Podcasts about blue cross blue shield association

Brian D. Pieninck didn't take a conventional path to healthcare leadership. He started his career as an 18-year-old IT contractor and spent two decades working across the industry before becoming President and CEO of CareFirst Blue Cross Blue Shield. He now also serves as Chair of the Blue Cross Blue Shield Association, bringing both local and national perspective to the role. In this episode, Keith Figlioli speaks with Pieninck about what it means to lead a not-for-profit regional payer at a time of seismic change. With 3.6 million members and coverage that spans commercial, Medicare, and Medicaid, CareFirst has become a vital part of healthcare access and infrastructure across the Mid-Atlantic. Pieninck reflects how demographic shifts, rising costs, and policy uncertainty are challenging how healthcare organizations evolve, while staying focused on long-term outcomes.  Pieninck and Keith discuss: Advancing health equity as part of the community. Pieninck sees CareFirst not just as a payer, but as part of the region's civic infrastructure, creating economic opportunities, delivering care through primary and urgent care locations, and supporting long-term health equity initiatives across Maryland, DC, and Northern Virginia. Medicaid coverage and its downstream impact. With nearly half of children in Maryland and DC relying on Medicaid, Pieninck warns that cuts or disruptions don't reduce the need for care; they push it into higher-cost, less coordinated settings like emergency departments. The balloon effect in healthcare financing. As costs are squeezed in one area, they inflate in another. Pieninck challenges the idea that market forces can realign care efficiently. He discusses how efforts to contain spending in one area often lead to inefficiencies elsewhere, and the system ends up paying more later because early, lower-cost interventions are underfunded or inaccessible.  Innovation that simplifies the system. Through CareFirst's innovation arm, Healthworx, Pieninick highlights the need to design a system that works for people by reducing complexity and embedding support directly into the healthcare experience. AI and infrastructure: opportunity meets readiness. With nearly three decades of experience on the technology side of healthcare, Pieninck is bullish on AI's potential—especially now that it's available at a price point that can scale. Real progress, he notes, will depend on thoughtful governance, better interoperability, and models built around human needs. This episode offers a look at how one regional plan is thinking through the tensions between access, affordability and innovation, and what that means for the broader system.  To hear Brian D. Pieninck and Keith discuss these challenges in depth, listen to this episode of Healthcare is Hard: A Podcast for Insiders. 

On this episode of Empowering Workplaces we welcome Lynn Merritt, CHRO at Blue Cross Blue Shield Association. Lynn shares with us how she's creating a culture of trust, transparency, and inclusion across a huge network of community-focused healthcare organizations. With 20+ years in healthcare HR, she shares the ups and downs of piloting initiatives like a four-day workweek pilot, why really listening to employees matters, and how being authentic keeps teams engaged and motivated.Join hosts Sanja Licina, PhD, and Guille Santana for this inspiring conversation full of real talk about making work better and more meaningful. Plus, Lynn's top tips for HR leaders trying to do the same.

Cathy Kennedy, a President of National Nurses United, joined the America's Work Force Union Podcast to discuss the potential impact of staffing cuts at Veterans Affairs hospitals, the urgent need for better legislation to prevent workplace violence and the push for Medicare for All. Merrilee Logue, Executive Director of the National Labor Office at Blue Cross Blue Shield Association, joined the America's Work Force Union Podcast to discuss statistics related to cancer diagnoses, the importance of preventive care and screenings and a union's role in supporting members through their cancer journeys.

Merry Christmas! America's Work Force Union Podcast is spending Christmas Day looking back at some of the best episodes of 2024! Join us as we revisit the first interview of 2024 with United Mine Workers of America President Cecil Roberts, who discussed the Warrior Met Strike in Alabama, outdated protective equipment for miners and the dangers of silica dust. Next up for the America's Work Force Union Podcast's Best of 2024 on Christmas Day is the Jan. 29 interview with Merrilee Logue, Executive Director of the National Labor Office of the Blue Cross Blue Shield Association, who discussed the NLO and ensuring the NLO provides the best solutions for all union members.

About Paul Markovich:Paul Markovich is the president and CEO of Blue Shield of California, a nonprofit health plan generating $24 billion in annual revenue and serving 4.8 million members across various markets in California. With over 25 years of experience at Blue Shield, Paul has driven numerous innovative initiatives, including funding a statewide provider directory, supporting the development of a statewide health information network for holistic patient care, and partnering with the California Medical Association to pilot new care delivery models. His leadership focuses on reimagining healthcare by leveraging technology and creating a system that is both affordable and high-quality.Previously, Paul served as the chief operating officer, overseeing crucial areas such as healthcare services, network management, marketing, and customer operations. He has a history of introducing groundbreaking products and services, including the first California Health Maintenance Organization to allow self-referrals to specialists and online access to member benefits. Paul serves on the boards of the Blue Cross Blue Shield Association and America's Health Insurance Plans. A North Dakota native and Rhodes Scholar, he holds a master's degree in philosophy, politics, and economics from Oxford University and a Bachelor of Arts in International Political Economy from Colorado College, where he also played Division I hockey.Things You'll Learn:Blue Shield of California's collaboration with Salesforce aims to digitize the prior authorization process, making it as seamless as credit card transactions and eliminating the need for outdated fax machines.Rather than making incremental improvements, Blue Shield focuses on creating a new, functional healthcare system with comprehensive digital health records.Successful healthcare innovation requires strong collaborations, as exemplified by the partnership with Salesforce for real-time data integration.Paul emphasizes the importance of learning from failures and aligning with skilled partners to drive meaningful innovations.Blue Shield's nonprofit mission centers on providing affordable, stress-free healthcare access and improving patient care through advanced digital solutions.Resources:Connect with and follow Paul Markovich on LinkedIn.Follow Blue Shield of California on LinkedIn and visit their website

Merrilee Logue, Executive Director for the National Labor Office of the Blue Cross Blue Shield Association, joined the America's Work Force Union Podcast to discuss her battle with breast cancer during Breast Cancer Awareness Month. She shared what she learned from her battle in hopes it will help others navigate their care post-diagnosis. Greg Leroy, Executive Director of Good Jobs First, joined the America's Work Force Union Podcast to discuss an article that examined the impact of film and televsion subsidies on state and local communities.

IN THIS EPISODE...Prioritizing niche expertise transforms post-signature work relationships by fostering deeper trust and alignment. When vendors excel in a specialized area, they bring unparalleled value, making them indispensable partners. This focus sharpens collaboration, enhances communication, and ensures that both parties are committed to a shared vision, driving long-term success.This episode features Kirk Mitchell, the Director of the Vendor Management Office at Blue Cross Blue Shield Association. He leads the development of supply base operating capacity, impacting healthcare operations for over 5 million Americans. Kirk excels in creating and managing complex IT relationships, contracts, and sourcing projects, delivering valuable solutions for BCBS Plans.------------Full show notes, links to resources mentioned, and other compelling episodes can be found at http://BlendedWorkforcesAtWork. (Click the magnifying icon at the top right and type “Kirk”)If you love this show, please leave us a review. Go to http://RateThisPodcast.com/blended Love the show? Subscribe, rate, review, and share! Be sure to:Check out our website at http://BlendedWorkforcesAtWork Follow Karan on LinkedIn, X, and InstagramFollow SDL on LinkedIn, X, and InstagramABOUT SHOCKINGLY DIFFERENT LEADERSHIP (SDL):This podcast is brought to you by Shockingly Different Leadership, the go-to firm companies trust when needing to supplement their in-house HR teams with contract or interim HR, Learning, and Culture experts to assist with business-critical People initiatives during peak periods of work. Visit https://shockinglydifferent.com to learn more.-------------WHAT TO LISTEN FOR:1. What are the key responsibilities in managing complex contracts?2. How can diverse teams collaborate effectively in contract management?3. What benefits come from partnering with smaller vendors?4. How can small businesses stay relevant with larger clients?5. What are the trade-offs between offshoring and onshoring?6. How does legal design help manage complex contracts?7. Why are stakeholder skills crucial for leadership?------------FEATURED TIMESTAMPS:[02:37] A Peek into Kirk's Life Outside Work[03:49] Core Responsibilities of Kirk's Job[06:40] Collaboration and Coordination in Contract Management[07:33] Collaborating with Vendors[09:07] Vendor Sourcing and Integration[11:23] The Benefits of Partnering with Smaller Vendors[14:45] Strategies for Small Businesses and Self-Assessment[18:57] The Trade-Offs of Offshoring vs. Onshoring[23:00] Signature Segment: Kirk's entry...

Sara Dorner, President of Rockford United Labor, AFL-CIO, joined the America's Work Force Union Podcast to discuss how unions can become more accessible to women and improve relationships with their local community. Merrilee Logue, Executive Director of the Blue Cross and Blue Shield National Labor Office, and Duncan Lawson, Director of Market Intelligence for Government Programs for the Blue Cross Blue Shield Association, joined the America's Work Force Union Podcast to discuss the healthcare landscape and options available to union members as they approach retirement.

Send us a Text Message.In this episode of Lessons From Leroy, host Leroy Smith interviews Junius Nottingham Jr., former Federal Agent and current Executive Director of the National Anti-Fraud Department for Blue Cross / Blue Shield Association.  He is also the Founder and CEO of J-NOTT-GTT Foundation, which is dedicated to raising awareness of Lynch Syndrome, that is estimated to affect 1 in 279 people or almost 1.2 million individuals in the United States.   Their discussion promises to be riveting and informative...Tune-In and Enjoy!You can get more information and donate to the J-NOTT-GTT Foundation at the following:  www.jnottgtt.org or by contacting Lessons From Leroy at info@lessonsfromleroy.comThank you for listening! Send comments and episode suggestions to: info@lessonsfromleroy.com or Leroy@lessonsfromleroy.com

In this episode of Becker's Healthcare Podcast, host Laura Dyrda sits down with Rebecca D'Amico, Chief of Staff to the CEO and Vice President of Strategy at Blue Cross Blue Shield Association. Rebecca provides an in-depth look at the strategic initiatives shaping the future of healthcare insurance. She discusses her role in steering the organization through industry challenges, the importance of innovation in healthcare, and the strategies Blue Cross Blue Shield is implementing to enhance member experiences and outcomes. Tune in for a compelling conversation on the evolving landscape of healthcare insurance and leadership.

In this episode of Becker's Healthcare Podcast, host Laura Dyrda sits down with Rebecca D'Amico, Chief of Staff to the CEO and Vice President of Strategy at Blue Cross Blue Shield Association. Rebecca provides an in-depth look at the strategic initiatives shaping the future of healthcare insurance. She discusses her role in steering the organization through industry challenges, the importance of innovation in healthcare, and the strategies Blue Cross Blue Shield is implementing to enhance member experiences and outcomes. Tune in for a compelling conversation on the evolving landscape of healthcare insurance and leadership.

Join us as Dr. Adam Myers, former Chief Clinical Transformation Officer at Blue Cross Blue Shield Association, shares his expertise and insights. Discover the pressing healthcare issues of 2024, Dr. Myers' excitement and concerns, and the key attributes essential for healthcare leaders to thrive in the coming years.

