Bright Spots in Healthcare
Each episode, I interview innovators in the healthcare industry to extract the strategies, tactics, tools, and/or routines they utilize to generate extraordinary, positive outcomes. We highlight and breakdown these bright spots so you can apply them at your organization. "See a bright spot .... and clone it!"
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Navigating Healthcare Interoperability with CommonWell’s Paul Wilder
03/11/2025
Navigating Healthcare Interoperability with CommonWell’s Paul Wilder
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 Marketplace, how patient access to data is improving, the increasing role of FHIR, and the critical aspects of trust and AI in healthcare. Paul provides key insights to help you and your organization position yourself for success. This episode was recorded live at ViVE 2025 in Nashville. About CommonWell CommonWell is a not-for-profit interoperability advocate and Qualified Health Information Network under the Trusted Exchange Framework and Common Agreement (TEFCA), which facilitates the secure exchange of patient data across more than 36,000 provider sites, representing over 238 million individuals nationwide. CommonWell has enabled the exchange of more than 7.7 billion healthcare records. Visit . About Paul Paul is leading the organization as it enters a new chapter in its pursuit of empowering clinicians, practitioners and individuals with interoperability services via its robust, nationwide network. With more than two decades of experience in health IT, Paul has held various roles focusing on imaging, clinical informatics, and interoperability. Before joining CommonWell, Paul was Vice President of Strategy & Business Development for Philips Interoperability Solutions. He also spent close to 10 years with one of the largest regional HIE networks in the world, the New York eHealth Collaborative (NYeC)—serving as its Chief Information Officer, Vice President of Product Management and Program Director for NYeC’s Regional Extension Center. During his time with the NYeC, he helped nearly 10,000 primary care providers attest to Meaningful Use and solidified the state’s status as one of the national leaders in health IT adoption. Each role enabled him to work and hear directly from providers and end-users of Electronic Health Records (EHRs)—which gives him an important perspective as a leader in health IT adoption and execution. Paul received his Master of Business Administration from New York University, with a concentration in Finance and Operations. He also holds two bachelor’s degrees from the University of Pennsylvania: one from the College of Arts and Sciences in Economics and the other from the School of Engineering and Applied Science in Biomedical Science. Paul lives in the New York area with his wife, two daughters and their newest family member, their dog Penny. 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 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
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Innovating Product Design for Growth and Member Engagement
03/04/2025
Innovating Product Design for Growth and Member Engagement
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 are successfully navigating this evolving market Panelists: Maria Baker, VP, Health Strategy & Delivery, Highmark Health Lena Perelman, VP, Medicare Product Operations, SCAN Health Plan Roni Mansur, Vice President of Product Management, Mass General Brigham Health Plan Suzi Pigg, Vice President, Payers, TytoCare https://www.brightspotsinhealthcare.com/events/innovating-product-design-for-growth-and-member-engagement/ This episode is sponsored by TytoCare: TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are six times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for the successful deployment and adoption of the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 250 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.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
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How Plans Can Evolve from Segmentation to Personalization in Population Health
02/25/2025
How Plans Can Evolve from Segmentation to Personalization in Population Health
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 transformation in action. Panelists: Karen Hanlon, EVP & COO, Highmark Health Laurent Rotival (EVP & CIO, Cambia Health Solutions) Michael Serbinis, Founder & CEO, League Bios: https://www.brightspotsinhealthcare.com/podcast-episodes/ This episode is sponsored by League: Founded in 2014, League is the leading healthcare consumer experience platform, reaching more than 20 million people worldwide and delivering the highest level of personalization in the industry. Payers, providers, and consumer health partners build on League’s platform to deliver high-engagement healthcare solutions that improve health outcomes. To date, League has raised $235 million in venture capital funding, powering the digital experiences for some of healthcare’s most trusted brands, including Highmark Health, Manulife, Medibank, and Shoppers Drug Mart. 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
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Predictive Analytics & Proactive Healthcare Leveraging AI to Transform Risk Management and Care Management
02/18/2025
Predictive Analytics & Proactive Healthcare Leveraging AI to Transform Risk Management and Care Management
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 Takeaways: How health plans are leveraging AI to transition from segmentation to personalization The role of unified data lakes in driving insights and improving member experiences Real-world examples of AI in chronic disease management, risk stratification, and end-of-life care The power of AI-driven predictive models in enhancing underwriting accuracy 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.
