Podcasts about health plans

In this episode, I interview Ruthann Anderson, CEO of CAPCA (California Association of Pest Control Advisors). Ruthann explains that CAPCA represents licensed PCAs (Pest Control Advisors) who she describes as “plant doctors,” often recommending non-chemical solutions such as irrigation changes, soil sampling, and nutrition adjustments before turning to pesticides. They advise across agriculture, turf, ornamental, and urban environments, and CAPCA focuses on statewide education and advocacy to support the profession. She discusses challenges like public perception and inconsistent enforcement in the past. A major example is the BeeWhere program, which CAPCA helped modernize to improve communication between beekeepers and pesticide applicators to reduce bee losses, showing how collaboration across groups leads to better outcomes.We also discuss the complexity of pest management, including public health issues like rat infestations, and the misconception that agriculture uses chemicals carelessly. Ruthann mentions grant-funded work documenting over 200 examples of PCAs choosing non-chemical approaches, which CAPCA plans to publish.We also dive into United Ag's mission to transform healthcare in agriculture: simplifying access, reducing costs, and putting empathy first with zero-copay clinics in rural communities. Ruthann highlights how thoughtful decisions, whether in farming or healthcare, lead to better outcomes, and she shares how CAPCA members can leverage United Ag's network for reliable health coverage.CAPCA: https://capca.com/Kirti Mutatkar, President and CEO of UnitedAg. Reach me at kmutatkar@unitedag.org, www.linkedin.com/in/kirtimutatkarUnitedAg website - www.unitedag.orgUnitedAg Health and Wellness Centers - https://www.unitedag.org/health-benefits/united-agricultural-benefit-trust/health-centers/Episode Contributors - Ruthann Anderson, Kirti Mutatkar, Dave Visaya, Rhianna MaciasThe episode is also sponsored by Brent Eastman Insurance Services Inc. - https://brenteastman.comBlue Shield of California - https://www.blueshieldca.comElite Medical - https://www.elitecorpmed.comGallagher - https://www.ajg.com/SAIN Medical https://sainmedical.com/MDI Network - https://www.mdinetworx.com/about-us

Senate Democrats were promised a vote by mid-December on extending the enhanced subsidies for the Affordable Care Act, but Republicans still can't decide whether they want to put forward their own alternative or what that might include. Meanwhile, both the Centers for Disease Control and Prevention and the Food and Drug Administration are roiled by debates over vaccines. Alice Miranda Ollstein of Politico, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Paige Winfield Cunningham of The Washington Post join KFF Health News' Julie Rovner to discuss those stories and more. Also this week, Rovner interviews KFF Health News' Aneri Pattani about her project tracking the distribution of $50 billion in opioid legal-settlement payments.  Plus, for “extra credit” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: The New York Times' “These Hospitals Figured Out How To Slash C-Section Rates,” by Sarah Kliff and Bianca Pallaro.  Joanne Kenen: Wired's “A Fentanyl Vaccine Is About To Get Its First Major Test,” by Emily Mullin.  Paige Winfield Cunningham: The New York Times' “A Smartphone Before Age 12 Could Carry Health Risks, Study Says,” by Catherine Pearson.  Alice Miranda Ollstein: The Independent's “Miscarriages, Infections, Neglect: The Pregnant Women Detained by ICE,” by Kelly Rissman.  

Comprehensive coverage of the day's news with a focus on war and peace; social, environmental and economic justice. Photo Ted Eytan Trump pick to head NASA gets second confirmation hearing after nomination pulled then reinstated; New Democratic Coalition announces health plan including protecting ACA subsidies; Senators discuss Russian abductions of Ukrainian children, legislative responses; Family of Colombian fisherman files human rights complaint over US boat strike that killed him; Trump's name added to building of US Institute of Peace that DOGE tried to dismantle The post New Democratic Coalition unveils health plan with ACA protections; Senators discuss Russian abductions of Ukrainian children – December 3, 2025 appeared first on KPFA.

This episode of the Pharmacy Quality Solutions Quality Corner Show explores the critical, coordinated efforts between health plans and pharmacies to improve patient health outcomes, particularly in light of National Diabetes Month (November), recognizing that over 38 million Americans live with diabetes.Podcast Host Kerri Musselman, Director, Clinical Transformation, Pharmacy at PQS by Innovaccer discusses with guest Bahar Davidoff, VP, Clinical Programs & Pharmacy with SCAN Health Plan, insights on how community pharmacies can transition from a focus on prescription dispensing revenue to a successful clinical service model.

Just weeks before some tax credits for Affordable Care Act premiums expire, the Trump administration floated a plan to extend the enhanced aid — but it was met with immediate GOP pushback. Meanwhile, health secretary Robert F. Kennedy Jr. says he ordered the Centers for Disease Control and Prevention to revise its website to suggest childhood vaccines might be linked to autism. Alice Miranda Ollstein of Politico, Sandhya Raman of CQ Roll Call, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News' Julie Rovner to discuss those stories and more. Also this week, Rovner interviews Joanne Kenen and Joshua Sharfstein about their new book, “Information Sick: How Journalism's Decline and Misinformation's Rise Are Harming Our Health — And What We Can Do About It.” Visit our website for a transcript of this episode.Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: The New Yorker's “A Battle With My Blood,” by Tatiana Schlossberg.  Alice Miranda Ollstein: CNBC's “Meta Halted Research Suggesting Social Media Harm, Court Filing Alleges,” by Jonathan Vanian.  Sarah Karlin-Smith: The Guardian's “Influencers Made Millions Pushing ‘Wild' Births — Now the Free Birth Society Is Linked To Baby Deaths Around the World,” by Sirin Kale and Lucy Osborne.  Sandhya Raman: KFF Health News' “Kids and Teens Go Full Throttle for E-Bikes as Federal Oversight Stalls,” by Kate Ruder.  

