Podcasts about evolent health

California is full of hardworking people—nurses, teachers, delivery drivers, baristas—who keep our communities running. Many of them live paycheck-to-paycheck, making too much to qualify for most government benefits, but not enough to afford the basics. For nearly 2 million Californians, Covered California provides a critical lifeline, offering access to affordable health insurance and now basic needs support. Dr. Monica Soni, Chief Medical Officer of Covered California, joins Claudia to talk about the program's important and expanding role in the California landscape. We discuss:What the working poor really need: breathing room in their budgets to afford healthy foodOperating a startup within governmentHow collaboration across Covered California, Medi-Cal and CalPERS – which together cover 45% of Californians – will drive faster and more aligned health improvement in CaliforniaMonica's team uses experiments and user research to shape every aspect of the program:“But I do think in our DNA is this idea of innovation. In-house, we have a research team that does randomized controlled trials. We're committed to hyper transparency. Almost all of our data is released. We stratify it by everything we can think of to really identify where there might be pockets of coverage that aren't there or outcomes that are suboptimal. And we do a lot of deep listening with consumers and with the community to help inform what we do.“Relevant LinksRead more about Covered California's Innovative Program to Improve Population HealthSee the details on Covered California's Data and Research toolsAnnouncement of the launch of Covered Californians Population Health InvestmentsMore info on how Covered California uses email nudges for enrollmentAbout Our GuestDr. S. Monica Soni is the Chief Medical Officer, and a Chief Deputy Executive Director at Covered California, leading the organization's Health Equity and Quality Transformation division. In this capacity she is responsible for health equity, health care strategy, medical policy, and other clinical operations to continuously improve not only the health services provided through Covered California's contracted health plans, but also California's delivery system.She is a board-certified internal medicine physician with more than a decade of experience working in both inpatient and outpatient settings and continues to see patients. She is an Associate Professor within the UCLA Department of Medicine and the Charles R. Drew University Department of Internal Medicine, where she is committed to residency diversification and pipeline development.Prior to joining Covered California, Dr. Soni served as Associate Chief Medical Officer within Evolent Health focused on the delivery of high-quality, cost-effective specialty care for the over 16 million supported Medicaid lives across the United States. During her time at the organization, she played a critical role in clinical informatics, provider engagement, value-based strategies and innovation. Dr. Soni also served as the Director of Specialty Care for the Los Angeles County Department of Health

This episode covers:In this episode, we discuss how whole-body scans can revolutionize healthcare, the benefits of getting comprehensive insights into an individual's health through whole-body scans, how preventative scans can empower individuals to take proactive steps toward better health, and so much more.Dr. Dan Durand MD is the Chief Medical Officer at Prenuvo, the world's largest and most advanced network of clinics dedicated exclusively to proactive whole-body MRI for early-stage disease detection and precision medicine. Dan leads the clinical and operational staff within Prenuvo's clinics, oversees the clinical research team, and serves as President of the Prenuvo Medical Group. Before joining Prenuvo, Dr. Durand held various leadership roles at LifeBridge Health, including enterprise Chief Clinical Officer, Chief Innovation Officer, and system-wide Chair of Radiology. Dan was the founding leader of LifeBridge's Clinically Integrated Network of 2,000+ providers spanning 5 hospitals and 125 locations. Over the course of his tenure, he also oversaw value-based contracting, research, digital health, clinical artificial intelligence, physician/APP recruiting, online booking, ambulatory quality, and virtual care. Prior to joining LifeBridge, Dan held leadership roles with Johns Hopkins Medicine and Evolent Health, and earlier in his career he worked as a consultant with McKinsey & Company. Dr. Durand serves on the adjunct faculty of Stanford University and the George Washington University and holds a courtesy appointment with the Johns Hopkins University Carey School of Business. He trained at the Johns Hopkins University School of Medicine and is dual boarded in adult and pediatric radiology.Links mentioned during this episode:$300 off Prenuvo Scan: www.prenuvo.com/LYONSLyons' Share Instagram: www.instagram.com/thelyonsshareJoin Megan's Newsletter: www.thelyonsshare.org/newsletter

This episode's Community Champion Sponsor is Ossur. To learn more about their ‘Responsible for Tomorrow' Sustainability Campaign, and how you can get involved: CLICK HERE---Episode Overview: How can we transform musculoskeletal care to improve outcomes and reduce costs? Our next guest, Rob Cohen, is tackling this challenge and more as CEO of Livara Health. With over two decades of healthcare leadership experience, Rob brings a unique perspective on value-based care and population health management. Previously leading companies like Bamboo Health and Evolent Health, Rob witnessed firsthand the transformative impact of innovative healthcare solutions. While together, Rob shares why he is driven by a passion to make healthcare more connected and sustainable and his vision to reimagine musculoskeletal management through comprehensive care planning, delivery, and navigation. Join us to discover how Livara's purpose-built solutions are enhancing patient experiences, optimizing clinical outcomes, and driving down costs for health plans and providers. Let's go! Episode Highlights:Emphasizes improving healthcare by building on existing strengths rather than total disruptionAddresses musculoskeletal (MSK) spend challenge: $400 billion annually, growing twice as fast as general healthcareOffers comprehensive MSK care: planning, navigation, and delivery to reduce unnecessary proceduresReports significant outcomes: 45% cost reduction, 35% fewer surgeries, 60% less opioid usePredicts future trend: integration of specialty value-based care programs for cohesive patient careAbout our Guest: Rob Cohen is the CEO of Livara Health, a value-based musculoskeletal (MSK) management company providing care planning, care delivery and care navigation to improve outcomes and lower costs for people with MSK conditions.Prior to joining Livara, Rob was the CEO at Bamboo Health, where he led the company's national expansion from 25 states to 45 states and was responsible for rapid revenue growth in new product lines and new market segments. Prior to Bamboo, Rob served as Market President at Evolent Health where he was responsible for market growth and managed the P&L and operations for partnerships with health systems. Prior to Evolent, Rob held leadership roles with Healthways, Wellpoint, The Walt Disney Company, and McKinsey & Company.He is a firm believer in the power of healthcare as a catalyst for positive change and is committed to making a meaningful difference in the lives of others.Links Supporting This Episode:Livara Health Website: CLICK HERERob Cohen LinkedIn page: CLICK HERELivara Health LinkedIn page: CLICK HERE Mike Biselli LinkedIn page: CLICK HEREMike Biselli Twitter page: CLICK HEREVisit our website: CLICK HERESubscribe to newsletter: CLICK HEREGuest nomination form:

The healthcare system is in freefall with rising costs, worse care, and frayed patient-provider relationships.Is value-based care the cure?Join us in this week's HealthBiz Brief, as Emily Young, President of Tufts Medicine, and Courtney Fortner, President and CEO of Navvis, as they detail how their partnership is expanding value-based care with an eye on improving quality, affordability, and experience.

What do payers think about prior authorization? Dr. Andrew Hertler is Chief Medical Officer at Evolent Health. He recently co-authored an op-ed about prior authorization, touching on gold-carding, a controversial solution to addressing prior authorization challenges. Joining Hertler is regular guest John Hennessy, a Principal with Valuate. Topics include:Why exceptions can sometimes be problematic.What happens after a prior authorization is rejected.Pathways: Who makes the decisions? How are they updated?How should pharma  think about payers?What can manufacturers and market access do to help pathways?Follow Andrew on  LinkedIn. Follow Valuate on LinkedInLearn more about Valuate.

Cameron Carter is the CEO and Co-Founder of Rosarium Health (fka Rose Health). Prior to launching Rosarium Health, he spent the past decade in value-based care operation and business development roles at DaVita Inc., Bright Health, Evolent Health, and Truven Health Analytics. Before his value-based care roles, Cameron spent time in academic research roles studying solutions to reduce healthcare disparities in underserved communities in the United States. He is a founding member of the Childhood Disparities Research Laboratory at the University of Michigan-Ann Arbor and has taught undergraduate physiology courses at the University of Michigan-Ann Arbor, University of Massachusetts-Amherst, and Colorado State University.‍ Rosarium Health distinguishes itself as a pioneering risk-bearing, enablement platform with a robust integrated service provider network, dedicated to connecting healthcare professionals and home remodeling companies with households in need of accessible modifications. This innovative approach is rooted in the belief that enhancing household accessibility is pivotal in facilitating in-home care, reducing healthcare disparities, and curtailing total medical expenses across various demographics. Recognized for their impactful work, Rosarium Health has garnered accolades such as winning the 2022 National Institute of Aging Start-Up Challenge and participating in the 2023 Texas Medical Center HealthTech Accelerator, reflecting their commitment to creating a more accessible, equitable, and economically sustainable healthcare landscape. Meet Rosarium Health: https://www.rosariumhealth.com/ Watch the Full Interview: https://youtu.be/lslysrm3Ogo Unlock career success with "Riderflex Guide 2.0: Mastering Job Interviews." Over 30 years of recruitment expertise. Strategies for new graduates, seasoned professionals. Master virtual interviews,  and challenging questions. Get your copy today at: https://tinyurl.com/Mastering-Job-Interviews Listen to real stories from successful business leaders, CEOs, and entrepreneurs on the Riderflex podcast hosted by CEO Steve Urban. The Riderflex Podcast: https://www.youtube.com/channel/UC5NDLaxEqkMsnlYrc5ntAPw Trust Riderflex, a premier headhunter and employment agency based in Colorado, to recruit top talent for your team. Visit https://riderflex.com/ to learn more about our executive recruiting services. Podcast Sponsor: Kura Home Services, Air Duct Cleaning & Home Maintenance. For All your Home Maintenance needs!  https://www.kurahome.com/kura-home-services-colorado/ #AccessibilityMatters #InnovativeHealthcare #RosariumHealth #AccessibleLiving #riderflexpodcast #careeradvice #Podcast #entrepreneur #ColoradoRecruitingFirm #recruiting #Colorado #National #Riderflex #TalentAcquisition #Employment #JobTips #ResumeTip --- Support this podcast: https://podcasters.spotify.com/pod/show/riderflex/support

Today, we're excited to get to know Yubin Park, PhD. Yubin is the Chief Data and Analytics Officer at ApolloMed, a leading physician-centric, technology-powered, risk-bearing healthcare company. Yubin leads Apollo's data team in building data analytics tools to improve the efficacy of value-based care delivery.  Founded in 1992, ApolloMed (NASDAQ:AMEH) is a risk-bearing healthcare company of over 10k providers, using next-generation analytics technology to deliver high-quality value-based care to more than 1.3 million members. Yubin has decades of experience applying machine learning and data mining techniques to help providers understand how to coordinate care and reduce unnecessary healthcare costs. Prior to ApolloMed, Yubin served as Chief Technology Officer and Co-Founder of Orma Health which was acquired by Apollo Medical Holdings. Prior, he was the CEO/CTO and Co-Founder of Accordion Health, a data-driven platform for value-based care (acquired by Evolent Health). He now serves as the Chief Data and Analytics Officer at ApolloMed.  Yubin is an Adjunct Professor at Emory University teaching a graduate level course in Machine Learning. He holds advanced degrees in Machine Learning and Data Mining from UT Austin, and a bachelor's in Electrical Engineering from KAIST. He regularly publishes research and analytics on LinkedIn, often breaking down complex healthcare papers from JAMA and NEJM to make them easier to understand for less technical audiences. In this episode, we cover Yubin's founder journey pivoting into value-based care and building/selling his companies, approach to leadership, how ApolloMed differentiates itself in providing value-based care, and advice for technical founders.

