
This Bright Spots in Healthcare episode is sponsored by Icario
Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.
With healthcare costs skyrocketing, one employer found a solution to the high cost of providing healthcare to associates and their dependents. In 1991, Harris Rosen, President & COO, Rosen Hotels & Resorts actively took control of the hotel chain’s healthcare spending with extremely successful results: healthier employees – and a savings of $460 million in healthcare costs.
Rosen and two members of his executive team - Ashley Bacot, President of Provinsure, and Kenneth Aldridge Jr, RN, BSN, MS-HSA, the Director of Health Services at the Rosen Medical Center - discuss the hotel chain’s cutting-edge healthcare system, which enables associates to achieve quality care, improved outcomes and lower costs.
Hear how the program is structured and the critical factors contributing to its success. Find out if this novel approach is right for your organization.
To be successful in a rapidly evolving and crowded healthcare marketplace, health plans must find innovative ways to connect with consumers where they are and on their terms. While rethinking how to engage consumers, Humana created a fundamentally new service experience to deliver better outcomes and meet the whole-health needs of seniors. During the conversation, Dr. Pabo shares details on the insurer’s journey to create the new service experience — from conception to the marketplace. Hear the trials and tribulations the insurer faced as it implemented Author by Humana and find out how consumers are responding to the new experience. Learn the steps your organization can take a similar approach to elevate the consumer experience.
This episode is sponsored by Insignia Health
Insignia Health empowers healthcare organizations and health professionals around the world to assess patient activation and develop strategies for the efficient application of healthcare resources. As activation increases and individuals become better managers of their health, utilization costs decline and patient satisfaction improves. The Patient Activation Measure® (PAM®) and over 15 years of health activation research form the cornerstone of a complementary suite of solutions that help clinicians, coaches and population health providers improve health outcomes and lower costs. Today, Insignia Health supports the health activation efforts of more than 250 organizations touching the lives of millions of patients in dozens of countries.
Every day 79,000,000 Americans choose between paying their medical bills and basic needs like food and shelter. Medical debt destroys the financial stability of large segments of America’s most vulnerable communities and also targets the middle class, driving many families who are barely getting along into poverty. Craig Antico, Co-Founder, RIP Medical Debt and Tammie Jackson, Vice President, Go-to-Market Strategy and Sales, TransUnion Healthcare discuss why they believe it is a smart business decision for healthcare providers to abolish medical debt. Hear why they believe forgiving medical debt can help improve an individual’s health and wellness, and how providers can benefit from debt forgiveness.
Decoded Health CEO Mark Hanson and GYANT CEO & Co-Founder Stefan Behrens, MBA, PhD, joined us for our first-ever innovation debate to discuss their separate approaches to creating a virtual front door for hospitals and health systems, and how their strategies and tools dramatically change both the consumer and provider experience.
This Bright Spots in Healthcare Podcast is Sponsored by Inflect Health
Silicon Valley healthcare innovation hub Inflect Health was spun off from parent company Vituity to form a new nationwide, multispecialty investment partnership, owned and led by physicians and healthcare business experts. Headquartered in the San Francisco Bay Area with offices across America, Inflect Health provides guidance and financial support to early-stage healthcare and health-tech companies building promising solutions that offer to meet the needs of today’s evolving healthcare landscape. With its robust access to frontline providers, health systems, and industry players, Inflect Health connects the capital to innovators to physicians, catalyzing real-time, real-world innovation and disruption unlike anyone else.
Secretary Shulkin, the 9th Secretary of Veterans Affairs, shares bright spots within the Veterans Administration that may be applicable at private hospitals, health systems and health insurers. The discussion touches on topics including consumer centricity, whole-person care, digital health, mental health and innovation.