Guests:  Louis DeStefano, Chief Growth Officer, Oscar Health Jon Van Der Veer, DO, Founder & CEO, Hy-Vee Health In this special HLTH interview, Bright Spots in Healthcare host Eric Glazer speaks with two leaders shaping one of the most innovative payer–provider–retail collaborations in the country: Louis DeStefano, Chief Growth Officer, Oscar Health Jon Van Der Veer, DO, Founder & CEO, Hy-Vee Health Together, Oscar Health and Hy-Vee Health are building a new kind of health plan, one that blends local access, convenient care, primary care-first design, and tech-enabled member experience. Think of it as a hybrid model: part direct primary care, part advanced digital platform, part community-rooted retail ecosystem. This conversation dives into how the two organizations are integrating brick-and-mortar clinics, urgent care, pharmacy, SDOH-friendly retail access, and Oscar's tech stack, including "Oswell," Oscar's AI-powered clinical support tool, to deliver a personalized and coordinated experience. Topics We Cover: Why healthcare must be local, convenient, and relationship-driven How the partnership blends a supermarket chain, primary care clinics, and a tech-enabled health plan into one member experience How ICHRA is opening new doors for employer-driven personalization The role of AI and tools like Oswell in interpreting labs, improving communication, and augmenting care What a modern, scalable direct primary care model could look like The 10-year vision for this collaboration and where it expands next This episode offers a first look into a payer–retail–provider model that could reshape consumer expectations, and redefine how employer-sponsored and individual coverage works in the coming decade. References and Mentions: Learn more about the partnership between Oscar Health and Hy-Vee Health - https://www.hioscar.com/hy-vee-health Meet Oswell, Oscar Health's new health AI agent - https://www.hioscar.com/oswell  Dr. Garrison Bliss, widely recognized as the "Godfather of Direct Primary Care" -  https://www.linkedin.com/in/garrisonblissmd/ Bios: Louis DeStefano: https://hlth.com/events/usa/speakers/2025/louis-destefano Dr. Jon Van Der Veer: https://hlth.com/events/usa/speakers/2025/jon-van-der-veer Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email hkrish@brightspotsventures.com About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation. We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the "bright spots" in healthcare—proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com. Visit our website:  www.brightspotsinhealthcare.com. Follow Bright Spots in Healthcare: https://www.linkedin.com/company/shared-purpose-connect/

In this episode, Steve Tringale, President of Mass General Brigham Health Plan, shares how the organization is expanding its product portfolio, entering the dual eligible market, and investing in integrated digital care management to better support members across all stages of life.

The Cost of Thanksgiving and New Health Plans by Ohio Farm Bureau Podcast

On Wednesday's "Connecticut Today," host Paul Pacelli wondered if it's time for the State of Connecticut to offer a non-profit "public option" healthcare insurance plan to help folks who are being priced out of the Affordable Care Act - or "Obamacare" (00:53). Fairfield GOP State Sen. Tony Hwang reacted after state regulators voted to block a proposed sale of the Aquarion Water Company (14:56). University of New Haven Associate Professor of Accounting, Finance, and Taxation Dr. Jim Mohs talked about a new report regarding the Trump White House's tariff policies (18:03). Finally, Hearst Connecticut Media Senior Columnist and Editor Dan Haar dropped by for his weekly update (23:34)

Better use of technology, the transition from analogue to digital, and greater innovation are at the heart of the 10 Year Health Plan. This includes plans to make the NHS app a gateway to the entire NHS, integrate AI into clinical pathways, create a new Health Data Research Service, make genomic sequencing at birth universal, utilise wearable technology in treatments as standard, and to improve uptake and adoption of medicines. What are the potential benefits of greater use of technology and innovation in the NHS? Are there any risks associated with this? How deliverable is the 10 Year Health Plan's vision for the use of technology and innovation in the NHS? What are the barriers to greater adoption of technology and innovation more broadly? And how can these be overcome? How can investment in technology and innovation be protected and prioritised?   To discuss these questions and more, we were joined by an expert panel including: Matthew Chisambi, Director of Imperial College Health Partners Johan Kahlström, President and Managing Director, UK and Ireland at Novartis Pharmaceuticals UK Sam Roberts, Chief Executive of the National Institute for Health and Care Excellence This event was chaired by Nick Davies, Programme Director at the Institute for Government. We would like to thank Novartis Pharmaceuticals UK for kindly supporting this event. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Better use of technology, the transition from analogue to digital, and greater innovation are at the heart of the 10 Year Health Plan. This includes plans to make the NHS app a gateway to the entire NHS, integrate AI into clinical pathways, create a new Health Data Research Service, make genomic sequencing at birth universal, utilise wearable technology in treatments as standard, and to improve uptake and adoption of medicines. What are the potential benefits of greater use of technology and innovation in the NHS? Are there any risks associated with this? How deliverable is the 10 Year Health Plan's vision for the use of technology and innovation in the NHS? What are the barriers to greater adoption of technology and innovation more broadly? And how can these be overcome? How can investment in technology and innovation be protected and prioritised? To discuss these questions and more, we were joined by an expert panel including: Matthew Chisambi, Director of Imperial College Health Partners Johan Kahlström, President and Managing Director, UK and Ireland at Novartis Pharmaceuticals UK Sam Roberts, Chief Executive of the National Institute for Health and Care Excellence This event was chaired by Nick Davies, Programme Director at the Institute for Government. We would like to thank Novartis Pharmaceuticals UK for kindly supporting this event.

