Bright Spots in Healthcare

Leaders from Independence Blue Cross, Oscar Health and TytoCare explore how health plans can leverage various solutions effectively to optimize pricing structures; exploring technology adoption, cost-effectiveness, and market competitiveness. Our panel of industry experts will share successful strategies and real-world examples you can implement in your organization.   Topics covered include: Matching benefits with member personas Evolving virtual care beyond video Various innovations in product design  Bringing price transparency to ACA and Medicare Advantage products How to penetrate new, highly competitive markets   Guests: Jonathan Stump, Vice President, Product Services, Independence Blue Cross Bill Bradley, Vice President, Insurance Product Development, Oscar Health Meni Shikhman, Vice President, TytoCare   Bios: https://www.brightspotsinhealthcare.com/events/differentiating-your-product-in-the-healthcare-insurance-marketplace/   This episode is sponsored by TytoCare TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are five times higher than traditional telehealth services, reduces the total cost of care by an average of five percent, diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for successfully deploying and adopting the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 220 major health systems and plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.

Kody Kinsley, Secretary of North Carolina’s Department of Health and Human Services, joins Eric to discuss how his state is improving the lives of families and children by expanding Medicaid and improving the mental health system.    Secretary Kinsley shares strategies for improving behavioral healthcare access and benefit design for North Carolina’s Medicaid and Medicare members, including peer support programs, mental health crisis lines, and data systems to track the availability of beds and individuals in need.    The conversation also explores the importance of improving healthcare infrastructure through Medicaid, focusing on preventative measures and addressing social determinants of health.    About Secretary Kinsley Kody Kinsley serves as North Carolina’s Secretary of Health & Human Services, overseeing a department with over 18,000 staff and a $38 billion budget.   With experience centered on health policy and operations, Kinsley worked on digital healthcare transformation, national education, and labor policies and served as the COO and CFO of the U.S. Treasury.   Secretary Kinsley’s three priorities for the department include Investing in behavioral health and resilience, improving child and family well-being, and building a solid and inclusive workforce. Under his leadership, North Carolina expanded Medicaid and received the most significant investment to bolster the mental health system in over a decade. Kinsley grew up in Wilmington, earning his bachelor’s degree from Brevard College and his master’s in Public Policy from the University of California at Berkeley.   

Leaders from Humana, Blue Cross, and Blue Shield of Rhode Island delve into the dynamic landscape of specialty value-based care, sharing valuable insights and actionable strategies for navigating its complexities.    Show Guests: Alexander Ding, MD, MS, MBA, Associate Vice President for Physician Strategy and Medical Affairs, Humana  Nick Lefeber, Senior Vice President, Value-Based Care, Contracting, Data & Analytics, Blue Cross Blue Shield of Rhode Island Rachel Winokur, Chief Executive Officer, TailorCare   https://www.brightspotsinhealthcare.com/events/the-evolution-of-specialty-value-based-care/   This episode is sponsored by TailorCare   TailorCare is a risk-based care navigation program that provides deeply personal support to patients living with joint, back, and muscle pain. By combining a careful assessment of patients’ symptoms, health history, preferences and goals with predictive data and the latest evidence-based guidelines, TailorCare helps patients choose —and navigate—the most effective treatment pathway for them, every step of the way.  

Melissa Newton Smith, Founder of Newton Smith, and Keslie Crichton, Chief Sales Officer of BeneLynk, join Eric to discuss the introduction of the CMS Health Equity Index, which will replace the reward factor within the Medicare Advantage Star Rating program measurement. The Health Equity Index will be a seismic change for Medicare Advantage plans and impact revenue associated with Star Ratings. Melissa and Keslie share success stories from plans preparing for the change.  Links to documents mentioned during the episode: "Associations Between Annual Medicare Part D Low-Income Subsidy Loss and Prescription Drug Spending and Use": https://jamanetwork.com/journals/jama-health-forum/fullarticle/2814604 Associations Between Annual Medicare Part D Low-Income Subsidy Loss and Prescription Drug Spending and Use   About Melissa Melissa is the founder of Newton Smith. She brings over 25 years of experience in Star Ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. Most recently, She served as Chief Consulting Officer at Healthmine   Melissa is a well-known healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, quality performance, health outcomes, and the member experience.    About Keslie Keslie has worked in managed care for over 25 years, focusing on SDoH solutions that improve members' lives and provide a return on investment for our clients. Keslie drives enterprise growth and innovative partnerships to improve outreach strategies and health outcomes for our client’s members.  Keslie works closely with BeneLynk’s product team to offer differentiated services and capabilities to maintain its market leader position.  This episode is sponsored by BeneLynk BeneLynk is a national provider of Social Care solutions for Medicare Advantage and Managed Medicaid health plans. They 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.

  Leaders from Independence Blue Cross, Banner| Aetna, and Scene Health share exclusive insights on successfully accomplishing chronic condition management success with fewer resources.    Our expert panel explores patient-centered and technology-enabled approaches that elevate chronic care management efficiency and effectiveness. Don't miss the opportunity to learn about strategic solutions tailored to the unique challenges of Medicaid and Medicare health plans.   Panelists: Robert Groves, MD, Chief Medical Officer & Executive Vice President, Banner| Aetna Reetika Kumar, MD, FACP, Vice President, Market Clinical Solutions and Pharmacy Services, Independence Blue Cross Sebastian Seiguer, CEO & Co-Founder, Scene Health Bios: https://www.brightspotsinhealthcare.com/events/meeting-goals-for-chronic-condition-management-with-fewer-resources/   This episode is sponsored by Scene Health Meet Scene Health, the industry leader in MedEngagement. They are going beyond traditional medication adherence to transform disease management.   Scene’s MedEngagement approach uses 1:1 async video to deliver medication support at scale.   Scene helps members get better fast—getting to the doctor, getting their meds, taking them as prescribed, and getting labs and vitals—driving cost-effective utilization and improving multiple clinical and quality measures in as little as 90 days.   Scene was commercialized out of Johns Hopkins, and has developed the most extensive catalog of peer-reviewed publications among medication adherence companies. Visit its website at www.scene.health for more information.

Leaders from Blue Cross and Blue Shield of Illinois, Independent Health, Evry Health and Vori Health discuss GP-1s and their role in addressing the global challenge of obesity. The panel shares innovative, multidisciplinary strategies you can implement to complement lifestyle interventions and other therapeutic approaches in your organization. * Improving outcomes by pairing GLP-1s with evidence-based behavior change * Considering musculoskeletal (MSK) health in obesity treatment * Understanding the role of GLP-1s in delivering value-based care   Panelists: Shelley Turk, Divisional Senior Vice President of Health Care Delivery, Blue Cross and Blue Shield of Illinois Martin Burruano, Vice President, Pharmacy Services, Independent Health Mamata Majmundar, MD, Chief Medical Officer, Evry Health Mary O'Connor, MD, FAAOS, Co-Founder & Chief Medical Officer, Vori Health   https://www.brightspotsinhealthcare.com/events/how-innovators-are-addressing-glp-1s-obesity-and-msk/   This episode is sponsored by Vori Health Vori Health is a specialty medical practice delivering a virtual-first musculoskeletal (MSK) solution to help members get back to their lives faster. As the only nationwide MSK practice with doctor-led care teams, Vori Health is the most convenient way to access appropriate care for back, neck, and joint pain without bouncing around the healthcare system. Whether members need a diagnosis, non-opioid prescription, personalized physical therapy, or health coaching, they can turn to Vori Health for evidence-based care and effective end-to-end support. This holistic model reduces unnecessary surgeries, enables faster recoveries, and lowers MSK spend with up to a 4:1 ROI. For more information visit www.vorihealth.com.

Seema Kumar, CEO, Cure, an innovation campus in New York City, joins Eric to discuss how artificial intelligence can positively impact healthcare and lead to more innovation. She shares how AI has been used in healthcare and the promise it holds for the future.   The conversation also highlights the Cure Xchange Challenge: Health AI For Good, an initiative to incubate innovations by healthcare startups and entrepreneurs across disciplines and sectors to use artificial intelligence (AI) responsibly and equitably. Cure collaborated with MIT Solve for the Challenge and an independent board of judges selected the ten finalists. The winners will be announced later in the First Quarter of 2024.   Seema shares the stories of several finalists including, Oben Health, an AI-enabled platform that facilitates the delivery of healthcare screenings, education and treatment via barbershops and salons, and Nutrible, artificially intelligent social workers.     This episode is part of a series of episodes featuring the Clinton Global Initiative Commitments to Action action from the Clinton Global Initiative. Please listen to the previous episode, Safe Babies Safe Moms: Rethinking Equitable Access and Maternity Care, available on all podcast apps.   About Cure Cure is an innovation campus in NYC boasting laboratories, lecture, and office space, as well as technology and other amenities to set up innovators for success across the healthcare industry, including academic institutions and other nonprofits. Visit the website at: https://cure.345pas.com/   About Seema Before Cure, Seema spent nearly 20 years at Johnson & Johnson in senior leadership roles, most recently as the Global Head of Office of Innovation, Global Health and Scientific Engagement, and served on J&J’s Innovation Strategy, Public health leadership and the COVID-19 vaccine steering committee. Before her tenure at J&J, Seema was the Chief of Staff to Dr. Eric Lander and the Chief Communications Officer at the Whitehead Institute/Massachusetts Institute of Technology Center for Genome Research, where she played a leadership role in the Human Genome Project.   

Blue Shield of California, Highmark, Intellihealth and NourishedRX discuss how they are mitigating the high costs of GLP-1s with lifestyle interventions such as behavior change, physical exercise, nutritional counseling, coaching to optimize outcomes for members living with obesity and diabetes.   Hear real-life examples and best practices to equip your members with the tools and strategies to achieve lasting success in managing obesity and diabetes beyond the limitations of GLP-1s.    PANELISTS Angie Kalousek Ebrahimi, Senior Director of Lifestyle Medicine, Blue Shield of California Timothy Law, DO, Chief Medical Officer, Highmark Health Katherine H. Saunders, M.D., Executive Vice President & Co-Founder, Intellihealth Lauren Driscoll, Founder & CEO, NourishedRx   https://www.brightspotsinhealthcare.com/events/lifestyle-modification-strategies-to-support-those-living-with-obesity-and-diabetes/   This episode is sponsored by NourishedRX NourishedRx is a leading digital health and nutrition company specializing in comprehensive nutrition solutions for consumer and health plan members living with diabetes, obesity and other diet-related conditions.    NourishedRx recognized food's healing and connective power, and partners with healthcare organizations nationwide to address the nutritional needs of their most vulnerable populations. The NourishedRx B:B:C health and nutrition platform facilitates and optimizes personalized, culturally concordant food in addition to the tools necessary to drive lasting behavior change – leveraging technology so YOU can all deliver at scale.   Beyond diet, NourishedRx engages with health plan members and patients to support their whole health and lifestyle more broadly. They engage consumers with omnichannel wrap-around support and education, enabling individuals to make informed choices and gain a deeper understanding of the impact of their diet and lifestyle on their overall well-being, empowering them for the long term.   NourishedRx is well suited as an early alternative and/or companion therapy to specialized obesity treatment, including GLP-1 and other Anti-Obesity Medication therapies.

Blue Shield of California, Highmark, Intellihealth and NourishedRX discuss how they are mitigating the high costs of GLP-1s with lifestyle interventions such as behavior change, physical exercise, nutritional counseling, coaching to optimize outcomes for members living with obesity and diabetes.   Hear real-life examples and best practices to equip your members with the tools and strategies to achieve lasting success in managing obesity and diabetes beyond the limitations of GLP-1s.    PANELISTS Angie Kalousek Ebrahimi, Senior Director of Lifestyle Medicine, Blue Shield of California Timothy Law, DO, Chief Medical Officer, Highmark Health Katherine H. Saunders, M.D., Executive Vice President & Co-Founder, Intellihealth Lauren Driscoll, Founder & CEO, NourishedRx   https://www.brightspotsinhealthcare.com/events/lifestyle-modification-strategies-to-support-those-living-with-obesity-and-diabetes/   This episode is sponsored by NourishedRX NourishedRx is a leading digital health and nutrition company specializing in comprehensive nutrition solutions for consumer and health plan members living with diabetes, obesity and other diet-related conditions.    NourishedRx recognized food's healing and connective power, and partners with healthcare organizations nationwide to address the nutritional needs of their most vulnerable populations. The NourishedRx B:B:C health and nutrition platform facilitates and optimizes personalized, culturally concordant food in addition to the tools necessary to drive lasting behavior change – leveraging technology so YOU can all deliver at scale.   Beyond diet, NourishedRx engages with health plan members and patients to support their whole health and lifestyle more broadly. They engage consumers with omnichannel wrap-around support and education, enabling individuals to make informed choices and gain a deeper understanding of the impact of their diet and lifestyle on their overall well-being, empowering them for the long term.   NourishedRx is well suited as an early alternative and/or companion therapy to specialized obesity treatment, including GLP-1 and other Anti-Obesity Medication therapies.

Leaders from Blue Cross Blue Shield of Michigan, Highmark and Quest Analytics discuss the importance of a network provider strategy for health plans. To stay competitive and meet the evolving needs of their members, health plans are examining and reimagining their provider strategies.    By focusing on areas such as compliance, network adequacy, data integrity, and performance metrics, plans are redefining their own roles and enhancing quality and affordability for their members.   Panelists include: Steve Anderson, Vice President, Hospital Contracting & Network Administration, Blue Cross Blue Shield of Michigan   Jim Brown, Vice President, Western Pennsylvania Operations and Strategic Priorities, Highmark Health   Steve Levin, CEO, Quest Analytics   Bios: https://www.brightspotsinhealthcare.com/events/differentiating-your-health-plan-reimagining-your-provider-network-strategy/   Quest Analytics sponsors this episode Quest Analytics’ software platform empowers you to analyze, expertly manage meticulously, and impeccably report on your provider network‘s adequacy and the provider data accuracy across your entire organization and all lines of business. You can trust them! CMS does, and they are among eight of the nation’s largest health plans that leverage its software and services, not to mention multiple state regulatory agencies and many of the nation’s leading health systems and provider groups. They manage, measure and monitor health plan network performance so that together, we can elevate the health of communities nationwide. They also enable health plans to differentiate their position in the marketplace through a vastly superior provider network. My words, not theirs, and I know I am simplifying things a bit …but think of them as the Kayak for physician quality and accessibility data. For more information, please visit the Quest Analytics website at http://www.questanalytics.com./     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    

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. 

Senior healthcare leaders from AmeriHealth Caritas, AvMed, HealthTeam Advantage, and ReferWell share strategies health plans can use to understand gaps in care throughout the member journey.    For health plans participating in risk-based agreements, gaps in care have severe implications for members' health outcomes and their ability to attain higher quality scores necessary to receive financial bonuses and drive member enrollment.    Hear how plans leverage data and real-time analytics to effectively and efficiently close time-sensitive care gaps to improve HEDIS, Stars and other quality scores.   Topics covered include: Provider Plan Partnerships Building a Relationship with Members Identification & Targeting Systems & Incentives   Confirmed Panelists Marsha Barlocker, RN, BSN, MS, Senior Director, Quality & Case Management, HealthTeam Advantage Chad Baugh, Chief Strategy Officer, ReferWell Vandna Bhrany, Vice President, HEDIS Strategy & Analytics, AmeriHealth Caritas Frank Izquierdo, Senior Vice President Provider Solutions and Strategic Alliances, AvMed   Bios: https://www.brightspotsinhealthcare.com/events/last-minute-gaps-in-care-strategies/   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. 

