Podcasts about lumeris

Dr. David Carmouche, Executive Vice President and Chief Clinical Transformation Officer at Lumeris, joins the podcast to discuss how the new presidential administration is shaping healthcare policy and the evolving role of AI across the industry. He shares his observations on how some organizations are embracing AI while others remain hesitant and emphasizes the critical role primary care plays in driving the broader patient experience. Dr. Carmouche also offers thoughtful advice to emerging leaders navigating today's complex healthcare landscape.

This episode recorded live at the Becker's Hospital Review 15th Annual Meeting features David Carmouche, MD, Executive Vice President & Chief Clinical Transformation Officer at Lumeris. Dr. Carmouche discusses how Lumeris is leveraging AI to redefine primary care delivery, scale access, and improve outcomes—without sacrificing quality or provider trust.This episode is sponsored by Lumeris.

Lumeris introduces Tom, an agentic AI solution designed to support primary care teams and bridge the 2 billion-hour primary care gap in the US. In this episode, Dr. David Carmouche, Chief Clinical Transformation Officer at Lumeris, shares insights into the company's new agentic AI solution, Tom, and how it aims to revolutionize primary care. David discusses Lumeris's history, rooted in the belief that technology is crucial for high-quality, accountable primary care. He explains how Tom leverages the company's data aggregation capabilities to launch multiple coordinated agents on behalf of patients, proactively extending care and freeing up clinicians' time. David also highlights the pressing need to address the 2 billion-hour primary care gap in the US and how Tom can help bridge it by automating tasks, providing services that should happen but aren't, and upskilling the delivery of primary care. Tune in to learn how Lumeris is leveraging AI to transform primary care, improve patient access, and empower clinicians! Resources: Connect with and follow Dr. David Carmouche on LinkedIn. Learn more about Lumeris on their LinkedIn and website. Email David directly here.

About Dr. David Carmouche:Dr. David Carmouche is the Chief Clinical Transformation Officer at Lumeris. He is a visionary leader in transformational healthcare delivery with a unique blend of provider, payer, retail, and integrated delivery network leadership experience.Things You'll Learn:Lumeris has launched Tom, an agentic AI solution designed to support primary care teams and extend primary care to more Americans.Tom leverages Lumeris's data aggregation capabilities to launch coordinated agents that proactively address patients' needs and improve care coordination.There's an estimated two billion-hour gap in primary care in the US, and technology like Tom is essential to bridge this gap and ensure access for all.AI can help automate tasks, provide services that aren't currently happening, and upskill the delivery of primary care.Lumeris is approaching the deployment of Tom cautiously, with guardrails and thorough testing, to ensure it enhances the provider-patient relationship rather than replacing it.Resources:Connect with and follow Dr. David Carmouche on LinkedIn.Learn more about Lumeris on their LinkedIn and website.Email David directly here.

We're discussing Compassion in Code: Leveraging Technology for Personalized Patient Care! Faisel and Dan are joined by Dr. David Carmouche: Executive Vice President & Chief Clinical Transformation Officer at Lumeris.Our conversation revolves around industry adoption of cutting edge healthcare technologies, working with the factors that influence health equity, and AI-Physician collaboration for better health coaching.

In this conversation, Dr. David Carmouche discusses the critical transition from fee-for-service to value-based care in the healthcare industry, emphasizing the role of AI in enhancing primary care and improving patient outcomes. He highlights the financial pressures on health systems and the importance of aligning incentives to achieve sustainability. The discussion also covers the innovative solutions offered by Lumeris and the transformative potential of AI in automating care processes and improving patient engagement. Finally, Dr. Carmouche addresses the need for regulatory guardrails as AI becomes more integrated into healthcare delivery.In this episode , they discuss:The shift from fee-for-service to value-based care is essential for financial sustainability.AI is poised to transform primary care delivery and patient engagement.Healthcare costs have been deemed unsustainable for decades, necessitating change.Aligning incentives is crucial for improving patient outcomes in healthcare.Lumeris has a decade-long history of partnering with health systems for value-based care.AI can automate and standardize care processes, enhancing efficiency.Data availability and interoperability are key to successful value-based care models.Generative AI can proactively engage patients and improve care delivery.Training clinicians to effectively use AI is vital for its successful integration.Regulatory guardrails will be necessary as AI becomes more prevalent in healthcare.A little about Dr David Carmouche: David Carmouche, MD, is the Executive Vice President & Chief Clinical Transformation Officer at Lumeris. Dr. Carmouche is a visionary leader in transformational healthcare delivery, with a unique blend of provider, payer, retail, and integrated delivery network leadership experience.Prior to joining Lumeris, Dr. Carmouche served as Walmart's Senior Vice President of Healthcare Delivery, where he led the fleet of Walmart Health centers, Walmart Health Virtual Care, a value-based care partnership with Optum, and Walmart's work to address Social Determinants of Health. Dr. Carmouche has also held significant leadership roles with Ochsner Health, the largest nonprofit academic healthcare system in the Gulf South, and Blue Cross Blue Shield of Louisiana, where he introduced the company's first value-based care contracts. Earlier in his career, he built and led a multidisciplinary internal medicine and preventive cardiology practice.Dr. Carmouche attended Tulane University and LSU Medical School in New Orleans. Board-certified in Internal Medicine, he completed his residency at the University of Alabama at Birmingham, where he later served as Chief Resident. He serves as President of the Board of the Consortium for Southeastern Healthcare Quality and on the advisory board at Stellar Health. He has served on the board of the National Association of Accountable Care Organizations.