In this episode, Steve Tringale, President of Mass General Brigham Health Plan, shares how the organization is expanding its product portfolio, entering the dual eligible market, and investing in integrated digital care management to better support members across all stages of life.

Pop quiz: If your health insurance premiums keep climbing, should you just go catastrophic and pocket the savings? Joe Saul-Sehy, OG, and CFP Anna Allem tackle that exact question, along with a handful of other money decisions that keep Stackers up at night. From navigating healthcare coverage gaps to figuring out when (and how) to withdraw from a 529, this Monday mailbag episode is packed with the practical advice you need, served with the basement humor you've come to expect. The health insurance conversation gets real: what catastrophic plans actually cover (spoiler: less than you think), how to plan for the gaps, and whether gambling on your health is ever a smart financial move. Then Anna breaks down the 529 withdrawal strategy that saves you headaches at tax time, and the crew tackles a listener who's spooked by market volatility and wondering if it's time to bail. But it wouldn't be Monday without some chaos—Joe's cat decided to add drama to the morning, Doug brings trivia about counterfeit currency (because of course), and the gang updates you on the charity challenge where Stackers can support financial literacy and maybe win some prizes in the process. Plus: OG delivers movie reviews to help you figure out what's actually worth your streaming time this week. What You'll Walk Away With: • The truth about catastrophic health plans—when they make sense and when they'll leave you exposed • How to handle healthcare coverage gaps without gambling your financial future • The smart way to withdraw from a 529 so you don't accidentally trigger taxes or penalties • Why market volatility isn't a reason to panic—and what to do instead of bailing on your portfolio • How diversification and rebalancing keep you sane when the headlines get scary • A reminder that financial planning (like cat wrangling) rarely goes exactly as planned This Episode Is For You If: • You're staring at rising health insurance premiums and wondering if there's a better way • You've got a 529 but aren't sure how to actually use it without screwing up • Market dips make you nervous and you want to know if you should be doing something • You're tired of generic financial advice and want real answers to your specific questions • You believe learning about money should involve at least a few laughs (and maybe some cat stories) Got a Question for the Basement? Drop it in the comments or send it our way—you might just hear Joe Saul-Sehy, OG, and Anna tackle it in an upcoming mailbag episode. And if you want to support financial literacy while competing for prizes, check out the charity challenge details in the show. Deeper dives with curated links, topics, and discussions are in our newsletter, The 201, available at https://www.stackingbenjamins.com/201 Enjoy! Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode, Kevin Adams, CEO of HealthEdge, discusses how health plans can overcome legacy technology challenges through modernization, business process as a service (BPaaS), and AI-driven efficiency. He shares insights on building stronger operational foundations and how next-generation automation is reshaping payer operations. This episide is sponsored by HealthEdge.

A local politician lays out the reasons why it might be the right time to reconsider an old argument

The Democrats may be on the brink of the losing the government shutdown battle, but are Republicans going to be the ones paying for soaring healthcare costs?  Learn more about your ad choices. Visit podcastchoices.com/adchoices

This week on the Ohio Ag Net Podcast, Ty Higgins catches up with Trevor Kirkpatrick of the Ohio Farm Bureau to discuss the launch of the new Ohio Farm Bureau Health Plans, now open for enrollment, offering more affordable health coverage options for Ohio's farm families and small businesses. Dusty Sonnenberg talks with Julia Brown of the Ohio Soybean Council about the inaugural Ohio Soy Immersion Experience, a new program designed to give farmers an inside look at how the soybean checkoff works to grow demand and build value. Dale Minyo wraps things up with a visit to Wilmington College to learn about the school's new Agriscience Complex and how the facility will expand hands-on learning opportunities for the next generation of agricultural leaders with Dr. Chad McKay.

Hometown Radio 11/05/25 6p: A discussion about Medicare health plans

Get answers to your biggest questions about shopping for a health plan. Where do most people get health insurance?Many people get health coverage through an employer, such as your job, your spouse's job, or a parent's job (an option until you turn 26). Others buy it through HealthCare.gov, where you might qualify for an income-based tax credit to lower your premium. What should you look for when choosing a health plan? Compare the Summary of Benefits and Coverage for different plan options. This document gives you an apples-to-apples comparison of how much you pay for different types of care and what limits apply. Ask if a plan covers your doctors and medications. How do I know if a plan is affordable? The premium is the monthly cost you pay. It's usually straightforward with an employer plan. If you're shopping for an individual plan on HealthCare.gov, have an estimate of your annual income ready because your premium tax credit depends on your income. Pay attention to out-of-pocket costs as these can vary widely. Take note of the plan's deductible and the copays for visiting the emergency room, a specialist, and a primary care physician. If there's a deductible, how much is covered before I meet it? Any plan you buy on HealthCare.gov must cover preventive care before you reach your deductible. Preventive care services include annual checkups and school vaccines for your children. If your kids get sick, some plans will cover primary care for free or a copay or offer free virtual visits and telemedicine before you meet the deductible. If you're considering a high-deductible plan, know what coverage you'll get before you meet your deductible. This factor could be the difference between plans that have a similar monthly premium or a similar deductible. When is open enrollment? You can sign up for a new health plan on HealthCare.gov during open enrollment from November 1 to January 15. To get coverage that starts January 1, you must enroll by December 15. For health plans through your job, the enrollment period varies. Ask your company's human resources department for the dates. What red flags should I look for? Limited benefit health plans. These health plans might have a lower monthly premium, but they don't provide major medical coverage. Limited plans aren't part of HealthCare.gov and only cover certain services at specific coverage amounts. Pressure to buy now. No one should pressure you to buy a plan without giving you a chance to read the fine print. Examine the Summary of Benefits and Coverages before you buy anything so that you understand all the coverage and exclusions, their provider network, and the medications they cover. Upfront requests for personal information. Never share your phone number, credit card, or Social Security number unless you're on a trusted site like HealthCare.gov or an official insurance company website. Be suspicious of unsolicited phone and email offers. Questions? Visit HealthCare.gov or call our Help Line at 800-252-3439.Use these tips to shop smart for health coverage.Health care coverage guide.How to apply and enroll.Alternative health plans.Know what kind of health insurance you're buying.