Evolent Health, Inc., Q2 2023 Earnings Call, Aug 02, 2023

Julianne Eckert, Senior Director of Clinical Quality, Clover Health, Andre Bliss, Director of Medicare STARs, UPMC Health Plan and Marisa Howard, Senior Director, MA Operations, Evolent Health, share practical strategies and best practices to help Medicare Advantage plans to execute a successful star rating strategy. Learn significant trends and gain critical insights to help your plan earn and sustain a 4+ star rating in an era of rapid change!   This episode is sponsored by Evolent Health Services Evolent Health Services is disrupting healthcare administration, generating exceptional clinical efficacy and better risk adjustment for health organizations while simplifying the overall administration process. Similar to what Tesla did with automobiles and Amazon did with retail, Evolent Health Services is helping to transform our healthcare industry from antiquated to innovative. The uniqueness of Evolent is TECH: they have the industry's only trustworthy end-to-end integrated platform, along with  TOUCH: some of the most innovative people in the business know how to operate the solution for and with every type of health plan.or risk-bearing provider org  

Chicago faith leaders delivered sermons about mental health issues to destigmatize the subject and provide congregants with resources. Reset talks with Pastor Ira Acree of Greater St. John Bible Church and Katie McKillen, Chicago Regional Vice President of Evolent Health.

On this episode of the Pursuit of Health Podcast we return to the issue of healthcare economics with our guest, Ms. Andrea Zalusky. She brings over a decade of experience in the field of healthcare administration, with a particular focus as of late on the transition from a “Fee-for-Service” (FFS) to a “Value-based care” (VBC) approach to the financing of medical care. She explains that, like doctors, she has engaged in this work because she wanted to help as many people as possible become and stay healthy. With a Masters Degree in Public Health from Columbia after studying Global and Health Policy at Johns Hopkins University, Ms. Zalusky has worked in the northeast from New York to New Jersey to establish a consistent approach to healthcare. Through her work she remains intent on improving the health and well-being of the populations that live in these areas.Ms. Zalusky is  currently leading value-based care operations for Optum Care in the New York and New Jersey region, focused on supporting physicians, hospitals, and post-acute care facilities be successful in these programs.  Prior to Optum, she worked at CareMount Health Solutions where she managed operational programs focused on reducing readmissions in partnership with major hospital systems. Prior to these operations focused roles, she also had time with both Evolent Health and other consulting firms, where she  gained experience with population health program implementation and Value-based care models all across the US - working with physician groups, hospitals and Accountable Care Organizations to help them be successful in this new model of care.  Ms. Zalusky takes our audience through some of the details behind the concepts of Population Health and Value-based payment systems in a way that is enlightening and reassuring. She explains some of the hurdles and successes along the way and shares her ultimate goal of finding a balance that allows for the achievement of 4 crucial elements to a well functioning healthcare system in the U.S.. Along the way she emphasizes the sentiment that  “Our system is indeed broken and the people deserve better.” Ms. Zalusky explains that this venture towards Value-based payments has been in the works for years. It has required persistence, legislation and time to finally get off the ground. Though she is honest that we have a long way to go, she contends that there is no turning back to a Fee-for-Service system. She reassures us that the key to a successful transition from FFS to VBC over the next several years is to work in partnership with clinicians so that they can best implement their evidence-based knowledge to the betterment of everyone.We look forward to your feedback on this and any prior episodes. Dr. Fethke and the POH team can be reached on Facebook and Instagram @drfethkemd and our website at drfethkemd.com

This week, Andreessen Horowitz, a Silicon Valley venture capital firm, announced it had invested $350 million in Flow, a “community-driven” rental startup founded by Adam Neumann. This values the company at $1 billion and it hasn't even opened its door yet. We discuss the announcement, the return of Neumann, and the American housing crisis. In this episode we also explore: Rivian's latest quarter And check in with Evolent Health, a stock that's managed to do well in 2022 If you want to hear Rory's extended elevator pitch in full, make sure to listen to the extended version of the podcast in the MyWallSt app. MyWallSt operates a full disclosure policy. MyWallSt staff may hold long positions in some of the companies mentioned in this podcast. --- Send in a voice message: https://anchor.fm/stock-club/message --- Send in a voice message: https://anchor.fm/stock-club/message

Achieving health equity begins with an ability to identify health disparities and their causes Without adequate data and measures, inequities remain unseen and unaddressed. Our expert panel discusses the importance of leveraging data and analytics to understand, measure, and support equity improvement efforts. They will share successful strategies and best practices you can bring back to your organization.   Panelists: R.J. Briscione, Senior Director, Social Determinants of Health Strategy & Execution, Aetna, a CVS Health Company, Merrill Friedman, RVP, Inclusive Policy and Advocacy, Anthem, Inc., Amy Riegel, Senior Director, Housing, CareSource, Nick Jones, Director, Healthy Neighborhoods Healthy Families, Nationwide Children's Hospital, Katie McKillen, Regional President, Market Operations, Evolent Health   This episode is sponsored by Evolent Health Services Evolent Health Services provides modern administrative and clinical capabilities along with managed services to health plans and risk-bearing organizations. We drive operational efficiency through higher levels of automation, enhance member engagement using a modern, fully integrated end-to-end platform, and leverage AI to convert data into actionable insights. visit:evolenthealthservices.com  

Steve Wigginton is the CEO of iCario, a health action company, and he has over 20 years in the healthcare industry under his belt. Some companies he's worked with include NoviHealth, Sutter Health, Valence Health, and Evolent Health. Steve knows, working successfully in the healthcare industry means having an excellent understanding of human behavior. In this episode, we talk about how behavioral psychology affects access to care and why the digital divide exists, plus a good deal more. Do you have any thoughts? Please email us at hello@rosenmaninstitute.org. We post new episodes every Monday. “The Health Technology Podcast” is produced by Herminio Neto, hosted by Christine Winoto, and engineered by Andrew John Rojek    