Send us a Text Message.Welcome to another exciting episode of the Healthcare Trailblazers podcast! Today, we are thrilled to have Eric Weaver, a prominent voice in healthcare transformation. Eric shares his inspiring journey from a clinical laboratory scientist to a leader in value-based care. We delve into his experiences, the challenges of the healthcare system, and his optimistic outlook on the future of healthcare, especially in the realm of AI and technology.Key Takeaways:Eric Weaver's Background: Eric shares his journey from Central Texas to becoming a significant voice in healthcare, starting from the clinical side to value-based care management.Transition to Value-Based Care: Eric discusses his initial disillusionment with the fee-for-service model and how his trip to Cuba inspired him to start an Accountable Care Organization (ACO) in West Texas.The Role of ACOs: Insights into the creation and management of multiple ACOs in Texas, focusing on the importance of high-touch primary care and community-based interventions.Impact of the Pandemic: Discussion on how the pandemic has highlighted the need for value-based care and how it has accelerated certain healthcare transformations.Challenges and Opportunities: Eric shares his views on the challenges faced by large healthcare players like Walmart Health and the potential of telehealth and AI in transforming healthcare delivery.Future of AI in Healthcare: An optimistic outlook on how AI can revolutionize healthcare by improving clinical decision-making, enhancing patient care, and reducing costs.Importance of Storytelling: Eric emphasizes the power of storytelling in driving value-based care and shares his journey in starting his own podcast to amplify these stories.Lumeris' Role: Introduction to Lumeris, a value-based care enablement company, and how it supports healthcare organizations in their journey towards sustainable and effective care delivery.AI's Potential in Healthcare: Discussion on the current applications and future potential of AI in aggregating data, predicting medical conditions, and augmenting clinical intelligence.Eric's Vision for Healthcare: A hopeful perspective on the future of healthcare, the need for collective recognition of change, and the role of leaders in driving this transformation.

In value-based care, technology is the catalyst, but success requires management and aligned incentives for better, cost-effective care. In today's episode, Jean-Claude Sagbini, a leading expert in technology and engineering for population health management at Lumeris shares the foundational role of technology in succeeding in value-based care within healthcare. Jean-Claude underscores the importance of understanding the populations and individual patients being served, which requires access to diverse, often unstructured healthcare data. He explores the vital role technology plays in value-based care and how it enables healthcare providers to understand and serve their patient populations effectively. Jean-Claude highlights the challenges of accessing and aggregating vast amounts of healthcare data and the transformative insights that can be derived through machine learning and AI. He discusses Lumeris' approach to using generative AI, keeping physicians at the forefront, and implementing necessary guardrails to ensure quality outcomes. Furthermore, he explores the future of primary care and how AI-powered solutions can revolutionize how healthcare services are delivered.  Join us as we discuss the vital role of technology in value-based care, the use of generative AI, and the future of AI-powered primary care. Resources: Connect with and follow Jean-Claude on LinkedIn. Follow Lumeris on LinkedIn. Visit Lumeris on their Website.