  Nashville General Hospital CEO Joseph Webb,D.Sc., MSHA, FACHE, joins Eric to discuss how  the hospital is using innovation to fulfill its mission and vision to improve the health and wellness of Nashville  – one neighbor at a time.   During the conversation, Dr. Webb shares details on two innovative initiatives Nashville General implemented to address health equity and transform care delivery. Food Pharmacy - In 2018, Nashville General launched the Food Pharmacy to provide access to food for individuals living with food insecurity and to educate those individuals about which foods best fit within the care plan based on their chronic conditions. Congregational Health and Education Network (CHEN) -  Launched in 2017, CHEN is a 501(c)(3) faith-based initiative with local churches and educational institutions with a primary focus on reducing health disparities for communities of color through education attainment, access to healthcare, and health literacy. Currently, CHEN includes 100 faith-based organizations of all denominations throughout Nashville.   In addition, Dr. Webb provides a blueprint to help other health organizations implement  similar, innovative programs to promote healthy communities and reduce health disparities.   About Dr. Webb Since joining Nashville General in 2015, Dr. Webb has successfully led efforts to improve patient outcomes, enhance the patient experience and grow revenues.    Before joining Nashville General Hospital, Dr. Webb served as chief operating officer for Common Table Health Alliance in Memphis, Tennessee. As a former chief executive operating officer for Methodist Le Bonheur South Hospital in Memphis, Tennessee, he held additional chief executive roles for Healthcare Services of America at Coastal Carolina Hospital and Northwest Mississippi Regional Medical Center.   Dr. Webb is board certified in Healthcare Management and is a Fellow of the American College of Healthcare Executives. Nationally, he serves as a board member of America’s Essential Hospitals and as chairman of the Governance Committee. He serves on the board of the Nashville chapter of the American Heart Association and as a board member of NashvilleHealth. Dr. Webb is a member of Omega Psi Phi, Incorporated.    Dr. Webb earned a Doctorate of Science in Health Services Administration and a Master of Science in Hospital and Health Services Administration from the University of Alabama at Birmingham. He also holds a Bachelor of Science and Master of Science in Health and Physical Education from Tennessee State University. About Nashville General Hospital A leading safety net hospital with 150 beds and more than 22 clinics. Nashville General Hospital serves as the index teaching hospital for the historic Meharry Medical College.    Nashville General has earned multiple accreditations for its evidence-based measures and practices that provide quality healthcare. These include The Joint Commission’s Gold Seal of Approval accreditation, NCQA PatientCentered Medical Home accreditation, the NCQA Diabetes Recognition Program, accreditation by the Commission on Cancer for Nashville General’s Robert E. Hardy Cancer Center, and Level 3 TNCPE Performance Excellence Award.    The hospital also has increased its revenue sources through expanded healthcare services and launched initiatives to attract new commercially insured patients. These efforts ensure that every patient receives high-quality care at Nashville General Hospital regardless of their ability to pay.

Healthcare leaders from Geisinger, Intermountain Health, UNC Health and TytoCare join Eric to discuss how AI and machine learning transform the member journey and empower members to take a more active role in their health. Our experts share successful strategies and best practices your healthcare organization can implement to change the member experience.    Hear the following case studies and learn how: Intermountain Health physicians use AI to diagnose pneumonia Geisinger leverages AI and machine learning to identify patients at higher risk for colon cancer to ensure they go for a colonoscopy UNC Health determines which patients are best suited for home health care vs. the hospital with AI and machine learning TytoCare drives better patient adoption of virtual care technologies with AI   Panelists:  Nathan Dean, MD, Section Chief of Pulmonary and Critical Care Medicine, Intermountain Medical Center Rachini Moosavi, Chief Analytics Officer, UNC Health Karen M. Murphy, PhD, RN, EVP/Chief Innovation and Digital Transformation Officer, Geisinger Ohad Pollak, Chief Marketing Officer, TytoCare Bios: https://www.brightspotsinhealthcare.com/events/how-ai-is-changing-patient-engagement   This episode is sponsored by TytoCare TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are five times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for successfully deploying and adopting the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 220 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.

Healthcare leaders from Health Net, Horizon Blue Cross Blue Shield of New Jersey and Socially Determined shared successful Medicaid Redetermination strategies and best practices to help ensure your plans’ most vulnerable populations do not lose essential health coverage.   With the end of the Public Health Emergency and the Medicaid continuous coverage provision in April, Redetermination could cause 18M Americans to lose health coverage, creating care gaps for the most vulnerable & widening health disparities. Our expert panel provides you with important information about navigating the disenrollment storms ahead.   Mildred Menos, Director, Medicaid Product Administration, Horizon Blue Cross and Blue Shield of New Jersey Darrel Ng, Vice President, Communications & Marketing, Health Net Trenor Williams, MD, Co-Founder & CEO, Socially Determined Bios: https://www.brightspotsinhealthcare.com/events/the-disenrollment-tsunami-how-to-fix-your-medicaid-redetermination-strategy/   This episode is sponsored by Socially Determined Socially Determined is leading the transformation of health care delivery and payment through social risk analytics and solutions. Our SocialScapeⓇ SaaS platform, data and industry-leading expertise empower health systems, plans and other risk-bearing organizations to better manage risk, improve outcomes and advance equity at scale. Recently named by Fierce Healthcare as one of the 15 most promising healthcare companies, Socially Determined is headquartered in Washington, DC. Visit: www.sociallydetermined.com

Phylicia Schroder, Manager, Provider Engagement and Quality Analytics at Blue Cross Blue Shield of Arizona Medicare Advantage and Janine Wakim, Head of Operations at ReferWell, join Eric to discuss how the plan is transforming the member journey by instituting a cultural shift putting the member’s needs above the plan’s needs, adding that to accomplish this goal, the plan uses data and predictive analytics to learn about what makes its members unique. Topics covered during the episode include: - Member journey mindset - Navigation and physician scheduling - Data integration, risk mitigation (as it relates to CAHPS) and  - Provider engagement.  Phylicia and Janine share many bright spots your plan can implement to provide a tailored experience for your members!   About Phylicia Phylicia is a highly skilled Medicare Stars quality (HEDIS, CAHPS, HOS) analyst and strategist who specializes in data analysis, extrapolation and visualization through building dashboards in Power BI, technology implementation, provider engagement and clinical workflows, project management, process improvement and documentation.  She is a true innovator who never says “No” and sees obstacles as opportunities to apply creative problem-solving to find a solution.   About Janine As Head of Client Operations, Janine Wakim is keenly focused on the success and satisfaction of ReferWell’s customers.  Janine leads the team that works with some of the largest healthcare systems and payers in the United States from onboarding to growth to ongoing support.  She is an operations leader with over 20 years of experience in strategic planning and process improvement, leading client experience and business analytics teams. At Gartner, she served as the lead in building the offshore center of excellence for Business Analysis to provide insights into the Research and Advisory business to grow its footprint and retain its client base. She also served in leadership roles at Datto and Potoo Solutions. Janine earned a Bachelor of Science in Finance from Lehigh University, an MBA from Columbia Business School, and an MPH in Hospital Administration from Columbia University Mailman School of Public Health. This episode is sponsored by ReferWell Health plans are acutely aware that they are measured and graded on quality, experience and health equity more so than ever before. Their biggest challenge is to impact those areas directly. ReferWell helps health plans advance health equity by scheduling underserved members for the care they need, be it medical, care gap appointments or — through your community partnerships — appointments for transportation assistance, nutritional counseling, mental health services and other community-based organization offerings. Data shows that ReferWell’s solution directly impacts the members who need it most.    ReferWell care navigators find the Perfect Match right at the referable moment (when the member is leaning into their care) and schedule the member while on the phone. 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. For more information, visit www.referwell.com.  

Psychedelic Researcher and Psychologist Alex Belser, PhD, joins Eric to discuss the efficacy and safety of psychedelics,  how they are being applied in practice and the potential pharmacoeconomic or business impact this category of medications can have. Alex also shares information on the latest research and developments in psychedelics.   About Alex Dr. Alex Belser is a licensed psychologist and researcher focused on psilocybin, MDMA, and DMT therapies. At Yale, Dr. Belser is investigating a psychedelic treatment for OCD. He is the Chief Clinical Officer of Cybin, where he is the co-creator of a new model of psychedelic-assisted psychotherapy called EMBARK.

Leaders from Humana, SCAN and NourishedRx discuss the link between food, nutrition security and health and the idea that food and nutrition programs can improve health. Many Americans lack access to nutritious food due to food insecurity, contributing to high rates of chronic disease, poor health outcomes and health disparities, especially among underserved communities.    Our expert panel will share solutions and strategies health plans can adopt to improve health equity, reduce healthcare costs and alleviate the adverse impact of limited access to healthy food among your most vulnerable populations.    Panelists Romilla Batra, MD, MBA, Chief Medical Officer, SCAN Leah Brucchieri, Director of Medicare Growth and Innovation at Humana Lauren Driscoll, Founder and CEO of NourishedRx Bios: https://www.brightspotsinhealthcare.com/events/equity-engagement-nutrition-innovations-empowering-the-underserved/   This Episode is sponsored by NourishedRx NourishedRx aims to eradicate poor diet and nutrition insecurity as top drivers of death, disease, and disparities. Founded in 2019 by Lauren Driscoll, NourishedRx is a digital health and nutrition company that helps people live healthier lives and supports health equity. Leveraging the healing and connective power of food, NourishedRx partners with healthcare organizations nationally to nourish their most vulnerable members, build healthy relationships, and support health equity. NourishedRx delivers highly personalized, culturally relevant meals and groceries to members, along with wrap-around whole health support and nutrition education. The NourishedRx solution delights and engages members and promotes connection that enables NourishedRx not only to support dietary health and glean actionable insights regarding gaps in care and health-related social needs. Through this solution, NourishedRx can drive better health outcomes and lower overall costs at scale. Visit the website at nourishedrx.com

Psychedelic Researcher and Psychologist Alex Belser, PhD, joins Eric to discuss the efficacy and safety of psychedelics,  how they are being applied in practice and the potential pharmacoeconomic or business impact this category of medications can have. Alex also shares information on the latest research and developments in psychedelics.   About Alex Dr. Alex Belser is a licensed psychologist and researcher focused on psilocybin, MDMA, and DMT therapies. At Yale, Dr. Belser is investigating a psychedelic treatment for OCD. He is the Chief Clinical Officer of Cybin, where he is the co-creator of a new model of psychedelic-assisted psychotherapy called EMBARK.  

Healthcare leaders from AmeriHealth Caritas, Cigna Healthcare, Highmark, Reliant Medical Group and Corporate Insight share innovations in mental health, including how their organizations are incorporating and maximizing digital mental health tools and platforms. Learn strategies and approaches you can implement in your organization.   Panelists Yavar Moghimi, MD, Chief Psychiatric Medical Officer, AmeriHealth Caritas  Sam Nordberg, PhD, Chief of Behavioral Health, Reliant Medical Group  Demetrios C. Marousis, MA, MBA, LPC, Director, Behavioral Health, Highmark  William M. Lopez, MD, CPE, National Medical Director-Virtual Care, Senior Medical Director-Behavioral Health, Cigna Healthcare Lauren Roncevic, Senior Director of Healthcare Research, Corporate Insight Bios: https://www.brightspotsinhealthcare.com/events/how-digital-mental-health-is-making-an-impact/   Want more information about our Executive Roundtable Summit on August 24 & 25 in Boston? Visit our website for more information: https://www.brightspotsinhealthcare.com/summit/   This episode is sponsored by Corporate Insight. Corporate Insight delivers competitive intelligence, user experience research and consulting services to the nation’s leading healthcare, financial services and insurance institutions. As the recognized industry leader in customer experience research for over 30 years, Corporate Insight has been the trusted partner to corporations seeking to improve their digital capabilities and user experience. Their best-in-class research platform and unique approach of analyzing the actual customer experience helps corporations advance their competitive position in the marketplace. Visit their website at: www.corporateinsight.com  

GT Sweeney, Chief Information Officer, Healthfirst and Sami Boshut, Chief Information Officer, MediSys Health Network, Inc., join Eric to discuss how their organizations collaborated to create a cloud-based platform that enables seamless sharing of patient data across the care continuum.     The platform connects longitudinal data from claims, quality measures and electronic health records (EHRs) to identify gaps in care, making it easier for providers to address patient needs in real-time. The two discuss how the platform supports the next phase of value-based care by ensuring providers have the right information at the right time to address the needs of patients.    Sweeney and Boshut also outline a blueprint to help other organizations implement similar provider-centric technology systems.   .

  John Petito, Corporate Vice President, Transformation, SCAN Health and Ashish V. Shah, CEO, Dina, discuss the power of benefits navigation in attracting and retaining members for Medicare Advantage plans and other government programs.    The average Medicare beneficiary has access to over 43 Medicare Advantage plans, and offering supplemental benefits such as home-centered care enables plans to compete and differentiate in the marketplace. But plans must ensure members understand the benefits and that the navigation experience is seamless – and painless.    John and Ashish share successful strategies and best practices plans can implement to improve member experience and ensure members receive the care they need.    Topics include:   How the Medicare Advantage market is shifting New opportunities for risk-bearing entities  Why navigation is so hard and how to enhance it Measuring navigation strategy Improving CAHPS and STAR Ratings through enhanced benefit navigation   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.

Healthcare leaders from Blue Shield of California, CareSource, UT Health Austin and Vori Health discuss the importance of adopting a whole-person approach across the broader healthcare experience to maximize value, drive healthy behavior change and ensure more equitable care.    Learn how to develop an integrated whole-person solution framework and implement strategies to support members with chronic and high-risk conditions. Topics include: Adopting self-service digital tools and applications to engage members Providing access to resources, health coaches, medication, and mental/behavioral health support Leveraging medical and SDoH data to determine unique needs, tailor care, and sustain healthy behavior change   Panelists: Judith Davis, Vice President Clinical Operations, Ohio Market, CareSource, Angie Kalousek Ebrahimi, Senior Director, Lifestyle Medicine, Blue Shield of California, Karl Koenig, M.D., M.S., Executive Director, Musculoskeletal Institute; Division Chief of Orthopaedic Surgery, Associate Professor of Surgery and Perioperative Care, Dell Medical School, Ryan A. Grant, MD, MBA, FAANS, Founder and Chief Executive Officer, Vori Health Bios: https://www.brightspotsinhealthcare.com/events/reduce-total-cost-of-care-innovative-whole-person-models-for-high-cost-conditions/   Request discount code for our Payer & Provider Summit: https://www.brightspotsinhealthcare.com/summit-promo/ This episode is sponsored by Vori Health Vori Health is a specialty medical practice delivering a virtual-first musculoskeletal (MSK) solution to help members return to their lives faster. As the only nationwide MSK practice with doctor-led care teams, Vori Health is the most convenient way to access appropriate care for back, neck, and joint pain without bouncing around the healthcare system. Whether members need a diagnosis, non-opioid prescription, personalized physical therapy, or health coaching, they can turn to Vori Health for evidence-based care and effective end-to-end support. This holistic model reduces unnecessary surgeries, enables faster recoveries, and lowers MSK spending with up to a 4:1 ROI, for more information, visit www.vorihealth.com.

