Podcasts about Blue Shield

https://youtu.be/B9j1nlRifHM Alex Fernandez, CEO of Synergy Orthopedic Specialists, is driven by a mission to help physicians Build a Multi-Site Medical Practice that creates wealth, equity, and independence beyond their personal labor. By bringing independent physicians together, building scalable organizations, and expanding access to integrated services, Alex helps doctors operate as entrepreneurs while delivering a more convenient and cost-effective patient experience. In this conversation, Alex introduces The Multi-Site Scaling Framework—Visualize Your Target EBITDA, Align With Your Partners, Remove Yourself From the Center, Build Systems, and Build Margin Around Your Core Business. He explains why starting with the desired enterprise value creates a clearer path for growth, why alignment must be a gate for every partnership or acquisition, and how strong systems allow a business to operate without depending on its founder. Alex also shares how vertical integration, company culture, geographic expansion, and AI-assisted processes can improve profitability while preserving independent medical care. — Build a Multi-Site Medical Practice with Alex Fernandez  Good day, dear listeners. Steve Preda here with the Management Blueprint Podcast, and welcome Alejandro “Alex” Fernandez, the CEO of Synergy Orthopedic Specialists, a team of surgeons and specialists that believes in providing patients with an integrated approach to musculoskeletal—I’m glad I could pronounce this—medical care through 15 locations throughout San Diego. Alex, welcome to the show.  Thank you. Thank you. Yeah, I appreciate that. I’ve enjoyed your show, and I’m happy to be here.  Well, I’m always interested when I meet with medical provider companies or CEOs who have been doctors, because I grew up in a family of two doctors, and so I was exposed to some of the challenges of being a doctor and running a hospital. So that’s going to be interesting. So my favorite question that I ask recently to all our founders is, what is your personal why, and how are you manifesting it in your practice and in your business?  Yeah, for sure. And so my why, as you put it, comes from where I started. I actually don’t come from a family of physicians. I started not where I ended up. I’m a son of Cuban immigrants. My parents fled Castro in the ’60s, and I was born in Puerto Rico. Later on, my family took a lot of our family in the Mariel boatlift in 1981 and took hundreds of people out of Cuba. But in reality, the concept or the reality is that my parents didn’t have a lot of money. They had some connections, but they believed that I should have a college education.  But I had to work my way through eight years of college to get my bachelor’s. So I landed in healthcare as an accident. It was a small medical practice. I was basically doing front desk and medical records, and then later on learned how to do the billing, all by hand at that time. There were no electronic medical records. And I started basically at the front desk, and I watched something that I never really forgot, which is, you have these brilliant physicians, people that can diagnose patients and help them and cure them, but when it came to business, they were never taught anything about business.  So this is where I believe I have generated value over the years: basically, built companies that actually create wealth, and the wealth for the physicians in particular.Share on X I think physicians are very entrepreneurial. At least that’s the idea to begin with, is, “I’m going to go into the practice of medicine and have my own business.” But somewhere along the line, the business becomes almost like an ATM machine. It’s no different than any other entrepreneur that starts a business. They are the business. Without them, if they go away for a couple of days, the business doesn’t make any money, and they don’t really know how to do that. So what I’ve done over the years is I have gotten smaller groups of physicians to come together, form larger organizations, larger groups, and eventually built larger private businesses that can have EBITDA, equity earnings that can basically provide some additional wealth.  Particularly, I try to help them think of themselves as capitalists, not as day laborers. Because in reality, in most businesses, and particularly physicians, they’re cranking the wheel, and the more they produce, the more they work, the more they earn. But in some cases, they don’t understand how to get away from that. How to earn from all the other things that they control. Because physicians do control 80% of the spend in healthcare but earn probably no more than 5% of it.  Wow. That is shocking. So they’re not using the leverage properly, probably.  Yeah. Sometimes they know it’s there, but physicians in general are risk-averse. Just starting their own business is hard enough. Then having to figure out how to capitalize from all the levers that they have, that’s completely different. And they’re no different than, I would say, lawyers or accountants that start a small business. At some point in time, you have to figure out, how do you make the business big enough that it operates and works without you?  Yeah, I love that. I love that. And what makes you feel strongly for physicians?  Well, particularly independent physicians, I think it’s a dying breed. Years ago, I would hear the stories of my parents where they’d say, “Hey, we took you to the pediatrician,” and my dad would be friends with the OB-GYN that took care of my mom and the pediatrician. And I remember them naming them by first name or even meeting them at the social club. But nowadays, it’s very transactional. It’s very fast. There’s no connection.  So I think that’s why there’s been this whole surgence of concierge physicians where you pay extra. Because in truth, in order to make a living, the business of healthcare is compressed by downward pressures from the government and from other institutions that say, “We’re going to pay you less, but you have to have a significant amount of compliance, and you have to spend more money on this, and you have to do that.” And then at the same time, the cost of living goes up.  The employees need to make more money. Your rent goes up. The supplies continue to increase. So you have the static or lower reimbursement from the different payers, whether it’s Medicare, the government, or private institutions, and then an increase of expenses happening. That’s very strange to any business. In any other business, you say, “Well, if my costs go up, I increase my prices, and then maybe my margins are a little bit less, but I still have a significant margin.” In healthcare, you almost have to just work more in order to generate more revenue, and the expenses hopefully will increment a little bit more, but your earnings will be the same or less. So it’s a very tough situation for an independent physician.  That’s why more and more, especially physicians coming out of training, look for jobs with health systems, with the Kaisers of the world or the different large institutions in the United States, so that way they can go ahead and just go to work and take care of patients and not worry about the business of healthcare.  Yeah. But then these big hospitals turn into bureaucracies, and then they still have to worry about that in a different way.  And that’s personally the second part to that question you asked me. That’s why I like working with physicians and not necessarily with health systems. I’ve never held a job with a hospital. Not that I haven’t wanted to. It’s just, I think the nature of the bureaucracy of a health system creates some things that I’m not personally interested in.  Yeah. Well, I can see that. So Alex, this is a podcast of frameworks, as you know. So what’s a framework that has helped you build your business, maybe generate an insight, understand situations, maybe influence these physicians to come together in your roll-ups? Whatever framework you developed, could you share something with our listeners?  Yeah. Yeah, for sure. Most owners in a business—and I’ll talk in generic terms. I’ll try to make sure I don’t use any slang for healthcare—but most businesses build their business for income. They want to make income for their families, for themselves. They want to be able to take care of the people that they’re with. But they don’t really think about it from a perspective of, “Let me build a business that can multiply.” Maybe they want to, but in a lot of areas, it’s just hard for them.  I actually grew up in the bridal business. My parents had bridal stores. They basically did wedding packages, and that’s the business that I grew up in. Every summer, I would go and do the cash register or help rent tuxedos and things like that, or do filing and bookkeeping. So that’s where my entrepreneurial spirit comes from. It’s my parents. But I always saw them where maybe they built one or a couple stores, two, three stores, and they would kind of stop there. But I think I learned a lot from my dad in particular around multi-site operations in a retail industry, and I took that back into the healthcare business.  So one of the first things I think that a business owner has to do is they have to underwrite their own exit first.Share on X They have to think of growth and particularly of the value of the business if they were ever going to sell it. Figure out what your EBITDA or enterprise value is going to be, and then go from there. Then make the alignments first, but don’t make it the goal. Most people chase the volume, the customers, more locations, more deals, spend years fixing what they bolted on in order to flip it, but they don’t really take the time to align it. So I think the client, the partnership, the acquisition—you have to figure all that out at the beginning and then fix it later.  If I run into an acquisition that we’re looking at, and I don’t see the alignment from whoever I’m going to partner up with, I know it’s going to be a deal that’s going to go bad eventually. We all have to be thinking the same way. Then the other thing, like I already mentioned this a couple of times, but you have to take yourself out of the center. If you’re the CEO, you’re the business owner, and the business depends on you—you can’t go on your two- or three-week vacation to Europe or wherever you want to go, and when you come back, the business is in disarray or didn’t survive—you don’t really have a business.  You just have a job that costs you a lot of money to maintain. I think that’s where operating systems earn their keep. I haven’t really run the EOS program, but I’ve read the book, and I really like the idea of the scorecards, and I used it particularly when I came to this opportunity in San Diego. Getting everybody to row in the same direction. A business that runs with a founder and a single thing, it’s one that won’t get very far.  But on the other hand, if the founder figures out a way to build systems around them and bring in the right people, that’s going to make the business way more successful. And the last one I would say is own the margin around your core. Don’t just sell the core service. Figure out what else you have. And I think in healthcare in particular, I was mentioning this: doctors control a significant amount of what happens to a patient, but they don’t figure out ways to vertically integrate the business to have access or have the opportunity to earn some revenue and some earnings from the actual business they refer to.  So what I’ve done over the years, particularly in gastroenterology, I grew a medical practice of gastroenterologists. A couple of them came together, and it was around 50 million in revenue when I came in. And one of the first things I started doing was figuring out, how do we add, let’s say, imaging services? So we added CT. How do we add infusion services? Because back then, there were some significant drugs that were coming into market around infusion. But later on, we said, “Hey, we have an investment in an ASC, but why don’t we do the investment so the investment’s part of the group? So all the doctors can benefit from that.  And when we actually equitize the business in the future, that could be part of our exit if there’s equity there.” And then the next question was, “Well, why don’t we sell the prep that we give people before they get the colonoscopy?” So we got licensing around pharmacy, and then we said, “Well, what about anesthesia? What about pathology?” And so on and so on. So when I went to New York City and I ran a dermatology group, we built a path lab for the derms. When I came here to the orthopedic group, we had PT locations, expanded to multiple PT locations, improved the contracts around durable medical equipment, the bracing, even added anesthesia and started our own ambulatory surgical center.  So always trying to figure out, how can you vertically integrate the business to try to capture as much as you can from the client that’s in front of you? Not only just from a money perspective, but also from an experience perspective, being able to provide it all under one roof and being able to give the patient, the customer, a great experience. You want to provide outstanding medical care. Quality medical care is kind of like a base. If you go to a doctor, you expect to get better. But what we see in healthcare a lot is that people don’t think about it.  Like, in our offices, we say, “Thank you for choosing Synergy Orthopedics.” We know patients have a choice, so we have to develop a model that allows the patient to say, “Hey, I want to go here because these guys have it all under one roof.” But more importantly, that’s typically what the hospitals have. But hospitals charge for the same thing I provide two and three times more because they have a different type of leverage with the contracts. So I always say, “Why did the duck cross the road? Oh, because they went from the hospital to the ambulatory surgical center to get a colonoscopy to save 700 bucks.” I mean, it’s literally that simple.  And I don’t think patients in general know that, but I think the doctors have a great opportunity to control the delivery system, provide a great experience for the patients, and at the same time, make some money from things that they don’t physically have to do. They can hire the physical therapist, et cetera.  Yeah. Okay, so that’s great. So what I’m hearing, the framework is: think of growth first—what’s the EBITDA you want? Then create alignment, take yourself out of the center, build systems, and build margin around your core business. So that’s wonderful. Now, step two, I’m not 100% clear on. So you said make alignment with partners, but don’t make it the goal. What do you mean by that?  Well, because particularly I’ve been involved in private equity medical groups. So with private equity, you have cash, you have leverage, so you can go and buy, buy, buy, buy. In private equity, to a degree, they want growth. But I’ve been in deals where the thesis was, for example, we’re all going to be rowing in the same direction with the same flag, same brand, and we’re going to transfer from having—there were four medical groups, so four different, distinct medical groups—and we’re putting them together under what’s called a management services organization, a management company, and basically form one larger group.  But that was never aligned because the doctors, in their head, said, “You’re acquiring me, so you’re buying this magnificent, outstanding business. Now why do you want to change my electronic medical records? Why do you want to change the way we do our, let’s say, revenue cycle management or billing? Why do you want to change our brand? Our brand’s fantastic.” Even though they were all called Dermatology blah, blah, blah, something and something. So you have to make sure that the people that you’re going to bring on board, whether it’s through acquisition, merger, or just employment, that they really believe in your story, that they believe in the core vision of the business.  Not just try to put people in there and make more deals, get more locations, spend more years, and then you put all these things together and you bolt them up, but you spend more time trying to fix it. In my Gastro Health and in the ortho business, we always started with, “Let’s make sure we have our house in order before we go out and start growing the organization and adding more to what we have.” The last thing you want to do is add more and then find out that you have to spend more time fixing it.  No, that makes sense. But then you qualified it. You said, “Don’t make it the goal. Don’t make alignment the goal.” So how does it become the goal? What’s the risk there?  So no, make it the gate, not the goal. Meaning, alignment is extremely important, but you want the alignment to be the one thing that puts you together. But at the end, everybody has to be buying into the idea. It’s not the only goal. Their goal is also money. The goal is growth. But it has to be one of the key things. In healthcare, I tend to think, and particularly with private equity, that’s not perceived. It’s more about getting deals done.  Yeah. They don’t care about the mission. They don’t care about the vision, the alignment.  I think they do. In their thesis, they do, and they want it. But it’s kind of like, at the end, you’re looking at this business. They want to sell, you want to buy, you have money, they want money, and sometimes it’s just easier to say, “Well, we can grow from $30 million to $60 million, from $10 million of EBITDA to $20 million of EBITDA. We’re going to get, instead of a 10 multiple, we’re going to get a 15 multiple.”  So sometimes that gets in the way. And I would say, by the way, I worked with great and fantastic private equity firms, so I’m not saying they all think that way. But for sure, the perception is that they’re going to go in and try to make deals happen because they do have an end goal. Their end goal is to their investors that gave them funds, that they told them they were going to get them a four-, five-, seven-times multiple on their investment.  So in your own business, Synergy Orthopedic Specialists, is this a private equity-funded business or is it bootstrapped?  No. No, it’s bootstrapped. The physicians, when I came on board—at that time, I started with them six years ago in 2020, and the market was really hot still, ’21, ’22, ’23, and then the interest rates went up, and then things have softened. I think also they got softened for what we’ve been discussing earlier. There’s been a lot of deals that have been done where acquisitions were done in multiple states. There’s not a lot of synergy or a lot of things that were worked out to try to make sure that the organization was working together, the multiple organizations that were acquired.  And the idea was, if we buy four million-dollar businesses, they will be, instead of an eight-times multiple, they’ll be a 10- or 12-times multiple. So I think there’s a lot of deals that are stuck in the marketplace right now, and the groups are trying to figure out how to evolve the organization after five, six, seven years from, “Hey, we let you alone. We let you be. But now we need to start integrating. Now we have to start building an enterprise. Now we have to start building a real platform.” And I think that the organizations that did that earlier have been able to exit and done a much better multiple and growth.  And also the key is, in these transactions where people get together, a lot of times it’s all about the fun. “Hey, we go out to dinner, and everybody’s well, and everybody’s happy, and how much money we’re going to make,” and blah, blah. But nobody really asks the tough questions, or some people do because they actually don’t want the deals to get done. But I think it comes from the buyer. The buyer needs to be very upfront with what they want to accomplish with a transaction, whether, again, a merger or an acquisition.  You want to make sure that you’re extremely transparent about what the end goal is going to be. And if the end goal is like, “Hey, I’m going to leave you alone for a year, but in a year and one day, your name’s going to change, your software’s going to change, your HR is going to change. And by that time, we’ll figure out about your staff, and we might probably cut 25% of your staff because you’re bloated, and we actually have to make you a little bit more fit and trim so you can actually be able to grow and provide better care to your patients.”  So what I’m seeing is, it’s quite impressive. You have 15 locations, you have a huge service mix. You have, compared to the number of locations and service mix, a limited number of people. So how do you maintain the Synergy standard? And how do you manage this complexity with such low—low per— It took— How many people?  Yeah, it’s—right. Yeah, I agree. It’s taken some time. Again, I wouldn’t say that it’s perfect. We’re always evolving, changing. I mean, I always say the only constant thing in healthcare is change. But it started with the company culture. When I first got here, there were four or five organizations that came together, and they were still using their old names. Synergy Orthopedics was like this little kind of byline under their business cards. It wasn’t really the brand.  And then over time, we got people in the organization rowing in the same direction, using the same flag, and over time we started to dominate the market. We started to be perceived, and we are today, the largest independent medical orthopedic group in San Diego. So when people think of MSK, we take care of the hockey team, we take care of the soccer team, we take care of professional players. The larger organizations reach out to us about developing contracts, direct contracts to provide services to them.  So that took a long time, but it started with building that company culture. And along the way, some people left. Some people just didn’t fit what we were trying to build. And it wasn’t just me. I didn’t do this by myself, of course. The reality was we built a team around what we were trying to create. Physicians, in this case, are the leaders. Physician leadership was there, and this is what they wanted as well. So I think, yes, when we’re now in other counties we’re in Riverside County, so we’re north of San Diego. We’re all the way to Palm Desert and looking to grow into Orange County and L.A. County eventually.  So the goal is also in growth, and size allows leverage and negotiation power with the different payers. And that’s very different than in other industries where you have a payer, let’s say Blue Shield or Anthem or United, that kind of controls how you’re going to provide service, how much they’re going to pay you, et cetera, et cetera. So the only way to really have any type of seat at the table is that your organization has to be large enough and a market leader and basically be something, or an organization, that they can’t say no to, that they want to have in their network. So that’s how we’ve been able to do this over the last five, six years now.  So what drives the growth? Is it the acquisitions? Is it geographic expansion? Is it payers refer business? What’s the driver?  All of it. You have to do everything. It’s like that movie, Everything Everywhere All at Once. It’s like you have to do everything. We started by first creating the brand and the company culture, expanding that brand and company culture by figuring out who having the right seats on the bus, making sure the right people that wanted to be with us were there. And then we said, “Okay, we don’t have a spine program. Let’s figure out how we recruit a spine doctor. Let’s figure out how we recruit a pain doctor.  Let’s get a foot and ankle specialist because we don’t have one. Let’s expand our sports medicine program.” So we took over a fellowship training program in San Diego that was probably going to expire, and then we took it over and continued the legacy of the physician that started it from the beginning. We’ve done some mergers. We’ve done some acquisitions. We’ve done some new locations. We’ve expanded our physical therapy footprint. We built out an ambulatory surgical center. That was a big endeavor. These things cost millions and millions of dollars. Just in construction alone, it was like $600… I think our overall investment’s somewhere around $12, $15 million, so highly leveraged. We brought in a partner, a national partner, to help us run and fund the enterprise.  We started an anesthesia division. So I would say you have to do everything, and all of it together, as time goes by, creates that vision. As long as you have the vision, like I said, the beginning thing is you have to start with the end goal. And the end goal is we want to build a business that’s independent. That’s our goal. We don’t want to be sold or be part of the hospital system. So you have to build the end goal, work through the process, grow it, and do all the things at the same time, which is extremely hard, I would say.  Yeah. This is fascinating. So you have a lot of complexity. You have a lot of locations, a lot of services, 50 providers. I mean, sometimes doctors can be cats, hard to manage them. Eagles, eagles. I always say, try to get eagles to fly in a straight line. Impossible. Yeah.  But if you had a magic wand and you could fix one thing in your business in the next 12 months, what would it be?  I will be honest, it’s expenses. Expenses can and I’ve talked about this before the pressures in the healthcare industry really are driven around expenses. We just got an increase in minimum wage in healthcare, specifically in California, where a physician practice now has to pay $23 an hour for a minimum-wage job, where minimum wage is almost half of that if you’re in any other industry. So I think everybody should make more than $23, particularly in San Diego. It’s a very expensive place to live.  But I think it’s more around the pressures that are put on the industry, but the levers are not there to increase revenue to be able to support or subsidize those expenses. So, for all intents and purposes, we’re looking at how we increase revenue by keeping expenses the same, or fixed, or a little bit higher than what they are, by augmenting with AI, like every other industry is doing. Figuring out whether it’s using AI in your MRI to be able to process the imaging faster, clearer, better, and be able to add three or four more patients a day. That profit goes straight to the bottom line.  It might be before we had people that are scribes that basically did the documentation of the history, the notes, and the medical records. Now doctors are using—well, they’ve been using voice recognition for a while—but now you’re doing ambient AI, where basically it’s listening to the conversation with the patient, of course with the patient’s approval, and being able to document all that information into the record much faster, quicker, better, and more precise. And so on. Answering the phones, being able to—when the patient gets statements, we typically send out statements every two weeks.  But when we send them, we send thousands of statements, so we get thousands of phone calls. You can’t get all those phone calls when somebody says, “I owe $50, and I don’t know why,” and being able to have an AI that tells you, “The $50 is because you had a copayment or you had a deductible, and it’s due to your insurance program with whatever the insurance is.” And they’re like, “Oh, okay.” “You want to pay that right now?” “Yes.” It sends you a text to your phone, qualifies who you are, you click on it, you put your payment information. The information goes in, the payment gets posted. Nobody got involved. AI took care of the whole process. So we’re trying to figure out how to assist the staff without having to let go. At least my intent is not to let go of people.  My intent is to try to make sure that we do the best job possible and use AI to augment the process, not to replace the staff. I get very worried, in general, about what’s going on with AI as an industry, where people are saying, “Well, I use it as my assistant. I use it as this.” Well, I started at the front desk. If there are no front desk jobs, how could I have been CEO of this multimillion-dollar organization if I didn’t get a foot in the door to begin with? So I feel very worried for my kids that are growing up. One’s studying to be a psychologist, the other one’s in marketing. How are they going to learn and grow in an industry or a business if they can’t get their foot in the door?  Yeah. That is a concern. I don’t know if we can fix it, but I’m worried about it too. So Alex, who would you like to listen to this podcast and to take action? And what kind of action should they take?  Well, I think it’s generic. I always say, I have an MBA in healthcare administration, but I could have gone and done any type of business. Like I said to you, I grew up in the retail industry. So I think it’s more around, if you’re an entrepreneur and you have talent and you’ve worked really hard at doing something, you have to figure out how to hire the right people so that they can do a job that maybe you don’t know how to do, how to scale up a business by investing in it, making sure you don’t look at your business as an ATM machine or a salary that pays you every week or every period of time, but look at it as you’re an entrepreneur, a capitalist.  You’re building an organization. You’re providing jobs for people. But at the end, the business has to give you more than your salary. There has to be equity in the enterprise, and that’s the money you’ll be able to use to maybe have leverage or to use in order to add that next location or look at what’s the next opportunity, whether you’re, again, a doctor or you’re running a retail organization that wants to have multiple locations. The key is, think of the end goal. And the end goal, not necessarily that you’re going to sell, but what is it going to be? What is the business that you want to have valued at, and how have they grown?  Look and listen to other people like yourself, Steve, and all the different things that you do in regard to building that journey of the business, and figure out how to take the next step and the next step and the next step. It doesn’t happen overnight. You don’t get from a $50 million company to a $150 million company. It took me seven years to get there. But it’s done by augmenting and adding features and adding services, but doing it very intelligently, thinking it through, not just adding it for the sake of adding it, then, like I said before, having to bolt it on and try to fix more of the problems, creating more problems.  No. Fix your house, figure out where you’re at, make sure it’s earning equity. Maybe you have to reprice. Maybe you have to figure out how the business needs to run a little bit nimbler. Maybe you have to use technology, whether it’s AI answering the phone because you’re the guy that—you have a pizza shop. Why do you have to have people answering? Have the AI take the order, have the AI tell people to go to the website, and so on, so you can have pizzas going out of your store every five minutes. So for sure, there are great opportunities. And if you’re a business owner, I want you to think that you can. It’s not impossible. It can be done. You don’t need an MBA. You just need to work hard and think it through and come up with a business plan and an idea on how you want to get there.  Yeah. Well, this is very inspiring. So if you are a founder, you’re running a business, or you’re about to start a business, look at what Alex has done. He was a son of Cuban immigrants, came to this country, built from nothing a 15-location, 50-provider medical group, and works with private equity, advises companies as well. Follow his example.  So Alex Fernandez, thank you for sharing your wisdom on the show. And if you’re listening and you enjoyed this conversation, stay tuned because I have a couple of exciting entrepreneurs every week who come on the show and share their secrets and frameworks with you. So thanks for coming, Alex, and thank you for listening. Important Links: Alex's LinkedIn Alex's website

In this episode, Amanda Free, Anthem Blue Cross and Blue Shield of Georgia Commercial President, discusses improving healthcare affordability, expanding access in rural communities, strengthening value-based care partnerships and helping members make smarter choices about where and how they receive care.