This episode is sponsored by Insignia Health
Insignia Health empowers healthcare organizations and health professionals around the world to assess patient activation and develop strategies for the efficient application of healthcare resources. As activation increases and individuals become better managers of their health, utilization costs decline and patient satisfaction improves. The Patient Activation Measure® (PAM®) and over 15 years of health activation research form the cornerstone of a complementary suite of solutions that help clinicians, coaches and population health providers improve health outcomes and lower costs. Today, Insignia Health supports the health activation efforts of more than 250 organizations touching the lives of millions of patients in dozens of countries.
Experts from Banner Health, Brigham & Women’s Hospital, Highmark, Insignia Health and UPMC Health Plan share success stories and best practices on how increasing activation not only helps consumers become better managers of their health but utilization and costs decline and consumer/patient satisfaction improves. Learn how you can implement their innovative ideas in your organization.
This episode is sponsored by Insignia Health
Insignia Health empowers healthcare organizations and health professionals around the world to assess patient activation and develop strategies for the efficient application of healthcare resources. As activation increases and individuals become better managers of their health, utilization costs decline and patient satisfaction improves.
The Patient Activation Measure® (PAM®) and over 15 years of health activation research form the cornerstone of a complementary suite of solutions that help clinicians, coaches and population health providers improve health outcomes and lower costs. Today, Insignia Health supports the health activation efforts of more than 250 organizations touching the lives of millions of patients in dozens of countries.
David Contorno, Founder of E Powered Benefits and Dr. Alex Lickerman, Founder, Chief Medical Officer, and Direct Primary Care Physician, ImagineMD, discuss why primary care should be the foundation of our healthcare system. They also talk about why the financial incentive model for primary care doesn’t work and why direct primary care is a better model. Learn how to financially design a direct primary care program and find out which organizations have implemented successful direct primary care models.
Kevin Lynch is the Founder, President and CEO of The Quell Foundation, discusses how healthcare payers and providers can employ empathy to remove the stigma of mental health and help the millions of Americans suffering from mental illness get the treatment they need.
The Quell Foundation’s mission is to reduce the number of suicides, overdoses, and the incarceration of people with mental health illnesses. Just five years after its inception, The Foundation is a nationally acclaimed mental health organization known for turning advocacy into statistical change, through its prestigious scholarship program and educational documentary series, Lift the Mask.
This Bright Spots in Healthcare episode is sponsored by Icario
Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.
Leaders representing CVS Health, Magellan, medical Mutual and UPMC Health Plan join Eric to share bright spots in chronic disease management programs. View bios: https://www.sharedpurposeconnect.com/bios-03112021/):
Ellen Beckjord, Associate Vice President, Population Health and Clinical Transformation, UPMC Health Plan, Caroline Carney, MD, MSc, FAMP, CPHQ, Chief Medical Officer, Magellan Health; Tere Koenig, MD, Executive Vice President and Chief Medical Officer, Medical Mutual; Jonah Mink, MD, Medical Director, Healthy.io; Kenneth Snow MD, Clinical Portfolio Medical Director, Transformation Team, CVS Health
This episode of Bright Spots in Healthcare is sponsored by Healthy.io. Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for at-home urinalysis and digital wound management. Their home urinalysis kit aids in the diagnosis of chronic kidney disease, urinary tract infections, and prenatal testing and is used by leading health-care systems worldwide.
As a result of the COVID-19 pandemic, health plans are transforming how they engage with their members. Expectations are raised as consumers change how they shop, socialize, and live their everyday lives, driving health plans to change their relationships with their members to be more consumer-centric
An all-star panel of experts from Anthem, Highmark, Bright Health Plan, and Icario success stories and actionable strategies for creating meaningful experiences to engage and empower members. Panelists include Stacy Byers, Vice President, Customer Experience, Highmark; Mark Dodge, AVP, Stars, Risk and Quality, Bright Health Plan; Merrill Friedman, Senior Director, Disability Policy Engagement, Anthem; and Steve Wigginton, CEO, Icario
This Bright Spots in Healthcare episode is sponsored by Icario.
Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.