The special episode of The Dish on Health IT episode provides insights and coverage from the recent HIMSS24 conference. Hosts Pooja Babbrah, the PBM and Pharmacy Lead and Jocelyn Keegan, Payer/Practice Lead with Point-of-Care Partners dig into their observation from HIMSS24 before reacting to stakeholder interviews from the floor of the Interoperability Showcase on topics ranging from the impact of the final CMS interoperability & prior authorization, benefits of API adoption and pharmacy interoperability opens with a montage of HIMSS24 attendees. --NOTE: The sound quality of the kiosk interviews is not ideal. If you prefer, you can watch this episode on video for close captioning of the kiosk interviews--The episode opens with a montage of HIMSS24 attendees sharing what they find valuable about attending HIMSS. Pooja Babbrah then opens the episode explaining that she and co-host Jocelyn Keegan share their key takeaways and insights from the biggest health technology conference in the industry. Jocelyn started the conversation off by sharing her observation that the work over the last 15 years to forge scalable connections to improve data fluidity has been fruitful and reached a tipping point. Importantly, the conversations we heard at HIMSS24 showed an acknowledgment as important as data fluidity is the content of what we are exchanging, and that data quality is just as important. Jocelyn then shared her second observation which is that we need to build a skillset and pool of resources who can do the next phase of work that is needed. She shared that when she worked in the financial industry which was at the time transitioning to interoperability and automation, they had to hire and develop the critical thinkers needed to think through how to best leverage technology, approach change management and do the abstractions needed to be successful. Health IT is at a similar place; we probably need more clinical informaticists because how we use technology in clinical workflows is extremely important, but we also need operational experts to help pull through how shifts in one workflow should get pulled through in others. She went on to say that we need people understand data mapping and why clean data is so important. Pooja thanked Jocelyn for her insights before sharing her own. She mentioned that she heard talk about whether ViVE and HIMSS could both survive because they occur so close together, and are big investments for companies to make to attend or exhibit. She shared that her view is that they are different enough in programmatic and attendance mix that she believes they both have value and will survive. Adding to Jocelyn's point about data quality, Pooja added that data governance and sending the right data to the right people at the right time versus just sending a data tsunami. Pooja continued by adding that it's also important to meet people where they are. This was clear at the post-acute care listening session. Some care facilities are not yet FHIR-enabled, some can send data via FHIR but perhaps are not yet API-enabled, how can we meet those facilities where they are even if they aren't using cutting-edge technology? Most stakeholders are going to be somewhere on a spectrum of tech adoption. We need to be flexible in how we do things. Pooja went on to say that another observation is that the importance of consent management will continue to grow, and that real work is starting to be done to figure out what patient-centered consent management might look like. We need to be able to exchange the right data at the right time with the right people, but we need to ensure we have the right consent to go along with it. Pooja mentioned some industry initiatives on consent including the HL7 FHIR at Scale Taskforce Accelerator, which has launched a new consent project. Public meetings for the FAST Consent project have launched and will be held regularly. A consent learning lab was held at HIMSS24 for the second year in a row. Pooja expressed that she attended both last year's and this year's events and she could feel a shift including the presence of regulators who were in the room. She explained that the conversation focused on actual work and progress being made in California and Florida as well as a huge focus on the role of consent in connecting health data and human services data.Next Pooja and Jocelyn listened and reacted to stakeholders who stopped by the POCP Kiosk in the Interoperability showcase to give their perspectives on the final CMS prior authorization & interoperability rule, API adoption, and pharmacy interoperability. Interviewees at the kiosk included:Colin Banas, Chief Medical Officer for DrFirst, shared insights on medication management and prior authorization.Polina Vaserman, Vice President of product Management with MHK, discussed the complexities and proposed improvements in prior authorization final rule.Lathe Bigler, Vice President of Clinical Network Services at First Databank provided perspectives on leveraging FHIR APIs for improving price transparency and patient care.Lenel James, Business Lead - Health Information Exchange & Innovation, Blue Cross Blue Shield Association, highlighted the use of FHIR APIs to enhance data accessibility for all stakeholders, including patients, payers, and providers, underscoring the importance of making healthcare data available across the care continuum to improve service delivery and care coordination.Melanie Marcus, Chief Marketing and Customer Experience Officer at Surescripts highlighted the role of pharmacies in expanding care access and the necessity for interoperability and policy support.Kathryn Ayers Wickenhauser, Sr. Director of Community Strategy at DirectTrust discusses the critical role of pharmacists in delivering care and the role of Direct Messaging can play in supporting this work. Themes from the interviews and host response include: CMS Interoperability and Prior Authorization: There has been broad acknowledgment of the positive progress this final rule will make towards enhancing interoperability and refining the prior authorization processes is widespread, with some hoping for additional policies to go even further.Healthcare Ecosystem and CMS Policies: The industry acknowledges the complexities of medications requiring prior authorization. There's an expectation for CMS to broaden its research and policy scope to include specialty medications, recognizing their critical importance.Impact of Technology and Innovation: The importance of adopting standards like FHIR for improving healthcare interoperability is emphasized. Leveraging technology and standard adherence is highlighted as crucial for enabling effective communication among healthcare stakeholders, reducing administrative burdens, and improving patient care quality.Pharmacy's Essential Role: Pharmacies are spotlighted as key to healthcare delivery, especially in underserved areas. There's strong advocacy for improved pharmacy interoperability and integration into the care team, stressing the need for policies, payment reforms, and access to health information to support their expanded role.Using Existing Technologies: The discussions promote the practical use of existing technologies and workflows to address healthcare delivery challenges effectively. This pragmatic approach centers on solving immediate patient care and business problems with available tools and sharing successful industry practices to foster broader adoption.Future Directions and Collective Engagement: A desire for ongoing engagement with health IT innovations, with a focus on interoperability, is clear in future industry events. The importance of collaborative efforts within the community and across the industry is underscored as critical for driving advancements in health IT and interoperability.After Pooja and Jocelyn listened and reacted to the interviews, Pooja shifted to close out the episode. She took a moment to reflect on the rich dialogue and insights shared by professionals across the healthcare ecosystem. She acknowledged the collective and collaborative effort that is fundamental to advancing health IT, underscoring the critical role of technology, the growing importance of pharmacies in the healthcare delivery ecosystem, and the collective anticipation for the evolution of policies concerning specialty medications and the work toward a better way to manage consent. With a nod to the resilience and spirit of innovation that defines the HIMSS conference, Pooja expressed gratitude for the contributions of all speakers and participants, celebrating another successful year of sharing, learning, and collaborating. Looking ahead with optimism, she voiced enthusiasm for the next HIMSS, where the community will reconvene to delve deeper into healthcare's pressing issues, explore new advancements, and foster further collaborations that promise to shape the future of health IT.

Dr. Adam Myers is a distinguished figure with a comprehensive understanding of the healthcare delivery system. Dr. Myers brings a wealth of knowledge gained from his multifaceted experience across various realms of the health sector, including payors, healthcare delivery, and physician provider networks. Currently serving as an advisor and board member for several healthcare delivery and technology companies, Dr. Myers is at the forefront of innovative solutions that are shaping the future of healthcare. Previously, Dr. Myers served as the Chief Clinical Transformation Officer for the Blue Cross Blue Shield Association, where his advocacy for community health and health equity played a pivotal role in setting the vision for a more equitable and affordable healthcare system. His tenure at the Cleveland Clinic, as Chief of Population Health and Director of Cleveland Clinic's Community Care program, showcases his leadership in clinical, operational, research, training, and strategic initiatives. With a background as Chief Operating Officer and Chief Medical Officer of Texas Health Resources Physician Enterprise, and as a board member of the Joint Commission, Dr. Myers has been a driving force in healthcare innovation and quality improvement. Dr. Myers is an alumnus of Centenary College of Louisiana and Louisiana State University Medical Center. His commitment to continuous learning is evident in his completion of a master's in healthcare management from Harvard University. He further honed his expertise through a residency at His Image Family Practice Residency at Hillcrest Medical Center in Tulsa, Oklahoma, and a fellowship in Advanced Obstetrics at the University of Oklahoma obstetrics and gynecology department. Join us as Dr. Adam Myers shares his invaluable insights, drawing from his wealth of experience, and sheds light on the dynamic and ever-evolving landscape of healthcare.

About our guest: Paul Kingsbury is a retired Fleet Master Chief (U.S. Fleet Forces Command) with 31 years of service. He currently serves as the Director of Uniformed Service Relations at the Blue Cross Blue Shield Association. He's the host of the ‘Cutlass Podcast,' a podcast specializing in leadership lessons and guidance. He's authored or co-authored the 2nd Edition of the Chief Petty Officer's Guide, the Petty Officer's Guide, and the latest edition of the Bluejacket's Manual. He's served as the President of the Non-Commissioned Officers Association (NCOA) and the co-director of Outreach and Brand Ambassador for the U.S. Naval Institute. He's published several articles on Navy policy and issues in Proceedings, the USNI Blog, and Joint Forces Quarterly, receiving awards in both the U.S. Naval Institute General Essay and Enlisted Essay Contests.   About the Episode: Congrats are in order for the newly selected Command Master Chiefs and Command Senior Chiefs. Damo made it y'all. Damon and Tish poke a little fun and congratulate Damo on his selection as a Senior Enlisted Leader. He discusses his thoughts and anticipation about going into a new role. They briefly discuss the story about the Chief who's recently been accused of espionage.   Retired Fleet Master Chief, Paul Kingsbury joins the show to just chat it up with the gang. He talks about his upbringing as a catholic altar boy in a blue-collar family in South Florida in the 1980s. He discusses his early days as an Electrician's Mate (EMN) in the Nuclear Power Plant. How do you even become a Fleet Master Chief? What's the difference between a Force and a Fleet Master Chief? How easy is it for a Fleet Master Chief to make changes? This leads us down a dark rabbit hole about who really runs the military. How's the work/life balance of a CMC moving up to FLTCM? How did Paul get the opportunities to write (and co-author) the CPO Guide, Petty Officer Guide and Bluejacket's Manual? How is the transition to a civilian after 31 years of Military Service?  Paul details the craziest thing that he's seen on a ship while underway. How difficult is it to sustain relationships the higher you climb up the leadership level? Paul explains why he thinks the CPO Selection board has an impact on CPO behavior. Paul's #Dobetter - “What got you here, won't get you there.” These and more topics are covered in this episode of the ‘Permission to Speak Freely' podcast. Remember to follow the ‘Permission to Speak Freely' podcast on TikTok, Facebook, Discord, Instagram, and Twitter, and subscribe on YouTube.       Keep up with the ‘Permission to Speak Freely' podcast on our social media and YouTube - https://linktr.ee/Ptsfpodcast     Listen to The Cutlass Podcasty (by Paul Kingsbury) - https://podcasters.spotify.com/pod/show/paul-kingsbury03     Keep up with Paul Kingsbury on his social media platforms: U.S. Naval Institute - https://www.usni.org/people/paul-kingsbury Linkedin - https://www.linkedin.com/in/paul-kingsbury-3bb8a8b3/ Cutllass Leadership (Website) - https://www.cutlassleadership.com/paul X - https://twitter.com/kingsburypaul1?lang=en     For the Books:   The Chief Petty Officer's Guide (Paul Kingsbury) - https://www.usni.org/press/books/chief-petty-officers-guide-2nd-edition   Petty Officer's Guide (Paul Kingsbury & Daniel Richard) - https://www.usni.org/press/books/petty-officers-guide   The Bluejacket's Manual, 26th Edition (Thomas J. Cutler, Mark T. Hacala, and Paul Kingsbury) - https://www.usni.org/press/books/bluejackets-manual-26th-edition-0       Links and more from this Episode:   Navy Chief Charged with Espionage - https://www.dailymail.co.uk/news/article-13110621/amp/us-navy-chief-japan-charged-espionage.html   Air Force Member Set Himself on Fire Outside Israeli Embassy - https://www.nbcnews.com/news/us-news/us-air-force-member-set-fire-israeli-embassy-dc-died-rcna140455       Additional Credits: PTSF “Theme Music” - Produced by Lim0

In this episode, we are honored to have Fleet MCPO (R) Paul Kingsbury, Director of Uniform Service Relations at Blue Cross Blue Shield Association, as our special guest. Paul explains the little-known facts and intricacies of the Federal Employees Dental and Vision Insurance Program (FEDVIP), shedding light on who is entitled to this valuable program and what benefits it provides to eligible individuals. Whether you're a retired Veteran navigating post-military life, an active-duty Servicemember, or someone interested in the FEDVIP program, this episode provides valuable information and perspectives.  --- Send in a voice message: https://podcasters.spotify.com/pod/show/yournextmission/message

