Podcasts about Optum

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: T1D in the Olympics & Superbowl, Trump RX goes live, Ozempic pill available soon, tech updates from Medtronic, Beta Bionics, Eversense 365 and more! Announcing Community Commericals! Learn how to get your message on the show here. Learn more about studies and research at Thrivable here Please visit our Sponsors & Partners - they help make the show possible! Omnipod - Simplify Life All about Dexcom  T1D Screening info All about VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Episode transcription with links: Welcome! I'm your host Stacey Simms and this is an In The News episode.. where we bringing you the top diabetes stories and headlines happening now. A reminder that you can find the sources and links and a transcript and more info for every story mentioned here in the show notes. Quick reminder: We are just over one week from our first Moms' Night Out event of the year. While the plans are all set – the speakers, the vendors, the raffles and the fun is ready to go, it's always amazing how many people hear of these event last minute. That's fine, they're welcome! But if you're thinking of attending a future event – registration is open for We're going to Nashville next March 6-7 and Detroit in September – no need to wait. And we've got Club 1921 events for health care professionals and patient leaders in 6 cities this year! All the info is over at diabetes-connetionss.com events/   Okay.. our top story this week: XX Gotta be a quick shout out to some incredible T1D athletes – we had TWO in the super bowl this past weekend – Chad Muma of the New England Patriots and Logan Brown of the Seattle Seahawks AND there are at least two athletes with type 1 competing at the Winter Olympics. Hannah Schmidt competes in ski cross for Canada – she was diagnosed with Type 1 diabetes at age 12 years old.  Anna FarnSchadt Fernstäd a Czech skeleton racer diagnosed in 2022 after she'd already been to several Olympics. We wish them all the best!   https://english.radio.cz/skeleton-racer-anna-fernstadtova-overcoming-adversity-headfirst-down-ice-8876699 XX The government website TrumpRx.gov is live..  the website does not sell prescription drugs. Instead, it allows people to look up their drugs and then navigate to buy them elsewhere, either from a major drug company or a pharmacy. The 43 drugs listed on the site have prices ranging from $3 to over $5,500. TrumpRx does include warnings that the site may not be the best option to save money on prescriptions. Each product page advises: "If you have insurance, check your co-pay first — it may be even lower." For now, the website says its prices are for people paying with their own money, rather than going through insurance. The only insulin listed right now is Lilly's insulin lispro – and it's the same price as you'd find through Illy's insulin value program. I looked up diabetes meds.. For example, if you have an insurance co-pay of $25 a month for Farxiga, a drug often used for diabetes, you would be paying $182 on TrumpRx. As you can imagine, though ,this is complicated and as with most of our healthcare system, it may be good in some cases and not much help in other.  I'd suggest calling your local pharmacist or checking with your human resource dept. https://www.nytimes.com/2026/02/06/health/trumprx-prescription-drug-prices-consumers.html XX Novo Nordisk will launch some doses of its oral semaglutide for diabetes under the brand name Ozempic pill in the second quarter of this year. The company said the U.S. Food and Drug Administration has approved Ozempic tablets in three different doses. Novo says The new Ozempic name is intended to help patients and health care professionals more easily recognize the available treatment options for type 2 diabetes Semaglutide tablets have been available under the brand name Rybelsus Ruh BELL sis for diabetes since 2019 but with different dosing. The pill is also approved to reduce the risk of certain cardiovascular conditions in adults with type 2 diabetes who are at high risk for these events. The FDA had approved the new doses based on a bioequivalence study and the clinical trial data for Rybelsus, Novo said. https://www.reuters.com/business/healthcare-pharmaceuticals/novo-launch-ozempic-pill-diabetes-second-quarter-this-year-2026-02-04/ XX https://www.contemporarypediatrics.com/view/early-screening-for-type-1-diabetes-found-effective-in-children XX Possible new way to identify and track the progress of type 1 diabetes before clinical onset. A recent study published in Science Advances described the application of subcutaneous microporous scaffolds. These are inserted and have been shown to  identify changes in cancer, multiple sclerosis, and T1D by capturing changes of immune cells over the course of a disease. This is a proof of concept study in mice.. so very early days. https://www.news-medical.net/news/20260204/Implantable-immune-scaffold-predicts-type-1-diabetes-weeks-before-symptoms.aspx XX A large global genetics study shows that many key drivers of Type 2 diabetes operate outside the bloodstream. In a major international project led in part by the University of Massachusetts Amherst and Helmholtz Munich in Germany, researchers linked hundreds of genes and proteins to the disease. The work, published in Nature Metabolism, points to a key challenge in diabetes research: the biology behind rising blood sugar does not play out the same way in every part of the body. It also shows why including people from many backgrounds matters, since genetic clues that stand out in one population may be faint or invisible in another. Huge study, 2.5 million people worldwide comparing patterns across seven tissues tied to diabetes and four global ancestry groups, then asked a simple question: what do you miss if you only measure blood? Across the seven tissues, the researchers found causal evidence pointing to 676 genes. Yet overlap with blood was limited: only 18% of genes with a causal effect in a primary diabetes tissue, such as the pancreas, showed a matching signal in blood. At the same time, 85% of genetic effects observed in diabetes-relevant tissues were completely absent from blood-based analyses. The findings lay out a roadmap for future research aimed at understanding the biological pathways underlying Type 2 diabetes and developing more effective treatments. https://scitechdaily.com/massive-global-study-rewrites-the-biology-of-type-2-diabetes/ XX Express Scripts settled the U.S. Federal Trade Commission's claims its insulin pricing practices violated antitrust and consumer protection laws, and agreed to changes aimed at lowering costs for patients, insurers and small pharmacies The settlement, first reported by Reuters, fits with that goal, and allows the FTC to pare down a case brought by the former Biden administration against Cigna's Express Scripts, UnitedHealth Group Inc's (UNH.N), Optum unit and CVS Health Corp's (CVS.N), CVS Caremark. The case against Optum and Caremark is ongoing. Pharmacy benefit managers, which set how drugs are covered by health insurance, have faced a decade of scrutiny from regulators and lawmakers over pricing practices. While the industry has already made reforms, the settlement gives the FTC power to enforce broader changes at Express Scripts. The 10-year agreement restricts Express Scripts' ability to engage in practices critics say contribute to high costs, like pocketing rebate payments from drugmakers based on the list price of drugs. The FTC estimates the agreement could save patients as much as $7 billion over a decade. https://www.reuters.com/world/cigna-settles-ftc-insulin-case-commits-overhauling-drug-pricing-2026-02-04/ XX Audio? Congress has passed bipartisan legislation to extend and strengthen the Special Diabetes Program (SDP), a cornerstone of Federal investment in type 1 diabetes (T1D) research. The President signed the legislation and it is now law. Extends the SDP through December 31, 2026, and increases funding from $160 million to $200 million annually. Strengthens overall funding for the National Institutes of Health (NIH) by $415 million. Increases diabetes research funding at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) by $10 million. Created by Congress and administered by the NIH, the SDP has contributed nearly $3.6 billion to T1D research and has played a role in nearly every major breakthrough in the field. A recent study conducted by Avalere Health shows that of the nearly 3.6 billion invested into the SDP by Congress since the establishment of the program, the Federal Government has realized $50 billion in healthcare savings through improved health outcomes from the use of SDP driven therapies and devices https://www.breakthrought1d.org/news-and-updates/congress-passes-bipartisan-extension-of-the-special-diabetes-program-securing-critical-t1d-research-funding/ XX Dexcom is rolling out what they're calling AI-enabled enhancements to Stelo, further transforming how users track and understand their glucose health. Expanded Smart Food Logging including a comprehensive nutrition database of more than 1M meals that provides a breakdown of calories, carbohydrates, protein, fat, dietary fibers, and more. More ways to meal track including text search, barcode scanning or taking a photo of the meal, creating a seamless and intuitive meal tracking solution. A redesigned Daily Insights feature which will introduce a new interface with more personalized recommendations. The newest features will launch nationwide in the coming weeks.  XX Beta Bionics has received a warning letter from the Food and Drug Administration following an inspection last year, the company disclosed on Friday. The diabetes technology company said in a securities filing that the warning letter concerns non-conformities with the company's quality management system, medical device reporting, and correction and removals. The warning letter has not yet been posted by the FDA.   The company said in the filing that it has already taken actions to improve the processes described in the warning letter, and it is working on a written response to the FDA.   The firm does not expect the warning letter to affect the planned launch of a new insulin patch pump by the end of 2027. Beta Bionics unveiled a prototype of the device, called Mint, last year at the American Diabetes Association's Scientific Sessions. The company also does not expect the warning letter to affect its financial results. https://www.medtechdive.com/news/beta-bionics-receives-fda-warning-letter/811140/?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue%3A+2026-02-04+MedTech+Dive+%5Bissue%3A81423%5D&utm_term=MedTech+Dive&fbclid=IwY2xjawPwhDZleHRuA2FlbQIxMABicmlkETFaUUcyYmNQWldjZ2xudElic3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHouF8M3IstTyslPRgeHWUWVVdOAGOtzPWt_yNFcj9eYruqSPz3e86Iwcbpt8_aem_7q4D97vJVjHKfEwvoyUpgw XX Sequel Med Tech is reviewing co-founder Dean Kamen's ties to Jeffrey Epstein after recently released documents revealed new details about the longstanding relationship between the two men. The documents show that Kamen visited Epstein's island, and remained in contact with him for years after Epstein was convicted of sex crimes involving minors. Kamen has not been accused of any wrongdoing. In a statement, Sequel Med Tech said the Manchester-based company is aware of the documents pertaining to Kamen and – quote - "Sequel's Board of Directors has unanimously decided to engage an external law firm to review these disclosures and provide recommendations aligned with our mission to serve people living with diabetes," Kamen has not issued a statement regarding his reported connection to Epstein.   https://www.bostonglobe.com/2026/02/04/metro/nh-dean-kamen-jeffrey-epstein-review/ https://www.bostonglobe.com/2026/02/04/metro/nh-dean-kamen-jeffrey-epstein-review/ https://www.nbcboston.com/news/local/nh-inventor-placed-on-leave-after-epstein-messages-surface-report-says/3888569/ XX Abbot reports 860 serious injuries linked to the recall of some of its glucose monitoring sensors. We told you about this recall late last year, these numbers are an FDA update.     Abbott said the sensors can provide incorrect glucose readings over extended periods, which could lead to users making dangerous treatment decisions, including eating excessive carbohydrates along with skipping or delaying insulin doses, potentially leading to serious health risks. The company said it has identified and resolved the cause of the issue, which relates to one production line among several that make Libre 3 and Libre 3 Plus sensors.   https://www.reuters.com/business/healthcare-pharmaceuticals/abbott-recalls-glucose-sensors-after-seven-deaths-linked-faulty-readings-2026-02-04/ XX Updates from Medtronic & Senseonics – and a first from Nick Jonas.. right after this..   I'm excited to share that the FDA has cleared the MiniMed 780G system with the Instinct sensor, made by Abbott, for people with type 2 diabetes.  Medicare has also now approved coverage for the Instinct sensor for use with the MiniMed 780G system. This clearance and expanded coverage mean more people will have access to pairing our most advanced automated insulin delivery technology with the Instinct sensor, that offers a smaller, 15-day sensor experience.  They're also launching the MiniMed 780G system Pump Evaluation Program.  This program gives individuals living with diabetes the ability to try the full MiniMed 780G system at no cost for 30 days.† This includes the pump, the sensor of their choice, one month of infusion sets and reservoirs, everything but the insulin. They'll contact your doctor for you to get a prescription and get the process rolling. https://www.medtronicdiabetes.com/pump-evaluation-program XX Senseonics announced today that its Eversense 365 continuous glucose monitor (CGM) system received CE mark approval – that's European clearance.  This comes on the heels of the launch of Eversense 365 with Sequel Med Tech's twiist pump, marking the first pump integration for the CGM. Senseonics plans to launch Eversense 365 in Germany, Italy, Spain and Sweden in the coming months. Meanwhile, Senseonics continues to work toward an FDA investigational device exemption (IDE) submission for its next-generation Gemini transmitter-less CGM by the end of this year. https://www.drugdeliverybusiness.com/senseonics-ce-mark-eversense-365-cgm/ XX A huge shout out to Dr. Emily Blum, who just accomplished riding 100 miles in Antarctica for Breakthrough T1D! Despite having no direct connection to Type 1 Diabetes, Emily has been riding and fundraising for BreakthroughT1D for 10 years now. She is an integral part of the Georgia Ride team, training and riding many miles, and most importantly has raised tens of thousands of dollars to support the cause of ridding the world of T1D. She is surgeon and deeply involved with medical innovation, with an incredibly busy schedule, but jumped at the chance to take on the challenge of riding a century on every continent. Having already completed North America, Europe, Australia, Asia, and now Antarctica, only Africa and South America remain. Emily rides on and continues to be an inspiration to everyone who meets her. XX   https://diabetes-connections.com/t1d-connection-and-people-magazine-elise-zach-share-their-story/ XX Nick Jonas's becomes the first artist ever to wear a CGM on an album cover - new upcoming solo album Sunday Best, releasing Feb. 6.  The release says: This marks a powerful step forward in normalizing diabetes and raising awareness for the condition on a global scale. This moment adds to the growing visibility of diabetes in pop culture, alongside milestones like a Type 1 diabetes Barbie and Pixar characters wearing diabetes technology.