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Revolutionizing Member Engagement: How Icario is Powering Personalized Healthcare Outreach
02/11/2025
Revolutionizing Member Engagement: How Icario is Powering Personalized Healthcare Outreach
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 approach focuses on knowing the member through data to improve engagement and outcomes. Beyond Transactions to Long-Term Engagement – Many health plans operate in silos, leading to disconnected member experiences. Icario’s platform shifts from one-time interactions to continuous, AI-driven engagement that adapts to member behaviors and preferences. Smart Outreach Strategies – Effective member engagement requires understanding preferences (text, email, phone, or mobile apps), timing communication to when members are most responsive, and avoiding member abrasion through excessive outreach. Leveraging AI and Machine Learning – Icario’s new platform, Aivella, goes beyond rules-based engines to incorporate machine learning. Based on member responses, it dynamically adjusts outreach strategies in real time. About Marc Marc Willard is responsible for Icario’s overall strategy, growth, and operations. Marc has over three decades of experience leading digital transformation and technology in the digital health sector. Marc is passionate about improving lives with industry-leading, cloud-first digital health platforms. Marc brings a unique and highly relevant set of abilities, operational experiences, and industry relationships to Icario at the perfect time in the company’s development. Before joining Icario, Marc founded Certify, where he pioneered the first cloud-based data and interoperability platform connecting providers and payors at scale. Marc founded Transcend Insights at Humana, the merger of three Humana acquisitions, including Certify. Transcend developed and launched an innovative cloud-based population health platform. At Humana Corp, as SVP, he led all member, patient, and provider digital engagement initiatives. These initiatives were focused on data and analytics to improve care delivery and quality and lower healthcare costs. In addition, Marc holds several board member positions. Marc studied Electronic Engineering at Farnborough College of Technology and in classic entrepreneurial style, left to focus on his first start-up. Outside work, he enjoys spending time with his wife and family, collecting classic cars, and being on the water. He also mentors entrepreneurs while supporting the start-up community, which he finds very rewarding. Find Marc on : https://www.linkedin.com/in/marcwillard/ About Icario Icario serves health plans using robust whole-person data, predictive behavioral science, and a proprietary engagement platform to offer personalized experiences that meet members where they are in their health journey. Icario combines the industry's largest member data repository with unparalleled industry expertise to implement health action programs that deliver personalized member engagement, reduce abrasion and encourage positive health behaviors. Visit . Follow Bright Spots in Healthcare on : https://www.linkedin.com/company/shared-purpose-connect/ Check our page: https://www.youtube.com/@BrightSpotsinHealthcare
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A Successful Lifestyle Modification Program with former Philadelphia Eagles’ VP of Player Performance
02/04/2025
A Successful Lifestyle Modification Program with former Philadelphia Eagles’ VP of Player Performance
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. He has two decades of experience working with athletes, almost all of them in the NFL …his resume beyond the Eagles job includes the LA Rams, Miami Dolphins, Detroit Lions and his alma mater, the University of Toledo. Rath was voted “NFL Strength and Conditioning Coach of the Year” not once but twice and was elected as the inaugural President to represent the Professional Football Performance Coaches Association (PFPCA) in early 2023. Before Detroit, Rath was an Assistant Strength and Conditioning Coach at The University of Toledo, where he directed the strength and conditioning programs for all fifteen of the school’s Olympic sports.
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Innovations in Senior Care & Value-Based Models with InnovAge’s Richard Feifer, MD
01/28/2025
Innovations in Senior Care & Value-Based Models with InnovAge’s Richard Feifer, MD
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. Lessons on advanced care planning and end-of-life support that prioritize patient goals. Operational strategies for managing costs while maintaining exceptional patient experiences. Richard explores the economic and practical sustainability of the PACE model, providing actionable insights for healthcare leaders aiming to replicate its success. Link to DC Bipartisan Report on PACE mentioned in podcast: https://bipartisanpolicy.org/press-release/improving-access-to-and-enrollment-in-programs-of-all-inclusive-care-for-the-elderly-pace/ About Richard As a physician executive with broad healthcare industry experience, Dr. Richard Feifer helps organizations achieve their fullest potential in an ever-changing environment. Rich is a board-certified internist with clinical experience in primary care, geriatrics, and urgent care medicine. As a health system leader, he has also developed expertise in population health management, value-based payment models, clinical analytics, and technology-driven healthcare transformation. Rich has dedicated his career to improving the quality and efficiency of healthcare and the health of populations he has served. Most recently, as executive vice president and chief medical officer of Genesis HealthCare, he led one of the nation's largest skilled nursing and long-term care providers, operating over 400 facilities in 25 states in 2019. As president of Genesis Physician Services, a Genesis subsidiary with over 450 physicians, nurse practitioners, and physician assistants in 2019, he navigated the successful transition to value-based care delivery. In that capacity, he also launched and served as chief medical officer of the only national accountable care organization focused on nursing home residents, LTC ACO. Prior to joining Genesis, Rich was Aetna’s chief medical officer of National Accounts, leading the department of Clinical Consulting, Strategy, and Analysis, which helped large employers improve the health and productivity of their employees and dependents. Before Aetna, Rich served as vice president of Clinical Program Innovation and Evaluation at Medco, where he was responsible for the organization’s portfolio of care enhancement programs. A graduate of Brown University and the University of Pennsylvania School of Medicine, Rich received his master’s in health services management from Columbia University. He is an assistant clinical professor at the University of Connecticut and a board member of the Accreditation Commission on Health Care. About InnovAge Our passion and mission is to help frail seniors age in their own homes with dignity. InnovAge has done this through PACE for more than 30 years. As the largest provider of the Program of All-inclusive Care for the Elderly (PACE) based on participants served, InnovAge is dedicated to expanding this successful program to serve as many seniors as possible nationwide. In some communities, like Philadelphia, PACE is known as Living Independence for the Elderly. With InnovAge's Program of All-inclusive Care for the Elderly (PACE), older individuals have a team of healthcare professionals focused on providing all the connected care they need. This helps seniors live at home for as long as possible, instead of going to a nursing home or other care facility.