Hear proven results from a successful group medical visit program. Learn how group visits helped patients adopt healthy habits and significantly change behaviors. The session features perspectives from experts representing the different stakeholders — lead physician, advanced provider, team leader, and patient — in a successful group visit program. Find out how Health Plans and Provider organizations can benefit from group appointments and get the blueprint to build your own program.
This episode of Bright Spots in Healthcare is sponsored by Healthy.io. Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for at-home urinalysis and digital wound management. Their home urinalysis kit aids in the diagnosis of chronic kidney disease, urinary tract infections, and prenatal testing and is used by leading health-care systems worldwide.
Randy Oostra, DM, FACHE, President & CEO, ProMedica, and Vic Strecher, PhD, MPH, Professor, University of Michigan School of Public Health, discuss how ProMedica is incorporating “personal determinants of health” to improve care and outcomes. They also share how having a strong life purpose is essential to health and well-being.
Bios: https://www.sharedpurposeconnect.com/bios-01142021/
This Bright Spots in Healthcare episode is sponsored by Icario.
Icario (formerly Revel + NovuHealth) is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.
Healthcare advocate, entrepreneur, and author Dave Chase discusses why healthcare is so expensive and shares some radical ways to reinvent healthcare during this episode. Dave highlights case studies featured in his new book, Relocalizing Health: The Future of Healthcare is Local, Open and Independent, which details the solutions employers and local community leaders can take to reduce healthcare costs and improve healthcare benefits for their plan members.
Listen to this episode to find out:
- Why and how healthcare can be provided and funded locally
- What healthcare can learn from the craft beer industry
- How a boutique hotel in Florida, a town in Sweden, and a community in Alaska all
- How you can get a free copy of Dave's book
This Bright Spots in Healthcare episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change. It's really a very fresh way of thinking about engagement and SDOH. Revel Health and NovuHealth announced a merger on October 1, 2020, to create a leading technology platform company focused on healthcare member engagement.
Check them out at www.revel-health.com or www.novu.com
Our expert panel discusses the importance of listening and responding to the voice of the healthcare consumer to improve the overall patient/member experience, clinical outcomes, and personalized care. Panelists include: David Langer, MD, Chair, Neurosurgery, Lenox Hill Hospital and star of Netflix docuseries Lenox Hill; Melinda Karp, MBA, Executive Director, The Center to Advance Consumer Partnership; and Senior Vice President, Consumer Partnership, Commonwealth Care Alliance; Tom Meier, Vice President - Product Development, Innovation, and Member Experience, BlueCross BlueShield of South Carolina; and David Webster, MD, MBA, VP &, Executive Medical Director, Clinical Services, Highmark Health.
This podcast is sponsored by the Center to Advance Consumer Partnership
The Center to Advance Consumer Partnership (CACP) helps organizations realize the often-untapped value of their consumers’ voices. Building on proven approaches pioneered by its founder, Commonwealth Care Alliance, CACP works with innovative healthcare and human services leaders to develop capabilities, build infrastructure, and cultivate relationships that ensure consumers with the most significant needs become enduring organizational partners, invaluable to shaping strategy and action. Together as partners, organizations and consumers are inspired to build trust and co-design solutions that really work to improve outcomes and enhance experiences.
Our expert panel discusses the importance of listening and responding to the voice of the healthcare consumer to improve the overall patient/member experience, clinical outcomes, and personalized care. Panelists include: David Langer, MD, Chair, Neurosurgery, Lenox Hill Hospital and star of Netflix docuseries Lenox Hill; Melinda Karp, MBA, Executive Director, The Center to Advance Consumer Partnership; and Senior Vice President, Consumer Partnership, Commonwealth Care Alliance; Tom Meier, Vice President - Product Development, Innovation, and Member Experience, BlueCross BlueShield of South Carolina; and David Webster, MD, MBA, VP &, Executive Medical Director, Clinical Services, Highmark Health.