In this episode, Jessica Lopez-Liggett, Commercial State Plan President for Anthem Blue Cross and Blue Shield in Indiana, discusses rising healthcare costs, simplifying the member and provider experience through technology, and expanding high-quality, lower-cost care through provider partnerships. She also shares why addressing social determinants of health and bringing employers, providers and community organizations together is critical to improving healthcare.

Were Democratic attorneys general preparing to wage a legal battle against Donald Trump before voters even went to the polls? On this episode of The Tudor Dixon Podcast, Tudor is joined by The Center Square investigative reporter Adam Herbets to discuss documents showing that more than 20 Democratic state attorneys general entered into a common-interest agreement as early as April 2024—months before Donald Trump won the presidential election. The agreement allowed the states to coordinate on what they called “federal accountability projects,” which Herbets says have since resulted in roughly 100 lawsuits against the Trump administration. Herbets explains how the states coordinated their legal strategies, why questions are being raised about taxpayer resources and public-record transparency, and whether these lawsuits are becoming a political and fundraising tool. He also details how states including California and New Jersey allocated additional money toward legal challenges involving the Trump administration. Tudor and Herbets also examine the growing role of money in politics, Gavin Newsom’s fundraising relationships with nonprofits and major corporations, government contracts, and the increasingly blurred line between political influence and public policy. The Tudor Dixon Podcast takes a closer look at the money, political power, and legal battles shaping government—and asks what taxpayers deserve to know about what is happening behind the scenes.See omnystudio.com/listener for privacy information.

In this episode, Jessica Lopez-Liggett, Commercial State Plan President for Anthem Blue Cross and Blue Shield in Indiana, discusses rising healthcare costs, simplifying the member and provider experience through technology, and expanding high-quality, lower-cost care through provider partnerships. She also shares why addressing social determinants of health and bringing employers, providers and community organizations together is critical to improving healthcare.

While the podcast team is taking a Radical Sabbatical, Kim is interviewing authors of the books that have had a big impact on her in the past two years.  In this episode, Kim speaks with Rob Lalka, the author of The Venture Alchemists - How Big Tech Turned Profits Into Power.    In this episode of Radical Sabbatical, Kim sits down with Rob Lalka, author of Venture Alchemist, to study what the founders of Facebook, Google, and the “PayPal Mafia” were saying and writing before anyone was paying attention to them. They explore what separates the leaders who stayed grounded from the ones who didn't. They ask a hard question: does it matter if a leader got corrupted by too much money and power or if they started out bad to the bone? Every leader (indeed, every one of us) has good and bad inside. The one that wins is usually the one that gets fed. The question is whether the venture capital model feeds the good — or does it feed the bad, setting founders up to be corrupted by their own success?  Kim and Rob explore the contrasting origins of major tech companies like Facebook and Google. They discuss the implications of Mark Zuckerberg's early actions (for example, an IM while in college with a friend who asked him how he got access to people's personal information and he replied “they trusted me, the dumb f–ks;”). What does it mean that Google's founders started out thinking Google would have to be a non-profit so that advertising wouldn't bias information but wound up selling trillions of ads?  The conversation also delves into the impact of the PayPal Mafia and the controversial book by Thiel and Sachs, The Diversity Myth. Rob discusses the complexities of free speech and the implications of outlier behavior. He emphasizes the importance of moral leadership in corporate culture and critiques the philosophical influences of figures like Ayn Rand and Milton Friedman on business ethics. Rob expresses hope for the future, particularly through the potential of his students to create positive change in society. Books & Articles mention by Rob:   George Packer - article in The Atlantic - The Venture-Capital Populist https://www.theatlantic.com/magazine/2026/06/david-sacks-crypto-ai-venture-capital/686941/ Max Chafkin - The Contrarian: Peter Thiel and the Rise of the Silicon Valley Oligarchs https://elmstreetbooks.com/book/9781984878557 Jimi Soni - The Founders: The Story of Paypal and the Entrepreneurs Who Shaped Silicon Valley https://www.amazon.com/dp/1501197266?lv=shuf&channelId=500&plpRedirect=mhFallback Guest Background: Rob Lalka is the author of The Venture Alchemists - How Big Tech Turned Profits Into Power.  He is also the Albert R. Lepage Professor in Business and executive director of the Albert Lepage Center for Entrepreneurship and Innovation at Tulane University. He is on the board of directors of Blue Cross and Blue Shield of Louisiana, Public Democracy, Inc., and Venture For America in New Orleans. Previously, he served on the U.S. Secretary of State's policy planning staff and in the State Department's Office of Global Partnerships, was a director at Village Capital, and was a senior advisor at the Howard G. Buffett Foundation. CHAPTERS (00:40) Introduction to Alchemy and Venture Capital (03:04) The Power Dynamics in Business Models (05:33) Zuckerberg's Origin Story and Its Implications (07:40) The Contrast with Google's Founding Philosophy (09:47) The Role of Advertising in Business Models (12:43) The Historical Context of Business Practices (14:59) The Golden Spike and Economic Inequality (14:59) The Impact of the PayPal Mafia and Diversity Myth (22:00) The Controversy of Free Speech and Homophobia (25:07) Outlier Behavior and Its Implications (28:03) The Rape Issue and Its Consequences (30:27) Moral Leadership and Corporate Culture (33:08) Philosophical Influences on Business Ethics (40:30) Hope for the Future and the Role of Education Connect with the Radical Candor team: ⁠⁠⁠⁠⁠⁠Website⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠YouTube⁠⁠⁠ Keywords venture capital, alchemy, business models, Zuckerberg, Google, advertising, economic inequality, PayPal Mafia, diversity myth, entrepreneurship free speech, outlier behavior, corporate culture, moral leadership, business ethics, philosophy, education, AI Learn more about your ad choices. Visit megaphone.fm/adchoices

"It begins with you, but it's not about you."That may have been my favorite quote from this conversation—but when you're sitting down with a true healthcare legend like Cora Tellez, it's nearly impossible to pick just one.In this episode of The H.I.T. Podcast, Toby Kennedy talks with Cora, whose remarkable career has spanned nearly five decades. From leading organizations like Kaiser Permanente, Blue Shield of California, Prudential, and Health Net to founding Sterling Administration and launching new ventures in healthcare innovation, Cora shares the leadership lessons that have shaped her extraordinary journey.This conversation is packed with timeless wisdom for leaders, entrepreneurs, HR professionals, and anyone looking to make a lasting impact.In this episode:Cora's incredible journey through the healthcare industryThree leadership principles that have guided her careerWhy failure should lead to learning—not blameWhy no leader succeeds aloneThe importance of addressing personnel issues earlyFinding purpose, building community, and aging wellHow creativity outside of work can make you a stronger leaderWhether you're leading a company, managing a team, or simply looking to grow, Cora's insights are practical, inspiring, and as relevant today as ever.

