Unlocking Success Through Specialty Value Based Models
Release Date: 10/04/2024
Bright Spots in Healthcare
What if I told you that in 2025, the way we access and exchange healthcare data will be fundamentally different? For years, we've talked about interoperability—but now, we’re seeing it take shape. Nearly 40% of the CommonWell network and most Q-HINs are responding to patient access requests, opening the door to a new era of seamless, secure, and patient-driven data exchange. Paul L. Wilder, Executive Director of CommonWell Health Alliance, joins Eric to explore the future of healthcare data and the evolving landscape of healthcare interoperability. Learn about the CommonWell...
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Highmark Health, Mass General Brigham Health Plan, SCAN, and TytoCare leaders discuss strategies for creating innovative, high-impact healthcare products. Tune in to learn: How traditional health plans are rethinking product design in the face of growing competition from direct-to-consumer models Strategies for creating more personalized, flexible, and transparent offerings that resonate with today’s healthcare consumers The role of data, technology, and innovation in modernizing health insurance products Real-world success stories from leading organizations who...
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Health plan leaders from Cambia Health Solutions, Highmark Health and League share strategies for driving consumer engagement, improving health outcomes, and optimizing payer-provider relationships. Learn how health plans can shift from broad segmentation strategies to truly personalized, member-centric healthcare by harnessing data, AI, and digital transformation. Learn how health plans are using AI-driven insights to deliver tailored interventions. 📈 Discover how personalization can enhance member satisfaction and retention. 🔍 Hear real-world examples of digital...
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Top healthcare leaders from HAP, Independent Health, Johns Hopkins Health Plans and Prealize Health explore how predictive analytics and artificial intelligence (AI) revolutionize risk management and care delivery. The discussion delves into real-world applications of AI-driven predictive analytics to enhance patient engagement, improve outcomes, and reduce costs. Learn how leading health plans use AI to identify high-risk populations earlier, optimize care pathways, and improve patient outcomes. If you’re interested in the future of healthcare innovation, this is a must-listen! Key...
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Marc Willard, CEO, Icario, joins Eric to discuss Icario’s new, innovative platform and how it improves member engagement and health outcomes. The conversation also touches on the challenges health plans face in adapting to changing member needs, the importance of data integration and organization, and the potential impact of AI-driven solutions on healthcare delivery and cost reduction. Here are some key takeaways from the conversation: The Power of Personalization – Health plans are lagging in using AI and data-driven insights to create truly personalized member experiences. Icario’s...
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Ted Rath, former VP of Player Performance for the Philadelphia Eagles and two-time “NFL Strength and Conditioning Coach of the Year,” joins Eric to share the most effective approaches to creating a Super Bowl contender in the NFL and provide insights on goal setting, mindset shifts, and building sustainable habits. These lessons can be applied directly to your approach to lifestyle modification programs and value-based care strategies. Links: About Ted Rath Ted Rath is the author of and the former Vice President of Player Performance for the Philadelphia Eagles. ...
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Richard Feifer, MD, Chief Medical Officer of InnovAge, joins Eric to explore the transformative potential of the PACE (Program of All-Inclusive Care for the Elderly) model. Richard shares compelling stories and strategies showcasing how PACE integrates medical, physical, social, and emotional care to improve outcomes for seniors and individuals with complex needs. Listeners will gain insights into: The unique interdisciplinary care team (IDT) approach and how it delivers personalized, efficient care. Innovations in reducing hospitalizations and shifting care to home-based settings. ...
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Kenneth Harper, VP & GM of Dragon at Microsoft, joins Eric to discuss how health systems are deploying AI to help busy clinicians. He explains how Microsoft’s AI tool, DAX Copilot, improves access to care by streamlining administrative tasks and lightening clinicians' documentation workloads. Ken shares several examples of health systems successfully using the tool with positive results. The conversation also covers overcoming implementation challenges, including clinician adoption and the future of AI in healthcare. About Kenn Kenn Harper has been working in the conversational AI...
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Michael Serbinis, CEO and Founder of League, sits down with Eric to for a compelling discussion on how digital innovation is reshaping healthcare. Discover how League’s platform empowers health plans like Highmark to deliver personalized, data-driven experiences that simplify navigation, improve engagement, and enhance member satisfaction. Mike shares fascinating insights on: The power of a unified digital front door for healthcare consumers Real-world examples of how League amplifies care access and reduces costs The role of personalization in creating Amazon-like...
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Shereef Elnahal, MD, MBA Under Secretary for Health at the Department of Veterans Affairs, joins Eric to discuss the transformative potential of psychedelic-assisted therapies for veterans. The conversation explores the VA's groundbreaking initiatives, including their funding of studies on MDMA and psilocybin, and how these therapies address conditions like PTSD, depression, and addiction. Dr. Elnahal highlights the VA's role as a leader in mental health research and shares a vision for how these breakthrough therapies could revolutionize care for millions. Learn how veterans...
info_outlineValue-based care leaders from Kaiser Permanente, Premera, UnitedHealthcare and TailorCare discuss the evolving landscape of specialty value-based care. They explain how their plans drive success with innovative approaches designed to optimize care and improve outcomes—even with their most complex, high-cost members.
Our expert panelists share practical strategies for navigating the most effective treatment pathways, from leveraging predictive data and the latest evidence-based guidelines to assessing members’ symptoms and goals.
Topics covered include:
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Strategie Planning
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Technology Enablement
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Solutions in Action
Featured Guests
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Romilla Batra, MD, Senior Vice President, Chief Medical Officer – Clinical Strategy & Solutions, Premera Blue Cross
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Hemant Keny, MD, Lead for Senior Surgical Care Program, Kaiser Permanente Northern California
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Donna Laliberte O’Shea, MD, MBA, CPE, National Vice President, Operations and Chief Medical Officer, UCS Population Health and VBC, UnitedHealthcare
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Rachel Winokur, Chief Executive Officer, TailorCare
Guest Bios: https://www.brightspotsinhealthcare.com/events/unlocking-success-through-specialty-value-based-models/
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. Website: www.tailorcare.com