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In this debut episode of Quality Talks With Peggy O'Kane, Founder and President of NCQA, Peggy is joined by Dr. Sachin Jain, CEO of SCAN Group and SCAN Health Plan, to explore a provocative question: Why isn't health care better at getting better?Measuring—Not Missing—What Matters: Anxieties about access and affordability plague everyday people. But quality measurement's focus is elsewhere. Is health care chasing the wrong metrics and missing the big picture? The Complacency Crisis: Sachin says the core issue is a reluctance to embrace real reform, noting the industry's tendency to want improvement without being willing to change fundamental practices. He calls for a bolder approach. Rethinking Medicare & Medicare Advantage: Sachin challenges rosy view of traditional Medicare, and describes how a legal battle over a flawed Medicare Advantage star rating raised questions about how measuring quality affects care. Simplifying for Impact: Sachin proposes focusing on three or four areas, emphasizing patient experience, ease of access and basic care for common conditions. He urges cost transparency, simpler administrative processes and renewed competition.Key Quote:“ If we all just took care of our own part of the ecosystem, we'd get 20, 30% better. But instead, the most industry talking points are about, ‘Hey, we don't get paid enough for what we do.' Everyone who's making money claims that they're losing money on X, Y, or Z lines of business. Everyone complains about regulatory capture, so there's just a bit of having normalized the abnormal. And I think that that's the thing we have to undo if we're going to actually make the kinds of forward progress that we're hoping to make as an industry.”-Sachin Jain, MDTime Stamps:(01:44) Inspired by Our Mentors in Health Care(04:27) How Does Health Care Get Better?(7:28) The Trap of Toxic Positivity (11:34) Misplaced Nostalgia for Traditional Medicare(18:05) The Stars Program Controversy(22:13) Simplifying Health Care MeasurementLinks:Connect with Sachin Learn More About SCANConnect with PeggyLearn More About NCQA
In this episode, Senthu Arumugam, Chief Commercial Officer at SCAN Health Plan, discusses the evolving Medicare Advantage landscape, the impact of market disruptions, and how technology and stability-driven strategies can improve member experiences.
In this episode, Senthu Arumugam, Chief Commercial Officer at SCAN Health Plan, discusses the evolving Medicare Advantage landscape, the impact of market disruptions, and how technology and stability-driven strategies can improve member experiences.
In this episode, Troy Shaffer, VP of Contact Center Operations at SCAN Health Plan, discusses the evolving healthcare landscape. He shares insights on leveraging technology for member engagement, balancing investments, and maintaining a personalized service approach while driving operational efficiency.
Howie and Harlan are joined by Sachin Jain, CEO of the nonprofit Scan Health Plan, who argues that the managed care industry must dramatically reorient itself towards patient care. Harlan looks at the long-term health effects of the L.A. wildfires and an effort to replace the widely used body-mass index; Howie reflects on the growing mistrust of doctors and its connection to declining vaccination rates. Links: Wildfires and Health “Los Angeles wildfires: Firefighters face several more critical hours of Wednesday's dangerous winds” “Health Effects Attributed to Wildfire Smoke” “Long-term exposure to wildfire smoke associated with higher risk of death” Redefining Obesity “Definition and diagnostic criteria of clinical obesity” “Move aside BMI: There's a better way to define obesity, commission finds” “New obesity definition sidelines BMI to focus on health” “New Obesity Definition Challenges Current Use of B.M.I.” Toward a More Humane Managed Care Industry Scan Health Plan Sachin Jain: “The Path Forward for the Health Insurance Industry” Sachin H. Jain: “The path forward for the US Health Insurance Industry begins with saying “We Are Sorry” Sachin Jain: “In 2025, I urge you to start seeing things clearly” Sachin Jain: “What It Really Takes to Listen to Patients” “Lyft is driving patients to see their doctors and saving insurers big money” Trust and Vaccinations “Americans' Ratings of U.S. Professions Stay Historically Low” “Childhood Vaccination Rates Were Falling Even Before the Rise of R.F.K. Jr.” “Falling Child Vaccinations” Health & Veritas Episode 95 with Peter Hotez “Meta to end fact-checking, replacing it with community-driven system akin to Elon Musk's X” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.
Howie and Harlan are joined by Sachin Jain, CEO of the nonprofit Scan Health Plan, who argues that the managed care industry must dramatically reorient itself towards patient care. Harlan looks at the long-term health effects of the L.A. wildfires and an effort to replace the widely used body-mass index; Howie reflects on the growing mistrust of doctors and its connection to declining vaccination rates. Links: Wildfires and Health “Los Angeles wildfires: Firefighters face several more critical hours of Wednesday's dangerous winds” “Health Effects Attributed to Wildfire Smoke” “Long-term exposure to wildfire smoke associated with higher risk of death” Redefining Obesity “Definition and diagnostic criteria of clinical obesity” “Move aside BMI: There's a better way to define obesity, commission finds” “New obesity definition sidelines BMI to focus on health” “New Obesity Definition Challenges Current Use of B.M.I.” Toward a More Humane Managed Care Industry Scan Health Plan Sachin Jain: “The Path Forward for the Health Insurance Industry” Sachin H. Jain: “The path forward for the US Health Insurance Industry begins with saying “We Are Sorry” Sachin Jain: “In 2025, I urge you to start seeing things clearly” Sachin Jain: “What It Really Takes to Listen to Patients” “Lyft is driving patients to see their doctors and saving insurers big money” Trust and Vaccinations “Americans' Ratings of U.S. Professions Stay Historically Low” “Childhood Vaccination Rates Were Falling Even Before the Rise of R.F.K. Jr.” “Falling Child Vaccinations” Health & Veritas Episode 95 with Peter Hotez “Meta to end fact-checking, replacing it with community-driven system akin to Elon Musk's X” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.
"There's been a degree of toxic positivity in US healthcare," says Dr. Sachin Jain, CEO of SCAN Health Plan. In this episode about healthcare's need for radical change, Dr. Jain challenges industry orthodoxy and calls for a leadership revolution. From Medicare Advantage turbulence to the failures of healthcare consolidation, he offers an insider's view of what needs to change.We cover:
Cheryl Phillips, M.D., AGSF, is the immediate past president and CEO of the Special Needs Plan Alliance, and currently a Senior Program Consultant with the John A Hartford Foundation. She has extensive experience in health policy, Medicare Advantage and the Program of All-inclusive Care for the Elderly (PACE). As a fellowship-trained geriatrician, her clinical practice focused on the continuum. She served as a primary care health policy fellow under Secretary Tommy Thompson and currently chairs The SCAN Foundation Board of Directors and serves as a director on the SCAN Health Plan and Group Boards. Today, we discuss the 4 M's that will help you prepare for each appointment, the burden of being the connector and care coordinator with specialists, dealing with assumptions and expectations, the dangers of anesthesia and falls, and much more. I hope you enjoy our conversation.
Don't Force It: How to Get into College without Losing Yourself in the Process
In today's episode, I sit down with Sachin Jain, an old friend and very successful CEO of a healthcare company. We discuss how he integrated his interests in social justice and policy with his family's encouragement to pursue medicine, his ideas on mentorship, and the arc of his career.BioSachin H. Jain, MD, MBA is CEO of SCAN Group and SCAN Health Plan, one of the nation's largest not-for-profit Medicare Advantage plans, which serves more than 300,000 members across California, Nevada, Arizona, Texas and New Mexico. Previously, Dr. Jain was President and CEO of CareMore and Aspire Health, which served 200,000 Medicare and Medicaid patients in 32 states. He also served as Chief Medical Information & Innovation Officer at Merck & Co., was Senior Advisor to the Administrator of the Centers for Medicare & Medicaid Services (CMS) and was the first Deputy Director for policy and programs at the Center for Medicare and Medicaid Innovation (CMMI).Dr. Jain graduated from Harvard College and earned his MD from Harvard Medical School and MBA from Harvard Business School. He is Adjunct Professor at the Stanford University School of Medicine and is a member of the boards of America's Health Insurance Plans (AHIP), Omada Health, Advantage Healthcare Services, and The Paul & Daisy Soros Fellowships for New Americans. Follow Sachin on LinkedIn.Access free resources and learn more about Sheila and her team at Signet Education at signeteducation.com or on LinkedIn at https://www.linkedin.com/in/sheilaakbar/.