This podcast is sponsored by the Center to Advance Consumer Partnership
The Center to Advance Consumer Partnership (CACP) helps organizations realize the often-untapped value of their consumers’ voices. Building on proven approaches pioneered by its founder, Commonwealth Care Alliance, CACP works with innovative healthcare and human services leaders to develop capabilities, build infrastructure, and cultivate relationships that ensure consumers with the most significant needs become enduring organizational partners, invaluable to shaping strategy and action. Together as partners, organizations and consumers are inspired to build trust and co-design solutions that really work to improve outcomes and enhance experiences.
The world of medicine moves fast and constantly changing as evidenced by the COVID-19 pandemic David Nash, MD, MD, MBA, Founding Dean Emeritus, Jefferson College of Population Health, Dr. Daniel David, MD, Medical Director, K2P and Mary Ellen Beliveau, MEd, Founder and CEO, K2P discuss why It’s essential for physicians and providers to keep pace with the latest medical information to transform patient care, enable continuity of care, and mitigate risks across hospitals and healthcare systems. They also talk about how a personalized curriculum
Our incredible panel of experts discusses how to effectively identify roadblocks to virtual care for patients in more vulnerable and underserved communities. They share strategies for bridging the “digital divide” and improving health outcomes from leaders “in the trenches” trying to improve quality and access. Panelists include Kemi Alli, MD, CEO, Henry J. Austin Health Center; Anita Ramsetty, MD, CCMS, Medical Director, Faculty Advisor, CARES Clinic & Director, Student Service Learning, College of Medicine; Medical University of South Carolina; Sara Ratner, Senior Vice President, Government Programs and Strategic Initiatives, Revel Health; Jorge Rodriguez, MD, Health Technology Equity Researcher & Hospitalist, Department of General Internal Medicine, Brigham and Women's Hospital.
This Bright Spots in Healthcare episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change. It's really a very fresh way of thinking about engagement and SDOH. Check them out at www.revel-health.com.
With information on COVID-19 evolving daily, our expert physician panel shares their thoughts on what we can expect from the virus over the next several months. They will also discuss lessons learned from the past seven months. Their conversation addresses topics tied to antibodies, treatment best practices, racial inequalities, innovation, and more!
Panel:
- Dr. Michael Saag, one of the most influential infectious disease doctors in the country and who is frequently on a number of major media outlets including C-SPAN, CNN, NBC, ABC and The Washington Post (he also survived COVID-19 back in March)
- Dr. Ofole Mgbako, an infectious disease fellow at Columbia University Irving Medical Center in Harlem where racial disparities around Covid-19 are at the forefront
- Dr. Gregory Katz, a cardiologist at Vassar Brothers Medical Center who will share his experiences (the good, the bad and the ugly) treating COVID-19 patients in the ICU at the height of the pandemic in New York City
- Harry Saag, MD, FACP, Co-founder and CEO, Roster Health; Hospitalist, NYU Langone Health
This episode of Bright Spots in Healthcare is sponsored by Knowledge to Practice (K2P), a leading provider of personalized, competency-based lifelong learning for practicing physicians, hospitals, and healthcare systems.
Through K2P’s advanced digital learning platform, practitioners can assess and maintain core medical competencies and keep pace with emerging medicine. Importantly, K2P’s solutions help transform patient care and mitigate risks across hospitals and healthcare systems.
Reliant Medical Group CMO Dr. Thad Schilling and Chief Behavioral Health Officer Dr. Samuel Nordberg walk us through the health system’s decision to rethink its approach to primary care by embedding mental health into primary care practices. They also discuss the business drivers behind the decision. and why they chose the full spectrum model, which makes mental health a permanent part of primary care, over the more popular collaborative care model.
Thad and Sam’s bios are available here: https://www.sharedpurposeconnect.com/bios-10082020/
Cara McNulty, DPA, President, Aetna Behavioral Health and Sara Ratner, Senior Vice President, Government Programs and Strategic Initiatives, Revel Health discuss the importance of removing the stigma behind mental illness in order to reach “silent sufferers” - patients suffering in silence rather than seek treatment for their mental disorder. Topics covered include why it’s essential for health plans and systems to identify silent sufferers, how the COVID-19 pandemic increased the need to help silent sufferers and how to measure the financial impact.