Steve Wigginton, CEO of Icario discusses the company's platform Icario Connect. He talks about how health IT can help a long overdue overhaul of health plans and how health plans are embracing data insight and behavioral analytics to drive real health changes. Steve Wigginton is the CEO of Icario. Steve is responsible for the overall strategy, growth, and operations of the company. Previously the CEO of NovuHealth, Steve became the CEO of Icario in 2020 following NovuHealth's merger with Revel. Steve has a 25-year track record of driving growth, culture, and innovation in healthcare and is passionate about creating a better experience for members, patients, and providers. Steve came to Icario from Sutter Health | Aetna, a 50/50 joint venture between Aetna, a CVS Health company, and Sutter Health, a not-for-profit integrated health delivery system in northern California. There, he served as the joint venture's first CEO, responsible for launching an innovative health insurance business, delivering best-in-class clinical care, and driving breakthrough consumer and member experiences. Before that, Steve served as CEO of Valence Health, where he led and grew the business following its acquisition by Evolent Health, doubling revenues and scaling operations internationally. Prior to the Valence acquisition, Steve was the chief development officer at Evolent Health, responsible for driving growth, partnerships, and the brand. Additional leadership roles in technology-driven care management, physician practice management, and healthcare supply chain businesses round out Steve's experience. Steve holds a bachelor's and master's degree of business administration from Indiana University, Kelley School of Business. #Icario #IcarioConnect

In this Podcast today, I will discuss the company Evolent Health! Listen to the podcast for details! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/thressa-sweat/support

Evolent Health, Inc., Q1 2021 Earnings Call, May 05, 2021

In this episode we talk to Dr. Shantanu Nundy (Chief Medical Officer of Accolade) about his role at the company, his new book Care After Covid, and why it's more than fine to have questions about the vaccine.  **More on Shantanu** Dr. Shantanu Nundy, Chief Medical Officer of Accolade, oversees the company's clinical strategy and solutions to improve health outcomes for individuals and families, as well as the experience and relationships they have with their providers. Shantanu is a practicing primary care physician and technologist with expertise in combining medicine and innovation with deep knowledge of the healthcare industry and global health policy. Prior to joining Accolade, Shantanu served as Senior Technology Advisor in the World Bank Group's Health, Nutrition, and Population Global Practice. In this role, he accelerated the adoption of health innovation and technology across the Bank's $15 billion healthcare portfolio in low- and middle-income countries. Shantanu served as Director of the Human Diagnosis Project, a healthcare AI startup company, and Managing Director for Clinical Innovation at Evolent Health, population health, and predictive analytics company, where he improved hospital and chronic disease outcomes for more than two million individuals in the U.S. Shantanu is also co-inventor of SMS-DMCare, automated text messaging software for individuals with diabetes. The technology was one of the first mHealth interventions to demonstrate improved health and lower costs, and to be adopted by the World Health Organization's eHealth Compendium. Shantanu's work has been recognized by the MacArthur Foundation and been featured in The Wall Street Journal, Washington Post, Harvard Business Review, Forbes, The Atlantic, The Journal of the American Medical Association, Psychology Today, Rolling Stone, Wired Magazine. and others. He is the author of Stay Healthy At Every Age, a Wall Street Journal top five book in health and wellness of 2010. Shantanu practices primary care at Mary's Center, a federally qualified health center serving a large, immigrant community in Washington, D.C. He is a graduate of MIT (BS), Johns Hopkins (MD), and the University of Chicago (MBA). He lives with his wife and two daughters in Washington, D.C. Shantanu practices primary care at Mary's Center, a federally qualified health center serving a large, immigrant community in Washington, D.C. He earned his Bachelor of Science from MIT, Doctor of Medicine from Johns Hopkins University, and Master of Business Administration from the University of Chicago.   Follow The Startup Life On Facebook, Instagram, Twitter, or LinkedIn Follow the StartupBlog or buy some gear from our website. Subscribe to our Patreon to listen to ad-free episodes, exclusive content, and digital products that we are beginning to offer. You can also donate to the show via CashApp: $TheStartupLifePod Follow us on Clubhouse to interact with the show when we create content there. Check out other great podcasts from The Binge Podcast Network. Written by: Dominic Lawson Executive Producers: Dominic Lawson and Kenda Lawson Music Credits: **Show Theme** Behind Closed Doors - Otis McDonald **Break Theme** Cielo - Huma-Huma  

Daniel J. Durand, M.D. serves as the chief innovation officer and chairman of radiology for LifeBridge Health. He led the LifeBridge Health ACO, LLC, and previously served as the first director of accountable care for Johns Hopkins Medicine. Prior to Hopkins, Dr. Durand was a vice president and member of the executive leadership team at Evolent Health, a health care IT startup. He also worked as an associate with McKinsey & Co. out of the firm's Washington, D.C., office. Dr. Durand earned his medical degree at The Johns Hopkins University School of Medicine and has more than 20 years of experience in health care, science, and technology. John Marchica, CEO, Darwin Research GroupJohn Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives.About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz., with a satellite office in Princeton, N.J.