Noah Hopton, CEO and Founder of Finvisor, helps startups and growing businesses simplify operations by building integrated back-office teams that combine accounting, finance, payroll, HR, insurance, and technology. By combining experienced financial professionals with modern technology, Noah enables businesses to streamline operations, stay compliant, and focus on sustainable growth.  In this conversation, Noah introduces The Adjacent Extension Framework—Earn the Trust, Build the Relationship, Listen for Other Problems, Connect Other Specialists, and Empower the Team with Tech. He explains why proactive service creates lasting client relationships, how solving adjacent business challenges leads to sustainable growth, and why integrated back-office teams outperform disconnected vendors. Noah also shares how AI is reshaping finance operations by automating repetitive work, empowering finance professionals to focus on strategic decision-making, and helping businesses leverage technology to enhance—not replace—human expertise. — How to Outsource Your Back Office with Noah Hopton  Good day, listeners. Steve Preda here with the Management Blueprint Podcast, and my guest today is Noah Hopton, the CEO and Founder of Finvisor, helping seed and Series A companies that have outgrown spreadsheets and part-time bookkeepers but aren’t ready for a full-time finance team yet. Their job is to give you the financial clarity to make good decisions at every stage of growth. Noah, welcome to the show.  Yeah. Pleasure to be here, Steve.  Well, great to have you here, and I’m very curious about your career and your business and what you built here. I’m particularly curious about your personal ‘Why’ and how you manifest it in your business.  Personal ‘Why.’ That’s great. Well, I’ll be honest, I didn’t go in thinking I was going to be an accountant or run an accounting firm. You know, I studied accounting in school. Eventually, I thought I was going to probably be more in a kind of front-of-house sales relationship because I enjoyed the people part—making relationships and meeting people.  But I was very fortunate that I found the consulting, fractional CFO world, where I got to discover a love of problem-solving, creating relationships, and creating value for clients. For me, it was kind of this love of helping clients understand their business, helping clients understand what to think about around the corner, where it's not just being in-house with one set of books that you're closing.Share on X  When you’re at Finvisor, my day-to-day, at least when I started, was probably working with 10 to 12 clients a month and helping them understand, “Okay, how did they perform last month? Can they hire a certain number of people? And what’s the plan going forward?”  Yeah, I mean, that’s super helpful. I started life in accounting as well with KPMG, and what attracted me was to essentially have that language of business so that I would be able to understand how a business works and have this confidence of not flying blind, right? That’s really, really cool. So how did you evolve from a CFO into a founder? What was the trigger point for you?  So I was very fortunate. I actually was at a prior firm at one point when I started my career, and they were a little bit like the cobbler with bad shoes, where eventually they decided they had to close shop, and clients were going to be given notice. I, myself, was given notice saying, “Hey, in a week, you’re not going to have a job, Noah.” And so I was really given this moment in life, saying, “Hey, if I enjoy what I’ve been doing, do I think I could do it better than the firm I’d been at?  And do I want to make this leap into being a founder and starting a business?” And so my co-founder and I both talked to each other and said, “Look, we love our clients. We love what we’ve been trying to build. I think we just need to do a little bit of a refresh and restructuring of how this operates.” And so we started our own company. I was very lucky that I started with about, I had about 30 clients and a team of four on day one, which I think is unusual.  Most people in the accounting space start off as a one-person shop, trying to grow from one to two, and having to double their clients or double their size to get there. We were fortunate to have five team members and 30 clients on day one. Originally, our vision was just, “Hey, let’s help with the fractional CFO and the bookkeeping,” but that really evolved over time as we added additional services and really understood where our clients were having problems in their back office.  What are the areas where maybe the insurance brokers they’d been working with weren’t very hands-on and kind of came in once a year? Our clients were asking us, as their CFO, “Hey, can you help us select our health insurance?” And we’re like, “Well, we’re kind of doing the broker’s job. Why don’t we build out our own team?” So that was one of the first verticals we moved into and added by building an insurance brokerage. From there, we kept building, where now not only do you have your CFO and accountant helping you, but you also have them with the ability to go out to market, help you compare quotes, and help get your insurance in place. So you’re essentially expanding the array of virtual services that you’re providing, or fractional services that you’re providing, to your clients?  Correct. Yeah. We really try to own the full back office end to end because I think a lot of people deal with, “Okay, great, I have a bookkeeper, I have a tax accountant, I have an R&D tax provider,” and they’re dealing with four or five different vendors that don’t really communicate. The client is the person playing telephone between the two, and we’re like, “Wait, stop. Why is this the solution?” We should just build a different business where it’s all under the Finvisor umbrella.  It’s all full-time team members who are actually working together on behalf of the client, even if fractionally. Some of our clients only need five hours of a payroll specialist, but they need someone to own that role, and they need that person to be able to talk to their sales tax team because it’s like, “Oh, we hired someone in a new state. Is sales tax applicable there?” And connect those dots because, when you have these disconnected providers, you have a lot of things that can drop because they’re not in people’s field of view.  Yeah, I mean, it’s a great service. If you can get a competent team that will take care of your back office, then you can focus on figuring out message-market fit and then essentially scaling revenue. You don’t have to worry about it, and you don’t have to babysit inexperienced people that maybe you can afford to hire, but who would not be able to own the job.  Yeah, exactly. I mean, it’s kind of the, “Do you want to…” You know, I think at least when we started in 2014, there was more of a generalist bookkeeper. That’s kind of the typical solution people went with. Nothing against that, but it’s kind of nice to have dedicated specialists in the different back-office areas that you need. I mean, bookkeepers are great.  They’re usually not your best payroll and HR people. They’re not thinking about California final-paycheck laws, or whether you need to offer a 401(k) if you hire someone in California. Whereas, if you have someone whose entire job is payroll and HR, and you need Finvisor to help run your payroll, they’re going to be thinking about those edge cases and helping you along so that you can just build your business, get to the next milestone, and not worry about tripping yourself up because of compliance, taxes, or a lack of visibility in your reporting. Yeah, that’s great peace of mind. So this podcast is about frameworks, and I wonder, what is your framework? How do you help your clients, or how do you figure things out? What have you developed? We’re about 400 frameworks in, so I’m looking for something unique that helps you and is easy to explain—three to five steps maximum.  Yeah. I mean, one of the ones that comes to mind for us is what we’ve really called the Adjacent Extension Framework. So, first, do really good work and earn your client's trust in one area. Makes it easy for them to approach you.Share on X For us, it’s historically been accounting. People think, “Great, get my books put together.” But for us, it’s really about creating a relationship and earning the client’s trust.  Then, as step two, listen for the other problems they’re having. What are the adjacent problems they’re asking you to solve? And then for us, what we’ve really done is double down in those other areas by building specialists in those verticals. Once you’ve earned the client’s trust, if you’re doing their accounting and all of a sudden they’re struggling with invoicing or collections, you can say, “Hey, we can also help you with accounts receivable and collection efforts because we see your AR balance increasing on your financial statements.” At that point, they’re already thinking, “Great, I like working with this person.  Let’s give their team a try and help us solve another problem.” So, for us, it’s really been about finding those adjacent problems, building a team that specializes in them, and then connecting the client with the right expert. The last piece that’s really coming to market now is using technology to empower the team. Historically, a lot of our value came from having experts who could handle the edge cases or the gray areas between payroll, accounting, taxes, and sales tax. Now, with technology, you can also build the data infrastructure to highlight what’s happening for the client while helping guide the team as they manage those clients.  Love it. So what I’m hearing is, number one—or maybe even number zero—is do a great job, right?  The trust.  Okay. So that’s maybe another way of saying it: earn the trust. But is doing a good job enough to earn that trust, or is there more to it?  I mean, I think in any service business, you want to be proactive. A lot of bookkeepers, accountants, and even legal professionals are usually waiting for the client to ask a question before providing an answer. I think the goal should be to think ahead for the client and proactively provide guidance. That came naturally for us because we sit in the fractional CFO seat.Share on X  But even if you’re just doing bookkeeping, you can still catch these things for clients and help them out. Or if you’re selling P&C insurance and helping clients with their general liability coverage, you can think about what other types of coverage they may need. So I’d say the more proactive you can be, the better. The other thing is meeting clients where they already are.  For us, a lot of our clients are on Slack, so we connect with them on Slack. We chat with them as if we were full-time employees because we don’t want the experience to feel different. We don’t want you to feel like you’re emailing a generic support inbox and not knowing when someone is going to get back to you. If you only need fractional-level support, it shouldn’t feel like you’re getting fractional value or a fractional level of communication.  I love it. So you actually own the function inside the organization, so it feels like you’re part of the team, or your people are part of their team. So that builds the trust. So, do a great job, or earn the trust, number one. Number two, build the relationship. Number three, listen to other problems that they might have. Number four, connect them to other specialists. And number five, empower the team with technology.  Yeah. That’s a lot of it. I mean, as an advisor, we’ve grown… I mean, 60% of our growth comes from client referrals. So I think you know you’re doing something right if clients are recommending you to their friends and network. And so hopefully, if someone’s listening to this and you’re not getting referrals, you should be thinking about, “How do we either create more trust for our clients to be referring us, or how do we become more top of mind when clients are having these conversations?”  That’s great. So 60% of your growth comes from referrals. What’s the other 40%? How do you drive growth? What drives growth for you? What’s the other way to drive growth besides referrals?  Yeah. I mean, I think it’s also being connected with the ecosystem that you’re in. In our space, there are a lot of technology partners. Think about Xero, which is an accounting software, QuickBooks Online, NetSuite, payroll software like Rippling, Bill.com. They all have accounting partnerships, and the more you can build with them and grow your team alongside them, clients will reach out to them and say, “Hey, do you have someone who can help us set up Bill.com or help us set up Rippling?  We don’t have a payroll team to do our state tax registrations.” So we’ve seen a lot of good momentum as our software partners start sending us clients to help us grow. I think the other area is trying to figure out where you can have partnerships that will do introductions. We’ve been very fortunate in partnering with a number of VCs. Obviously, the VCs have worked with us because we’re on the board, or we had a mutual client. A lot of them will start to build partnership channels, and it’s a great opportunity.  They’ll say, “We just invested in this company, and you should go talk to Noah’s team to help with your accounting or your fractional CFO.” So it’s really about finding those tangential operators or entities that complement whatever you’re doing.  So are these primarily personal relationships that need to scale, or do you have a way to scale this across other people in your organization—this ability to develop partners? Or is it mainly you?  It depends on the role. A lot of our fractional CFOs on the team continue to build relationships. I would say probably 40% of our new clients come through a channel that’s not through me. There’ll be other people on our team who have built relationships with another VC or another software company. I think one of the key things we’ve always focused on is hiring people who are very, I would say “doers” might be the wrong word, but people who can self-manage and be project managers.  If you find the right people who can take a step back and look at the bigger picture, I mean, sometimes people come to Finvisor and they don’t realize that we ourselves are a business. Yes, you’re doing accounting like you were in-house and getting the books closed, but if you do good work and you realize clients are having problems, you have to think, “Hey, how can I help clients more and also help Finvisor create a win-win?” A lot of times, when we’re hiring, we’re trying to find people who have that type of drive to continue building and helping us internally, and not just do one part of the puzzle they’re responsible for. That might not be the most direct answer, but I would say a lot of it is hiring—making sure it's not just me leading the growth, but me building a team that can help lead the growth outside of just me.Share on X  Yeah. So how do you share the context so that your team members can connect the dots as well as you can? What’s your approach to that?  There’s a couple of ways we’ve done it. One way is we use a note-taker that then feeds into our CRM. For all client communication, whether they meet with us on Zoom or Google Meet, the transcripts are put into a centralized hub for us. It also connects to our CRM in terms of what we’re doing for the clients. At any point in time, someone can ask, “Hey, what’s going on with this client?” They can understand, “Great, this is what the payroll team talked to them about this week.  This is what the CFO team talked to them about last month. These are the problems they’ve been bringing up.” So we can capture that information without it having to be provided orally every single time, and without having to rely on a chat or an email to the team. There are some moments when it’s useful to give the team a larger update, but in general, it’s good to figure out a way to capture the essence of what you’re doing for your clients so that the team can then, in an AI chat-specific way, talk through, “Hey, great, what’s going on with this client? What are their needs? What has changed in the last six months? Who’s working on the client?”  I’ll have a VC that we’re talking to say, “Oh, we’re looking to invest in the CPG space and this type of vertical. Do you have any clients?” We’re at a point now where I don’t know every client. I usually have an idea about most clients, but there are definitely clients where I don’t know everything that’s happened in the last six months because I don’t talk to all 200 clients.  