Welcome to RIMScast. Your host is Justin Smulison, Business Content Manager at RIMS, the Risk and Insurance Management Society.   In this episode, Justin interviews Megan Miller, the CEO of the Spencer Educational Foundation, and John Button, ERM strategist and RIMS-CRMP Workshop instructor. The episode is divided into two interviews. Justin and Megan review the Spencer activities coming up around RISKWORLD 2026 and later, with a focus on driving students into insurance and risk careers and on providing risk scholarships to build the industry. Justin and John focus on John's ERM and risk philosophies and the key skills and knowledge the next wave of risk practitioners will need as risk management moves into strategic risk modes. They discuss the RIMS-CRMP virtual workshops that John teaches, and James Lam's RIMS-CRO Certificate Program in Advanced Enterprise Risk Management, which John endorses. They talk about RISKWORLD 2026, which is coming up.   Listen for tips on inviting the next wave of students into the risk profession and preparing for upcoming trends in risk.   Key Takeaways: [:01] About RIMS and RIMScast. [:17] About this episode of RIMScast. We will be joined by Spencer Educational Foundation CEO, Megan Miller, and ERM strategist and RIMS-CRMP Workshop instructor, John Button. But first… [:47] RIMS Risk Foundations Certificate Program. This beginner program will guide you through the risk landscape and help evaluate the purpose, function, and process of risk management. On completion, you will receive a Digital Risk Foundation certificate and 24 RIMS CE credits. [1:07] Cohort Number One starts on February 10th and 11th, with "Fundamentals of Risk Management," and then, on February 25th, "Risk Taxonomy," followed by two on-demand courses. Register now because the next cohort will be held in August. A link is in the notes. [1:28] RIMS members always enjoy deep discounts on the virtual workshops. [1:32] Webinars The next RIMS webinar will celebrate Women's History Month by exploring the success of women in construction risk on March 6th. We'll be joined by a Chief Risk Officer, an underwriter, and a broker. [1:45] They will explore their career paths, risk and safety philosophies, and lend some insight as to why this is the time for the next generation of leaders to rise. Visit RIMS.org/webinars and check out the link in this episode's show notes. [2:00] RISKWORLD General registration is open for RISKWORLD 2026, which will be held from May 3rd through the 6th in Philadelphia, Pennsylvania. Visit RIMS.org/RISKWORLD or RIMS.org. Register today to take advantage of those sweet advance rates through the end of this month! [2:24] On with the Show! Returning to RIMScast is one of my favorite people, the CEO of the Spencer Educational Foundation, Megan Miller! Spencer Day is coming up on February 23rd. We want to hear all about what she has in store for us this month, and at RISKWORLD 2026. [2:50] Megan Miller will also present a special introduction for the "Hard Hats and High Stakes" Webinar on March 6th. Let's get to it! [3:08] Interview! Spencer Educational Foundation CEO Megan Miller, welcome back to RIMScast! [3:30] Megan says the Spencer Educational Foundation had a great year in 2025. They surpassed their goals. They're riding into 2026 on top of the wave. They are also starting Year 1 of implementing their next Five-Year Strategic Plan through 2030. [3:55] Megan says they have some big growth goals; they're hoping to raise $10 million a year by 2030. They ended last year at just over $4 million. [5:13] Spencer Day on February 23rd is held in conjunction with Insurance Careers Month. The Insurance Careers movement is to get students thinking about careers in insurance. [5:29] Holding Spencer Day during Insurance Careers Month raises awareness about what the Spencer Educational Foundation is doing to help drive more students into insurance careers. [5:36] The Spencer Educational Foundation tries to raise at least $7,500 from individual contributors that day to fund an additional scholarship. If they can raise $7,500, they can give out one more scholarship in 2026 and set one more person on the path to a career in risk. [6:18] At RISKWORLD, the Spencer Educational Foundation holds three events: Pickleball Social on Saturday, May 2nd, with sponsor Optum, the Gallagher Topgolf Golf Tournament on Sunday, May 3rd, and the 5K Fun Run on Tuesday, May 5th, with new sponsor Bold Penguin. [7:59] The 5K Fun Run will take place at Boathouse Row at 6:30 a.m. [8:57] The Spencer Soirée will be held on Monday, May 4th, at 5:30 p.m. It's Spencer's big donor appreciation event. At the Spencer Soirée, Spencer announces the winners of the International Student Risk Management Challenge that takes place all day on Sunday, behind closed doors. [9:16] On Monday morning, you'll have the opportunity to see the top three student teams present. Over 50 teams are competing. They submit their papers online, and the judges select the top eight teams to be flown to RISKWORLD. In 2025, half of the teams were international. [10:01] For some students, it was the first time they had ever been to the U.S. It's an incredible opportunity. In 2024, the team from Hyderabad, India, won. Justin had them as RIMScast guests. [10:20] The 2025 winning team was from the University of Wisconsin-Madison. [10:32] At the RISKWORLD conference, the top eight teams present behind closed doors on Sunday, and the judges select the top three. On Monday, those presentations are open to the public. It's impressive to hear the students talking through their cases. Come and watch! [10:53] On Monday, at the Spencer Soirée donor appreciation event, the first, second, and third place winners are announced, with cash prizes. It's a big audience, and the students answer the judges' questions. Megan says that the students are poised and super bright. [12:08] The 2026 Spencer Funding Their Future Gala will be held on Thursday, September 17th, back at the Waldorf Astoria, which was recently reopened after extensive renovations. Megan says it's stunning. [13:30] There are two honorees for the gala, Sierra Signorelli from Zurich, and Marya Propis from RT Specialty. Marya was one of the earliest RIMScast guests. She has been heavily involved in Spencer. [13:51] Megan says Zurich has been a strong partner of the Spencer Educational Foundation for a very long time. Sierra has taken on an expanded role at Zurich. [14:09] Marya is the former board chair who hired Megan within the Spencer organization. [14:35] For more information about the Funding Their Future Gala, listeners can reach out to Megan Miller or Brianne Kelly-Prensa at the Spencer Educational Foundation. [15:00] Megan mentions some of the new names at the Spencer Educational Foundation. Brianne Kelly-Prensa is the new Development Manager, helping Megan with fundraising and finding new partnerships. Amisha Kitani is the new Program Administrator. [15:31] Amisha was an intern at LVMH through Spencer's internship grant program. [16:10] Megan was a Spencer scholarship recipient. While she was at Swiss Re, she received a Spencer scholarship for the part-time Master's program. Spencer was very instrumental in helping Megan complete her MBA. [16:37] Spencer also has two board members who are Spencer scholarshop recipients: Robin Roeder and Cristina Vigilante. As Spencer grows and impacts more students, he loves to see them come back into the fold. [17:13] Justin shares details about the presenters of the RIMS webinar on March 6th, "Hard Hats and High Stakes: Women Leaders Shaping Construction Risk Management," including a special introduction by Megan Miller. Megan is excited about it. [19:01] The webinar is not only in honor of Women's History Month but also in advance of Construction Safety Awareness Week in May. Justin says this important sector deserves the spotlight. [19:39] If you have any questions for Megan, find her at SpencerEd.org. Justin tells Megan, it is such a pleasure to see you again. [19:56] Our next interview features John Button, CRMP, an Enterprise Strategic and Technology Risk Strategist for American Systems and an Instructor for the UCLA Extension Business School, specifically for implementing their Enterprise Risk Management course. [20:24] John Button is one of the instructors for the RIMS-CRMP Virtual Workshop Series. John will be leading the March 10th and 11th Workshop, and the June 9th and 10th Workshop. [20:39] We are going to get a glimpse into his risk perspective and philosophy. We're going to talk about strategic risk management and where he believes ERM is headed in the short and long term. Let's get to it! [20:52] Interview! RIMS-CRMP Commissioner John Button, welcome to RIMScast! [21:10] John heard about the RIMS-CRMP from other practitioners who were getting certified. John worked with Joseph Mayo on a couple of his books, the latest being Cultural Calamity. Joseph suggested the RIMS-CRMP to John. John looked into it. [21:41] John fell in love with the RIMS-CRMP, as it is a foundational risk management certification. [21:52] Justin adds that John Mayo was the first RIMS-CRMP Story. John says the RIMS-CRMP has been a pretty exclusive club, but it's spreading quickly around the globe, and once you've gotten it, you start to see who else has it. [23:16] Justin asks about strategic risk management. John says when he was studying for the RIMS-CRMP, he was well aware of strategic risk management, and he had been an enterprise risk management advisor at Gartner, but it wasn't practiced as much then as we see it today. [23:45] While studying for the RIMS-CRMP, John learned of the RIMS Strategic Risk Management Framework. He thinks it is one of the clearest ways of thinking about strategic risk management. It started connecting the dots for him about the value chain and benchmarking. [24:21] John says there's been an evolution in business from hazard risk to operational risk to strategic risk, and the real value is within strategic risk management. With strategic risk, what we focus on is largely the business model or foundational assumptions of the organization. [25:22] It will involve your customers, your financial model, your capabilities, and your value proposition. Strategic management deals with deciding the direction of a company, where you are trying to go, and the business model for how you are going to achieve success. [25:48] John says strategic is fundamentally different from operational, which may involve the execution of parts of the strategy, keeping the lights on, and running the business. [26:21] John says the most important skills for future risk leaders are to understand the decision science and analysis component of measuring uncertainty. That involves a basic understanding of statistics, probability theory, and the psychology of biases. That's critical. [27:23] John tells of helping develop risk quantification courses for RIMS for risk managers to learn how to measure and communicate risk in economic terms, for leaders in an organization. That skill set will differentiate risk practitioners in companies in achieving goals and objectives. [28:18] The people in an organization doing the work of mitigating the risk are often labeled as owning the risk. John says a risk is an uncertainty that will negatively impact an objective. Whose objective is threatened by the risk? Knowing that, you can build the accountability bridge. [29:58] John says when the ownership of risk is not known, most executive decision-makers use System One, instinctive thinking. System Two thinking requires deliberation and problem-solving. When a risk owner is identified, executives switch to System Two thinking. [31:37] Accountability is a by-product of risk owner identification. [32:09] Quantitative risk analysis allows you to accurately and mathematically measure risk. You can't count risk with ordinal scales that only tell you the order of things. When you measure risk quantitatively or statistically, you can accurately forecast the financial impact of an event. [33:51] That forecast enables executives to make more informed decisions. You can add risks in a mathematically coherent way. You can see how risks hang together for the organization. [35:12] John says a good risk culture is an organization that practices what it preaches. John would expect to see incentives built into measuring performance. It's not just whether you met your goals and objectives, but also whether you followed good risk management practices. [36:38] John says a lot of organizations speak to it, but what they say and what they do are often two separate things. [37:13] There's a big push right now for using more quantitative tools and skills for doing risk management. Risk management is more than quantitative measurement or decision analysis. John sees mistakes from companies looking only at the short term. [37:57] If you do risk management well, with a solid risk culture, there is always the possibility or probability of failure. Any company, even with great risk management, can be susceptible to systemic risk and big surprises. Having a good risk culture lowers the probability of failure. [38:47] John says they touch on risk culture during the RIMS-CRMP Workshops. It's about trying to develop a programmatic and systematic approach to risk that is consistent, coherent, and serves as the foundation for further growth. It's the beginning of the journey, not the end of it. [39:30] John discusses flipping the script from uncertainty to opportunity. He notes that risk managers often focus on compliance, which was great in the past. The future, with its move toward strategic risk management, will need far more than risk event forecasts. [41:03] John believes the next phase will come from using your imagination, in collaboration with AI, to see beyond the five-year strategy timeframe, to develop hypotheses and a different kind of forecast about where trends, drivers, and conditions will show up in the risk landscape. [41:56] John thinks risk management will move outside of the organization. The next wave of practitioners will be equipped quantitatively, helped by AI, and will help to steer strategy and the strategic direction of business models to find the opportunities for innovation. [42:27] Justin says this has been such an enlightening conversation and mentions that John will be leading the virtual workshops for RIMS-CRMP on March 10th and 11th and June 9th and 10th. What is John Button's instruction style? [42:53] John enjoys teaching. He's currently teaching Implementing Enterprise Risk Management at UCLA. What's important to him is making sure people are crystal-clear, understand the foundation, and can analyze the concept. [43:19] John reduces most challenges in risk management to communication. What one person means by cyberrisk may not be what somebody else means. He makes sure those he is teaching feel confident when they walk away, ready to go. His teaching style is thorough. [43:59] John always stays back after the webinar to answer questions. Some people contact him later with questions, and he's more than happy to help them. [44:18] Justin mentions the RIMS-CRO Certificate Program in Advanced Enterprise Risk Management, hosted by James Lam. John introduced himself to James Lam at the FAIR Conference 2022, after reading his book. John took the RIMS-CRO Certificate Program. [45:07] John says they worked live for about four hours every other week for six sessions, with each module building on the previous one. The next cohort will begin in April. Registration closes on April 6th. That course will run biweekly from April 14th to June 23rd, 2026. [45:55] Check out RIMS's social channels to see a testimonial from John talking about the course. It was extremely beneficial for him and for the others who shared their perspectives on it. [46:40] John will be at RISKWORLD 2026. Last year was his first RISKWORLD, and having attended a lot of business conferences, he shares that he was blown away by how awesome RISKWORLD is. John invites you to reach out to him if you go, and he'll be happy to talk to you. [47:15] Special thanks to both of our guests, Megan Miller, the CEO of the Spencer Educational Foundation, and John Button, one of our valued RIMS-CRMP Commissioners and virtual workshop instructors. [47:29] Links to SpencerEd.org and to John's upcoming virtual workshops for the RIMS-CRMP Exam Prep are in this episode's show notes. Register now, and let them know how great they sounded on RIMScast in February 2026! [47:46] Plug Time! You can sponsor a RIMScast episode for this, our weekly show, or a dedicated episode. Links to sponsored episodes are in the show notes. [48:15] RIMScast has a global audience of risk and insurance professionals, legal professionals, students, business leaders, C-Suite executives, and more. Let's collaborate and help you reach them! Contact pd@rims.org for more information. [48:33] Become a RIMS member and get access to the tools, thought leadership, and network you need to succeed. Visit RIMS.org/membership or email membershipdept@RIMS.org for more information. [48:50] Risk Knowledge is the RIMS searchable content library that provides relevant information for today's risk professionals. Materials include RIMS executive reports, survey findings, contributed articles, industry research, benchmarking data, and more. [49:07] For the best reporting on the profession of risk management, read Risk Management Magazine at RMMagazine.com. It is written and published by the best minds in risk management. [49:21] Justin Smulison is the Business Content Manager at RIMS. Please remember to subscribe to RIMScast on your favorite podcasting app. You can email us at Content@RIMS.org. [49:33] Practice good risk management, stay safe, and thank you again for your continuous support!   Links: RISKWORLD 2026 Registration — Open for exhibitors, members, and non-members! Reserve your booth at RISKWORLD 2026! Spencer Educational Foundation | Spencer Day — Feb. 23, 2026 RIMS Legislative Summit — March 18‒19, 2026 on Capitol Hill, Washington, D.C. | Register now! RIMS-CRO Certificate Program In Advanced Enterprise Risk Management | April‒June 2026 Cohort | Led by James Lam RIMS Risk Management magazine | Contribute RIMS Now RISK PAC | RIMS Advocacy RIMS-Certified Risk Management Professional (RIMS-CRMP) | Insights Video Series Featuring Joe Milan! The Strategic and Enterprise Risk Center RIMS Diversity Equity Inclusion Council RIMS-CRMP Story, featuring John Button Upcoming RIMS-CRMP Prep Virtual Workshops: RIMS-CRMP Exam PrepMarch 10‒11 | April 21‒22, 2026 | June 9‒10, Virtual Full RIMS-CRMP Prep Course Schedule See the full calendar of RIMS Virtual Workshops "Applying and Integrating ERM" | Feb 4. 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RIMS Virtual Workshops On-Demand Webinars RIMS-Certified Risk Management Professional (RIMS-CRMP) RISK PAC | RIMS Advocacy RIMS Strategic & Enterprise Risk Center RIMS-CRMP Stories — Featuring RIMS President Manny Padilla!   RIMS Events, Education, and Services: RIMS Risk Maturity Model®   Sponsor RIMScast: Contact sales@rims.org or pd@rims.org for more information.   Want to Learn More? Keep up with the podcast on RIMS.org, and listen on Spotify and Apple Podcasts.   Have a question or suggestion? Email: Content@rims.org.   Join the Conversation! Follow @RIMSorg on Facebook, Twitter, and LinkedIn.   About our guests: Megan Miller, CEO, Spencer Educational Foundation John Button, RIMS-CRMP, Enterprise, Strategic & Technology Risk Strategist, American Systems   Production and engineering provided by Podfly.  