This is the final episode in a four part series with heads of strategy at providers and payers from across the healthcare ecosystem to explore “the new normal” in a post-COVID operating environment. For this episode Keith Figlioli welcomed Sukanya Soderland, Chief Strategy Officer at Blue Cross Blue Shield of Massachusetts, to explore how a regional payer is adapting. This follows previous episodes that offered a diverse perspective from heads of strategy at:A regional health system, OhioHealth (Episode 58)A national health system, CommonSpirit Health (Episode 59)A national payvider, Humana (Episode 60)To wrap up this series, Sukanya provides a glimpse into the strategy at BCBS MA, the largest health plan in Massachusetts and a mostly commercial-focused payer that serves nearly three million members across New England. Unlike most not-for-profit organizations, BCBS MA pays significant federal, state, and local taxes and assessments. Without soliciting or receiving charitable donations, or benefiting from tax-exempt financing, BCBS MA stays competitive by generating a small margin from operations that it reinvests in its business, people, and technology, and by remaining deeply focuses on the community its serves.In her discussion with Keith, Sukanya shared her outlook on issues including:Shared empathy between operations and innovation. For any head of strategy, serving the immediate needs of an organization is equally as important as anticipating and planning for future demands and market forces. Sukanya discussed how business leaders can sometimes view innovation leaders as out of touch with current realities, while innovation leaders might view business leaders as “dinosaurs.” She talked about the importance of developing a culture of empathy and trust between these groups.Building vs. buying vs. co-designing. To stay competitive against larger, national organizations, regional payers must recognize what they do well and where they should partner with other like-minded entities to augment their capabilities. Sukanya talked about making decisions to partner or co-develop capabilities with others, including sister companies across the Blue Cross Blue Shield Association, as a way of advancing sustainable, non-profit healthcare. She also recognized the challenges with driving meaningful change in affordability, quality and consumer experience without being intimately involved in care delivery, and discussed creative ways of partnering with incumbent health systems or new and innovative care delivery models to make that happen.Changing dynamics in how people access care. One of the biggest changes Sukanya sees occurring over the next decade is the way people access care. She discussed several of the market factors driving this change from the supply and demand of primary care physicians, to Generation Z aging into adulthood. She talked about how healthcare is losing the “quarterback” function as young adults turn to social media, trusted contacts and convenience in place of a strong relationship with a primary provider, and how that impacts strategy.To hear Keith and Sukanya discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Serial Killer Richard Cottingham (The Times Square Killer) Documentary Cottingham was born in Bronx, New York in 1946, but his family moved to New Jersey when he was 12. He had two younger siblings. His father worked for an insurance company and his mother was a homemaker. His childhood was fairly normal. When his family moved to New Jersey, he entered seventh grade at St. Andrews, where he had trouble making friends since he was new to the area. Because he had poor eyesight, he wasn't good at sports. In high school, where he fit in better, he joined the track team because it allowed him time alone. After graduating, he found work as a computer operator at the insurance company where his father worked and also took computer classes. When he was 20, Cottingham got a job at the Blue Cross Blue Shield Association as a computer operator. In 1967, aged 21, Cottingham committed his first murder, fatally strangling a 29-year-old woman, Nancy Vogel, a crime he didn't confess to until 2010. In 1969, he was convicted of drunken driving and was sentenced to a $50 fine and 10 days in jail. At the age of 23, he married. In 1972, he was charged with robbery and sexual assult, but the case was dismissed. During his serial killing years, Cottingham had at least two affairs. In 1979, his wife filed for divorce. For some reason, she withdrew it after his arrest and moved to Poughkeepsie with their children. Killings and Incarceration Cottingham in court. From 1967 to 1980, Cottingham is known to have killed nine females and attempted to kill an additional four, though he has claimed to have killed as many as 100. On the night of December 15, he abducted a 26-year-old nurse named Maryann Carr from the parking lot near her apartment, took her to a motel, tortured and killed her. In March the following year, Cottingham, using the alias "John Schaefer", approached a woman named Karen Schilt in a bar, drugged her, took her to an unknown location, raped her and left her for dead in a sewer near an apartment complex. Because she was found by a hotel employee, she survived, but couldn't remember much useful information about the assault, so the case went cold until Cottingham's arrest. In October, he drugged, sexually assaulted and tried to kill a prostitute named Susan Geiger, who also survived. In the beginning of December of 1979, Cottingham solicited a pair of prostitutes, took them to the Travel Lodge Motor Inn in New York, spent the night torturing, killing and mutilating both of them, removing their heads and hands and taking them with him, and then set the room and the bodies on fire. They were found when the staff saw smoke coming from under the door. Only one of the victims, Deedah Godzari, was identified. The identity of the other remains unknown, though she is estimated to have been in her late teens. In 1980, Cottingham attacked four women within less than three weeks. The first, Valerie Ann Street, was killed in a motel room and burned like the previous two victims. The next, Pamela Weisenfield, survived her attack. On May 15, the burned body of Ann Reyner was found in a hotel room in Manhattan South. She was also burned, but Cottingham didn't remove her head or hands; instead, he cut off both her breasts. On May 22, he solicited a prostitute named Leslie Ann O'Dell and took her to the Quality Inn Motel in Hasbrouck Heights, the same motel to which he had taken Valerie Ann Street and killed her. While he was torturing O'Dell, security staff heard her screams and called the police. When Cottingham tried to run, he was caught by them and arrested. Among his possessions, they found handcuffs, an open roll of duct tape, leather S&M gear, a toy gun, a knife and the drug he had used to incapacitate his victims. During interrogation, Cottingham claimed to have paid O'Dell $180 for sex and that everything he did to her had been consentual. Further investigation connected him to more crimes; his fingerprint was found on a pair of handcuffs found on Valerie Ann Street's crime scene. When the police searched his home, they found mountains of evidence linking him to other murders, such as the key to Mary Ann Carr's apartment, a toy koala bear and a pair of earrings that had belonged to Valerie Ann Street, and jewelry belonging to Deedah Godzari and Ann Reyner. His handwriting also linked him to the motel rooms he had rented and committed the killings inside. The following year, Cottingham was found guilty of 15 of the 20 counts for which he was charged. Over the next three years, he was put on trial for his additional murders and attempted murders. During the proceedings, he attempted suicide twice. In total, he was convicted of five murders (he confessed to Nancy Vogel's murder many years later) and sentenced to hundreds of years in prison, a sentence he is still serving. In 2020, he confessed to three more murders. Modus Operandi Cottingham targeted petite blondes in their late teens-mid-20s and most often prostitutes. He would solicit them somehow, drug them by spiking their drinks with Tuinal (a date rape drug used before Rohypnol became available) in bars and take them somewhere secluded, usually to a motel, where he would bind them, gag them with duct tape, brutally rape, torture and stab them before killing them by strangling them with a ligature. Presumably to make identification harder, he would sometimes cut off their heads and hands and take the parts with him. Among his known methods of torture were severely biting and scratching their nipples, cutting around the breasts and threatening them with a toy gun and leaving it within their reach so they could try to grab it only to discover that it was fake. He would also make his victims call him "master". He took trophies such as jewelry and other personal belongings. After the crimes, he went to great lengths to cover them up, sometimes hiding the bodies in secluded locations or even setting them and the room they were in on fire. Known Victims Maryann Carr, Cottingham's fifth victim. October 28, 1967, Ridgefield Park, New Jersey: Nancy Schiava Vogel, 29 (strangled) July 17, 1968, Midland Park, New Jersey: Jacalyn "Jackie" Harp, 13 (strangled) 1969: April 7, Saddle River, New Jersey: Irene Blase, 18 (strangled) July 14, Emerson, New Jersey: Denise Falasca, 15 (strangled) August 9 1974, Montvale, New Jersey: Lorraine Marie Kelly and Mary Ann Pryor (both were raped, tortured by burning, and drowned) Lorraine Marie Kelly, 17 Mary Ann Pryor, 16 December 15-16, 1977, Bergen County, New Jersey: Maryann Carr, 26 (raped, tortured, beaten, and fatally strangled) 1978: March 22-23, New York City, New York: Karen Schilt, 22 (attempted; raped and left for dead in a sewer; was rescued) October 10, Hackensack, New Jersey: Susan Geiger, 19 (raped and attempted to kill; was pregnant at the time) December 1-2, 1979, New York City, New York: The Travel Lodge Motor Inn killings (both were raped, tortured, and fatally strangled; burned and had their heads and hands cut off post-mortem): Deedah Godzari, 22 An unidentified victim, 16 1980: May 5, Hasbrouck Heights, New Jersey: Valerie Ann Street, 19 (bit and cut her breasts, beaten, and fatally strangled) May 12, Teaneck, New Jersey: Pamela Weisenfield (attempted; bit repeatedly and beaten) May 15, New York City, New York: Jean Reyner, 25 (raped, repeatedly stabbed, tortured, and fatally strangled; burned and removed both of her breasts post-mortem) May 22, Hasbrouck Heights, New Jersey: Leslie Ann O'Dell, 18 (attempted; beaten, raped, sodomized, non-fatally slashed with a knife, bit her breasts, and tortured)

A looming government shutdown could impact crucial healthcare programs. A new study conducted by the Blue Cross Blue Shield Association is the latest to find that outpatient care at hospitals is more expensive compared to surgery centers or physician's offices. And, most ambulance rides are out of network, according to a new report. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Inside Health Care, we talk Medicaid with a large, equity-focused provider about the end of the Fed's pandemic-related emergency Medicaid provisions. Following that, a chat with one of our 2022-2023 PCMH Certified Content Expert Quality Award winners. Later on, some fast facts for you in observance of World Hepatitis Day.Elevance Health, a large multi-state health insurance provider, is the largest managed care company in the Blue Cross Blue Shield Association. In September of 2022, an Elevance Health subsidiary, Simply Healthcare Plans of Florida, became one of the first health care organizations in the U.S. to earn accreditation in NCQA's Health Equity Accreditation Plus program.We interview Elevance Health Medicaid President Aimée Dailey alongside Staff Vice President for Medicaid Whole Health Kalunde Wambua to find out more about the company's continued commitment to Equity improvement.We also talk with one of NCQA's 2022-2023 PCMH Certified Content Expert Quality Award winner, Susanne Campbell, Senior Program Administrator for the Care Transformation Collaborative of Rhode Island. We talked about the challenges of getting people on board with quality measurement. And we learned that, as measurement improves, customer focus improves, and health delivery becomes more efficient, all leading to solutions for resolving historic gaps in health equity.Finally, in our Fast Facts segment, we observe the World Health Organization's World Hepatitis Day, scheduled annually every July 28th. We include resources from the U.S. Department of Health and Human Services alongside an article from the NIH. Hepatitis awareness includes further reminders for childhood immunization, something NCQA measures in our HEDIS Measures package called Childhood Immunization Status, or C-I-S. The measure calculates the rates for a number of childhood vaccines and vaccine combinations. Among the vaccines in the list, alongside DTaP, MMR, and the flu, are vaccines for both Hep A and Hep B.We're also proud to announce that Inside Health Care won two media industry awards, both announced in June 2023. We won a Merit award from the Digital Health Awards. We've also been named a Gold Winner 2023 by the Hermes Awards. Thanks to all our interviewees and leadership staff at NCQA for their support along the way.

On this episode of DGTL Voices, Ed is joined by longtime friend, Dr. Adam Myers, Chief Clinical Transformation Officer at Blue Cross Blue Shield Association to chat how payers and providers can work more collaboratively, the BCBS Institiute, and a reminder to be the values that you want others to espouse. 

As we turn the page from 2022, health plans are facing new challenges impacting member experience, retention, and, most importantly, their member's health. This panel will offer insights on the priorities to focus on as we enter 2023. Topics include: the new reality health plans and members will face once the PHE ends and how getting ahead will avoid significant membership losses; CMS' increased weight on CAHPS surveys will lead to more focus on member satisfaction; New Social Need Screening and Intervention (SNS-E) requirement means that plans will need to get more serious about members' social needs by 2025 Panel: Mikal Sutton, Managing Director, Medicaid Policy, Blue Cross Blue Shield Association; Mildred Menos, Director of Member Advocacy and Community Outreach Transformation, Horizon Blue Cross Blue Shield of New Jersey; Steve Wigginton, CEO, Icario Link to bios: https://www.sharedpurposeconnect.com/events/2023-strategy-session-member-redetermination-cahps-and-social-needs/ This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through extrinsic and intrinsic motivations. Learn more at icariohealth.com.

July 13, 2022 ~ The President & CEO of the Blue Cross Blue Shield Association talks to Dan Loepp about the changing role of health care during the pandemic and the insurer's work helping communities recover from COVID-19.

In episode 11, host Peter Panageas invites two special guests to discuss how the BlueCross BlueShield Association, Independence Blue Cross, and Blue plans across the country are changing the trajectory of racial health disparities. His guests are Dr. Adam Myers, senior vice president and chief clinical transformation officer for the Blue Cross Blue Shield Association and Dr. Seun Ross, Director of Health Equity at Independence Blue Cross.

The threat of medical necessity denials of coverage – a mainstay of insurers to avoid paying claims – requires providers to have administratively costly utilization management (UM) departments. Good physician documentation and educated UM processes are highly effective in getting such denials overturned.  However, there are also so-called “technical denials,” in which real or alleged provider lapses in the prior authorization process arise that can be hard, or even impossible, to overcome.  During the next live edition of Monitor Mondays, Marvin Mitchell, director of case management and social services at San Gorgonio Memorial Hospital in Banning, Calif., will report on this emerging audit trap, and also discuss how to avoid or overcome these crafty insurer maneuvers.Other segments reported by an array of trusted subject matter experts will include the following:The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors, including the Recovery Auditors (RAs).  Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment. Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.  Legislative Update: Cate Brantley, legislative analyst for Zelis, will report on current healthcare legislation. SDoH Report: Lenel James, business lead for the Blue Cross Blue Shield Association, will report on the news that's happening at the intersection of healthcare regulations and the social determinants of health (SDoH). Mr. James will be substituting for Tiffany Ferguson.  

The health of all Americans is on the line – particularly among the nation's communities of color, where maternal health issues, behavioral health issues, diabetes, and cardiovascular conditions have a disproportionate impact.Recognizing this national concern, the Blue Cross Blue Shield Association has devised a national health equity strategy to confront such health disparities. All this follows the release by the National Center for Health Statistics of 2022 ICD-10-CM codes, both new and updated, for education, food insecurity, and housing, with implementation effective beginning Oct. 1, 2021.During the next live edition of Talk Ten Tuesdays, Lenel James, MBA, an Health Level 7 (HL7) “fellow” and the business lead for Health Information Exchange and Innovation at the Blue Cross Blue Shield Association (BCBSA), will report on the massive effort underway. Lenel has been with BCBSA and has served as its voting representative to HL7 for almost 20 years, and has extensive experience in healthcare and technology strategy. He also serves as payor advisor for for the HL7 Da Vinci Project, and was elected to the HL7 Board in 2020.The live broadcast will also feature these other segments:Tuesday Focus: Patient Safety Indicators (PSI): Christel Kemble with Covenant Health will report on the vexing issue of patient safety indicators.Mental Health Report: Internationally renowned psychiatrist and award-winning author Dr. H. Steven Moffic will report on the “good, bad, and ugly” of America's collective mental health. The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.  News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

This episode is brought to you by the Blue Cross Blue Shield Association. Blue Cross and Blue Shield companies are in every ZIP code in every state, working to improve health and expand access to care. Community by community. For the health of America. I'm joined today by the top leadership of Seniorlink, an innovative company that provides coaching, emotional and financial support for families caring for loved ones.  Tom Riley serves as CEO, and Matt Marek is the President and Chief Operating Officer.  Together, they are working with Medicaid-eligible and Medicare Advantage members who want an alternative to nursing home care.  Seniorlink supports and provides the needed tools to the millions of family caregivers who are key to keeping their loved ones healthy and cared for in the home setting.    With November being National Family Caregivers Month, our discussion today is both timely and needed. 

Health is all about building daily habits. Whether it's what we eat, how many hours of sleep we get or how often we exercise, the choices we make have a lasting impact on our overall wellness. With 2022 upon us, government employees are laser-focused on choosing health coverage that meets their needs. But the new year is also an opportunity to set new goals and build healthy habits for the year ahead. As we look to the future, Federal employees and retirees may not be aware that there are a number of activities included in their healthcare plans they can take advantage of right now to improve their health. From gym discounts to wellness incentives, there are a multitude of opportunities that exist for government employees looking to make the most of their health benefits. In this third and final episode of “Discussions in Federal Healthcare," a podcast from the Blue Cross Blue Shield Association, in collaboration with GovExec's Studio 2G, we'll discuss how government employees can take advantage of wellness incentives and programs.

