Bright Spots in Healthcare

Sonny Goyal, Senior Vice President of Diversified Business Group and Chief Strategy Officer of Blue Cross Blue Shield of North Carolina (Blue Cross NC), joins Eric to share some of Blue Cross NC’s successful initiatives to help members live their best lives.    Sonny discussed Blue Cross NC’s approach to mitigating social determinants of health, explaining the insurer is utilizing test-and-learn models to build quantifiable evidence, scale up successful models and, eventually, expand those ideas through its benefit offerings across the state.   Sonny and Eric touch on several topics, including Blue Cross NC’s recent food insecurity pilot program, value-based care, provider relationships and community health initiatives.    After listening, you’ll have many bright spots to consider implementing in your organization!   Links to articles mentioned during the discussion: https://www.bluecrossnc.com/blog/expert-takes/transforming-health-care/food-is-medicine https://catalyst.nejm.org/doi/full/10.1056/CAT.22.0351 https://mediacenter.bcbsnc.com/news/blue-cross-nc-donates-500-000-to-the-forward-fund-established-to-support-transition-efforts-following-mill-closure   About Sonny Sonny leads the diversified business group at Blue Cross and Blue Shield of North Carolina (Blue Cross NC) while also serving as their chief strategy officer, He is responsible for thoughtfully guiding the company as it seeks to achieve sustainable long-term growth by enhancing its existing business and identifying opportunities to expand beyond via inorganic growth. Among other responsibilities, Sonny is accountable for managing and maturing the company’s best-in-class business partnerships and assets, shaping Blue Cross NC’s short-term goals and long-term strategy, portfolio planning and prioritization, corporate development and utilizing strategic intelligence to improve the experience of key stakeholders across the state. Before joining Blue Cross NC, Sonny served in leadership roles at several other leading companies in the healthcare, venture capital and finance sectors. Most recently, he was Executive Director for Corporate Strategy and Development for the Advisory Board Company in Washington, DC. Before that, Sonny led Mergers and Acquisitions for Highmark Blue Cross and Blue Shield; brokered acquisitions, divestitures and capital raises ranging from $250 million to $12 billion at Wells Fargo; and assisted in assessing venture capital investments for Garage Technology Ventures in Silicon Valley.  Connect with us on social media:  Facebook: facebook.com/brightspotshc Instagram: instagram.com/brightspotshc LinkedIn: linkedin.com/company/shared-purpose-connect Twitter: twitter.com/BrightSpotsinHC TikTok: tiktok.com/@brightspotshc

Former New Jersey Congressman and Health Transformation Alliance (HTA) CEO Robert Andrews joins Eric to discuss how HTA –  a cooperative of more than 60 of America’s leading employers –and its members employers are fixing our broken healthcare system by sharing data, challenging the status quo and implementing innovative solutions. Robert shares many bright spots from HTA, including initiatives in medication management and infant mortality. He explains how the cooperative has saved its member companies well over $2 billion in healthcare costs to date.   About Robert As CEO of the HTA, Robert oversees the strategic direction of approximately 60+ major corporations that have come together in an alliance to fix the broken healthcare system. He is also the Chairman of the Board of Lolo Health, a health tech company that connects consumers to a high-value health experience. Andrews previously led the Government Affairs practice at Dilworth Paxson law firm for two years before joining the HTA.   Before private practice, Andrews served as a Member of the United States House of Representatives for nearly 24 years. Upon his departure from Congress, President Barack Obama praised Andrews’ service as “an original author of the Affordable Care Act…and a vital partner in its passage and implementation” and cited his “tenacity and skill” in representing the people of New Jersey.   About HTA The Health Transformation Alliance (HTA) is a cooperative of more than 60 of America’s leading employers coming together to fix the broken healthcare system. Formed by four founding members in September 2015, the HTA member companies collectively are responsible for over 8 million employees, dependents, and retirees with an annual healthcare spend of $30+ billion.  Some members include Walgreens, 3M, Marriott, Shell, Coca-Cola and NextEra Energy.

