PopHealth Podcast

Health Net's Regional Medical Director Dr. Anshul Dixit and Vivant Health's Utilization Management Review Supervisor Kathleen Loredo share how they partner together with Dignity Health's greater Sacramento hospitals, including one recent effort that reduced unnecessary hospital stays by 400 while increasing provider show up rates by 20% after discharge.

Lisa Ramsey, a former Medi-Cal worker who created Medi-Cal Consulting Services, joins the show to share about updates on Medi-Cal eligibility, including reminders about some often misunderstood limits on income requirements.

Chrisina Mills, a leading advocate for the disability community, was recently appointed to serve as the Executive Director for the California Association of Area Agencies on Aging.  Christina, who was born with osteogenesis imperfecta (bones can easily break), has led a 25 year career in advocacy for the disabled community and looks forward to supporting older adults with initiatives that often align with both the aging and disability communities.

California Department of Health Care Services' Joanna Aalboe joins the show to share about the continued evolution of California Advancing and Innovating Medi-Cal (CalAIM)/Medi-Cal transformation as well as how managed care organizations (MCOs) will start to be measured in 2025 and beyond.

Cancer Resource Center of the Desert CEO Helen Palomino joins the show and shares how her organization has a large impact on the Mexican American community, majority of whom are on Medi-Cal, in navigating an often complex system in which residents choose to receive care on both sides of the border.

Dora returns to the show to recap Medi-Cal Transformation and the CalAIM initiative in 2024, including what's worked as well as challenges still to overcome in 2025 and beyond. Dora helps lead HC² Strategies, a statewide consultancy/facilitator that helps health plans, community based organizations, as well as other providers of social and medical care come together to create positive outcomes leveraging the new resources available via the CalAIM initiative.

Dr. Jauregui's parents were an inspiration to the work he now does in the Inland Empire, including serving with IEHP and even volunteering as a DJ at various community events. Dr. Jauregui shares about the impact his team has in serving over 1.5M IEHP members and how the Inland Coalition is developing a master plan to be rolled out to the 4.6+M individuals living in the Inland Empire

Disability Right California (DRC) and its 350 employees serve the community of over 10 millions individuals in california with developmental, behavioral, as well as physical health disabilities. Andy Imparato shares about the history of DRC, it's connection to federal efforts, and how he was inspired to get involved and ultimately have a career in serving as a leader in advocating for the rights of individuals with disabilities.

InnovAge leaders Maria and Shadie join host Gavin Ward to give background on InnovAge (including its growth in CA and other states), the "secret" of PACE, and why PACE's growth nationally may not be as rapid as other service types.

John joins the show and shares how he went from thinking he'd be a Summer Camp Director to leading the implementation of California's Data Exchange Framework. He discusses how his role as the Chief Data Officer for CAHHS as well as his Director role for the Center for Data Inisghts and Innovation is to help lead organizaitons, whether healthcare, county, or community based, to share pertinent information to best impact those they care for in California.

California Association of Health Plans (CAHP) President and CEO Charles Bacchi joins host Gavin Ward to discuss CAHP's 2024 Initiatives, upcoming CAHP Conference with over California 1,000 healthcare leaders, and more.

From a small clinic in downtown LA to impacting tens of thousands of lives in California and beyond, Gray shares how Titanium has expanded in scope and location to help the historically underserved access care in meaningful ways through traditional medical services as well as CalAIM funded enhanced care management, community supports, and more.

Colby Takeda, Pear Suite Co-Founder and CEO, shares how his upbringing, including serving in a nursing home as a teenager, was an inspirtation into serving his community and and ultimately becoming a national leader in the community health worker space. Since 2022's approval of the community health worker benefit in California, Colby shares how his tech enabled platform organization, Pear Suite, has helped community based organizations, including a barber shops, become commuinty health worker sites that are able to bill for their important work in the community.

Beginning no later than 2024, the California Department of Health Care Services (DHCS) required all Medi-Cal managed care organizations to have a chief health equity officer (CHEO). Valerie shares how BSC Promise Health Plan gave her the opportunity in 2022 to be its first CHEO and some of the progress she's made in her first 18 months.

The California Medical Association has partnered with Health Tech 4 Medicaid (HT4M) at its upcoming 2nd annual CMA HIT Summit, "Health IT In the Safety Net." HT4M's founder Adimika Arthur, whose career has been instrumental in ensuring access to care, joins the show to share the importance of Health IT on health equity and ensuring a safety net for those that may otherwise struggle to get the care they need.

From the highlights and challenges in 2023 to what to expect in 2024 and beyond, Gavin discusses CalAIM with guests Michel Huizar, Branch Chief, DHCS Managed Care Quality and Monitoring Division, and Dora Barilla, Co-Founder, HC² Strategies.

Michael's history with health plans and advocacy played a key role in his recruitment to lead C4A, an organization established to advocate and collaborate on behalf of California's "Triple As." Michael shares how his organization supports older adults throughout the state and what their focus is in 2024 and ahead.