Introducing Rewriting Wellness, a new podcast about the people behind the most innovative wellness companies. Learn new ways to improve your health, nutrition and fitness, and be inspired by the stories of the  entrepreneurs and visionaries behind these companies. We'll talk with leaders from Fitbit, Echelon, Farmbox, Sunbasket and Gympass to learn about the moments that changed everything. Brought to you by the Blue Cross Blue Shield Association and the Blue365 program, a free health and wellness discount program exclusively available to eligible BCBS members.

In this episode, we discuss how organizations can transform by delivering enhanced outcomes for customers, improving financial results, and increasing employee engagement with Lumevity. Featuring: Deb Rice-Johnson, president and chief growth officer at Highmark Inc., Larry Kleinman, chief human resources officer for Highmark Health, and Chris Little, senior vice president of strategic partnership growth at Highmark The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

The month of November tends to conjure up images of fall foliage, pumpkin patches and Thanksgiving dinner. But for federal employees, it also means it's time to start thinking about health benefits. Open season, after all, is right around the corner and it's only a matter of time before employees need to choose a health insurance plan for fiscal year 2022. But what do federal employees need to know about signing up for or renewing their health, dental and vision benefits this open season? That's the question our experts answer on this second episode of “Discussions in Federal Healthcare,'' a podcast from the Blue Cross Blue Shield Association, in collaboration with GovExec's Studio 2G, that aims to educate federal employees on healthcare benefits and services.

In this episode, hear from our experts on who is eligible for Medicare, and the benefits of Medicare Advantage plans. Did you know Medicare Advantage provides comprehensive coverage including vision, dental, and hearing services not included in traditional Medicare? Tune in to learn more about what factors to consider when choosing a health plan. Featuring: Lori Schoonmaker, Market president of National markets at Highmark and Ellen Galardy, Senior Vice President of Consumer Markets Strategy & Sales. The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Highmark Health and Penn State Health are teaming up to change the way health care is delivered. Through new facilities, medical research and value-based care, this partnership is increasing both accessibility and affordability for members and patients. Hear more from the experts on how we're scaling up to bring high-value care closer to home with Penn State Health. Featuring: Tom Doran, Chief Operating Officer for Highmark Health Plan, Steve Seftchick, Vice President of Network Partnerships at Highmark Health, and Dr. Safa Farzin, Senior Vice President of Community Practice Division at Penn State Health. The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

This episode is brought to you by the Blue Cross Blue Shield Association. Blue Cross and Blue Shield companies are in every ZIP code in every state, working to improve health and expand access to care. Community by community. For the health of America. Today we're focusing in on rural behavioral health, looking at Montana as an example for some of the barriers we're seeing nationwide, and a model for potential solutions to these challenges.   I'm joined by two experts providing the clinical and insurer perspectives:   Julie Kelso, a board-certified adult psychiatrist who served at the Billings Clinic from 2007-2021 as Department Chair, Program Director for the UW Montana Track psychiatry residency and medical director of Integrated Behavioral Health. Now at Riverstone Health in Yellowstone County, she's a collaborative care psychiatrist.   John Doran is the Divisional Vice President of External Affairs at Blue Cross and Blue Shield of Montana. With a background in journalism and communications, John oversees all government, public and media relations, community outreach, and corporate strategy for Blue Cross and Blue Shield of Montana.

NYT article US federal government ordered hospitals to publish their prices They've reacted by a) not complying b) complying or obfuscating the data on their website (weird locations, weird naming/number) It all shows an inconvenient truth - that US healthcare consumers are paying wildly different prices for their medical treatment It is literally the only business that you find out the price of treatment well after purchase Can you think of any industry that can do this? The secrecy is no secret - each insurer Aetna, Cigna, Humana, United and the Blue Cross Blue Shield Association negotiates separately with each hospital/doctor group and hospitals are bound to not ‘share' pricing information publicly Max fine from the US Feds = $109,500 per year. --- Send in a voice message: https://anchor.fm/dentaldepartures/message

Edwards Lifesciences (EW) an American medical technology company, specializing in artificial heart valves and hemodynamic monitoring. The stock hit an all-time high today. Anthem (ANTM) is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. The final stock Ken Rose discusses is Virpax Pharmaceuticals (VRPX). It's up over 250% following the response from FDA for a new anti-Covid spray.

What are the advantages of integrating medical and pharmacy benefits? Reduced costs, increased convenience, and improved health outcomes for members. Listen in to learn more about how streamlined care can maximize your benefits. Featuring: Tom Doran, Chief Operating Officer and Sarah Marche', Senior Vice President of Pharmacy and Clinical Strategy at Highmark Inc. The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

ASCO Daily News: Welcome to the ASCO Daily News podcast. I'm Geraldine Carroll, a reporter for the ASCO Daily News. The American Cancer Society reports that at least 42% of newly diagnosed cancers in the United States, excluding non-melanoma skin cancer, are potentially avoidable because they are attributable to lifestyle factors. Today we will discuss strategies and resources to help the oncology community focus on health promotion as a key component of cancer risk reduction as well as in survivorship care. Joining me for this discussion are Dr. Amy Comander, the director of breast oncology and cancer survivorship at the MGH Cancer Center in Waltham and at Newton-Wellesley Hospital, and Dr. Poorvi Desai, a hematologist-oncologist at Comprehensive Hematology Oncology in Tampa Bay, Florida. Both Dr. Comander and Dr. Desai are board certified in lifestyle medicine. My guests report no conflicts of interest relating to our topic today. And their full disclosures and those relating to all episodes of the podcast are available on our transcripts at asco.org/podcasts. Dr. Comander and Dr. Desai, it's great to have you on the podcast today. Dr. Amy Comander: Thank you so much for the invitation. Dr. Poorvi Desai: Thank you, it's really great to be here. ASCO Daily News: Dr. Comander and Dr. Desai, you recently co-wrote an interesting editorial featured in the ASCO Daily News that raises concerns about newly diagnosed cancers in the United States that are potentially avoidable because they are attributable to lifestyle factors. You also note that as the population of cancer survivors in the U.S. continues to grow, risk factors for cancer development are becoming more prevalent. So the obesity epidemic in the United States is a huge concern. This is just one risk factor for cancer. Dr. Comander, can you tell us about this and other risk factors and why oncologists should be addressing these risk factors sooner rather than later? Dr. Amy Comander: As you clearly stated, there's increasing prevalence of obesity in this country. And this has troubling consequences in terms of cancer risk and outcomes for specific types of cancer. Interestingly, just this week, we learned data from the annual report to the nation on the status of cancer that, overall, cancer death rates in the United States are declining, especially for lung cancer and melanoma. And this is amazing. And that is due to the incredible advances in treatments that we've witnessed over these past few years. But interestingly, for prostate cancer, colorectal cancer, and female breast cancers, death rates continue to increase or these declines have slowed or even leveled off. And in terms of understanding why that may be the case, it seems that lifestyle factors, such as obesity, lack of physical activity, [and] increased alcohol use, may be risk factors for why we are seeing these results. And therefore, further research will certainly need to be done in this area, but attention to these factors is very important. ASCO Daily News: Well, Dr. Desai, I'd like to ask you about your interest in lifestyle medicine. I understand you became interested in lifestyle medicine during your fellowship training. Can you tell us about this? Dr. Poorvi Desai: Yes, I recently just graduated from my hem-onc fellowship at USF and Moffitt Cancer Center. And I was really impressed during my fellowship looking into all of the data very particularly when it comes to every single different type of cancer. But one thing I thought was lacking was just the overall picture of lifestyle factors, and especially modifiable risk factors, when it comes to pre-survivorship along with things that patients can do during active treatment and in the survivorship phase. And I think that there are structures that are starting to appear to help guide us with more evidence-based data. And so I became very interested, as I had an attending in my internal medicine residency who was a part of lifestyle medicine. And through the American College of Lifestyle Medicine, I met several people around the country who had been working with organizations such as AICR, as well as the World Health Organization, [and] American Cancer Society. And there was a very big push on these lifestyle factors to look at them in a way that is actually studied through evidence and actual guidelines that I was never really taught about throughout my fellowship. So I made it a point to kind of self-teach a lot of this. But I definitely think that there's a role moving forward in bringing this to not just fellowship education but just all of oncology care, whether it's medical oncology, surgical, radiation, but just any oncology care team. ASCO Daily News: Well, you make a really great point. Evidence-based guidelines do exist to help facilitate lifestyle modification in cancer care, but there are barriers to health promotion in cancer care. Dr. Comander, what are the major barriers? Dr. Amy Comander: That's an excellent question because we know this is an important issue. And actually, it was an issue studied recently by ASCO. Dr. Ligibel and colleagues published a paper in 2013 that was a survey of oncologists and their understanding of obesity and other lifestyle factors and how they address these issues in clinic (DOI: 10.14694/EdBook_AM.2013.33.52).  And I think we can all say that our colleagues are well aware that obesity and lifestyle factors play an important role in cancer outcome. But in terms of the practical steps of how to address these issues with our patients, how to get our patients to lose weight, how to get our patient to exercise, how to help our patient cut back on alcohol use--those are just some examples--there really are limitations. And in that paper, they really outlined some of the reasons for that. Some of it is lack of education, as Dr. Desai just noted. She sought out teachings and lifestyle medicine as part of her fellowship training. She had to go elsewhere to look for that because it really wasn't part of the standard curriculum. So a lack of education, lack of resources. I'm fortunate to work in a cancer center with excellent oncology colleagues with expertise in nutrition, exercise, et cetera. But we know, in the rest of the country, not every doctor has access to these resources. And the third reason is really lack of clinician time. Our visits are very focused. And often the priority, of course, is discussing the patient's treatment, how is--I'm a breast cancer doctor. How is my patient doing on her endocrine therapy? What kind of side effects is she experiencing? How can I ensure she's complying with her medication? So there really isn't a lot of time to address these issues in a visit. So these are all factors we need to work on. ASCO Daily News: Well, how about solutions? How tough is it to convince patients who are grappling with the physical and emotional toll of cancer treatment to prioritize their nutrition and exercise? Dr. Desai, what do you think are the next steps? What would you say to oncologists who really do need to pay more attention to this? Dr. Poorvi Desai: So I think that one of the biggest things to take out of our article is that oncologists don't need to carry the burden of doing this by themselves. I think that while it does take a lot of resources, which is a big constraint, especially financially, I do think that there is a lot of worth in building a care team that's dedicated towards this. Or if that's not possible, then seeking out community, local, or national resources and kind of bringing together any other structure that's already in place and having a good referral to those areas, so that patients do understand that it is important to continue physical activity and working on nutrition. And I definitely think that it's something that patients feel they can have some control over. I think a lot of oncologists don't feel qualified to talk about these things because they are not very well taught in our education. And so I think then a lot of patients in this realm of lifestyle feel on their own in trying to figure out what's good for them, what's not good for them. There's a lot of misinformation online and unsolicited advice that can be given to our patients. There's a lot of fear around foods and what the right type of activity is. And I think that the more evidence-based information that we have to provide to our patients, we can be more confident in making these suggestions. And again, we don't--as oncologists, we don't need to be the ones who are actually doing all the counseling, doing all of this, making sure that they have their exercise prescriptions or whatever it may be, but at least acknowledging that this should be a part of the care team and seeking out resources that the care team can then take over. So that in conjunction with active treatment or in conjunction with survivorship care, this then becomes something that patients feel they have some kind of control over. And I also think that it's important that we don't over-promise and under-deliver as well. I think that it's important to show patients that these are things that are as important as their active treatment to pay attention to, but also as oncologists start becoming more comfortable with the idea of risk reduction and having the information to back up our claims that lifestyle is of the utmost important in cancer. ASCO Daily News: Absolutely. Dr. Comander, do you have any thoughts on this? Is it more difficult to do what Dr. Desai has described in a community practice than where you are in a larger institution? Dr. Amy Comander: I think Dr. Desai answered that question beautifully. I will add that, as an oncologist, what we say makes such an impression on our patients. Often our patients are recording what we say, or they have a family member with them writing down everything we say. So if we just tell our patient, it's really important for you to exercise--and that might just mean a 10 minute walk each day or walking to the mailbox to get the mail, starting with something very basic in terms of exercise counseling--can make a big difference. And so I think just the fact that, as Dr. Desai just stated, a doctor acknowledging that exercise has a role, nutrition has a role, stress management has a role, I think just that simple act has a big impact on our patients. And it's very important. ASCO Daily News: Indeed. Well, patients and survivors often grapple with depression, anxiety, fear of recurrence, financial issues, and more. Sleep disorders and insomnia can interfere with adherence to a nutrition plan or an exercise regime. Are there helpful tools available, or what are the helpful tools available to oncology practices to help them address these issues with their patients? Dr. Amy Comander: I think that's a really important question. We know that distress screening is actually incorporated into each visit. And that's recommended through the NCCN guidelines really to assess these issues you just inquired about--coping skills, anxiety, depression, financial issues, et cetera. So certainly, it's very important to ask our patients about these issues and refer them to appropriate colleagues, whether that's a mental health provider or social worker, to help address these concerns. I will also acknowledge ASCO has a number of great resources to help guide patients to. The website Cancer.Net has many resources that help patients find perhaps something in the community that could help them address these specific concerns. Dr. Desai, I'm interested in your comments as well. Dr. Poorvi Desai: I absolutely agree with you. I think that the NCCN is doing a really great job in compiling a comprehensive set of resources in their survivorship guidelines. There is that distress assessment thermometer that we had addressed in our article. We definitely understand that these psychosocial evaluations are pretty much of utmost importance. There's a lot of anxiety and distress that comes with a cancer diagnosis. And we know that it lasts. It has an impact that's lifelong. And so definitely one of the big pillars of lifestyle medicine is stress and social connectivity. And so we definitely are an advocate for having mental health professionals as a part of the care team and looking at mental and physical well-being going hand-in-hand. And I think one of the biggest things to understand is that we have to meet our patients where they are. And so we don't want to advocate for anybody saying, OK, now you have to exercise five times a day strenuously, and you have to eat perfectly, and all of these things that can be extremely overwhelming. And so I think that there are great guidelines. And I think the NCCN Survivorship Panel has put together a good amount of resources for us to show patients how to work on mindfulness strategies and sort of systematically work them through a very difficult diagnosis in order to slowly, but surely, result in those healthy lifestyle changes. I like to tell my patients that it's a marathon, not a sprint. Any progress is good progress. You don't have to be perfect. And I think that's definitely something that we should be mindful of when we talk about changing lifestyle behaviors. ASCO Daily News: Right. Dr. Comander, do you think there is a role for increased collaboration between oncology providers and primary care providers in the context of cancer survivorship, for example? Survivors might see their oncologists every few months, every 6 months, every year, but who is monitoring the hypertension, the weight gain? Who should own that responsibility, or is it a collaboration? Dr. Amy Comander: That's a great question. And as you stated at the beginning, thankfully due to advances in treatment and screening, the number of cancer survivors in this country is increasing greatly each year. And therefore, it is very important that we have a strong collaboration with our primary care colleagues in terms of providing excellent care for our patients following completion of primary treatment. So in my practice, it definitely is a collaboration. I'm fortunate to work with so many wonderful primary care physicians [and] we work together in terms of monitoring our patients' blood pressure, risk for cardiovascular disease, risk for diabetes and other chronic diseases, and certainly when it comes to other lifestyle interventions, such as weight management, management of substance abuse, et cetera. So that collaboration is really key. And I see primary care providers already playing a huge role in survivorship care. And I think that will continue to grow in time to come. ASCO Daily News: Well, as you said, the number of cancer survivors continues to grow. It's projected to increase to 22 million in the United States by 2030. So do you think the focus on lifestyle medicine will increase in the future? Let's start with Dr. Desai. Dr. Poorvi Desai: Yeah, I think that this has to become one of the major things that we regard. I think that most oncologists are very aware that our treatments are--they have long term consequences. We had mentioned in our article that there are two major themes to look at when it comes to survivorship care. One is infection-related mortality. But the other big one, which is what we focused on, was lifestyle--cardiovascular disease, cerebrovascular disease, accelerated aging with telomere shortening and metabolic changes that happen after cancer diagnosis and the treatments that patients receive. So a lot of what we are subjecting our patients to is truly aging in nature. And we have evidence to suggest that we can work on these lifestyle modifications as the forefront way to really help them overcome the fact that we have given them radiation to their chest or cardiotoxic medications, or whatever it may be. And that when they are overweight or obese, this can then further accelerate that process of metabolic aging. I think one of the things that's really important to talk about is assessing metabolic health. And so not just looking at their BMI, but how does their BMI actually break down into metabolic patterns? How much of this is bone density or muscle weight? We put patients a lot on hormonal treatments, which can then affect their fracture risk moving forward. And I think that we are very well aware of that. And so these are the things that should really be assessed because, like we've mentioned, one of the biggest reasons for, I guess, moving forward with the number of cancer survivors that we're going to have, a lot of it--the focus needs to shift, basically, to long term chronic disease management, in which lifestyle really does play a huge role. ASCO Daily News: Absolutely. Dr. Comander, is there anything else that you'd like to share before we wrap up the podcast today? I certainly do think your article pointed out the importance of using evidence-based guidelines to strive for the best possible outcomes for survivors and patients to prevent newly diagnosed cancers. Dr. Amy Comander: Yes, I think, as summarized in our article, we did provide resources that can help our colleagues address these concerns with our patients, since, again, some of us have not been educated about these topics during our medical training. So in addition to the excellent resources provided by ASCO, I would really refer our listeners to the AICR website, American Institute for Cancer Research. In addition, the American Cancer Society is playing a role in helping provide further education about the role of nutrition and physical activity in cancer survivorship. So the American Cancer Society is a great resource, as is the American College of Sports Medicine when it comes to exercise recommendations. And on their website, they have some great graphics that really illustrate what the recommendations are for exercise and what the benefits are for cancer survivors as well. And finally, we referred to the NCCN during this podcast. And of course, their guidelines are excellent and address these lifestyle behaviors as well. So I would just highlight those resources for our listeners in case they want to get more information. ASCO Daily News: Absolutely, some great resources there. Well, thank you, Dr. Comander and Dr. Desai, very much for sharing your valuable insight with us today on the ASCO Daily News podcast. Our listeners will find a link to your article in our show notes. Thank you very much. Dr. Amy Comander: Thank you so much for the invitation. Dr. Poorvi Desai: Thank you so much. ASCO Daily News: And thank you to our listeners for your time today. If you enjoyed this episode, please take a moment to rate, review, and subscribe wherever you get your podcasts.   Disclosures: Dr. Amy Comander: Consulting or Advisory Role: Advance Medical, Applied Genetic Technologies Corporation, Beam Therapeutics, Biogen, Inc., Blue Cross Blue Shield Association, CRICO Harvard Risk Management Foundation, Editas Medicine, GenSight Biologics, Harvard University, infiniteMD, RBC Investments, Sanofi SA, Vedere 1, WAVE Life Sciences Dr. Poorvi Desai: None disclosed.  Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

