Predictive Analytics & Proactive Healthcare Leveraging AI to Transform Risk Management and Care Management
Release Date: 02/18/2025
Doubling Down on Medicaid Innovation with Impact Health, HEALI, PHAB, and Vircho
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In this Bright Spots in Healthcare episode, host Eric Glazer brings together an all-star panel of leaders who are reshaping the future of Medicaid and social care. Our guests include: Laurie Stradley, CEO, Impact Health Lori Andrade, EVP, Health Equity Alliance of Long Island (HEALI) Joneigh Khaldun, MD, President & CEO, Public Health Accreditation Board (PHAB) Evan Jones, Chief Strategy Officer, Vircho Together, they explore: How community-based organizations (CBOs) are evolving into trusted healthcare partners Practical strategies for bridging healthcare and social care at...
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How Disruptors Defy the Odds with Dr. Imamu “Mu” Tomlinson
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What does it really take to challenge the status quo in healthcare, and win? Dr. Imamu “Mu” Tomlinson, CEO of Vituity and author of Less Than One Percent: How Disruptors Defy the Odds, joins host Eric Glazer to share hard-won lessons on leadership, resilience, and breaking barriers. In this energizing conversation, Mu discusses: How to turn “you can’t” into the fuel that drives innovation. Why being disagreeable, optimistic, and relentless are the core traits of true disruptors. Lessons healthcare can borrow from sports icons like Steph Curry and leaders in entertainment. Why...
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The Forecasting Frontier: How AI is Reshaping Risk, Revenue, and ROI
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Artificial intelligence is no longer just a buzzword, it’s a practical tool transforming how healthcare organizations prepare for the future. From evaluating and pricing risk with greater accuracy to identifying rising-risk members and strengthening long-term financial strategies, AI is reshaping the very foundations of forecasting in healthcare. In this episode, leaders from Florida Blue, Premera Blue Cross, Blue Shield of California, and Prealize Health share how they’re applying AI across actuarial, clinical, and data science domains to optimize decisions, improve outcomes, and drive...
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Closing the Member Engagement Gap with AI-Powered Actions
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Learn how AI is already working to close the member engagement gap, transforming intent into impact, personalizing care at scale, and creating the connected experiences members now expect. Leaders from Highmark Health, Ovatient, Cigna, and League share proven strategies, bright spots, and lessons learned in applying AI to drive measurable outcomes, lower costs, and improve the member experience. In this episode, you’ll learn: How AI is turning digital intent into meaningful health actions Real-world examples of personalized engagement that improved outcomes and savings Why the future...
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Missed Data, Missed Dollars: The Member Insights That Risk Models Are Blind To
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With member engagement driving everything from Star Ratings to care gap closures, health plans are rethinking how they connect with members—pairing rich data with human-centered strategies to create real moments of influence. In this episode, we explore how payers are: Combining multiple assessments, social risk data, and AI to build actionable member profiles Using empathy-driven outreach and concierge-style service to build trust Leveraging real-time insights to engage members at the right moment Aligning cross-functional teams to accelerate innovation and close gaps Turning...
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Lights, Camera, Adherence: Using Stories to Drive Star Ratings
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With adherence measures playing a major role in Star Ratings, Medicare Advantage plans are rethinking how they engage members—moving beyond transactional reminders to personalized, story-driven content that inspires real behavior change. In this episode, leaders from Zing Health, Horizon Blue Cross Blue Shield of New Jersey, and SmartStory share how they're using storytelling, data, and behavioral insights to: Improve medication adherence and close gaps at scale Design culturally relevant, human-centered messaging Translate member engagement into measurable Star Rating gains Avoid...
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New Growth Playbooks for a Changing Healthcare Market
Bright Spots in Healthcare
Episode Description: In this episode, League, Vori Health, and Fitzroy International unpack how healthcare organizations are rethinking growth, partnerships, and go-to-market strategies in a rapidly shifting environment. Learn how leading innovators are: Designing scalable, digitally enabled experiences to meet evolving consumer expectations Adapting sales and billing models amid policy and reimbursement uncertainty Attracting long-term, “patient capital” to fuel innovation in mission-driven organizations From enterprise partnerships to nimble, virtual-first care models, this...
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Closing the Gaps At Scale: Equitable Access Through Smart, Remote Primary Care
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Episode Description: How can healthcare leaders expand access and improve equity at scale without further burdening overstretched systems? In this Bright Spots in Healthcare episode, senior leaders from leading provider organizations explore how remote-first, tech-enabled primary care models are transforming access for diverse and underserved populations. Through real-world examples, clinical, innovation, and strategy experts will highlight how they’re leveraging data, team-based care, and smart technology to: Expand access to historically marginalized communities Improve care continuity...
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AI + Healthcare: Improving Value-Based Care & Financial Resilience
Bright Spots in Healthcare
Episode Description: In this episode, Atlantic Health System, Intermountain Health, and Navina explore how AI is transforming value-based care by boosting financial resilience and improving outcomes. Learn how these organizations are: Enhancing risk adjustment and closing care gaps Reducing administrative burden through AI-augmented workflows Equipping teams with real-time insights to drive performance under VBC models From virtual medical assistants to smarter financial planning, this discussion offers actionable strategies for leaders across clinical, operational, and financial...
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How Sutter Health Is Scaling AI Across the Enterprise (episode 2 of 2)
Bright Spots in Healthcare
Scaling AI across a healthcare system takes more than just good technology—it requires effective governance, operational focus, and the right data foundation. In Part 2 of our conversation with Kiran Mysore, Chief Data & Analytics Officer at Sutter Health, he explores how Sutter is operationalizing AI across its 24 hospitals and hundreds of care sites. You’ll hear: How the AI Council—a cross-functional governance body—ensures alignment, safety, and momentum What makes the “Sutter Navigator” platform a game-changer for operational visibility Why “speed of business”...
info_outlineTop 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 Takeaways:
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How health plans are leveraging AI to transition from segmentation to personalization
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The role of unified data lakes in driving insights and improving member experiences
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Real-world examples of AI in chronic disease management, risk stratification, and end-of-life care
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The power of AI-driven predictive models in enhancing underwriting accuracy
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How Generative AI is transforming customer service and operational efficiency
Our expert panel includes:
Bethany McAleer – Chief Actuary & Chief Analytics Officer, Johns Hopkins Health Plan
Amin Serehali – SVP & Chief Data & Analytics Officer, Independent Health
Mike Treash – SVP & COO, Health Alliance Plan
Dean Noble-Tolla – Chief Product Analytics Officer, Prealize Health
https://www.brightspotsinhealthcare.com/events/predictive-analytics-proactive-healthcare-leveraging-ai-to-transform-risk-management-and-care-management/
This episode is sponsored by Prealize Health
Founded by two industry thought leaders from Stanford University and through continuous partnership with Stanford, Prealize is a leading provider of AI-driven predictive analytics and insights to health plans, specialty care management companies, healthcare technology companies, employers, and providers across the nation. Committed to transforming healthcare from reactive to proactive, reducing healthcare costs and enabling more people to live healthier lives, Prealize and its partners positively influence the health trajectory of millions of people. www.prealizehealth.com