How Highmark, Independent Health, Johns Hopkins Health Plans, and MedOrion Are Rebuilding Member Engagement in Medicare Advantage
Release Date: 02/17/2026
The Care Model Hospitals Can’t Ignore: Sinai Chicago’s Community Health Worker Playbook
Bright Spots in Healthcare
What if the most effective care model isn’t built inside the hospital at all? This episode features the opening presentation from the recent Home Care Innovation Summit, a half-day virtual summit produced by Bright Spots Ventures in partnership with TytoCare, focused on how leading organizations are redesigning care to reach patients where they are. Kelly McCabe, Director of Community Health Innovations, Sinai Chicago and the Sinai Urban Health Institute (SUHI) shares a practical, equity-driven model: clinically integrating community health workers (CHWs) into care delivery to bridge the gap...
info_outline
MD Anderson Emergency Physician: AI Isn’t Enough Without a Digital Health Ecosystem
Bright Spots in Healthcare
In this episode of Bright Spots in Healthcare, recorded live at the ViVE 2026 conference, Eric Glazer sits down with Dr. Pavitra Krishnamani from MD Anderson Cancer Center to explore what it actually takes to build scalable digital health systems. As both a practicing emergency physician and digital health innovator, Dr. Krishnamani brings a frontline perspective to one of healthcare’s biggest challenges: why so many digital health tools fail to scale, and what separates technologies that succeed from those that don’t. While the industry continues to invest heavily in AI, wearables,...
info_outline
EmblemHealth, Doctors HealthCare Plans, Security Health Plan, & MedOrion: Rethinking CAHPS & Member Experience
Bright Spots in Healthcare
In this Bright Spots in Healthcare episode, host Eric Glazer brings together payer and strategy leaders to explore a fundamental challenge in Medicare Advantage: why improving experience is not about measuring more, but managing better. This conversation focuses on where performance is actually being lost across the member journey, not within individual programs, but in the gaps between them. Plans continue to invest in outreach, pharmacy, provider engagement, and member services, yet still struggle to translate those efforts into consistent member action and measurable outcomes. This is a...
info_outline
BCBSM, Healthfirst, CareFirst Community Health Plan, & Drips: MA Strategy Playbook
Bright Spots in Healthcare
In this Bright Spots in Healthcare episode, host Eric Glazer brings together payer leaders to explore a fundamental challenge in Medicare Advantage: why strong strategies often fail to translate into sustained performance. This conversation focuses on the gap between intention and execution, where plans invest heavily in programs, outreach, and data, yet still struggle to drive the member actions that ultimately determine cost, quality, and experience. This is a candid discussion for executives navigating rising pressure on margins, increasing complexity in member populations, and the growing...
info_outline
What’s Working in Chronic Care | CommonSpirit, Mount Sinai, White-Wilson + More
Bright Spots in Healthcare
Chronic care isn’t failing because of strategy. It’s breaking down in execution. In this episode of Bright Spots in Healthcare, host Eric Glazer brings together provider leaders to explore a critical issue: the loss of time, attention, and clinical capacity to inefficient workflows instead of patient care. This conversation highlights how organizations are making structural changes to reduce friction, improve follow-up, and build more sustainable chronic care models. 🎯 What you’ll learn: Why chronic care breaks down in workflow, not strategy How leading providers reduce...
info_outline
Essence Healthcare and Humana: Moving from Episodic Care to Longitudinal Outcomes
Bright Spots in Healthcare
In this Bright Spots in Healthcare episode, host Eric Glazer brought together payer and provider leaders to examine a major shift underway in specialty care. Historically, specialty models have been built around episodic intervention, stepping in after a condition has progressed. But as organizations take on greater accountability for outcomes and cost, that model is becoming harder to sustain. The conversation explored how AI, earlier signal detection, and more connected care models can help organizations identify risk sooner, guide members more effectively, and support better outcomes over...
info_outline
Texas A&M, HCA & Houston Methodist: What It Really Takes to Fix Rural Healthcare Access
Bright Spots in Healthcare
In this Bright Spots in Healthcare episode, host Eric Glazer convenes provider and health system leaders working at the front lines of rural healthcare transformation across Texas. The conversation explores what it actually takes to extend clinical expertise across distance, workforce shortages, and infrastructure gaps, and how organizations are redesigning care delivery to meet patients where they are. This is a candid discussion for leaders navigating real operational constraints while building models that can scale. Together, the panel explores how hybrid care, digital infrastructure, and...
info_outline
Turning AI into Real Results: A Population Health Blueprint from UC Davis Health
Bright Spots in Healthcare
In this episode of Bright Spots in Healthcare, recorded live at the ViVE 2026 conference, Eric Glazer sits down with Dr. Reshma Gupta from UC Davis Health to explore how health systems can translate artificial intelligence and predictive analytics into real operational improvement. As Chief of Population Health and Accountable Care, Reshma focuses on turning data and predictive insight into measurable outcomes across prevention, care management, and accountable care programs. Her work highlights a central challenge facing healthcare leaders today: many organizations have the models, but far...