Today’s Bright Spots in Health Podcast episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change. It's really a very fresh way of thinking about engagement and SDOH. Check them out at www.revel-health.com.
In this timely and important discussion, our expert panelists discuss strategies for improving health outcomes by reducing race-based obstacles in our healthcare system. They also share success stories on how SDOH initiatives and cultural competency programs are helping to bridge the long-standing racial disparities gap.
Panelist bios can be found on our website: https://www.sharedpurposeconnect.com/bios-09242020/
Today's Bright Spots in Healthcare Podcast episode is sponsored by mySidewalk, a technology company dedicated to empowering changemakers. Their web-based publishing platform allows healthcare and public health leaders to integrate effective storytelling with the largest collection of social determinants data in the country. mySidewalk works with their partners to democratize data and get knowledge in the hands of people who need it, so they can take ACTION around wellness and health programs, policy or legislation that improves the lives of many. This is so critical in making this our country healthier today and moving into the future. For more information, visit mysidewalk.com or contact hello@mysidewalk.com.
Today’s healthcare consumers have many choices and practicing empathy can be a key differentiating factor in a crowded marketplace. No app, drug, or medical device can replace genuine human connection. Our all-star panel of experts from Stanford Healthcare, Commonwealth Care Alliance, UPMC, Nemours Children’s Health System, and Barnes-Jewish Hospital, explore the roles empathy and innovation play in helping healthcare payers and providers deliver best-in-class care, services, and experiences. The panel also provides real-life examples of leveraging empathy as part of an overall consumer/patient experience strategy. (Panelist bios are available at: https://www.sharedpurposeconnect.com/bios-09102020/)
This podcast is sponsored by the Center to Advance Consumer Partnership
The Center to Advance Consumer Partnership (CACP) helps organizations realize the often-untapped value of their consumers’ voice. Building on proven approaches pioneered by its founder, Commonwealth Care Alliance, CACP works with innovative healthcare and human services leaders to develop capabilities, build infrastructure, and cultivate relationships that ensure consumers with the most significant needs become enduring organizational partners, invaluable to shaping strategy and action. Together as partners, organizations and consumers are inspired to build trust and co-design solutions that really work to improve outcomes and enhance experiences.
As COVID-19 spread across the country, primary care practices were forced to transform in a few short weeks. While causing economic upheaval in the health care system, the pandemic also showed how primary care can move into the future and deliver care in multiple ways.
Our expert panel discusses the key drivers of primary care transformation, what the future should look like, and how payers and providers can adapt to the evolving landscape. Topics covered during the discussion include virtual care, group visits, integrating behavioral health, racial disparities, remote patient monitoring, value-based payments, medical scribes and more!
Panelists:
Wayne Altman, MD, FAAFP, President, Family Practice Group (The Sagov Center for Family Medicine); Jaharis Family Chair of Family Medicine, Tufts University School of Medicine;
Daniel Horn, M.D. Director, Population Health, General Internal Medicine; Associate Medical Director at the Massachusetts General Physician Organization;
Dan McCarter, MD, FAAFP, National Director, Primary Care Advancement, ChenMed;
Karolina Skrzypek, MD, Medical Director in Provider Engagement, Blue Cross Blue Shield of Michigan.
You can find their bios on our website: https://www.sharedpurposeconnect.com/bios-08272020/
The Netflix docuseries Lenox Hill follows four doctors from Lenox Hill Hospital in New York City as they juggle their work and personal lives. Dr. David Langer, one of the show’s stars, shares anecdotes from the acclaimed series and what it was like to perform brain surgery while being filmed. He also discusses how Northwell Health is innovating the consumer experience, engaging patients, and reducing unnecessary hospitalizations. Dr. Langer also reflects on his journey as a doctor.