In this eye-opening interview, Clay sits down with Michael Jones, owner of Helping Hand Family Pharmacy in Vicksburg, to expose the pharmacy benefit manager (PBM) "racket" that's devastating independent pharmacies across Mississippi. Michael breaks down how PBMs—middlemen like Express Scripts (Cigna), CVS Caremark, and Optum (UnitedHealth)—started as claim consolidators but evolved into profit machines through spread pricing, manufacturer rebates, and vertical integration, forcing locals to sell meds below cost and leading to widespread closures.   He shares his fight's origin: Post-COVID reimbursement drops hit hard, shuttering stores like People's Drugstore, creating "drug deserts." Michael dug into campaign finances, uncovering PBM-linked donors influencing lawmakers, and went public—posting at his store and on social media—to rally customers. A Mississippi audit revealed Optum paying affiliates 20x more than independents, while PBM profits soar into billions.   Urgent action: Support House Bill 1672 (State Affairs Committee) and Senate Bill 2575 (Public Health and Welfare)—bills must exit committee by February 3. Michael urges calls to the Capitol switchboard at (601) 359-3770 to demand fair reforms. Last year's near-win died at the eleventh hour; don't let it happen again. This is a battle for community businesses—stand up before independents vanish!

In this episode, we're joined by Karthik Viswanathan. Formerly a product leader at AT&T, Macy's, and Optum, he's now the founder of TalAiro, an HR tech startup that is rethinking the operating system for recruiting. Karthik argues that the hidden failure of the modern tech stack is forcing the user to serve as a “manual integration layer. He explains how the push to "unbundle" features results in a “Chaos Tax”— consuming 40-60% of the workday with fighting disconnected tools rather than doing their jobs. Beyond that, Karthik also discusses: How AI can make work more human: Why the true value isn't in replacing jobs, but automating the "devil's cut" of administrative work. The journey from enterprise leader to founder: What building TalAiro from scratch taught Karthik about prioritization after years of leading enterprise product orgs, such as focusing on the 20% of workflows that drive 80% of the value Links LinkedIn: https://www.linkedin.com/in/karthikvish/ TalAiro: https://www.talairo.ai/ Chapters 00:00: Introduction 00:54: Karthik's product background 02:58: The "chaos tax" and how tool sprawl negatively impacts product efficiency 04:25: Challenges in HR tech 09:26: Working backwards from customer problems to build your digital solution 11:53: How TalAiro differentiates itself as an HR tool 15:03: The role of AI in enhancing human potential 20:59: Karthik's transition from enterprise to startup leader 27:14: Conclusion Follow LaunchPod on YouTube We have a new YouTube page (https://www.youtube.com/@LaunchPodPodcast)! Watch full episodes of our interviews with PM leaders and subscribe! What does LogRocket do? LogRocket's Galileo AI watches user sessions for you and surfaces the technical and usability issues holding back your web and mobile apps. Understand where your users are struggling by trying it for free at LogRocket.com (https://logrocket.com/signup/?pdr). Special Guest: Karthik Viswanathan.