Cheryl Phillips, M.D., AGSF, is the immediate past president and CEO of the Special Needs Plan Alliance, and currently a Senior Program Consultant with the John A Hartford Foundation. She has extensive experience in health policy, Medicare Advantage and the Program of All-inclusive Care for the Elderly (PACE). As a fellowship-trained geriatrician, her clinical practice focused on the continuum. She served as a primary care health policy fellow under Secretary Tommy Thompson and currently chairs The SCAN Foundation Board of Directors and serves as a director on the SCAN Health Plan and Group Boards. Today, we discuss the 4 M's that will help you prepare for each appointment, the burden of being the connector and care coordinator with specialists, dealing with assumptions and expectations, the dangers of anesthesia and falls, and much more. I hope you enjoy our conversation. TRANSCRIPT
In this episode of the BetterTech podcast, host Colin McCarthy speaks with Josh Goode, CIO at Scan Health Plan. Josh discusses how Scan uses technology to support seniors, emphasizing the evolution of their digital capabilities and the acceleration of digital adoption due to COVID-19. He highlights the importance of creating seamless, user-friendly experiences for seniors and supporting caregivers, as well as discussing Scan's data security measures. Josh also shares insights on emerging technologies like generative AI and their potential to enhance senior care, offering advice for organizations on implementing accessible and integrated tech solutions for seniors. --- Send in a voice message: https://podcasters.spotify.com/pod/show/bettertech/message
In our latest "Meet the Board" podcast episode, Managed Healthcare Executive Editors caught up with board member, Eric Hunter, CEO of Care Oregon, to discuss a number of topics, with one including the merger that never closed with SCAN Health Plan due to local opposition from Oregonians, emphasizing the need for partnerships to meet scaling and capital requirements. On the other hand, Hunter also praised Oregon's careful Medicaid redetermination, resulting in a smaller enrollment decline than expected. He also highlighted a new preventive medicine residency program with Oregon Health and Science University to improve healthcare for populations most at need. Before concluding the conversation with a question on what public official or figure of past or present he'd love to sit down over dinner with, Hunter briefly covered cybersecurity challenges and the potential impact of healthcare issues in the upcoming election.
SCAN Health Plan wins its Medicare Advantage star ratings lawsuit against CMS. The University of Pittsburgh Medical Center acquires Washington Health System. And a new study highlights racial and ethnic disparities within Medicaid renewal procedural issues. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.
Host Gil Bashe and Gregg Masters welcome Sachin Jain, MD, MBA, FACP the CEO of SCAN Health Plan, a multistate operator in the Medicare Advantage (MA) space. They discuss the state of the health plan market, prospects for innovation and explore some of the traditional obstacles in the way of a move into value based care. SCAN (Senior Care Action Network) is an organization that serves more than 300,000 members and generates revenues exceeding $4.8 billion, and a participant in the original 'social' HMOs program. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
Benjamin Reigle, founder and host of the Revenue Cycle podcast "My Good Friends," shares his extensive experience in the healthcare industry, including co-founding Health Rise Consulting Firm and leading initiatives at companies like McKinsey & Company and Accredited Health (now R1). He is also the CEO of Tarpon Health, a community driving automation for healthcare providers. In this episode, Benjamin dives into the topic of healthcare change, emphasizing the importance of understanding industry shifts. Stay tuned to gain insights into the evolving landscape of healthcare. The Change Healthcare breach, as discussed in the podcast episode with Benjamin Reigle, has had a profound impact on the healthcare industry. The breach resulted in challenges with claim submission, cash flow, and data security, affecting not only the operations of Change Healthcare but also having a ripple effect on healthcare providers, payers, and patients. The breach led to issues with claim submission, as some payers who relied solely on Change as their intermediary were unable to process claims. This created a backlog of claims and disrupted the revenue cycle for many healthcare organizations. Some providers resorted to manual processes, such as printing and mailing claims, which added complexity and delays to the billing process. Cash flow was significantly impacted by the breach, especially for smaller healthcare entities like physician groups and community hospitals. With claims not being processed efficiently, these organizations faced financial strain due to delayed payments and uncertainty about when the situation would be resolved. The lack of cash flow threatened the financial stability of these smaller entities, highlighting the importance of having contingency plans and backup systems in place. Data security concerns arose as a result of the breach, with questions about the extent of the data compromised and the potential implications for patient privacy. The breach raised questions about the adequacy of security measures in place and the vulnerability of healthcare systems to cyber threats. The need for enhanced data security protocols and proactive measures to prevent future breaches became a pressing issue for healthcare organizations. Experian Health Client Communication February 23, 2024 Experian Health is aware of Change Healthcare's (Optum's) announcement on February 21 about a cybersecurity incident affecting its systems. Experian's Cyber Incident Response team and Cyber Threat Intelligence teams have been engaged and are closely monitoring the situation. We have not seen evidence of a threat to Experian. Out of an abundance of caution and consistent with Experian's security practices, Experian has temporarily severed connectivity to Change Healthcare. During the period of this severed connectivity, there will be an impact to batch and EDI authorizations, claims and remits, claim status, eligibility, and notice of care transactions that Experian Health sends to Change Healthcare. Experian will resume connectivity to Change when it receives assurances from Change Healthcare that it has adequately contained the threat. Payers work with a variety of clearinghouses to process data. In many cases, multiple payer connections are available although sometimes payer connectivity may be limited or even exclusive to a single clearinghouse. In the majority of cases, transactions from Experian Health route directly to the requestedpayer. When connectivity is limited or certain routes are unavailable, however, it is common to route traffic through another clearinghouse. Below is a list of potentially impacted payers. Our teams are actively evaluating and rerouting transactions when an alternative route is available and will provide an update to this list as soon as possible. BCBS-MA Blue Cross Blue Shield of Massachusetts Claims 13162 1199 National Benefit Fund 93044 A & I Benefit Plan Administrators 37283 AAG-American Administravie Group 72467 ACS Benefit Services Inc. © Experian Health, Inc. Experian Confidential Information Page 2 of 28 83077 Advantek Benefit Administrators CB159 Advisory Health Administrators 65093 Advocate Physician Partners CB637 Aegis Administrative Services 128CA Aetna Better Health of California 128FL Aetna Better Health of Florida 68024 Aetna Better Health of Illinois 128KS Aetna Better Health of Kansas 128KY Aetna Better Health of Kentucky 128LA Aetna Better Health of Louisiana 128MD Aetna Better Health of Maryland 128MI Aetna Better Health of Michigan 46320 Aetna Better Health of New Jersey 34734 Aetna Better Health of New York 50023 Aetna Better Health of Ohio 23228 Aetna Better Health of