Dr. Eric S. Weaver is nationally recognized for his work in primary care transformation and value-based care. He is the Executive Director of the Accountable Care Learning Collaborative, a nonprofit organization established by former HHS Secretary Mike Leavitt and former CMS Administrator Dr. Mark McClellan to accelerate the value-based care readiness of healthcare organizations. Eric has an extensive executive leadership track record with physician-led ACOs and risk-bearing entities. He previously held the role of corporate vice president for Innovista Health Solutions, a population health management services organization, and oversaw enterprise capital investment strategy and technology adoption. Eric was also the President, and CEO of Austin, Texas-based Integrated ACO – one of the most successful physician-led Accountable Care Organizations in the Medicare Shared Savings Program before its acquisition by Evolent Health. Eric is a committed health care executive with Fellow designations from the American College of Healthcare Executives, the Medical Group Management Association and the Health Information and Management Systems Society. He received his Master of Healthcare Administration degree from Texas State University and his Doctor of Healthcare Administration degree from the Medical University of South Carolina. He was the recipient of the ACHE Robert S. Hudgens Award for Young Healthcare Executive of the Year and the Modern Healthcare “Up & Comers” Award in 2016. In addition, he was named to Becker's Hospital Review list of “Rising Stars: 25 Healthcare Leaders Under 40” in 2015, and awarded the Young Alumni Rising Award from Texas State University. In addition to his work as a healthcare executive, Eric serves on various Boards such as the Texas State Development Foundation, the Dell Medical School Society for Health & Business, and the Half Helen Foundation. In his free time, he enjoys spending time outdoors and traveling with his wife and daughter. Here in Episode #110 Eric starts our show with a leadership mindset that centers us around fostering strong relationships. Eric walks us through his career path going from the administration, and into blazing a path for value-based care. He also gives us a current state report of the state of value-based care. Eric shares a dark moment story around using leadership setbacks to gain career focus. He tells us why taking smart career risks will pay-off over time. He also highlights how to use your WHY, to build great teams. Eric shares how the ACLC continues to build strong partners throughout the pandemic. He gives us his personal AHA connected with improvement opportunities for healthcare. He shares thoughts on how quality people will drive healthcare transformations. He ties in connections between innovation, entrepreneurship, and value-based care. And gives us his best career advice. • Connect with Dr. Eric on LinkedIn • Learn more about the ACLC • Check out Eric's Podcast • Access the Healthcare QualityCast LinkedIn Group • Leaves Us a Rating • Earn Your Lean Six Sigma for Healthcare Certification • Request a Corporate Demo of our online QI Academy

The pandemic has had a tremendous impact on the business of healthcare.  With states canceling elective procedures and people deferring care for fear of being exposed to the virus, hospital and medical practice revenue is down. On the flip side, many health plans are sitting on a mountain of premiums that aren't being spent because of this deferred care, possibly leading to rebates in some cases and a ton of uncertainty in pretty much all cases. One less obvious outcome of all of this may fall on Medicare Advantage plans in 2021, and it threatens to lower payments by 4-6% in 2021. Medicare Advantage, of course, is the rapidly growing model that'll cover more than 24 million Americans this year. According to a recent Avalere report, these plans may be looking at both a sicker population and reduced payments in 2021 because of this deferred utilization. Here to help us understand why, and to share some advice for how Medicare Advantage plans can weather the storm is Dr. Matt Lambert, a practicing ER clinician, and Chief Medical Officer at Curation Health. A few actions Dr. Lambert suggests are:   Focus on the long game and be patient. For example, don't pay out more to shareholders and, instead, place revenue in short-term investments that they can access without penalty. Prioritize virtual care/telemedicine enablement/reimbursement now and moving forward. This will enable more members to access care while avoiding in-person treatment risks. Lead with interventions and the type of claim vs. volume of claims. MA plans will be best served to focus on capturing the key conditions that map specifically to chronic conditions as they drive the most improved outcomes, utilization and costs.   There's a lot of nuance to this story and the way Medicare Advantage payments are calculated. Dr. Lambert breaks it all down for us. Enjoy!   Dr. Matt Lambert Dr. Matt Lambert brings more than 20 years of experience as a clinician, CMIO, and change leader in value-based care, ensuring that patients receive more comprehensive care and that payers and providers better capture the value of their services. He is a practicing, board-certified emergency medicine provider who previously founded his own physician staffing company. Dr. Lambert was one of the founding members of Clinovations. During his time there he served as part of the leadership team for several electronic health record implementations at the nation's largest public health system in New York City, the University of Washington in Seattle, Johns Hopkins, Barnabas Health, Medstar, and Broward Health. He is also the author of two healthcare books: Unrest Insured and Close to Change: Perspectives on Change and Healthcare for a Doctor, a Town, and a Country. mlambert@curationhealth.com   Curation Health Curation Health was founded by a team of healthcare veterans and clinicians to help providers and health plans effectively navigate the transition from fee-for-service to value-based care. Their advanced clinical decision support platform for value-based care drives more accurate risk adjustment and improved quality program performance by curating relevant insights from disparate sources and delivering them in real time to clinicians and care teams. With Curation Health, clinicians enjoy a streamlined, comprehensive clinical documentation process that enables better clinical and financial outcomes while simultaneously reducing clinical administrative burdens on providers. Curation Health takes pride in combining the flexibility and speed of a startup with decades of leadership experience and know-how from roles in leading companies including Clinovations, Evolent Health, and The Advisory Board Company.   Web: curationhealthcare.com. LinkedIn: https://www.linkedin.com/company/curationhealth/ Twitter: https://twitter.com/curationhealth Case Study: https://curationhealthcare.com/a-case-study-on-curation-health-and-a-physician-group-in-the-midwest/   Links and Resources   Report: COVID-19 Pandemic May Reduce MA Risk Scores and Payments (Avalere) Unrest Insured by Dr. Matt Lambert Close to Change: Perspectives on Change and Healthcare for a Doctor, a Town, and a Country by DR. Matt Lambert Episode #122: Headwinds Impacting the Shift to Value-Based Care with Kyle Swarts and Dr. Matt Lambert   The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media. Music by StudioEtar

In this episode I have a conversation with Dr. Laura Gerald, the President of the Kate B. Reynolds Charitable Trust where she shares her story from going through medical school to become a Pediatrician to then switching to the field of public health. Dr. Gerald held several influential positions such as the State Health Director for the Division of Public Health for the North Carolina Department of Health and Human Services as well as a Managing Director of Evolent Health. Listen to her story of how she got to her position in the Trust and how she navigated her path.Omari on LinkedIn: https://www.linkedin.com/in/omari-richins-mphShownotes: thePHmillennial.com/episode25Support The Public Health Millennial: https://www.buymeacoffee.com/thephmillenialUse Code “thePHmillennial” for discount: https://thepublichealthstore.comWebsite: https://thephmillennial.comInstagram: https://www.instagram.com/thephmillenial (@thePHmillennial)Email List: https://thephmillennial.com/signup/Support the show (http://paypal.me/thePHmillennial)

