Bright Spots in Healthcare Podcast

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

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.   

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.

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, joined 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.   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.    About Icario Icario serves health plans 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. Visit Icariohealth.com.    

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.   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.   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, 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. She shares examples of how Nvidia's generative AI tools enhance clinician-patient interactions and streamline human-system experiences. Vega also discusses potential pitfalls and solutions to AI implementation that healthcare organizations should consider when implementing AI.   This episode was recorded live at HLTH 2024.   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, and 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.

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   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/   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.   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.  

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.   Segments:  Strategy & Culture Data & Decision-Making Personalization  Right Care, Right Time Panelists: 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 Bios: 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.   The Daily Coach Network is accepting applications for 15 new members starting in August. If you submit your application before July 29th and write "Bright Spots" in the referral section you'll receive an extra month on your first membership. Submit your application at apply.thedailycoachnetwork.com    To receive The Daily Coach newsletter, visit https://www.thedaily.coach/subscribe   Books mentioned during episode: Jocko Willink, Extreme Ownership: How U.S. Navy SEALs Lead and Win, Dichotomy of Leadership David Goggins, Never Finished James Clear, Atomic Habits       

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 th "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 and 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 and 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. Learn more at https://www.storiesformedicaltrust.org.   About Boston Medical Center Boston Medical Center is a non-profit 514-bed academic medical center and safety-net hospital in the South End neighborhood of Boston, Massachusetts. As part of the Boston Medical Center Health System, the hospital provides primary and specialty care to residents of the Greater Boston area. Boston Medical Center is a founding partner of the Boston Medical Center Health System, which is focused on creating a coordinated, equitable, value-based continuum of care to deliver world-class care to patients and health plan members. Find out more at www.bmc.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.  Link to report on Elevance's Whole Health Index (WHI) mentioned during show: https://catalyst.nejm.org/doi/full/10.1056/CAT.23.0015 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=1*qfwy3p*_ga*OTY3NTIzNTYzLjE3MDgxMjYyNDc.*_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 * Considering musculoskeletal (MSK) health in obesity treatment * 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.