Pennsylvania 38692 Aetna Better Health of Texas (Medicaid & CHIP) 128VA Aetna Better Health of Virginia 128WV Aetna Better Health of West Virginia 26337 Aetna Better Health Premier Plan MMAI 45221 Aetna OhioRISE 13334 Affinity Health Plan 46594 AFFINITY MEDICAL GROUP 37280 AGA 20048 Agate Resources Inc. (LIPA) 64158 Agency Services Inc ARA01 AgeRight Advantage AWNY6 Agewell New York 95422 AIDS Healthcare Foundation 12K01 Alabama Medicaid 91136 Alaska Carpenters Trust 44423 Alexian Brothers Community Services of TN 13550 ALICARE AHCA1 Alignment Healthcare 26160 AllCare Advantage 58234 Alliant Health Plans of Georgia 50749 Allianz Global Assistance 37308 Allied Benefit Systems A0701 Alta Bates Medical Group RP016 Alterwood Advantage 13343 Amalgamated Life - PA / Alicare 75137 AmeriBen Solutions Inc. TH095 American Family Insurance 62030 American General © Experian Health, Inc. Experian Confidential Information Page 3 of 28 31135 American Health Advantage of Mississippi 31125 American Health Advantage of Oklahoma 31130 American Health Advantage of Tennessee 31155 American Health Advantage of Texas 1066 American Healthcare Alliance 74048 American National Ins. Co. (ANICO) 44444 American Postal Workers Union Health Plan 48055 American Progressive Life and Health Insurance Company 56195 American Trust Administrators Inc. 54763 AmeriHealth Administrators 77799 AmeriHealth Caritas Delaware 77003 AmeriHealth Caritas Florida 27357 Amerihealth Caritas Louisiana (LACare) 47073 AmeriHealth Caritas Next - A Product of AmeriHealth Caritas VIP Next, Inc. 45408 AmeriHealth Caritas Next A Product of AmeriHealth Caritas Florida, Inc. 83148 AmeriHealth Caritas Next North Carolina 81671 AmeriHealth Caritas North Carolina 84243 AmeriHealth Caritas Ohio 22248 AmeriHealth Caritas Pennsylvania 77062 AmeriHealth Caritas VIP Care 87406 AmeriHealth Caritas VIP Care - Delaware DSNP 77013 AmeriHealth Caritus VIP Care Plus (Michigan) 77002 Amerihealth District of Columbia 77001 AmeriHealth NorthEast 64090 AmFirst Insurance Company (payer only accepts Secondary claims) 24818 Amida Care 79966 Amida Care Medicare 37105 Amita Health Medical Care Group 34192 Antares Management Solutions 29370 Anthem Ohio Medicaid 34196 Apex Benefit Services 83112 Apex Health 11081 Arcadia Healthcare Solutions - IPG 36364 Arcadia Healthcare Solutions - NPA 39185 ARISE 61184 Arkansas Superior Select 6603 ASAGEHA AAMG1 Asian American Medical Group 46156 Aspire Health Plan 36483 Aspirus Medicare Advantage 75068 Assurant Health Self Funded 74240 Assured Benefits Administrators 84320 Astiva Health 87020 Atlantic Coast Life © Experian Health, Inc. Experian Confidential Information Page 4 of 28 AVA01 Avalon Administrative Services 46045 Avera Health Plans 87098 Avesis (Vision) 59274 AvMed Inc. 65101 AXA Assistance_USA 77005 Bakersfield Family Medical Group 12X42 Banner Health SX145 Banner Health AZ 84323 Banner Medicare Advantage Prime HMO 81079 BayCare Select Health Plans 63100 Behavioral Health Systems 99320 Benefit & Risk Management Services 48611 Benefit Management Inc. of KS 37212 Benefit Management Systems Inc 88052 Benefit Plan Administrators 39081 Benefit Plan Administrators Co. (Eau Claire WI) 38238 BeneSys, Inc. 95606 Berkshire Lehigh Partners 62183 Better Health Plans Inc. CB987 Black Hawk 3036 Blue Benefit Administrators of MA 12B54 Blue Cross Blue Shield of Alabama 77078 Blue Cross Blue Shield of Arizona Advantage SB580 Blue Cross Blue Shield of District of Columbia (Carefirst) 12000 Blue Cross Blue Shield of District of Columbia (Carefirst) SB971 Blue Cross Blue Shield of Hawaii (HMSA) SB690 Blue Cross Blue Shield of Maryland (Carefirst) 12011 Blue Cross Blue Shield of Maryland (Carefirst) 12B15 Blue Cross Blue Shield of Missouri (Blue Cross) BCSVT Blue Cross Blue Shield of Vermont BOONG Boon Administrative Services 22286 BritCay 35182 Brodart 51037 Brokerage Concepts 94316 Brown & Toland Medical Group BTHS1 Brown and Toland Health Services 42020 Buckeye Ohio Medicaid 42150 Butler Benefit 23708 C&O Employees Hospital Association CAIPA California IPA 71057 Cannon Cochran Management Services Inc. Metairie LA 95399 CAP Management Systems 12X03 Capital District Physicians Health Plan 95112 Capital Health Plan © Experian Health, Inc. Experian Confidential Information Page 5 of 28 68011 Capitol Administrators 12K89 Care Access Health Plan (CAHP) 77082 Care Improvement Plus 66010 Care N' Care 57116 Care1st Health Plan of Arizona - Medicaid (DOS < 11/30/22) 11345 CareCentrix 14182 CareCore National 14180 CareCore National LLC (Oxford Radiology Claims) 14188 CareCore/WCNY RAD 75191 CareFirst Administrators/NCAS (Charlotte, NC) 75190 CareFirst Administrators/NCAS (Fairfax, VA) 93975 CareOregon Inc. 16307 CarePartners of Connecticut 31500 CareSource Ohio Medicaid 65391 CBHNP - HealthChoices 95167 Cedars-Sinai Medical Network Services 68063 Celtic Insurance 99111 Cencal Health 94312 Center for Elders Independence 13360 CenterLight Healthcare 23626 Central Pennsylvania Teamsters Fund 13193 Central Reserve Life Ins Co-Medicare Supplement 36215 Central States Health & Welfare Funds 84146 CHAMPVA - HAC CHERO Cherokee Nation Comprehensive Care Agency 34154 Chesterfield Resources Inc. 80141 Childhealth Plus by Healthfirst (CHP) 94321 Children First Medical Group 33065 CHOC - Children's Hospital Of Orange County Health Alliance 38308 Christian Brothers Services 59355 Christian Care Ministries 10629 Christus Health Medicare Advantage 52106 Christus Health TX HIX 38219 ClaimChoice Administrators (DOS >1.1.21) 11752 ClaimsBridge HPN 85468 Clear Spring Heath 13285 Clover Health 51579 Coastal Communities Physician Network 42049 Cofinity - Group Resources 22284 Colonial Medical 88091 Commercial Travelers/PHX 14315 Commonwealth Care Alliance 14316 Commonwealth Care Alliance - Medicare Advantage 60995 Community Care Inc. - Family Care (Wisconsin) © Experian Health, Inc. Experian Confidential Information Page 6 of 28 73143 Community Care Managed Health Care Plans of Oklahoma 35193 Community Health Alliance 48145 Community Health Choice 75261 Community Health Electronic Claims/CHEC/webTPA 37322 Companion Life 37363 Compsych 6105 ConnectiCare Inc 75284 Consolidated Associates Railroad 87843 Consolidated Health Plans 45321 Consumers Choice Health SC 99433 Contessa Health 46478 Continuum (formerly Marrick WRx) 55544 Conversion Plan-APWU THCP9 Cook Children STAR Plan 58231 Core Administrative Services 43160 Corizon Inc. 35202 Cornerstone Benefit Adminstrators CB268 Cornerstone Preferred Resources CMSP1 County Services Medical Program 58102 Covenant Administrators, Inc. 64068 Creative Medical Systems CC304 Curaechoice 38261 Dell Children's Health Plan (DCHP) 63740 DentaQuest Vision 84133 Denver Health and Hospital Authority DESRT Desert Medical Group 44006 Desert Oasis Healthcare 27133 Dignity Health MSO 12001 District of Columbia Medicaid 6102 Diversified Administration Corporation 74284 Driscoll Children's Health Plan 35186 Dunn and Associates Benefits Administrators Inc. TH084 Early Intervention Central 66122 Eastland Medical Group 31074 EBMC 31625 ElderPlan Inc. 4326 Element Care Inc. EMP01 Empire Physician's Medical Group 42149 Employee Benefit Systems 35112 Employee Plans LLC 20818 Essence Healthcare RP037 Eternal Health 35605 Everence I & P 32052 Everpointe © Experian Health, Inc. Experian Confidential Information Page 7 of 28 62160 eviCore 59313 Evolutions Healthcare Systems (New Port Richey FL) 22344 Exceedent LLC 12B38 Excellus - BCBS Utica Watertown 12B40 Excellus - Blue Cross Blue Shield Rochester Area 71412 ExclusiCare 22254 Fallon Community Health Plan 88055 First Agency FCC01 First Carolina Care 91131 First Choice Health Administrators 57103 First Choice Next (SC) 32456 First Choice VIP Care (SC - DSNP) 77009 First Choice VIP Care Plus by Select Health of South Carolina 59322 Florida Health Care Plan 48116 Florida Hospital Waterman 48117 FMH Benefit Services Inc. 64069 Fox-Everett Inc. 99660 Fresno PACE 34171 FrontPath Health Coalition 25169 Gateway Health Plan Medicaid PA 75273 Geisinger Health Plan 31140 Georgia Health Advantage 7205 Gilsbar Inc. 7689 Global Care