CDPHP, Johns Hopkins Medicine, Priority Health, ATRIO Health Plans and Vatica Health share successful strategies and best practices for provider-centric risk adjustment programs, which enable health plans to enjoy higher compliance, enhanced quality of care, improved risk score accuracy, higher Star and quality ratings and better financial performance. Learn how your plan can empower physicians to close care gaps, avoid common pitfalls and maintain compliant record documentation proactively.   Panelists: Gregg Kimmer, President & CEO, ATRIO Health Plans; Michelle Ilitch, MPH, Vice President, Vice President of Network Solutions and Value-Based Programming, Priority Health,; Colleen Gianatasio MHS, CPC, CPC-P, CPMA, CRC, CPCO, CDEO, CPPM, CCDS-0, CCS, and AAPC Approved Instructor, Director Clinical Documentation Integrity and Coding Compliance, Capital District Physician’s Health Plan (CDPHP);  Frank Shipp, FACHE, MBA, Executive Director, Johns Hopkins Clinical Alliance, Johns Hopkins Medicine; Hassan Rifaat, MD, CEO, Vatica https://www.sharedpurposeconnect.com/events/boosting-plan-performance-improving-provider-centric-risk-adjustment-staying-compliant/   For more information on our Payer & Provider Roundtable Summit: https://brightspotssummit.eventbrite.com   This episode is sponsored by Vatica Health Vatica Health is the #1 rated risk adjustment and quality of care solution for health plans and health systems. By pairing expert clinical teams with cutting-edge technology, Vatica increases patient engagement and improves coding accuracy and completeness. It helps identify and facilitate closure of care gaps and enhances communication and collaboration between providers and health plans. The company’s unique provider-centric solution helps payers, providers and patients achieve better outcomes, together.   Vatica is trusted by many leading health plans and thousands of providers nationwide. Healthcare research firm KLAS named Vatica “Best in KLAS” for risk adjustment in 2023. KLAS also named Vatica to its Emerging Solutions Top 20 list for innovative companies that have the greatest potential to impact and disrupt the healthcare market. For more information, visit VaticaHealth.com.

AmeriHealth Caritas, Blue Cross Blue Shield, Optum at Home & Reema Health share bright spots and novel tactics for engaging dual eligible beneficiaries. Discussion topics include: building a foundation of trust through a community approach, engaging hard-to-reach or historically unreachable members, and addressing health-related social needs to improve clinical outcomes   Panelists Include: Christopher McDade, Vice President, Medicare Integrated Health Plans and Revenue Management, AmeriHealth Caritas,  Leanna Moran, Managing Director of the Duals Market, Blue Cross Blue Shield of Rhode Island Catherine Mitchell, Chief Strategy Officer, Optum at Home Melissa Kjolsing, Head of Engagement Strategy, Reema Health Bios: https://www.sharedpurposeconnect.com/events/unique-approaches-to-building-trust-with-dual-eligible-members/ This episode is sponsored by Reema Health Reema is transforming how people navigate the gaps between health care and social care using technology and Community Guides who share their identity with the members they serve. Reema’s approach improves healthcare experiences, leading to higher member engagement and reduced costs.    Reema’s breakthrough health platform uses proprietary technology and predictive data modeling to identify people with the highest level of unmet social needs, power Community Guides with the right information to engage them meaningfully, connect them with the most relevant resources, and improve their health and lives. Because they believe in guiding all members to better health. Learn more at reemahealth.com

Joanne Mizell, Chief Operating Officer,  Banner|Aetna – a joint venture between CVS Health’s insurance arm, Aetna, and health system Banner Health – joins Eric to discuss what makes Banner|Aetna unique from other health insurers and its approach to whole person care.    She shared how the company uses MultiDisciplinary Care Teams to provide high-risk patients with a localized, high-touch, intensive care management strategy with a unique care approach to meet patients face-to-face. In addition to sharing numerous bright spots, including a Type 2 Diabetes Reversal program, Joanne lays out a blueprint for building innovative, whole person care programs.   About Joanne Joanne joined Banner|Aetna in February 2018 with over 20 years of Aetna experience and nearly 30 years in the Employee Benefits industry. In this role, and as a member of the executive leadership team, Joanne oversees the organization's operations. She supports the execution of the strategic goals set by Banner|Aetna’s Board of Directors and Chief Executive Officer.   Bright Spots in Healthcare has a new website! Please visit: https://www.brightspotsinhealthcare.com/   Register for our Payer & Provider Executive Summit on August 24 & 25 in Boston.: https://www.eventbrite.com/e/469644799237

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. 

Healthcare leaders from United Health Group, Blue Shield of California, Highmark, Oklahoma Complete Health (Centene) and TytoCare share real-world, virtual care success stories. Gain insight into how virtual care boosts outcomes improves equity and reduces costs. Hear case studies, lessons learned, and best practices you can implement in your organization.   Topics include: Engagement, Experience and Equity Plan Design Local as a Strategy and Hybrid Care   Industry Experts: Nina Birnbaum, Medical Director, Innovation Acceleration, Blue Shield of California; Barbara Koch, Senior Vice President, Office of Health Equity, UnitedHealth Group;  Timothy Law, DO, Chief Medical Officer, Highmark; Douglas Olivo, Director of Rural Care and Telehealth Services, Oklahoma Complete Health, a subsidiary of Centene; Si Yahav Tirosh, Director of Engagement Labs, TytoCare Bios: https://www.sharedpurposeconnect.com/events/success-stories-in-virtual-care-enrollment-engagement/ This episode is sponsored by TytoCare TytoCare allows users to access quality medical care anytime, anywhere, enabling providers to conduct a comprehensive examination of the ears, lungs, heart, throat, heart rate, temperature, skin, abdomen, and more ..all remotely. TytoCare’s handheld exam kit and app connect users with a clinician or specialist for a medical exam and telehealth visit no matter where they are. Clinicians can access clinical-quality exam data to help ensure patients receive the best remote diagnosis and treatment possible. Health providers, insurers, hospitals, clinics, businesses, and schools worldwide are leveraging TytoCare’s remote exam system to deliver on the full promise of telehealth. And when it comes to product design and the consumer experience, no one has them beat.  Companies who are already leveraging their knowledge and platform include Kaiser, Elevance, Amazon and the NHS to name a few. TytoCare is fully compliant and cleared with regulatory bodies, including FDA, CE, HealthCanada, ISO medical, HIPAA, HITRUST, and GDPR.  Visit: www.tytocare.com  

Senior leaders from Cigna, Independent Health, Regence, and Socially Determined join Eric to discuss how minimizing social risk helps plans garner higher quality and performance scores. Learn successful strategies for identifying, engaging, and addressing members with elevated social risks to drive gap closure and member retention. The session is full of bright spots you can implement in your organization! Panel:  Kathleen Faulk, Senior Vice President & General Manager, Government Programs, Regence; Angela Kloepfer-Shapiro, MD, MBA, Regional Medical Executive, Northeast and West Regions, Cigna Medicare Advantage;Dawn Odzywolski, Vice President, Medicare Programs, Independent Health; Ashley Perry, MPH, Chief Strategy & Solutions Officer, Socially Determined Bios:  https://www.sharedpurposeconnect.com/events/mitigating-social-risk-to-achieve-higher-star-ratings/   Summit Registration: https://www.eventbrite.com/e/469644799237   This episode is sponsored by Socially Determined Socially Determined is leading the transformation of healthcare delivery and payment through social risk analytics and solutions. Our SocialScapeⓇ SaaS platform, data and industry-leading expertise empower health systems, plans and other risk-bearing organizations to manage risk better, improve outcomes and advance equity at scale. Recently named by Fierce Healthcare as one of the 15 most promising healthcare companies, Socially Determined is headquartered in Washington, DC. Visit the website at www.sociallydetermined.com.

A well-crafted story can pack the emotional punch to turn routine presentations into productive relationships. Organizational storytelling expert and author Paul Smith joins Eric to share his popular and proven formula for telling a story. Paul discusses the following:  What is the optimal structure of a story? What different types of stories should we all have at our fingertips for our meetings with health plans and provider organizations? How do we leverage these stories to make a sales pitch? How do we use storytelling to close a sale?   At the end of the episode, you’ll have a blueprint for a new storytelling strategy for their sales organization!   About Paul Paul Smith is one of the world’s leading experts on organizational storytelling. He’s one of Inc. Magazine’s “Top 100 Leadership Speakers of 2018” and the author of three Amazon #1 bestsellers: Lead with a Story (now in its 11th printing, and published in 7 languages around the world), Sell with a Story, and The 10 Stories Great Leaders Tell; in addition to Parenting with a Story and his newest work, Four Days with Kenny Tedford. He’s a former executive at The Procter & Gamble Company and a consultant with Accenture before that.   Buy Paul’s book, Sell with a Story: https://www.amazon.com/Sell-Story-Capture-Attention-Build/dp/0814437117 Paul’s website: https://leadwithastory.com/

Industry leaders from MetroPlusHealth, Network Health, Priority Health and ReferWell discuss strategies to advance health equity and improve care access to achieve higher Star Ratings. As health equity initiatives play an increasingly important role in CMS programs, Medicare Advantage plans must commit to addressing social factors hindering access to care and driving members to take action to improve their health, such as scheduling a preventive care visit or completing a missed screening.  Topics include: Creating a true health equity strategy   Using a personalized approach to reaching the unreachable members Creating a trustworthy, comfortable approach to care access Navigation and scheduling Partnering with CBOs   Panelists: Elizabeth Benz, Vice President of Quality and Clinical Integration, Network Health; Gene Huang, Executive Chairman, ReferWell; Brindha Sridhar, Vice President, Customer Experience Strategy, MetroPlusHealth; Alexandria Tusek, Director, HEDIS & Data Analytics, Priority Health   Panelist Bios: https://www.sharedpurposeconnect.com/events/equity-timely-access-as-a-stars-strategy/   Bright Spots in Healthcare is hosting our first in-person event on August 24 & 25, 2023, in Boston.  The Executive Roundtable Summit is a unique and transformative gathering, bringing together like-minded leaders from health plans, ACOs, health systems, hospitals, government agencies and community-based organizations for large-scale conversations that matter to the future of healthcare.   Payer & Provider Roundtable Summit brochure:  https://images.magnetmail.net/images/clients/SPC_/attach/SPCEventBrochure3.pdf   Summit Registration:  https://brightspotssummit.eventbrite.com   This episode is sponsored by ReferWell ReferWell helps health plans advance health equity by scheduling underserved members for the care they need, be it medical, care gap appointments or — through your community partnerships — appointments for services like transportation assistance, nutritional counseling, mental health services and other community-based organization offerings.  

Carle Health, Cedars-Sinai, Cleveland Clinic, and CarePort, powered by WellSky, discuss innovative and novel approaches to care coordination. Topics include: real-time transparency, streamlining and improving communication, and Interoperability between partner organizations. Panelists: Cynthia Deculus, Chief Population Health Officer and Vice President, Population Health, Cedars Sinai; Margie Zeglen, MBA, RHIA, Vice President, Population Health, Carle Health; Jessica Hohman, MD, MSc, MSc, President and Medical Director, Cleveland Clinic Medicare Accountable Care Organization; Lissy Hu, M.D., MBA, President, Connected Networks, CarePort, powered by WellSky Bios: https://www.sharedpurposeconnect.com/events/novel-approaches-to-care-coordination-the-key-to-profitable-risk-models/   This episode is sponsored by CarePort, powered by WellSky CarePort is the leading care coordination network of 2,000 hospitals and 130,000 post-acute and community providers. The end-to-end platform bridges acute and post-acute EHRs, providing visibility into the patient journey for providers, physicians, payers and risk-bearing entities.  With CarePort, healthcare professionals can efficiently and effectively coordinate patient care with visibility and intelligence to manage patients as they move through the continuum. Visit website at: www.careporthealth.com

CareMount Health Solutions, VillageMD and Socially Determined leaders discuss the incentives and requirements laid out by the new ACO REACH model and how organizations can develop action plans to identify differences or disparities in their members' health status.  CMS replaced the Global and Professional Direct Contracting (GPDC) Model with the redesigned ACO Realizing Equity, Access, and Community Health (REACH) Model in 2023. ACO REACH is the first accountable care model to directly address health equity and access to care, with a specific directive to meet the needs of patients from marginalized and underserved communities.  Whether you participate in ACO REACH, the model provides vital insights into the future of value-based care and care collaboration.  Panelists: Gary Jacobs, Executive Director, Center for Government Relations and Public Policy, VillageMD; Kate Casaday, MPH, Director of Market Operations, CareMount Health Solutions; Ashley Perry, MPH, Chief Solutions Officer, Socially Determined Bios: https://www.sharedpurposeconnect.com/events/aco-reach-advancing-equity-and-optimizing-performance/   This episode is sponsored by Socially Determined Socially Determined is leading the transformation of healthcare delivery and payment through social risk analytics and solutions. Our SocialScapeⓇ SaaS platform, data and industry-leading expertise empower health systems, plans and other risk-bearing organizations to manage risk better, improve outcomes and advance equity at scale. Recently named by Fierce Healthcare as one of the 15 most promising healthcare companies, Socially Determined is headquartered in Washington, DC. Visit the website at www.sociallydetermined.com.

Dr. Errol L. Pierre, Senior Vice President, State Programs at Healthfirst, joins Eric to discuss how health plans, providers and other organizations can create a culture of health equity. He notes the challenges of obtaining the data necessary to understand where to start. Errol advises organizations to gain the patient's or member's trust to get the information. He also touches on setting ROI expectations for health equity programs, defining terms to normalize the discussion of health disparities within the organization and the business imperative of diversity.  Errol shares his identity-defining moments and experience as an executive of color in the healthcare industry. He talks about his new book,  The Way Up: Climbing the Corporate Mountain as a Professional of Color,  which profiles Errol’s career journey from working in a beauty salon warehouse to being a health insurance executive. The book also offers guidance from prominent executives of color and delivers a pragmatic and actionable guide to help underrepresented individuals from all ethnic backgrounds uncover their passion for achieving their professional goals and elevating their careers.   About Errol   Dr. Errol L. Pierre is a business executive, healthcare strategist, public speaker, professor, and author. He currently serves as a senior executive of Healthfirst, the largest nonprofit health plan in New York. He is also the former Chief Operating Officer of Empire BlueCross BlueShield, the largest for-profit health plan in New York.   Errol graduated from Fordham University with a bachelor’s degree in Business Administration. He later obtained a master’s degree in Health Policy and Financial Management from New York University. He completed his Doctorate in Business Administration from the Zicklin School of Business at Baruch College, focusing on Health Economics. He is a professor at Baruch College, Columbia University, and New York University, teaching Health Economics and Health Transformation and serves on several boards, including the Arthur Ashe Institute for Urban Health and MediNova.                                      

Leaders from Blue Cross Blue Shield Association; Horizon Blue Cross Blue Shield of New Jersey, and Icario, offer insights on the priorities to focus on as we enter 2023. As we turn the page from 2022, health plans are facing new challenges impacting member experience, retention, and, most importantly, their member’s health. Topics include: the new reality health plans and members will face once the PHE ends and how getting ahead will avoid significant membership losses; CMS’ increased weight on CAHPS surveys will lead to more focus on member satisfaction; New Social Need Screening and Intervention (SNS-E) requirement means that plans will need to get more serious about members’ social needs by 2025 Panel: Mikal Sutton, Managing Director, Medicaid Policy, Blue Cross Blue Shield Association; Mildred Menos, Director of Member Advocacy and Community Outreach Transformation, Horizon Blue Cross Blue Shield of New Jersey; Steve Wigginton, CEO, Icario Link to bios: https://www.sharedpurposeconnect.com/events/2023-strategy-session-member-redetermination-cahps-and-social-needs/ This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through extrinsic and intrinsic motivations. Learn more at icariohealth.com.