Mark Fithian is the cofounder of WideOpen, a consultancy that helps organizations achieve sustainable growth through strategic customer experience. Mark's expertise in CX is informed by more than thirty years of work across industries, partnering with leading brands such as Providence, SAP, PayPal, Optum, IBM, BMW, the American Cancer Society, and Microsoft. Before founding WideOpen, he held leadership roles on both the client and agency sides, as well as in strategic consultancies.Mentioned on the ShowRead Mark's profile on the WideOpen website: https://www.thisiswideopen.com/our-teamConnect with Mark on LinkedIn: https://www.linkedin.com/in/markfithian/Get Mark's book, The CX Imperative: https://a.co/d/316xGzXO'Brien and Mark discussed the book Good Strategy, Bad Strategy by Richard Rumelt: https://a.co/d/9GSTIfN Timestamps(00:00:00) Welcome to People Business with O'Brien McMahon(00:01:45) What is the difference between customer experience and user experience?(00:02:22) And how did you get into this work in the first place? (00:07:24) What is the purpose of business? (00:08:35) Why do businesses struggle with customer experience? (00:11:24) "The Great Distancing": what it is and why it hurts customer experience(00:13:44) What makes good incentives in customer experience? (00:15:15) How does a business know when they are doing CX well?(00:20:08) How does executive leadership get involved in good CX?(00:32:49) Who should be responsible for customer experience?(00:40:41) Mark's 5 Pillars of Customer Experience(00:44:19) What does strategy mean to you? (00:55:21) How to get started with customer experience and how to contact Mark Fithian.

This podcast is brought to you by Outcomes Rocket, your exclusive healthcare marketing agency. Learn how to accelerate your growth by going to⁠ outcomesrocket.com Real-time transparency between payers and providers is becoming one of the most transformative levers in the healthcare industry. In this episode, Madhu Pawar, Chief Product Officer at Optum, discusses how her team is tackling the long-standing inefficiencies buried in today's claims processes. She explains how Optum Real connects payers and providers through a real-time multi-party hub, uses AI to interpret contracts and encounter data, and equips providers with AI-first workflows that dramatically reduce denials, rework, and confusion for patients. Madhu also highlights early pilot results with Allina Health, demonstrating improvements in both patient experience and operational accuracy. She shares why 84% of first-time denied claims are avoidable, why eliminating that friction is at the core of Optum's mission, and why value-based care will benefit enormously from real-time intelligence. Looking ahead, Madhu outlines a bold vision in which real-time payment flows, AI-enabled clinical insights, and improved data exchange reshape the entire system's operations. Tune in and learn how real-time transformation could redefine healthcare's future! Resources Connect with and follow Madhu Pawar on LinkedIn. Follow Optum on LinkedIn and visit their website!

Kristi Henderson invented telehealth at the University of Mississippi Medical Center decades before anyone thought healthcare needed it. While her colleagues were optimizing traditional clinic workflows, Kristi was asking a different question: What if geography didn't dictate healthcare access? By the time the pandemic forced everyone else to figure out virtual care overnight, she'd already spent two decades perfecting it. What makes her approach distinctive isn't just her track record at Amazon, Ascension, and Optum. It's that she worked every level of the healthcare system for 24 years before reaching the C-suite. She understands frontline friction because she lived it. At Amazon, Kristi discovered a framework that changed everything: one-way doors versus two-way doors. Some decisions are irreversible and demand precision. Others are experiments where failure means pivoting fast. That distinction became her playbook for tackling problems most leaders won't touch. But her most counterintuitive move? When she became CEO of Confluent Health, her first hire wasn't a CFO or COO. It was a leader for internal communications. Because brilliant transformation plans fail without deliberate stakeholder engagement. Change happens at the speed of trust. Now Kristi is betting on something that sounds almost naively optimistic: that AI will finally give clinicians their time back by eliminating friction, not replacing human connection. She uses AI daily as her "sidekick" and is building an organization where technology supercharges what only humans can do. Key Takeaways: Why Kristi kept raising her hand for jobs no one else wanted and how taking the hardest assignments became her competitive advantage The Amazon framework that changed everything: one-way doors versus two-way doors, and how to know which type of decision you're making What "change happens at the speed of trust" actually means in practice when you're transforming organizations Kristi's "reverse innovation" approach: why bottoms-up transformation consistently outperforms top-down mandates The counterintuitive first hire Kristi made as CEO, and why communication infrastructure matters more than most leaders realize How to handle naysayers strategically instead of avoiding them or trying to convince them Why Kristi believes the workforce crisis isn't permanent if leaders focus on the right problem The specific ways Kristi uses AI daily as a CEO, and why she sees it as the key to bringing joy back to clinical practice About the Guest Kristi Henderson, DNP, is CEO of Confluent Health, a family of physical therapy and occupational therapy companies. She spent the first 24 years of her career as a practicing nurse practitioner before pioneering telehealth at the University of Mississippi Medical Center, long before the pandemic made it mainstream. Kristi has since led digital transformation at Ascension Health, built clinical operations for Amazon Care, and served as CEO of Optum Everycare. She's Board Chair of the American Telemedicine Association and affiliate faculty at Dell Medical School and the University of Washington School of Nursing. Her career has been defined by raising her hand for challenges others declined and building tech-enabled care models that improve outcomes while reducing clinician burden. Chapters 00:00 - Introduction at Confluent Health 01:57 - From Bedside to Boardroom: The Leadership Journey 06:10 - Amazon Care Lessons: One-Way vs Two-Way Doors 11:07 - Change Happens at the Speed of Trust 14:11 - Overcoming Naysayers: The Early Days of Telehealth 19:11 - Bringing Joy Back to Medicine 22:56 - AI Hacks and Daily Innovation Guest & Host Links Connect with Laurie McGraw on LinkedIn Connect with Kristi Henderson on LinkedIn Connect with Inspiring Women Browse Episodes | LinkedIn | Instagram | Apple | Spotify

Happy New Year from WEDI! Michael offers some quick bites from our top 3 most downloaded episodes of 2025: #3: Rethinking Value-Based Care: Why Children Can't Be Left Behind (Taylor Beery, Imagine Pediatrics, Ep 219) #2: Electronic Health Records- An Integral Partner in Health Care Accessibility (Prerana Laddha, Epic, Ep 189) #1: Bridging the Data Gap- The Role of Standards & Technology in Genomic Data Exchange (Dr Sandy Rolfe, Optum, Ep 188). Be sure to listen to these episodes in their entirety by visiting our podcast page, www.wedi.org/category/podcasts

The vision for Optum Real is to create real-time transparency between payers and providers in the moments of care that matter. Current AI technology, according to Puneet Maheshwari, SVP, GM of Optum Real is making this possible now.Optum is a major force in health care, serving nine out of ten health care systems and four out of five payers in the U.S. Optum Real is in pilot now with a number of health care organizations. During the pilot, the platform has achieved a 25% reduction in call volume in the first two weeks with one health care provider, a 42% reduction at another, and a reduction in errors in reimbursement submissions of up to 75% with a large health system in Minnesota.Learn more about Optum Real: https://business.optum.com/en/operations-technology/optum-real.html Healthcare IT Community: https://www.healthcareittoday.com/

About Madhu Pawar:Madhu Pawar is a board director and cross-disciplinary technology leader operating at the intersection of healthcare, data, and product innovation. She serves on the Board of Directors at Talkspace (NASDAQ: TALK) and is the Chief Product Officer for Optum Insight, where she drives product strategy and platform innovation across UnitedHealth Group's most critical assets. Prior to Optum, she spent over six years at Google leading the global SMB Ads product ecosystem—overseeing AI-driven insights platforms, multi-billion-dollar revenue lines, and large-scale engineering, product, and operations teams across multiple continents. Madhu also teaches consumer analytics in healthcare as an adjunct professor at Carnegie Mellon University. Earlier in her career, she was a partner in McKinsey's Global Healthcare Practice, where she built and scaled technology and services businesses for payers, providers, and fast-growth health companies. She began her career in software engineering at Hewlett-Packard Labs, earning patents in authentication and location-aware computing, followed by roles at PwC in security and technology. Madhu holds graduate degrees from Stanford School of Medicine and Carnegie Mellon University and a bachelor's in computer engineering from Nanyang Technological University.Things You'll Learn:Real-time data exchange between payers and providers can significantly reduce the confusion, delays, and costs associated with today's claims processes. AI-enabled reasoning over contracts and encounters improves accuracy from the start.Optum Real aims to bridge the transparency gap by connecting stakeholders through a multi-party hub, enabling real-time understanding of coverage and reimbursement. Early pilots show tangible reductions in denials and improved patient clarity.The majority of first-time denied claims are avoidable, signaling an industry-wide opportunity to remove unnecessary rework. Solving this problem increases efficiency for providers, payers, and patients.Real-time intelligence opens the door for more effective value-based care arrangements. When providers can see financial implications instantly, incentives align more naturally.The long-term vision includes real-time payment flows, AI-driven clinical decision support, and improved patient engagement. Breaking down paper-based silos will unlock entirely new use cases at scale.Resources:Connect with and follow Madhu Pawar on LinkedIn.Follow Optum on LinkedIn and visit their website.

In this episode (from our National Conference), moderated by WEDI Chair Merri-Lee Stine (Aetna) and featuring Steve Berkow (InterSystems), Anna Taylor (MultiCare), and Stephan Rubin (Optum), we dive into the real-world state of CMS 0057 implementation, bringing together perspectives from payers, vendors, providers, and the HL7 Da Vinci implementer community. Our guests unpack where progress is being made, where complexity has crept in, and why testing, trust, and simplicity are critical to success. From navigating multiple players and messy real-world data to lessons learned from incremental implementation, the conversation highlights practical solutions that can move the industry forward. We close with a look ahead to 2026 and what the 0057 landscape—and broader interoperability environment—may look like as policy, technology, and collaboration continue to evolve.