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Where AI is Currently Saving Healthcare – the Clinic
01/21/2025
Where AI is Currently Saving Healthcare – the Clinic
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 industry for 15+ years, helping to shape virtual assistant solutions across mobile phones, TV’s, cars, wearables, robotics, and most recently healthcare systems. He is currently responsible for running the Healthcare Virtual Assistant business at Dragon, a divisionof Microsoft ( formerly Nuance), which leverages an advanced suite of technologies combined with purpose-built hardware to streamline interactions with the EHR and creation of clinical documentation, allowing physicians to remain 100% focused on the patient without technology getting in the way. Kenn holds a B.S. in human factors engineering from Cornell University and a M.S. in human factors from Bentley University About DAX Copilot Serving as an AI assistant for automated clinical documentation, the Dragon Ambient eXperience (DAX) Copilot solution enables physicians to do more with less and improve clinical efficiency, physician and patient satisfaction and financial outcomes. Amplified by the power and scale of the Microsoft Cloud for Healthcare, it combines Nuance’s proven conversational and ambient AI with the newest and most capable generative AI model. 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, 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
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Driving Digital Healthcare Innovation
01/14/2025
Driving Digital Healthcare Innovation
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 experiences for healthcare Mike also reflects on lessons from his entrepreneurial journey, including his time working with Elon Musk and how it inspired his vision to transform healthcare. Listen in for actionable strategies on leveraging technology to meet evolving consumer expectations and drive better outcomes. About Mike Michael Serbinis founded League in 2014. League accelerates the digital transformation of the healthcare consumer experience (CX). Serbinis has led the company since its inception, raising over $235 million in funding and driving exponential growth as League powers healthcare’s biggest brands. Mike has had a long and distinguished career as a serial entrepreneur, rocket scientist, engineer and investor. Most recently, Serbinis was the founder and CEO of Kobo, a digital reading company that rivals Amazon’s Kindle worldwide. Before that, he founded cloud storage pioneer DocSpace and then built Critical Path, a messaging service that handled one-third of the world’s email. Serbinis is also Chair of the Board of Directors for the Perimeter Institute, the world’s leading center for scientific research in theoretical physics. Now, as the CEO of League, Serbinis is focused on healthcare transformation. Payers, providers and pharmacy retailers build on the League platform to accelerate digital transformation and deliver high-engagement, personalized digital experiences. Millions worldwide use and love solutions powered by League to access, navigate and pay for care. About League Founded in 2014, League is the leading healthcare consumer experience platform, reaching more than 20 million people around the world and delivering the highest level of personalization in the industry. Payers, providers, and consumer health partners build on League’s platform to deliver high-engagement healthcare solutions that improve health outcomes. To date, League has raised $235 million in venture capital funding, powering the digital experiences for some of healthcare’s most trusted brands, including Highmark Health, Manulife, Medibank, and Shoppers Drug Mart. 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, 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
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Exploring Psychedelic-Assisted Therapies with the VA's Dr. Shereef Elnahal
01/07/2025
Exploring Psychedelic-Assisted Therapies with the VA's Dr. Shereef Elnahal
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 themselves have driven this agenda, the promising outcomes from early studies, and the significant hurdles in bringing these therapies to scale. Tune in for a thought-provoking discussion on the future of mental health treatment for veterans and how the integration of psychedelic-assisted therapies could revolutionize care and improve the quality of life for those who have served. About Dr. Elnahal Dr. Shereef Elnahal is Under Secretary for Health at the United States Department of Veterans Affairs (VA). He was nominated by President Joseph R. Biden and confirmed by the United States Senate on July 21, 2022. As the Under Secretary for Health, Dr. Elnahal directs a health care system with an annual budget of approximately $102.2 billion, overseeing the delivery of care to more than 9 million enrolled Veterans. The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at over 1,300 health care facilities, including 171 VA Medical Centers and 1,120 outpatient sites of care of varying complexity (VHA outpatient clinics). VHA is the nation's largest provider of graduate medical education and a major contributor to medical and scientific research. More than 73,000 active volunteers, 127,000 health professions trainees, and more than 362,000 health care professionals and support staff are an integral part of the VHA community. Dr. Elnahal is physician