About Jean-Claude Saghbini:Jean-Claude Saghbini is a technology and engineering leader at Lumeris, focusing on improving healthcare outcomes and reducing costs in value-based care. With over 15 years of healthcare experience, he's dedicated to integrating technology into clinical workflows seamlessly.Before Lumeris, he served as the Chief Technology Officer (CTO) for Wolters Kluwer Health, leading AI innovation and clinical support solutions. He also worked as the General Manager and CTO at Cardinal Health, where he developed RFID solutions to enhance patient safety, clinical documentation accuracy, and operational efficiency. Jean-Claude holds multiple healthcare technology patents, and he has a strong educational background, including a Master's degree from MIT and a Bachelor's degree from the University of Massachusetts, Dartmouth. He serves on various boards.Things You'll Learn:Technology is the foundation of value-based care. In order to succeed, healthcare organizations need access to vast amounts of data and the ability to derive actionable insights from it. Technology plays a central role in aggregating, normalizing, and analyzing this data to improve quality and reduce costs.Generative AI, the latest frontier in AI technology, has the potential to revolutionize care delivery. From automating routine tasks to understanding messy data and extracting meaningful insights, generative AI can empower healthcare professionals to make faster and more informed decisions.While the benefits of AI are promising, it's crucial to have appropriate Guardrails in place to ensure quality and safety. Organizations must keep physicians and clinicians in the driver's seat while leveraging AI to automate tasks, improve efficiency, and enhance patient satisfaction.Resources:Connect with and follow Jean-Claude on LinkedIn.Follow Lumeris on LinkedIn.Visit Lumeris on their Website.

Host Dr. Nick van Terheyden aka Dr. Nick, discusses Burnout, Brilliance, and the Road Ahead with John Fryer, Chief Revenue Officer at Lumeris. Their discussion includes the healthcare journey from finance to Cerner Corporation, influenced by innovator Neil Patterson, and the emergence of value-based care, the need to align entrenched stakeholders for VBC & regulatory and policy changes, finding new influencers for positive change, potentially large employers, limited adoption of VBC is attributed to powerful stakeholders and lobbying groups, hindering its widespread adoption, & more. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Since diabetes is one of the few chronic conditions that can be very effectively managed by an individual, why are there so many people with poorly managed diabetes? Despite conventional logic, it's not that most people aren't willfully noncompliant with their diabetes care. Instead, many have extenuating socioeconomic or other circumstances that can lead to drifting away from their care plans. There is an opportunity in value-based care to engage diabetic patients more effectively through data-driven personalized care interventions.  By merging rich, non-traditional data sources such as purchase trends with foundational elements like claims and clinical services, trusted care team members can develop one-of-a-kind insights into individuals' risks and behaviors. Translating broad, extensive multiple data sets into actionable information specific to an individual holds the potential to better manage populations while simultaneously changing the trajectory for each patient living with a chronic disease. On this week's episode, we have: Richard Mackey, Chief Technology Officer at CCS, a company that transforms chronic care management by combining equipment and products with comprehensive education, monitoring, and coaching…serving more than 400 employers and more than 1,800 managed care plans nationally to support patients with diabetes.  Joining Richard on the podcast is Jean-Claude Saghbini, Chief Technology Officer at Lumeris who also serves on the advisory board for CCS. Richard and Jean-Claude address how technology-assisted disease management makes the patient experience less arduous. They also discuss how devices and digital tools such as continuous glucose monitors, insulin pumps, chatbots and smartphones can generate an enormous amount of new and unique data. The information from these additional data feeds can be used to derive valuable insights into both the individual and population levels to drive the future of personalized care. Episode Bookmarks: 01:30 Data-driven, personalized care interventions are key to effective chronic disease management. 02:00 Introduction to Richard Mackey and Jean-Claude Saghbini. 02:45 An overview of technology-assisted disease management. 04:00 Support Race to Value by subscribing to our weekly newsletter and leaving a review/rating on Apple Podcasts. 05:00 Diabetes is such a significant problem in the United States, affecting over 37 million people, and it leads to numerous health complications. 07:00 Richard provides his perspective on the potential for aggregating disparate data sources and applying advanced analytics to transform diabetes outcomes. 08:30 How technology solutions can enhance the relationship between the care provider and the patient. 09:00 An overarching data interoperability framework is not necessarily required to leverage the power of data and technical solutions. 09:30 Jean-Claude on balancing the aims of interoperability, data normalization, and predictability in data flows with current day realities. 12:00 The importance of partnerships in driving scale in population health management through combined data feeds and biometric capabilities. 13:00 Richard expounds on the importance of partnerships in data-driven solutioning and medical device optimization for effective delivery of VBC. 14:30 Jean-Claude on how healthcare organizations can extract insights from technology to change the trajectory of disease in their patient population. 16:00 Predictive analytics can accelerate progress in understanding relationships between external factors and human biology.   17:30 Richard discusses the impact of predictive analytics to enhance the reengineering of clinical pathways to deliver personalized care to patients. 18:15 The unique opportunity to customize patient segmentation at the individual-level (versus relying just on profiling patients at the population-level). 19:45 Jean-Claude on how SDOH predictive models focused on housing instability or...