In this episode, we sit down with Steve Wolin, CEO of Gravie, to explore how innovation is transforming health benefits for small and mid-sized businesses. Gravie believes members deserve a health plan that thinks beyond tradition—one that meets whole health needs with more care options and greater affordability.

In this Bright Spots in Healthcare episode, host Eric Glazer sits down with three leaders reshaping one of healthcare's most overlooked — yet mission-critical — functions: provider credentialing. Credentialing is the quiet infrastructure of trust in healthcare. When it's done right, patients get timely access to high-quality care, providers get paid faster, and health plans stay compliant. When it fails, backlogs grow, compliance risk skyrockets, provider satisfaction plummets, and member access suffers. Joining Eric for this discussion: Sandra Clarke, Former CFO & COO, Blue Shield of California Brett Dooies, Head of Product, Verifiable Janan Dave, VP of Operations, Verifiable Together, they explore how AI and automation are transforming credentialing from a slow, manual compliance task into a strategic capability that improves efficiency, trust, and network readiness. In this episode, you'll learn: Why credentialing sits at the intersection of compliance, provider experience, and member access How legacy processes, staffing limits, and messy data create hidden risk, and why backlogs can grow like quicksand Practical ways health plans are applying AI to reduce verification time, speed onboarding, and triage high-risk cases Why the most successful plans treat credentialing as infrastructure, not paperwork Key metrics to track when modernizing credentialing, including turnaround time, backlog clearance, audit readiness, and provider experience What to automate first,  and why humans still play a critical oversight role Bright Spots include: 97% automated verification in seconds across millions of records monthly New staffing and automation models that increase speed without compromising compliance Real-world examples where AI prevented risk exposure and accelerated network growth Leadership lessons in adopting AI responsibly and avoiding the "lift-and-shift" trap   This conversation offers payer leaders a real-world playbook to modernize credentialing and strengthen the foundation of your healthcare organization. Panelist Bios: Sandra Clarke is a healthcare executive and board advisor with over 25 years of experience leading finance, operations, and large-scale transformation across payer, provider, and life sciences organizations. As former CFO and COO of Blue Shield of California, she oversaw $25B in annual revenue and spearheaded initiatives delivering $700M in annualized savings while reimagining the company's pharmacy care model. Clarke has also held senior leadership roles at Daiichi Sankyo and Philips Healthcare and serves on multiple healthcare boards. She holds degrees from MIT, Bentley University, and Seton Hall University School of Law. Janan Dave is the VP of Operations at Verifiable, a start-up offering software and services solutions for healthcare organizations to ease the challenges surrounding provider network management. Janan has a background in public health and health policy, and has spent the last decade helping scale operations at various healthcare startups. She is passionate about building smart solutions to reduce waste in the healthcare system, and promote better care especially for the aging population, family caregivers, and women. Janan studied public health at the University of Pennsylvania, and lives in Brooklyn, NY. Brett Dooies is the Head of Product at Verifiable, where he leads the development of AI-powered solutions to simplify healthcare credentialing and monitoring. With a decade of experience building enterprise software, he specializes in applying advanced AI and analytics to enhance the customer experience and deliver transformative solutions. Drawing on his background in modernizing banking software, Brett is dedicated to creating products that drive operational excellence, uphold regulatory compliance, and improve data accuracy for Verifiable's partners, helping them scale with confidence in a complex ecosystem. Resources: MIT Sloan "Internet of AI Agents: State of AI in Business 2025" report finds that although over 80 % of organizations have piloted generative AI tools, only around 5 % have achieved meaningful business transformation—a gap dubbed the "GenAI Divide". It highlights that the primary barrier isn't model technology or regulation, but rather the failure of AI systems to integrate deeply into workflows, learn from feedback, and scale beyond the pilot stage. https://mlq.ai/media/quarterly_decks/v0.1_State_of_AI_in_Business_2025_Report.pdf Thank you to our Episode Partner, Verifiable: Verifiable is a credentialing and network monitoring platform built to help healthcare organizations optimize operations with error-free, fast verifications and to stay compliant with ease. Backed by their in-house NCQA certified credentialing team that bring a combined 60+ years of experience, Verifiable's innovation supports managing trusted networks at scale through 97% verification automation in seconds with millions processing each month. Verifiable works with leading healthcare organizations such as Humana Dental, Zelis, Talkspace, Headway, Empower Pharmacy, and many others.   Learn more about them at https://verifiable.com/ Want to go deeper or schedule a briefing with Verifiable? Email hkrish@brightspotsventures.com and we'll coordinate time with the Verifiable team to discuss how their approach can help your plan reduce costs, accelerate onboarding, and strengthen network integrity. About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.   We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the "bright spots" in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.  