If you haven’t seen the show, view the trailer on YouTube: https://www.youtube.com/watch?v=Hp04bzD5bJI
During this unique, high-level strategy session, High Performance Organization Expert David Hanna discusses how healthcare organizations can "reinvent" their capabilities to drive more value for patients, members and customers during this ever-changing healthcare landscape. David has helped some of the world's largest companies including Merck, UnitedHealthcare and Procter & Gamble achieve amazing results. Learn strategies you can use in your own organization to innovate and increase value.
World-renowned endocrinologist Paresh Dandona, MD, PhD discusses the importance of diabetes management and blood sugar control in treating the disease. He shares his groundbreaking research on the treatment of diabetes and the implications the discoveries have not only on patients’ lives but on society as a whole. Dr. Dandona also introduces the innovative certified diabetes educator (CDE) program he established to promote the screening and treatment of diabetes at the primary care level as well as help patients with medication management and controlling blood sugar levels. Patients working with CDE-Ambassadors saw significant improvement in diabetes control as well as a marked reduction in A1C levels and other cardiac risk factors. He also discusses how this program could be used for the treatment of other chronic diseases.
Today’s Bright Spots in Health Podcast episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change. It's really a very fresh way of thinking about engagement and SDOH.
If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Amazon, Marriott, Apple, you name it … they take a much more sophisticated approach than we do in health care, to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent. We in healthcare have not been that sophisticated in marketing to the patients who are at the highest risk of costing the most money. Until now. Check them out at www.revel-health.com.
Many people know ketamine as a party or street drug but it now used as a novel treatment for patients with treatment-resistant depression.
Depression is a common illness worldwide with the World Health Organization reporting more than 264 million people are affected. A large percentage of patients with depression do not respond to standard treatment, leading doctors to find novel treatments for depression including the use of oral ketamine.
Dr. Roger McIntyre, a professor of psychiatry and pharmacology at the University of Toronto founded the Canadian Rapid Treatment Centre of Excellence in a suburb of Toronto, Canada to offer intravenous ketamine infusion therapy to patients with mood disorders.
During the podcast, Dr. McIntyre talks about which patients are good candidates for ketamine use, the proper dosage, and any potential side effects. Dr. McIntyre also talks about the components of a ketamine therapy program, the challenges he faced building his clinic, and what he might do differently if starting again.
Community hospitals across the country are in the process of reopening services and operations closed as COVID-19 started to spread across the country. Rich Fernandez, president, Beth Israel Deaconess Hospital - Milton in Massachusetts, one of the states hit hardest by the COVID-19 virus, walks us through the hospital's reopening strategy and discusses the steps taken to adjust to the new normal while also ensuring the safety of staff, patients and visitors.
Rich touches on all aspects of the reopening from workforce management changes to the implementation of new patient waiting room procedures and everything in- between. He also shares some of the things he was most surprised about during the crisis and what the hospital is doing to prepare for a potential virus surge in the Fall.
Healthcare and community leaders from Bon Secours Mercy Health, CareSource, mySidewalk, and Selfhelp Community Services share success stories on leveraging SDOH and community partnerships to better engage their populations and to improve health outcomes. Find out how to overcome challenges and maximize the partnership. The “bright spots” discussed include food pantries, housing assistance, job support services, and programs for seniors.
Today's Bright Spots in Healthcare Podcast episode is sponsored by mySidewalk, a technology company dedicated to empowering changemakers. Their web-based publishing platform allows healthcare and public health leaders to integrate effective storytelling with the largest collection of social determinants data in the country. mySidewalk works with their partners to democratize data and get knowledge in the hands of people who need it, so they can take ACTION around wellness and health programs, policy or legislation that improves the lives of many. This is so critical in making this our country healthier today and moving into the future. For more information, visit mysidewalk.com or contact hello@mysidewalk.com.