Healthcare leaders from Blue Cross NC, KC Blue, Blue Cross MN and MOBE explore how leading health plans can leverage innovations in clinical, wellness and medication management to build and expand a whole-person care framework. Topics include: building digital care models for Whole-Person Care, developing an integrated whole-person solution; Leveraging pharmacy and medical claims data; and coordinating physical, behavioral and SDOH care. Panelists: Angela Lynn, Director of Care Management, NC Blue Cross; Laurie Gehrt, MSN, MBA, RN, CSMC, FACHE, Department Vice President, Care Management, KC Blue; Amy Bloomquist, Director of Population Health Design, Blue Cross MN; and Leslie Helou, PharmD, Vice President, Medication Strategies, MOBE Bios: https://www.sharedpurposeconnect.com/events/how-to-add-innovation-to-whole-person-care/ This episode is sponsored by MOBE MOBE is a health outcomes company. They improve health by providing a high-touch one-to-one coaching program focused on lifestyle, emotional well-being, and comprehensive medication management. Using advanced analytics, MOBE identifies populations where they can make a real difference in both individual health status and expense reduction for large employers and health plans. For more information, visit www.mobeforlife.com.   

Health leaders from Network Health, Health Net, Priority Health, and Health.io discuss how top health plans improve risk assessment and quality measures through innovations and at-home testing.    Topics include: Strategies for deploying novel solutions to drive member engagement and reduce costs for members, especially among traditionally unengaged populations Why removing barriers to testing with at-home solutions is a boon to health equity How accurate staging improves health outcomes for members with chronic conditions Working with provider networks for better management of members’ health   Panelists: Pooja Mittal, MD, Vice President, Chief Health Equity Officer, Health Net, Inc.; Megan Schmidt, Sr. Vice President, Employer Solutions, Priority Health; Mushir Hassan, MD, Chief Medical Officer, Network Health; Jonah Mink, MD, Medical Director, Healthy.io   This episode is sponsored by Healthy.io Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for an at-home urinalysis and digital wound management.    Their at-home kidney test, Minuteful Kidney, aids in the early detection of chronic kidney disease and helps close gaps in access and care for over 500,000 patients worldwide. It is the first and only smartphone-powered home kidney test to receive FDA clearance and the first digital health test to obtain FDA clearance across all smartphone devices.    Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high completion rates, and huge potential savings.   They are the first company to convert your smartphone into a clinical-grade medical device to allow patients to take the test – and receive results – in the comfort of their homes.  

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. 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 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/

Julianne Eckert, Senior Director of Clinical Quality, Clover Health, Andre Bliss, Director of Medicare STARs, UPMC Health Plan and Marisa Howard, Senior Director, MA Operations, Evolent Health, share practical strategies and best practices to help Medicare Advantage plans to execute a successful star rating strategy. Learn significant trends and gain critical insights to help your plan earn and sustain a 4+ star rating in an era of rapid change!   This episode is sponsored by Evolent Health Services Evolent Health Services is disrupting healthcare administration, generating exceptional clinical efficacy and better risk adjustment for health organizations while simplifying the overall administration process. Similar to what Tesla did with automobiles and Amazon did with retail, Evolent Health Services is helping to transform our healthcare industry from antiquated to innovative. The uniqueness of Evolent is TECH: they have the industry’s only trustworthy end-to-end integrated platform, along with  TOUCH: some of the most innovative people in the business know how to operate the solution for and with every type of health plan.or risk-bearing provider org  

Omolara Thomas Uwemedimo, MD, MPH joins Eric to discuss place-based interventions and how they are used to address health inequities. The place-based model focuses on improving health that aligns with community members, businesses, schools, churches and other institutions in a specific geographic location (a specific community or zip code). Omolara is a healthcare social entrepreneur, board-certified pediatrician, community health equity consultant, career transition & business coach, public health researcher & health justice advocate. She is CEO & co-founder of Strong Children Wellness, a multi-award-winning healthcare practice network in NYC, providing integrated physical, mental, and social health services for low-income communities of color.    This Episode of the Bright Spots in Healthcare is sponsored by Socially Determined Socially Determined is leading the transformation of healthcare delivery and payment through social risk analytics and solutions. Their social risk analytics platform, SocialScape, social risk data and industry-leading expertise empower health plans, providers, and other risk-bearing organizations to manage risk, improve outcomes, and advance equity at scale. To learn more, visit sociallydetermined.com  

Experts from Centene, Humana, UnitedHealthcare and TytoCare discuss leveraging hybrid-care models to improve access to care, close gaps in care and improve outcomes. Learn successful strategies and best practices you can implement in your organization. Hybrid care models provide a more personalized, flexible, and seamless patient journey, improving the in-person experience and giving patients more autonomy over their care.   Panel:  Tracy Rico, Director, Virtual Care Services, Superior HealthPlan (Centene Corporation); Erika Pabo, MD, MBA, Vice President Transformation & Central Operations, Centerwell/Humana; Donna O’Shea, Chief Medical Officer of Population Health Management, UnitedHealthcare; Elizabeth Hyatt, Director of Payer Solutions, TytoCare Bios: https://www.sharedpurposeconnect.com/events/how-hybrid-models-transform-value-based-care/ This episode is sponsored by TytoCare TytoCare is one of the world leaders in enabling providers to practice healthcare virtually. Imagine remote physician exams from your home. TytoCare has a consumer-friendly, remote exam system to deliver on the full promise of telehealth. https://www.tytocare.com/

Featuring Blue Shield of California, CommonSpirit, Kaiser Permanente, and Partnership to Align Social Care. The delivery of social care services in connection with healthcare requires new systems to organize the relationships and activities of healthcare payers, providers, community-based organizations (CBOs), and community members.  This panel will discuss integrating social care into healthcare delivery and the need for the organized delivery of social care services, including care coordination, through a multi-stakeholder health and social care ecosystem, as part of a whole-person approach to health.   Ji Im, MPH, Senior Director for Community and Population Health, CommonSpirit Sherry Novick, Community Health Lead, Social Health Practice, Kaiser Permanente June Simmons, MSW, CEO, Partners in Care Foundation Tim McNeil, COO & Founder, Freedmen’s Health Bios: https://www.sharedpurposeconnect.com/events/co-designing-social-care-payers-and-providers/ This episode is sponsored by the Partnership to Align Social Care Personal and community health outcomes significantly depend on our social, economic, and community conditions. Meeting our communities' social care and health care needs requires strengthening our systems of care and aligning health and social care. The Partnership to Align Social Care aims to achieve precisely this goal. We are a national collaborative that brings together healthcare and community leaders to co-design systems of care that will better meet the health and social care needs of individuals and communities. Learn more and join our efforts by visiting our website, www.partnership2asc.org.

Featuring: Blue Cross and Blue Shield of Michigan, Blue Cross and Blue Shield of Kansas City, Johns Hopkins HealthCare and Linkwell. Motivating Medicare members to take action to improve their health is a high priority for health plans. Our panel explores how health plans can meet members where they are at the right time and with the right message. Hear success stories and “bright spots” you can implement in your organization! Panel: Nathan Adams, CEO & President, Linkwell Health Bob Crawford, Vice President, Corporate Marketing and Customer Experience, Blue Cross Blue Shield of Michigan  Monett Jackson, Medicare Sales Strategy Manager, Blue Cross and Blue Shield of Kansas City Marketa Wills, MD, Chief Medical Officer, Johns Hopkins HealthCare https://www.sharedpurposeconnect.com/events/activate-todays-medicare-member-effective-engagement-strategies/ This panel is sponsored by Linkwell Health Linkwell Health is a consumer engagement technology company that creates healthy experiences for consumers by guiding them to take action to improve their health. Linkwell ’s world-class content and engagement programs are seamlessly delivered via their technology platform, designed to drive health engagement, activations, retention, and business results for some of the largest health plans and health services providers.  

Landmark Health CEO Chris Johnson joins Eric to share his vision for the aging health system of tomorrow and his organization’s mission to help seniors age in place by extending primary and urgent care into the homes of patients with challenging illnesses. Finally, Chris talks about the shift to value-based care and how providers can navigate the new landscape by leveraging technology to create and execute the most effective care plan for each individual.   Launched in 2014, Landmark currently is in 25 states with around 300,000 patients. By the end of next year, the integrated health provider will be in about 40 states with just over half a million patients. A fully mobile medical group, Landmark brings medical care into the homes of seniors and chronically ill patients. These home-based visits are conducted by doctors, advanced practitioners, and care team members to supplement the care patients receive from their primary care providers and specialists – at no additional cost.    Chris joined Landmark in 2017 as Vice President and General Manager, responsible for launching the New England market. Most recently, Chris has served as Landmark’s Head of Corporate Development, responsible for the company’s growth strategy, strategic partnerships, mergers and acquisitions, and public policy. In this position, Chris was integral in spearheading Landmark’s merger with Optum and leading the company’s integration into Optum’s Home and Community platform. He was named one of Aging Media Network’s 2022 Vision Series Leaders.   Before Landmark, Chris was a Principal at Innosight, a healthcare-focused growth strategy consultancy and Co-founder of Predilytics, a healthcare analytics business. Chris holds a Bachelor of Arts in economics from Harvard College. He also received his M.B.A. from Harvard Business School.   This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through extrinsic and intrinsic motivations. Learn more at icariohealth.com.  

Featuring Healthfirst, Colorado Access and Icario. The impending need for state Medicaid agencies and plans to administer redeterminations for Medicaid beneficiaries poses a risk of lost coverage for nearly 15 million individuals, especially for the vulnerable D-SNP population. Our expert panel provides insights into the groundwork needed to educate members about the requirements. Panelists: Marty Janssen, Senior Program Director, Colorado Access; Errol Pierre, Vice President, State Programs, Healthfirst; Andrey Ostrovsky, MD, FAAP, Former US Medicaid Chief Medical Officer, Managing Partner, Social Innovation Ventures; Aanchal Falken, Vice President, Strategy & Business Development, Icario   Bios: https://www.sharedpurposeconnect.com/events/redetermination-strategies-to-maximize-continuous-medicaid-coverage/   This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through extrinsic and intrinsic motivations. Learn more at icariohealth.com.

Healthcare leaders from Avera, Blue Shield of California, Renown Health and the Partners in Care Foundation discuss solving the last mile In healthcare, the link between the consumer and where care is delivered. When consumers can’t pass through the last mile connection to the healthcare delivery system, they never even get an opportunity to engage with healthcare up close. Our panel will share success stories and best practices for improving access, creating a new business model and engaging consumers in their care. Panelists:  Mitchell Fong, Vice President of Virtual Care, Renown Health Daniel Rivas, Senior Manager, Community Health, Blue Shield of California Rhonda Weiring, Vice President, Clinical Innovation, Avera @Home Dianne Davis, Vice President, Community Wellness, Partners in Care Foundation   Bios: https://www.sharedpurposeconnect.com/events/novel-approaches-to-last-mile-care/   This episode of Bright Spots in Healthcare is sponsored by Partners in Care Foundation. The Partners in Care Foundation aligns social care and health care to address the “Social Determinants of Health” that routinely affect diverse, under-served, and vulnerable populations. PICF serves as a bridge between medical care and what individuals can accomplish on their own at home, achieving greater equity of conditions and effectiveness of care. Partners’ evidence-based programs and services have been demonstrated to improve quality of life, help participants avoid suffering, and reduce costly hospital readmissions, Emergency Department visits, and nursing home placements.   For over two decades, the Partners in Care Foundation has been innovating and improving SDOH solutions and driving life-changing, life-saving alignment between social care and health care for those we serve. Please visit https://www.picf.org for more information.  

  Dina CEO Ashish V. Shah joins Eric to discuss the advantages and challenges in transitioning care from the hospital to the home. He shares what it takes to replicate the facility-based experience outside of the hospital and deliver measurable quality improvements cost-effectively. Ashish provides a step-by-step blueprint for creating an exceptional transition-to-home care model you can replicate at your own organization.    Our GuestAshish V. Shah is CEO of Dina  Ashish leads the Dina (Dena) team on its mission to power the healthcare industry’s transition to virtual and in-home care. He founded the company in 2015 and remains passionate about empowering care teams with the tools they need to help people age. A recognized thought leader, Shah previously served as CTO at Medicity, the market leader for vendor-neutral Health Information Exchange solutions (acquired by Aetna in 2011).    This episode is sponsored by Dina Dina powers the future of home-based care with its care-at-home platform and network that can activate and coordinate multiple home-based service providers, engage patients directly, and unlock timely home-based insights that increase healthy days at home. Dina works with many leading health systems, ACOs and health plans to extend their reach into the home to help people live their best lives.   The platform creates a virtual experience for the entire healthcare team so they can communicate with each other--and help patients and families stay connected--even though they may not physically be under the same roof. Dina helps professional, and family caregivers capture rich data from the home, using artificial intelligence to recommend evidence-based, non-medical interventions. 