Inc. GEM01 Global Excel Management GHOKC Global Health GMICC Global Medical Management 47083 GMS Inc. 76923 Good Shephard Hospice Inc. 45235 Government Employees Health Association (Multiplan) GRV01 Gravie Inc. 36338 Group Administrators Ltd. CB951 Group Benefit Services Inc. 39167 Group Health Cooperative of South Central Wisconsin 64246 Guardian Life Insurance Company of America 47738 Hamaspik Choice 59143 Harrington Health Non-EPO 62061 Harrington Health-Kansas (formerly known as Fiserv Health-Kansas) 4245 Harvard Community Health Plan 4271 Harvard Pilgrim 12K62 Hawaii Medicaid 62180 Health Change Pathway 62179 Health Choice Arizona 46221 Health Choice Insurance Co © Experian Health, Inc. Experian Confidential Information Page 8 of 28 62111 Health Cost Solutions 34158 Health Design Plus (Hudson OH) RP039 Health First Health Plans TH049 Health Management Administrators (HMA) 4286 Health New England SX030 Health Options Inc (FL - BCBS HMO) 80142 Health Partners of Philadelphia 20270 Health Payment Systems Inc. 83253 Health Plan of Michigan 68035 Health Plan of San Joaquin 44273 Health Plans Inc. 37290 Health Services for Children with Special Needs HCH01 Healthcare Highways 56731 Healthcare Resources NW 73147 Healthcare Solutions Group 71064 HealthChoice Oklahoma 85729 Healthcomp Inc. 56144 Healthgram Inc. 55204 Healthnow Division 94267 Healthpartners 59140 HealthPlan Services 75237 Healthsmart Accel 37272 HealthSmart Benefit Solutions 87815 HealthSmart Benefit Solutions fka Wells Fargo TPA.Inc. 75250 HealthSmart Preferred Care Inc. 60058 Hennepin Health 30862 Heritage Victor Valley Medical Group 95393 High Desert Medical Group 95461 Highmark Senior Solutions (WV) 46 Hill Physicians Medical Group HPIPA Hispanic Physicians IPA (Encounters Only) 12T11 HMA - Health Management Admin 86066 HMA Hawaii 75318 HMC HealthWorks aka Health Management Co 84555 HMO Louisiana Inc 91164 HMSO-Highline Medical Service Organization HLSTA Holista (Novant Health Direct to Employer) 88023 Hometown Health Plan Nevada 37224 HSBS Memphis 37256 HSBS Oklahoma City 31172 HSBS World Trade Center Health Program 37137 HSHS Medical Group IPA 61103 Humana Ohio Medicaid 94154 Humboldt-Del Norte Foundation for Medical Care © Experian Health, Inc. Experian Confidential Information Page 9 of 28 54750 Huron PACE 37279 IAA 19028 IBM Business Transformation Outsourcing Insurance Services Corporate 26054 iCare Health Solutions 97661 IEC Group - AmeriBen 41600 I'Mcare 40585 INDECS Corporation TA720 Independence Administrators MHM01 Independence Medical Group 12X01 Independent Health SX073 Independent Health INDPM Independent Physicians at Mercy 12X75 Indian Health Services SX171 Indian Health Services 35600 Indiana Childrens Special Health Care Services 35107 Indiana Teamsters Health Benefits Fund (Indianapolis IN) 95444 Indiana University Health Plan 26212 Indiana University Health Plan (Commercial) 30360 Individual Assurance Company 31053 Individual Health Insurance Companies 43471 Inetico Inc. 52196 Informed LLC 38343 Ingham Health Plan Corporation 31182 InnovAge TH012 Insurance Services of Lubbock 39182 InsuranceTPA.com 86304 Insurers Administrative Corp. 51020 Integra Administrative Group (Seaford DE) 31127 Integra Group 20050 Integrated Medical Solutions LLC 23287 Intergroup Services Corporation 93116 Interlink 11329 International Benefit Administrator RP075 Iowa Health Advantage 47262 IU Health Transplant Evaluation Program JLSFE JLS Family Enterprises 38310 JOHN MORRELL COMPANY CO. - AHPBA 68036 John Muir Mt. Diablo Health System 66003 Johns Hopkins Health Advantage 52189 Johns Hopkins Healthcare (EHP/PP) 52123 Johns Hopkins Healthcare (USFHP) 43178 Joplin Claims / Benefit Management Inc 34136 JP Farley Corporation 91617 Kaiser Foundation Health Plan of Colorado © Experian Health, Inc. Experian Confidential Information Page 10 of 28 94123 Kaiser Foundation Health Plan of Hawaii 94135 Kaiser Foundation Health Plan of Northern CA Region 52095 Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. 21313 Kaiser Permanente of Georgia 94320 Kaiser Self Funded 40137 Kalos Heath KCIPA Kane County BCBS 71066 Kansas Superior Select 95279 Keenan Associates (CA) 73100 Kempton Company 77039 Kern Health Systems 37217 Key Benefit Administrators (Indianapolis IN) 37321 Key Select 37323 Key Solution 23284 Keystone First 42344 Keystone First Community HealthChoices 77741 Keystone First VIP Choice 34145 Klais & Company KPS01 KPS-Kitsap Physician Services 72107 LA Blue Advantage Louisiana LACAR LA Care Health Plan 37116 Lake County Physicians Association 66125 Lakeside Medical Group LNDMK Landmark Healthcare Inc 52193 LBA Health Plans 37316 Leon Medical Center Health Plan LIB01 Liberty Advantage Health Plan (HMO SNP) 87071 Liberty Health Advantage 37281 Liberty Union 25181 LIFE Pittsburgh 41136 Life Trac 71498 LifeCircles PACE 76870 LifePath Hospice Inc LWA01 Lifeworks Advantage CB752 Lockard & Williams 37267 Loma Linda University Adventist Health Sciences Center Employee Health Plan 33036 Loma Linda University Healthcare SKLA2 Louisiana Medicaid - Ambulance claims 37175 Loyola Physician Partners 88056 Lucent Health Solutions 82694 Lucentis Copay Program 35183 Luminare Health (CoreSource OH) 35187 Luminare Health Internal (CoreSource-Internal) © Experian Health, Inc. Experian Confidential Information Page 11 of 28 75136 Luminare Health Little Rock (CoreSource Little Rock) 36334 MacNeal Health Providers- CHS 56139 Maestro Health Plan MCC01 Magellan Complete Care of Arizona MCC02 Magellan Complete Care of Virginia 1260 Magellan Health Services 11303 Magnacare 45341 Maine Community Health Options 35162 Managed Care Services LLC 52461 March Vision Care Inc. 53275 MARTINS POINT HEALTH CARE 83269 Mary Washington Health Plan 37121 Mashantucket Pequot Tribal Nation 86220 Mass Advantage 12T52 Masters Mates and Pilots Program TH111 Masters Mates and Pilots Program 88090 Mayo Clinic FL/GA 83028 MBA Benefit Administrators Inc (Salt Lake UT) 25160 MCA ADMINISTRATORS 88058 MED PAY 74323 MedBen (Newark OH) 56821 Medcost Benefit Services Bundled Billing 78857 Medica HealthCare Plan of Florida MAHC1 MEDICAL ASSOCIATES HEALTH PLAN L0170 Medical Card System ( MCS ) 62177 Medical Reimbursements of America L0210 Medicare y Mucho Mas ( MMM ) 95655 MediGold 35205 MedPartners Administrative Services RP062 Medstar Family Choice, Inc (DC) RP063 Medstar Family Choice, Inc (MD) 37050 Mental Health Consultants Inc. 86087 Merchants Benefit Administration 86052 Mercy Care Plan (AHCCCS) 33628 Mercy Maricopa Integrated Care 41124 Meritain Health Minneapolis 13265 MetroPlus Health Plan 23550 MFC & HealthPlus Peoria 47080 Midlands Choice Inc. 76079 Midwest Health Partners SKMS0 Mississippi Medicaid 12K17 Mississippi Medicaid SKMS1 Mississippi Medicaid 12K18 Mississippi Medicaid © Experian Health, Inc. Experian Confidential Information Page 12 of 28 64084 Mississippi Physicians Care Network 37233 Mississippi Public Entity Employee Benefit Trust MMS01 Missouri Medicare Select 13350 Moda Health 12X09 Molina Healthcare 38333 Molina Healthcare of California 51062 Molina Healthcare of Florida 61799 Molina Healthcare of Idaho 20934 Molina Healthcare of Illinois 38334 Molina Healthcare of Michigan 77010 Molina Healthcare of Mississippi MLNNV Molina Healthcare of Nevada 9824 Molina Healthcare of New Mexico - Salud 20149 Molina Healthcare of Ohio 46299 Molina Healthcare of South Carolina SX109 Molina Healthcare of Utah (aka American Family Care) 38336 Molina Healthcare of Washington ABRI1 Molina Healthcare of Wisconsin 73160 Molina Ohio Medicaid 7316V Molina Ohio Medicaid Vision 12M77 Montana Medicare 13174 Montefiore Contract Management Organization TLINS Monumental Life Insurance Company (AR) TRCLF Monumental Life Insurance Company (IA) TRP1E Monumental Life Insurance Company (IA, MD, PA) TRLTC Monumental Life Insurance Company (TX) SB941 Mountain State Blue Cross Blue Shield of West Virginia 20572 MSA Care Guard 80019 MSC (Medical Service Company) Group, Inc. RP036 Multicare Connected Care (MCC) 34080 Multiplan Wisconsin Preferred Provider Network 81883 Municipal Health Benefit Fund 27004 My