Angela D. Thomas, DrPH, MPH, MBA, Vice President, Healthcare Delivery Research, MedStar Health, joins Eric to discuss D.C. Safe Babies Safe Moms, a community-driven collaborative launched in 2020 to improve the health and well-being of mothers and infants in Washington, D.C., and reduce racial disparities in maternal and infant health outcomes – one of the most urgent challenges facing the District of Columbia. Combining the expertise of MedStar Health, evidence-based healthcare, and proven community-centric support services, Safe Babies Safe Moms offers services to support birthing individuals before, during, and after pregnancy and until their child reaches age three.  Angela shares success stories from families supported by the initiative and discusses the program's impact. For health systems interested in implementing a similar program, she outlines MedStar Health's steps in building and sustaining the initiative.   She also speaks about the role technology plays in the initiative. Safe Babies and Safe Moms recently launched a Clinton Global Initiative (CGI) Commitment to Action project to use artificial intelligence and machine learning to help reduce disparities in maternal and infant health. About Safe Babies Safe Moms Made possible by the A. James & Alice B. Clark Foundation, D.C. Safe Babies Safe Moms is a partnership between MedStar Health, Community of Hope, and Mamatoto Village to address critical maternal and infant care disparities in Washington, D.C., which has among the highest rates of maternal and infant mortality in the nation. In FY22, 15,346 mothers and babies received care through the program. Services offered include on-site mental health support during prenatal and postpartum visits, assessments for high-risk or complicated pregnancies, social support services for mothers and families who may be experiencing food or housing insecurity, pro-bono legal services, and other counseling on securing public benefits, transportation to and from appointments, infant care supplies, culturally-aware breastfeeding support, and more. About Angela Thomas Angela is responsible for leading a team of experts to apply rigorous scientific methods to enable next-generation healthcare delivery through quality, safety, innovation, health economics, payment reform, outcomes, health services research, data science, and health equity. She also ensures that these research activities leverage the collective leadership and unique strengths of MedStar Health and Georgetown University. Her research interests focus on health equity and patient safety.. As the Executive Leader of Safe Babies Safe Moms, Angela is responsible for ensuring the development, implementation, and evaluation of an evidence-based program that will reduce disparities in maternal and infant mortality in Washington, DC. In addition, she contributes her research expertise in disparities, health equity, and patient safety to the initiative to uncover the contributing factors leading to disparities in maternal and infant harm. Connect with us on social media: Facebook: facebook.com/brightspotshc Instagram: instagram.com/brightspotshc LinkedIn: linkedin.com/company/shared-purpose-connect Twitter: twitter.com/BrightSpotsinHC TikTok: tiktok.com/@brightspotshc

Leaders from CareFirst, CareSource, UPMC and Scene Health explore how proper medication adherence ensures a higher quality of life, improves health outcomes and reduces healthcare costs. Many health plans saw their overall Medicare Star Ratings drop this year due to one particular area – medication adherence. Our expert panel from top-rated plans shares innovative and actionable strategies for overcoming barriers to medication adherence.    Topics for discussion include: Reasons traditional approaches to medication adherence are not effective Best ways to speed up intervention with a personalized, member-centric approach Financial and ratings impacts of medication adherence measures   Confirmed Panelists Tom Manetti, Associate Vice President, Quality Products, CareSource Molly McGraw, PharmD, BCPS, Manager, Clinical Pharmacy, UPMC Health Plan Suzanne Moxham, Director, Quality, Accreditation, & Government Programs at CareFirst BlueCross BlueShield Sebastian Seiguer, CEO & Co-Founder, Scene Health   Bios: https://www.brightspotsinhealthcare.com/events/how-medication-adherence-can-be-much-more-than-medication-adherence/   Connect with us on social media: Facebook: facebook.com/brightspotshc Instagram: https://www.instagram.com/brightspotshc/ LinkedIn: https://www.linkedin.com/company/shared-purpose-connect/ Twitter: https://twitter.com/BrightSpotsinHC TikTok: https://www.tiktok.com/@brightspotshc This episode is sponsored by Scene Health  Meet Scene Health, the medication engagement company that's taking on the colossal $500 billion problem of medication nonadherence. But here's the twist – they're doing it in a novel way by leveraging asynchronous video engagement.   Scene's model of care enhances the CDC-endorsed gold standard for ensuring medication adherence, Directly Observed Therapy. Their team of pharmacists, nurses, and health coaches engage with members via back-and-forth videos to build trust through person-to-person connections and empower every patient to take every dose of medication properly.   And they're not just all talk. Scene Health has been clinically validated in 20 peer-reviewed publications and is already teaming up with Medicaid and Medicare health plans, public health departments, and life science organizations to tackle a range of conditions, from diabetes & asthma to sickle cell disease.

Kim Barrus, MSN, RN, PMP, Director, Clinical Outcomes Management, SelectHealth, joins Eric to discuss how her plan reinvented the consumer experience for ACA Marketplace health plans.    With almost half of ACA Marketplace customers complaining about making appointments with providers and other process challenges, SelectHealth committed to reversing the trend and implementing a complete, end-to-end consumer experience.    Kim shares the results of SelectHealth’s efforts and outlines the plan’s strategy giving members the seamless experience they want. Listen and get the roadmap for remaking your plan’s ACA consumer experience!   About Kim  Kim Barrus began her career with SelectHealth 26 years ago and has worked in various capacities. She developed the SelectHealth Advanced Primary Care (a.k.a. patient-centered medical home) program. She facilitated the initial pilots of the program in 2010. Today the program has 1,240 participating providers at 222 participating clinics. In her current role, Kim oversees quality, medical home, NCQA accreditation, HEDIS and CMS Stars.   Kim is a registered nurse who received her Bachelor of Science in Computer Information Systems and maintains a Project Management Professional (PMP) certification from the Project Management Institute (PMI).   This episode is sponsored by ReferWell Health plans must be acutely aware of their progress towards achieving their Care Gap Closure targets. Their most significant obstacle is to directly impact those specific areas, even though they have limited capabilities to do so.   ReferWell helps health plans improve access to care by efficiently scheduling members for the care they need.   ReferWell care navigators find the "Perfect Match" provider right at the referable moment when the member is saying yes to their care). They then seamlessly schedule the member's appointment while still on the call.  It’s a proven process that provides better access, experience and outcomes for members and better quality performance, which affects the health plan’s bottom line.