Josh Weisbrod from Network Health and Keslie Crichton and Sean Libby from BeneLynk join Eric to discuss opportunities and challenges in identifying and converting members to full dual status, including specific examples and an outlined roadmap into this additional revenue stream. After listening to this episode, you will understand: Why identifying members as “full or partial” matters How much revenue you may be leaving on the table What components need to be in place to convert members Our Guests Josh Weisbrod, Vice President, Risk Adjustment, Network Health Josh has over 20 years of healthcare, health insurance, healthcare analytics and human service experience working with local and national companies and state and federal agencies, specializing in health plan operations and data analytics. Sean Libby, President and Co-founder, Benelynk Sean has worked at the intersection of managed care and government benefit programs for the past 19 years. Before BeneLynk, Sean served as the President of Freedom Disability and Alpha Disability, one of the nation’s largest Social Security Disability and Veterans Advocacy companies. Before that, Sean served as Vice President, Sales for SSC Disability, providing government program benefit services for Managed Care Organizations. Keslie Crichton, Chief Revenue Officer, BeneLynk Keslie has over 25 years of comprehensive managed care and healthcare technology experience. Before BeneLynk She spent 13 years as Vice President of Sales at Change Healthcare and its predecessor companies Altegra Health and Social Service Coordinators, helping plans improve risk-adjusted revenue and quality performance scores through dual enrollment and retention, as well as health education campaigns. Acronym Glossary MSP - Medicare Savings Programs ABD- Age Blind and Disabled MAPP - Medicaid Purchase Plan SSI - Supplemental Security Income QMB - Qualified Medicare Beneficiary SLMB - Specified Low-Income Medicare Beneficiary QI-1 - Qualifying Individual SNAP - Supplemental Nutrition Assistance Program LIS - Low-Income Subsidy SSA - Social Security Administration CMS - Center for Medicare and Medicaid Services MAO - Medicaid Add On MA - Medicare Advantage HCC - Hierarchical Condition Category FPL - Federal Poverty Level MAGI - Modified Adjusted Gross Income PMPM - Per Member Per Month HRA - Health Risk Assessment D-SNPs - Dual Eligible Special Needs Plans We are pleased to provide you with this copy of the white Hi Sherry,   Are you leaving revenue on the table? Find out by listening to our new episode, Why You Shouldn’t Settle for Partial Duals, now live on Apple, Google, Spotify, Amazon Music or your favorite podcast app, and YouTube.   Josh Weisbrod, Vice President, Risk Adjustment, Network Health, Keslie Crichton, Chief Revenue Officer, BeneLynk and Sean Libby, President and Co-founder, BeneLynk, join me for an insightful discussion on the opportunities and challenges in identifying and converting members from partial dual to full dual status. Hear specific success stories and walk away with an outlined roadmap for capitalizing on this additional revenue stream.    In addition, we are pleased to provide this whitepaper, Are You Getting Partial Dual Premiums for Partial Dual & Full Dual Risk?, from our partner BeneLynk. I hope you find it valuable.  BeneLynk sponsors this Episode of Bright Spots in Healthcare. BeneLynk is arguably the most innovative Dual Advocacy organization in the country. Benelynk’s mission is to improve people’s lives and positively impact social determinants of health barriers by granting their healthcare partners the necessary information while providing healthcare consumers with the advocacy they deserve. They use innovative technology that enables their people to have a dynamic conversation that flows organically to meet social determinants of health challenges and, as such, can build stronger human connections. This carefully planned combination generates exceptional results. Visit their website at www.benelynk.com

Preventable hospital readmissions cost the healthcare system approximately $25 billion annually, and it is estimated that one of every five Medicare patients is readmitted to the hospital within 30 days of discharge. Our panel of experts shares insights and best practices on lowering readmission rates for patients with chronic health conditions through proven prevention and discharge programs and follow-up plans. Panelists: Troy Garland, MBA, RN, Vice President, Clinical and Quality Operations, Equality Health Sarah Keenan, RN, BSN, MSIHM, Chief Clinical Officer/President, Integrated Care, Bluestone Physician Services Michelle Nelson, Director, Health Improvement, United Regional Health Center ​Ashish V. Shah, CEO, Dina​   This episode is sponsored by Dina Dina powers the future of home-based care with its care-at-home platform and network that can activate and coordinate multiple home-based service providers, engage patients directly, and unlock timely home-based insights that increase healthy days at home. Dina works with many leading health systems, ACOs and health plans to extend their reach into the home to help people live their best lives.   The platform creates a virtual experience for the entire healthcare team so they can communicate with each other--and help patients and families stay connected--even though they may not physically be under the same roof. Dina helps professional and family caregivers capture rich data from home, using artificial intelligence to recommend evidence-based, non-medical interventions. Visit their website at dinacare.com

Digital technology can give organizations more data, giving them more visibility not only into patients’ clinical profiles but also population health profiles and socioeconomic profiles.  Our panel of experts will discuss how health plans can effectively tap the potential of digital technologies to improve care delivery, outcomes and equity for traditionally underserved populations. Learn strategies and best practices you can implement in your own organization! Panelists: Paula Gutierrez, Director, Health Equity, Director of Health Equity for CVS Kidney Care, a CVS Health Company  Seun O. Ross, Executive Director, Health Equity, Independence Blue Cross Paula LeClair, US General Manager, Healthy.io   Panelist bios: https://www.sharedpurposeconnect.com/events/health-equity-how-digital-technologies-are-reshaping-healthcare/   This episode is sponsored by Healthy.io Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for at-home urinalysis and digital wound management  Their smartphone-powered home kidney test (pause) aids in the early detection of chronic kidney disease and helps close gaps in access and care for over 500,000 patients worldwide. Beyond being recently featured by CNBC, Fast Company and the Financial Times, Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high completion rates, and the huge potential savings. They are the first company to convert your smartphone into a clinical-grade medical device to enable at-home testing with instant results.    

Risk adjustment is much more than a regulatory requirement for Medicare Advantage plans –  it can improve the quality of care by providing an accurate picture of each member’s health status and ensuring each member receives the right interventions and treatment.    Providers play an important role in risk adjustment, too. An engaged partnership between health plans and providers is vital to ensure beneficiaries receive valuable benefits.    Our panel of experts from Blue Cross Blue Shield of Illinois, CommuniCare Health Centers, Priority Health, SelectHealth and Vatica Health will share successful strategies and best practices for payers and providers to work in partnership to close gaps in care, achieve better clinical and financial performance, and support value-based care. Hear both payer and provider perspectives on building a successful relationship.   Confirmed Panelists: Jeslie Jacob, Divisional Vice President, Provider Analytics, Reporting & Connectivity, Blue Cross and Blue Shield of Illinois. Rebecca Welling, Associate Vice President, Risk Adjustment & Coding, SelectHealth Lisa Wigfield, RN, BSN, CCM, CRC, CDEO, Clinical Advisor, Risk Management, Priority Health Janie Reddy, DNP, FNP-BC, Director of Family Medicine, CommuniCare Health Centers Hassan Rifaat, MD, CEO, Vatica Health Bios: https://www.sharedpurposeconnect.com/events/elevating-risk-adjustment-by-activating-physician-participation/   This episode is sponsored by Vatica Health Founded in 2011, Vatica Health is the leading provider-centric risk adjustment and quality of care solution for health plans and health systems. By pairing expert clinical teams with cutting-edge, HITRUST-certified technology at the point of care, Vatica increases patient engagement and wellness, improves coding accuracy and completeness, facilitates the identification and closure of gaps in care, and enhances communication and collaboration between providers and health plans. The company’s unique solution helps providers, health plans, and patients achieve better outcomes together. Vatica Health is trusted by many of the leading health plans and thousands of providers nationwide. Vatica Health is a portfolio company of Great Hill Partners. For more information, visit www.vaticahealth.com/.  

Engaging high-needs Medicare and Medicaid members can be a huge barrier to better health and a consistent challenge for even the most innovative health plans. In order to successfully engage these members, health plans must meet them in the communities they live and work and provide the right solutions and resources. Our expert panel of leaders from UnitedHealth Group, UPMC Health Plan, and Reema Health along with the former mayor of Wahington D.C. share how using personalized, community-based solutions helps plans identify member needs, build meaningful relationships, establish trust, navigate care gaps and boost outcomes. Panelists: Cyrus Batheja, National Vice President, UnitedHealth Group; Kendra J. White, Senior Manager, Medicare Community Relations, UPMC for Life; Adrian Fenty, Former Mayor District of Columbia; Justin Ley, Co-Founder & CEO, Reema Health View Panelist Bios on our website This episode is sponsored by Reema Health Reema uses technology to power human relationships with the goal of improving health outcomes for people who are hardest to reach. Reema’s breakthrough health platform uses proprietary technology and predictive data modeling to identify people with the highest level of unmet social needs, power Community Guides with the right information to engage them meaningfully, connect them with the most relevant resources, and improve their health and their lives. For more information visit ReemaHealth.com.  

Socially Determined Co-Founder and CEO Trenor Williams, MD, talks with Eric about the importance of accessing and unlocking the potential of member demographic data,  including race, ethnicity and language, to identify social risk. Specifically, he shared details of his organization’s partnership with CareFirst BlueCross BlueShield to optimize interventions for populations with complex health needs.  CareFirst wanted to understand what drives the decisions people make regarding their health and healthcare but there is a lack of visibility into data and insights outside of the traditional healthcare setting. Socially Determined is helping identify social risks at the social domain level including financial strain, food insecurity, housing instability, transportation barriers, and health literacy challenges, enabling CareFirst to tailor personalized interventions for individuals with elevated health risks due to social drivers of health. Here’s a link to the press release announcing the partnership: https://www.sociallydetermined.com/carefirst-partnership   About Trenor Williams Trenor co-founded Socially Determined in 2017 and is responsible for leading the company’s mission and fundraising activities with strategic investors as well as providing executive oversight to clients. As the son of a social worker, Trenor saw firsthand how the insights his mother gleaned during in-home client visits provided a more holistic story of a person than he ever got as a family physician. Inspired by this experience, he created the company to give organizations full visibility into social risk factors so they could understand its impact on the people and communities they serve and strategically intervene. Prior to Socially Determined, Trenor was the Medical Director of Family Practice at Mammoth Hospital in California. He went on to serve as Lieutenant Commander in the United States Naval Reserve.   This Episode of the Bright Spots in Healthcare is sponsored by Socially Determined Socially Determined is a physician-founded, Social Risk Intelligence and solutions company, providing risk analytics, data, and advisory services to industry-leading organizations committed to assessing and addressing Social Determinants of Health (SDOH) and social risk among the communities and populations they serve – and bear risk for. Visit their website at https://www.sociallydetermined.com/

Loneliness is associated with worsening health-related quality of life, increased mortality, higher risk for a variety of physical and mental health conditions, and other poor health outcomes. While loneliness is typically applied to seniors, it can apply at any age. Michelle Bentzien-Purrington, SVP, Senior Vice President, MLTSS, Molina Healthcare and Cindy Jordan, Co-founder & CEO of PYX Health, share strategies and best practices tied to reducing the impact of loneliness on Medicare and Medicaid populations.  This episode is sponsored by PYX Health Founded pre-pandemic, Pyx Health is the first proven solution used to treat loneliness. The Pyx Health platform combines a friendly technology application with a call center staffed with certified, compassionate humans. We work with health insurers who have demonstrated improving loneliness improves cost (57% reduction in medical spending), health (82% improved loneliness and depression) and engagement (73% feel more connected to care teams).

Featuring: David Shulkin, MD, Former U.S. Secretary of Veterans Affairs Kacey L. Serrano, MPA, CPC, CRC, Director, Medicare Stars and Risk Adjustment, Arkansas Blue Cross and Blue Shield Sean Libby, President, BeneLynk Today, 22% of Medicare Advantage members are veterans of the United States Armed Forces and 5% of Medicare Advantage members use the Department of Veterans Affairs (VA) for some of their healthcare needs. However, many health plans don’t have a full understanding of the care their veteran population needs. Panelists share how Medicare Advantage plans can address social determinants of health (SDOH) for its veteran members by identifying their veteran populations and coordinating care with the VA. Topics for Discussion include: Identifying your Medicare Advantage veterans, discovering the value of documenting VA care and understanding military service as a Social Determinant of Health.   This episode is sponsored by BeneLynk, a national provider of social determinants of health (SDoH) 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. By employing one dynamic conversation that flows organically to meet social determinants of health challenges, we build stronger human connections that are supported by innovative technology. We help Medicaid members to retain their benefits through a comprehensive outreach campaign providing information and assistance. All of our services are customized to the specific geography where we provide services and 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.   Panelist bios available at: https://www.sharedpurposeconnect.com/events/medicare-quality-and-risk-knowing-your-veteran-population/

Reaching hard-to-reach populations takes heart, determination, and support. And it’s hard. Just because you’re communicating, doesn’t mean you’re connecting. Our panel explores ways health plans can make sure they meet their members where they're at and how to navigate the complicated outreach process. Panelists: Merrill Friedman, RVP, Inclusive Policy and Advocacy, Anthem; Ben Line, SVP, Complex Member Services, UnitedHealthcare; Traci Massie, Director, Government Programs, Optima Health; Sara Ratner, SVP, Government Markets & Strategic Initiatives, Icario This Bright Spots in Healthcare episode is sponsored by Icario. Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com  

In order to implement an effective SDOH strategy, healthcare organizations must develop an infrastructure to integrate both clinical and social interventions. Our panel of experts from Melanin & Medicine, MetroPlus Health, Priority Health, ProMedica, and Socially Determined shares best practices, lessons learned, and key considerations to help you design a roadmap to address social determinants of health (SDOH), social risk factors and social needs among the communities, populations and individuals you serve. Panelist bios: https://www.sharedpurposeconnect.com/events/your-new-sdoh-roadmap-integrating-social-care-into-healthcare/   This episode is sponsored by Socially Determined Socially Determined is a Social Risk IntelligenceTM and solutions company, providing risk analytics, data, and advisory services to industry-leading organizations committed to assessing and addressing Social Determinants of Health (SDOH) and social risk among the communities and populations they serve – and bear risk for. To that end, we offer a purpose-built analytics platform, SocialScape®, to quantify, visualize, and mitigate the impact of SDOH and social risk – at scale.   SocialScape generates community-level SDOH risk exposure indices, individual-level social risk factor scores, and advanced analytics that empower organizations to understand how SDOH and social risk impacts key business metrics, including suboptimal utilization, total cost of care, quality measure attainment, and health equity, as well as member engagement, satisfaction, and retention. Our platform and expertise are trusted by organizations across the healthcare ecosystem including health plans, health systems, life science companies, non-profits, and foundations.

 Dr. Jonah Mink, Medical Director of Health.io discusses how health plans can convert data into actionable insights by leveraging focused chronic care service providers with at-home or last-mile care or diagnostics. Jonah also shares how health plans are generating clinical results and revenue from partnerships with service providers and offers guidance on what plans should consider when thinking about a partnership. He also discusses how partnerships with chronic care-focused service providers help reduce health disparities in the community.   Jonah cares deeply about health equity and social justice and has expertise in new models of technology and relationship-based care delivery that address access gaps and improves care quality. Jonah completed his residency training in Family Medicine and Community Health at the University of Pennsylvania works as a family medicine doctor in the U.S. and Israel.   To receive a copy of the Healthy.io whitepaper, Actionable Approaches to Population Health, please complete this form: https://www.sharedpurposeconnect.com/population-health/   This episode is sponsored by Healthy.io Healthy.io is an innovative healthcare company that uses smartphone technology to make remote clinical testing possible. Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for at-home urinalysis and digital wound management. Their home urinalysis kits aid in the diagnosis of chronic kidney disease, urinary tract infections and prenatal testing and serves over 500,000 patients worldwide. Beyond being recently featured by CNBC, Fast Company and the Financial Times, Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high patient adherence and the huge potential savings

Achieving health equity begins with an ability to identify health disparities and their causes Without adequate data and measures, inequities remain unseen and unaddressed. Our expert panel discusses the importance of leveraging data and analytics to understand, measure, and support equity improvement efforts. They will share successful strategies and best practices you can bring back to your organization.   Panelists: R.J. Briscione, Senior Director, Social Determinants of Health Strategy & Execution, Aetna, a CVS Health Company, Merrill Friedman, RVP, Inclusive Policy and Advocacy, Anthem, Inc., Amy Riegel, Senior Director, Housing, CareSource, Nick Jones, Director, Healthy Neighborhoods Healthy Families, Nationwide Children's Hospital, Katie McKillen, Regional President, Market Operations, Evolent Health   This episode is sponsored by Evolent Health Services Evolent Health Services provides modern administrative and clinical capabilities along with managed services to health plans and risk-bearing organizations. We drive operational efficiency through higher levels of automation, enhance member engagement using a modern, fully integrated end-to-end platform, and leverage AI to convert data into actionable insights. visit:evolenthealthservices.com  

Eric goes one-on-one with Chris Delaney, Founder, and CEO of Insignia Health. During the episode, Chris talks about consumer centricity and the importance of the patient activation measure (PAM) for health plans and providers. He provides various case studies and overall guidance on how to successfully implement activation programs that work. This episode is sponsored by Insignia Health Insignia Health provides the only empirically derived and quantifiable model for healthcare organizations, professionals and consumers to co-create personalized healthcare strategies to improve health self-management. By continuously measuring and increasing patient activation, our clients empower individuals to unlock their potential, leading to better health outcomes, lower costs and improved well-being. And now, as part of Phreesia, Insignia Health further expands the spectrum of organizations that can leverage patient activation to achieve their strategic objectives and connect with patients before, during and after their healthcare encounters. Their partners include hospitals and health systems, health plans and insurers, pharmaceutical companies and government health programs around the world, including direct contracts with leading healthcare organizations like the Centers for Medicare and Medicaid Services (United States) and the National Health Service (England). In order to improve a consumer’s health, we have to meet them where they are. The Patient Activation Measure® (PAM®) is a 10- or 13-item survey that measures a patient’s current knowledge, skills and confidence to manage their own health and healthcare. PAM’s design and results are validated by hundreds of published studies from researchers around the world. Visit: insigniahealth.com

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.