Choice Wisconsin 65085 NAA (North America Administrators L.P.) (Nashville TN) 53011 NALC/Affordable 58182 NAPHCARE INC. ASHC1 National General 52104 National Telecommunications Cooperative Association (NTCA - Staff) 52103 National Telecommunications Cooperative Association (NTCA) SKNE0 Nebraska Medicaid 12K19 Nebraska Medicaid 12M19 Nebraska Medicare 96107 Neighborhood Health Partnership (NHP) 5047 Neighborhood Health Plan Rhode Island © Experian Health, Inc. Experian Confidential Information Page 13 of 28 96240 Neighborhood Health Plan Rhode Island - Exchange, Unity, Integrity 66055 Netcare Life and Health Insurance (Hagatna Guam) 77076 Network Health Insurance Corp-Medicare 39144 Network Health Plan of Wisconsin Inc. 95998 NEW AVENUES INC. NCH11 New Century Health - IEHP Oncology NCH09 New Century Health - Vista Cardiology 75281 New Era Life Insurance Company 12K90 New Hampshire Medicaid 12K22 New Mexico Medicaid 7707C New York Hotel Fund 81085 Next Level Health Partners 38225 NGS American Inc 88050 NHBCAUX NHC01 NHC Advantage 81264 Nippon Life Insurance Company of America 36347 Northern Illinois Health Plan 88027 Northern Nevada Trust Fund OSCAR Novanet 71080 Novasys Health Network PHMD1 NP Providence Health Plan Commercial PHMD2 NP Providence Health Plan Medicare PHMD3 NP Providence Health Plan OHP PHMD4 NP Yamhill County CCO 37299 Nyhart 14142 NYS DOH UCP 36400 Oak West Physician Association 69879 OCRW Orange County Health Services Dept - Ryan White Program 34189 Ohio Health Choice PPO 74431 Ohio PPO Connect 71065 Oklahoma DRS DOC 65074 Olympus Managed Health Care 22321 One Call Medical 56190 OptiCare Managed Vision 96277 Optimed Health Plans 13382 Orthonet - Uniformed Services Family Health Plan OSFC9 OSF Healthcare Central OSFE9 OSF Healthcare East I & P 72436 PACE Central Iowa 86711 PACE Southeast Michigan 20416 PacificSource Community Solutions 93029 PacificSource Health Plans 20377 PacificSource Medicare 94115 Palo Alto Medical Foundation © Experian Health, Inc. Experian Confidential Information Page 14 of 28 4218 Pan American Life Insurance Group 52613 PARTNERS BEHAVIORAL HEALTH MANAGEMENT PARTH Partners In Health 66008 Passport Advantage 61325 Passport Health Plan by Molina Healthcare 20510 Patient Physician Cooperatives 27048 Payer Fusion 20172 Pennsylvania Pace 72126 Peoples Health Network 72099 PHCS Claims (formerly American LIFECARE) PA513 Physician Associates of the Greater San Gabriel Valley 36345 Physicians Care Network (Rockford IL only) MHM03 Physicians Health Network 83276 Physicians Health Plan of Michigan Medicare PMGSC Physicians Medical Group of Santa Cruz County 47027 Physicians Mutual Insurance Company 91171 Physicians of Southwest Washington 55768 PIEDMONT COMMUNITY HEALTH PLAN 24735 Pinnacle Claims Management Inc. 84109 Pinnacol Assurance IP057 Pomona Valley Medical Group 95411 Positive Healthcare Florida (FL MCO PHC/PHP) 36373 Prairie States Enterprises Inc. 73145 Preferred Community Choice/PCCSelect/CompMed 14966 Preferred Health Partners CB404 Preferred Health Plan of the Carolinas 41147 PreferredOne (MN) 65054 Premier Eye Care 88051 Premier HealthCare Exchange, Inc. (PHX) 5003 Presbyterian (NM) 46311 Presence ERC 61604 Prime West Health Plan 37268 Prism Network Inc. 93082 Prominence Health Plan of Nevada 83352 Prominence Healthfirst SX133 Providence of Oregon Health Plan 77240 Providence PACE CA SX187 Providence PPO 48100 ProviDRs Care Network PH001 Pruitt Health Premier PSKW0 PSKW Physician Reimbursement Program 89461 Quality Care Partners CX077 Quality Plan Administrator, Inc 73067 QuikTrip © Experian Health, Inc. Experian Confidential Information Page 15 of 28 57117 QVI Risk Solutions Inc. 44219 Reading Hospital Employer Group 95449 Regal Medical Group SB611 Regence Blue Shield Idaho 12B88 Regence Blue Shield Idaho 38221 Regency Employee Benefits 79846 Reliance Community Care Partners 36396 Resurrection Healthcare Preferred 74205 Right Care from Scott & White RIOS1 RIOS SOUTHWEST MEDICAL GROUP RCMG1 RIVER CITY MEDICAL GROUP 45281 Riverside Health Inc. 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Experian Confidential Information Page 16 of 28 SMSD0 South Dakota Medicare 23253 Spectrum Administrators Inc. - TPA Allentown PA (IHS Gateway Payer) 73099 Standard Life and Accident (Secondary claims only) 46407 Stanford Healthcare Advantage 61425 Starmark TRP1P Stonebridge Life Insurance Company (TX) 95202 SummaCare Health Plan 37301 Summit America Insurance Services Inc. 77306 Sutter Connect - Solano Regional Medical Foundation (SRMF) 94269 Sutter East Bay Medical Foundation 77302 Sutter Gould Medical Foundation 77304 Sutter Medical Group of the Redwoods 56621 Sutter Senior Care TALMG Talbert Medical Group 88067 Tall Tree Administrators 43619 Teamsters Medicare Trust for Retired Employees 20212 Tethys Health Ventures TXCSM TEXAS CHILDRENS HEALTH 76048 Texas Children's Health Plan 75228 Texas Childrens Health Plan (Medicaid) 31403 Texas Independence Health Plan 68423 The Care Network/The Savannah Business Group 75600 The City of Odessa 95677 The Health Plan 23223 The Loomis Company - TPA Wyomissing PA (IHS Gateway Payer) 59227 The MEGA Life & Health Insurance Company-OKC J1746 Thomas McGee THIPA Torrance Hospital IPA 37284 TransChoice-Key Benefit Administrators 31118 Tribute Health Plan SX176 Tricare for Life 12X43 Tricare for Life SX163 Tricare for Overseas 12X46 Tricare for Overseas 12C01 Tricare West 31144 TRIHEALTH PHYSICIAN SOLUTIONS 56089 Trillium Health Resources TRNPC Trinity Health Pace TRIN1 Trinity HealthShare 42137 TRISTAR Benefit Administrators L0230 TRUSTED HEALTH PLAN 91078 Trusteed Plans Service Corporation 94603 UC-Davis Health 74223 UICI Administrators © Experian Health, Inc. Experian Confidential Information Page 17 of 28 41206 Ultra Benefits Inc. 95266 UMR - Harrington 52180 UMWA Health & Retirement Funds 35198 Unified Group Services 62170 Unified Health Services RP064 Unified Life UPN99 Unified Physicians Network 87042 Union Pacific Railroad Employees Health Systems 38260 United Benefit Advisors 84132 United Medical Alliance 86003 UnitedHealthcare Community Plan / PA - formerly AmeriChoice Personal Care 25175 UnitedHealthcare Community Plan / SC (formerly Unison) 88337 UnitedHealthcare Ohio Medicaid 8357V UnitedHealthcare Ohio Medicaid Vision 95999 UnitedHealthcare West (formerly PacifiCare PPO - All States) 33001 Universal Care - California 9830 University Family Care 37601 University of Illinois at Chicago Div of Specialized Care for Children 45282 University of Maryland Health Advantage IP056 Upland Medical Group 37324 Upper Peninsula Health Group (TPA) 38337 Upper Peninsula Health Plan (Medicaid) 93092 US Benefits 12X31 US Department of Labor 90551 US Family Health Plan 74095 USAA (United Services Automobile Association) 13407 USFHP - St. Vincent Catholic Medical Centers of New York 12K42 Utah Medicaid SKUT0 Utah Medicaid 12115 VA Fee Basis Programs 43259 Valor Health Plan 77701 Vantage Health Plan 50701 VGM Homelink VVIPA Victor Valley IPA 25924 VieCare Life and Beaver and Life Lawrence Counties 25923 VieCare LIFE Butler 73743 Village Family Practice VLGMD Village MD 26545 VillageCareMAX 12003 Virginia Medicaid 12004 Virginia Medicare 63114 Viva Health Plan 31626 VNA Homecare Options 85256 Wabash Memorial Hospital Association © Experian Health, Inc. 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[00:04:42] Cybersecurity breach at Change. [00:08:55] Cash flow challenges for healthcare groups. [00:13:37] Major issues in healthcare cybersecurity. [00:16:28] Hackers demanding ransom for data. [00:20:45] Cybersecurity threats in healthcare. [00:24:40] Healthcare system vulnerabilities. [00:29:53] Lack of transparency in communication.
In this conversation, Becker's connects with Dr. Sachin H. Jain, CEO of SCAN Group and SCAN Health Plan. Tune in to learn about emerging diagnostic testing and treatment trends that are capable of delivering a high degree of quality care and how patients can be more actively engaged in managing their health with their care teams through support from new technologies. This episode is sponsored by Cue Health.