Dr. Tara Burnett-Lewis discusses how shared medical appointments (SMAs) helped diabetes patients at the Johnston County Public Health Department in North Carolina, lower their A1C scores by 10%. Johnston County has a very rural population so SMAs give patients a sense of community and help them realize they are not alone. Tara shares how peer support helps build the patients’ confidence in their ability to manage their health and maintain active and fulfilling lives.
In addition, Tara talks about the value of SMAs and lays out the steps you can take to create your own SMA program.
Today’s Bright Spots in Health Podcast episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change. It's really a very fresh way of thinking about engagement and SDOH.
If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Amazon, Marriott, Apple, you name it … they take a much more sophisticated approach than we do in health care, to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent. We in healthcare have not been that sophisticated in marketing to the patients who are at the highest risk of costing the most money. Until now. Check them out at www.revel-health.com.
As part of its focus on the social determinants of health, CareSource, a health insurance plan serving Medicaid members in Ohio has invested heavily in programs to provide safe and affordable housing to members to improve both individual and community health.
In her role as director of housing at CareSource, Amy Riegel, is responsible for creating innovative approaches to innovative and sustainable approaches to integrating health and housing. In this podcast, Amy discusses how access to safe and affordable housing can improve both the health of an individual and a community. In particular, she shares details of the insurer’s Health Beginnings at Home program, which provides housing to homeless pregnant women in order to decrease infant mortality rates.
Today’s Bright Spots in Health episode is sponsored by Revel Health, who is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change. It's really a very fresh way of thinking about engagement and SDOH.
If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Amazon, Marriott, Apple, you name it … they take a much more sophisticated approach than we do in health care, to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent. We in healthcare have not been that sophisticated in marketing to the patients who are at the highest risk of costing the most money. Until now. Check them out at www.revel-health.com.
World-renowned video marketing expert Todd Hartley discusses how healthcare companies can easily implement and leverage video storytelling to stand out during the COVID-19 pandemic. Drawing on his experience working with celebrities, world leaders, and enterprises, He’ll share the latest tips, tricks, and strategies for successfully using the power of storytelling to your patients, members, and customers.
Communicating and Marketing to Healthcare During COVID-19
As COVID-19 shifts the focus of healthcare organizations towards saving lives, companies marketing to the healthcare industry need to rethink their existing approaches and try new ideas.
Hear winning strategies from experts in B2B marketing, social media, content marketing, virtual events, client insights, and market research. In addition, an IT Director from a leading health system shares the secrets to successfully marketing to healthcare organizations during these unprecedented times.
Today’s podcast episode with Dr. Gregory Katz is part of our live, Population Health Executive Roundtables Series (https://www.sharedpurposeconnect.com/virtual-roundtable-recordings/).
During my interview, Dr. Katz discussed what it’s like in the ICU during the COVID pandemic, the ethical dilemmas he and his peers are facing at Vassar Brothers Medical Center (400-bed hospital in Poughkeepsie, NY), and he also enlightens us with some really interesting opportunities for innovation. Finally, there are a lot of great, relevant questions asked by our audience of healthcare leaders, which Greg generously answers.
As an aside, Dr. Katz publishes a terrific email newsletter featuring his thoughts on health, medicine, and COVID-19: https://gregorykatz.substack.com/
The sponsor for today’s episode is us, Shared Purpose Connect, the producer of the Population Health Executive Roundtable and Bright Spots in Healthcare Podcast!
If your organization is looking to read leaders at the provider and/or pay organizations, consider using events as the hub to your marketing and lead generation strategy, and consider partnering with Shared Purpose Connect to accomplish this.
Shared Purpose Connect produces events from soup-to-nuts, working with your team to incorporate you as a thought leader within our roundtable discussion and/or podcast, support you in producing different marketing content derived from or connected to the event, and assist you in lead generation and networking. We become an important extension to your marketing teams. Our other partner companies (“sponsors”) include larger companies like Vituity, Commonwealth Care Alliance and Lumeris, and smaller organizations like Reveal Health and Roster Health. If you are curious, email me directly at eglazer@sharedpurposeconnect.com, @EricGlazer (Twitter), or Eric Glazer on LInkedIn. We can schedule a no-pressure brainstorming meeting.