Patrick Young, president of population health for Hackensack Meridian Health and Jeff Smith, chief commercial officer at value-based managed services operator Lumeris, share the success story of payer-provider partnership Braven Health.   Mentioned in this episode: Fact sheet on the prior authorization and interoperability proposed rule Key points in the 2024 Medicare Advantage proposed rule

On episode 59 of PSQH: The Podcast, Michael Cousins, Chief Analytics Officer at Lumeris, talks about efforts to increase the adoption of advance directives.

Meet Seema Verma:Seema Verma serves on the board of directors for Lumeris, LifeStance Health, WellSky, and Monogram Health. Previously, Seema served as the Administrator for the Centers for Medicare and Medicaid Services (CMS). She was also the Founder, President, and CEO of SVC. Seema received an undergraduate degree in Life Sciences from the University of Maryland, and a Master's in Public Health from John Hopkins UniversityKey Insights:From her work at the state level in Indiana to the national stage at CMS, Seema Verma has established herself as one of the nation's preeminent health policy leaders.Determining Priorities. While CMS administrator, Seema focused on issues that impacted large groups of stakeholders and solved multiple problems at once. For example, addressing interoperability improves quality of care and decreases costs. (12:34)Good Business Practices for Government. Under Seema, CMS reorganized to increase efficiency. The regional offices were better integrated with the national team in terms of communication and workflow, and reorganized by centers of excellence rather than location. (19:12)Advice from a Mentor. No matter the job, there will be some level of dysfunction. Successful people are able to navigate an environment, regardless of the hurdles, to accomplish goals and make the most of the experience. (25:52)This episode is hosted by Sanjula Jain, Ph.D. She is a member of the Advisory Council for Her Story, co-founder of Think Medium, and the SVP, Market Strategy and Chief Research Officer at Trilliant Health.Relevant Links:Former Medicare leader Seema Verma joins board of health tech firm LumerisOne-On-One With Trump's Medicare and Medicaid Chief: Seema VermaHealthLeaders Women in Healthcare Leadership Podcast: Seema Verma

On February 24th, the Centers for Medicare & Medicaid Services (CMS) revealed the highly-anticipated fate of the Innovation Center's (CMMI) Direct Contracting model options, announcing a redesign of the Global Professional Direct Contracting (GPDC) Model and the permanent cancellation of the Geographic Direct Contracting (“Geo”) Model. The revamped and rebranded GPDC model—now called Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH)— aims to better reflect the agency's vision and Administration's priorities for system transformation.  The new ACO REACH model has incorporated stakeholder feedback to alleviate the concerns of GPDC's critics while maintaining the key features of the model and building on the momentum of the accountable care movement. ACO REACH also adds in exciting new components aimed at closing health equity gaps in keeping with the Innovation Center's Ten Year Plan released late in 2021. This special podcast episode offers a short background on the model's history and recent controversies leading up to the announcement, summarizes the major provisions of the new ACO REACH Model, outlining the key changes from the GPDC design, and considers potential implications for the Direct Contracting Entities (DCEs) currently participating in the GPDC model as well as the broader value movement. Joining this week we have two leading strategists in value-based care, Joe Satorius and Rick Goddard. They come to us from Lumeris - an accountable care delivery innovation company that enables health systems to deliver value-based care through advanced technology, risk-management, and outcome-based managed services. The ACLC and Lumeris have partnered to bring you the most in-depth information on the ACO REACH model. In addition to this episode, please download our free Intelligence Brief. Episode Bookmarks: 02:00 Background on the new ACO REACH payment model and its focus on health equity 03:00 Don't forget to download the Intelligence Brief on ACO REACH released by the ACLC in conjunction with this podcast episode! 04:00 Background on Joe and Rick and their work at Lumeris 05:00 The complete redesign of the Global Professional Direct Contracting (GPDC) model 07:00 Rick and Joe provide perspective on the future of the Value-Based Care movement and the unsustainability of fee-for-service 08:30 CMMI's Goal to have all Medicare beneficiaries in an accountable care relationship by 2030 11:00 Joe discusses CMS' newly-refined eligibility criteria and why that matters when it comes to advancing health equity, promoting provider leadership and engagement, and enhancing beneficiary protections 12:00 The new ACO REACH requirement for 75% board representation from participating providers. 13:00 How ACO REACH incentivizes providers to address social disparities with underserved beneficiaries 15:00 The progression of capitation options in the ACO REACH model 16:30 Rick provides an extensive overview of the professional and global tracks of ACO REACH and the various capitation options that drive economics 20:00 The strategic implications of Total Care Capitation (TCC) and how network curation and design can support performance success and aligned behavioral economics 22:00 The Primary Care Capitation (PCC) + Advanced Payment Option (APO) 22:45 The importance of assessing risk appetite and value-based care readiness 25:00 Rick discusses the Health Equity Benchmark Adjustment – a new change to benchmarking methodology in the ACO REACH model 29:00 Providing greater and more equitable access to underserved communities, while leveraging telehealth and other value levers 32:00 Joe discusses risk adjustment methodology within ACO REACH and addresses concernsabout risk score gaming and over-coding 34:00 The 3% cap, the coding intensity factor, and demographic adjustments that serve as guardrails to inappropriate risk score increases

