Brightspotsinhealthcare Podcasts

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 Pro…

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: Prod…

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 …

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 …

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 expe…

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 covera…

Phylicia Schroeder, 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 accom…

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 and business impact this category of medications can have on patients with severe mental illness. Alex shares information on the latest research and develo…

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 un…

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…

G.T. Sweeney, Chief Information Officer, Healthfirst and Sami Boshut, Chief Information Officer, MediSys Health Network, Inc., join Eric to discuss how their organizations collaborated with a technology company to create a cloud-based platform that enables seamless sharing of patient data across the care continuum. The platform connects longitudina…

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…

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 im…

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 performa…

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 imp…

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 p…

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 imp…

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 organ…

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 f…

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…

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 …

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 Presi…

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 red…

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 t…

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 …

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; Levera…

Health leaders from Network Health, Health Net, Priority Health, and Healthy.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 …

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 …

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 ga…

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…

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…

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…

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.…

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 n…

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 educat…

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…

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…

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…

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 thr…

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 trad…

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…

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 fro…

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 inter…

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…

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 th…

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 Po…

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 …

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 guid…

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 …

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 …