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A Conversation with Highmark Leaders - Innovations in Digital and Hybrid Care

Bright Spots in Healthcare

Release Date: 12/17/2024

Navigating Healthcare Interoperability with CommonWell’s Paul Wilder show art Navigating Healthcare Interoperability with CommonWell’s Paul Wilder

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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Innovating Product Design for Growth and Member Engagement show art Innovating Product Design for Growth and Member Engagement

Bright Spots in Healthcare

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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How Plans Can Evolve from Segmentation to Personalization in Population Health show art How Plans Can Evolve from Segmentation to Personalization in Population Health

Bright Spots in Healthcare

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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Predictive Analytics & Proactive Healthcare Leveraging AI to Transform Risk Management and Care Management show art Predictive Analytics & Proactive Healthcare Leveraging AI to Transform Risk Management and Care Management

Bright Spots in Healthcare

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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Revolutionizing Member Engagement: How Icario is Powering Personalized Healthcare Outreach show art Revolutionizing Member Engagement: How Icario is Powering Personalized Healthcare Outreach

Bright Spots in Healthcare

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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A Successful Lifestyle Modification Program  with former Philadelphia Eagles’ VP of Player Performance show art A Successful Lifestyle Modification Program with former Philadelphia Eagles’ VP of Player Performance

Bright Spots in Healthcare

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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Innovations in Senior Care & Value-Based Models with InnovAge’s Richard Feifer, MD show art Innovations in Senior Care & Value-Based Models with InnovAge’s Richard Feifer, MD

Bright Spots in Healthcare

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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Where AI is Currently Saving Healthcare – the Clinic show art Where AI is Currently Saving Healthcare – the Clinic

Bright Spots in Healthcare

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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Driving Digital Healthcare Innovation show art Driving Digital Healthcare Innovation

Bright Spots in Healthcare

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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Exploring Psychedelic-Assisted Therapies with the VA's Dr. Shereef Elnahal show art Exploring Psychedelic-Assisted Therapies with the VA's Dr. Shereef Elnahal

Bright Spots in Healthcare

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...

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Doug Henry, PhD, Vice President and Medical Director of Enterprise Behavioral Health at Highmark Health, and Mari Vandenburgh, Vice President of Health Programs and Solutions at Highmark Health, join Eric to share Highmark’s innovative approaches to transforming care delivery through digital and hybrid solutions.

Topics include:

  • Post-Acute Care Innovations: AHN At-Home Care program’s multidisciplinary approach integrates mental health support to reduce readmissions and save $600 PMPM in total care costs.

  • Addressing Network and Access Gaps: Highmark’s strategic initiatives to expand access through geo-analysis, virtual-first strategies, and enhanced provider partnerships.

  • Virtual Mental Health: A closer look at Highmark’s partnership with Spring Health to provide personalized, outcome-driven mental health care, achieving symptom remission in six weeks or less for 70% of patients with moderate to severe conditions.

  • Living Health Strategy: Leveraging personalized nudges and integrated digital platforms to boost member engagement, with 79% receiving their first mental health care through the program.

  • Innovation for Loneliness and Beyond: Doug shares groundbreaking grant projects, such as using technology and social prescriptions to address loneliness and improve senior care outcomes.

This episode is packed with actionable insights for health plans seeking to close access gaps, enhance member experience, and drive measurable outcomes in mental health and beyond.

Tune in to learn from Highmark’s bright spots and discover strategies to replicate their success.

 

About Doug and Mari

  • Doug is a clinical psychologist licensed in Pennsylvania and California and brings over 20 years of experience in professional applied psychology, including inpatient, outpatient, and administrative assignments. Attracted by the integrated payer-provider model and emphasis on patient-centered treatment, he joined the Allegheny Health Psychiatry and Behavioral Health Institute in 2017 as vice president. In addition to his role at the enterprise, he continues to serve as a leadership dyad for the Institute.

Before joining AHN, Dr. Henry served as clinical administrator at Western Psychiatric Institute and Clinic for UPMC Child and Adolescent Behavioral Health Services, the UPMC Center for Autism and Developmental Disorders, and the UPMC Center for Eating Disorders.

  • Mari is responsible for identifying and managing best-in-class healthcare solutions to improve Quadruple Aim outcomes related to chronic and episodic clinical conditions and validating multi-year business case value drivers and ROI. She has been with Highmark in various roles since 2005. Mari has a Bachelor of Science from Duquesne and a Master of Health Administration from the University of Pittsburgh.

About Highmark Health

Highmark Health is a $27 billion national, blended health organization with one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health’s 44,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, including Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, enGen, and Helion.

 

We’d love to hear from you!

Send your comments, suggestions and ideas to [email protected]

Bright Spots in Healthcare is produced by Bright Spots Ventures.

Bright Spots Ventures brings healthcare leaders together to share working solution or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized, peer events along with sales and go-to-market consulting. We believe that finding a bright spot, and cloning it, is the most effective strategy to improve healthcare in our lifetime.

Visit our website to learn more about the show!

www.brightspotsinhealthcare.com