Dr. Cynthia Brandt joins Eric to discuss her mission to unlock philanthropy to improve health for children and mothers around the world through the foundation, which directs all fundraising for the Lucile Lucile Packard Children’s Hospital Stanford and for the maternal and child health programs at Stanford University School of Medicine. Cynthia shares some“bright spots” in children’s healthcare today. In addition to the foundation’s mission, the discussion also touches on topics from health equity to the evolution of philanthropy in healthcare.    Cynthia Brandt is Chief Executive Officer & President of the Lucile Packard Foundation for Children’s Health. Since 2018 she has been on a mission—with the outstanding team at the Foundation—to unlock philanthropy to improve health for all kids and moms, in Silicon Valley and around the world. During 20+ years in fundraising and communications, Cynthia has contributed to important missions and great teams as Campaign Director for the Smithsonian Institution, VP for Advancement at Mills College, and Associate Dean for External Relations at Stanford University’s School of Humanities & Sciences. She is grateful and motivated to give back because others’ generosity allowed her to pursue a PhD and MA in sociology at Stanford and a BA in English and fine arts at Vanderbilt. Cynthia is passionate about the potential for science to heal humanity and the planet. She is emphatic that this work must be grounded in empathy and a commitment to lift up all people equally.

Our panel of experts from Commonwealth Care Alliance, Molina Healthcare of Ohio and BeneLynk share best practices for addressing the SDOH needs of your dual eligible members. Walk away with ideas you can implement in your own organization to close gaps in care, improve outcomes, and reduce costs. Topics include: Topics include: Combining technology with the human touch; Segmenting your population by key determinants; Using SDOH Z-Codes to prioritize patient outreach; Designing programs to change behavior; Determining ROI   Panelists: Pamela Tropiano, RN, BSN, MPA, CCM, Vice President, Healthcare Services, Molina Healthcare of Ohio, Inc. Lauren Easton, MSW, L.I.C.S.W. Vice President, Integrative Program Development and Clinical Innovation, Commonwealth Care Alliance Sean Libby, President, BeneLynk   Panelist Bios https://www.sharedpurposeconnect.com/events/leveraging-sdoh-to-increase-dual-eligible-penetration/   This episode is sponsored by BeneLynk, a national provider of social determinants of health (SDoH) 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.  By employing one dynamic conversation that flows organically to meet social determinants of health challenges, we build stronger human connections that are supported by innovative technology. We help Medicaid members to retain their benefits through a comprehensive outreach campaign providing information and assistance. All of our services are customized to the specific geography where we provide services and 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.

Anthem’s Chief Health Officer Shantanu Agrawal, MD, talks to Eric about what the insurer is doing to lessen the effect of social determinants of health (SDOH). He shares the results from Anthem’s recently released report,  Driving Our Health: A study exploring health perceptions in America, a national survey of 5,000 U.S. adults. Anthem conducted the study to raise awareness of the impact social drivers such as housing, transportation, and food insecurity have on our health outcomes. View the report at: https://www.thinkanthem.com/wp-content/uploads/Anthem-SDOH-Results-Report.pdf Shantanu discusses some of the programs Anthem has implemented to ensure its members get the resources they need to live healthy lives. One example he cited was the opening of a locally owned grocery store, Indy Fresh Market, in a food desert in Indianapolis, Indiana. The store was funded by a grant from the Anthem Foundation and the Local Initiatives Support Corp. of Indianapolis.     This episode is the first in a short series of episodes where we will be highlighting bright spots in the community. This grassroots, bottom-up, local approach to health is rapidly gaining momentum as a way to take innovations in technology data collection and analytics, and combine it with the foundational elements of personal, high quality, high touch primary care that Americans received in the 50s and 60s. 

Health plans today are facing simultaneous pressures to improve member experience, increase healthcare quality and reduce costs. Hear how leading health plans are designing and implementing exceptional member experiences, boosting quality rating and helping members achieve better health outcomes! Also, learn how looking at the member experience through a financial services lens yields powerful insights about targeting members with a data-centric approach.    Expert panelists: Cynthia Weiss, RN, MSM, BSN, Director, Quality, Accreditation, and Wellness, AvMed Health Plans; Topher Wurts, Partner, and CMO, Chief Outsiders and Louise Briguglio, SVP, Integrated Experience Group, Icario. View their bios at: https://www.sharedpurposeconnect.com/events/demystify-the-member-experience-to-make-your-health-plan-more-competitive-and-improve-quality-ratings/   This Bright Spots in Healthcare episode is sponsored by Icario. Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com

As healthcare works toward value-based care, closing care gaps and engaging consumers in preventive health is a high priority among payers and providers as it reduces costs and improves health outcomes. In this podcast, leaders from Blue Cross Blue Shield of Illinois, Clover Health, Health.io and Humana share successful strategies for closing gaps in care, improving health outcomes and reduce costs. Topics include preparing for the 2022 and 2023 HEDIS measures, analyzing data, measuring provider performance and the impact of SDOH. Panelists: Nicole Lowery, Director of Population Health Strategy, Office of Health Affairs and Advocacy, Humana Jeslie Jacob, Divisional Vice President, Provider Performance | Provider Analytics, Reporting and Connectivity, Blue Cross Blue Shield of Illinois Julianne Eckert, Director of Quality Improvement, Clover Health Paula Leclair, U.S. General Manager, Healthy.io   This podcast is sponsored by Healthy.io. Healthy.io is an innovative healthcare company that uses smartphone technology to make remote clinical testing possible. Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for an at-home urinalysis and digital wound management  Their home urinalysis kits (pause) aids in the diagnosis of chronic kidney disease, urinary tract infections and prenatal testing and serves over 500,000 patients worldwide. Beyond being recently featured by CNBC, Fast Company and the Financial TImes, Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high patient adherence and the huge potential savings 

In this episode, UnitedHealth Group National Vice President Cyrus Batheja joins Eric to share his inspirational personal story and how it motivates his desire to break down the barriers to healthcare. During the conversation, it becomes clear Cryus is a remarkable individual. He details his family’s journey to America and his experience growing up in this country as a first-generation immigrant. We all get to understand how Cyrus’s background provides him a unique perspective that enables him to be exceptional at his work.  Cyrus advises us on the importance of utilizing empathy as a strategy by driving meaningful cultural change within the workplace. He discusses tactics like poverty simulation, motivational interviewing and special training.  This episode is full of thought-provoking concepts and ideas. Cyrus’s journey reminds us to be thankful for being born in this country and inspires us to improve the quality of life for the consumers we serve. This Bright Spots in Healthcare episode is sponsored by Icario. Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com  

In this episode, Lisa Davis, Senior Vice President and Chief Information Officer at Blue Shield of California (BSC) sits down with Eric to talk about BSC's overall Health Reimagined strategy, BSC's Portfolio Product Models, and their new partnership with Google Cloud. In addition, Lisa dives into criminal and counterintelligence and how the overall data strategies at the Department of Defense and U.S. Marshals  Service influenced BSC’s current data strategy.  A jam-packed conversation full of strategies, tactics, and bright spots! This episode is sponsored by MedorionMedorion created the first and only Health Behavior engine, based on 50 years worth of Behavioral Science expertise integrated into a revolutionary AI Software as a Service (SaaS), focused on "Behavioral Persuasion". The Behavioral Persuasion platform solves healthcare management challenges by understanding the decision barriers members face when taking a decision regarding their health, with the goal of bettering healthcare management and improving the well-being of millions of individuals. Visit www.medorion.com for more information about the platform.

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.

Leaders from Humana, ProMedica, Health Plan of San Mateo, Alliance of Community Health Plans, and Insignia Health share case studies and best practices for leveraging health data to drive consumer activation, improve health outcomes and reduce costs. Topics include: Using AI, machine learning, and language processing to drive more effective communication and activation Engaging providers in consumer activation and engagement Measuring ROI of data investments Utilizing social needs data to engage consumers in underserved communities This episode of Bright Spots in Healthcare is sponsored by Insignia Health Insignia Health empowers healthcare organizations and health professionals around the world to assess patient activation and develop strategies for the efficient application of healthcare resources. As activation increases and individuals become better managers of their health, utilization costs decline and patient satisfaction improves. The Patient Activation Measure® (PAM®) and over 15 years of health activation research form the cornerstone of a complementary suite of solutions that help clinicians, coaches and population health providers improve health outcomes and lower costs. Today, Insignia Health supports the health activation efforts of more than 250 organizations touching the lives of millions of patients in dozens of countries.

Panelists: Cara McNulty, President, Behavioral Health & EAP, CVS | Aetna Claire Neely, MD, FAAP, President & CEO, Institute for Clinical Systems Improvement   The mental health experience can be daunting and lonely with the stigma attached preventing many people from getting the care they need.  With the COVID-19 pandemic exacerbated mental health issues at an astonishing rate, the need for more accessible care has increased significantly.  This panel explores new approaches to reduce the stigma around mental health and make it easier for people to get the treatment they need. The discussion covers the collaborative care model of integrating mental and physical health as well as the components of a new care model being piloted in select CVS HealthHUB locations in partnership with Minute Clinic.   This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.  

Drawing on his decades of interviewing some of the biggest names in sports, business, politics and pop culture, author and Esquire Writer-at-Large Cal Fussman shares how the power of storytelling can help hospitals and health plans make better connections with patients and members. 

Experts from Mass General Hospital, Excellus BlueCross BlueShield, AvMed and Appnovation discuss bright spots in consumer engagement and how to reinvent your patient engagement strategies. Panelists:  Ana Eberhard, Vice President, Member Experience, AvMed Susie Hume, Director of Digital Strategy, Experience and Delivery at Excellus BCBS Susan Edgman-Levitan, PA, Executive Director of the John D. Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital Steve Peretz, Director, Health Experience & Product Strategy, Appnovation   This episode is sponsored by Appnovation Appnovation is a global digital consultancy that combines strategy, user experience and design, technology and managed services to deliver human-centered digital experiences.   Their award-winning team creates standout digital experiences by collaborating with brands to understand the individual challenges and goals for every initiative.    With extensive experience throughout the Life Sciences industry, they work alongside providers and payers to provide the framework to define, execute, and validate digital concepts with their intended patient and caregiver audiences.   To find out more, visit them at www.appnovation.com 

How Payers and Providers Can Drive Better Health Literacy in Underserved Communities Dr. Lisa Fitzpatrick, MD, MPA, MPH, CEO and Founder of Grapevine Health has dedicated her life to improving Health Literacy and diffusing the distrust around healthcare in our underserved communities. During this interview, Lisa shares strategies and tactics to help for payers and providers better address health literacy to reduce avoidable healthcare costs and inspire healthy behaviors. About Dr. Lisa  Lisa Fitzpatrick, MD, MPA, MPH is the Founder, and CEO of  Grapevine Health, an organization that engages and collaborates with patients and the community to improve health literacy and engagement on their terms. improve health literacy and health care engagement by learning and deeply understanding motivations and factors influencing medical decision-making. Dr. Lisa is a medical doctor who has also worked at the Centers for Disease Control and Prevention. Her career has spanned research, clinical medicine, global health, community health education and patient advocacy. She recently served as the medical director for Washington DC’s Medicaid program. She is also a clinical professor and professorial lecturer for the George Washington University School of Medicine and Milken Institute School of Public Health. A member of the Aspen Institute Global Leadership Network, she was selected as a 2017 Aspen Institute Health Innovator Fellow. Dr. Lisa has a Masters in Public Health from the University of California-Berkeley School of Public Health and a Masters in Public Administration from the Harvard Kennedy School of Government.  

Dr. Talya Schwartz, President & CEO of MetroPlus Health Plan joins Eric on the podcast!   Talya and Eric discuss overall strategy and approaches a CEO must consider and how to manage relations with both local municipalities and community--based organizations (CBOs). Talya shares specific examples around how to more effectively build roots within your community and how to implement successful incentive programs for the Medicaid population. Eric asks her about the “how tos” and “how local is local?” when health plans are revisiting their overall community-based strategy.   About Talya Schwartz Dr. Talya Schwartz was appointed President & CEO of MetroPlus Health Plan in 2019. During her tenure, MetroPlusHealth has achieved a 20% growth in membership, a five-star rating from New York State’s Consumer Guide, and an increase in overall net worth. Prior to her appointment, Dr. Schwartz served as the Chief Medical Officer at MetroPlusHealth She was a postdoctoral researcher at the University of Pennsylvania and served as a Fellow at the National Institutes of Health. Dr. Schwartz earned her medical degree from the Sackler School of Medicine, completed her residency in Pediatrics at (may-mon-i-dees) Maimonides Medical Center in Brooklyn, New York, and practiced at the Children’s National Medical Center in Washington, DC.     About MetroPlus Health Plan  MetroPlusHealth is the plan of choice for over 600,000 New Yorkers. It was recently ranked the #1 health plan among all 15 New York State Medicaid plans in overall quality. The health plan’s robust network of primary care doctors and specialists includes many independent community providers. Culturally sensitive, and fluent in more than 40 languages.   Interesting in extending your thought leadership, content market and networking? Consider partnering with Shared Purpose Connect, producers of the Bright Spots in Healthcare podcast. For information on how we can integrate your marketing goals into our programming, please contact Tony Flynn, head of business development & partnerships, at [email protected].   View our upcoming shows, and past guests and episodes, at www.sharedpurposeconnect.com.

As new solutions emerge to help overcome common SDoH barriers, considering how health plans fit into the larger picture comes into focus. Our panel of healthcare leaders share new ideas and approaches to health equity in government programs, including broadband access, food access programs, and more. Panelists include: R.J. Briscione, Senior Director, Social Determinants of Health Strategy & Execution, CVS | Aetna Creshelle Nash, MD, MPH, CHIE, Medical Director for Health Equity and Public Programs, Arkansas Blue Cross and Blue Shield Tejaswita Karve, Ph.D., Director, Quality Improvement, Johns Hopkins HealthCare Lora Alexander, Vice President, Engagement & Design, Icario   This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.  