Evolent Health, Inc. - Q3 2020 Earnings Call - Nov 05, 2020

By Michael Tetreault, Editor-in-Chief, Host, The DocPreneur Leadership Podcast. Today I sit down with the Chief Executive Officer (CEO), Steve Wigginton who leads Sutter Health | Aetna, the jointly-owned health care company formed by Sutter Health and Aetna. Sutter Health | Aetna is a joint venture that brings together Sutter Health's network of nationally recognized, high-quality doctors and hospitals with Aetna's leading health plan expertise, cutting-edge data, analytics and health information technology, and shared care management capabilities. This joint venture aims to deliver a differentiated, personalized experience for members and is designed to improve efficiency and lower the cost of care, resulting in greater affordability. We sat down to discuss: + Ways in which health systems are creating innovative partnership with technology and telehealth companies and Doctors + Creative ways Doctors are managing new technologies to help Patients + Benchmarking quality and tracking data + Insight into Leadership and Business Management inside local primary care clinics, obstacles, opportunity and more. Steve is responsible for building a market-leading health care business serving the Northern California market, delivering best in class clinical care, breakthrough consumer and member experiences, and expanded options that make health care easier to access and easier to understand. Steve is a respected leader with a proven record of accomplishment in driving culture, growth and innovation in the health care industry. He has a passion for creating a better health care experience for members, patients and the providers who deliver care. Most recently, Steve served as the CEO of Valence Health. In this role, Steve doubled revenues, scaled operations internationally and led the cultural and operational integration of the business following the acquisition of Valence by Evolent Health in mid-2016. Prior to the Valence acquisition, Steve served as Evolent's Chief Development Officer responsible for driving growth, brand and health system partnerships. In previous roles, Steve served as the founding CEO of Medley Health, as president of Health Integrated and as Executive Vice President of Neoforma. Steve has a bachelor's and master's degree of business administration from Indiana University. Resources and Mentions www.sutterhealthaetna.com www.ConciergeMedicineFORUM.com www.DocPreneurPress.com www.ConciergeMedicineToday.com www.DirectPrimaryCare.com Press Releases Mentioned Sutter Health | Aetna Teams up with Heal to Bring Doctors to Member's Doors https://www.sutterhealthaetna.com/en/about-us/news/sha-heal-to-bring-doctors-to-members.html Sutter Health | Aetna Offers Access to Primary Care Anytime, Anywhere https://www.sutterhealthaetna.com/en/about-us/news/sha-access-primary-care-anytime.html Sutter Health | Aetna Enlists Docent Health to Elevate Member Experience https://www.sutterhealthaetna.com/en/about-us/news/sha-enlists-docent-health.html

Welcome to the Executive Innovation Show Podcast, brought to you by One Touch Telehealth. During this podcast hear host, Carrie Chitsey, talk with Steve Wigginton. Steve Wigginton is the CEO of Sutter Health | Aetna in Northern California, a joint venture between the two parent companies. Wigginton is a respected leader with a proven track record of driving culture, growth, and innovation in the healthcare industry, having been CEO of Valence Health, Chief Development Officer of Evolent Health and founding CEO of Medley Health.Listen to “What are Hospitals + Payers Role in Virtual Care?” as we discuss: Steve Wigginton talks with Carrie Chitsey about the 50-50 joint venture with Aetna and Sutter Health. Listen as Steve talks about how this joint venture can leverage the emerging capabilities that technology has, such as virtual care. He also talks about the benefits it has for providers, employers, and patients. How can health systems across America deliver a great patient experience that lowers costs and while improving patient outcomes? Steve talks about the advantages payers, employers and patients can receive by these sort of 50/50 joint ventures. Migrating to a value-based care model from a fee for service model, hear Steve give his reasoning as to why a fee for service model does not best serve the patients. Are health systems starting to realize that upfront investments in patients have long-term healthcare cost reduction? Are we there yet? Should digital healthcare innovation come from the payer, hospital or the provider? Hear Sutter Health | Aetna CEO talk about the hurdles a health system must face to reach a level of totality across the delivery system. From human capital management training and internal workflow, he explains there must be a maturation process to connect these virtual health capabilities across the board. One of the biggest problems in America’s healthcare system is rural healthcare. Steve Wigginton gives his top three things rural health community CEOs should be thinking about as 2020 approaches in regards to prioritizing virtual care for better patient outcomes. As always we ask Steve what are the top two healthcare-related things that keep him up at night. Besides teens, what are they? Stay up to date with Steve Wigginton and Sutter Health | Aetna as they continue to bring innovation to healthcare. How can your health systems provide better virtual care? Grab all your resources to learn how to impact patient outcomes, implement virtual care and patient experiences.Support the show (http://www.helpinghumans.care)

This week, we welcomed back Rep. Terri Branham Clark of Boyd County.  We spoke with her about the incredible performance of Rocky Adkins in Eastern Kentucky, and what Andy Beshear needs to do to shore up support in that part of the state.  She also talked about serving in her first legislative session, her approach to working on bills, and how she plans to tweak her approach next year. Before the interview, Robert updated us about the Special Session, Jazmin talked through the negative ads already permeating the campaign, and Robert talked about the sale of Passport to the for-profit Evolent Health.  Plus, Quick Hits!