During this 90-minute interview, Dr. Harry Saag, an internist at NYU Langone Medical Center, details his two-week battle with the virus and how his bout with the virus impacted how the treated COVID-19 patients when he returned to his job.
As he describes his journey to get well, he shares how he cared for his father, who also contracted the disease, the progression of the virus, the symptoms he dealt with and how he knew he was recovered from the virus. Harry also shares the day-to-day challenges he and other health workers face on the frontlines in New York City.
Dr. Cole Zanetti joins me to discuss Why “Positive Deviance” Should be Part of Every Healthcare Organization’s Strategy. Find out why positive deviance should be a part of every healthcare organization’s strategy!
Cole outlines how healthcare leaders can begin to adapt a Positive Deviance strategy at your organization and how you can get started. He also covers how an organization can measure the ROI and justify the investment in various Positive Deviance initiatives. It’s a jam packed 50+ minutes full of great insights and ideas.
So grab a pen and paper or your tablet and get ready to learn ….. about a really exciting bright spot in healthcare.
Today’s episode is sponsored by Roster Health. Roster is solving for social determinants of health through community health workers. They ASSIST ORGANIZATIONS ON IMPROVING OUTCOMES IN A VARIETY OF VALUE-BASED ARRANGEMENTS WHERE FINANCIAL OUTCOMES ARE TIED TO PATIENT OUTCOMES SUCH AS:
- 30-day readmission reduction programs
- Full-risk contracts
- Upside and downside risk contracts
- Bundled payment programs
If you are a healthcare organization participating in a value-based contract, check out Roster Health.com.
. ... they are a new bright spot in healthcare.
Dr. Samuel Nordberg joins me to discuss why, and how, Reliant Medical decided to rethink their approach to primary care. If you are in the process of integrating behavioral health with primary care, or are at least thinking about it, this is a must listen!
Sam outlines for us the key components to building an embedded model, the business drivers to why Reliant not only invested in new processes, but new real estate. He also talks about what healthcare can learn more software developers in building a new program like this, and we also spend a good amount of time on the blocking and tackling: operations, clinical framework, staffing and of course metrics for success. It’s a jam packed 50+ minutes full of great insights and ideas.
So grab a pen and paper or your tablet and get ready to learn ….. about a really exciting bright spot in healthcare, Reliant Medical Group’s embedded primary care model.
Today’s episode is sponsored by Revel Health. If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Toyota, Hershey’s, Apple, you name it … they take a sophisticated approach to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent. We in healthcare have not been that elaborate in marketing to the patients who are at highest risk of costing the most money. Until now. Check out revel health at www.revel-health.com. ... they are a new bright spot in healthcare.
Dr. Marianne Sumego, Director of Shared Medical Appointments at Cleveland Clinic, joins Eric for a jammed packed conversation about how Cleveland Clinic has mastered the shared medical appointment and how it benefits patients (with an emphasis on diabetics).
Marianne provides you history behind shared appointment and why Cleveland Clinic decided to invest in the program, she informs you on how SMAs are run and we even get to hear how it affects the skeptical, know it all consumer.
We also discuss the power of peer support, we dive into the How Tos so you can get an understanding of what you will need to mimic this program, we dive into HIPAA concerns, medical practice concerns and of course the business drivers Cleveland Clinic considers when financing this innovative approach to engaging and treating consumers with certain illnesses.
If you are in value based care, chronic care or simply love hearing innovating ideas ... this interview will fly by!
The episode is sponsored by Revel Health. If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Toyota, Hershey’s, Apple, you name it … they take a sophisticated approach to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent. We in healthcare have not been close, to being that elaborate in marketing to our consumers, patients, who are at highest risk of costing the most money. Until now. Check out revel health at www.revel-health.com. ... they are a new bright spot in healthcare.