Value-based care requires new thinking in both how we pay for care (i.e. alternative payment models) and how we engage consumers to seek care (i.e. benefit design). During this podcast, A. Mark Fendrick, MD, Director of the Center for Value-Based Insurance Design at the University of Michigan, discusses the origins and evolution of V-BID and why he believes designing health benefit plans to reduce financial barriers to essential, high-value clinical services is the answer to lowering healthcare costs. Mark, who is also a professor in medicine and public health at the University of Michigan, and shares real-world examples of V-BID implementation and how it has helped public and private payers increase the use of high-value services, lower consumer out-of-pocket costs, and reduce health care disparities. Hew also talks about incorporating digital into V-BID, the differences between V-BID and Value-Based Care, and the challenges of implementing V-BID and how to overcome them.   This episode of Bright Spots in Healthcare is sponsored by Healthy.io.  Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for an at-home urinalysis and digital wound management. Their home urinalysis kit aids in the diagnosis of chronic kidney disease, urinary tract infections, and prenatal testing and is used by leading healthcare systems worldwide.

When intrinsic motivation isn't enough, a different approach to close gaps and increase satisfaction is needed. We know that rewards are effective, particularly with Medicaid members, but what's the magic number, reward, or incentive that sparks action? Our panel of experts - MaryAnn Faralli, Highmark Health Options - Deleware, Marty Janssen, Colorado Access, Daniel Weaver, Gateway Health and Cory Busse, Icario - offer real-life examples of leveraging rewards and incentives to drive Medicaid beneficiaries to take action to improve their health. Learn everything you need to start an effective rewards program for your Medicaid beneficiaries   This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.  

With healthcare costs skyrocketing, one employer found a solution to the high cost of providing healthcare to associates and their dependents. In 1991, Harris Rosen, President & COO, Rosen Hotels & Resorts actively took control of the hotel chain’s healthcare spending with extremely successful results: healthier employees –  and a savings of $460 million in healthcare costs.    Rosen and two members of his executive team - Ashley Bacot, President of Provinsure, and Kenneth Aldridge Jr, RN, BSN, MS-HSA, the Director of Health Services at the Rosen Medical Center - discuss the hotel chain’s cutting-edge healthcare system, which enables associates to achieve quality care, improved outcomes and lower costs.   Hear how the program is structured and the critical factors contributing to its success. Find out if this novel approach is right for your organization.

To be successful in a rapidly evolving and crowded healthcare marketplace, health plans must find innovative ways to connect with consumers where they are and on their terms. While rethinking how to engage consumers, Humana created a fundamentally new service experience to deliver better outcomes and meet the whole-health needs of seniors. During the conversation, Dr. Pabo shares details on the insurer’s journey to create the new service experience — from conception to the marketplace. Hear the trials and tribulations the insurer faced as it implemented Author by Humana and find out how consumers are responding to the new experience. Learn the steps your organization can take a similar approach to elevate the consumer experience.   This episode is sponsored by Insignia Health Insignia Health empowers healthcare organizations and health professionals around the world to assess patient activation and develop strategies for the efficient application of healthcare resources. As activation increases and individuals become better managers of their health, utilization costs decline and patient satisfaction improves. The Patient Activation Measure® (PAM®) and over 15 years of health activation research form the cornerstone of a complementary suite of solutions that help clinicians, coaches and population health providers improve health outcomes and lower costs. Today, Insignia Health supports the health activation efforts of more than 250 organizations touching the lives of millions of patients in dozens of countries.

Every day 79,000,000 Americans choose between paying their medical bills and basic needs like food and shelter. Medical debt destroys the financial stability of large segments of America’s most vulnerable communities and also targets the middle class, driving many families who are barely getting along into poverty. Craig Antico, Co-Founder, RIP Medical Debt and Tammie Jackson, Vice President, Go-to-Market Strategy and Sales, TransUnion Healthcare discuss why they believe it is a smart business decision for healthcare providers to abolish medical debt. Hear why they believe forgiving medical debt can help improve an individual’s health and wellness, and how providers can benefit from debt forgiveness.

Decoded Health CEO Mark Hanson and GYANT CEO & Co-Founder Stefan Behrens, MBA, PhD, joined us for our first-ever innovation debate to discuss their separate approaches to creating a virtual front door for hospitals and health systems, and how their strategies and tools dramatically change both the consumer and provider experience. This Bright Spots in Healthcare Podcast is Sponsored by Inflect Health   Silicon Valley healthcare innovation hub Inflect Health was spun off from parent company Vituity to form a new nationwide, multispecialty investment partnership, owned and led by physicians and healthcare business experts. Headquartered in the San Francisco Bay Area with offices across America, Inflect Health provides guidance and financial support to early-stage healthcare and health-tech companies building promising solutions that offer to meet the needs of today’s evolving healthcare landscape. With its robust access to frontline providers, health systems, and industry players, Inflect Health connects the capital to innovators to physicians, catalyzing real-time, real-world innovation and disruption unlike anyone else.  

Secretary Shulkin, the 9th Secretary of Veterans Affairs, shares bright spots within the Veterans Administration that may be applicable at private hospitals, health systems and health insurers. The discussion touches on topics including consumer centricity, whole-person care, digital health, mental health and innovation. This episode is sponsored by Insignia Health Insignia Health empowers healthcare organizations and health professionals around the world to assess patient activation and develop strategies for the efficient application of healthcare resources. As activation increases and individuals become better managers of their health, utilization costs decline and patient satisfaction improves. The Patient Activation Measure® (PAM®) and over 15 years of health activation research form the cornerstone of a complementary suite of solutions that help clinicians, coaches and population health providers improve health outcomes and lower costs. Today, Insignia Health supports the health activation efforts of more than 250 organizations touching the lives of millions of patients in dozens of countries.

Experts from Banner Health, Brigham & Women’s Hospital, Highmark, Insignia Health and UPMC Health Plan share success stories and best practices on how increasing activation not only helps consumers become better managers of their health but utilization and costs decline and consumer/patient satisfaction improves. Learn how you can implement their innovative ideas in your organization. This episode is sponsored by Insignia Health Insignia Health empowers healthcare organizations and health professionals around the world to assess patient activation and develop strategies for the efficient application of healthcare resources. As activation increases and individuals become better managers of their health, utilization costs decline and patient satisfaction improves. The Patient Activation Measure® (PAM®) and over 15 years of health activation research form the cornerstone of a complementary suite of solutions that help clinicians, coaches and population health providers improve health outcomes and lower costs. Today, Insignia Health supports the health activation efforts of more than 250 organizations touching the lives of millions of patients in dozens of countries.

David Contorno, Founder of E Powered Benefits and Dr. Alex Lickerman, Founder, Chief Medical Officer, and Direct Primary Care Physician, ImagineMD, discuss why primary care should be the foundation of our healthcare system. They also talk about why the financial incentive model for primary care doesn’t work and why direct primary care is a better model. Learn how to financially design a direct primary care program and find out which organizations have implemented successful direct primary care models.

Kevin Lynch is the Founder, President and CEO of The Quell Foundation, discusses how healthcare payers and providers can employ empathy to remove the stigma of mental health and help the millions of Americans suffering from mental illness get the treatment they need.    The Quell Foundation’s mission is to reduce the number of suicides, overdoses, and the incarceration of people with mental health illnesses. Just five years after its inception, The Foundation is a nationally acclaimed mental health organization known for turning advocacy into statistical change, through its prestigious scholarship program and educational documentary series, Lift the Mask.   This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com.

Leaders representing CVS Health, Magellan, medical Mutual and UPMC Health Plan join Eric to share bright spots in chronic disease management programs. View bios: https://www.sharedpurposeconnect.com/bios-03112021/): Ellen Beckjord, Associate Vice President, Population Health and Clinical Transformation, UPMC Health Plan, Caroline Carney, MD, MSc, FAMP, CPHQ, Chief Medical Officer, Magellan Health; Tere Koenig, MD, Executive Vice President and Chief Medical Officer, Medical Mutual; Jonah Mink, MD, Medical Director, Healthy.io; Kenneth Snow MD, Clinical Portfolio Medical Director, Transformation Team, CVS Health This episode of Bright Spots in Healthcare is sponsored by Healthy.io. Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for at-home urinalysis and digital wound management. Their home urinalysis kit aids in the diagnosis of chronic kidney disease, urinary tract infections, and prenatal testing and is used by leading health-care systems worldwide. 

As a result of the COVID-19 pandemic, health plans are transforming how they engage with their members. Expectations are raised as consumers change how they shop, socialize, and live their everyday lives, driving health plans to change their relationships with their members to be more consumer-centric An all-star panel of experts from Anthem, Highmark, Bright Health Plan, and Icario success stories and actionable strategies for creating meaningful experiences to engage and empower members. Panelists include Stacy Byers, Vice President, Customer Experience, Highmark; Mark Dodge, AVP, Stars, Risk and Quality, Bright Health Plan; Merrill Friedman, Senior Director, Disability Policy Engagement, Anthem; and Steve Wigginton, CEO, Icario   This Bright Spots in Healthcare episode is sponsored by Icario. Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com. 

Hear proven results from a successful group medical visit program. Learn how group visits helped patients adopt healthy habits and significantly change behaviors. The session features perspectives from experts representing the different stakeholders — lead physician, advanced provider, team leader, and patient — in a successful group visit program. Find out how Health Plans and Provider organizations can benefit from group appointments and get the blueprint to build your own program. This episode of Bright Spots in Healthcare is sponsored by Healthy.io. Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for at-home urinalysis and digital wound management. Their home urinalysis kit aids in the diagnosis of chronic kidney disease, urinary tract infections, and prenatal testing and is used by leading health-care systems worldwide.   

Randy Oostra, DM, FACHE, President & CEO, ProMedica, and Vic Strecher, PhD, MPH, Professor, University of Michigan School of Public Health, discuss how ProMedica is incorporating “personal determinants of health” to improve care and outcomes. They also share how having a strong life purpose is essential to health and well-being.    Bios: https://www.sharedpurposeconnect.com/bios-01142021/ This Bright Spots in Healthcare episode is sponsored by Icario. Icario (formerly Revel + NovuHealth) is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through the use of extrinsic and intrinsic motivations. Learn more at icariohealth.com. 

Healthcare advocate, entrepreneur, and author Dave Chase discusses why healthcare is so expensive and shares some radical ways to reinvent healthcare during this episode. Dave highlights case studies featured in his new book, Relocalizing Health: The Future of Healthcare is Local, Open and Independent, which details the solutions employers and local community leaders can take to reduce healthcare costs and improve healthcare benefits for their plan members. Listen to this episode to find out:  Why and how healthcare can be provided and funded locally  What healthcare can learn from the craft beer industry  How a boutique hotel in Florida, a town in Sweden, and a community in Alaska all  How you can get a free copy of Dave's book This Bright Spots in Healthcare episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change.  It's really a very fresh way of thinking about engagement and SDOH. Revel Health and NovuHealth announced a merger on October 1, 2020, to create a leading technology platform company focused on healthcare member engagement.  Check them out at www.revel-health.com or www.novu.com  

Our expert panel discusses the importance of listening and responding to the voice of the healthcare consumer to improve the overall patient/member experience, clinical outcomes, and personalized care. Panelists include: David Langer, MD, Chair, Neurosurgery, Lenox Hill Hospital and star of Netflix docuseries Lenox Hill; Melinda Karp, MBA, Executive Director, The Center to Advance Consumer Partnership; and Senior Vice President, Consumer Partnership, Commonwealth Care Alliance; Tom Meier, Vice President - Product Development, Innovation, and Member Experience, BlueCross BlueShield of South Carolina; and David Webster, MD, MBA, VP &, Executive Medical Director, Clinical Services, Highmark Health.   This podcast is sponsored by the Center to Advance Consumer Partnership The Center to Advance Consumer Partnership (CACP) helps organizations realize the often-untapped value of their consumers’ voices. Building on proven approaches pioneered by its founder, Commonwealth Care Alliance, CACP works with innovative healthcare and human services leaders to develop capabilities, build infrastructure, and cultivate relationships that ensure consumers with the most significant needs become enduring organizational partners, invaluable to shaping strategy and action. Together as partners, organizations and consumers are inspired to build trust and co-design solutions that really work to improve outcomes and enhance experiences. 

Our expert panel discusses the importance of listening and responding to the voice of the healthcare consumer to improve the overall patient/member experience, clinical outcomes, and personalized care. Panelists include: David Langer, MD, Chair, Neurosurgery, Lenox Hill Hospital and star of Netflix docuseries Lenox Hill; Melinda Karp, MBA, Executive Director, The Center to Advance Consumer Partnership; and Senior Vice President, Consumer Partnership, Commonwealth Care Alliance; Tom Meier, Vice President - Product Development, Innovation, and Member Experience, BlueCross BlueShield of South Carolina; and David Webster, MD, MBA, VP &, Executive Medical Director, Clinical Services, Highmark Health. This podcast is sponsored by the Center to Advance Consumer Partnership The Center to Advance Consumer Partnership (CACP) helps organizations realize the often-untapped value of their consumers’ voices. Building on proven approaches pioneered by its founder, Commonwealth Care Alliance, CACP works with innovative healthcare and human services leaders to develop capabilities, build infrastructure, and cultivate relationships that ensure consumers with the most significant needs become enduring organizational partners, invaluable to shaping strategy and action. Together as partners, organizations and consumers are inspired to build trust and co-design solutions that really work to improve outcomes and enhance experiences. 

The world of medicine moves fast and constantly changing as evidenced by the COVID-19 pandemic David Nash, MD, MD, MBA, Founding Dean Emeritus, Jefferson College of Population Health, Dr. Daniel David, MD, Medical Director, K2P and Mary Ellen Beliveau, MEd, Founder and CEO, K2P discuss why It’s essential for physicians and providers to keep pace with the latest medical information to transform patient care, enable continuity of care, and mitigate risks across hospitals and healthcare systems. They also talk about how a personalized curriculum  

Our incredible panel of experts discusses how to effectively identify roadblocks to virtual care for patients in more vulnerable and underserved communities. They share strategies for bridging the “digital divide” and improving health outcomes from leaders “in the trenches” trying to improve quality and access. Panelists include Kemi Alli, MD, CEO, Henry J. Austin Health Center; Anita Ramsetty, MD, CCMS, Medical Director, Faculty Advisor, CARES Clinic &  Director, Student Service Learning, College of Medicine; Medical University of South Carolina; Sara Ratner, Senior Vice President, Government Programs and Strategic Initiatives, Revel Health; Jorge Rodriguez, MD, Health Technology Equity Researcher & Hospitalist, Department of General Internal Medicine, Brigham and Women's Hospital.   This Bright Spots in Healthcare episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change.  It's really a very fresh way of thinking about engagement and SDOH. Check them out at www.revel-health.com.

With information on COVID-19 evolving daily,  our expert physician panel shares their thoughts on what we can expect from the virus over the next several months. They will also discuss lessons learned from the past seven months. Their conversation addresses topics tied to antibodies, treatment best practices, racial inequalities, innovation, and more!   Panel: Dr. Michael Saag, one of the most influential infectious disease doctors in the country and who is frequently on a number of major media outlets including C-SPAN, CNN, NBC, ABC and The Washington Post (he also survived COVID-19 back in March) Dr. Ofole Mgbako, an infectious disease fellow at Columbia University Irving Medical Center in Harlem where racial disparities around Covid-19 are at the forefront  Dr. Gregory Katz, a cardiologist at Vassar Brothers Medical Center who will share his experiences (the good, the bad and the ugly) treating COVID-19 patients in the ICU at the height of the pandemic in New York City Harry Saag, MD, FACP, Co-founder and CEO, Roster Health; Hospitalist, NYU Langone Health   This episode of Bright Spots in Healthcare is sponsored by Knowledge to Practice (K2P), a leading provider of personalized, competency-based lifelong learning for practicing physicians, hospitals, and healthcare systems. Through K2P’s advanced digital learning platform, practitioners can assess and maintain core medical competencies and keep pace with emerging medicine. Importantly, K2P’s solutions help transform patient care and mitigate risks across hospitals and healthcare systems.