Digital Health Talks - Changemakers Focused on Fixing Healthcare
See what is happening now at www.healthimpactlive.com YouTube Video: https://www.youtube.com/watch?v=sDiCcQ0i9DsOriginally Published: Oct 25, 2023 Join us for an engaging exploration of the dynamic world of AI-Powered Patient Engagement. In this session, we'll delve into the evolving role of artificial intelligence in healthcare, assessing both its vast potential and the real needs of patients. We will discuss the advantages AI brings to healthcare, the practicality of increased access to care through technology, and the profound ways in which AI and technology are enhancing the overall patient experience. From bridging the gap between potential and reality to addressing the ethical considerations, this discussion promises to shed light on the transformative power of AI in healthcare. Megan Antonelli, Chief Executive Officer, HealthIMPACTCorinne Stroum, Director of Consumer Experiences & Insights, SCAN Health Plan
At this year's HLTH conference in Las Vegas, Nevada, JC sat down with Sachin Jain, MD, CEO of SCAN Health Plan, a not-for-profit provider of Medicare Advantage plans based in Long Beach, California. They discuss SCAN's planned merger with Care Oregon and broader competition in the MA market as well as the growing tension between providers and MA plans. Hosted on Acast. See acast.com/privacy for more information.
What does it mean to lead from the heart — to look beyond the percentages to see the people most vulnerable in our communities in need of care?AHIP's very own Robert Traynham was joined by Eric C. Hunter, president & CEO of CareOregon, and Sachin H. Jain, MD, MBA, CEO, SCAN Health Plan and SCAN Group, for a thought-provoking and honest conversation about serving people who are economically disenfranchised, homeless, or otherwise vulnerable and disadvantaged as they struggle accessing care and treatment.
Technovation with Peter High (CIO, CTO, CDO, CXO Interviews)
797: Josh Goode, CIO at SCAN Health Plan, discusses the tremendous growth of the company throughout his tenure and the areas he has focused on to achieve that growth. He explains the pivotal role the CIO plays in shaping the digital customer experience and dives deep into the progress of the company's overall modernization journey. Following the company's acquisition of CareOregon, Josh explains the process behind integrating acquisitions from a digital and technology perspective and how this helps to grow the company in addition to the organic growth and expansion efforts. Josh also talks about the strong technology culture at SCAN, facets of its data strategy, and the Emerging Technology Operating Model he developed to address the emergence of artificial intelligence and find its use cases. Finally, Josh looks ahead at the trends in technology on his radar and reflects on his career path including his pivot to the not-for-profit space as well as the keys to his career success.
Technovation with Peter High (CIO, CTO, CDO, CXO Interviews)
797: Josh Goode, CIO at SCAN Health Plan, discusses the tremendous growth of the company throughout his tenure and the areas he has focused on to achieve that growth. He explains the pivotal role the CIO plays in shaping the digital customer experience and dives deep into the progress of the company's overall modernization journey. Following the company's acquisition of CareOregon, Josh explains the process behind integrating acquisitions from a digital and technology perspective and how this helps to grow the company in addition to the organic growth and expansion efforts. Josh also talks about the strong technology culture at SCAN, facets of its data strategy, and the Emerging Technology Operating Model he developed to address the emergence of artificial intelligence and find its use cases. Finally, Josh looks ahead at the trends in technology on his radar and reflects on his career path including his pivot to the not-for-profit space as well as the keys to his career success.
Dr. Sachin H. Jain, Chief Executive Officer of Scan Health Plan joins the podcast to compare Medicare Advantage versus traditional Medicare and governmental health insurance programs versus private health insurers.
In this two-part series that delves into the perspectives of those at the front lines of HIPAA liability, Andrew Sylora, Associate, Vedder Price, speaks with Anthony Archer, Chief Privacy Officer, Scan Health Plan, about the difficulties of maintaining HIPAA compliance in a complex workforce. They discuss case studies of HIPAA breaches that have occurred at health plans, strategies for mitigating against breaches, and the practical elements for training and implementing organizational components to protect against breaches. From AHLA's Health Care Liability and Litigation Practice Group.To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
This week, we're excited to get to know Sachin Jain, CEO of SCAN Group & SCAN Health Plan. Sachin Jain is charged with leading the organization's growth, diversification, and emerging efforts to reduce healthcare disparities. Founded in 1977, SCAN Health Plan is a not-for-profit, Medicare Advantage plan that provides healthcare coverage to Medicare beneficiaries in California, Arizona, Texas and Nevada. SCAN's revenues top $4.3B and the organization serves 300,000 patients. Under Sachin's leadership, SCAN has grown its revenues by more than $1B. Previously, Dr. Jain was President and CEO of CareMore and Aspire Health. Dr. Jain is also an adjunct professor of medicine at the Stanford University. Prior to joining CareMore, Dr. Jain was global Chief Medical Information & Innovation Officer at Merck & Co. From 2009-2011, Dr. Jain worked in leadership roles at the US Department of Health and Human Services, where he was senior advisor to the administrator of the Centers for Medicare & Medicaid Services (CMS) and many other leadership positions in healthcare policy. Dr. Jain graduated from Harvard College with a BA in government and continued on to earn his MD from Harvard Medical School and MBA from Harvard Business School. He trained in medicine at the Brigham and Women's Medicine and Harvard Medical School, and continues to practice medicine. This is a packed episode. Sachin shares his thoughts on toxic positivity in the healthcare industry, impact over virtue signaling, clinician burnout, and his predictions for the future of healthcare.
Healthcare leaders from Alignment Health, SCAN, ATI Advisory and Dina discuss the importance of MA plans to ensure members understand available non-medical benefits. Making the experience painless is essential to attracting and retaining members – and improving CAHPS and Star Ratings. Learn successful strategies and best practices your plan can implement to improve member experience and ensure members receive the care they need. Topics include: Humanizing the navigation process; creating a culture of customer service; using technology to streamline benefit navigation, and leveraging home-centered care Panel: Dawn Maroney, CEO of Alignment Health Plan and President, Markets of Alignment Health John Petito, Corporate Vice President of Strategy & Transformation, SCAN Health Plan Ashish V. Shah, CEO, Dina Anne Tumlinson, CEO, ATI Advisory Bios: https://www.sharedpurposeconnect.com/events/maximizing-the-impact-of-supplemental-benefits-to-increase-star-ratings/ Payer & Provider Executive Roundtable Summit Registration: https://www.eventbrite.com/e/payer-provider-roundtable-summit-engagement-clinical-bright-spots-registration-469644799237 This episode is sponsored by Dina Dina provides benefits and care coordination solutions to support health plans and providers as they extend care management into the home. Customers use our SaaS technology to digitize their network of community and home-centered providers; transform coordination workflows so they spend less time with phone calls and faxes; collect performance data to improve their network continuously; and capture meaningful data directly from home. Last year, Dina was named to the Inc. 5000 list of fastest-growing companies and CB Insights Digital Health 150 list of companies transforming healthcare with digital technology.
Seniors in the LGBTQ+ community today are aging in a country that is much more open to conversation about LGBTQ+ care and wellness than when they were young, but they still face barriers to care and coverage. Sachin Jain, MD, president and chief executive officer of SCAN Group and SCAN Health Plan, and Jill Selby, senior vice president of product development, marketing, and market expansion for SCAN Health Plan, share how the health insurance industry can facilitate coverage and cultural change to reduce barriers to care for LGBTQ+ seniors.