Leaders from Humana, Healthfirst, Health Leads and Vesta Healthcare join Eric to discuss the future of home healthcare for Medicare Advantage plans. As care delivery strategies evolve, the home is critical in achieving clinical and customer satisfaction ratings that drive business success. Home health is also vital to providing equitable care to all members. Our expert panel lays a blueprint for implementing a successful home care model that your plan can use.   Confirmed Panelists: Susan Beane, MD, FACP, Executive Medical Director, Clinical Partnerships, Healthfirst Chase Dailey, Principal, Home Solutions, Humana Randy Klein, CEO, Vesta Health Dominique Morgan, Chief Operating Officer, Health Leads   https://www.brightspotsinhealthcare.com/events/medicare-advantage-and-the-next-generation-in-home-health-strategies/   This episode is sponsored by Vesta Healthcare Vesta Healthcare is a specialized virtual medical group providing high-touch medical support to patients with chronic conditions. Our program uses technology and patient and caregiver engagement to act on insights gleaned from the first mile of patient care: the home.    We connect the entire care team - patients, family, caregivers, insurance plans, agencies, doctors, and nurses - to support the best care at home. The ancient Roman goddess of hearth and home inspired our name, Vesta, because our mission is to ensure that people stay in the comfort of their homes as long as possible.   Connect with us on social media: Facebook: facebook.com/brightspotshc Instagram: https://www.instagram.com/brightspotshc/ LinkedIn: https://www.linkedin.com/company/shared-purpose-connect/ Twitter: https://twitter.com/BrightSpotsinHC TikTok: https://www.tiktok.com/@brightspotshc

Leaders from Network Health, UPMC Health Plan, Healthmine and Benelynk explore how Medicare Advantage plans can attain 5-Stars and share bright spots on improving outcomes for members with social risk factors. Learn how closing gaps in care and reducing health disparities can help your plan reach 5 Stars!   Topics include:  CMS Health Equity Index Product Enhancement Member Activation and Engagement Payer/Provider Collaboration Social Care Strategy Blueprint   Panelists: Andre Bliss, Ph.D., MBA, Director, Medicare STARs, UPMC Health Plan  Mallory Mueller, (she/her/hers) Director Quality Health Integration, Network Health Cherie Shortridge, Senior Advisor, Healthmine  Sean Libby, President, BeneLynk Bios: https://www.brightspotsinhealthcare.com/events/evolution-of-sdoh-2024-and-beyond/   BeneLynk sponsors this episode BeneLynk is a national provider of Social Care solutions for Medicare Advantage and Managed Medicaid health plans. We serve plans and their members by creating a human-to-human connection and providing the assistance a member needs to get the benefits they deserve.   We build stronger human connections supported by innovative technology by employing one dynamic conversation that flows organically to meet Social Determinants of Health challenges.   All of our services are customized to the specific geography, where we provide the members with the specific information they need to keep their benefits in place.   Our mission is to improve lives and positively impact Social Determinants of Health barriers by providing our healthcare partners with the information they need and people with the advocacy they deserve.

Healthcare leaders from Humana, myPlace Health, Mom’s Meals, and SCAN explore the latest product and benefit design trends for the aging population. Our expert panel shares strategies and best practices your plan can implement to bridge the social and clinical care gap and empower seniors to create a lifetime of healthy habits.    Topics include: Product Segmentation SDOH/Supplemental Benefits Care Models Payer and Provider Collaboration   Panelists: Catherine Macpherson, MS, RDN, Senior Vice President of Healthcare Strategy & Development, Mom’s Meals Erika Pabo, MD, MBA, Chief Transformation Officer & Central Operations, Centerwell & Conviva, Humana Lena Perelman, Senior Director, Product Development, Market Expansion, SCAN Health Plan Robert Schreiber, MD, AGSF, Vice President and National Medical Director, myPlace Health   Bios: https://www.brightspotsinhealthcare.com/events/the-future-of-senior-health-equitable-access-open-enrollment/   The Episode is Sponsored by Mom’s Meals Getting the right nutrition is essential to achieving and maintaining good health – yet accessing balanced meals that also support health challenges and fulfill personal tastes is not always as easy as it should be.   At Mom’s Meals, our passion is to provide nourishment and deliver wholesome meals to the homes of those who need better nutrition to support their health and wellness, no matter where they live. It’s the reason we’ve built our business from our own personal roots, caring for our clients as we do our own family and loved ones.   Our menus are designed by professional chefs and registered dieticians to taste great and support the nutritional needs of common chronic conditions. Clients get to choose every meal, every order. Meals are delivered to any address, no matter how remote.   To learn more visit momsmeals.com.