Unexpected Strategies That Are Closing Gaps in Medicare & Medicaid
Release Date: 04/01/2025
Doubling Down on Medicaid Innovation with Impact Health, HEALI, PHAB, and Vircho
Bright Spots in Healthcare
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
Bright Spots in Healthcare
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
Bright Spots in Healthcare
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
Bright Spots in Healthcare
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
Bright Spots in Healthcare
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
Bright Spots in Healthcare
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
Bright Spots in Healthcare
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_outlineTraditional approaches to closing care gaps in Medicare Advantage often fail to reach the members who need it most. This episode goes beyond conventional strategies to explore how innovative, remote, and community-driven solutions are transforming chronic care management—particularly for cardiometabolic conditions like diabetes, hypertension, and heart disease. Learn how health plans are leveraging proactive outreach, virtual engagement, and data-driven interventions to improve HEDIS scores, boost Star Ratings, and drive better long-term outcomes. Through real-world case studies and expert insights, we’ll uncover scalable, cost-effective approaches that enhance care access, reduce avoidable hospitalizations, and deliver measurable impact for both members and plans.
Panelists:
Michael Harris, CEO, HealPros
Tejaswita Karve, Ph.D. - Healthcare Quality and Innovation Leader, Stars Leader, Mass General Brigham Health Plan
Mike Rapach, SVP Government Programs, President & CEO, CareFirst Community Health Plan Maryland
Daniel Weaver, SVP Stars and Quality, Zing Health
Bios: https://www.brightspotsinhealthcare.com/podcast-episodes/
This episode is sponsored by HealPros:
HealPros helps health plans find and address missed care opportunities in member’s homes, at events in their communities, and remotely. Our team specializes in helping polychronic members access the care they need, from anywhere. HealPros’ Care Access Pros completed over 70,000 in-home visits in 2024 and is committed to engaging even more members in 2025 - including those that are hard-to-reach – as we work towards our vision of transforming millions of live each year. Our Care Connection Specialists make over 4,000,000 calls to members each year. With a sophisticated logistics operation, national footprint, and national network of providers, HealPros is available to work in all 50 states and the US Virgin Islands. For more information, visit www.healpros.com.
Bright Spots in Healthcare is produced by Bright Spots Ventures
Bright Spots Ventures brings healthcare leaders together to share working solutions 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, and 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 at www.brightspotsinhealthcare.com