What happens when a class clown from Monaghan builds one of the most quietly impactful healthtech companies in Europe - and then takes on the U.S. healthcare system? In this year-end episode of The Shot of Digital Health Therapy, we sat down with Neill Dunwoody

This episode, from our November National Conference, explores one of healthcare's most persistent challenges: how hospitals and health plans can move from operating at cross-purposes to truly rowing in the same direction. Our guests are Danielle Lloyd, SVP of Private Market Innovations and Quality Initiatives, AHIP and Molly Smith, Group VP for Public Policy, American Hospital Association. Led by moderator Stephan Rubin from Optum, Danielle and Molly dig into the misconceptions that providers and payers often hold about each other and discuss how better data transparency, shared incentives, and policy alignment — including recent CMS rules such as 0057F — can help bridge long-standing divides. The 3 examine the future of prior authorization, the promise and limits of interoperability initiatives like TEFCA and the CMS Aligned Network, and why value-based care still struggles to scale despite years of policy focus. Finally, they look ahead to the role of AI, automation, and emerging data standards in reshaping care delivery and payment, and ask what real payer-provider collaboration must look like to deliver a more seamless, efficient, and patient-centered healthcare system.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Rob Lott interviews Dan Arnold of Brown University to discuss his recent paper exploring higher payments within UnitedHealth's Optum network, which found UHC Paid Optum providers more than non-Optum Providers using price transparency data. Order the November 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

About Harpaul Sambhi:Harpaul Sambhi is a serial entrepreneur and the founder of Magical, where he's building Agentic AI for healthcare to transform how people and systems interact in one of the world's most vital industries. Based in the San Francisco Bay Area, Harpaul combines a deep technical background with a passion for human-centered innovation. Before founding Magical in 2020, he built and sold Careerify to LinkedIn, where he later led product initiatives within LinkedIn Talent Solutions and Microsoft, helping shape the future of talent acquisition and HR technology.Alongside building companies, Harpaul has served as Entrepreneur in Residence at Bain Capital Ventures, Advisor at On Deck, and a Limited Partner in leading VC funds, including Bain Capital Ventures, iNovia Capital, and OnDeck. Earlier in his career, he authored Social HR (published by Thomson-Reuters) and lectured at the Schulich Executive Education Centre on innovation, technology, and the evolving workplace.At his core, Harpaul is guided by simple principles—striving to be a good human and a dedicated father, husband, son, brother, and friend—while working with great people to build great products that make a difference. A graduate of the University of Waterloo with a degree in electrical engineering, he continues to live by curiosity, humility, and the drive to create technology that serves people, not the other way around.About Doug Hires:Douglas Hires is a seasoned healthcare executive, consultant, and entrepreneur with over 35 years of leadership experience across the healthcare and information technology sectors. Based in Dallas, Texas, Douglas has built a distinguished career driving operational excellence, business transformation, and financial performance for some of the nation's leading healthcare organizations. His expertise spans providers, payers, government, and life sciences, and his track record includes accelerating growth, restructuring operations, and guiding organizations through strategic reinvention.Currently, Douglas serves as Executive Advisor at Magical, Managing Partner at JD Hires Advisory Group, and Founder & President of New World Wine Designs, where he combines his business acumen with his passion for fine wine and craftsmanship through bespoke wine cellar design and building. He also advises healthcare and sales organizations through roles with Healthcare IT Leaders and SalesSparx LLC, lending his strategic insight to help teams scale with precision and purpose.Previously, Douglas held multiple senior leadership roles at Optum, including Chief Operating Officer for OptumInsight Provider and COO of the Hospital Services Division, overseeing end-to-end revenue cycle operations for Dignity Health's 36 hospitals. His earlier career includes executive roles at Santa Rosa Consulting, 3M Health Information Systems, SoftMed Systems, and First Consulting Group, where he earned recognition as a respected thought leader and sought-after industry speaker.Things You'll Learn:Agentic AI surpasses automation by reasoning, adapting, and executing end-to-end workflows, thereby freeing healthcare workers from repetitive tasks.Healthcare organizations are already seeing results, such as doubling prior authorization volume while cutting staff needs and decision times in half.The shift from RPA to agentic AI mirrors the evolution from MapQuest to autonomous vehicles, smarter, smoother, and self-correcting.Successful AI adoption requires attention to change management and staff reallocation, not just technology deployment.Evaluating AI vendors using six key pillars (reasoning, adaptability, interoperability, agility, scalability, and fault tolerance) helps cut through the hype and identify real solutions.Resources:Connect with and follow Harpaul Sambhi on LinkedIn.Connect with and follow Doug Hires on LinkedIn.Follow Magical on LinkedIn.Visit Magical's website.

Join us for a deeply human and candid conversation with someone who has mental health experiences from every angle. Melissa Fors Shackelford is a healthcare executive and the author of the Amazon #1 Best Seller, Harnessing Purpose.While Melissa is known for building compelling brands and advising Fortune 100 leaders, her path to purpose was forged through personal adversity. In this episode, we normalize the conversation on family mental health and substance abuse as Melissa shares:The Impact of Family Adversity: How growing up with family members affected by substance abuse profoundly shaped her life choices, empathy, and career path.The Power of Experience: Her invaluable perspective gained from working at institutions like Hazelden Betty Ford and how it taught her about the complexity of mental health and recovery.The Vital Tool: The role of journaling as a non-negotiable practice for processing difficult emotions and finding clarity in the face of chaos.Making the Leap: What inspired her to leave behind a high-level corporate career (at Optum, Cigna, etc.) to bet on herself and build her own purpose-driven consulting practice, Shackelford Strategies.Breaking the Barrier: Why making yourself available to ask for help is the most crucial step in activating your support circle and fostering true mental resilience.Melissa brings a rare blend of corporate expertise and personal vulnerability, proving that leading with integrity requires you to first understand and embrace your own story. This episode offers essential encouragement for anyone seeking to blend their personal challenges into a foundation for meaningful impact.Support the showHave a question for the host or guest? Want their freebee? Are you looking to become a guest or show partner? Email Danica at PodcastsByLanci@gmail.com.This show is brought to you by Coming Alive Podcast Production.CRISIS LINE: DIAL 988

This week on That Entrepreneur Show, host Vincent A. Lanci sits down with Melissa Fors Shackleford, award-winning marketer, bestselling author of Harnessing Purpose, and founder of Shackleford Strategies. With over 20 years of experience leading marketing for powerhouse organizations like Optum, Cigna, and Hazelden Betty Ford, Melissa brings unmatched insight into what it means to build a brand with soul — one grounded in authenticity, purpose, and impact.In this inspiring episode, Melissa reveals how to: ✨ Build a mission-driven brand that goes beyond logos and taglines.

The Trump Administration reaches a deal to lower prices on weight loss drugs, the FDA fast-tracks biosimilars, and a new report shows UnitedHealthcare pays its Optum physicians more than others. Hear the latest on The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The state of Minnesota is hiring a third-party auditor to look for fraud in 14 Medicaid programs. These programs are intended to provide housing and care for people with disabilities and severe mental illnesses. Gov. Tim Walz announced Wednesday the state will temporarily stop paying providers of these services while the auditor, Optum, analyzes billing. A statement from the governor's office said this pause will last 90 days, but's not clear when it will begin. Josh Berg is director of Minnesota services and strategic growth for nonprofit Accessible Space, Inc. He's also on the board of directors of Association of Residential Resources in Minnesota, which lobbies on behalf of disability service providers. He spoke to MPR News host Nina Moini about how this pause could impact how providers can care for people with disabilities and severe mental health illnesses.

Approximately one in four people will face a cancer diagnosis. For most, the hardest part won't be the treatment itself but the waiting, the 3 AM questions, the logistical maze of care coordination that can mean the difference between hope and despair. Ann Stadjuhar knows this truth from both sides of the stethoscope. When Ann navigated her own cancer diagnosis, she had every advantage: 20 years of healthcare expertise, knowledge of case volumes, connections to top surgeons at Optum. Yet even she found the system overwhelming. Her uncle in rural New Mexico wasn't as fortunate; by the time he reached MD Anderson, inadequate local care had sealed his fate. These parallel experiences crystallized Ann's mission at Reimagine Care: ensuring no one faces cancer alone, regardless of their zip code or insider knowledge. This conversation comes at a critical moment. As cancer increasingly strikes younger populations, with many cancers now appearing in people's 20s and 30s rather than their 50s, we need innovators who understand that technology without empathy is just expensive machinery. Ann represents a new breed of healthcare leaders who see AI not as a replacement for human connection, but as a way to multiply it. "The worst part of cancer is the wait," Ann explains. "We can be there 24/7 to understand whether there may be social determinants of health needs. I need a ride to treatment. I need someone to watch my dog. I have issues paying my electric bill. Sometimes people are honestly more comfortable telling the bot they're having these challenges." After two decades revolutionizing digital health from women's health to pandemic response centers, Ann calls cancer care her "capstone." She's witnessed how the 18-month health system adoption cycle literally costs lives. Now, armed with Meta glasses and AI tools that multiply her capabilities "times four," she's racing against a broken system where your uncle's zip code shouldn't determine whether his cancer stays operable. In this episode of Inspiring Women with Laurie McGraw, discover how one woman's journey through cancer transformed into a mission to democratize access to the kind of insider knowledge that can save lives. From the Cancer X Accelerator to Reimagine Care's AI companion REMI, Ann reveals why the future of cancer care isn't about choosing between humans and machines. It's about creating technology sophisticated enough to know that sometimes, the most advanced intervention is simply helping someone find a dog sitter so they don't miss chemotherapy. For Ann Stadjuhar, reimagining cancer care isn't about replacing human connection. It's about multiplying it. In a healthcare system where staying curious might be the difference between innovation and stagnation, between treatment and tragedy, she's proof that the most powerful technology is the kind that remembers to be human. Key Insights: Why patients confess more to AI than to their doctors, and what that means for care How social determinants of health become matters of life and death in cancer treatment The hidden complexities even healthcare insiders struggle to navigate Why the next generation needs emotional intelligence more than technical skills How one woman's cancer diagnosis became a blueprint for system-wide change About the Guest:  Ann Stadjuhar brings 20+ years of digital health innovation to her role as Chief Growth Officer at Reimagine Care. From launching pharmaceuticals to scaling population health tools, she's run what she calls "the gauntlet" of healthcare transformation. Her personal cancer journey while at Optum revealed the gaps even insiders face, inspiring her mission to ensure 24/7 companionship for every cancer patient through AI-powered human care. Guest & Host Links Connect with Laurie McGraw on LinkedIn Connect with Ann Stadjuhar on LinkedIn Connect with Inspiring Women Browse Episodes | LinkedIn | Instagram | Apple | Spotify

How one organization is tackling primary care issues by reducing burnout, building team-based models, and using technology to create a better practice environment.

On episode 244, we welcome Troyen Brennan to discuss the pitfalls of the US healthcare system, the fee-for-service model's implications for patient outcomes, primary care as a more viable alternative, Walmart's failed attempt to establish primary care clinics, Optum's contrasting success, how to incentivize primary care, AI streamlining prior authorizations, increasing government funding and venture capital for primary care, how preventative care keeps patients from falling through the cracks, and why medical professionals tend to dislike the business side of medicine. Troyen A. Brennan is an adjunct professor of health policy and management at the Harvard T. H. Chan School of Public Health. A former professor of medicine at Harvard Medical School and the former chief medical officer at CVS Health, he is the author of The Transformation of American Health Insurance: On the Path to Medicare for All and Just Doctoring: Medical Ethics in the Liberal State. His new book, available October 7, 2025, is called Wonderful and Broken: The Complex Reality of Primary Care in the United States. | Troyen A. Brennan | ► Website | https://www.researchgate.net/scientific-contributions/Troyen-A-Brennan-38805570 ► Linkedin | https://www.linkedin.com/in/troyen-brennan-494bb533 ► Wonderful and Broken Book | https://amzn.to/3KBnjQD Where you can find us: | Seize The Moment Podcast | ► Facebook | https://www.facebook.com/SeizeTheMoment ► Twitter | https://twitter.com/seize_podcast ► Instagram | https://www.instagram.com/seizethemoment ► TikTok | https://www.tiktok.com/@seizethemomentpodcast ► Patreon | https://bit.ly/3xLHTIa  

How do we produce better health outcomes and an exceptional experience at a lower cost, at scale, every day? Learn how a large health care services company is striving to serve its population's physical, mental, pharmacy, social, and financial needs through three core areas: value-based care, pharmacy services, and technology...