Eric and Rick discuss the evolution of value-based care over the last decade; the ins and outs of Direct Care Entities (DCEs), which Rick describes as one of the “most progressive” options in value-based care; and how a partner like Lumeris can help health care systems transition to value-based models.

While artificial intelligence can be complex, it has the potential to improve public health. Tune in to this episode to hear Dr. Ben Alexander, Senior Vice President of Digital Health and Analytics at Lumeris, discuss how the health industry can lean on AI and machine learning as well as how Lumeris is using the technology to improve care for patients. Ben also addresses concerns about the pitfalls of AI if left unmanaged and shares how the bigger danger is not fully utilizing the technology in healthcare.This episode is sponsored by Lumeris.

Jake and Gabe discuss the events on Lumeris in the 3rd Episode of Loki. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/jacob-borucki/support

HealthLeaders Strategy Editor Melanie Blackman speaks with Seema Verma, a health policy expert and consultant, and former administrator of the Centers for Medicare and Medicaid Services, who shares what drives her to work in healthcare policy, her goals in serving as board of director for both Lumeris and Monogram Health, her thoughts on the Biden Administration, and advice for future leaders. Music used: Track: Pixies, Artist: Ketsa, Attribution license: Attribution 4.0 International (CC BY 4.0).

ACOs are increasingly moving into two-sided risk options with MSSP BASIC E and ENHANCED. The Direct Contracting model (with both Professional and Global options) introduces new opportunities and flexibilities that are not included in other CMMI models or through the MSSP. Prospective participants must act now to evaluate their model options in preparation for the 2022 performance year, with both MSSP and DC application cycles quickly approaching. CMS will soon reopen the MSSP for the 2022 performance year, and the application period for DC's second and final cohort is also expected to open around in Spring 2021, according to CMMI's latest timeline.  Now is the time for organizations to evaluate options and make decisions.  To aid in that analysis and decision-making, the ACLC and Lumeris partnered together to develop an intelligence brief (coming soon) that is also the focus of this podcast episode. The brief is designed to help provider organizations who are ready to take on significant levels of downside risk to judiciously evaluate the available options, consider the general opportunities and risk associated with the models, compare the methodological differences between MSSP BASIC Level E and MSSP ENHANCED with DC Professional and DC Global, and assess organizational fit. We share detailed comparisons across 7 key areas:   Participant Eligibility  Beneficiary Attribution  Financial Benchmarking  Quality Performance  Payment Models  Financial Settlement   Additional Benefits  Our guest this week is Rick Goddard, Senior Director of Market Strategy at Lumeris. Rick is a subject matter expert on value-based payment models and primarily serves as an enterprise strategist. Prior to joining Lumeris, Rick served as the Director of Clinical Innovation at Advocate Physician Partners / Advocate Health Care where led the Clinical Innovation Team. His in-depth operational and consulting experience makes him the perfect guest to help organizations considering their next step on this race to value!  (Information coming from CMS is ongoing and any opinions are not necessarily those of Lumeris, the Accountable Care Learning Collaborative, or our research associate Leavitt Partners.) Access the transcript for this episode here. Glossary of Acronyms: MSSP – Medicare Shared Savings Program ACO – a contracted entity in the MSSP DC – Direct Contracting (new CMMI payment model) DCE – a contracted entity in the DC model APM – Alternative Payment Model MA – Medicare Advantage CMS – Centers for Medicare and Medicaid Services CMMI – Center for Medicare and Medicaid Innovation TIN – Tax ID# (ACO participants in the MSSP are contracted by TIN) NPI – National Provider ID # (DCE participants are contracted by the individual NPI)   Episode Bookmarks: 4:50 Rick Goddard explains his personal connection with mental health and how that informs his “Why” 6:00 Finding balance and lessons learned from training for the Ironman World Championship 7:00 “What excites me is that value is starting to get momentum in the environment, and that thaws out providers and forces them into the game.” 8:50 The accomplishments of the MSSP (growth, building a bridge to risk, and $2B in savings to date) 11:30 The early years of the Pioneer and MSSP ACO programs and what we learned as an industry 12:30 “The upside-only ACO opportunity didn't have the teeth, nor did the program offer effective levers for us to succeed in managing the total cost of care.” 12:40 MSSP Challenges (e.g. beneficiary complaints and CCLF opt-outs, delays in data sharing, “black box” reconciliation) 14:00 “There weren't enough managed care-like designs to assist MSSPs to progress in risk.” 14:40 CMS offering incentives for ACOs to accept risk (e.g. SNF 3-day rule, Telehealth waivers, an availability to work with a prospective attribution model) 15:00 “Up until the Next Generation ACO,