Today’s episode features the following guests: Ross Bjella, MBA, is the founder and CEO of Alithias, a patient advocacy and population health analytics company serving self-insured employers, insurance companies, networks, and third-party administrators. (EP163)   John Lynn is the founder of the HealthcareScene.com network, which currently consists of 10 blogs containing over 11,000 articles, with John having written over half of the articles himself. These EMR and health care IT-related articles have been viewed over 18 million times. (EP124/171)   Gary Frazier is a disrupter and founder of OM Healthcare, Inc., a health care technology start-up established in 2015. He has over 18 years of business development experience and over 13 years of executive-level hospital and health system strategy expertise. (EP168) David Smith is from Avia and founder of Third Horizon Solutions. He is chief development officer, where he is responsible for expanding the firm’s influence in the health care market. (EP135)   Alex Jung is global strategist at Ernst and Young. She is a partner/managing director in Parthenon-EY, where she works primarily on growth strategy projects. (EP189)   Joe Murad is president and CEO at Pokitdoc. He most recently served as managing director and head of individual exchange solutions for Willis Towers Watson, where he was responsible for the largest private health insurance exchange. (EP183)   Frazer Buntin is president of value-based services from Evolent Health. He has worked in strategic and operations leadership positions for the past 17 years. He is responsible for managing the operational performance of Evolent Health’s partners. (EP202)   A.G. Breitenstein is a partner at Optum Ventures. She was most recently the co-founder and chief product officer at Humedica, one of the earliest big-data analytics companies in health care. (EP207) 02:21 Ross Bjella’s short list—5 action items—for employers to get the most for their money out of the health care system. 03:05 Take control of employer health care costs by gaining access to their health care data. 03:18 Offer an incentive-based plan design. 03:32 Create virtual narrow networks. 03:46 Offer live care navigators. 04:10 The importance of controlling health care costs. 04:43 The emotional component behind what an employer must do to maximize the value of their health care. 05:10 Disruptive vs incremental change, and what’s really happening in health care. 06:17 John Lynn of HealthcareScene.com, and why it’s so tough for disrupters to break into the health care system. 07:26 The weird dynamic of the false market that is health care. 08:46 Health care regulations making it difficult to disrupt the market. 13:15 Gary Frazier’s opinion on connecting value-based care and empowered patients. 15:20 What value-based care is really about. 16:17 David Smith elaborates on the problem with assuming empowered patients change health care. 18:21 Rational decision making and how that isn’t always present in health care. 19:19 Alex Jung and the “messy middle” of the economic side of health care. 19:44 How the economic model, not the business model, of health care is broken. 21:36 “Is [this] necessary?” 22:13 Joe Murad and the “messy middle” in medical services pricing. 23:11 Frazier Buntin and where we are in the transition from fee for service to value-based care. 24:09 Is this change driven from the health system or major employers? 25:00 A.G. Breitenstein and the power of consumers en masse to move markets.

Frazer Buntin has worked in strategic and operations leadership positions for the past 17 years and currently serves as the president of value-based services for Evolent Health. Evolent Health partners with leading provider organizations to achieve superior clinical and financial results in value-based care, actively managing care across Medicare, Medicaid, and commercial and self-funded adult and pediatric populations. Frazer is responsible for managing the operational performance of Evolent Health’s partners. Prior to Evolent, Frazer served as CEO for WhiteGlove Health, a population health management firm providing primary health care services to self-insured employers and health plans. Previously, Frazer was co-founder, president, and CEO for Silvercare Solutions, one of the largest providers of primary care and health care management services to the senior population in the United States. Prior to Silvercare, he served in several senior-level roles for Healthways Inc. and Dollar General Corporation. Frazer currently serves on the board of Leadership Health Care and holds an MBA from Vanderbilt University and a BS degree from The University of the South. 01:39 How the strategy of holding on to fee for service (FFS) in health systems is very risky. 03:17 How a value-based care (VBC) model can build clinical integration. 04:18 Why clinical integration isn’t really happening with an FFS model. 05:07 Are better patient outcomes the proxy for value-based care? 06:14 “If you define value in health care as cost over quality, and you don’t change the quality at all, but you lower the cost, you’re still increasing health care value.” 08:37 “You can define quality as a reduction in patient admissions.” 11:54 Reducing practice variability. 13:35 The factors to include in shared savings and the cost side of health systems and physician groups. 14:41 “What does it cost to go achieve those shared savings?” 17:05 The challenges of switching from FFS to VBC. 17:30 “People will tend to default back to what they know, and what they know is fee for service.” 18:04 Who pushes VBC through, when it’s easier to revert back to FFS? 20:07 Sacrificing the short term for the long term. 21:45 Frazer’s estimated timeline for when value-based care will tip the scales on fee for service in terms of reimbursement and profit. 24:29 Are there areas where reducing unnecessary costs align in both FFS and VBC? 28:10 “The level of innovation when people get on board is just stunning.” 31:15 Evolent’s role in this transition in care models. 31:42 “We help health systems that are ready to move.”

Eric is established as a national expert on the impact of health care reform on health care providers and is a respected thought leader in the hospital health system industry. A consultant with deep experience in health plan strategy, design, prevention care, and productivity and behavioral economics, Eric serves as the national leader of direct provider solutions for Collective Health. A former executive at Evolent Health and principal with Towers Watson, he has worked in the employee benefits business for 30-plus years as an advisor to hospital and health system clients, developing health benefit and prevention care strategies that align with the health system’s population health business. Eric focuses on improving the poor health of health care workers and professionals as a first step to improving patient satisfaction and quality outcomes. He frequently speaks about the direct link between improving health care workers’ health and boosting patient satisfaction and quality outcomes. Eric is a published author, including the book STOP!: 21 Stops to Reduce Stress and Enhance Joy, and has authored more than 20 articles on employee benefit topics, including "Fixing the Broken Triangle," "The Healthcare Benefit Crisis—Ten Years Later" in 2015, "Choice Architecture—A Tool for Ratcheting Up Benefit and Wellness Results," "eACOs—The Health Plan of the Future," and "The Healthcare Benefit Crisis." A member of several "Who’s Who" lists for business executives, Eric graduated from the University of Illinois with a BA in psychology and earned his MBA from the University of Chicago Booth School of Business. Eric lives in Franklin, Tennessee, with his wife, Sherry, and enjoys travel related to history, architecture, and baseball. Together, Eric and Sherry have 7 children, 5 grandsons, and 2 more grandchildren on the way. He has been a volunteer docent for the Frank Lloyd Wright Preservation Trust. 02:30 The disintermediation of health systems and employers by insurance carriers. 02:56 “... the facilitators of payments …” 04:09 How does the move away from the best interest of the buyer and seller in health care manifest? 06:31 “Health care eats wages.” 08:31 The variances in health care. 08:55 Cost and quality in health care. 09:32 An employer-driven economy in health care vs an employer-paid economy in health care. 11:20 Defining ACO—accountable care organization. 12:49 The two forms of moving to a more value-based care—carrier-based ACOs and direct ACOs. 13:43 The use of direct ACOs. 14:47 “30% of employers are ... considering a direct-contracted ACO.” 17:03 How Collective Health’s direct contract with employers works. 17:58 Why providers choose to take risk and move toward value-based care with ACOs. 22:33 Are ACOs a direct threat to insurance carriers? 27:31 Providers taking initiative to go directly to employers. 30:17 Setting up measurement framework.