In this episode of The SEANC View, our team speaks with Thomas Friedman, executive administrator of the North Carolina State Health Plan, about the recently launched Lantern program. Lantern offers state employees and teachers access to free elective surgeries (orthopedics and bariatrics) with high-quality providers across the state, including travel and lodging coverage when needed. They discuss how Lantern aims to reduce overall health costs through price transparency and bundled care, upcoming expansions (including maternity care), and efforts to manage pharmaceutical expenses. The conversation also touches on rural access, provider incentives, and open enrollment.

Laurent Rotival, executive vice president and chief information officer for Regence, talks about how Regence first started its work in AI a decade ago and how that work has evolved in helping Regence meet the needs of members.

In this special author conversation, George and Patrick talk with longtime Academy instructor Frank Pennachio, as he explains what drove him to write The Silent Danger, uncovering how … Read More » The post Frank Pennachio on Fiduciary Risks Hidden in Self-Funded Health Plans | Author Conversation appeared first on Insurance Journal TV.

This episode features Dr. Richard Celko, Chief Dental Officer at UPMC Health Plan who discusses challenges with access to dental care in rural areas, strategies for addressing community needs, and insights on current events shaping the dental industry.

This episode features Richard Greene, President of Clever Care Health Plan, discussing how the organization is growing through a unique model that combines Eastern and Western medicine, invests in culturally tailored community centers, and builds sustainable relationships with providers and members across California.

Proverbs 3:7-10

Brandon Weber, Co-founder & CEO of Nava Benefits, joined us on The Modern People Leader.We talked about why benefits have become the second-largest company expense — and how HR can “moneyball” their healthcare spend, cut down on benefits-related admin work, and deliver better employee outcomes through the emerging “alt marketplace.”---- Nava Links:

Hometown Radio 10/21/25 5p: A discussion about Medicare health plans

This installment of Health Care Beat continues our series on the intersection of artificial intelligence and health care, focusing on the legal and compliance challenges that come with rapid innovation. Co-hosts Chris DeMeo and Amanda Genovese welcome Seyfarth attorney Caroline Pieper to explore how AI is reshaping health plan administration — particularly with respect to claims administration — and the regulatory, ethical, and fiduciary considerations organizations must navigate when adopting or hiring service providers that use these tools. Read the full transcript of the episode here: https://www.seyfarth.com/dir_docs/podcast_transcripts/HCB_Episode53.pdf

This episode features Dr. Richard Celko, Chief Dental Officer at UPMC Health Plan who discusses challenges with access to dental care in rural areas, strategies for addressing community needs, and insights on current events shaping the dental industry.

This episode features Richard Greene, President of Clever Care Health Plan, discussing how the organization is growing through a unique model that combines Eastern and Western medicine, invests in culturally tailored community centers, and builds sustainable relationships with providers and members across California.

As South Africa grapples with the National Health Insurance (NHI) proposal, one doctor is pioneering a private-sector alternative aimed at the millions who find medical aid too expensive. Dr. Reinder Nauta, founder of the National Healthcare Group , is building a new low-cost model targeting a price point of around R200 per month. Nauta reveals how the system works, using technology like WhatsApp and a nurse panel to triage patients before referring them to a network of 3,000 GPs.

10.7.2025 #RolandMartinUnifltered: Day 7 Shutdown Chaos, Schumer’s Health Plan, Trump Threatens Pay, Bondi Hearing Fire, Kyren Lacy CaseIt's day seven of the government shutdown. Senate Minority Leader Chuck Schumer lays out the Democrats' plan to hold the line for American healthcare.The twice-impeached, criminally convicted felon-in-chief, Donald "The Con" Trump, is saying furloughed federal workers aren't guaranteed back pay, and airports are seeing major delays. California Congresswoman Sydney Kamlager-Dove will join us to talk about all of this. Today, in a heated hearing on Capitol Hill, Attorney General Pam Bondi testified regarding the Department of Justice. We'll show you some of the exchanges she had with Illinois Senator Dick Durbin.The Louisiana NAACP is calling for accountability in the Kyren Lacy case. State police have released body camera footage that may explain why Kyren was blamed for the fatal crash.We'll speak with another candidate who wants to be the next mayor of New Orleans. In our Shop Black Star Network Marketplace segment, we will feature fashionable scrubs specifically for healthcare professionals.#BlackStarNetwork partner: Fanbasehttps://www.startengine.com/offering/fanbaseThis Reg A+ offering is made available through StartEngine Primary, LLC, member FINRA/SIPC. This investment is speculative, illiquid, and involves a high degree of risk, including the possible loss of your entire investment. You should read the Offering Circular (https://bit.ly/3VDPKjD) and Risks (https://bit.ly/3ZQzHl0) related to this offering before investing.Download the Black Star Network app at http://www.blackstarnetwork.com! We're on iOS, AppleTV, Android, AndroidTV, Roku, FireTV, XBox and SamsungTV.The #BlackStarNetwork is a news reporting platform covered under Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research.See omnystudio.com/listener for privacy information.

This is the beginning of our 6th year!!! This week, Diane interviews Jason Dutra with BuddyIns again.   We discuss tax-benefits of worksite LTC insurance and hybrid life/LTC worksite plans. How are these plan offerings different than other group benefits that employers offer? How can employers use group life/LTC plans to show how much they care about their employees? When employees know their employer cares about them and their families, they are more productive.  Everyone is happier, and employee retention is strong. If you are a business owner with at least 3 employees, there are worksite LTC plans available for you to consider.  These plans have guaranteed issue rights, so no medical questions to qualify. If you are an employee and have been declined for LTC, you can ask your employer if they would consider offering this benefit to some or all the people who work there. Schedule some time with me to explore options    

On this Ropes & Gray podcast, health care partners Ben Wilson and Mike McGrath discuss the current trends and challenges in health plan mergers and acquisitions, with a focus on the Medicare Advantage market. They explore the factors driving deal activity, such as financial distress among smaller plans and strategic partnerships for growth, as well as evolving federal and state regulatory requirements. The conversation provides practical guidance for health plan leaders on maximizing value, preparing for regulatory approvals, and addressing nonfinancial considerations like star ratings and compliance history when pursuing M&A opportunities.