*From time to time we'll re-air a previous episode of the show that our newer audience may have missed.* In this episode of Her Story hosted by Dr. Joanne Conroy, President and CEO of Dartmouth-Hitchcock, and Dartmouth-Hitchcock Health, we sit down with Kim A. Keck, President and CEO, Blue Cross Blue Shield Association. Joanne and Kim discussed how Kim's unconventional path ultimately led to her appointment as the first woman to serve as the Blue Cross Blue Shield Association's president and CEO since the organization was founded four decades ago.

This episode is brought to you by the Blue Cross Blue Shield Association. Blue Cross and Blue Shield companies are in every ZIP code… in every state, working to improve health and expand access to care. Community by community. For the health of America.   Jacob Sattelmair is Co-Founder and CEO of Wellframe, a digital health management company… providing care management and advocacy solutions to health plans nationwide. Under his leadership, Wellframe has partnered with dozens of health plans all across the country ...  to improve their relationships with members, to close gaps in care, …and improve health outcomes.   Jake is a Harvard-trained epidemiologist who has also been a World Economic Forum Young Global Shaper.  He shares with us how his own personal health experiences and doctoral research influenced his decision to take a risk, to innovate,  and start Wellframe. He's got an amazing story which will inspire you.

It's 2021 and healthcare is a hot topic. Throughout the COVID-19 pandemic, government employees have been at the frontlines — distributing tests and vaccinations, answering questions about health benefit eligibility and ensuring constituents receive the care they need during these turbulent times.  But how can we ensure federal employees are able to access the same level of care they've provided to citizens? After all, healthcare is complicated. Signing up for benefits shouldn't be.  Introducing “Discussions in Federal Healthcare,'' a new podcast from Blue Cross Blue Shield in collaboration with GovExec's Studio 2G, that aims to educate federal employees on how they can take full advantage of healthcare benefits and services. On this pilot episode, GovExec's James Hanson catches up with Bill Breskin and David Yoder, two experts from the Blue Cross Blue Shield Association, to discuss the current healthcare landscape.