In this episode of Robots and Red Tape, host Nick Schutt interviews Anoop Mehendale, an entrepreneur and AI innovator with extensive experience in healthcare and data analytics, to explore AI's transformative potential in revolutionizing healthcare through unified medical records and data-driven solutions. Anoop shares his journey from building an R&D center for Daimler Chrysler in India to launching an AI-driven healthcare startup that went IPO in 2022. He discusses how AI can address healthcare's data fragmentation, streamline administrative inefficiencies, and enhance patient care, drawing from his work at Highmark, Optum, and Aetna. Reflecting on the White House's CMS-led initiative for unified medical records, Anoop notes, “With AI, you can do a lot more with a massive dataset” (53:24), emphasizing its potential to boost research and personalize medicine while addressing challenges like standardization and privacy concerns. He delves into the need for industry-specific AI benchmarks and a convenor role for CMS to align data standards, advocating for AI as a collaborative tool that complements human oversight. Tune in for insights on how AI can reshape healthcare, from improving patient outcomes to advancing public health research. Subscribe for more insights on AI.

Nick is a rider who proves that passion, persistence, and maybe a touch of stubbornness can take you pretty far—whether that's up a Wasatch climb at sunrise or across the finish line at Leadville. He grew up in Salt Lake City as the oldest of three kids. He earned his Eagle Scout, served an LDS mission in Milan, Italy, earned his Economics degree from the U and MBA from Westminster. He even found time to volunteer at the 2006 Turin Winter Olympics, supporting the U.S. Olympic Team with athlete services and translation. He's been with Optum for 23 years, working his way up from sales to Director of Business Operations, and I think he'd tell you the reason he's stayed so long is because of the people and relationships. He's been married to his wife, Jennilynn, for 17 years - and she keeps him fueled with plenty of baked goods. He is a proud dad of two (one through fertility treatments and one through adoption), and shares his home with Bella, a 5-year-old St. Bernard who probably weighs more than all of his bikes combined. He's been passionate about sports since he was young. He ran track and cross country, once ran a marathon, finishing in 4hrs and 4 min, and swore ‘never again,' and eventually found his true love in cycling. Since then, he's tackled countless endurance events—multiple century rides, six LOTOJAs, Steamboat Springs Gravel, and most recently, the Leadville 100 MTB. Nick is so grateful for the Mi Duole team. Riding with them has pushed him to grow as a cyclist while also creating meaningful friendships that extend beyond the bike.  Around the house, he's known as the guy who fills the garage with bikes, never stops talking about cycling, and occasionally finishes a project or two in between rides. Passionate, disciplined, and just stubborn enough to keep pushing through the hard stuff is what makes him such a strong rider and a great husband and father.

Welcome to the Health Marketing Collective, where strong leadership meets marketing excellence.On today's episode, we're joined once again by Melissa Fors Shackelford, health marketing strategist, accomplished consultant, renowned keynote speaker, and now Amazon's #1 bestselling author with her new book, “Harnessing Purpose: A Marketer's Guide to Inspiring Connection.” Host Sara Payne leads a deep-dive conversation into the essential role of purpose in marketing, exploring how both personal and brand purpose are at the very heart of meaningful work and, crucially, business success.Melissa draws on two decades of shaping brand and growth strategies for healthcare organizations, including Optum, Hazelden Betty Ford, and Cigna's Evernorth, to share why connecting our personal “why” with the organizational mission isn't just aspirational, but also practical, powerful, and profitable. Together, Sara and Melissa unpack the realities of burnout and the so-called “soul-selling” reputation that sometimes haunts the marketing profession, contrasting it with Melissa's own purpose-driven approach. The episode explores how leaders and organizations can avoid performative platitudes, instead cultivating authentic, values-aligned cultures that foster engagement, resilience, creativity, and tangible business outcomes.Whether you're feeling disconnected from the “why” of your day-to-day or are a marketing leader looking to inspire deeper commitment within your team, today's discussion is packed with actionable guidance, real-world examples, and candid advice on harnessing purpose for both individual fulfillment and organizational growth.Key Takeaways:Aligning Personal and Brand Purpose Unlocks Engagement and Performance: Melissa emphasizes that the most effective marketing and the most fulfillment for marketers happens when personal purpose aligns with brand values. Marketers who understand both their own “why” and their organization's mission are more resilient, creative, and motivated, producing authentic campaigns that resonate internally and externally.Purpose-Driven Companies Outperform Competitors: The episode isn't just about feel-good motivation Melissa cites research (from the likes of HBR and Deloitte) that shows 85% of businesses with a clear purpose see sales increase, while 42% without purpose see stagnation or decline. Purpose-driven organizations attract like-minded employees and customers, resulting in higher engagement, loyalty, and performance.Authenticity and Consistency Are Essential to Building Trust: Saying the right things isn't enough; posting values on lanyards or walls without truly living them can actively erode employee and consumer trust. Melissa and Sara discuss why it's critical for leadership to model values and use them as a filter for decisions from hiring to service delivery, especially in high-stakes sectors like healthcare.Purpose as a Decision-Making Filter Empowers Employees: The ultimate goal is for every employee to use company purpose and values as a guide in daily and “in the moment” decisions, especially when leaders aren't around. This means purpose isn't just strategy, it's culture, empowering staff with clarity and confidence, and fueling both psychological safety and creative risk-taking.Marketing Can and Should Be a Force for Good: Melissa challenges marketing's manipulative stereotype by sharing real healthcare examples where marketing ethics and mission-driven approaches protect vulnerable populations and foster positive change. She encourages all marketers to use their role for good, highlighting the growing importance of authenticity in both B2C and B2B environments.To connect with Melissa Fors Shackelford or learn more about her bestselling book, visit harnessingpurpose.com or reach out on...

FHC #186: From rare diseases to rural America, Optum's CEO talks healthcare's future In this special return to Season 10, which focused on transformative technologies in medicine, Fixing Healthcare hosts ... The post FHC #186: Optum CEO on AI, big data & preventing disease appeared first on Fixing Healthcare.

Hannah Ryu is a storyteller, AI Strategist, and the co-founder of Oak Theory, a creative technology studio specializing in UX/UI, web, application design, and development. We explore: Co-founding a creative technology studio, aiming to address the lack of diversity in UX design firms.  Confronting negative self-talk/narratives when building a business The role of perfectionism in Korean culture The exciting utility of AI in creating tailored educational information for children, increasing accessibility to education Use of AI for self-reflection and as a starting point to engage in therapy How to maintain being human through curiosity, accepting that we make mistakes, and unconditional love ========================================== Hannah's full bio: Hannah is a storyteller, AI Strategist, and the co-founder of Oak Theory, a creative technology studio specializing in UX/UI, web, application design, and development. With over a decade of experience across branding, UX/UI, and digital strategy, she partners with organizations navigating transformation, helping them turn complexity into clear, scalable experiences.  As a first-generation Korean American and mother of two, Hannah brings a layered lens to leadership, blending creative instinct, cultural awareness, and operational know-how, especially during times of growth, change, or reinvention. Her expertise has been trusted by industry leaders and universities like Google, Optum, Columbia University, and Vanderbilt University. She's been featured at the Women in Tech Global Conference, on the top 0.5% business podcast The UpFlip Podcast, and in outlets such as Forbes, Success Magazine, and Entrepreneur. The company's websites are oaktheory.co and undertheoak.co. Under the Oak is a media company that seeks to discuss how to be more human. Socials: https://www.instagram.com/oaktheory.co/ https://www.linkedin.com/in/hannahryu/ 

Kevin Sommers is a 2018 graduate of the Harbert College of Business at Auburn University. He currently serves as the Assistant Chief Financial Officer of TriStar Skyline Medical Center, part of HCA Healthcare, in Nashville, TN. He has worked at SCA Health (part of Optum and United Health) in their Financial Operations group, supporting surgery centers and surgical hospitals across multiple states. Before that, Kevin was a member of the finance team at UAB Health System in Birmingham, Alabama.Originally from Huntsville, Alabama, Kevin is a proud alumnus of Auburn University, holding a degree in accounting. He furthered his education at the University of Alabama at Birmingham with a Master of Science in Health Administration and a Master of Business Administration. Outside of work, Kevin enjoys staying active with golf, tennis, and pickleball, and loves to travel and spend time with family and friends. He currently serves on the Young Alumni Council for the Harbert College of Business and is an avid supporter of Auburn athletics.

Over 160 million Americans are served by Optum, yet many still don't fully understand what it actually does—or why it matters.Dr. Patrick Conway, newly appointed CEO of Optum and former head of CMS Innovation Center and Blue Cross NC, joins Steve for a wide-ranging discussion on the state of healthcare delivery, affordability, and the potential of value-based care at a national scale. With experience spanning the frontlines of medicine to top government and corporate leadership, Conway breaks down how Optum aims to improve care while controlling costs—and why he continues to practice as a pediatric hospitalist on weekends.We cover:

Believe it or not, 60% of healthcare payments in the US are tied to value. But it's still surprisingly hard to find examples of health systems that have been doing VBC at scale, successfully, over time. So that's what Advisory Board researchers set out to do. And across 66 conversations with 44 systems, we found four systems with approaches worth emulating. This week, we're unpacking the approach at one of those systems: Advocate Health. Host Abby Burns sits down with Don Calcagno, Chief Population Health Officer and President of Advocate's largest clinically integrated network, Advocate Physician Partners. Don lays out how putting operations at the center has led Advocate to become one of the top-performing systems in Medicare risk models, generate millions of dollars in savings, and, most importantly, improve quality of care. Not to mention, juggle over 100 VBC contracts across 13 accountable care organizations and clinically integrated networks, and carry $1 billion in capitated risk. Links: Read the case study: Inside Advocate Health's VBC approach that saved $136M VBC self-assessment: Find out where your organization stands 2025 Advisory Board Summit- Carlsbad, CA - join us for the full event, and check out our session featuring another VBC case study Registration is live for our VBC Roundtable in October: HOME - How to deliver the next era of VBC Ep. 243: What's now and what's next in value-based care How UNC Health made VBC sustainable in an academic health system Optum Advisory can help you create a VBC strategy for growth and profitability. Connect with an expert. How to succeed in VBC — according to Optum experts VBC success is possible. Here's how. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Believe it or not, 60% of healthcare payments in the US are tied to value. But it's still surprisingly hard to find examples of health systems that have been doing VBC at scale, successfully, over time. So that's what Advisory Board researchers set out to do. And across 66 conversations with 44 systems, we found four systems with approaches worth emulating. This week, we're unpacking the approach at one of those systems: Advocate Health. Host Abby Burns sits down with Don Calcagno, Chief Population Health Officer and President of Advocate's largest clinically integrated network, Advocate Physician Partners. Don lays out how putting operations at the center has led Advocate to become one of the top-performing systems in Medicare risk models, generate millions of dollars in savings, and, most importantly, improve quality of care. Not to mention, juggle over 100 VBC contracts across 13 accountable care organizations and clinically integrated networks, and carry $1 billion in capitated risk. Links: Read the case study: Inside Advocate Health's VBC approach that saved $136M VBC self-assessment: Find out where your organization stands 2025 Advisory Board Summit- Carlsbad, CA - join us for the full event, and check out our session featuring another VBC case study Registration is live for our VBC Roundtable in October: HOME - How to deliver the next era of VBC Ep. 243: What's now and what's next in value-based care How UNC Health made VBC sustainable in an academic health system Optum Advisory can help you create a VBC strategy for growth and profitability. Connect with an expert. How to succeed in VBC — according to Optum experts VBC success is possible. Here's how. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Deb Bubb is the former Chief People Officer at Optum and Co-founder of The Institute For Moral Imagination.  This ThoughtCast is an insightful chat about creativity, passion, and purpose. Our guest, Deb Bubb, shared with us how she pivoted into a new chapter of her life, chasing a passion and building something new. Deb also spoke about the fears, uncertainty, and challenges of making a transition and embracing the unknown. The conversation centered on the idea that every life is a creative act. By embracing all of our creativity, we have a way to access all our potential. She shares how she has built creativity and art into her life. This discussion will energize you to dive into your creativity and look for art all around you.  Get in touch Visit us at tignum.com Email us at contact@tignum.com Think clearer. Show up better. Maximize impact.