leader who previously served as President and Chief Executive Officer of University Hospital in Newark, NJ from 2019 through 2022. Dr. Elnahal led University Hospital through the COVID-19 public health emergency. The hospital has served as a model for urban hospital and regional response efforts. In addition to his leadership during the pandemic, Dr. Elnahal oversaw substantial improvements in care quality and patient safety at University Hospital, leading to improvements against national benchmarks. Prior to his time at University Hospital, Elnahal served as New Jersey’s 21st Health Commissioner, appointed to the Cabinet post by Governor Phil Murphy and confirmed unanimously by the New Jersey Senate. During his nearly two years as Commissioner, he expanded the New Jersey Health Information Network, an interoperability platform that allows for electronic exchange of patient health information among healthcare providers. He worked closely with New Jersey First Lady Tammy Murphy on her Nurture NJ campaign to help improve infant and maternal health outcomes and reduce health disparities—a mission he continued at University Hospital, with its top tier maternal health services. He also made strides in curbing the opioid epidemic, granting funding to institutions to facilitate data sharing and public health reporting, and marked NJ as the first state in the nation to allow EMS responders to use buprenorphine in the field to prevent withdrawal after naloxone. Dr. Elnahal previously served as VA’s Assistant Deputy Under Secretary for Health for Quality, Safety, and Value from 2016 through 2018, overseeing national policies around quality of care for the VHA, and as a White House Fellow in the VA from 2015-16. During that time, he co-founded the VHA Innovation Ecosystem, a program that continues to foster the spread of innovation and best practices that improve Veteran care across the nation. Dr. Elnahal holds an M.D. from Harvard Medical School and an M.B.A. with Distinction from Harvard Business School. Press Release from VA New research would determine the benefit of psychedelics for treating PTSD and depression in Veterans: https://news.va.gov/press-room/to-improve-care-for-veterans-va-to-fund-studies-on-new-therapies-for-treating-mental-health-conditions/ VA Health: https://www.va.gov/health-care/ VA Mental Health Resources: 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, 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
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How AI is Reshaping Healthcare - An Interview with NVIDIA’s Vega Shah
12/24/2024
How AI is Reshaping Healthcare - An Interview with NVIDIA’s Vega Shah
Vega Shah, PhD, Product Marketing Manager Lead for Healthcare & Life Sciences, NVIDIA, joins Eric to explore the evolution of generative AI in healthcare and how harnessing the technology will transform the future of patient care. Vega delves into the cutting-edge ways NVIDIA’s AI tools are enhancing clinician-patient relationships and optimizing the healthcare experience for everyone. Get real-world examples of AI in action, insights into overcoming common challenges, and strategies for implementing AI effectively in healthcare organizations. This episode is packed with valuable takeaways for anyone looking to understand the transformative potential of AI in reshaping patient care. Don’t miss it! This episode was recorded live on October 22, 2024 at HLTH 2024 in Las Vegas. About Vega Vega leads go-to-market strategies for Healthcare & Life Sciences Solutions at NVIDIA, collaborating with a diverse range of partners including cloud service providers, biotech, and digital health companies. Her expertise in biotech software stems from her previous role as a product manager at Dotmatics, where she developed cloud-based tools for research analytics. Her career trajectory also includes shaping product strategies for drug discovery at Benchling, a prominent lab data management company. Outside of her professional life, Vega is passionate about building scientific communities in the Bay Area. She is founder of Techbio Transformers - a community of operators working at the intersection of biology and AI. About NVIDIA NVIDIA’s invention of the GPU sparked the PC gaming market. The company’s pioneering work in accelerated computing—a supercharged form of computing at the intersection of computer graphics, high-performance computing, and AI—is reshaping trillion-dollar industries like healthcare and fueling the growth of many others. NVIDIA Clara – a healthcare application framework for imaging, genomics, smart hospitals, and drug discovery – is accelerating the journey to precision medicine. About NVIDIA Healthcare & Life Sciences Solutions To meet the need for personalized medicine, next-generation clinics, enhanced quality of care, and biomedical breakthroughs to treat disease, the healthcare industry has to embrace new computing capabilities. With NVIDIA, institutions can harness the power of AI and to define the future of medicine. NVIDIA Healthcare & Life Sciences: 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 webiste: www.brightspotsinhealthcare.com
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A Conversation with Highmark Leaders - Innovations in Digital and Hybrid Care
12/17/2024
A Conversation with Highmark Leaders - Innovations in Digital and Hybrid Care
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 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!