Great health care doesn't end when a patient leaves the doctor's office. Social Determinants of Health (SDOH) are the unseen social factors that affect a person's health, like where they live, what they eat, and even their education level. Learn more from expert, Nebeyou Abebe, about how health care and insurance providers can address SDOH to treat the member's whole health. Featuring: Nebeyou Abebe, Senior Vice President of Social Determinants of Health and Lori Schoonmaker, Market President of National Markets at Highmark. The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Hear how data fueled the equitable distribution of the COVID-19 vaccine. From identifying vulnerable members through the CDC's Social Vulnerability Index to activating outreach and vaccination efforts, listen in to learn how data can make a difference. Featuring: Matthew Rhenish, senior vice president of pharmacy and market strategies at Highmark Inc. and Richard Clarke, senior vice president, chief analytics officer at Highmark Health To view an extended version of this podcast, visit: https://www.youtube.com/watch?v=ole9vhjTxeo&t=1s The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Contact Bob Kolodgy: https://www.linkedin.com/in/bob-kolodgy-a5849214/About Bob Kolodgy: https://www.bcbs.com/about-us/leadership/robert-kolodgyBob's Interview for Forbes CFO Network with IMA's Jeff Thomson: https://www.forbes.com/sites/jeffthomson/2020/02/07/the-finance-leader-in-health-care-an-interview-with-the-cfo-of-blue-cross-blue-shield-association/?sh=418e829169acBCBS: https://www.bcbs.com/FULL EPISODE TRANSCRIPTAdam: (00:00) Welcome to episode 126 of Count Me In. Thanks for coming back and listening to IMA's podcast. I'm your host, Adam Larson and today's expert guest is Bob Kolodgy. Bob is Executive Vice President and Chief Financial Officer for Blue Cross Blue Shield Association, a national Federation of 35 independent community-based and locally operated Blue Cross Blue Shield companies. In his role, he is responsible for the blue's federal employee program, oversees the national employee benefits administration, and has overall accountability for Blue Cross Blue Shield brand management, and the associations finance, licenser, enterprise information technology, and information security areas. During his conversation with my co-host Mitch, Bob discusses the role of the CFO in building organizations ready for the future. Keep listening to hear his perspective on innovation, data, and value. Mitch: (01:02) So for our conversation today, we really want to emphasize the role of the CFO and making sure that they are capable of building organizations ready for the future. Now, innovation certainly is a term we use often in accounting and finance as organizations seek to create and increase value. So to start off, I would really like to know what innovation means to you. Bob: (01:31) Yeah, thanks Mitch and thanks for the opportunity to address IMA today, it's a great group and I love to be part of your events, so thank you for that. You know, with respect to innovation and accounting, let's put it in perspective and I've always said this at the beginning of innovation conversations with finance people. It's like, well, we don't want you all to be all that innovative, I mean, your accountants after all. And you need to be careful, right? So there's all kinds of, accounting principles and things like that. And we don't want you to be creative with that now, maybe be creative about how you do what you do, right? And so how can you as an accountant, or a finance person in an organization, actually innovate in a way that creates value. And so, when we try to take that apart, I look at value as the sum of three things, cost or efficiency, quality, and service. And so anyone can apply those principles to what they do I think, and add value. And so for me, innovation, particularly in accounting and finance in those disciplines really is focused more on those things and keeping them in balance, right? So innovation can accelerate any one of those things and as long as it does that without detracting from the other two, it's adding value. So for me, it's kind of that simple. And, when you look at what we've been in for the last, 14 or 15 months with the pandemic, it really sort of dots the eye on the need for innovation, right? We had to pivot in so many ways that we never would have expected so quickly and, you know, true innovations have come out of that in many forms and now its a matter of advancing those and in some cases bringing them to scale. There were certain things that came out of the pandemic that were really innovative and they're going to stick whether we expected that to happen or not. The time after the pandemic will be, not like anything we expected or planned on our prior trajectory. Mitch: (03:37) Yeah, I completely agree, among these different conversations that I have, I've certainly seen many organizations who have explained that they will be adapting some of these ongoing principles moving forward and making it part of their business, because of how they had to pivot and adapt in the last year plus. My next question, continuing on this topic, as far as innovation goes and the different components that you spoke about, what is specifically the CFO's role when it comes to initiating this change, enabling innovation and driving the anticipated results, evaluating those results, where does the CFO really make an impact? Bob: (04:16) Yeah, I think innovation and enabling new thinking and so forth is really an area where the modern CFO can differentiate themselves from the more traditional financially focused leader, and if it's done well, the CFO can become the corporation's architect for business value. I saw an article recently from Accenture on this, and I found it very, very interesting and poignant. CFOs are uniquely positioned if they apply certain levers that they have access to, to be able to create this differentiation and be the architect of business value. And just to list off the levers quickly, visibility of the whole enterprise, the CFO typically because they deal with all parts of the company has a view into what is going on in all those parts and the ability to see where synergies exist across those verticals, the ability to do analytics and have access to data across the enterprise is really critical. CFOs, not only have access to financial data, but now more and more operational and market data and, a variety of things that they can bring together to bring insights that are actionable to the organization. Understanding enterprise risk is a critical role that the CFO or critical conversation, or are part of the conversation the CFO can bring, because they can measure risk and they know that you may be able to take risks in one area of the company and balance that off with some protection and hedge and the other areas of the company. The CFO can and should have a strong relationship with all the C-level executives in the company, right? So there should be good working relationships there and the CFO's ability to mentor and discuss things with his or her peers in a way that brings to life this greater business value. And finally the financial authorities, I mean the CFO obviously has a financial authority within the organization and can reinforce the economic basis for investment decisions, right? So the CFO can bring voice to somebody else's idea, in a way that that person may or may not be able to do. And so, these things can really be exploited by better collaboration with C-level peers, by leading in with unique insights, whether it's based on data, unique analytics, perspective on risk, or what have you, and then taking ownership for ensuring that value is extracted from all of the new technology and data platforms. These things are proliferating coming up all over the place. And I think it's the CFO's responsibility to make sure there's a value equation attached to each of those, or if not, make sure everybody else understands that and make sure that expectations are aligned along those vectors and CFO needs to be able to cultivate a good commercial awareness and stay ahead of the curve of the industry, right? So whether it's regulatory change, federal policy changes, the business environment, changing the competitive landscape, changing or just trends and particularly important, I think is understanding what the potential disruptors are. You know, I'm in healthcare, there are disruptors all around our industry, whether you're talking about health plans, providers, pharmaceutical companies, there all kinds of people with great ideas about how to do what we do differently. And so being aware of that is critically important as you try to bring innovation and value into your organization. Mitch: (07:38) That's great and I want to go a little bit further on some of the points you just made right there because many often relate innovation, they hear innovation and think of technology, right? That's one of the biggest things and in the recent year plus we've seen, regardless of the pandemic, some of the biggest technology innovation in accounting and finance has come through automation and the availability of data. So I think aligning our thoughts here on what you were just talking about as far as what innovation really is from your perspective, being able to take advantage of some technological advancements that have become available to us. But really, the value creation that you were just talking about. If it's in healthcare for you or accounting and finance professionals, how do you as a CFO go about harnessing the data, because there is so much of it at this point and truly making or creating value from that data? Bob: (08:31) Sure. You know, health insurance is a huge data business. We have records and you can imagine, Blue Cross Blue Shield provides health insurance for 110 million people in the country. And so we have all the claim records for them, for their medical care and for the pharmacy use. And so we know a lot, but what we know is relatively thin, right? So we know, a person went to the hospital and they went to the ER and had an x-ray and got their broken leg set, but we don't have the x-ray results. We don't have the depth of the diagnostics and stuff that were done in the hospital. So not only are we looking at our own data, which is enormous, but we're bringing in, we call it nonconforming data from other sources, right? So connecting with hospital systems, electronic medical records, for instance, to import data that makes what we have even richer and gives us the ability to do way more with the data. And I'm going to talk about a couple of those things. So just in terms of examples, one of the things that the Blue Cross Blue Shield association strives to be as a thought leader in healthcare. And so we developed this health of America report series that is a data-driven set of analytics and we do publications periodically on different topics. So using our data and the insights from our data to try to identify challenges in healthcare space, right? So last year, maybe it was even a year and a half ago, we did a study on millennials and try to understand their relative health compared to prior generations and what particular health issues were prevalent for millennials and we had some really interesting findings. First of all, millennials are more likely to have some certain chronic conditions and perhaps less likely to live a long and healthy life then the prior generation, which was a startling finding. And then additionally, a lot of behavioral health issues from millennials were evidence which enables us to say, okay, well, if that's a population cohort that we want to take care of and take good care of, then we need to adapt certain things, we need to adapt certain chronic care management approaches that are particularly important for millennials and we need to build a better behavioral health or mental health system to accompany the physical health part, right? And so it's things like that and our ability to take huge data sets and study different population cohorts within them, come out with findings that are creating actionable insights that we can build into our products, build into our service set and so forth to achieve our mission of taking better care of people for the health of America. This whole thing rides on, as I was describing earlier, the ability to combine data from disparate sources, right? So interoperability is a huge issue in healthcare. Interoperability in healthcare is really kind of scarce right now, right? So what I described, it's really easy to say, oh, health plan, it's going to just go to the big hospital systems in their network and they're going to connect with their electronic medical records systems and they're going to import all this deep rich data about people, we're going to go out and buy a market data prism clusters, whatever to understand the socioeconomics of a population and we're going to combine all that stuff and come up with all these rich insights, but there's not a standard and we're working on it. And, again, with our footprint in the industry being pretty big we can help drive interoperability solutions so that data is exchanged in a consistent way that when you particularly hit on data elements and a report, it means the same thing no matter what system you're in and that it's safe and secure. So those things are critical to interoperability and that's one of the underpinnings that we're working on, in terms of our data approach. Finally, I'll call out a few companies, the Blue Cross Blue Shield companies, and there are now 35 of them domestically and hundreds internationally. The 35 domestics that joins to do corporate venturing. And so we're in our fourth corporate venture fund right now with a total of about 900 million of assets under management and I'm just going to highlight a couple of the companies that are in the blue venture fund portfolio that are doing really interesting and relevant things with respect to data. So advocacy insights is a cloud-based data management and interoperability platform that's specifically built for healthcare. So it's able to connect the payers and the providers and the other participants in the healthcare ecosystem in a unique way. There's a company called Alacura, which provides data analytics and network optimization for services about aeromedical transport. So, you see the copiers and the airplanes that are taking people either, with respect to the helicopter, it might be from what they call a scene run. So if there was an accident on the highway, someone's really in bad shape they'll call a copter instead of an ambulance so that they can get to the critical care center more quickly. And there are a lot of, transports of critically ill people for, transplant operations and high level things where they have to be moved from place to place really quickly. So this platform matches up air medical transport and medical capabilities. And then finally, a company called Prove. Prove provides, mobile focused identity authentication and data management platform, which improves member engagements. It reduces operating costs and streamlines digital processes. The origin of Prove was this two-factor authentication. So, Prove has tons and tons of cell phone numbers in it. So it knows if you're in a call center and you've got Prove kind of bolted onto your inbound calls. It can tell you who the person is and then your system can match that to a member record so that, that call center operator is click, click right into the information about the person calling. So really valuable and it alleviates the need to do some additional authentication when the person calls, right? So, a lot of times you call and they say, okay well, what's your mother's maiden name? Or, you know, what's the name of your first pet you had when you were a kid or something along those lines. So, Prove is another platform that the venture funds have invested in that are really helping us move in this data space. Mitch: (15:05) So it sounds like you have a tremendous amount of data, truthfully more than I could think of, but it obviously makes sense as you're explaining where it all comes from and how it all works together. As a CFO of the organization in being able to share insight like this, it sounds like it's just a tremendous amount of opportunity, right? There's a ton of opportunity with data, but just for our listeners, I think everybody also recognizes with opportunity comes challenges. So when it comes to innovation, this data, taking all of this opportunity and creating value from it, how do you navigate really through these different challenges? And, just thinking back to one of the first points you made in that last response about the health of millennials. The findings that you have from your research must prove to kind of contradict maybe some of the initial forecasts that you've had. So things like that, what goes into really leading your organization for success into the future? Bob: (16:07) Yeah. When you think about that, and particularly with financial people, it's a lot about forecasting. And so we do a whole bunch of financial forecasting, but we do all kinds of other forecasting as well. And I guess for me, the best go-to here is, our industry, right? Health insurance, and I'm going to talk about health insurance in the context of the pandemic. And I think it'll point out some things that we knew and some things that we didn't know, and probably one of the most impactful externalities that we've ever experienced in our professional careers, right? I mean, unless you're a hundred years old, you haven't been through a pandemic before. So, you know, we're not a hundred years old. What happened to us last year, when the pandemic hit was a really, a series of conflicting headwinds. So we had headwinds with our customers and our customers are the members, who subscribe and the employers who generally buy the insurance for that person, right? So it's sort of a two level customer set and what people needed because of the volatility and loss of jobs and uncertainty for business was premium relief, right? So they're asking us, “Hey, look, cut us some slack on premiums for a while”. And we did, we extended grace periods and things like that, in some cases we forgave premium for people that were in certain tough economic times and things like that. So on the customer side, that was one of the first things that came to us. So, from a financial person's perspective, oh, okay, well we're not going to collect this quickly, or we're not going to collect it all. And so what does that mean, and how much is that worth? Then it was, okay, now let's make sure that everyone has access, right? Because the last thing you want when you're a health insurer is for people, your members not to be able to get care when they need it, okay. Because that's what we're here to do. We're here to make sure you can get care when you need it, and it gets paid for. So the ability to accept access testing for COVID, the vaccines when they were available, and just services in general, right? Because the hospital system kind of shut down when COVID hit with all the elective procedures and things like that. And so we needed to make sure that people understood if they were really sick, you can still get in. You need to be protected, you need to be this and that. So it was a matter of waiving copays and some of the economic barriers in our benefit design so that people could get all of the testing and COVID treatment that they needed. And so we spent a bunch of time on there. So that's the customer step. Our supply chain, so to speak, in health insurance is the providers, right? It's the hospitals, the doctors, the drugs, the air ambulance companies, you know, all those things, the PT providers, the surgeons, et cetera. And the way we generally pay our supply chain in the industry is based upon volume, right? So they do something, we pay them, we call that fee for service, right? You go to the doctor, he checks you out, he bills us, or he or she bills us and we pay the doctor. That's called fee for service medicine. But when volume goes through the floor, like it did in March and April of 2020, we're not paying them because there's no service being provided. So providers got cash short pretty quickly and they needed help. So we put providers in some cases on interim payments, we'll pay you a certain amount per month based on what your historical spend has been, for us and we'll settle up later. So we're getting less cash from our customers and we're needing to front cash to those providers who were in kind of a tough spot. And fortunately we have the wherewithal, particularly blue plans are very well capitalized, had the wherewithal to be able to do this at least for a while. So then it's like, okay, well, what does all that mean to us? So I described with that shortage of cash need, we ourselves had COVID related costs that were new to us, right? There didn't used to be that diagnosis, there didn't used to be treatment, there didn't used to be Regeneron use for people that are impatient, all the ventilator use that was early in the pandemic and all those things were new costs for us. On the other side of it, there was this huge downdraft in terms of the cost of medical care. And so because people were deferring care and delaying elective procedures, there was an enormous amount of reduction in our expenses. And so you put all those things together and try to make a forecast. I mean, uncertainty was just more than it's ever been before, and we'd need to look to the future now and figure out, well what's next. We know what happened in 2020, the big piece of our boss went down, some pieces went up, we also had costs for ourselves because we put our workers remote. So any employer who went remote, we had to add bandwidth, we had to have people get here to set up at home and all those kinds of things so we had all of those costs. But as we look to the future and healthcare health insurance is a long-term play, you need to know what's going to happen because of all the deferred care this year, when we look at the procedures that were deferred, they were largely good preventive medicine. People weren't going to get the care that they typically would get the routine diagnostics and stuff like that, to make sure that they don't have some underpinning chronic condition or some underpinning acute event on the way. So without having that preventive stuff, that good spend going on what is going to happen to people next, and probably what will happen to people next is there'll be more acute episodes, that'll be more expensive and probably damaging to people's overall health status. But we don't know what that is yet because we're still just coming out of the pandemic and the medical consumption while it's kind of at a normal level, it's comprised of a different distribution of things, more COVID stuff and less typical elective and diagnostic stuff. So there will be long-term implications that we just don't know what those are yet, but we're still doing forecasts, it doesn't stop us from doing forecasts. We're taking our best guess. We've got actuaries all over the place, trying to figure this stuff out and understand what's going to happen with the changing utilization patterns. The other thing that happened in the pandemic in our industry, which I think is really interesting, and again, tough to project, the uptake on telemedicine. Because people didn't want to go or couldn't go to the doctor's office, doctors made themselves available to people through things like zoom and video and a bunch of other technologies that actually are good and probably going to be more the way of the future. It won't all be that way, some of it will go back to the face-to-face doctor's office stuff, but there's a fair amount of telemedicine that will continue, and that was accelerated and as a result of the pandemic. And then finally, like everybody else, we're figuring out what this return to office looks like, right? Trying to figure out when it's going to be safe to send our people, what the office is going to look like, who's going to be in, who's not going to be in or hybrid mode, or what is it going to be? And what's the cost of that, right? Right now we've got a bunch of office space we're not using. We have to rationalize that at some point in the future. So all these things go into our projections, but I've been a CFO long enough to tell other CFOs, my advice just be careful. That's all. Know what could happen, do a lot of sensitivity analysis, but just be careful and protect your balance sheet because you've got a strong balance sheet you can weather stuff like this and if you don't have a strong balance sheet, it's going to be harder. Mitch: (23:33) Well, that's really the perfect way to kind of segue into this last question for you here. We certainly covered a lot when it comes to innovation and particularly the past year and a half, a lot of the changes. It was difficult, you know, 2020 and you said the last 14, 15 months, I think we can both agree that there are some positive outcomes that we can kind of focus on, as far as innovation goes and being able to, incorporate some of this into our business as sustainable operations, but just kind of closing thoughts from you, if you wouldn't mind sharing, when it comes to the role of the CFO and again, we're trying to lead organizations into the future successfully, sustainably. What does that look like? What are some of the last thoughts and pieces of advice you have for our listeners? Bob: (24:20) Yeah, I think some of the lessons learned in the pandemic relate to several areas. Infrastructure is one of those and not only within organizations, but within industries, it was fascinating to me to see in a totally unrelated to healthcare per se, but the way the supply chains work in the country created shortages of things that people wanted to hoard when the pandemic came up, right? So all of a sudden, this is an interesting example, but people were hoarding paper products and the way the supply chain was making paper products was a certain amount for industrial use or commercial use in office buildings, institutions, and things of that nature and a certain amount for home consumption. And what happened when the pandemic hit is home consumption went way up and institutional consumption went down and the supply chain wasn't ready to make that pivot. It took months and months for them to normalize that, cause it's the same product, it just comes in a different package, in a different shape for them to normalize that and get it figured out. Another infrastructure piece, and this is a healthcare specific one for the healthcare ecosystem is, the pandemic really put a spotlight on serious racial disparities and access to care. And we've known anybody who's been in healthcare has known for a long time that there are disparities and that people of modest means have a tougher time getting the same access and good health care that people with greater means may be able to obtain. And whether it's the prevalence of COVID in a particular population, which was higher again for populations that were more socially and economically challenged, particularly people of color and one relates to the other, but the outcomes the same outcome, there were many more cases and serious cases of COVID in populations of color. And that is a terrible thing, but I don't think it's a surprise to anyone in healthcare just sort of dotted the “I” in what we already knew. The good thing about it is that we're coming out with a greater focus on some of those things. I'll talk about that in a minute. The readiness of organizations to do these pivots was very unlevel. I think some organizations pivoted really well and others just kind of went out, you know, like almost went out of business and so think about restaurants, right? I live in Chicago and there's a lot of restaurants. Well, there aren't as many restaurants as there used to be. There are some great restaurants that obviously couldn't take patrons or indoor dining and so they pivoted to carry out and some of them did it really quickly, but some of them couldn't do it at all. I mean, you can really tell as kind of a finance person, you walked down the street and you just look at a restaurant that's doing a decent carry out business and one that's just boarded up and I think it again gets back to how much depth they get, right, to absorb that shock. And so being prepared for that is something that I think organizations really need to do and reinforcing the importance of having the resources and frameworks in place to deal with contingencies. Plan ahead, okay. Well, what if, I don't think anybody ever would have done a, “what if” on a pandemic, but you might've done “what ifs” on other catastrophes that would have had similar consequences and understanding if this, then that with your business is just a really, really important thing whether you're a big company, like a health insurance company or an entrepreneur, you know, running a shop on Alstead avenue in Chicago. Some of the positive things I mentioned earlier, the acceleration of tele-health, innovation was accelerated, digital transformation was accelerated because we had to, and I think those things will stick and they'll stick in just about every sector. I mean, think about the volume of things that are being bought through all of the delivery vendors, right? Amazon, whatever, you know, and all the likes of them. And again, we live in the city, you can get almost anything delivered to our house, whether it's food, groceries, supplies, tools, whatever it is, and in a pandemic, that's what everybody did. So the growth there, and I think, again, a certain amount of it isn't permanent, but a lot of it is permanent. And I think that, that in our case, in healthcare at the tele-health conversion was truly one that was pandemic driven to a different trajectory. And then for organizations, you don't realize you have to be nimble and agile at this point, then you haven't been paying attention because so many things happen so quickly. I mean, we took our workforce remote in a week and we decided to do and in a week later, it was done. And that was it. And 95% of those people haven't set foot in this office since, which is pretty remarkable when you think about it. And the ability to do that and continue your business really means being agile and being nimble, and being adaptable. And now it's a matter of resilience, right? So it's a matter of making sure your folks feel connected and that they feel strong every day because they're working in a whole different paradigm than they were before. So, I think, I don't know who said it, but no good crisis should go unattended, and crisis creates opportunity for those that are really thinking and willing to pivot and willing to act and I think that that's been true with this pandemic. There are things that you would never think you would do and people, many people thought just in terms of the office environment, we need to be in the office every day, everyone needs to be here, that's our culture, that's how we roll, that's just the way it needs to be and I think that what we've done in the last 14 or 15 months has shown us, it's not really the way it necessarily needs to be, might still be for some companies the best way, but not for all companies and I think people have found a different way to work. It's going to permanently change the workforce in this country. I mean, think about the idea of more jobs just being remote period, where you never have to go to an office. That puts the pool of potential employees for a company exponentially bigger than it used to be. Because if my company no longer requires people to work in Chicago five days a week, that opens up the entire country to us in terms of opportunities. And it opens up opportunities for people everywhere in the country that they wouldn't have had if they weren't local before. So I think it's really a lot of things here that have come out of this that are going to be decent improvements for us in the future. And everybody talks about back to normal, there's no going back to normal. We're going to a different spot. Not exactly sure what it is, but we're going to a different spot that isn't going to be what normal used to be and it isn't going to be where we are today. So that's what I kind of firmly believe in. That's the advice I would give to the audience. Closing: (31:12) This has been Count Me In, IMA's podcast providing you with the latest perspectives of thought leaders from the accounting and finance profession. If you like what you heard and you'd like to be counted in for more relevant accounting and finance education, visit IMA's website at www.imanet.org.