Episode 6 of Healthcare Beans podcast Cityblock Health is a unicorn startup serving high quality healthcare to low-income communities. Episode takeaways: (1) There are several high profile companies supporting the nation's transition to value-based healthcare. Cityblock Health is at the forefront. Here's a short list: Oak Street Health, Iora Health, Lumeris, and UniteUs. (2) Managing healthcare spending for complex, low-income patients is not an easy task - many smart, dedicated people have tried and failed. (3) Addressing the social determinants of health may be the determining factor for long-term success - not just for Cityblock Health, but for the entire sector. ~ James Transcript Hello and welcome to Healthcare Beans, I’m your host James Haven. In this episode, I’m going to focus on a rather interesting startup in value-based healthcare. On Healthcare Beans, I often talk and write about the many federal and state programs which address some really big challenges in healthcare (mostly around lowering healthcare spending or expanding access to good healthcare) and to be fair, the results of these government programs are kind of mixed. Many of these programs fall under some sort of accountable care model and these models try to connect physician (or hospital) payment to patient health outcomes; to put it simply, this means good doctors are rewarded for delivering good care, and bad doctors are financially penalized. But again, the results of these programs are mixed; many of them have not actually reduced the cost of healthcare (at least not in any significant way), and only a few programs show some promise in doing that in the near future. Outside of government programs, there are many interesting and valuable developments in the private sector, and in the end, it wouldn’t be surprising if healthcare companies make some real lasting changes in terms of lowering the cost of healthcare and improving our health outcomes. And the companies I’m currently thinking about use different types of data along with specialized care teams in order to manage (or drive down) healthcare spending. These companies (that I think are worth keeping an eye on) are Oak Street Health, Iora Health, Lumeris, Unite Us, and Cityblock Health. And I include these company names with links in the show notes, if you’re interested in learning more about them. So with that, I’d like to dive more deeply into Cityblock Health. Cityblock is headquartered in Brooklyn NY, and operates across NYC, Connecticut, Chicago and Washington DC. The company specializes in delivering quality healthcare to low-income patients. Now, when you hear “low-income” a few key points come to mind. Low-income patients often have more health problems than people with average incomes, and this is a well-known pattern coming out of numerous studies in Medicare and Medicaid. And because low-income patients have more health problems, they’re much more expensive to care for; they’re more likely to end up in the emergency room, and more likely to be hospitalized. And perhaps most importantly, low-income patients have social service needs that are often unmet. And that could be a lack of transportation, or unstable housing, not having enough nutritious food, being socially isolated... so not having nearby friends or family – and studies have shown these types of social problems play a huge role in poor health outcomes. Going back to Cityblock Health, the company just completed Series C fundraising and is currently valued at over $1 billion, so perhaps there’s an IPO in the near future. And early reporting suggests the company’s healthcare delivery model can reduce unnecessary health spending among complex patients. All in all, I’d love to invest in Cityblock Health if given the chance (it’s a very exciting company), but at the same time, it’s really important to understand just how difficult it is to truly reduce healthcare spending (emergenc...