But I can go to our central hub to gain that information and understand, “Okay, great, which client is looking to fundraise and might want to be connected to this VC?” It’s a nice way to connect the dots. They’re looking to invest. The client is looking to raise. We also do brown-bag sessions. We’re a distributed team, so I think you have to be a little more intentional about how you educate the team. We’ll have weekly meetings where we walk through new technology, new changes in what we’re offering, new positioning, and continue educating the team in a more structured format.  The other thing we’ve done to help the team understand what’s going on is to make information as accessible as possible, similar to how we communicate with clients. So the team doesn’t have to log in to a pretty outdated CRM to pull information on a client. It’s either available directly in the Slack conversation or in a more modern tool like Notion, where you can easily search and find the information you want. So basically, you’re managing and harvesting your data and using that to feed people information about how they can develop partnerships. Is that what I’m hearing?  Yeah. And I think a lot of it is also figuring out which playbooks and processes are repeatable, documenting them better, and then educating the team around them. For example, with our fractional CFOs, we want to be in the board meeting. If we can be in the board meeting, A, we can help clients answer questions about their finances more easily, and B, it’s good to have visibility into what the board is saying about the business and where they want to go.  Then, obviously, the VCs are going to say, “Oh, great, this is Ian at Finvisor.” If he reaches out to me about a partnership, they’re going to have a better understanding of what we do because they’ve been in the room with us—or they’ve been in a virtual or in-person boardroom with us.  So you’re basically sharing the playbook so that they have a better understanding of what they can refer you for. Correct. Yeah.  So, switching gears here, Noah, what’s one thing that you’re trying to actively figure out in your business right now?  I mean, the question everyone is trying to figure out, at least in my space, is how they’re going to use AI in some fashion. That’s the kind of million-dollar question everyone keeps talking about—AI in accounting, AI in finance. Right now, we’re really structured in how we’re trying to use it and apply it. But the question I have is, what’s the next year going to look like? What’s five years going to look like as this technology gets more legs and more trust behind it? We’re pretty intentional about what we’re building and how we’re using some of the newer technology with AI. But I think there’s a lot that, at least for me, you have to continue to iterate. The world today feels different than it did three months ago. I’d say for most of Finvisor’s history—and this has been 12 years—it hasn’t felt like that, where a year later things might feel marginally different because we’re maybe 20% bigger or whatever might have happened.  Now, I think there’s a lot more excitement and unknown around technology and how it can either make people more efficient or help highlight and surface better issues that clients need to talk through. But I also feel like we’re in a moment where everyone’s trying to throw AI into every technology. So we're also trying to stay true to who we are, which is people first, relationships first—technology powering us, not being the solution.Share on X  So as you’re scaling AI to improve the information that your people have, your CFOs have, that presumably is going to lead to people doing less of the mechanical, repeatable tasks and more of the judgment tasks. So how do you scale judgment as you’re scaling the impact with AI?  On our side, I think it’s A, trying to organize and structure the data coming in. B, trying to create tooling that isn’t unique to one client but is built in a way that can be customized for each customer. A lot of the firms I talk to that are in the Finvisor space just take a blanket approach—turn Claude on for every fractional CFO, let them connect it to QuickBooks, and try to figure out their own playbooks.  That’s not how we’ve ever run the business. We don’t just hire accountants and let them run the accounting and see how the output turns out. We’re more focused on figuring out what is actually useful for review. Right now, I think AI has been most helpful around quality. It can definitely check that things are consistent and make sure edge cases are being caught.  I think we’re going to get to a future state where it’s not only making sure quality is at the 95th percentile of confidence, but also giving visibility into metrics like CAC, LTV, and churn—things that would normally take longer to pull together. Your fractional CFO might currently spend hours reviewing Stripe data or Shopify data to come to a conclusion. AI can cut out maybe 40% of that data-cleanup layer, where it’s like, “Okay, now they have the tools to dig in and understand what the underlying problem is,” instead of spending so much time cleaning up the data and getting everything organized.  So currently, at least my thesis is that it’s going to allow us to manage more clients because some of the day-to-day—I don’t want to call it busy work—but the work you have to do before you get to the exciting parts of the job will become more automated and less manual, like pulling data out of Stripe, Shopify, your CRM, or NetSuite.  So does that mean you’ll have a different type of people, maybe higher-level thinkers? Or do you think you can elevate your current team to that level?  Yeah. I think you’re… Sorry, I know I was originally answering this through the fractional CFO lens. Most of our fractional CFOs are already at the top of that organizational pyramid. For them, it’s really about helping them have cleaner data, better visibility into the actions they need to take, and better insight into what they should be reviewing and discussing with the client.  If I think more broadly about the back-office finance team, I do think a lot of the more generalist staff accountant and AP specialist roles won’t be spending as much time on the day-to-day blocking and tackling. If a client has 1,000 transactions a month flowing through their bank and credit cards, historically that accountant would sit in QuickBooks Online clicking “Okay, okay, okay,” reviewing every transaction and coding it. Eighty percent of those transactions will simply be coded automatically in real time as they come in. That leaves them to focus on the 20% that actually requires human judgment.  For me, the question is, can we continue to empower those people to be more impactful with that 20%? Are they the right people for that 20%? We’ve always tried to hire people who are proactive and broader thinkers, so I think we have the right team to step into that. If we’d built a traditional BPO model with an outsourced accounting team made up of people who were really just coding transactions at a basic level, I’d be more worried because getting those people to step up and handle edge cases is difficult.  But that’s not how we’ve historically built Finvisor. We’ve always tried to find people who are a little more… I’d rather hire an A-plus player than a B-player just because there’s some savings in the cost structure. I’d rather have the right people who can perform 80% of the time when they’re at bat than just hire someone because they’re cheaper.  Yeah.  Wrong baseball analogy there, but yeah.  Yeah, I understand. So you have A-plus people. Maybe the people who are doing more bookkeeping-type services—their jobs may become automated—but your A-players are going to have best-in-class information, and they can serve more clients that way.  Yeah. I still think that if you think about the typical accounting structure—if you’re working in-house and you have a bookkeeper and a controller—it’s still helpful. Depending on the size of the company, if you’re a small company, you probably won’t need that bookkeeper.  The controller can handle the edge cases and close the books. But at a certain scale, you’ll still want that junior resource supporting the controller so the controller can focus on the higher-level, more strategic work. I think people will simply be able to do more with less if they’re the right person. There will be people who, if they aren’t good at staying on their toes and figuring out edge cases, won’t be the right fit.  AI will probably replace some of those roles. But I think there’s a great opportunity for people who can think more strategically. They don’t have to be a CFO. They can just be a really smart bookkeeper who’s good at handling edge cases. They’ll simply be able to manage three times as many clients as they could when they had to code every single transaction.  Okay. If you had a magic wand and you could fix one thing in your business over the next 12 months, what would it be?  One area that we probably haven’t prioritized enough because of growth is SEO, AEO, and our overall sales build-out. Our paid advertising hasn’t been the strongest part of our business because it hasn’t been the top priority. If I had a magic wand, I’d have someone clean up our SEO and AEO visibility because I know clients love us and we do great work, but I don’t think we’re showing up the way I’d like from an SEO and AEO perspective. So that would be it. Yeah.  Yeah. Yeah. Love it. So, who are your ideal customers? Who do you want knocking on your door? Is it venture-backed companies primarily, or do you also work with private company founders? Who are your sweet-spot customers?  A lot of our clients are going to be in that 5-to-50-employee range, where they don’t need a full-time back office, a full-time accountant, a full-time CFO, or a full-time payroll specialist, but they need someone to own those roles. That way, we can put together the right Finvisor team to support them. We’ve intentionally made ourselves pretty modular, so while the largest group of our clients is in the tech VC world, we also have a lot of SMBs—law firms, beauty businesses, and other professional services businesses.  I would say that, if you looked at the Finvisor client base as a whole, you’d probably see a lot of startups. But we’re also starting to see more SMBs and more traditional businesses that don’t have VC funding but still need help with their accounting, bookkeeping, and modernizing their back office. So it’s a bit of both. Most of our clients are going to be in that 10-to-50- or 100-employee range, where they’re complex enough that they care about their financials and want to understand what they spent last month, where they’re going, and how they’re going to get there.  Earlier-stage companies are sometimes just a little too early. If you’re a one- or two-person company with just an idea, there’s a reason people think about their financials on more of a cash basis. They can think about the five clients they’re working with. Their bank balance ties pretty closely to their financials. There’s not a huge difference between the two when you’re a sole proprietor.  But as you start to evolve, that’s where Finvisor can provide more value. For all of our clients, we do accrual accounting, so we’re recognizing your revenue and your costs over the life of the service. As you start to grow and build, that’s really helpful. Obviously, if you’re at day one, it’s less impactful because you’re living more day to day, week to week, and month to month.  Steve Preda: Okay. So if we have those kinds of companies—which we do among our listeners—and they hear about this and want to fix their back office and outsource it to a reliable partner who can help them own those functions and give them good advice, what’s the best entry point? Where should they go, and how can they connect with you personally as well?  Yeah. hello@finvisor.com comes to me and the sales team. There’s probably a 95% chance you’ll talk to me if you reach out because I still love connecting with most new businesses that come through the door. The other area I wanted to call out that could be helpful for businesses is PEOs. PEOs are great, but I think at some point clients need to graduate from the PEO, and Finvisor is uniquely positioned to be both your insurance broker—helping you quote large-group plans—and your payroll and HR team to help you leave the PEO.  For a lot of our clients, once they pass that 100-employee mark, it’s like, “Great, we now qualify for a large-group plan,” which might have better rates than what they’re getting through the PEO. They just don’t have the team or bandwidth to get off the PEO. We’ll come alongside those larger companies and say, “Great, let’s quote a large-group plan for you. We’ll also put together a transition plan to register you in the 20 states where your employees are currently located.  We’ll make sure you get your workers’ compensation and employment practices liability insurance in place so there’s really no difference—apples to apples—from being in the PEO to running your own payroll.” We help with that transition because I’m always surprised to see companies with hundreds of employees still on a PEO, where the savings could be in the hundreds of thousands of dollars if they left. They just don’t have the internal team because they’ve always been on a PEO. They’ve never had to do state registrations, so they don’t know how to do them. Because of that, they’re usually not looking for an alternative path to get off that structure. We can at least review it with them and help them out if it’s a good fit. And just to remind our listeners what a PEO is, in case they don’t know.  Oh, sorry. Yeah. A PEO is a Professional Employer Organization. If you’ve heard of companies like TriNet or Justworks, they’re PEOs. In the health insurance space, there are four primary ways you can get health insurance. Most companies start with small-group plans in the early days because they’re state-mandated. For example, in California, if you’re under 100 employees, the rates my company gets would be the same rates Steve’s company gets if we’re both under 100 employees and we’re asking Blue Shield for a quote from the same ZIP code. That’s small-group insurance.  Then there’s level-funded, where carriers quote specifically based on your employee group. There’s large-group, which is somewhat similar but designed for larger organizations. Then there’s the PEO. Let’s say you’re a 10-person company. You don’t have enough employees to qualify for large-group health insurance, which is usually discounted because the risk is spread across hundreds of employees. The PEO says, “We’ll employ your team. Instead of you directly employing 10 people and buying health insurance for only those 10 people, we’ll employ your team and give you rates based on the 10,000 employees we already have.” PEOs are really popular in places like California and New York, where health insurance is very expensive.  But once you get above about 100 employees, you can usually qualify for your own large-group rates, which are similar to what the PEO is getting. The difference is that the PEO is generally marking up those rates because they need to make a margin on the plan. You can often get those rates directly yourself.  Yeah. That makes perfect sense. Okay. So if you’re listening to this and you’re building a venture-backed startup, or you’re the founder of a professional services firm, a law firm, or another small business with 10 to 100 employees, and you don’t yet have the budget—or maybe you simply don’t need—a full-time CFO, insurance advisor, HR leader, and other functional specialists, then reach out to Noah and Finvisor.  Check out what they have to offer and see what services might be a good fit for your business. Thanks, Noah, for coming on the show and sharing your expertise. It’s fascinating to see how this field is evolving, how you’re tapping into technology, and how you’re focusing on the highest-quality CFOs to help your clients. If you enjoyed this conversation, stay tuned.  Follow us on YouTube, Apple Podcasts, or wherever you get your podcasts. Make sure you don’t miss an episode. Every week, we bring you exciting entrepreneurs and their best management frameworks. Thanks for coming, Noah, and thanks for listening.  Thanks, Steve. Appreciate it. Important Links: Noah's LinkedIn Noah's  website Noah's email: hello@finvisor.com