Under the California Department of Health Care Access and Information, Elizabeth shares how the newly created Officer of Healthcare Affordability is helping the most populous state to manage healthcare costs through growth targets and other efforts for 40M Californians.

Over 15M Californians are Medi-Cal beneficiaries, yet there are so many misceptions about Medi-Cal and very few Californians truly understand Medi-Cal eligibility. Lisa shares how she went from an entry level Medi-Cal worker to an expert, where she now leads a team that helps families navigate Medi-Cal, including asset and income limits, or lack thereof.

Beau shares how an initial stint as a temporary worker landed him a role with California's In-Home Supportive Sevices that became a springboard into his career as he ultimately become well versed in California's long term supports (LTSS) and services as well as home and community based services (HCBS). That foundation has helpd Beau become one of Anthem and California's leaders for the California Advancing and Innovating Medi-Cal (CalAIM).

L.A. CARE is one of the largest health plans in CA, serving millions in L.A. County, primarily Medi-Cal beneficiaries. L.A. CARE CMO Dr. Sameer Amin joins host Gavin Ward to share some of the highlights of his first year and what we can expect in 2024 with the state's largest Medi-Cal managed care organization.

Charles joins the show and shares about the latest CAHP initiatives and what to expect at the annual 2023 conference where over 1,000 leaders from DHCS, Health Plans, and providers gather in the desert.

WellSpace Health has been serving the Greater Sacramento area for many decades, and the CalAIM initiative is only going to increase its impact. Wellspace leaders Christie Gonzales and Cordia Losh join the show to share about the impact WellSpace has had in the community and what's to come through the CalAIM initaitive, enhanced care management, and more.

Susan Phillip joins the show to discuss the process and results of DHCS' procurement and results for the 2024 managed care plan contracts. Susan, who serves as DHCS' Deputy Director, Health Care Delivery Systems, shares how she came into the role and what we can expect heading into 2024 and beyond.

Leza joined the show and shares how her passion for older adults has led to her work wtih CCOAin the Golden State. CCOA's latest initiatives include efforts to ensure the aging population has access to legislative meetings as well as a recognized voice and influence into lawmaking.

Health Net's VP of Communications and Marketing joined the show to share how the end of the pandemic and Public Health Emergency (PHE) is making the annual Medi-Cal redetermination of eligibility unlike recent years before as Californians were automatically renewed during the PHE. The state, Health Net, and other Medi-Cal plans are making significant outreach attempts to ensure Medi-Cal beneficiaries know how to renew their eligibility, but 2-3 million Californians are still expected to lose eligibility.

Dan discusses his journey as the son of immigrant parents that inspired Dan to make a difference in Kern County where he's spent his entire life. From ICU nurse to leading enhanced care management efforts of the 20th largest county in the US, Dan's shares how he's played a role in saving lives both literally and figuratively as he now helps lead enhanced care management efforts in Bakersfield and Kern County.

So many Californians provide care to their loved ones and often don't know where to turn for help and support. Michelle shares how her own journey as a caregiver led to her receiving support from Valley CRC. Now as the Executive Director, Michelle shed lights on how caregiver resource centers throughout the state like hers in the Central Valley region can be a great resource for caregivers.

Dr. Wada returns to PopHealth Podcast to share some of the initial results of IEHP's California Advancing and Innovating Medi-Cal (CalAIM) efforts as well as what's to come next for IEHP, including how the end of the Covid-19 related Public Health Emergency (PHE) may have a significant impact on eligibility for the Medi-Cal population.

Jon joins the show to give some insight into what the American College of Healthcare Executives is all about and how it has helped shape him into the leader he is today as VP, Ancillary Services, at MLK Community Healthcare. We also learn how Jon just welcome his 4th child and his unexpected connection with party buses.

America's Physican Groups' New President and CEO Susan Dentzer joins the podcast to share about her first 9 months in the role as well as what's to come in 2023, including ACO Reach and direct contracting, for the organization that is "taking responsibiity for America's health."

Lisa joins the show and shares how she's grown into a policy expert during the 2000s and how Transform Health got its start in Sacramento. Lisa typically is the facilitator of meetings and discussions, but it's great to have her "on the other side" to hear her story as well as she and Transform Health are literally transofrming healthcare in California and througout the country, including a focus on Medicaid waivers.

CCHP Chief Medical Officer Dr. Dennis Hsieh discusses the inspiration behind his passion for his leadership role at Contra Costa Health Plan, the county operated health system serving the East Bay. We learn of his shared passion for soccer with host Gavin Ward, but more importantly how his time as a young man serving in Chinatown was an inspiration for him to be a leader that seeks quality care delivery for his members in Northern California.