This episode of Tuning Healthcare features Brian Lobley, Executive Vice President, Health Markets at Independence Health Group, the parent company of Independence Blue Cross in Philadelphia. He is also a founding member and the board chair of Quill, a newly formed joint venture between Independence Health Group and Comcast. Brian shares his perspective on the opportunity for payers and providers to collaborate in improving health outcomes and the consumer experience. Particularly in the age of COVID-19, the acceleration of healthcare innovation and the move away from fee-for-service will continue to spur industry transformation. “I think what is emerging is a recognition across all stakeholders that the fee-for-service marketplace needs massive, massive transformation. Customers are demanding it. Providers are looking forward to it on how they earn incentives and help drive adherence, and quality and costs down, and payers as the intermediary need it. We need to be able to get to equations where we're able to do partial or full risk deals.” – Brian Lobley, Executive Vice President, Health Markets, Independence Health Group In this episode, Brian and Lumeris Senior Vice President Nigel Ohrenstein discuss: • How a large commercial payer is helping its members through COVID-19 • The market dynamics encouraging industry transformation that have emerged during the pandemic • What successful payer-provider collaboration looks like in the future • The complexities of the healthcare journey for patients and caregivers • Rethinking the consumer experience in healthcare • How payers and providers can help drive value-based care outcomes together • The need for innovative partnerships in healthcare across all verticals To tune in, subscribe below: Soundcloud: https://soundcloud.com/lumerishealthcare iTunes: https://podcasts.apple.com/us/podcast/tuning-healthcare-powered-by-lumeris/id1468061183 Tune IN: https://tunein.com/podcasts/Podcasts/Tuning-Healthcare-p1270312/ Spotify: https://open.spotify.com/show/5lSXJs7CbiHhgN93rW35fI Stitcher: https://www.stitcher.com/podcast/lumeris/tuning-healthcare-powered-by-lumeris The opinions of the podcast guests are not necessarily reflective of those of Lumeris. Cited works: • Text Message Alert 1 Sound. Available at http://soundbible.com/2154-Text-Message-Alert-1.html. • ECG Sound. Available at http://soundbible.com/1730-ECG.html. • AM Radio Tuning Sound. Available at http://soundbible.com/2099-AM-Radio-Tuning.html. • Intro music. Gordon Household. August 2019. WAV File.

Host Jim Tate talks to Nigel Ohrenstein who manages Lumeris’ business development and operations in the eastern half of the U.S. Nigel has extensive healthcare experience in operational, business development and consultative sales, and helps healthcare organizations to successfully make the journey from volume- to value-based care. His is a subject matter expert in such areas as population health and revenue management, value-based care, physician compensation, care management, and provider engagement. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play HealthcareNOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Today’s podcast episode with Dr. Gregory Katz is part of our live, Population Health Executive Roundtables Series (https://www.sharedpurposeconnect.com/virtual-roundtable-recordings/).   During my interview, Dr. Katz discussed what it’s like in the ICU during the COVID pandemic, the ethical dilemmas he and his peers are facing at Vassar Brothers Medical Center (400-bed hospital in Poughkeepsie, NY), and he also enlightens us with some really interesting opportunities for innovation. Finally, there are a lot of great, relevant questions asked by our audience of healthcare leaders, which Greg generously answers.   As an aside, Dr. Katz publishes a terrific email newsletter featuring his thoughts on health, medicine, and COVID-19: https://gregorykatz.substack.com/   The sponsor for today’s episode is us, Shared Purpose Connect, the producer of the Population Health Executive Roundtable and Bright Spots in Healthcare Podcast!   If your organization is looking to read leaders at the provider and/or pay organizations, consider using events as the hub to your marketing and lead generation strategy, and consider partnering with Shared Purpose Connect to accomplish this.    Shared Purpose Connect produces events from soup-to-nuts, working with your team to incorporate you as a thought leader within our roundtable discussion and/or podcast, support you in producing different marketing content derived from or connected to the event, and assist you in lead generation and networking. We become an important extension to your marketing teams. Our other partner companies (“sponsors”) include larger companies like Vituity, Commonwealth Care Alliance and Lumeris, and smaller organizations like Reveal Health and Roster Health. If you are curious, email me directly at eglazer@sharedpurposeconnect.com, @EricGlazer (Twitter), or Eric Glazer on LInkedIn. We can schedule a no-pressure brainstorming meeting. 