Frank Williams and Seth Blackley, CEO and Co-Founder, and President and Co-Founder, of Evolent Health respectively, recount the story of Evolent from an initial idea to IPO in 3.5 years. While still wondering if they've made it as a $400M startup, they reflect on what it means to be one of the few publicly traded healthcare company, the power of taking a consultative approach to healthcare, and their belief that talent is everything.

Eric Parmenter provides a wealth of information that is sure to help you understand how value-based care differs from the HMO model and benefits providers.  Listen in to learn just how value-based care will impact the future of health-care pricing models. You can find show notes and more information by clicking here: http://bit.ly/2aiFgjp

They rang the bell, now what? We sit down with the CEOs of Evolent Health and Fitbit, who led two industry-changing IPOs to discuss how their companies deliver and grow in the wake of going from startup to public company.

Over the course of a 20-year career, Trevor has started, built, shut down, funded, bought and sold technology and service companies, largely in the healthcare industry as an entrepreneur, investor and executive search consultant. In this current chapter of his entrepreneurial/A.D.D.-fueled professional career, Trevor serves as the Chairman of Oxeon Holdings, a healthcare growth services firm that connects our healthcare company partners with the fundamental drivers of business growth: great people, transformational business development partnerships, strategic investments, next generation business ideas and other growth-related services. On a day-to-day basis, Trevor leads Oxeon Partners, an Invested Executive Search firm that finds the right leaders to drive growth for healthcare technology and service companies. The firm invests in our clients, both emotionally and financially, and aligns itself with the long-term growth and success of the companies we work with. Trevor has overseen leadership team development across the C-Suite with many of Oxeon's clients including Evolent Health, athenahealth, The Advisory Board Company, Health Catalyst, HealthGrades, Imagine Health, Clover Health, Grand Rounds, Accolade, Pager, GoHealth, Brighton Health, Landmark Health, Avalon, Omada, Sutter Health, Intermountain and others. Along with leading Oxeon's invested executive search firm, Trevor also serves as the Managing General Partner of Oxeon Investments I LLC and Oxeon Investments II LLC, which provide strategic growth capital to venture-capital and private equity-backed healthcare technology and service companies. Finally, Trevor is the Founder and on the Board of Directors and Investment Committee of Cien Ventures, a venture studio that leverages Oxeon Partners' network of relationships to conceive and start healthcare technology and service companies. Trevor currently sits on the Board of Directors of CureSearch for Pediatric Cancer, Friends of Hudson River Park Trust, Patient Steward, Dossier Health and also serves on Advisory Boards for numerous other companies. Prior to starting Oxeon Partners, Trevor's career was wide-ranging – see above re: entrepreneurial/A.D.D. – as a co-founder of a number of start-up technology and service companies where he served as a CEO, Managing Partner, President & COO, as well as, VP of Marketing, Strategy, Sales and/or Business Development. His companies have been funded by leading VC firms including Softbank, General Atlantic, Draper Fisher, BEV Capital and Goldman Sachs, and have been acquired by Continuus Software (NASD: CNSW), PiperJaffrey (NYSE: PJC) and SaveTree, LLC. Trevor is an annoyingly big fan of the Boston Red Sox and also loves fly-fishing for trout, the Black Crowes and the Rolling Stones (which he plays too frequently during his shifts as Office DJ). He graduated from the University of Pennsylvania where he would stand absolutely no chance of being admitted today. He is a committed soccer and little league coach, teacher of swimming, skiing, bike riding, skating, reading, drawing and all other activities pursued by his three young children Charlie, Tess and Catie. Trevor, his inordinately patient and wonderful wife Megan, their kids and two golden retrievers (Oxeon employees 5 & 6) live in the Tribeca neighborhood of New York City. 00:00 Trevor explains what Oxeon Holdings, and his role at the company.00:30 How Oxeon Holdings assists healthcare companies during their company growth.1:50 The various aspects of Oxeon Holdings work and services that it provides for its clients.03:00 Oxeon Holdings mission is to make people healthier.4:30 The difference between a successful healthcare player and a failure is the team in place.09:30 Why healthcare is not an enticing industry to entrepreneurs seeking their fortunes.10:00 “Healthcare is not a get-rich-quick industry; that's not what healthcare is about.”10:40 How government reform and other systemic changes within the healthcare industry is pushing outside investors to invest in health companies and startups.14:00 Why many hospital systems are still driven by the pay-for-service model, and thus motivated mainly from a financial standpoint, not one that may serve patients best.17:30 How busy Oxeon Holdings is, and why.21:00 Oxeon Investments, and how Oxeon Holdings invests and handles their money.22:10 Oxeon Holding's criteria behind making an investment.23:45 Why start-ups are, and should, be asking for more than just money from their investors.28:00 “We wake up everyday wanting to be the best Executive Search in Healthcare. Not the biggest, the best.”29:00 Trevor explains Oxeon Holdings' Venture Studios initiative.36:30 Trevor talks unicorns.