Motivating Medicare Advantage members to take the clinical actions needed to promote and support their care is a high priority for health plans. Data shows that talking to peers with whom they can relate and share common health issues benefits members and engages them more in their health Our panel of experts from Humana, Regence, SCAN Health Plan and Wisdo discuss how incorporating peer support programs in your MA plans can improve clinical outcomes, lower costs and boost engagement for members with chronic diseases, behavioral health issues and other social determinants of health. Hear "bright spots" and practical strategies you can implement in your health plan. Panelists: Mike Franz, MD, Senior Medical Director of Behavioral Health, Regence; Lisbeth Briones-Roberts, Chief Togetherness Officer, SCAN Health Plan; Jennifer Spear, Associate Director, Population Health, Humana; Boaz Goan, Founder & CEO, Wisdo Health. This episode is sponsored by Wisdo Wisdo is a peer support and clinical referral platform designed to address the harmful consequences of loneliness, social isolation, and lack of engagement on health and medical costs. Founded in 2018, over 500,000 adults ages 18-80 have joined Wisdo, making it one of the market's largest and most diverse peer support platforms. Wisdo clients include health plans, gov't agencies, behavioral health providers, and SDOH services. https://www.wisdo.com/
Sachin Jain (CEO, Scan Health Plan) joins the show to talk about his experience working at his grandfather's rural hospital in India, as well as his healthcare predictions for 2023. This episode is part of our "CareTalk @ HLTH 2022" interview series. You can listen to the rest of our interviews from HLTH 2022 on your favorite streaming service, or by going to www.caretalkpodcast.com.ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy.GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webFOLLOW CARETALKSpotifyApple PodcastsGoogle PodcastsFollow us on LinkedIn#hlth #hlth2022 #caretalk #healthcare
Dr. Sarita A. Mohanty, MD, MPH, MBA (https://www.thescanfoundation.org/about/board-of-directors/sarita-a-mohanty/), serves as the President and Chief Executive Officer of The SCAN Foundation, one of the largest foundations in the United States focused on improving the quality of health and life for older adults. Its mission is to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. The SCAN Foundation was created as an independent charitable organization in April 2008 through a $205 Million one-time contribution from the not-for-profit SCAN Health Plan, a not-for-profit, Medicare Advantage based in Long Beach, California. Previously, Dr. Mohanty served as the Vice President of Care Coordination for Medicaid and Vulnerable Populations at Kaiser Permanente; Assistant Professor of Medicine at USC; Chief Medical Officer of COPE Health Solutions, a health care management consulting company; and Senior Medical Director at L.A. Care, the largest U.S. public health plan. Dr. Mohanty completed her Internal Medicine residency at Beth Israel Deaconess Medical Center and research fellowship at Harvard Medical School. She earned her MD from Boston University, MPH from Harvard University, and MBA from UCLA. She completed undergraduate work at UC Berkeley. She currently is an Associate Professor at the Kaiser Permanente Bernard J. Tyson School of Medicine and is a practicing internal medicine physician with Kaiser Permanente.Dev InterruptedWhat the smartest minds in engineering are thinking about, working on and investing in.Listen on: Apple Podcasts Spotify Healthy Lifestyle Solutions with Maya AcostaAre you ready to upgrade your health to a new level and do so by learning from experts...Listen on: Apple Podcasts Spotify Graced HealthFor women who want simple and grace-filled ways to take care of herself and enjoy a...Listen on: Apple Podcasts Spotify
Digital Health Talks - Changemakers Focused on Fixing Healthcare
HealthIMPACT Live Presents: Healthcare Innovation Reboot Part II - If HDO Innovation is a Profession, What Should a Disciplined Innovation Lifecycle (“IL”) look like?YouTube Video: https://youtu.be/WchtVvIOt-IOriginally Published: May 23, 2022We'll close out today with an amazing interview with Dr. Sachin Jain, CEO and President of SCAN Health Plan. Dr. Jain sits down with our very own Janae Sharp, CEO and Founder of The Sharp Index. They will lay the framework for our interactive roundtable discussion on innovation at Healthcare Delivery Organizations (HDOs). We will further explore innovation as a profession and discuss how to define an innovation lifecycle at HDOs. This follow-up session will dive deep into an existing innovation lifecycle ontology and conduct brainstorming and peer reviews of what could be turned into a set of documents and collateral we can use to build HDO innovation into a proper profession and establish a framework for a common set of values, steps, processes, and procedures that can be applied to the HDO Innovation space. Sachin Jain, MD, MBA, President & CEO, SCAN Health Plan Janae Sharp, Founder, The Sharp Index
SCAN Health Plan's Sharon Jhawar, chief pharmacy officer, and Timshel Tarbet, VP of business excellence and diversity strategy, discuss the plan's effort to reduce disparities in medication adherence among Black and Hispanic members, and how they found the movable outcome in a seemingly intractable health issue.
Aastha Madaan Farr, Senior Legal Counsel, SCAN Health Plan, speaks to three South Asian health care attorneys about their career journeys, the status of South Asians in the legal profession, and the advice they would give to students or early career attorneys interested in entering the health law field. Aastha's guests are Manasa Gopal, Associate General Counsel, Columbia University Irving Medical Center, Alaap Shah, Partner, Epstein Becker and Green, and Kavitha Babu, Assistant U.S. Attorney, Northern District of Illinois. Provided in collaboration with the South Asian Bar Association of North America.
SCAN's Sr. VP of Healthcare Services Eve Gelb joins SCAN backed myPlace Health Founder and CEO Robbie Pottharst in a 2-part episode that explores how SCAN is leveraging innovative models of care (ie CalAIM, PACE) that bring together both health and social services that historically were either unavailable and/or unable to be managed well with traditional models of care.
Experts from Cigna, SCAN Health Plan and UPMC Health plan share strategies and best practices for generating higher HEDIS and STAR ratings by advancing a holistic approach to their members' care including “last mile” strategies and caregiver support coupled with physical, behavioral and social needs. Panelists include Ellen Bjeckford, PhD, MPH, Associate Vice President, Population Health and Clinical Transformation, UPMC Health Plan, Evan Falchuk, Chairman & CEO, Family First, Sophie Howlett, Manager, Population Health, SCAN Health Plan Grant Tarbox, DO, Regional Medical Executive, West/Northeast Region, Cigna Medicare, Kendra White, Senior Manager, Community Relations, UPMC for Life, UPMC Health Plan. Bios:https://www.sharedpurposeconnect.com/events/medicare-advantage-novel-approaches-to-whole-person-care/ This episode is sponsored by Family First More than ever, Americans are struggling with the complex realities of caregiving. Family First is the first expert-led and technology-powered caregiving solution for Medicare members. By integrating clinical data and social determinants of health, our multi-disciplinary Care Teams craft and implement comprehensive care plans to solve Medicare members' most urgent caregiving needs, close care gaps, increase member satisfaction and decrease the intensity of care needed. To learn more, visit www.Family-first.com.
If you've done any work in the fields of Geriatrics Medicine or Healthy Aging, you've almost certainly come across Jennie Chin Hansen, my guest on today's episode. Jennie is the former President of AARP, the former CEO of the American Geriatrics Society and currently a Board Member of the SCAN Health Plan (which funds the Healthy Skeptic, MD Podcast). Jennie also spent 25 years as a nurse leader at the San Francisco-based On Lok program developing creative care models for older adults, including the Program for All-Inclusive Care for the Elderly (PACE), which has become a national Medicare program. In today's episode, Jennie and I discussed what the next several years may look like for the field of Geriatrics and the care of older adults.
: In October of this year, The Kaiser Family Foundation released a study that showed 7 in 10 Medicare Beneficiaries did not shop for new plans during the 2018 open enrollment period. If this is the case, then why all the focus on plan design enhancements each year? To help us understand what Medicare Advantage plans are currently doing to attract and retain members and what they might do better is Betsy Seals. Betsy is the CEO and Co-founder of Rebellis Group, a consulting firm with deep expertise in health plans, PBM and government regulations. The Rebellis Group helps organization with strategy and operational processes to help optimize their business models. Betsy has 20-years' experience in the healthcare industry and has worked for notable companies such as Scan Health Plan, Anthem, and Gorman Health Group. Show notes: Betsy listens to podcasts that are related to healthcare matters. As a busy working mother, the last book she read was Where the Crawdads Sing by Delia Owens.
SCAN Group, mostly known for SCAN Health Plan, is expanding not just on the Medicare Advantage side in 2022, but also through it's Healthcare in Action medical group, addressing care for the homeless population. Our episode checks out what's new with executives Jill Selby (SCAN Health Plan) and "street medicine" expert and SCAN Group's Healthcare in Action CEO Dr. Michael Hochman.
Our panel of experts from Banner Health, BlueCross BlueShield of South Carolina, SCAN Health Plan and other leading healthcare organizations share case studies and best practices for engaging consumers in decision-making and behavior change to improve health outcomes. Find out why a human-centric approach may help persuade consumers to actively participate in their healthcare. Learn how AI technology and behavior science principles can improve health delivery by pinpointing the underlying psychological, environmental, and economic drivers and barriers behind people's health decisions. Panelists: William (Tripp) Jennings MD, FACEP, Vice President, Clinical Innovation Officer, BlueCross BlueShield of South Carolina Alexandra Morehouse, Chief Marketing Officer, Banner Health Eve Gelb, Senior Vice President, Member & Community Health, SCAN Health Plan Shai Levi, Co-Founder, and COO, Medorion Technologies Andrea Wallace, Manager, Product Development, Business Lab, Emergent Holdings This episode of Bright Spots in Healthcare is sponsored by Medorion Technologies Medorion aims to help organizations manage the entire process of health management more efficiently, and take strides that will change medical behavior across entire populations and improve the lives of millions of individuals. Medorion's behavioral intelligence software provides health insurers with an in-depth understanding of members and their concerns, enhancing health plans in all areas pertaining to human behavior. Utilizing behavior-based insights, the Medorion EBR™ platform enables payors to personalize and automate one-on-one member conversations at scale, based on health decision barriers. Medorion's SaaS facilitating proactive interactions that improve health delivery and financial outcomes.
Building empathy with your customers is vital, particularly when your audience is part of the ‘silver tsunami' of a rapidly growing ageing population. In this episode we're joined by Archie Dey, Director of Consumer Experience and Insights at SCAN Health Plan to discuss how they listen to and empathize with their customers, from trainings to […] The post 261: SCAN Health Plan – Building Customer Empathy appeared first on The CX Cast ® by Forrester.