Get your top questions around the Covid-19 vaccine answered—from how it works and vaccine efficacy, to the rollout and building herd immunity. Special guest Dr. Amy Crawford-Faucher of Allegheny Health Network shares how you can play a part in keeping our communities safe and healthy. Featuring: Dr. Amy Crawford-Faucher, vice chair of Allegheny Health Network's Primary Care Institute and medical director for telemedicine at AHN The Covid-19 vaccines from Moderna, Pfizer and Johnson & Johnson protect many people and have very little risk – it is far safer to get vaccinated than to get COVID-19. To view an extended version of this podcast, visit: https://www.youtube.com/watch?v=sxhimv1Pjgw&t=12s The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Since 2012, the Blue Cross Blue Shield Association has been involved in a class-action lawsuit pertaining to their alleged national anti-competitive policies. So then, why are leaders receiving calls from third-party vendors offering to submit claims? And why do so many of these vendors’ websites appear to look exactly like the official Blue Cross Blue Shield Settlement page? OneDigital’s team of compliance leaders discuss what’s really going on, the steps if any employers may wish to take and how to determine if it’s worth your organization’s time to take any next steps.  Dive into the recent Health Care Happenings Podcast episode for a review of the Blue Cross Blue Shield Antitrust Settlement now.  Tune in to the last Health Care Happenings Episode here: The American Rescue Plan Act, 2021 + COBRA Premium Subsidies. 

This episode is brought to you by the Blue Cross Blue Shield Association. Blue Cross and Blue Shield companies are helping more people access health care by expanding telehealth and virtual care. Rising to meet the challenge, for the Health of America.   Jason Gorevic is CEO of the global virtual healthcare leader, Teladoc Health.  2020 was a monumental year for Teladoc as demand for telehealth exploded in the midst of the pandemic.  Jason shares the behind-the-scenes story of how he and his team navigated this rapid growth while meeting critical health care needs, all while completing the major acquisition of digital disease management company Livongo.    I've worked closely now with Jason as a member of the Teladoc board for seven years, and I'm constantly inspired by his vision, his leadership, and how he's transformed a near start-up to a billion-dollar global enterprise.  He is truly rethinking American health.

The adage knowledge is power couldn't be more true when it comes to health care. This episode highlights how Highmark Inc. is empowering both consumers and employers with meaningful data to ultimately change the way they engage providers and make informed health care decisions. Through the introduction of Well360 Clarity, Highmark is helping members secure the highest quality providers and support them to find the optimal site of care. Featuring: Lisa Marsh, Director of Clinical Sales Consulting and Dr. Philip Majewski, Senior Medical Director of Clinical Strategy & Analytics for Commercial Markets. The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

In today's episode we speak with Mike Joyce. We learn about volunteer opportunities that can gain you useful knowledge in your audit career, along with interdepartmental symbiosis that can allow for a much smoother audit process.  If you still want even more. Then you will definitely want to tune in to hear Mike's advice to newer auditors, or his pointers for auditors that are aspiring to become CAEs.  Mike Joyce is the Chief Auditor and Compliance Officer with Blue Cross & Blue Shield Association in Chicago. He also served as the Chairman of the Board for the Institute of Internal Auditors.

Psych Hub interviews Kim Keck, President and CEO of Blue Cross Blue Shield Association, the first female leader in its 40-year history.  Kim shares her commitment to combatting long-standing social issues influencing mental health. You'll hear why your zip code can be a more significant factor to your overall health than your genetic code.

Covid-19 has triggered a rise in mental health and behavioral health issues across general populations, but its impact is exacerbated on children, adolescents, and young adults. Hear from our panel of mental health professionals to learn how you can identify risks, start conversations and seek care for mental health across this age group. For immediate mental healthcare or referrals, please call your pediatrician or primary care provider. For more mental health resources check out Magination Press, the Booster Buddy app, and the Anxiety and Depression Association of America (ADAA). Featuring: Dr. Alicia Kaplan, MD – Psychiatry, Allegheny Health Network, Dr. Doug Henry, PhD – VP of Allegheny Health Network's Psychiatry and Behavioral Health Institute and Dr. Tania Kannadan, MD – Child & Adolescent Psychiatry, Allegheny Health Network The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Host Jeff Bernhard is joined by Mike Warfel, VP of Government Affairs at Highmark Inc., to discuss the impact of Biden's administration to health care. They cover anticipated changes to the COVID-19 action plan, Medicare expansion, adjustments to healthcare costs, and more. Featuring: Mike Warfel, VP of Government Affairs, Highmark Inc. To listen to an extended, video version of this interview, visit YouTube.com/HighmarkInc. The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Following last week’s armed insurrection at the U.S. Capitol, corporations are starting to pull financial support from President Donald Trump and certain Republicans. JPMorgan Chase and Goldman Sachs are suspending political donations in general for at least six months. Blue Cross Blue Shield Association and Marriott are suspending donations specifically to Republicans who objected to the certification of the presidential election. And PGA of America pulled a championship tournament from a Trump golf course. On today’s show: the continuing economic fallout of a failed insurrection. Plus, how economic recovery might look now that COVID-19 vaccines are rolling out and the success of TV reboots.

Following last week’s armed insurrection at the U.S. Capitol, corporations are starting to pull financial support from President Donald Trump and certain Republicans. JPMorgan Chase and Goldman Sachs are suspending political donations in general for at least six months. Blue Cross Blue Shield Association and Marriott are suspending donations specifically to Republicans who objected to the certification of the presidential election. And PGA of America pulled a championship tournament from a Trump golf course. On today’s show: the continuing economic fallout of a failed insurrection. Plus, how economic recovery might look now that COVID-19 vaccines are rolling out and the success of TV reboots.

In this episode of Her Story hosted by Dr. Joanne Conroy, President and CEO of Dartmouth-Hitchcock, and Dartmouth-Hitchcock Health, we sit down with Kim A. Keck, President and CEO, Blue Cross Blue Shield Association. Joanne and Kim discussed how Kim's unconventional path ultimately led to her appointment as the first woman to serve as the Blue Cross Blue Shield Association’s president and CEO since the organization was founded four decades ago.

Host Jeff Bernhard is joined by Highmark Health guests Tracy Saula, SVP of Living Health Solutions, and Richard Clarke, Chief Analytics Officer, to dive into their ambitious strategy to transform the future of health. Living Health is all about reinventing the health experience of a person and their clinician. They also discuss the world-class analytics powering this endeavor, the impact on the patient and clinician relationship, and the role of technology in long-term care. View an extended version of this interview by visiting YouTube.com/HighmarkInc Featuring: Tracy Saula, SVP, Living Health Solutions & Strategy Enablement at Highmark Health, and Richard Clarke, Chief Analytics Officer at Highmark Health. The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

On FEDtalk this week, join host Tony Vergnetti for a discussion with the leading players in federal employee insurance. In our second annual Open Season show, the guests will cover life and healthcare insurance options federal employees may be considering this year. The discussion will feature Shane Canfield, CEO of WAEPA, as well as David Yoder, Vice President of Member Care and Management at Blue Cross Blue Shield Association, and Bill Breskin, Senior Vice President of Government Programs at Blue Cross Blue Shield Association. The show airs live on Friday, November 20, 2020 at 11:00 am ET on Federal News Network. You can stream the show online anytime via the Federal News Network app and listen to the FEDtalk podcast on PodcastOne and Apple Podcasts. FEDtalk is a live talk show produced by Shaw Bransford & Roth P.C., a federal employment law firm. Bringing you the insider’s perspective from leaders in the federal community since 1993. FEDtalk is sponsored by the Federal Long Term Care Insurance Program (FLTCIP). The FLTCIP is sponsored by the U.S. Office of Personnel Management, insured by John Hancock Life & Health Insurance Company, under a group long term care insurance policy, and administered by Long Term Care Partners, LLC (doing business as FedPoint).

On FEDtalk this week, join host Tony Vergnetti for a discussion with the leading players in federal employee insurance. In our second annual Open Season show, the guests will cover life and healthcare insurance options federal employees may be considering this year. The discussion will feature Shane Canfield, CEO of WAEPA, as well as David Yoder, Vice President of Member Care and Management at Blue Cross Blue Shield Association, and Bill Breskin, Senior Vice President of Government Programs at Blue Cross Blue Shield Association. The show airs live on Friday, November 20, 2020 at 11:00 am ET on Federal News Network. You can stream the show online anytime via the Federal News Network app and listen to the FEDtalk podcast on PodcastOne and Apple Podcasts. FEDtalk is a live talk show produced by Shaw Bransford & Roth P.C., a federal employment law firm. Bringing you the insider’s perspective from leaders in the federal community since 1993. FEDtalk is sponsored by the Federal Long Term Care Insurance Program (FLTCIP). The FLTCIP is sponsored by the U.S. Office of Personnel Management, insured by John Hancock Life & Health Insurance Company, under a group long term care insurance policy, and administered by Long Term Care Partners, LLC (doing business as FedPoint).