In this episode, Susan Mullaney, Chief Operating Officer at Blue Shield of California, discusses how stronger payer-provider partnerships, AI, value-based care, and pharmacy innovation can improve health outcomes, lower costs, and reshape care delivery for the future.

In this episode, Susan Mullaney, Chief Operating Officer at Blue Shield of California, discusses how stronger payer-provider partnerships, AI, value-based care, and pharmacy innovation can improve health outcomes, lower costs, and reshape care delivery for the future.

Emily McAndrews from Anthem Blue Cross and Blue Shield joins us for a conversation about home and vehicle modifications and how thoughtful changes can help older adults stay safer, more independent, and more comfortable. We talk about the parts of daily life that can become harder over time, from moving through the house to getting in and out of the car, and why planning ahead can bring relief before a crisis happens. We also reflect on legacy and share ways families can spot scams during vulnerable seasons.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

What a week for the Minnesota Gophers! Both Mark Coyle and Dawn Plitzuweit have new contract extensions. The Gophers have finally scheduled games with St. Thomas in both men's and woman's basketball. Williams Arena, at least by name, is no more. Welcome to “The Barn by Blue Cross and Blue Shield of Minnesota”. Ross Brendel and Manny Hill are back for Gophers 101!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

What a week for the Minnesota Gophers! Both Mark Coyle and Dawn Plitzuweit have new contract extensions. The Gophers have finally scheduled games with St. Thomas in both men's and woman's basketball. Williams Arena, at least by name, is no more. Welcome to “The Barn by Blue Cross and Blue Shield of Minnesota”. Ross Brendel and Manny Hill are back for Gophers 101!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Raine shares about her journey as a social worker, including gaining her JD while winning runner up in the Ms. Hawaii pageant, starting as a frontline social worker in a hospital setting, to ultimately leading a social work team while building programs around the CalAIM initiative at Blue Shield California. Raine closes out the show discussing her next chapter and the start of her own consulting firm.

On today's episode of the America's Work Force Union Podcast, we are covering a massive amount of ground—from the halls of the Ohio Statehouse to the structural healthcare barriers facing union moms across the country. Segment 1: Ohio Labor Under Fire with Melissa Cropper Melissa Cropper, President of the Ohio Federation of Teachers (OFT) and Secretary-Treasurer of the Ohio AFL-CIO, joins the show to unpack three simultaneous attacks on Ohio workers and the democratic process: The Midnight Pension Raid: How a 1 a.m. budget amendment stripped elected educators of control over the State Teachers Retirement System (STRS) board, and the legal battle (plus House Bill 719) fighting to reverse it. HB 698 & Higher Ed Restrictions: How this compliance mechanism is weaponizing state funding to restrict collective bargaining and aggressively police DEI roles. Union Busting in the Stacks: A look at the Columbus Metropolitan Library administration's aggressive anti-union campaign ahead of a critical mid-June election—and details on the June 7 community rally at Franklin Park. Segment 2: Breaking the Silence on Perinatal Mental Health For Mental Health Awareness Month, we sit down with Merrilee Logue, Executive Director of the Blue Cross and Blue Shield's National Labor Office, and Arin McClune, Clinical Quality Senior Program Manager with the Blue Cross Blue Shield Association National, to tackle the leading cause of pregnancy-related deaths in America: maternal mental health disorders. The Stark Reality: Up to 20% of women experience these disorders, yet fewer than 20% are ever screened. The Racial Equity Gap: Why women of color are twice as likely to suffer from maternal mental health challenges but only half as likely to receive care. The Union Solution: With 68% of mothers with young children in the workforce, find out how labor leaders can advocate for remote work, flexible scheduling, and integrated mental health benefits to build a culture of solidarity and support. Go Behind the Scenes of the Labor Movement: Every victory starts with workers standing together. Subscribe to the America's Work Force Union Podcast to get the latest interviews with the leaders, organizers, and advocates building true worker power. If you or someone you know is struggling with mental health or in crisis, help is available. Call or text 988 to reach the Suicide & Crisis Lifeline.