California Association of Health Plans' (CAHP) Charles Bacchi joins the show to give some background on the work of CAHP, including some of its memorable moments in his nearly 2 decades with CAHP.  Charles also shares about his cowboy background and CAHP's upcoming annual conference in October with the some of California's biggest names in healthcare.

California Department of Health Care Services' Chief of the Benefits Division Lisa Murawski joined host Gavin Ward to provide details on the new Community Health Worker (CHW) benefit that has been years in the making.  The new benefit delivery doesn't require someone with a clinical background to make a big impact in the healthcare community, and will likely be a new career pathway for individuals seeking to serve their local healthcare community members that may have previously been underserved and/or unsure how to navigate the healthcare system.

Dora joins the show and shares how a combination of blessings, hard work as a healthcare leader (and mom), as well as a miracle have paved the way to today, where Dora and HC2 Strategies are leading large scale CalAIM collaborations between health plans, providers, and the community.

Dr. Schultz shares how his work serving individuals goes beyond just the Inland Empire and San Diego, but also to the Himalayas. He also shares how Federally Qualified Health Centers like Neighborhood Healthcare provide services for individuals that may otherwise struggle to access primary and other medical care.

California Department of Health Care Services' Anastasia Dodson helps give an overview of the "dual eligible" population in California and how upcoming changes will impact the delivery of care for Californians who have both Medicare and Medi-Cal (Mediciad in California), now called Medicare Medi-Cal Plans (MMPs or Medi-Medi plans), for Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (EAE D-SNPs).

Martha, a Medi-Cal beneficiary as a child in Ventura County, shares how her journey in the managed Medi-Cal world has ultimately led her to help lead a team that manages the care of millions of lives in California, including many that receive care in rural areas.

Yingjia, who serves in the role of Assistant Deputy Director, Health Care Benefits and Eligibility for California's Department of Health Care Services, joins the show to share how the significant eligibility adjustments shown during the pandemic (ie public health emergency) will be unwound and what that means to some of the millions of Californians on Medi-Cal.

Health plan and CalAIM expert Paige Brogan joins the show to share how the opportunity to make a big impact inspired her to join BSC Promise Health Plan. Paige gives some insight into the early days of CalAIM and while she is enthiusiastic about CalAIM, she shares why other medical leaders may be more in a sit and wait approach before celebrating the initiative.

Palav joins host Gavin Ward to discuss the new Popation Health Management efforts that DHCS is launching in 2023 in California. Before getting into the details, Palav reveals her competiveness in board games and where her passion for serving the safety net was inspired.

Rebecca shares how her journey to become a nurse and experience with worker's compensation set a foundation that allowed her to build a population health department at Partnership Health Plan of California.

Michael joins the show ande breaks down new opportunities for care and support that are available through California's new CalAIM initiative. CalOptima is the largest insurer in Orange County, caring for over 25% of the Orange County population, which may be a surprise vs. what the general public may think of when it comes to the OC demographics.

L.A. Care's Senior Director of Safety Net Initiatives' background in policy and community service helped prepare her to serve beneficiaries for California's largest managed Medi-Cal provider. Cynthia breaks down how the new CalAIM community supports are helping equip L.A Care to better serve its 2+ million membership.

SCAN's Sr. VP of Healthcare Services Eve Gelb joins SCAN backed myPlace Health Founder and CEO Robbie Pottharst in a 2-part episode that explores how SCAN is leveraging innovative models of care (ie CalAIM, PACE) that bring together both health and social services that historically were either unavailable and/or unable to be managed well with traditional models of care.

Dr. Wada shares how both his parents and UCLA were inspirtation in his choice to become a public servant, but not until after a stint as a bartender in London. Dr. Wada gives an overview of IEHP and how CalAIM is bringing enhanced care management and community supports to managed medi-cal beneficiaries across the Inand Empire and throughout California.

Social workers, whether we know it or not, are in our lives direclty or indirectly on a daily basis, caring for us, our loves ones, and our community.  Chris joins the show to share how the Society for Social Work Leadership in Health Care brings together up and coming social work leaders alongside veterans to advocate, collaborate, and cultivate an envionrment that ultimately benefits all served by social workers in healthcare.  Chris also shares about their upcoming annual conference in October in Nashville, TN.

Case Management leaders help ensure hospitals are running smoothly and efficiently, while at the same time leading a team that equips patients for success once they discharge from a hospital, or what Providence may call a "ministry."  Debbie joins the show and will touch on her journey and how she leads a team serving patient populations of all types in Santa Monica, CA.

Hospital Readmissions Guru and Healthcare Futurist Dr. Josh Luke takes a look back over the past 10 years to share what strategies have worked with readmission prevention. Josh also shares about how he became known as a expert in the readmission and care transitions space through his development of the National Readmission Prevention Collaborative, which took off in the early days of the readmission penalties.

Liz shares how the Center for Medicare and Medicaid's (CMMI's) "Innovation Center" tests care and reimbursement models that often become the norm, including accountable care models and much of what we've have seen in the value movement.