info_outline
Highmark, Healthfirst, Colorado Access & DarioHealth: Redesigning Care Between Visits
Bright Spots in Healthcare
In this Bright Spots in Healthcare episode, host Eric Glazer convenes health plan leaders who are focused on what happens beyond the clinic visit, the moments between care where behavior, adherence, and risk quietly take shape. The conversation centers on how plans are operationalizing care without proximity by extending support into daily life, redesigning benefit strategies, and moving from episodic measurement to longitudinal influence. This is a candid discussion for executives who are still building, still questioning assumptions, and still shaping what sustainable, whole-person care can...
info_outline
Sidecar Health CEO Patrick Quigley: Fixing Health Insurance by Rewiring the Incentives
Bright Spots in Healthcare
What happens when a health plan stops trying to optimize a legacy system and instead rebuilds the model itself? In this episode of Bright Spots in Healthcare, Eric Glazer sits down with Patrick Quigley, CEO and co-founder of Sidecar Health, for a candid conversation about redesigning health insurance around transparency, incentives, and consumer agency. Rather than focusing on incremental reform, this discussion explores what changes when members can see prices before they receive care, when benefits are structured around clear dollar amounts instead of opaque contracts, and when savings can...
info_outlineIn this Bright Spots in Healthcare episode, Medicare Advantage leaders confront a hard truth: high activity does not guarantee high impact. As Stars cut points rise and margins tighten, traditional segmentation and broad outreach strategies are no longer sufficient.
This discussion explores how leading plans are shifting from static stratification to dynamic signal monitoring, identifying which members are realistically movable, and embedding behavioral intelligence directly into operational workflows. The focus is not on doing more. It is on doing what measurably drives lift.
Our guests include:
-
Amin Serehali, Chief Data and Analytics Officer, Independent Health
-
Mike Leiper, Director of Government Quality Programs, Highmark
-
Brendan Generelli, Director of Medicare Stars and Quality, Johns Hopkins Health Plans
-
David Burianek, Chief Strategy Officer for Health Plans, MedOrion
Together, they explore:
-
How plans are distinguishing between theoretical risk and practical movability, concentrating outreach on members whose behavior can realistically change within a defined window.
-
How leading organizations are integrating claims, pharmacy, grievance, complaint, and social drivers data with behavioral science modeling to move beyond rules based campaigns.
-
Why simultaneous pressure across HEDIS, CAHPS, and Part D often reflects fragmentation in engagement strategy rather than isolated measure failures.
-
How targeted pilots within defined populations create clarity before scaling enterprise wide changes.
-
Why timing is emerging as a strategic lever, with continuous signal monitoring replacing annual segmentation refresh cycles.
-
How embedding intelligence into frontline workflows improves alignment between engagement effort and measurable Stars influence.
Panelist Bios:
https://www.brightspotsinhealthcare.com/events/beyond-segmentation-how-medicare-advantage-engagement-is-being-rebuilt/
Download the Episode Guide:
Get key takeaways and expert highlights to help you apply lessons from the episode.
https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/02/Updated-Episode-Guide-Beyond-Segmentation.docx.pdf
Key Insights Summary:
Find the top six strategic insights from the discussion, including detailed speaker takeaways and moderator notes.
https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/02/Key-Takeaways-Beyond-Segmentation-2.12.26.docx.pdf
Resources:
Companion Brief: From Segmentation to Signals
This companion brief expands on the behavioral intelligence framework discussed in the episode, outlining how health plans can identify movable phenotypes, align engagement timing with readiness signals, and measure causal lift against specific Stars drivers.
Inside you will find insights on:
-
Shifting from annual risk stratification to continuous behavioral signal monitoring
-
Identifying members whose behavior is realistically influenceable within a defined measurement window
-
Reducing wasted outreach and improving ROI through precision targeting
-
Embedding intelligence into operational workflows rather than post hoc reporting
To request your copy, email nroberts@brightspotsventures.com.
Thank You to Our Episode Partner, MedOrion:
Medorion partners with Medicare Advantage plans to integrate behavioral science and advanced analytics into engagement strategy. By layering behavioral phenotyping onto clinical and utilization data, Medorion helps plans identify which members are movable, optimize outreach timing, and improve measurable Stars performance. Learn more at https://medorion.com/.
Schedule a Conversation with MedOrion:
To explore how behavioral intelligence can strengthen your engagement strategy and improve measurable lift across HEDIS, CAHPS, and Part D, reach out to nroberts@brightspotsventures.com to schedule a discussion with David Burianek and the Medorion team.
About Bright Spots Ventures:
Bright Spots Ventures helps healthcare leaders separate signal from noise and accelerate the adoption of what works. We bring health plan, provider, and innovation leaders together through curated content and high-trust convenings to build meaningful relationships and turn insight into action. Explore our podcast at www.brightspotsinhealthcare.com.