And - a worker refused entry into a Belfast pub because he was in work clothes.

Mike and Maggie bring the latest Ag news from around Alabama. Also, we introduce a new segment to the AgCast. Mac Higgenbotham brings us the first Field Staff Report. This is what's going on the frontline of agriculture for last week.Visit Alabama Farmers Federation for more on the headlines covered here. Also, subscribe to the Cultivator to get more Ag news from around the state and in our nation.You can also visit Sweet Grown Alabama for information from Mac's report.

This week, State Treasurer Brad Briner visited The SEANC View Podcast for an extensive interview covering everything from the status of the State Health Plan to the prospect of cost-of-living adjustments for retirees. In the last few weeks, Briner's office has been on quite a roll. On Tuesday, he announced a significant agreement with CVS Caremark that has ended a long-standing dispute and is expected to bring savings to Plan members. It may also enable the plan to cover GLP-1 drug treatment for weight loss once again. Last week, his office brokered a deal between Duke and Aetna that will allow State Health Plan members to continue to see Duke doctors in-network. We discussed the state retirement system and the need for true COLAs for retirees at length as well. He elaborated on his comments on NC Newsline this week, stating that changes to the system's investing strategy may allow for a raise in 2027. He also discussed fees, in-house management, and the creation of an Investment Authority to oversee the system.

As the leaves change, your health plan should, too. Episode 167 is a solo conversation and Dr. Anthony Balduzzi shares a practical framework for adapting your routines to the realities of fall—colder weather, shorter days, and a busier social calendar. Expect simple moves you can apply immediately to keep progress steady. We cover cold-weather training options and how to build indoor contingencies you'll actually use. You'll also learn why less daylight can impact mood, sleep, and consistency—and what to do about it with smart light exposure and Vitamin D updates. On the nutrition front, Dr. A makes fall eating easy: warming crock-pot meals, seasonal produce swaps (hello, squash and pomegranate), and a straightforward holiday strategy that lets you enjoy the feast without losing momentum. Finally, we zoom out: seasonal planning is about rhythm, not perfection. With a few proactive adjustments, you can stay grounded through fall, glide into winter, and keep stacking wins week after week. Plus—live event invites for 2026 if you want to take the next step in person. Key TakeawaysBuild a seasonal plan: what worked in summer may not work in fall. Create indoor training contingencies (space, equipment, time block). Protect mood/sleep as daylight drops: morning light or full-spectrum lamp. Vitamin D: consider testing and/or increasing D3 + K2 during low-sun months. Use warming, one-pot meals (stews, slow-cooker) for easy adherence. Seasonal swaps: squash, root veg, pomegranate for micronutrients & fiber. Holiday strategy: small protein snack pre-event; protein/veg first; dessert last. Leverage calories: strength train the day after big meals or add a light fast. Guard your circadian rhythm: earlier wind-down as evenings get darker. If travel ramps up, prep a portable routine and default meals. Think in systems (routines + environment) rather than willpower. Consider in-person events for accountability and momentum spikes. Alitura: For Great Skin Care ProductsAlitura makes 100% natural, toxin-free products with ingredients like grass-fed colostrum, CoQ10, and plant stem cells. Visit https://alitura.com/ and use FITFAMILY at checkout for 10% off your first order.Featured Events & LinksFit Father / Fit Mother LIVE 2026 — August 7–9, 2026 Super Early Bird pricing now through Dec. 1. Click here and plan to join us!Sedona Retreats — Fit Mother Retreat March 2026. Fit Father Retreat April 2026. Belize Service Trip — June 6-12, 2026. See what it's about here.Want To Change Your Life? Check Out Foundations!Foundations is a simple, sustainable, and specific weight loss program designed especially for busy women over 40. With short metabolic training workouts, an easy-to-follow meal plan, and an accountability team there for you every step of the way, Foundations can help you lose weight, regain energy and vitality, and live life to the fullest.