Welcome to the Health Marketing Collective, where strong leadership meets marketing excellence. In today's episode, host Sara Payne sits down with Mike Cronin, Cofounder and Chief Strategist at Verve, to explore the evolving landscape of creativity in B2B healthcare marketing. Mike, whose impressive résumé includes brand and campaign strategy for UnitedHealth Group, Blue Cross Blue Shield, Optum, and revered consumer brands like Harley-Davidson and Samuel Adams, brings a rare blend of creative vision and strategic rigor to his work. His fundamental belief? That creative work's purpose is to move people, not just fill space. In this conversation, Mike and Sara dive deep into how B2B health brands can move beyond “safe” ideas and unlock emotionally resonant, unforgettable campaigns—even within highly regulated and risk-averse spaces. They discuss why simplicity is a superpower, the importance of strategic “boxes,” and how marketing leaders can create environments where big swings are encouraged, not stifled. Along the way, Mike shares memorable stories from his work (including a campaign that fused Lizzo's “Good as Hell” into healthcare advertising), offers insight into the universal human truths marketers often miss, and outlines what separates teams that produce great creative from those that simply make noise. Thank you for being part of the Health Marketing Collective, where strong leadership meets marketing excellence. The future of health care depends on it. Key Takeaways: Creativity Thrives Within Constraints: Mike challenges the conventional wisdom of “thinking outside the box.” He argues that true creativity is often unlocked not by limitless freedom, but by well-defined strategic constraints. It's within the confines of a focused brief—what Mike calls “the freedom of a tight brief”—that intelligent, emotionally resonant ideas emerge. Rather than aiming for “crazy” or “flashy,” the best creative is smart, intentional, and purpose-driven. Emotion and Human Truth are Universal, Even in B2B: B2B often gravitates toward rational benefits: cost savings, efficiency, or productivity. But, as Mike notes, even financial administrators and clinicians are humans first—they respond to messages that tap into universal emotions and experiences: hope, fear, dignity, and relief from frustration. Brands that connect on this human level, rather than just touting features and benefits, become memorable and meaningful. Strategic Alignment is the Key to Unlocking Great Creative: Teams that produce truly breakthrough work consistently prioritize strategy. When everyone is aligned on the core insight and brief, creativity can flow freely within those parameters. Conversely, weak or vague direction leads to “safe,” generic campaigns. Mike's experience shows that great creative always starts with a shared, sharp strategic foundation. Boldness is Essential for Breaking Through the Noise: Healthcare, especially B2B, often defaults to playing it safe (“everything's blue”)—but in a crowded marketplace, standing out is non-negotiable. Mike advocates for boldness that is grounded in the brand's truth and strategically anchored. The result: unforgettable, not just noisy, marketing. Leadership's Role: Foster Honesty, Empathy, and Trust: Leadership sets the tone for creativity and trust. Mike urges CMOs and marketing leaders to lead with clarity and honesty—eschewing “BS” and toxic positivity for real, truthful dialogue about challenges and opportunities. Teams (and audiences) respond to authenticity; when leaders call things as they are and create space for truth, better work results. Resources and Contact: Want to connect with Mike or learn more about Verve's approach to strategic creativity? Visit

Once called a “unicorn” for her entrepreneurial approach, Vicki Apodaca is a seasoned marketer, entrepreneur, and philanthropist. Vicki has been a founding member of several tech startups (Phalanx, StellarFi, Joust, and Soply), and have also been through two exits (Joust acquired by ZenBusiness, Starship HSA acquired by Optum). Her passion in go-to-market and marketing strategy has led her to now be a Fractional CMO and Advisor across several startups worldwide. A native Burqueña, Vicki co-founded the New Mexico chapter of Techqueria – a Latinx in tech 501(3)(c) nonprofit – and NMClimate – a community for climate and energy-focused entrepreneurs. She lives in a cozy home with her partner and two Pekingese who run their house. Links NM Lottery Program FiatVentures Advisors site Phalanx site Techqueria New Mexic0 site Atomic 66 site Q Station site SpaceValley Foundation site CNM Ingenuity site nDigitize site Vicki on LinkedIn 

Welcome to The Power Lounge. In this episode, we explore a significant shift in healthcare marketing with our guest, Melissa Forrest Shackleford. With over twenty years of experience, Melissa has developed inclusive marketing strategies for organizations such as Optum and the Hazelden Betty Ford Foundation. She joins host Amy Vaughn to discuss how inclusive marketing can challenge stigmas in healthcare.Melissa details her journey and the impact of purpose-driven marketing in breaking down barriers and fostering meaningful consumer connections. The conversation covers the effectiveness of inclusive initiatives, the importance of language and accessibility, and provides practical strategies for obtaining executive support for inclusive marketing efforts. Additionally, Melissa highlights the tools and innovations that are driving change in the industry.This episode offers valuable insights and actionable advice for marketers, healthcare professionals, and anyone committed to making a difference. For further reading, Melissa's book, "Harnessing Purpose: A Marketer's Guide to Inspiring Connection," provides more comprehensive knowledge. Join us in building a more inclusive future.Chapters:00:00 - Introduction02:14 - "Evan North's Transformative Marketing Impact"04:57 - Understanding Consumer Stigma Insights08:18 - "Understanding Health Care Marketing Challenges"11:04 - Fighting Stigma in Lung Cancer Screening13:27 - Progress in Health Care Perception17:26 - Authenticity in Testimonies20:10 - Inclusive Marketing Awareness23:50 - Person-First Language Explained25:15 - Language Nuance and Impact30:56 - Delivery Service Boosted Sales33:29 - Reaching Diverse Audiences Economically37:26 - Champion Accessible UX Today41:44 - Purpose-Driven, Authentic Marketing44:25 - "Values-Driven Consumer Purchases"48:36 - Beyond Performative Inclusivity51:14 - Inclusive Audience Targeting Importance54:02 - Essential Inclusive Marketing Strategies55:25 - OutroQuotes:"Inclusive marketing means truly seeing and understanding each person, unlocking its transformative power."- Amy Vaughan"Shifting from stigma to understanding changes perceptions, saves lives, and forges genuine connections."- Melissa Forrest ShacklefordKey Takeaways:Breaking Stigma Starts with UnderstandingAuthentic Representation MattersAccessibility is Key to InclusivityLanguage as a Powerful ToolLeveraging Technology for PersonalizationInclusivity Equals GrowthConnect with Melissa Forrest Shackleford:LinkedIn: https://www.linkedin.com/in/mfors/Check out Melissa's book: https://a.co/d/5HGTje6Connect with the host Amy Vaughan:LinkedIn: http://linkedin.com/in/amypvaughanPodcast: https://www.togetherindigital.com/podcast/Learn more about Together Digital and consider joining the movement by visiting https://togetherindigital.comSupport the show

It feels like only yesterday that workforce challenges were the biggest problem facing the healthcare industry. While COVID-19-related staffing shortages may have declined, an inefficient workforce can still threaten health system operations and finances. Often, systems turn to staffing ratios or benchmarks to determine whether they need more cuts or more hires. However, systems need more than staffing ratios to make sure they have the right headcount and the right expertise in place to safely and effectively care for patients. The question is: if workforce benchmarks aren't enough, then what is? To answer that question, host Rachel (Rae) Woods invites Advisory Board nursing expert Ali Knight to unpack the state of the workforce five years after the peak of COVID-19. Later, Rae brings on Optum Advisory workforce management experts Sherilynn Quist and Anne Schmidt to break down their work in the field, addressing what they call the “blocking and tackling” of workforce efficiency within a hospital. Links: Optum Advisory: Healthcare consulting services [Webinar, May 18] Broaden your definition of the nursing care team Insights from Advisory Board's 2024 workforce benchmarks [Roundtable, Aug. 18-19] How to thrive in an evolving nursing landscape Ep. 205: Live from ViVE 2024: Four leaders on how technology is redefining clinical work Ep. 207: Nurses Week 2024: Build care teams, not assembly lines 2025 Advisory Board Summit - Carlsbad, CA Advisory Board Fellowship Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

It feels like only yesterday that workforce challenges were the biggest problem facing the healthcare industry. While COVID-19-related staffing shortages may have declined, an inefficient workforce can still threaten health system operations and finances. Often, systems turn to staffing ratios or benchmarks to determine whether they need more cuts or more hires. However, systems need more than staffing ratios to make sure they have the right headcount and the right expertise in place to safely and effectively care for patients. The question is: if workforce benchmarks aren't enough, then what is? To answer that question, host Rachel (Rae) Woods invites Advisory Board nursing expert Ali Knight to unpack the state of the workforce five years after the peak of COVID-19. Later, Rae brings on Optum Advisory workforce management experts Sherilynn Quist and Anne Schmidt to break down their work in the field, addressing what they call the “blocking and tackling” of workforce efficiency within a hospital. Links: Optum Advisory: Healthcare consulting services [Webinar, May 18] Broaden your definition of the nursing care team Insights from Advisory Board's 2024 workforce benchmarks [Roundtable, Aug. 18-19] How to thrive in an evolving nursing landscape Ep. 205: Live from ViVE 2024: Four leaders on how technology is redefining clinical work Ep. 207: Nurses Week 2024: Build care teams, not assembly lines 2025 Advisory Board Summit - Carlsbad, CA Advisory Board Fellowship Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

There is a lot happening in federal policy that may affect healthcare payment transformation and care delivery. But we've said it before: healthcare leaders can't afford to focus on fighting near-term fires at the expense of driving long-term success and sustainability. Amidst the uncertainty, it's more important than ever to push forward conversations about how we can structurally evolve our systems to align incentives to patient health. So, in this episode, we're talking about value-based care. Host Abby Burns invites Advisory Board expert Clare Wirth and Optum Advisory expert Erik Johnson to unpack the state of VBC in early 2025, and where they see it going next. They debate whether bundles can truly be considered “value-based care,” how specialty care will fit into the future VBC landscape, and which payer lines of business they have their eyes on. Links: VBC in 2025: What's now and what's next Inside Advocate Health's VBC approach that saved $136M How UNC Health made VBC sustainable in an academic health system The obstacles between health systems and VBC success Ep. 201: Value series: What does health system VBC adoption actually look like? Ep. 231: Big deal, little deal, or no deal? A 2024 health policy retrospective Value-based care landing page Optum Advisory can help you design a VBC strategy that drives sustainable growth and profitability. Get in touch Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