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Responsible GLP-1 Strategies: Structuring Benefits for Economic Viability and Proven Member Results
12/10/2024
Responsible GLP-1 Strategies: Structuring Benefits for Economic Viability and Proven Member Results
Leaders from Arkansas Blue Cross and Blue Shield, CVS Caremark, Independent Health and Vori Health explore how healthcare leaders tackle members’ weight management challenges by creating comprehensive programs that responsibly integrate GLP-1 medications while controlling costs. Key Discussion Topics: Benefit Design and Prior Authorization Programs: Crafting strategies to balance access and affordability. Integrated, Whole-Person Care: Addressing weight management holistically to improve outcomes. Leveraging Bright Spots: Applying successful approaches from other areas to optimize GLP-1 management. Future Innovations: Exploring emerging opportunities to enhance weight management programs. Panel: Ryan A. Grant, MD, MS, MBA, FAANS, CEO and Co-Founder, Vori Health Martin Burruano, Vice President, Pharmacy Services, Independent Health Mark T. Jansen, M.D., Vice President, Chief Medical Officer, Arkansas BlueCross BlueShield Ilona Smith, SVP of Employer, Government and Coalitions, CVS Caremark Bios: Request Whitepaper To request the whitepaper, Integrating GLP-1s into the Future of MSK Care, from our partner Vori, please submit this form: 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: We’d love to hear from you! Send your comments, suggestions and ideas to
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An Inside Look at HealthIMPACT 2025
12/06/2024
An Inside Look at HealthIMPACT 2025
Megan Antonelli, Founder & CEO of HealthIMPACT and HealthIMPACT Chairperson Shahid Shah, Publisher & CEO, Medigy, join Eric to give Bright Spots in Healthcare listeners a sneak preview of the HealthIMPACT Forum 25, taking place on January 22-23, 2025, in New York City. Megan and Shahid share what makes their event different from other healthcare conferences – purposeful content that creates conversations that lead to meaningful connections. They also discuss the theme, Powering the Patient-Led Revolution for Healthcare Anywhere and mention some key things to look forward to at the event, including Keynote Speaker Chelsea Clinton, who will lead a panel discussion on digital innovation. In addition to Clinton, the conference's speakers include hospital leaders from top health systems, including Atrium Health, Mayo Clinic, Northwell Health, and Oschner Health. Megan also discusses how HealthIMPACT partners with Road Recovery, which has been changing lives through music since 1998 by combining music industry mentorship with mental health support for young people battling addiction and adversity. About HealthIMPACT HealthIMPACT isn't just another conference—it's a catalyst for change. For a decade, we've been the no-PowerPoint, no-BS platform where healthcare providers, payers, pharma, and patients converge to drive digital health implementation and adoption because you have to have both to make an IMPACT. Join C-suite IT and clinical executives at the forefront of healthcare transformation as we explore how to deliver superior outcomes, enhance experiences, and achieve operational excellence in the new era of healthcare anywhere. To register for the event, go to Use the code BRIGHTSPOTSVIP to receive a 20% discount on the registration fee. About Shahid Shahid N. Shah is an internationally recognized and influential healthcare IT thought leader who is known as “The Healthcare IT Guy” across the Internet. He is a consultant to various federal agencies on IT matters and winner of Federal Computer Week’s coveted “Fed 100” award given to IT experts that have made a big impact in the government. Shahid has architected and built multiple clinical solutions over his almost 20-year career. He helped design and deploy the American Red Cross’s electronic health record solution across thousands of sites; he’s built two web-based EMRs now in use by hundreds of physicians; he’s designed large groupware and collaboration sites in use by thousands; and, as an ex-CTO for a billion dollar division of CardinalHealth he helped design advanced clinical interfaces for medical devices and hospitals. Shahid also serves as a senior technology strategy advisor to NIH’s SBIR/STTR program helping small businesses commercialize their healthcare applications. Shahid runs three successful blogs. At http://shahid.shah.org he writes about architecture issues, at http://www.healthcareguy.com he provides valuable insights on how to apply technology in health care, at http://www.federalarchitect.com he advises senior federal technologists, and at http://www.hitsphere.com he gives a glimpse of the health-care IT blogosphere as an aggregator. About Megan A relentless creator and knowledge seeker who brings people together to solve big problems, Megan believes face-to-face meetings give everyone a shared focus, bringing forth new insights, a clearer sense of purpose, and solutions that impact long-term performance. An experienced event executive with extensive knowledge of healthcare, technology, and corporate management strategy. Developed and managed hundreds of events for health system, physician, health plan, pharmaceutical, digital marketing, and technology executives. A creative and passionate leader interested in how technology is transforming healthcare delivery, the way people work, and global market dynamics. 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: We’d love to hear from you! Send your comments, suggestions and ideas to
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One-on-One with Natalie Davis CEO, United States of Care
12/03/2024
One-on-One with Natalie Davis CEO, United States of Care