In this episode, Dr. Tunde Sotunde, President and CEO of Blue Cross and Blue Shield of North Carolina & CuraCor Solutions, discusses the drivers of rising healthcare costs, the importance of value-based care and whole-person health, and how innovative programs and partnerships are improving access, affordability, and outcomes across the state.

Kristen Berglin, Senior Clinical Consultant for Regence BlueShield was honored as a Community Hero as part of the Behind the Shield series, a partnership between Regence BlueShield and Sounders FC. The content series, profiling both Sounders players and community leaders, celebrates humans showing extraordinary grit and determination in their everyday lives. Kristen has a background in clinical nursing and health care management, having worked as an RN on a busy medical-surgical and pediatrics unit before transitioning to nurse case management. Andrew Thomas is this episode’s featured player for Behind the Shield. Andrew discusses his development as a kid in the Watford Academy, his decision to play and attend Stanford University, and the guidance he’s received from coaches and mentors at the Sounders. See omnystudio.com/listener for privacy information.

367: Activate Good - Leading with Fearlessness and Purpose (Marjorie Maas)Episode SummaryNonprofit leaders carry the weight of the next grant, the next major gift, the next board meeting - and that constant worry doesn't make the work more productive, it just makes it heavier. In Episode #367, Patton talks with Marjorie Maas, CEO of Share Good, based in Omaha, NE, about what it actually looks like to lead with fearlessness when stakes are high and resources are tight. Marjorie leads a national technology and community-building nonprofit that helps cities position generosity in one place - now active in nine markets from Charlotte to Detroit to Omaha and beyond - and she shares the mindset shifts that have shaped both her organization's growth and her own “patchwork quilt” career path. She unpacks the difference between scarcity thinking and an abundance mindset rooted in logical thinking rather than blind faith, why emerging leaders shouldn't talk themselves out of their passion, and why governance fluency is something professionals should be building early — not waiting for an executive seat to learn. Listeners will walk away with a practical framework for leading through uncertainty, language for coaching the next generation of nonprofit professionals, and a clearer sense of how to keep moving forward when fear shows up.About MarjorieMarjorie Maas is the CEO of Share Good, a national technology and community-building nonprofit that connects passion to action in hyperlocal communities by giving nonprofits a shared megaphone to tell donors and volunteers what they need. She leads the growth and expansion of Share Good's national footprint and supports the SHARE Family of community partners across the country. Before joining Share Good in December 2022, Marjorie launched and directed SHARE Omaha, building a platform that promotes more than 700 nonprofits across the Greater Omaha and Council Bluffs metro, and earlier created and implemented the corporate social responsibility strategy for Blue Cross and Blue Shield of Nebraska, redesigning their corporate giving and volunteerism programs. Her 20-plus-year career spans arts marketing, statewide grantmaking, and CSR — a winding path she calls a “patchwork quilt” and credits as the very thing that prepared her for the work she does now.ResourcesConnect with Marjorie on LinkedInLearn more about Share Good at ShareGoodUSA.org — visit the About Us page for community case studies and video testimonialsConcept referenced: Ikigai — the Japanese framework for the overlap of mission, vocation, profession, and passionBook recommendation: The Dip by Seth Godin — a quick, essential read on knowing when to push through a setback and when to walk awayAlso mentioned: Mindset by Carol Dweck (Patton's reference on growth vs. fixed mindset)Follow Your Path to Nonprofit Leadership — and please leave a review!Learn more about the leadership resources at Armstrong McGuire — ArmstrongMcGuire.com

In this episode, Dr. Tunde Sotunde, President and CEO of Blue Cross and Blue Shield of North Carolina & CuraCor Solutions, discusses the drivers of rising healthcare costs, the importance of value-based care and whole-person health, and how innovative programs and partnerships are improving access, affordability, and outcomes across the state.

This episode recorded live at the Becker's Spring 2026 Payer Issues Roundtable features Ellen Sexton, Executive Vice President and Chief Growth Officer, Blue Shield of California. She discusses tackling healthcare affordability, scaling virtual care and digital tools like Virtual Blue, and using AI and data-driven strategies to improve access, reduce ER utilization, and enhance member experience while maintaining trust and quality.In collaboration with Hippocratic AI.

In this episode, Tim Lieb, Senior Vice President of Commercial Markets at Blue Shield of California, discusses the three-year impact of Virtual Blue, including lower costs, reduced ER utilization, improved access to care, and how virtual first models are reshaping employer and individual health plans.

In this episode, Tim Lieb, Senior Vice President of Commercial Markets at Blue Shield of California, discusses the three-year impact of Virtual Blue, including lower costs, reduced ER utilization, improved access to care, and how virtual first models are reshaping employer and individual health plans.

A blizzard, a body in the snow, and a case that's divided a town—and the internet. In this episode, we break down the mysterious death of Boston police officer John O'Keefe and the explosive murder trials of Karen Read, where accusations of drunken rage collide with claims of a massive police cover-up. What really happened on Fairview Road… and who, if anyone, is telling the truth? Merch and more: www.badmagicproductions.com  Timesuck Discord! https://discord.gg/tqzH89v Want to join the Cult of the Curious PrivateFacebook Group? Go directly to Facebook and search for "Cult of the Curious" to locate whatever happens to be our most current page :) For all merch-related questions/problems: store@badmagicproductions.com (copy and paste) Please rate and subscribe on Apple Podcasts and elsewhere and follow the suck on social media!! @timesuckpodcast on IG and http://www.facebook.com/timesuckpodcast Wanna become a Space Lizard? Click here: https://www.patreon.com/timesuckpodcast. Sign up through Patreon, and for $5 a month, you get access to the entire Secret Suck catalog (295 episodes) PLUS the entire catalog of Timesuck, AD FREE. You'll also get 20% off of all regular Timesuck merch PLUS access to exclusive Space Lizard merch. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode, Mike Stuart, President and CEO of Blue Shield of California, shares how his finance and provider background shapes a systems approach to improving health outcomes, strengthening provider partnerships, and addressing rising healthcare costs. He also discusses the growing impact of chronic disease and why collaboration across the healthcare ecosystem is critical to making care more affordable and accessible.

In this episode, Mike Stuart, President and CEO of Blue Shield of California, shares how his finance and provider background shapes a systems approach to improving health outcomes, strengthening provider partnerships, and addressing rising healthcare costs. He also discusses the growing impact of chronic disease and why collaboration across the healthcare ecosystem is critical to making care more affordable and accessible.

Payers are operating at the center of converging pressures: rising costs, accelerating utilization, heightened public scrutiny, and a wave of CMS reforms that are reshaping expectations around transparency, interoperability, prior authorization, and accountability. Medicare Advantage has become the front line for these shifts—exposing tensions between regulatory oversight, margin compression, and growing demands for better member and provider experiences. Against this backdrop, health plans are being asked to do more with less—while proving real value through measurable outcomes, trust, and access. In this episode, recorded in February at the ViVE digital health and healthcare innovation conference, Rae Woods moderates a conversation with payer and technology leaders on how AI and data are being used to reduce payer–provider friction, rethink prior authorization, and improve the member experience—without losing sight of accountability or return on investment. Panelists include: Ali Khan, MD, Chief Medical Officer, Medicare at Aetna (a CVS company) Kay Judge, MD, Chief Medical Officer, Medicare at Blue Shield of California Syed Mohiuddin, MD, Head of Healthcare, Anthropic We're here to help: Podcast | 276: The AI gold rush is changing how humans (and clinicians) make decisions Research | How to succeed using AI: Lessons from 4 leading organizations Expert Insight | Inside CMS' final rule changes for 2026 Learn more about the ViVE conference Register today for the 2026 Advisory Board Summit in Washington, D.C. Updating COVID-19 management protocols may help address long-term impacts A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

What happens when a high-performing leader hits a wall they never saw coming? Kimberly Arnold knows firsthand. After she spent decades leading large-scale transformations at PwC, Salesforce, and Blue Shield of California, a perfect storm of personal and professional pressures sent her on a 15-week stress-induced medical leave. That experience opened her eyes to what most leadership development overlooks: the powerful role your nervous system plays in how you show up under pressure. Now, as founder of the Mastering Pressure System™, she teaches leaders simple, body-based practices that restore composure in seconds.Kimberly reveals the neuroscience behind why your body reacts before your mind even catches up—and why that matters for every decision you make. You'll hear how she walked into a room of 12 distraught stakeholders at Salesforce and used a quick physical reset to stay open, curious, and collaborative when blame was flying in every direction. She shares her PACE framework (Pause, Acknowledge, Center, Engage) and practical techniques you can use in minutes to interrupt stress reactions, prevent cortisol buildup, and lead from a place of clarity rather than reactivity.Kimberly helps leaders and teams master their performance under high pressure without compromising their relationships or their health. As founder of the Mastering Pressure System™, she teaches repeatable tools leaders apply to interrupt reactive patterns and reset in minutes. Drawing on decades of leadership at PwC, Salesforce, and Blue Shield of California, plus 15 years as a certified somatic teacher, Kimberly brings lived experience to turning high-pressure moments into clear thinking, sound judgment, and collaborative solutions. You'll discover: Why your body signals danger before your mind doesHow the PACE framework interrupts stress in secondsWhat pushing harder actually costs your leadership credibilityThe simple posture shift that boosts your confidenceHow a long exhale can prevent cortisol from building up Connect with Kimberly Arnold on Social MediaLinkedIn YouTube Kimberly's ResourcesResilient Reset   Newsletter   Meet with Kimberly   Check out all the episodesLeave a review on Apple PodcastsConnect with Meredith on LinkedIn

V tejto časti sa pozrieme na systematický prehľad o vapingu a rakovine, trochu porozprávame o prebiehajúcej misii Artemis II a ešte preskúmame ako je to s blue shieldom. Zdroje The carcinogenicity of e-cigarettes: a qualitative risk assessment https://www.nasa.gov/mission/artemis-ii/ https://en.wikipedia.org/wiki/Artemis_II https://www.nasa.gov/missions/artemis-ii/arow/ Blue shield pseudovedu nepropagujeme tak zdroje nebudu. Image by Nasa

On this episode of Fostering Change, Rob Scheer is joined by leaders and advocates working directly with young people transitioning out of foster care: Sarah Baumgartner of Anthem Blue Cross and Blue Shield, Brian Robinson of Kids' Voice of Indiana, and Princess Martinez Casanova, a foster youth leader and member of the Youth Impact Board at Kids' Voice.For Comfort Cases, partnerships have always been central to the mission. The organization's first corporate Packing Parties began in Indiana with Elevance Health and Anthem Blue Cross and Blue Shield in 2008. Since then, Anthem has remained a longstanding partner, demonstrating an ongoing commitment to corporate responsibility and to supporting children and youth experiencing foster care.Today, that commitment continues through collaboration with Kids' Voice of Indiana, working together to raise the voice of youth transitioning out of foster care by creating resources, providing transition support, and expanding opportunities for education and career advancement.As Foster Care Awareness Month approaches in May, this conversation highlights the importance of recognizing the needs of young people preparing to age out of the system — and the role partnerships play in helping them build strong, independent futures.Episode HighlightsThe importance of supporting youth as they transition out of foster careHow corporate partnerships can expand resources and opportunities for young peopleThe role of Kids' Voice of Indiana in advocating for older youth and preparing them for independenceThe impact of mentorship, advocacy, and youth voice in shaping better outcomesReal-life success stories, including pathways to higher education and career developmentAbout the GuestsSarah Baumgartner is the Older Youth Case Manager on the Foster Care Team at Anthem Indiana Behavioral Health Services. She brings more than 20 years of experience in mental health, including residential treatment, school-based counseling, and private practice. Her work focuses on supporting older youth as they transition from foster care to adulthood.Brian Robinson is the Director of Older Youth Initiatives for Kids' Voice of Indiana. With more than 25 years of experience working with children and families, including serving as a Guardian ad Litem since the early 1990s, he centers his work on preparing older youth in foster care for independence.Princess Martinez Casanova is a bilingual education advocate, foster youth leader, and member of the Youth Impact Board at Kids' Voice of Indiana. After immigrating from Mexico as a teenager and entering foster care at fourteen, she is now attending DePauw University on a full scholarship, studying Education Studies and Spanish, and advocating for foster youth and immigrant communities.About the WorkThe collaboration between Anthem Blue Cross and Blue Shield and Kids' Voice focuses on:Transition support for youth aging out of foster careElevating youth voice and advocacyExpanding access to education and career pathwaysThese efforts reflect a shared commitment to helping young people move from foster care into adulthood with the tools, support, and opportunities they need to succeed.Connect & Learn MoreKids' Voice of Indiana: https://kidsvoicein.org/Facebook: @AnthemMedicaidInstagram: @anthembcbsX (Twitter): @AnthemBCBSLinkedIn: Anthem Blue Cross Blue Shield – Medicaid Health Plans

Doc Reed has worn many hats in his time as a business owner. From being one of the founders of HUK adn NOMAD hunting and fishing apparel, where he took these brands to more than $50 million in sales in just four years, to to being an auditor for Blue Cross and Blue Shield to his current venture as president of Marsh Hen Mill out of Edisto Island, SC. Marsh Hen Mill is revitalizing the old trade of stone ground grits and heirloom rice in the low country of South Carolina.  Doc shares with us the challenges of the appareal business and his transition into Marsh Hen Mill as President. He goes on to share how his faith has been instrimental to his companies and their success. 