As the leaves change, your health plan should, too. Episode 258 is a solo conversation and Dr. Anthony Balduzzi shares a practical framework for adapting your routines to the realities of fall—colder weather, shorter days, and a busier social calendar. Expect simple moves you can apply immediately to keep progress steady. We cover cold-weather training options and how to build indoor contingencies you'll actually use. You'll also learn why less daylight can impact mood, sleep, and consistency—and what to do about it with smart light exposure and Vitamin D updates. On the nutrition front, Dr. A makes fall eating easy: warming crock-pot meals, seasonal produce swaps (hello, squash and pomegranate), and a straightforward holiday strategy that lets you enjoy the feast without losing momentum. Finally, we zoom out: seasonal planning is about rhythm, not perfection. With a few proactive adjustments, you can stay grounded through fall, glide into winter, and keep stacking wins week after week. Plus—live event invites for 2026 if you want to take the next step in person. Key TakeawaysBuild a seasonal plan: what worked in summer may not work in fall. Create indoor training contingencies (space, equipment, time block). Protect mood/sleep as daylight drops: morning light or full-spectrum lamp. Vitamin D: consider testing and/or increasing D3 + K2 during low-sun months. Use warming, one-pot meals (stews, slow-cooker) for easy adherence. Seasonal swaps: squash, root veg, pomegranate for micronutrients & fiber. Holiday strategy: small protein snack pre-event; protein/veg first; dessert last. Leverage calories: strength train the day after big meals or add a light fast. Guard your circadian rhythm: earlier wind-down as evenings get darker. If travel ramps up, prep a portable routine and default meals. Think in systems (routines + environment) rather than willpower. Consider in-person events for accountability and momentum spikes. Save With a Troscriptions TrialIf you're on a mission to simplify and accelerate your path to health optimization and feel better now, Troscriptions is where to start. Give it a try at troscriptions.com/FITFAMILY or enter FITFAMILY at checkout for 10% off your first order.Featured Events & LinksFit Father / Fit Mother LIVE 2026 — August 7–9, 2026 Super Early Bird pricing now through Dec. 1. Click here and plan to join us!Sedona Retreats — Fit Mother Retreat March 2026. Fit Father Retreat April 2026. Belize Service Trip — June 6-12, 2026. For information please write belize@fitfatherproject.comWant To Change Your Life? Check Out Foundations!Foundations is a simple, sustainable, and specific weight loss program designed especially for busy men over 40. With short metabolic training workouts, an easy-to-follow meal plan, and an accountability team there for you every step of the way, Foundations can help you lose weight, regain energy and vitality, and live life to the fullest. Click here to see everything you get when you...

We're talking about the tax credits that help people buy health insurance through state and federal health insurance exchanges. David W. Johnson and Julie Murchinson tell us who wins and who loses in the shutdown showdown on, “Erasing Enhanced Premium Tax Credits for ACA Health Plans,” the new episode of the 4sight Health Roundup podcast, moderated by David Burda.

Rising clashes between hospitals and insurers are exposing outdated fee-for-service infrastructure. As payer–provider clashes surge, healthcare infrastructure is under pressure. We unpack what's fueling these disputes, how they impact patients, and why flexible platforms may be the key to moving forward.

Bridging Home, Family, and Health Plans: Avanlee Christine on Caregiver-First Health Innovation StartUp Health community member Avanlee Christine, CEO & Co-founder of Avanlee Care, joins Unity Stoakes on StartUp Health NOW to share how a pivot from fundraising to customer development unlocked product traction, investor interest, and partnerships with innovative health plans. From Billings, Montana, Avanlee explains why integrating unpaid family caregivers into care workflows improves outcomes, raises satisfaction, and helps Medicare Advantage plans do more with less. In this episode: How shifting focus from pitching to building sparked inbound VC interest, including the first venture investor Why 60% of Medicare Advantage members rely on informal caregivers, and how formalizing that communication closes gaps Practical ways caregiver engagement boosts stars, adherence, annual wellness visits, and CAHPS Lessons from scaling a health tech company in Montana, with support from mentors and investors like Esther Dyson Real talk on resilience, motherhood, team building, and staying alive through tough cycles What health plan leaders, quality and risk teams, and investor partners should know about Avanlee Care right now Listen for: Simple, structured steps health plans can take to bring caregivers into the loop A founder's playbook for surviving early years, finding product-market fit, and creating momentum outside traditional tech hubs     Are you ready to tell YOUR story? Members of our Health Moonshot Communities are leading startups with breakthrough technology-driven solutions for the world's biggest health challenges. Exposure in StartUp Health Media to our global audience of investors and partners – including our podcast, newsletters, magazine, and YouTube channel – is a benefit of our Health Moonshot PRO Membership. To schedule a call and see if you qualify to join and increase brand awareness through our multi-media storytelling efforts, submit our three-minute application. If you're mission-driven, collaborative, and ready to contribute as much as you gain, you might be the perfect fit. » Learn more and apply today. Want more content like this? Sign up for StartUp Health Insider™ to get funding insights, news, and special updates delivered to your inbox.

Small business have a few different options for offering coverage to their employees Learn about these 3 options and how your role as an agent fits in.   Read the text version   Register with Ritter Insurance Marketing   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Resources: ACA 101: Selling Under-65 Health Insurance ACA Enrollment Periods Explained Contract & Get Appointed to Sell with Health Insurance Companies Community-Based Marketing for Insurance Agents Meet Your Sales Team Simplify Marketplace Enrollment with HealthSherpa Six Ways to Generate ACA Leads Social Media Marketing for Insurance Agents FREE eBook DOWNLOAD The Insurance Agent's Guide to Generating Referrals FREE eBook DOWNLOAD The ICHRA Opportunity for Agents ft. Lisa Marzolino & Danica Stover   References: “Agents & Brokers: How to Register to Sell Shop Insurance.” HealthCare.Gov, www.healthcare.gov/small-businesses/agents-and-brokers/. Accessed 25 Aug. 2025. Author: Louise Norris | Date Posted: October 11. “Can Small Businesses Use the ACA's Health Insurance Marketplaces (Exchanges)?” Healthinsurance.Org, 2 May 2025, www.healthinsurance.org/faqs/ive-heard-a-lot-about-health-insurance-exchanges-but-what-are-shop-exchanges/. “Find Local Help.” Local Assistance for Health Insurance Application, www.healthcare.gov/find-local-help/. Accessed 25 Aug. 2025. “Individual Coverage Health Reimbursement Arrangements (HRAS).” HealthCare.Gov, www.healthcare.gov/small-businesses/learn-more/individual-coverage-hra/. Accessed 25 Aug. 2025. “Nexben.Com.” Nexben, 22 May 2024, www.nexben.com/. “Promoting Healthcare Choice and Competition Across the United States.” Federal Register, 17 Oct. 2017, www.federalregister.gov/documents/2017/10/17/2017-22677/promoting-healthcare-choice-and-competition-across-the-united-states. “What Is a QSEHRA?” Healthinsurance.Org, 7 July 2025, www.healthinsurance.org/glossary/qualified-small-employer-health-reimbursement-arrangement/.   Follow Us on Social!  Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.