This episode was recorded on Monday, October 21, 2024, at in Las Vegas Natalie Davis, co-founder and CEO of United States of Care, joins Eric to share her thoughts on the current healthcare system and how her organization is advocating for a more affordable, dependable, personalized and understandable healthcare system. In addition, Natalie shares insights from the USofCare’s recent research and the policy solutions her organization is advancing to deliver the healthcare experience people want and ensure our healthcare system works better for everyone. About Natalie Natalie believes that making our healthcare system work better for everyone has never been more critical. She is dedicated to bringing together leaders and advocates nationwide who can help create meaningful change in our nation’s inequitable health care system. She brings all her personal and professional experiences to the fight for better health care, working to expand access to quality, affordable health care to help people right now while working towards durable federal policies centered on the needs of people to provide real and lasting solutions for everybody. Natalie Davis has spent nearly two decades shaping American healthcare policy to ensure that all people have access to affordable, quality care. In 2018, she co-founded United States of Care with Andy Slavitt, focusing on a person-centered approach to healthcare solutions and forging partnerships with organizations, advocacy groups, and communities to drive systemic change. Her prior roles include serving as Senior Advisor at CMS, where she supported a major healthcare expansion, and as Director at the Bipartisan Policy Center, where she launched reform initiatives to develop innovative, politically viable healthcare solutions. About the United States of Care United States of Care is a non-profit organization focused on building a healthcare system that serves everyone. Its mission is to ensure people can access affordable, quality care that meets their needs regardless of their background or circumstances. Working with leaders, communities, and individuals nationwide, the United States of Care focuses on developing innovative, non-partisan solutions to healthcare challenges, emphasizing policy, patient experience, and health equity. 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: We’d love to hear from you! Send your comments, suggestions and ideas to
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How Providers Are Maximizing Hybrid Care and Home-Based Interventions
11/26/2024
How Providers Are Maximizing Hybrid Care and Home-Based Interventions
OSF HealthCare, Providence, UMass Memorial Medical Center, and TytoCare share actionable strategies and best practices to transform hybrid care and offer patients personalized, flexible and accessible care. Our expert panel also explores how virtual care reduces costs and addresses healthcare challenges like staff shortages. Key topics include: Maximizing Hybrid Care Models: Panelists explore how hybrid and home-based care models – supported by technology, are revolutionizing how providers deliver care – making it more accessible, efficient, and impactful. Home-Based Healthcare Innovations: Real-world success stories highlighted how providers make healthcare accessible from the comfort of home, schools, and community centers. Technology-Driven Solutions: Technical tools enable immersive primary care experiences remotely, enhancing connectivity and care delivery for families. Highlights: Providence: Kate Baars shared how remote patient monitoring helps achieve compelling clinical and financial outcomes OSF OnCall: Jennie Van Antwerp walked us through innovations in acute and digital care delivery at OSF. UMass Memorial Medical Center: Dr. John Broach discussed how the medical center utilizes technology to drive efficient responses and care, eliminating ED visits. TytoCare: Tina Nelson highlighted strategic partnerships that enable healthcare access for underserved communities through remote technology. Panelists: Kate Baars, Executive Director, Product Development, Virtual Care & Digital Health, Providence Jennie Van Antwerp, MSN, RN, Director, Digital Acute Care/ Digital Care Division, OSF OnCall (Colleen Reynolds) John Broach, MD, Division Direction for EMS and DIsaters Medicine, UMASS Medical Center Christina (Tina) Nelson, Strategic Partnership Manager, TytoCare This episode is sponsored by TytoCare TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are six times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for the successful deployment and adoption of the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 250 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at .
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How to Create More Bright Spots in Post-Acute and Home Care
11/15/2024
How to Create More Bright Spots in Post-Acute and Home Care
Healthfirst, myPlace Health and Wellsky share their successful strategies for reducing readmissions, improving health outcomes and reducing costs through post-acute and home care. Topics covered include: Building your provider partnerships beyond the traditional transition of care program Reducing readmissions among higher-risk Medicare Advantage members? Ensuring members receive high-quality home health care after being discharged from skilled nursing facilities, and what made this approach stand out in terms of impact Susan J. Beane, MD FACP, Executive Medical Director, Health System Transformation, Healthfirst Robert Schreiber, MD, Vice President & National Medical Director, myPlace Health Andy Eilert, President, Payer & Emerging Markets, WellSky Bios: https://www.brightspotsinhealthcare.com/events/how-to-create-more-bright-spots-in-post-acute-and-home-care/ This episode is sponsored by Wellsky WellSky is one of America’s largest and most innovative healthcare technology companies leading the movement for intelligent, coordinated care. Our proven software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations scale processes, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care. WellSky serves more than 20,000 client sites — including the largest hospital systems, blood banks, cell therapy labs, home health and hospice franchises, post-acute providers, government agencies, and human services organizations. Informed by more than 40 years of providing software and expertise, WellSky anticipates clients’ needs and innovates relentlessly to build healthy, thriving communities.