Send us Fan MailLisa Davis is a technology executive who has served as CIO and tech leader for some of the world's most complex organizations, including Intel, Blue Shield of California, the U.S. Marshals Service, and the Department of Defense. She is now focused on shaping the next generation of leaders and advocating for women and diverse talent in STEM through her board work, executive coaching, and her forthcoming book, The Only Woman in the Room: How to Win in a Workplace Still Built for Men.In this episode, Lisa draws on 30+ years leading technology at the highest levels of government and enterprise to make the case that the future of AI depends on who gets to build it, and as long as women remain locked out of those rooms, we are getting it dangerously wrong.In this conversation, we discuss:Why women's representation in STEM has fallen from 34% in the mid-1980s to 22% today, and why that decline is a crisis for the future of AI, not just the workplace.Why the real risk isn't the technology itself but the leadership teams making AI decisions without diverse voices at the table.The structural systems that were never designed for women to thrive, and why redesigning them is a business imperative, not a social favor.Why current corporate layoffs are being falsely attributed to AI, and what leaders need to start saying out loud.Why girls begin dropping out of math and science as early as middle school, how cultural norms around "bossiness" suppress leadership potential, and what parents and organizations can do to intervene earlier.What Lisa says women who finally reach the executive table must do differently, and why most don't.Resources:Subscribe to the AI & The Future of Work NewsletterConnect with Lisa on LinkedIn or visit her website to learn more about her book.AI fun fact articleOn how to navigate life transitions with Bruce Feiler, award-winning author and popular TEDx speaker 

It’s like something out of Indiana Jones - art curators scrambling to save priceless artworks as bombs rain down. When it comes to casualties of war, the most confronting are human, but what about the cultural soul of a nation, with collections valued into the billions also being in the firing line? Find out more about The Front podcast here. You can read about this story and more on The Australian's website or on The Australian’s app. The weekend edition of The Front is co-produced by Claire Harvey and Jasper Leak. The host is Claire Harvey. Audio production and editing by Jasper Leak who also composed our theme.See omnystudio.com/listener for privacy information.

I'm excited to share the 45th episode of This is Ag! featuring Chris Devers, CEO of Rancho Cielo, who is no stranger to transforming lives and communities. Rancho Cielo, a nonprofit in Salinas, California, provides at-risk youth with education, mentorship, and hands-on training in agriculture, culinary arts, automotive, and construction, giving them the tools to build practical skills and sustainable careers. Under Chris's leadership, the school has launched groundbreaking initiatives, including the first Future Farmers of America chapter at a charter school, dual enrollment with Hartnell College, and innovative projects like mobile refrigeration units for local organic farmers. Chris's approach puts students first, ensuring their foundational needs are met while connecting them to opportunities that empower them to thrive. Through stories of alumni like Ashley Soto, who went from a work crew member to running her own construction company, and Samuel, who became a hotel engineer and entrepreneur, Chris demonstrates how mentorship, opportunity, and community investment create lasting impact. This conversation highlights why investing in people with empathy, opportunity, and purpose isn't just good for individuals but also strengthens entire communities. Rancho Cielo: https://www.ranchocieloyc.org/ Kirti Mutatkar, President and CEO of UnitedAg.  Reach me at kmutatkar@unitedag.org, www.linkedin.com/in/kirtimutatkar UnitedAg website - www.unitedag.org UnitedAg Health and Wellness Centers - https://www.unitedag.org/health-benefits/united-agricultural-benefit-trust/health-centers/ Episode Contributors - Chris Devers, Kirti Mutatkar, Dave Visaya, Rhianna Macias The episode is also sponsored by Brent Eastman Insurance Services Inc. - https://brenteastman.com Blue Shield of California - https://www.blueshieldca.com Elite Medical - https://www.elitecorpmed.com Gallagher - https://www.ajg.com/ SAIN Medical https://sainmedical.com/ MDI Network - https://www.mdinetworx.com/about-us

Episode Topic: Bridging Gaps, Empowering CommunitiesAI holds immense promise, yet Ketan Paranjape warns the “last mile” remains a formidable barrier. From rural Indiana to India, infrastructure gaps and cultural nuances challenge the scalability of digital health. Explore how we can bridge this divide by prioritizing human kinship and ethical innovation over mere algorithmic speed. Featured Speakers:Dr. Ketan Paranjape, Bioscope AIBukata Hayes, Blue Cross and Blue Shield of MinnesotaEmily Ho, NorthwesternErwin Tan, AARPShelley Kendrick '10 MNA, EcumenRead this episode's recap over on the University of Notre Dame's open online learning community platform, ThinkND: https://go.nd.edu/418575.This podcast is a part of the ThinkND Series titled The Rural Health Revolution. Thanks for listening! The ThinkND Podcast is brought to you by ThinkND, the University of Notre Dame's online learning community. We connect you with videos, podcasts, articles, courses, and other resources to inspire minds and spark conversations on topics that matter to you — everything from faith and politics, to science, technology, and your career. Learn more about ThinkND and register for upcoming live events at think.nd.edu. Join our LinkedIn community for updates, episode clips, and more.

Concern is growing for the large number of UNESCO World Heritage sites in Iran, after the famed Golestan Palace was damaged in bombing over the past few days. Joining Seán is a man from an organisation which seeks to protect sites of cultural heritage in conflict zones.Professor Peter Stone is the President of the Blue Shield and joins to discuss.

In this episode of the podcast, Ross and Jeana discuss a range of topics, from the recent imposition of daylight saving time to the ongoing conflict in Iran. They also delve into the world of finance, discussing the impact of the war on oil prices and the stock market. Additionally, they talk to Paul Markovich, CEO of Blue Shield of California, about the complexities of healthcare pricing and potential solutions. The conversation also touches on a settlement between Live Nation and the Department of Justice, and Jeana shares her experience hosting a special International Women's Day show on KBCO.See omnystudio.com/listener for privacy information.

In this episode, we're joined by Paul Markovich, CEO and president of Blue Shield of California, as he breaks down the complexities of the US healthcare system. He shares his insights on why healthcare is so expensive, citing the profit-driven nature of the industry and the lack of transparency in pricing. Paul also discusses the impact of the Affordable Care Act and the potential solutions, including the Trump administration's efforts to simplify prescription drug distribution. He highlights the need for consumers to have more control over their healthcare costs and the importance of making healthcare more affordable for all Americans.See omnystudio.com/listener for privacy information.

Today's guest is Carey Smith, Former President and CIO of XcelerateHealth and Chief Technology Innovation Officer (CTIO) of Blue Cross and Blue Shield of Minnesota. XcelerateHealth is a health-tech startup and business unit of Blue Cross and Blue Shield of Minnesota, focused on AI-driven digital products to transform healthcare insurance experiences. Carey joins Emerj's Nick Gertsch to discuss how leaders can structure talent and workforce AI so decisions are consistent, reviewable, and aligned with organizational controls. Smith also shares practical steps for tightening decision rights, improving data readiness, and designing workflows where AI accelerates hiring and mobility without increasing risk. This episode is sponsored by Eightfold AI. Learn how brands work with Emerj and other Emerj Media options at go.emerj.com/partner Want to share your AI adoption story with executive peers? Click emerj.com/expert for more information and to be a potential future guest on the 'AI in Business' podcast!

Blue Cross and Blue Shield of Kansas City Welfare v. United States

In this episode, Jennifer Schirmer, VP of Growth and Community Engagement and interim VP of Duals Program Integration at Blue Shield of California Promise Health Plan, breaks down the sweeping Medicaid changes under HR1 and their impact on California's Medi-Cal members. She shares how her team is investing in high touch outreach, community partnerships, and duals integration to help vulnerable populations maintain coverage and access to care amid rising administrative complexity.

What happens when a Wall Street bond analyst, urban planner, freelance filmmaker, and investment banker all become the same person, and that person ends up running healthcare benefits for 215,000 people at the University of California? Laura Tauber didn't follow the rulebook. She followed curiosity. Laura Tauber is the Executive Director of Self-Funded Health Plans at the University of California, Office of the President. She oversees PPO plans, HMO plans, and benefit partnerships with Anthem and Blue Shield for a workforce that spans everything from Nobel laureates to gardeners — active employees, early retirees, and families spread across California and beyond. 60% of that workforce is unionized. 5 of her campuses have no medical center. And 50-60% of total plan spend runs through UC's own health system, meaning she's constantly negotiating with the very hospitals she depends on. It started not in healthcare — but in natural resources. Laura studied environmental policy, nearly became a forester, spent a summer in rural Montana, and realized that wasn't the life for her. She pivoted to urban planning, moved to San Francisco in 1982 in the middle of a recession, couldn't find work, and called a friend in New York who happened to be hiring at a bond insurance company. That one phone call put her in healthcare. She became a healthcare bond analyst — spending years doing deep financial analysis for hospitals, understanding how CFOs and CEOs think, what keeps them up at night, what their numbers actually mean. Then she moved to Blue Shield of California. Then Accenture as a healthcare strategy consultant. Then a stint in investment banking — where her biggest revelation wasn't finance, it was that she hated banking but loved strategy. Then Scan Health Plan. Then Kaiser. And somewhere in the middle of all of it, she took what she calls "a long sabbatical or a midlife crisis" — left healthcare entirely, got a BFA in cinematography, worked freelance for the BBC, worked on a travel show, and worked on a Spike Lee film. Then she came back. And everything clicked. In this conversation, Laura breaks down what it actually takes to make high-stakes benefit decisions across a system this complex — balancing member needs, budget constraints, union contracts, provider negotiations, pharmacy costs, and the constant pressure of doing right by people whose lives depend on the decisions you make. We go deep on: How her background across hospitals, health plans, investment banking, and consulting gives her a different lens when she looks at data — and why that multi-perspective thinking shapes every decision she makes The GLP-1 decision that consumed 18 months of her life — every study, every doctor conversation, every ethical consideration — and the hard call she ultimately made The $2 million hemophilia cure problem and the question underneath it: if a drug pays for itself over time and it's the right thing to do for the member, can you afford not to cover it? Why she still pulls up the raw spreadsheet herself instead of reading the summary — and why that habit has repeatedly led her to insights her own team missed What "making room at the table" actually looks like in practice — and how her first boss at UC gave her the opportunities that shaped everything that followed How she thinks about developing the next generation of leaders: understanding where people want to go, clearing the path for them, and supporting them even when that means helping them leave Why healthcare is fundamentally different from every other corporate environment — and why that emotional dimension is exactly what draws her to it Every detour Laura took — the bond analysis, the urban planning, the film set — gave her a way of thinking about problems that a straight-line career never could have built. This conversation is about what that actually looks like in practice.