Loneliness correlates more strongly with health outcomes than many other traditional risk factors, such as tobacco use and high cholesterol. In today's episode, Julianne Holt-Lunstad, PhD, a Professor Psychology at Brigham Young University and Lisbeth Briones-Roberts, the Chief Togetherness Officer for SCAN Health Plan, talk about the problem and what to do about it. Also hear the latest on the Delta variant of COVID-19.**Be sure to subscribe to The Healthy Skeptic MD on your favorite podcast app and on Youtube!Link for our channel on podcast apps and Youtube: wavve.link/healthyskepticmd
M&M sit down with Sachin Jain, CEO of Scan Health Plan to talk about the dangers of incrementalism and how SCAN is using the managed care framework to innovate care delivery for the neediest populations in California.
Dr. Michael Hochman gives a rundown of the week's medical news and announces an exciting new partnership with Scan Health Plan!**Be sure to subscribe to The Healthy Skeptic MD on your favorite podcast app and on Youtube!Link for our channel on podcast apps and Youtube: wavve.link/healthyskepticmd
Carlos Amezcua and Lisa Remillard discuss predictions people in 1921 had about 2021. It's a fascinating look back to what the hopes and dreams of today would be. Guests include SCAN Health Plan, "Nomadland" Oscar nominated director Chloe Zhao, Influencer Davante Wilson and the people behind California Debt Relief and DebtReliefCenter.org. --- Support this podcast: https://anchor.fm/beondtv/support
In this episode, Josh Goode, CIO of SCAN Health Plan, discusses their digital programs, the patient population they serve, and how they evaluate digital technologies and deploy it at every stage of the care journey for improved outcomes. Being a Medicare Advantage plan, SCAN Health deals with the senior population. They strive to address the digital divide in the […]
In this episode, Josh Goode, CIO of SCAN Health Plan, discusses their digital programs, the patient population they serve, and how they evaluate digital technologies and deploy it at every stage of the care journey for improved outcomes. Being a Medicare Advantage plan, SCAN Health deals with the senior population. They strive to address the digital divide in the […]
Carlos Amezcua and Lisa Remillard discuss are kids hanging on to the "Bank of Mom and Dad" longer? Plus do you know that you can change your healthcare plan right now? SCAN Health Plan is explaining. Guests include "Firefly Lane" stars Katherine Heigl and Sarah Chalke, Pussycat Dolls' Carmit Bachar, Fitness by Tony Hill and a new documentary film on Kobe Bryant murals by Patrick Green called "Sincerely, Los Angeles". All interviews always available on beond.tv and on our BEONDTV Roku and Amazon Fire apps! --- Support this podcast: https://anchor.fm/beondtv/support
How do you feel about working from home? Carlos & Lisa are talking about the pros and cons of working from home. Plus how it's impacted our business. How has it impacted your business? Guests in today's show include journalist Matthew Schwartz who has a new book called "Confessions of an Investigative Reporter", and Dr. Avital Harari is sharing her experience getting the COVID-19 vaccine, plus IRS spokesman Raphael Tulino is helping us understand how the stimulus and other life events in the past year will impact our taxes. Our friends at SCAN Health Plan are helping California's seniors get vaccinated! Looking for help? They want to be there for you. And Golden Globe nominee and actress Vanessa Kirby is talking about her powerful role in "Pieces of a Woman". All content available at beond.tv! --- Support this podcast: https://anchor.fm/beondtv/support
Dr. Sachin Jain, MD, MBA, FACP (CEO & President of SCAN Group and SCAN Health Plan) joins the show to discuss the 12 unsettling lessons he learned while trying to make healthcare better. About Dr. Sachin Jain, MD, MBA, FACP:Sachin H. Jain is an American physician who held leadership positions in the Center for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC). From 2015 to 2020, he served as president and chief executive officer of the CareMore Health System. In June 2020, it was announced that he would join the SCAN Group and Health Plan as its new President and CEO. He is also an adjunct professor of medicine at the Stanford University School of Medicine and a Contributor at Forbes. In 2018, he was named one of American healthcare's most 100 most influential leaders by Modern Healthcare magazine (#36).Watch this episode on YouTube: https://youtu.be/67Wpz3OdFDM
In 1977, the Senior Care Action Network, now known as SCAN was formed. Experts in medicine, gerontology, psychology and social services were brought together to deliver on a mission to keep seniors healthy and independent through a variety of divisions and services and various community benefit programs including SCAN Health Plan and Independence at Home. We're pleased to share an interview with one of our many dedicated friends at SCAN, specifically Denise Likar, vice president of the Independence at Home division. --- Send in a voice message: https://anchor.fm/coping-to-care/message
Our hosts are joined by Sachin H. Jain, MD, MBA, FACP, President and CEO of SCAN Group and Health Plan.
Our hosts are joined by Sachin H. Jain, MD, MBA, FACP, President and CEO of SCAN Group and Health Plan.
The Howard Alumni Movemakers Podcast hosted by Joshua Mercer
Brandon William Jones is a high impact analytical leader with deep experience across sales, operations and finance roles for high-growth consumer and enterprise tech products. Today, as Director and Head of North America Sales Development for LInkedIn, Brandon is working towards a mission of digitally mapping out the global economy to connect talent with opportunity at a massive scale. In this role, he oversees an organization that serves as North America's growth and talent engine, accounting for over 1% of the company's employees across offices in San Francisco, Chicago and New York City. Previously, Brandon headed Google Cloud's Sales Development across the Americas, its fastest growing region accounting for over 60% of global business. Before that, Brandon headed Product Operations for 7 of Google's technology products, including Google's Virtual Reality and Augmented Reality efforts, Digital Content, and a number of confidential products within the Advanced Technology & Products division. Prior to joining Google, Brandon accumulated nearly a decade of experience in finance, strategy, technology and operational roles at Fortune 500 companies including Bank of America Merrill Lynch, Johnson & Johnson and Mercer. In addition to serving as a strategic advisor to Stanford School of Medicine's Healthcare Innovation Lab, Brandon sits on the corporate board of SCAN Health Plan, one of the nation's largest non-for-profit Medicare Advantage plans with ~$4B in revenue, and serves as a member of the Audit & Compliance and Governance committees. Brandon is also an investor in real estate and a number of startup companies focused on frontier technologies. Brandon has served as a partner of the Silicon Valley Social Venture Fund, a member of the Milken Institute Young Leaders' Circle and the advisory boards of The Mr. October Foundation for Kids, Cultivating Aspiring Leaders and the Martin Luther King Jr. Youth Center. Brandon has spoken at world-class leadership summits including The Aspen Institute's Socrates Seminars and Renaissance Weekend. Brandon hosts the Series B Show podcast, which highlights the journeys of key influencers across tech, culture and business and has featured guests including Y-Combinator CEO Michael Seibel, Hall of Fame Baseball Player Reggie Jackson, Microsoft Chairman John W. Thompson, and “Father of the Internet” Vint Cerf. Brandon holds an MBA from Harvard University, where he was a Merrill Lynch, Robert A. Toigo and HBS Leadership Fellow, and a BBA in Computer Systems from Howard University, where he was a Reginald F. Lewis Scholar. Brandon resides in Palo Alto, CA with his wife Charlotte and two children. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/humovemakers/message Support this podcast: https://anchor.fm/humovemakers/support
SCAN Health Plan is one of the nation's largest not-for-profit Medicare Advantage plans, serving more than 215,000 members in California including the Inland Empire. Eve Gelb with SCAN Health Plan came on the program to discuss how to deal with senior’s mental health and well-being under stay-at-home orders. Gelb says SCAN announced plans to allocate more than $5.1 million in emergency funding to support COVID-19 relief for seniors. The funds will be used to address a variety of needs for vulnerable seniors and others at risk due to the effects of the COVID-19 pandemic.
Did you know that in the United States there are over 80,000 centenarians? Those are Americans who have made it to age 100 and beyond. They were born at a time when the life expectancy was just 53-1/2 for men and 56 for women. Today, life expectancy is 76 for men and 81 for women. So what is it like to be age 100 or older? And what can we learn from the men and women in this demographic? LA photographer Robert Duron is finding out. Robert is in the midst of photographing 100 of the nation's centenarians for California-based health plan SCAN, which is celebrating America's 80,000 plus centenarians with a new digital portrait series called, "stages: 100 over 100." Robert Duron has photographed famous athletes and musicians, models and even Ron and Nancy Reagan for the LA Chamber of Commerce. But "stages: 100 over 100" is nothing like his commercial work. Robert tells us how this project is different and what he's learned from the centenarians. He shares his approach to the photo shoots and why "stages: 100 over 100" is a project he wishes he could focus on exclusively.To purchase a transcript of this episode please visit this page: TranscriptsExplore the project: "stages: 100 Over 100"See some of Robert's other work: Robert Duron PhotographySubscribe to The Agewyz Podcast: iTunesGot a story to share? Email us any time at jana@agewyz.com