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A New Era for Consumer Engagement and HEDIS: Combining the Human Touch with AI
11/08/2024
A New Era for Consumer Engagement and HEDIS: Combining the Human Touch with AI
AmeriHealth Caritas, Health Alliance Plan, Highmark Health and Icario discuss how AI transforms healthcare by creating personalized experiences that drive performance improvements and enhance member engagement. Learn how high-ranking health plans reinvent their approach to member experience to elevate your HEDIS scores, improve health outcomes and streamline data processes. Guests: Vandna Bhrany, MPH, Vice President, HEDIS Strategy and Analytics, AmeriHealth Caritas Tracy Saula. Senior Vice President, Chief Product and Experience Officer, Highmark Health Cory Busse, VP, Strategy, Icario Mike Treash, Senior Vice President and Chief Operating Officer, Health Alliance Plan Bios: This episode is sponsored by Icario Icario serves health plans by using powerful whole-person data, predictive behavioral science, and a proprietary engagement platform to offer personalized experiences that meet members where they are in their health journey. Icario combines the industry's largest member data repository with unparalleled industry expertise to implement health action programs that deliver personalized member engagement, reduce abrasion and encourage positive health behaviors.
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Innovations in Lifestyle Change & the Role of Primary Care
11/01/2024
Innovations in Lifestyle Change & the Role of Primary Care
Banner|Aetna, Blue Shield of California, Healthfirst and TytoCare explore innovative strategies that health plans can leverage to drive meaningful lifestyle modifications among members, improve health outcomes and reduce the rising costs of chronic disease. Our expert panel also discusses the role of primary care in empowering members to adopt healthier behaviors. Topics include: Building a culture that fosters habit formation for long-term success Supporting members using GLP-1s for weight management Addressing Social Determinants of Health (SDOH) to improve outcomes Leveraging technology to encourage sustainable lifestyle modifications Panelists: Joe Brennan, Vice President, TytoCare Robert Groves, MD, Executive Vice President and Chief Medical Officer, Banner|Aetna Eric Glazer, Host (moderator) Angie Kalousek, Senior Director, Lifestyle Medicine, Blue Shield of California Amanda Parsons, MD, MBA, Vice President, Clinical Management, Healthfirst Bios: https://www.brightspotsinhealthcare.com/events/innovations-in-lifestyle-change-the-role-of-primary-care-2/ This episode is sponsored by TytoCare TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are six times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for the successful deployment and adoption of the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 250 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at .
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Unlocking Success Through Specialty Value Based Models
10/04/2024
Unlocking Success Through Specialty Value Based Models
Value-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: Strategie Planning Technology Enablement Solutions in Action Featured Guests Romilla Batra, MD, Senior Vice President, Chief Medical Officer – Clinical Strategy & Solutions, Premera Blue Cross Hemant Keny, MD, Lead for Senior Surgical Care Program, Kaiser Permanente Northern California Donna Laliberte O’Shea, MD, MBA, CPE, National Vice President, Operations and Chief Medical Officer, UCS Population Health and VBC, UnitedHealthcare Rachel Winokur, Chief Executive Officer, TailorCare Guest Bios: 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
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Innovations in Medicare Advantage and Beyond: How Devoted Health is Transforming Care
08/08/2024
Innovations in Medicare Advantage and Beyond: How Devoted Health is Transforming Care
Alec Peterson, MD, Chief Medical Officer of Acute and Specialty Care at Devoted Health, joins Eric to explore the innovative care delivery model that sets Devoted Health apart from other Medicare Advantage plans. Devoted Health uniquely integrates healthcare coverage with its in-house, virtual, and in-home care provider, Devoted Medical, in partnership with leading healthcare providers to offer comprehensive care for older Americans. Alec shares the key strategies behind Devoted Health’s impressive success and delves into how Devoted Medical’s groundbreaking model has driven high member satisfaction and improved clinical outcomes. He also unveils the roadmap for achieving a 5-star rating from CMS for their Medicare Advantage plans in Florida and Ohio. About Alec Alec Petersen, MD, is an internal medicine physician and Chief Medical Officer, Acute & Specialty Care with the Devoted Medical team of Devoted Health. In his role, Petersen leads Devoted Health’s Care on Demand program and focuses on maximizing the potential of innovative at-home care delivery without overstressing an already maxed-out healthcare workforce. After receiving his medical degree from Vanderbilt University School of Medicine, Alec completed a clinical fellowship and MBA at Harvard. Before his career in medicine, he served as a military intelligence officer. About Devoted Health Founded in 2017 by brothers Todd and Ed Park, Devoted Health is a new kind of healthcare company providing all-in-one care for older Americans. Members of the company’s best-in-class insurance plans can receive care through their trusted PCP and complementary preventative care services through Devoted Medical, the first virtual and in-home medical group built from the ground up to serve the specific needs of the Medicare population. The Devoted Medical team of mission-oriented clinicians works closely with members’ primary care physicians and Devoted’s full-service Guides to deliver a new model of advanced primary care, powered by deeply specialized clinical programs and proprietary technology that enables intensive care coordination.