Today's conversation will transform your thinking about emotions. Instead of viewing emotions as negative experiences to push away or control, our guest helps us understand them as our body's guidance system, much like a compass that helps us navigate. Fear and anger, often thought of as negative emotions, are the body's survival mechanisms that are designed to protect our lives. You'll discover practical insights on recognizing physical sensations, befriending your feelings, and using emotional intelligence to become a better coach and leader. Want to know more about relating to your own emotions and showing up as your best for your clients? Join us to learn more!Joie Seldon, MA, is the founder of the Emotional Evolution Institute and the author of Emotions: An Owner's Manual. An innovator in emotional intelligence, she is a life and professional success coach and EQ trainer. She has worked with clients at NASA, AT&T, Wells Fargo, Blue Shield, Dolby, and others. Her clients range from tech professionals and healthcare workers to C-suite executives. With 25 years of experience as an actor and acting teacher, 10 years as a somatic psychology therapist, and a lifetime of personal growth engagement, Joie has developed an innovative approach to teaching people how to release limiting behaviors and use their emotions as the powerful guidance system they are meant to be.Show Highlights:Misconceptions, judgments, and misunderstandings about emotionsGrowing the relationship with your emotions, especially fear and anger, by recognizing and tolerating the sensations you experienceOur feelings and thinking have to work together.The message of fear is “pay attention.”The results when people shift their perspective on emotionsDealing with emotions that arise in coaching conversationsUnderstanding the difference between stress tears and sad tearsThe value of taking private time to process your grief and effectively giving others space for their grief and discomfortA coach's job is not to rescue or “fix”; everyone just wants to be seen and heard.Joie's top “Aha moments” with clientsWhat coaches should understand about emotions being used as a compass“Emotions are energy in motion.” (Be curious about emotions.)Joie's key takeaway for listeners: “Emotions are the link between the tangible and intangible. Pay attention to how you feel, and listen to what information emotions give you.

C.B. v. Blue Cross and Blue Shield of

Cara Munnis was wearing an N95 mask while taking care of her daughter with norovirus all night because she had a critical meeting the next day and "I cannot get this thing." She showed up, ran the meeting, and afterward couldn't tell if anyone noticed she was operating on "one brain cell processing everything." Welcome to being a Chief Product Officer and a mom. Here's what most people don't know about the CPO role: it has the shortest tenure of any C-suite position—less than half that of other executives. You're supposed to be "Switzerland," the neutral party among competing stakeholders. But you're constantly telling your C-suite peers—very kindly—why their ideas are going to sink or swim. The real transformation wasn't navigating those politics. It was what happened when Cara's daughter was born seven years ago. "For someone who's led massive technology transformations multiple times, it's very ironic how hard this transition was for me." The evening checkboxes—that sacred 5-8pm window where she prepared for the next day—vanished instantly. It took five years to build a new operating system where she hired without compromise and delegated with her eyes closed. In this conversation, Cara explains why she's "obsessed" with finding the economic denominator, why Conway's Law means your product will mirror your org structure, and why staying close to technology was the best career advice she ever got. After describing her relentless discipline and surgical precision, she deadpans: "I haven't been fired yet, so I dunno, I guess it's okay." This is a masterclass in product leadership that scales, parenting that doesn't apologize, and ruthless prioritization when you're scraping for minutes in your day. Key Takeaways: How to choose the right ladder to climb—make career decisions based on intentionality, not just opportunity or speed How to turn constraints into leadership advantages—use the pressure of working parenthood to force yourself to hire without compromise and delegate with confidence How to stay close to technology in any role—even as a non-technical leader, understanding architecture helps you defend budgets, win deals, and articulate competitive advantages How to shift your communication style as you move into executive roles—listen more, ask questions even when you know the answer, and bring others along instead of leading with your opinion How to design org structures that create better products—use Conway's Law (products mirror internal communication structures) to intentionally build teams that will produce the outcomes you want About the Guest: Cara Munnis is Chief Product Officer at Care Lumen and Operating Partner at Newfire Global Partners, bringing over 15 years of healthcare technology product leadership to organizations navigating the intersection of clinical outcomes and business results. She spent six years at Amwell advancing from Senior Director to VP of Product Management, previously served as Head of Product for Digital Health at Blue Shield of California, and held leadership roles at Iora Health and Best Doctors. With a pre-med degree from College of the Holy Cross and an MBA from Bentley University, Cara is Pragmatic Marketing Certified – Level III and known for her ability to balance strategic product vision with rigorous execution while fostering collaborative team environments. Chapters [Placeholder for Chapters] Guest & Host Links Connect with Laurie McGraw on LinkedIn Connect with Cara Munnis on LinkedIn Connect with Inspiring Women Browse Episodes | LinkedIn | Instagram | Apple | Spotify

Whoo BOY! This week's episode is packed with info and stats. How did the US healthcare system get so expensive and complicated? Is it still better than some form of universal care? Throwing a lot of history and stats at you today, and comparing our model to the healthcare models of some other countries to show that there are other ways. Ways far cheaper for the average citizen that work as well as ours. So... why don't we change? Merch and more: www.badmagicproductions.com Timesuck Discord! https://discord.gg/tqzH89vWant to join the Cult of the Curious PrivateFacebook Group? Go directly to Facebook and search for "Cult of the Curious" to locate whatever happens to be our most current page :)For all merch-related questions/problems: store@badmagicproductions.com (copy and paste)Please rate and subscribe on Apple Podcasts and elsewhere and follow the suck on social media!! @timesuckpodcast on IG and http://www.facebook.com/timesuckpodcastWanna become a Space Lizard? Click here: https://www.patreon.com/timesuckpodcast.Sign up through Patreon, and for $5 a month, you get access to the entire Secret Suck catalog (295 episodes) PLUS the entire catalog of Timesuck, AD FREE. You'll also get 20% off of all regular Timesuck merch PLUS access to exclusive Space Lizard merch. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

On this episode host Fred Goldstein invites Janna Evans, Director of Pharmacy Sales Support at Blue Cross and Blue Shield of Texas, as they continue their rare disease series with a focus on hemophilia and the substantial clinical, financial, and psychosocial burdens it places on patients and families. We discuss how health plans manage high-cost therapies, balance individualized patient needs with access requirements, and navigate prior authorization and step-therapy processes. Janna also highlights the need for better patient-reported outcomes, the day-to-day impact of the disease, and the broader considerations for employers and caregivers within managed care. This activity is supported by an independent medical education grant from Genentech Inc., and Pfizer Inc. AMCP offers CPE for this podcast through December 31, 2026. For additional information and to claim credit, please visit: ⁠The Power of Partnership: Bridging Patients and Payers in Hemophilia Management. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

See more: https://thinkfuture.substack.comConnect with Zoher: https://www.linkedin.com/in/zzkaru/---Everyone talks about AI—but it's data that still decides what works and what fails.In this episode of thinkfuture, host Chris Kalaboukis speaks with Zoher Karu, data and analytics leader with a PhD in engineering and experience at McKinsey, eBay, Citibank, Sears, and Blue Shield of California. Zoher now works with Taelor, a men's clothing rental subscription service using data and AI to personalize style at scale.Zoher explains why “dirty data” remains one of the biggest unsolved problems in business—and why the issue isn't technology, but how organizations are structured. Teams build data in silos to solve short-term problems, creating fragmented systems that AI can't magically fix.The conversation moves from fashion and personalization to a much bigger question: what happens when AI quietly takes over everyday decision-making?We cover:- How Taelor uses data, metadata, and human stylists to curate clothing- Why clothing sizes are a data nightmare—and what that teaches us about AI limits- The real reason data quality is still broken across industries- How siloed teams create long-term data problems- Why AI will reduce the effort of finding information, not eliminate thinking -A future where tasks like planning events, shopping, and inventory management become automated- What humans should focus on when machines handle the mundaneZoher's view of the future isn't flashy—it's practical. As AI handles more low-level optimization, human value shifts toward judgment, creativity, and deciding what actually matters.If you're interested in AI, data, personalization, or the future of everyday decision-making, this episode offers a grounded look at where we're really headed.

In this episode, Ellen Sexton, Executive Vice President and Chief Growth Officer at Blue Shield of California, discusses the impact of major policy changes on Medicaid and commercial markets, how her team is preparing for uncertainty, and the strategies needed to support members, stabilize employer coverage, and advance innovation across California's health care landscape.

On November 7, Commonwealth Club World Affairs of California, the nation's oldest and largest public affairs forum, will host The Asian American Foundation's (TAAF) first-ever AAPI Youth Mental Health Summit. Under the theme “Sparking Solutions Together,” the summit will convene hundreds of experts, advocates, funders, and business executives to address the urgent and often overlooked mental health challenges facing Asian American and Pacific Islander (AAPI) youth. From 2018 through 2022, suicide was the leading cause of death among Asian Americans aged 15–24, and the second leading cause of death among Native Hawaiians and Pacific Islanders. Yet despite being deeply impacted by the nation's mental health crisis, AAPI youth remain largely invisible in the national mental health conversation, and the data needed to understand their mental health is scarce at best. To fill the gap, TAAF released "Beyond the Surface" in December 2024, the most comprehensive study to date on AAPI youth mental health, which revealed: Nearly 1 in 2 AAPI youth screen positive for moderate depression; 1 in 3 have planned or attempted suicide; Stigma, family pressure, and silence keep many from seeking help; Only 53 percent feel comfortable talking with their parents; Just 1 in 4 have accessed formal care; and 46 percent have never seen a mental health provider. Building on these findings, the November 7 summit will bring together leading experts to spark dialogue on breaking stigma, closing gaps in care, and exploring how community partners and technology are reshaping the ways young people seek and receive support.  Join us online to hear from: Midori Francis, Actor, "Grey's Anatomy" Ryan Alexander Holmes Owin Pierson, Creator and Mental Health Advocate Lisa Ling, Journalist Noopur Agarwal, VP of Social Impact, MTV Norman Chen, CEO, The Asian American Foundation (TAAF) Philip Yun, Co-President and Co-CEO, Commonwealth Club World Affairs Rushika Fernandopulle, MD, Practicing Physician; Co-Founder and Former CEO, Iora Health; TAAF Board Member Juliana Chen, MD, Chief Medical Officer, Cartwheel Perry Chen,Director of Programs and Partnerships, Behavioral Health at Blue Shield of California Rachel Miller, Founder & CEO, Closegap Meena Srinivasan, Founding Executive Director, Transformative Educational Leadership Ayesha Meer, Executive Director, Asian Mental Health Collective Henry Ha, Program Director, Community Youth Center of San Francisco Anne Saw, PhD, HOPE Program Reid Bowman, MPH, CHES, Outreach & Program Manager, UCA Waves Rupesh Shah, COO of Crisis Text Line Tone Va'i, LCSW, Clinician, Samoan Community Development Center Amy Grace Lam, PhD, Chief Program Strategist, Korean Community Center of East Bay Christine Yang, ASW, Korean Community Center of East Bay Christina Yu, LCSW, Clinical Supervisor, Korean Community Center of East Bay William Tsai, PhD, Associate Professor, New York University Cindy H. Liu, PhD, Associate Professor, Department of Pediatrics and Psychiatry, BOBA Project, Harvard Medical School Tiffany Yip, Professor of Psychology, Fordham University Quynh Nguyen, TALA (Thriving AANHPI Leadership Accelerator) Fellow   This program is presented by The Asian American Foundation and Commonwealth Club World Affairs.   For full program, please visit:  https://www.commonwealthclub.org/events/archive/video/youth-mental-health-summit-sparking-solutions-together Learn more about your ad choices. Visit megaphone.fm/adchoices

Blue Shield of California's Julianne Holloway joins host Gavin Ward to help explain the often conplex world of DSNP, or Duals Special Needs Plans, for individuals that qualify for both Medi-Cal (known as Medicaid Nationally) and Medicare