This episode of Tuning Healthcare features Jordanna Davis, President of the Rockingstone Group. Listen to Nigel Ohrenstein, Senior Vice President at Lumeris and Jordanna discuss her experience in working on healthcare reform, why transparency is critical for transforming the industry, the challenges of consumerism, the Direct Contracting model from CMMI, and how providers continue to evolve toward risk contracts. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

In this episode of Tuning Healthcare, Paul Keckley, Managing Editor of The Keckley Report, a healthcare policy analyst and widely known industry expert discusses major changes across the industry. Hosted by Nigel Ohrenstein, Senior Vice President at Lumeris, Paul shares insights from his experience in working on the Affordable Care Act, how primary care is evolving, the changing dynamics between payers and providers, and the why leadership, technology, scale and access to capital will support the move to risk. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

This episode of Tuning Healthcare features Niyum Gandhi, Executive Vice President and Chief Population Health Officer at New York’s Mount Sinai Health System. Niyum and Nigel Ohrenstein, Senior Vice President at Lumeris, discuss the importance of leadership buy-in for effective transformation, how to evaluate the right risk contracts and collaborative payers, the importance of engaging physicians, and why primary care needs to scale effectively to be successful in value-based care models. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

In this episode of Tuning Healthcare, Ryan Panchadsaram, the former U.S. Deputy Chief Technology Officer and now advisor at renowned venture capital firm Kleiner Perkins, shares insights across technology, disruption, and winners in the future healthcare system. Listen to Ryan and Nigel Ohrenstein, Senior Vice President at Lumeris, talk about why data transparency is key to achieving value-based healthcare, what the healthcare industry can learn from the Ubers and Airbnbs of the world, two things today’s most successful healthcare companies have in common, and who will win and lose in the new healthcare system. Find all of our show podcasts on your favorite podcast platforms. www.healthcarenowradio.com/listen/

In this episode of The Cerner Podcast, we’re joined by Richard Jones, CEO of Essence Healthcare and chief corporate development officer of Lumeris, and David Raney, vice president, CoxHealth Network, to discuss their experiences and success in the provider-sponsored health plan market.

On the Wednesday, July 17th, 2013 broadcast at 12 Noon Pacific/3PM Eastern our special guests are Jim Hansen, VP of Lumeris 's Accountable Delivery System Institute and Dr Jerry Penso Chief Medical and Quality Officer the American Medical Group Associaton (AMGA). We'll discuss the recent announcement by the Centers for Medicare and Medicaid of the results from the first year of participation in the Pioneer ACO program. Depending on who you speak with, there is a different take on how to interpret the movement within and out of the Pioneer program. For background see: Pioneers Take Arrows While Settlers’ Get the Land?’at @ACOwatch. Join us for a timely and informative exchange on this important development in the roll out of the Affordable Care Act. For additional context, check out the 'This Week in Health Innovation with Michael Millenson'. Join us!

On the Wednesday, May 1st 2013 broadcast at 12 Noon Pacific/3PM Eastern, my special guest is Tom Doerr, MD.  Dr. Doerr is a primary care physician practicing geriatric medicine in St. Louis and director of innovation research for Lumeris aka @Lumeris. He is also the vice president of clinical strategy for an IPA and a faculty member of the Accountable Delivery System Institute (ADSI), aka @adsinst. According to their website, Lumeris is: '...is an accountable care delivery innovation company offering health systems, payers, and providers operational support, technology, and consulting services.' While, ADSI is: '...the premier resource for health systems, health plans, large physician groups, and self-insured employers seeking proven solutions and practical guidance on establishing successful models of accountable care.' Clearly Lumeris, with deep roots into the Medicare Advantage world as well as seasoned insights forged via its first mover advantage experience during the 'bleeding edge' (an idea ahead of it's time) of 'Healtheon era' has a lot to say about ACOs, accountable care and the effective re-engineering of our at risk healthcare delivery and financing non-systems. Join us for an informative session. For context, check out Dr. Doerr's informative piece on the Healthcare Blog, titled: 'The Nine C’s of Successful Accountable Primary Care Delivery.'