In this episode of Bright Spots in Healthcare, we explore The Next Frontier in Self-Funded Benefits. Don Antonucci, CEO of Providence Health Plan and Ali Diab, CEO of Collective Health share how their new partnership is reshaping the employer-sponsored benefits landscape. The conversation dives into: Why aligning provider and member needs is essential for a truly seamless healthcare experience How transparency and simplicity can unlock smarter healthcare decisions The role of innovation and technology in reducing complexity for both employers and employees How strategic partnerships can accelerate growth and deliver more affordable, high-quality care This discussion offers practical insights for health plans, employers, and healthcare leaders looking to design benefits that drive satisfaction, savings, and long-term success. Panelist Bios: https://www.brightspotsinhealthcare.com/events/the-next-frontier-in-self-funded-benefits-inside-providence-health-plans-new-partnership-with-collective-health/ Resources & References Start with Why by Simon Sinek (Book) - https://simonsinek.com/books/start-with-why/  How Great Leaders Inspire Action – TED Talk by Simon Sinek - https://www.ted.com/talks/simon_sinek_how_great_leaders_inspire_action Healthcare Models to Explore: Kaiser Permanente (U.S.) – cited as effective at integrating coverage and care into one user experience Israel – highlighted as having a national health service with user-friendly, electronic front doors for care and transparency in costs Japan – also noted for its efficient, transparent national health service with easy access and clear financial responsibility for patients Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email hkrish@brightspotsventures.com  About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation. We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.

In this episode, Zack Myers, National General Manager at SCAN Health Plan, discusses the organization's expansion into new markets, its nonprofit approach to provider partnerships, and how innovative models like iSNPs are improving care and independence for seniors.

The state of public health in the United States has never been more fragmented or less trusted. We need a whole systems approach, paired with personal health initiatives, which is why we're calling for a new way. This is the People's Health Plan, in 10 Pillars. To read more about this, you can head over to jeffkrasno.substack.com - and I'd love to hear what you think about this plan. Let me know at jeff@onecommune.com or on Substack.

The news to know for Wednesday, September 10, 2025! We're discussing how the war in the Middle East might have expanded with an unprecedented attack.  Also, new health advice for American children that's being called “historic.” And why experts believe an increasing number of American high schoolers lack basic reading and math skills (hint: it's not just the pandemic).  Plus: data indicating the job market might be struggling more than we realized, Apple's latest releases—including the skinniest iPhone ever—and this year's new Girl Scout cookie inspired by ice cream.   Those stories and even more news to know in about 10 minutes!    Join us every Mon-Fri for more daily news roundups!  See sources: https://www.theNewsWorthy.com/shownotes Become an INSIDER to get AD-FREE episodes here: https://www.theNewsWorthy.com/insider Sign-up for our Friday EMAIL here: https://www.theNewsWorthy.com/email Get The NewsWorthy MERCH here: https://thenewsworthy.dashery.com/ Sponsors: Go to https://www.cookunity.com/newsworthyfree for Free Premium Meals for Life. Thanks to CookUnity for supporting the show! Save 20% off Honeylove by going to honeylove.com/NEWSWORTHY! #honeylovepod To advertise on our podcast, please reach out to ad-sales@libsyn.com

The Over-50 Fitness & Health Plan The body is always adapting; if you do it right, you will respond great! (1:42) Considerations to take into account when constructing a routine for this avatar. (5:49) The RIGHT Way to Workout & Eat to Get GREAT Results if You're Over 50 Years Old. An effective full-body workout 2 days a week. (8:52) Day 1: Push a sled, incline dumbbell chest press, cable rows, standing dumbbell shoulder press, dumbbell curls, press down, and a plank. (12:02) Day 2: Trap bar deadlift, push-ups, pull-downs, rear flys, hammer curls, closer grip push-ups, cable chop, and standing calf raises. (18:03) Activity: Aim for 8k steps a day, then 10k, and then 12k steps a day. (21:57) Diet: Women eat 30, men eat 45 grams of protein per meal FIRST, eat veggies SECOND, and eat a starch or fruit LAST. (23:40) Sleep: No electronics, take glycine and magnesium before bed, and aim for a 9-hour window. (26:13) Supplements: Multivitamin, 2000IU Vitamin D plus K, and creatine 10 grams a day. (26:57) Related Links/Products Mentioned Visit MASSZYMES by biOptimizers for an exclusive offer for Mind Pump listeners! **Code MINDPUMP10 at checkout for 10% off any order. ** August Special: MAPS 15 50% off! ** Code MUSCLE50 at checkout ** How Do I Choose The Right Weight? (LIFT RESPONSIBLY) – Mind Pump TV Mind Pump TV - YouTube – Search ALL exercises with videos and coaching cues mentioned above. The Active Plank- An 6-Pack Building Powerhouse – YouTube Walking 8,000 steps just 1-2 days a week linked to significant health benefits Mind Pump # 2402: The 5 Reasons Why Walking is King for Fat Loss (Burn More Fat than Running & How to Do it Correctly) Mind Pump # 2650: Top 7 Underrated Supplements Mind Pump # 2497: The Amazing & Weird Side Effects of Creatine Mind Pump Podcast – YouTube Mind Pump Free Resources