Reliant Medical Group CMO Dr. Thad Schilling and Chief Behavioral Health Officer Dr. Samuel Nordberg walk us through the health system’s decision to rethink its approach to primary care by embedding mental health into primary care practices. They also discuss the business drivers behind the decision. and why they chose the full spectrum model, which makes mental health a permanent part of primary care, over the more popular collaborative care model.   Thad and Sam’s bios are available here: https://www.sharedpurposeconnect.com/bios-10082020/

Cara McNulty, DPA, President, Aetna Behavioral Health and Sara Ratner, Senior Vice President, Government Programs and Strategic Initiatives, Revel Health discuss the importance of removing the stigma behind mental illness in order to reach  “silent sufferers” - patients suffering in silence rather than seek treatment for their mental disorder. Topics covered include why it’s essential for health plans and systems to identify silent sufferers, how the COVID-19 pandemic increased the need to help silent sufferers and how to measure the financial impact. Today’s Bright Spots in Health Podcast episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change.  It's really a very fresh way of thinking about engagement and SDOH. Check them out at www.revel-health.com.

In this timely and important discussion, our expert panelists discuss strategies for improving health outcomes by reducing race-based obstacles in our healthcare system. They also share success stories on how SDOH initiatives and cultural competency programs are helping to bridge the long-standing racial disparities gap.    Panelist bios can be found on our website: https://www.sharedpurposeconnect.com/bios-09242020/ Today's Bright Spots in Healthcare Podcast episode is sponsored by mySidewalk, a technology company dedicated to empowering changemakers. Their web-based publishing platform allows healthcare and public health leaders to integrate effective storytelling with the largest collection of social determinants data in the country. mySidewalk works with their partners to democratize data and get knowledge in the hands of people who need it, so they can take ACTION around wellness and health programs, policy or legislation that improves the lives of many. This is so critical in making this our country healthier today and moving into the future. For more information, visit mysidewalk.com or contact [email protected].

Today’s healthcare consumers have many choices and practicing empathy can be a key differentiating factor in a crowded marketplace. No app, drug, or medical device can replace genuine human connection. Our all-star panel of experts from Stanford Healthcare, Commonwealth Care Alliance, UPMC, Nemours Children’s Health System, and Barnes-Jewish Hospital, explore the roles empathy and innovation play in helping healthcare payers and providers deliver best-in-class care, services, and experiences. The panel also provides real-life examples of leveraging empathy as part of an overall consumer/patient experience strategy. (Panelist bios are available at: https://www.sharedpurposeconnect.com/bios-09102020/)   This podcast is sponsored by the Center to Advance Consumer Partnership The Center to Advance Consumer Partnership (CACP) helps organizations realize the often-untapped value of their consumers’ voice. Building on proven approaches pioneered by its founder, Commonwealth Care Alliance, CACP works with innovative healthcare and human services leaders to develop capabilities, build infrastructure, and cultivate relationships that ensure consumers with the most significant needs become enduring organizational partners, invaluable to shaping strategy and action. Together as partners, organizations and consumers are inspired to build trust and co-design solutions that really work to improve outcomes and enhance experiences. 

  As COVID-19 spread across the country, primary care practices were forced to transform in a few short weeks. While causing economic upheaval in the health care system, the pandemic also showed how primary care can move into the future and deliver care in multiple ways. Our expert panel discusses the key drivers of primary care transformation, what the future should look like, and how payers and providers can adapt to the evolving landscape. Topics covered during the discussion include virtual care, group visits, integrating behavioral health, racial disparities, remote patient monitoring, value-based payments, medical scribes and more!   Panelists:  Wayne Altman, MD, FAAFP, President, Family Practice Group (The Sagov Center for Family Medicine); Jaharis Family Chair of Family Medicine, Tufts University School of Medicine; Daniel Horn, M.D. Director, Population Health, General Internal Medicine; Associate Medical Director at the Massachusetts General Physician Organization;  Dan McCarter, MD, FAAFP, National Director, Primary Care Advancement, ChenMed;  Karolina Skrzypek, MD, Medical Director in Provider Engagement, Blue Cross Blue Shield of Michigan.  You can find their bios on our website: https://www.sharedpurposeconnect.com/bios-08272020/

The Netflix docuseries Lenox Hill follows four doctors from Lenox Hill Hospital in New York City as they juggle their work and personal lives. Dr. David Langer, one of the show’s stars, shares anecdotes from the acclaimed series and what it was like to perform brain surgery while being filmed. He also discusses how Northwell Health is innovating the consumer experience, engaging patients, and reducing unnecessary hospitalizations. Dr. Langer also reflects on his journey as a doctor.   If you haven’t seen the show, view the trailer on YouTube: https://www.youtube.com/watch?v=Hp04bzD5bJI

During this unique, high-level strategy session, High Performance Organization Expert David Hanna discusses how healthcare organizations can "reinvent" their capabilities to drive more value for patients, members and customers during this ever-changing healthcare landscape.    David has helped some of the world's largest companies including Merck, UnitedHealthcare and Procter & Gamble achieve amazing results. Learn strategies you can use in your own organization to innovate and increase value.

World-renowned endocrinologist Paresh Dandona, MD, PhD discusses the importance of diabetes management and blood sugar control in treating the disease. He shares his groundbreaking research on the treatment of diabetes and the implications the discoveries have not only on patients’ lives but on society as a whole. Dr. Dandona also introduces the innovative certified diabetes educator (CDE) program he established to promote the screening and treatment of diabetes at the primary care level as well as help patients with medication management and controlling blood sugar levels.  Patients working with CDE-Ambassadors saw significant improvement in diabetes control as well as a marked reduction in A1C levels and other cardiac risk factors. He also discusses how this program could be used for the treatment of other chronic diseases. Today’s Bright Spots in Health Podcast episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change.  It's really a very fresh way of thinking about engagement and SDOH. If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Amazon, Marriott, Apple, you name it … they take a much more sophisticated approach than we do in health care, to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent.  We in healthcare have not been that sophisticated in marketing to the patients who are at the highest risk of costing the most money.  Until now.  Check them out at www.revel-health.com.      

Many people know ketamine as a party or street drug but it now used as a novel treatment for patients with treatment-resistant depression. Depression is a common illness worldwide with the World Health Organization reporting more than 264 million people are affected. A large percentage of patients with depression do not respond to standard treatment, leading doctors to find novel treatments for depression including the use of oral ketamine.  Dr. Roger McIntyre, a professor of psychiatry and pharmacology at the University of Toronto founded the Canadian Rapid Treatment Centre of Excellence in a suburb of Toronto, Canada to offer intravenous ketamine infusion therapy to patients with mood disorders.  During the podcast, Dr. McIntyre talks about which patients are good candidates for ketamine use, the proper dosage, and any potential side effects. Dr. McIntyre also talks about the components of a ketamine therapy program, the challenges he faced building his clinic, and what he might do differently if starting again.         

Community hospitals across the country are in the process of reopening services and operations closed as COVID-19 started to spread across the country. Rich Fernandez, president, Beth Israel Deaconess Hospital - Milton in Massachusetts, one of the states hit hardest by the COVID-19 virus, walks us through the hospital's reopening strategy and discusses the steps taken to adjust to the new normal while also ensuring the safety of staff, patients and visitors. Rich touches on all aspects of the reopening from workforce management changes to the implementation of new patient waiting room procedures and everything in- between. He also shares some of the things he was most surprised about during the crisis and what the hospital is doing to prepare for a potential virus surge in the Fall.

Healthcare and community leaders from Bon Secours Mercy Health, CareSource, mySidewalk, and Selfhelp Community Services share success stories on leveraging SDOH and community partnerships to better engage their populations and to improve health outcomes. Find out how to overcome challenges and maximize the partnership. The “bright spots” discussed include food pantries, housing assistance, job support services, and programs for seniors. Today's Bright Spots in Healthcare Podcast episode is sponsored by mySidewalk, a technology company dedicated to empowering changemakers. Their web-based publishing platform allows healthcare and public health leaders to integrate effective storytelling with the largest collection of social determinants data in the country. mySidewalk works with their partners to democratize data and get knowledge in the hands of people who need it, so they can take ACTION around wellness and health programs, policy or legislation that improves the lives of many. This is so critical in making this our country healthier today and moving into the future. For more information, visit mysidewalk.com or contact [email protected].

Dr. Tara Burnett-Lewis discusses how shared medical appointments (SMAs) helped diabetes patients at the Johnston County Public Health Department in North Carolina, lower their A1C scores by 10%. Johnston County has a very rural population so SMAs give patients a sense of community and help them realize they are not alone. Tara shares how peer support helps build the patients’ confidence in their ability to manage their health and maintain active and fulfilling lives. In addition, Tara talks about the value of SMAs and lays out the steps you can take to create your own SMA program.  Today’s Bright Spots in Health Podcast episode is sponsored by Revel Health, which is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change.  It's really a very fresh way of thinking about engagement and SDOH. If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Amazon, Marriott, Apple, you name it … they take a much more sophisticated approach than we do in health care, to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent.  We in healthcare have not been that sophisticated in marketing to the patients who are at the highest risk of costing the most money.  Until now.  Check them out at www.revel-health.com.      

As part of its focus on the social determinants of health, CareSource, a health insurance plan serving Medicaid members in Ohio has invested heavily in programs to provide safe and affordable housing to members to improve both individual and community health. In her role as director of housing at CareSource, Amy Riegel, is responsible for creating innovative approaches to innovative and sustainable approaches to integrating health and housing. In this podcast, Amy discusses how access to safe and affordable housing can improve both the health of an individual and a community. In particular, she shares details of the insurer’s Health Beginnings at Home program, which provides housing to homeless pregnant women in order to decrease infant mortality rates.  Today’s Bright Spots in Health episode is sponsored by Revel Health, who is innovating how healthcare organizations think about pop health and consumer engagement. In brief, Revel Health focuses on understanding people. They know the populations you struggle with like Medicaid or Medicare Advantage, are NOT about population health — it’s about the individual. And this is the most important point I want to make, they approach healthcare differently, by understanding the values and belief systems of the individual, so they can create a personalized plan to drive positive behavioral change.  It's really a very fresh way of thinking about engagement and SDOH. If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Amazon, Marriott, Apple, you name it … they take a much more sophisticated approach than we do in health care, to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent.  We in healthcare have not been that sophisticated in marketing to the patients who are at the highest risk of costing the most money.  Until now.  Check them out at www.revel-health.com.    

World-renowned video marketing expert Todd Hartley discusses how healthcare companies can easily implement and leverage video storytelling to stand out during the COVID-19 pandemic. Drawing on his experience working with celebrities, world leaders, and enterprises, He’ll share the latest tips, tricks, and strategies for successfully using the power of storytelling to your patients, members, and customers.

Communicating and Marketing to Healthcare During COVID-19  As COVID-19 shifts the focus of healthcare organizations towards saving lives, companies marketing to the healthcare industry need to rethink their existing approaches and try new ideas. Hear winning strategies from experts in B2B marketing, social media, content marketing, virtual events, client insights, and market research. In addition, an IT Director from a leading health system shares the secrets to successfully marketing to healthcare organizations during these unprecedented times.

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

During this 90-minute interview, Dr. Harry Saag, an internist at NYU Langone Medical Center, details his two-week battle with the virus and how his bout with the virus impacted how the treated COVID-19 patients when he returned to his job. As he describes his journey to get well, he shares how he cared for his father, who also contracted the disease, the progression of the virus, the symptoms he dealt with and how he knew he was recovered from the virus. Harry also shares the day-to-day challenges he and other health workers face on the frontlines in New York City.

Dr. Cole Zanetti joins me to discuss Why “Positive Deviance” Should be Part of Every Healthcare Organization’s Strategy. Find out why positive deviance should be a part of every healthcare organization’s strategy! Cole outlines how healthcare leaders can begin to adapt a Positive Deviance strategy at your organization and how you can get started. He also covers how an organization can measure the ROI and justify the investment in various Positive Deviance initiatives. It’s a jam packed 50+ minutes full of great insights and ideas. So grab a pen and paper or your tablet and get ready to learn ….. about a really exciting bright spot in healthcare. Today’s episode is sponsored by Roster Health.  Roster is solving for social determinants of health through community health workers.  They ASSIST ORGANIZATIONS ON IMPROVING OUTCOMES IN A VARIETY OF VALUE-BASED ARRANGEMENTS WHERE FINANCIAL OUTCOMES ARE TIED TO PATIENT OUTCOMES SUCH AS: 30-day readmission reduction programs Full-risk contracts Upside and downside risk contracts Bundled payment programs If you are a healthcare organization participating in a value-based contract, check out Roster Health.com. . ... they are a new bright spot in healthcare.

Dr. Samuel Nordberg joins me to discuss why, and how, Reliant Medical decided to rethink their approach to primary care.  If you are in the process of integrating behavioral health with primary care, or are at least thinking about it, this is a must listen!   Sam outlines for us the key components to building an embedded model, the business drivers to why Reliant not only invested in new processes, but new real estate.  He also talks about what healthcare can learn more software developers in building a new program like this,  and we also spend a good amount of time on the blocking and tackling: operations, clinical framework, staffing and of course metrics for success. It’s a jam packed 50+ minutes full of great insights and ideas. So grab a pen and paper or your tablet and get ready to learn  ….. about a really exciting bright spot in healthcare, Reliant Medical Group’s embedded primary care model.    Today’s episode is sponsored by Revel Health.  If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Toyota, Hershey’s, Apple, you name it … they take a sophisticated approach to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent.  We in healthcare have not been that elaborate in marketing to the patients who are at highest risk of costing the most money. Until now. Check out revel health at www.revel-health.com. ... they are a new bright spot in healthcare.  

Dr. Marianne Sumego, Director of Shared Medical Appointments at Cleveland Clinic, joins Eric for a jammed packed conversation about how Cleveland Clinic has mastered the shared medical appointment and how it benefits patients (with an emphasis on diabetics).   Marianne provides you history behind shared appointment and why Cleveland Clinic decided to invest in the program, she informs you on how SMAs are run and we even get to hear how it affects the skeptical, know it all consumer.  We also discuss the power of peer support, we dive into the How Tos so you can get an understanding of what you will need to mimic this program, we dive into HIPAA concerns, medical practice concerns and of course the business drivers Cleveland Clinic considers when financing this innovative approach to engaging and treating consumers with certain illnesses.  If you are in value based care, chronic care or simply love hearing innovating ideas ... this interview will fly by! The  episode is sponsored by Revel Health.  If you have ever talked to the most sophisticated agencies on Madison Avenue, the ones that represent the biggest consumer brands you know like Coke, Toyota, Hershey’s, Apple, you name it … they take a sophisticated approach to identifying consumers, and then understanding the consumer's values well enough to truly influence behavior change, in a way that benefits the brand they represent.  We in healthcare have not been close, to being that elaborate in marketing to our consumers, patients, who are at highest risk of costing the most money. Until now. Check out revel health at www.revel-health.com. ... they are a new bright spot in healthcare.