There is a lot happening in federal policy that may affect healthcare payment transformation and care delivery. But we've said it before: healthcare leaders can't afford to focus on fighting near-term fires at the expense of driving long-term success and sustainability. Amidst the uncertainty, it's more important than ever to push forward conversations about how we can structurally evolve our systems to align incentives to patient health. So, in this episode, we're talking about value-based care. Host Abby Burns invites Advisory Board expert Clare Wirth and Optum Advisory expert Erik Johnson to unpack the state of VBC in early 2025, and where they see it going next. They debate whether bundles can truly be considered “value-based care,” how specialty care will fit into the future VBC landscape, and which payer lines of business they have their eyes on. Links: VBC in 2025: What's now and what's next Inside Advocate Health's VBC approach that saved $136M How UNC Health made VBC sustainable in an academic health system The obstacles between health systems and VBC success Ep. 201: Value series: What does health system VBC adoption actually look like? Ep. 231: Big deal, little deal, or no deal? A 2024 health policy retrospective Value-based care landing page Enjoying this episode? Discover how Optum Advisory experts can help you design a VBC strategy to drive sustainable growth and profitability for your organization. Connect with one of our experts today. Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

In this episode, Dr. Ken Cohen, Executive Director of Translational Research at Optum Health, discusses the impact of value-based care models on patient outcomes. He shares key findings from his recent research, including how Medicare Advantage patients in value-based arrangements receive superior care and how these benefits extend to traditional Medicare patients.

Partnerships between health systems and life sciences play a critical role in giving patients access to the best data, therapies, and technologies available in the market. However, these partnerships can be less fulfilling if both sides don't align on purpose and expectations. This week, host Rachel (Rae) Woods invites Advisory Board expert Fanta Cherif to break down the current state of health system and life sciences partnerships, share the spectrum of collaboration options, and the strategic middle ground that is often overlooked, but can serve as a lifeline in today's challenging economic landscape. Let us know what you think about today's discussion, or share your ideas for future episode topics by leaving us a voice message or emailing us. Links: Ep. 151: Making vendor-provider partnerships work Ep. 183: John Muir Health and Optum reflect on what makes their partnership work How to bridge the communication gap in vendor-provider partnerships Metrics that matter: How different stakeholders define value in healthcare Join Advisory Board experts for these upcoming philanthropy webinars: March 20, 2025 (1-2 p.m. ET/10-11 a.m. PT): What the future of health system growth means for philanthropy leaders Register here: What the future of health system growth means for philanthropy leaders April 1, 2025 (1-2 p.m. ET/10-11 a.m. PT): How market data can transform your philanthropy strategy Register here: Using market data to inform your philanthropy strategy A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Partnerships between health systems and life sciences play a critical role in giving patients access to the best data, therapies, and technologies available in the market. However, these partnerships can be less fulfilling if both sides don't align on purpose and expectations. This week, host Rachel (Rae) Woods invites Advisory Board expert Fanta Cherif to break down the current state of health system and life sciences partnerships, share the spectrum of collaboration options, and the strategic middle ground that is often overlooked, but can serve as a lifeline in today's challenging economic landscape. Let us know what you think about today's discussion, or share your ideas for future episode topics by leaving us a voice message or emailing us. Links: Ep. 151: Making vendor-provider partnerships work Ep. 183: John Muir Health and Optum reflect on what makes their partnership work How to bridge the communication gap in vendor-provider partnerships Metrics that matter: How different stakeholders define value in healthcare Join Advisory Board experts for these upcoming philanthropy webinars: March 20, 2025 (1-2 p.m. ET/10-11 a.m. PT): What the future of health system growth means for philanthropy leaders Register here: What the future of health system growth means for philanthropy leaders April 1, 2025 (1-2 p.m. ET/10-11 a.m. PT): How market data can transform your philanthropy strategy Register here: Using market data to inform your philanthropy strategy A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Back in December, we discussed why leaders should re-envision their approach to digital change management. But to truly implement digital change, health systems must understand their organization's success (or failure) to date. However, assessing digital progress is not a simple task. While models exist that measure digital maturity in other industries, there is a serious lack of tools to measure progress in the healthcare field—which is why we made our own. This week, host Rachel (Rae) Woods invites John League, Advisory Board digital health expert, and K. R. Prabha, Optum's Vice President of Strategy, Growth and Innovation to define what digital maturity for health systems looks like and unpack why so many organizations are stalled at merely “being” digital. Together, they introduce a new tool they've designed to help health systems assess their own digital maturity. For an on-the-ground perspective, Rae invites Dr. David Ingham, Vice President and Chief Information Officer of Allina Health, to discuss how Allina Health leveraged this tool to assess their progress and prioritize next steps on their digital journey. Links: Understand the digital maturity of your health system Ep. 233: Your digital strategy needs more than “change management” Connect with Optum Advisory to design your digital transformation strategy Allina Health Care & Medical Services In MN & Western WI Get in touch with us [Webinar, 2/19] Imaging market trends in 2025 Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Back in December, we discussed why leaders should re-envision their approach to digital change management. But to truly implement digital change, health systems must understand their organization's success (or failure) to date. However, assessing digital progress is not a simple task. While models exist that measure digital maturity in other industries, there is a serious lack of tools to measure progress in the healthcare field—which is why we made our own. This week, host Rachel (Rae) Woods invites John League, Advisory Board digital health expert, and K. R. Prabha, Optum's Vice President of Strategy, Growth and Innovation to define what digital maturity for health systems looks like and unpack why so many organizations are stalled at merely “being” digital. Together, they introduce a new tool they've designed to help health systems assess their own digital maturity. For an on-the-ground perspective, Rae invites Dr. David Ingham, Vice President and Chief Information Officer of Allina Health, to discuss how Allina Health leveraged this tool to assess their progress and prioritize next steps on their digital journey. Links: Understand the digital maturity of your health system Ep. 233: Your digital strategy needs more than “change management” Optum Advisory: Healthcare consulting services Allina Health Care & Medical Services In MN & Western WI Get in touch with us [Webinar, 2/19] Imaging market trends in 2025 Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

In this episode, Scott Becker and Jakob Emerson, Associate News Director at Becker's Healthcare, explore UnitedHealth Group's 2024 earnings report, the challenges faced in Medicare Advantage, and the strategic shifts at Optum, including its move away from urgent care.

When it comes to leadership, emotional intelligence often gets overlooked. For years, the American work culture has emphasized suppressing emotions in the workplace. But times are changing.Today, emotional intelligence is as crucial as any leadership skill–if not the most essential. Our guest is here to show us why it matters and how to manage our emotions effectively.Meet Roberta Fernandez. Roberta is a professional development consultant specializing in emotional intelligence and organizational cultural change. She holds a Master Practitioner certification in NLP and is a Board-certified Hypnotherapist, making her uniquely skilled in understanding human behavior. Roberta's past clients form a diverse portfolio, including Kemps, Sam's Club, Target, Optum, Pentair, governments, academic institutions, and private small businesses.In this episode, Roberta and I explore the transformative power of emotional intelligence in the workplace. Roberta shares how emotions influence behavior and introduces practical tools for managing team dynamics effectively.With practical tips on staying calm in heated situations, navigating tough conversations, and recognizing workplace emotions, this episode is packed with insights to improve your leadership and collaboration skills.Join the conversation now!Get FREE mini-episode guides with the big idea from the week's episode delivered to your inbox when you subscribe to my weekly email.Conversation Topics(00:00) Introduction(01:56) What is emotional intelligence?(04:06) Understanding and addressing your emotions(07:28) Why emotional awareness is critical for managers(11:32) The FARE framework (Focus, Associate, Repeat, and Expect) explained(16:45) Tips for navigating the emotions that come with change(19:21) How to manage emotions during heated conversations(25:19) Why do people act based on their beliefs(30:19) A great manager Roberta has worked for(31:16) Keep up with Roberta(31:22) [Extended Episode Only] How to proactively prevent a conversation from getting emotional(34:28) [Extended Episode Only] Using the Frame Tool for taking emotions out of team problem-solvingAdditional Resources:- Get the extended episode by Joining The Modern Manager Podcast+ Community for just $15 per month- Read the full transcript here- Follow me on Instagram here - Visit my website for more here- Upskill your team here- Subscribe to my YouTube Channel hereKeep up with Roberta Fernandez- Follow Roberta on LinkedIn and Instagram- Visit her website for more information hereFREE Emotional Intelligence Assessment and the Frame ToolRoberta is providing members of Podcast+ with access to her emotional intelligence assessment as well as “the frame” tool, which she explains in the extended episode.To get this guest bonus and many other member benefits, become a member of The Modern Manager Podcast+ Community.---------------------The Modern Manager is a leadership podcast for rockstar managers who want to create a working environment where people thrive, and great work gets done.Follow The Modern Manager on your favorite podcast platform so you won't miss an episode!

President-elect Donald Trump nominates Robert F. Kennedy Jr. as the next Secretary of the Department of Health and Human Services. And the Biden Administration sues to halt Optum's multibillion dollar acquisition of home health provider Amedisys on antitrust grounds. We get those stories—and more—coming up on today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.

In this podcast episode, Dr. Jonathan H. Westover talks with Jonathan Hunt Glassman and Joshua Lee about digital health innovations in addiction treatment. Jonathan Hunt Glassman - A healthcare entrepreneur and CEO of Oar Health, an addiction recovery platform that is revolutionizing the way people approach Alcohol Use Disorder (AUD) treatment. With over 15 years of experience in the healthcare industry, including strategic leadership roles at Humana, Optum, and Bain & Company, Jonathan combines his expertise with a personal journey of overcoming alcohol addiction to make a meaningful impact in the field of addiction and recovery. Joshua Lee specializes in medication-assisted treatment of alcohol and opioid use disorders. He conducts clinical trials and treats patients struggling with addiction as a primary care physician. As a Professor at NYU Grossman School of Medicine, he leads the Addiction Medicine Fellowship and conducts research focused on justice and community outcomes. He is ready to explore the intersection of addiction treatment with innovative solutions, and personal and professional growth. Check out all of the podcasts in the HCI Podcast Network!

All Home Care Matters and our host, Lance A. Slatton were honored to welcome Jonathan Hunt-Glassman CEO and Co-Founder of Oar Health as guest to the show.   About Jonathan Hunt-Glassman:   Jonathan Hunt-Glassman is the CEO and co-founder of Oar Health. Jonathan founded Oar Health after struggling with alcohol misuse for more than 15 years before taking back control over alcohol with help from medication. Before founding Oar, Jonathan held healthcare strategy leadership roles at Humana, Optum and Bain & Company.   About Oar Health:   Oar Health is a telehealth platform that simplifies access to a daily pill to drink less. Oar has helped more than 35,000 members get started with safe, effective, FDA-approved medication that helps them drink less or quit alcohol altogether.