For many healthcare startups and established vendors, partnering with payers is a crucial part of their business plan. And as we know, selling in healthcare is hard. It's even harder when you don't understand how these large corporations work. What do they want? How do they set priorities? How do they make purchasing decisions? How long does that process take? The list goes on, and if you're strategizing without this knowledge you're going to struggle. That's where this episode comes in. Today we're talking with Andrew Adrian-Karlin, Director of Business Platform Product at Highmark Health. Andrew sheds some light on how payers decide what to do and who they decide to do it with. This episode will help you build an effective framework for preparing, approaching, and successfully partnering with payers.   You'll Learn What are “products” from a health insurance point of view? What is the purpose of health insurance? Note: This is the same question we went deep on with Steve Krupa from HealthEdge on Episode 145. Steve's answer is also worth a listen. What are some things that payers are interested in from a “business processing” perspective? How do payers set priorities? What's the typical timeline for bringing on a new vendor and what factors contribute to it? What are the challenges, both internally and externally, that need to be managed when bringing on a new vendor? What can/should vendors do to minimize these challenges and shorten the timeline? How do external factors like the CMS Interoperability Rule or the COVID-19 pandemic impact your priorities? And a little bonus here: Why no one – not payer, not vendor, not lawmaker, and not even the regulator – fully understands new regulations and how that creates an early mover advantage. What are the best ways to keep a pulse on what a health plan is trying to do so that you can partner with them? NOTE: For more tactics on this one, Jeff Byers gave us the journalists take on Episode 62.   Andrew Adrian-Karlin Andrew Adrian-Karlin helps companies do new things by better applying technology. I'm proud to be transforming healthcare at Highmark Health. As the Director of Business Platform- Product at Highmark Health, Andrew focuses on building cross-functional teams and leading Product Managers. He is accelerating speed to market for new products, reducing the cost to market, and delivering improved experiences to Highmark's members. Andrew has more than 10 years of experience in Information Technology. Prior work has included diverse areas like data analytics, cybersecurity, post-merger integration, and system development. He holds a BS in Accounting from Case Western Reserve University, an MBA from Carnegie Mellon University, and a number of professional certificates and certifications. LinkedIn: https://www.linkedin.com/in/andrewadriankarlin/   Highmark Health One of America's leading health insurance organizations and an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. (the Health Plan) and its affiliated health plans (collectively, the Health Plans) work passionately to create a remarkable health experience for customers. Highmark Inc. and its Blue-branded affiliates proudly cover the insurance needs of 5.6 million members in Pennsylvania, Delaware, and West Virginia. As an industry, health care poses new challenges every day that require deep insights, constant innovation, and new solutions. The Health Plan business has boldly forged ahead with doing things differently, piloting new approaches, and breaking from the pack. Web: https://www.highmarkhealth.org/   Links and Resources Episode 145: How Payers Can Master Core Administrative Transactions and Deliver a World-class Experience to their Members and Providers w/ Steve Krupa Episode 141: The State of Payer Data with Jordan Bazinsky Episode 103: Selling to Health Systems: Advice for Digital Health Startups (Part 1) Episode 105: Selling to Health Systems: Advice for Digital Health Startups (Part 2) Episode 96: The CMS NPRM: Opportunities from the Payer Perspective Episode 85: Lessons on Selling in Healthcare w/ Dom Cappuccilli     The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media. Music by StudioEtar

This week, join host Jeff Bernhard and guests Lisa Schaffner and Jim Brown to discover how data and analytics are transforming our healthcare experience. Our experts use these powerful tools to understand current performance and anticipate future trends, creating a blended approach to providing appropriate, cost-effective care. Learn more about how analytics drive healthcare decisions on The Health Care Blog. Featuring: Lisa Schaffner, Vice President, Healthcare Analytics, Highmark Health and Jim Brown, Vice President, Enterprise Financial and Patient Analytics, Highmark Health The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Due to the growing physical and mental demands and implications on caregivers while we battle COVID-19, it is of great importance our community better understands these demands in order to support these courageous servants across the nation.   During this episode, we are joined by Maureen Sullivan, the chief strategy and innovation officer for Blue Cross Blue Shield Association, America’s largest health insurer covering one-in-three of all Americans.  While together, Maureen details the findings from BCBS’ recently published Health of America Report, titled “The Impact of Caregiving on Mental and Physical Health,’ tips and tricks for how our innovation community can innovate within BCBS and the caregiving space, and how all of us can participate in their upcoming Health of America Virtual Forum. I’m grateful to Maureen and her team for shining a light on this important and timely subject, as we continue to work to move the health of our industry and nation forward, by doing it together.  Episode Highlights: Overview of the Blue Cross Blue Shield project with caregivers and report BCBS partnership with Archangel The stressors of mental and physical health of caregivers during the pandemic Leveraging innovation and technology to help empower caregivers An invitation to BCBS’ upcoming Health of America Virtual Forum About Our Guest: Maureen Sullivan is chief strategy and innovation officer for the Blue Cross Blue Shield Association (BCBSA), a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies. The Blue System is the nation's largest health insurer covering one-in-three of all Americans. Sullivan has overall accountability for BCBSA’s strategy, marketing, development and innovation, research, group purchasing, strategic communications and educational programs. In this capacity, she leads several teams in providing wide-ranging services and strategic counsel to BCBSA leadership and BCBS Plans. Among the critical thought leadership initiatives Sullivan drives on behalf of the BCBS System are efforts to effectively leverage BCBS data to bring new insights to healthcare. This suite of programs includes the Blue Cross Blue Shield Health Index, a first-of-its-kind measure of community and national health; the Health of America report series, which highlights data-driven information on timely health topics; and the Alliance for Health Research, a partnership with leading academic institutions. Sullivan also supports BCBS companies in their efforts to transition care delivery to become more patient-focused and to succeed in all lines of business in an increasingly consumer-driven market. Her strategic guidance spans the development of innovative solutions within BCBSA and across the BCBS System, as well as multiple initiatives to further strengthen the BCBS brand across all lines of business, from individual consumers to large national employers.   Sullivan earned a master’s degree in public policy from the John F. Kennedy School of Government at Harvard University where she was a Kennedy Fellow. She also holds a bachelor’s degree with honors from Albertus Magnus College in New Haven, Conn. Links Supporting This Episode: BCBS website: (https://www.bcbs.com/) Maureen Sullivan LinkedIn page: (https://www.linkedin.com/in/maureen-sullivan-4b38754b/) Maureen Sullivan Twitter page: (https://twitter.com/msullivan001) Health of America Virtual Forum: (http://www.cvent.com/events/health-of-america-millennial-health-and-caregivers-forum-virtual-program/event-summary-ad21ec9eb8284821af0205b45a02aa5d.aspx) Health of America Report on “The Impact of Caregiving on Mental and Physical Health”: (https://www.bcbs.com/the-health-of-america/reports/the-impact-of-caregiving-on-mental-and-physical-health) 2019 Health of America Report on “The Health of Millennials”:... Support this podcast

The relationship between the healthcare payer and provider is critical to blending information to view a total health situation. Learn more about how we're improving capacity to manage the quality and cost of healthcare through clinical and financial alignment. Featuring: Jerry Walsh, Vice President, Provider Contracting and Relations, Highmark and Mark Wendling, MD, Executive Director, Physician-Hospital Organization, Lehigh Valley Health Network The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Testing for COVID-19 is essential to quickly identify, isolate, and treat infected patients. Host Jeff Bernhard is joined by Dr. Brian Parker, Chief Quality Learning Officer for Allegheny Health Network, to discuss the different types of tests, including the best time to get tested if you suspect you've been exposed to the virus. They also explore what it means to have COVID-19 antibodies and the likelihood of being reinfected. To learn more, visit the CDC testing website or ahn.org/coronavirus. If you suspect you have been exposed to the virus, please self-isolate and contact your primary care physician. Featuring: Brian Parker, MD, Chief Quality Learning Officer for Allegheny Health Network The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

We all want the highest quality healthcare for ourselves and our families. Learn how we are shaping the future of quality reporting through collaboration with value-focused providers and industry experts. Read more at National Committee for Quality Assurance and Agency for Healthcare Research and Quality. Featuring: Diane Gilworth, Former Senior Vice President, Clinical Services, Highmark Health and Sricharan Chalikonda, MD, Chief Medical Operations Officer, Allegheny Health Network The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

This is the second episode of Hitting a Higher Mark's three-part COVID-19 series. Over the next month, we will discuss various ways to stay safe during the coronavirus pandemic, the continuous impact it will have on our lives, and answer our listeners' burning questions. As we adjust to the new normal during the COVID-19 pandemic, many businesses are eager to reopen to employees and customers. Host Jeff Bernhard is joined by Dr. Susan Manzi, chair of the Medicine Institute at Allegheny Health Network, to discuss how businesses can safely reopen while protecting their employees, customers, and community. For more information, please visit ahn.org/coronavirus. To watch Highmark's back to school webinar, click here. Featuring: Susan Manzi, MD, Chair of the Medicine Institute at Allegheny Health Network The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

This is the first episode of Hitting a Higher Mark's COVID-19 series. Over the next month, we will discuss various ways to stay safe during the coronavirus pandemic, the continuous impact it will have on our lives, and answer our listeners' burning questions. Wearing a mask and social distancing are two of the simplest ways to protect yourself and others from contracting and spreading coronavirus. Host Jeff Bernhard is joined by Dr. Don Whiting, chief medical officer for Allegheny Health Network, to learn the facts around wearing a mask and social distancing. They also discuss the emergence and impact of a potential vaccine. To learn more, visit ahn.org/coronavirus. Featuring: Don Whiting, MD, Chief Medical Officer for Allegheny Health Network The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue

This episode is brought to you by the Blue Cross Blue Shield Association. Blue Shield companies are supporting health care partners on the frontline of this unprecedented fight. Ensuring patients don't have to worry about costs. Caring when it counts the most, for the Health of America. Dr. Kavita Patel is a Nonresident Fellow at the Brookings Institution and a practicing primary care physician in Washington, DC.  She previously served in the Obama Administration as a senior aide to Valerie Jarrett, where she played a critical role in health reform, financial regulatory reform, and economic recovery policies.   Dr. Patel also has a deep understanding of Capitol Hill from her time spent on the late Senator Ted Kennedy's staff as deputy staff director for the Senate Health, Education, Labor and Pensions Committee.    Kavita and I have worked together for years, including at the Bipartisan Policy Center and The Aspen Group, and she always has her finger on the pulse when it comes to the latest on healthcare policy.  Today, we're placing a timely focus on how healthcare can help schools reopen safely.   

Social determinants of health play a big part in our overall wellness. Access to healthcare, healthy food, and important life resources impact our health beyond the care at a doctor's office. Learn more about how we're supporting the health and well-being of communities by looking at its socio-economic factors such as safety, food security, and health literacy. Read more at highmark.auntbertha.com or find support by visiting findhelp.org. Featuring: Barbara Gray, Senior Vice President, Social Determinants of Health, Highmark Health and Erine Gray, Chief Executive Officer, Aunt Bertha The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

How does AI detect billions in fraudulent medical spend? Learn how we use artificial intelligence to investigate fraud earlier and lower healthcare costs. Read more at FraudScope.com or the National Health Care Anti-Fraud Association. Featuring: Kurt Spear, Vice President, Financial Investigation and Provider Review, Highmark and Musheer Ahmed, Chief Executive Officer, FraudScope The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Opioid Use Disorder effects millions of Americans each year. Our experts share how we are implementing ways to reduce the addiction rate in the regions we serve. Read more. Featuring: Charles DeShazer, MD, Chief Medical Officer, Highmark and Caesar DeLeo, MD, Vice President and Executive Medical Director, Strategic Initiatives, Highmark The views and opinions expressed in this program are those of the participants and do not reflect the views or opinions of Highmark, its subsidiaries or affiliates. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Highmark is a registered mark of Highmark Inc. © 2020 Highmark Inc., All Rights Reserved. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies.

Listen in as Trent Haywood, MD, JD, Senior Vice President and Chief Medical Officer of the Blue Cross Blue Shield Association, outlines key initiatives and goals for addressing social determinants of health, also referred to as addressing social risk factors or community barriers. Learn more about BCBSA's innovative partnerships, either nationally with Lyft for transportation services or locally with healthy meal delivery organizations. This episode is for all those who are already on the Social Determinants of Health bandwagon, as well as those more skeptical who want to understand the concrete goals such programs can bring forth.

Air Date: 12/19/18Writers: Mark D. Gomez, MD; Tiffany E.R. GomezHost: Mark D. Gomez, MDProducer: Tiffany E.R. Gomez Music: ©2018 The Wonderful Mr. Havis Follow Me on Social Media: Facebook: https://www.facebook.com/toyourhealthdrg/ Instagram: https://www.instagram.com/toyourhealthdrg/ Twitter: https://twitter.com/ToYourHealthDrG TO YOUR HEALTH WITH DR. G™Building Trust. Delivering Truth. An MDG Wellness LLC Production© 2018 MDG Wellness LLC. All Rights Reserved Music: ©2018 The Wonderful Mr. Havis. All Rights Reserved Episode Guests: Kwame Banahene, PharmD Pharmacist & Pharmacy Manager Walgreens (https://www.walgreens.com/) Lisa Heuser, PharmD Pharmacist & System Director, Clinical Pharmacy ServicesEdward-Elmhurst Healthcare (https://www.eehealth.org/) Veronica Mayer, PharmDPharmacist & Pharmacology Instructor, National University of Health Sciences (https://www.nuhs.edu/) Adjunct Instructor, Midwestern University (https://www.midwestern.edu/)Medication Therapy Management (MTM) Pharmacist, Blue Cross Blue Shield Association (https://www.bcbsm.com/index/about-us/our-company/blue-cross-blue-shield-association.html)

Tune in to FEDtalk this week for a look at the Open Season Virtual Benefits Fair, plus hear from Blue Cross Blue Shield Association about their best FEHB offerings during Open Season. October 6, 2017

Tune in to FEDtalk this week for a look at the Open Season Virtual Benefits Fair, plus hear from Blue Cross Blue Shield Association about their best FEHB offerings during Open Season. October 6, 2017

Keynote speaker Suzanne Belinson of Blue Cross Blue Shield Association speaks to CHI on May 9, 2017. Dr. Belinson will be speaking during the Coverage and Reimbursement of Advanced Diagnostics meeting at the Next Generation Diagnostics Summit, August 15-18th in Washington DC. Topics include using web-based platform where stakeholders can view evidence, if we need more standardized requirements for payers and regulators, and hopes for the conference. For more information please visit http://www.NextGenerationDx.com/Reimbursement-Diagnostics/