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The Blueprint for Speciality Value-Based Care
08/01/2024
The Blueprint for Speciality Value-Based Care
Rachel Winokur, CEO, TailorCare and Alex Bateman, CEO, United Musculoskeletal Partners (UMP) join Eric to discuss the evolution and adoption of specialty value-based care, highlighting the significant improvements in patient care, customer satisfaction scores, cost reduction and value creation. Hear how their two organizations partner with a commercial payer to manage musculoskeletal cases, ensuring they assess patients, understand their needs, and match them with the best providers in the market. Rachel and Alex also touched on the keys to implementing a successful value-based care strategy and underscored the transformative power of data analytics in shaping the future of healthcare. Segments Origin Story Payer Experience Patient Experience Pitfalls Strategy/Building An episode of The Bear, is referenced in the interview. Here is a link to a summary of the episode (Season 2, Ep. 2) About Alex Alex is an accomplished, results-driven healthcare leader with 20 years of development and operations experience in multi-state, multi-site healthcare services organizations. He is a proven talent and team builder who adapts and thrives in the changing healthcare space. He is analytical, confident in challenging environments, and regarded as a top company performer in both leadership and growth/development. About Rachel Rachel is the co-founder and CEO of TailorCare, a risk-based care navigation and health management company that provides deeply personal, data-driven support and clinical access to patients living with joint, back, and muscle pain. Prior to founding TailorCare, Rachel launched Bright Health Group, a value-based healthcare company committed to managing population risk. She served as Chief Business Officer of Bright before serving as the CEO of NeueHealth, the risk-based primary care delivery, provider enablement, and network management company she created within Bright. Rachel built her career in executive and leadership roles at Aetna, where she helped start the health plan’s population health management division, The Carlyle Group, as a healthcare investor, and at Datascope, a public medical device company she helped take private. Rachel has previously held positions at Bertelsmann and Goldman Sachs. About United Musculoskeletal Partners United Musculoskeletal Partners (UMP) was formed in December 2021 by Resurgens Orthopaedics, one of the nation's largest orthopedic practices. UMP partners with entrepreneurial, physician-owned orthopedic practices to deliver exceptional clinical care to patients around the country while simplifying the management functions of the practices under one umbrella company. Website: 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
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Revolutionizing Health Plans: The Connected Member Experience
07/26/2024
Revolutionizing Health Plans: The Connected Member Experience
BlueCross BlueShield of Tennessee, Cambia Health Solutions, Health Plan of San Joaquin/Mountain Valley Health Plan and Pager Health discuss how technology and innovation transform the member experience, improving clinical outcomes and consumer engagement. Segments: Strategy & Culture Data & Decision-Making Personalization Right Care, Right Time Panelists: Laurent Rotival, EVP & CIO, Cambia Health Solutions Victoria Worthy, CIO, Health Plan of San Joaquin | Mountain Valley Health Plan Sherri Zink, SVP, Chief Data & Engagement Officer, BlueCross BlueShield of Tennessee Rita Sharma, Chief Product Officer, Pager Health Bios: https://www.brightspotsinhealthcare.com/events/revolutionizing-health-plans-the-connected-member-experience/#url This episode is sponsored by Pager Health Pager Health is a connected health platform company that enables healthcare enterprises to deliver high-engagement, intelligent health experiences for their patients, members and teams through integrated technology, AI and concierge services. Our solutions help people get the right care at the right time and in the right place and stay healthy while simultaneously reducing system friction and fragmentation, powering engagement, and orchestrating the enterprise. Pager Health partners with leading payers, providers and employers representing more than 28 million individuals across the United States and Latin America.
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From the Sidelines to the Boardroom: Leadership lessons with Michael Lombardi
06/27/2024
From the Sidelines to the Boardroom: Leadership lessons with Michael Lombardi
Former NFL general manager and three-time Super Bowl winner Mike Lombardi joins Eric to share what he learned working with coaching legends Bill Walsh of the 49ers, Al Davis of the Raiders, and Bill Belichick of the Patriots, among others, during his three decades in football and how those core leadership lessons directly translate to managing health plans and hospital systems. He discusses building a winning team, handling high-pressure situations, adapting to change, decision-making under uncertainty, and cultivating a winning culture. The Daily Coach Network is accepting applications for 15 new members starting in August. If you submit your application before July 29th and write "Bright Spots" in the referral section you'll receive an extra month on your first membership. Submit your application at To receive The Daily Coach newsletter, visit Books mentioned during episode: Jocko Willink, ; David Goggins, James Clear,
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Convergence of Pharmacy & the Health Equity Index in 2024 and Beyond
06/21/2024
Convergence of Pharmacy & the Health Equity Index in 2024 and Beyond
CareSource, Independent Health, and AdhereHealth outline strategies for the upcoming Medicare Advantage Star Rating changes, focusing on medication adherence and the Health Equity Index (HEI) starting in measurement years 2024-2025 for the 2027 Medicare Advantage Star Rating Period. Under HEI, plans must identify disparities in populations with social risks and create intervention strategies to address these inequities. Tune in and gain insights on leveraging policy changes, predictive analytics, and strategic implementation to meet these new standards and reach or maintain 4+ Stars. Panelists: Amin Serehali, Senior Vice President, Chief Data & Analytics Officer, Independent Health Logan Fox, PharmD, MBA, Director, Enterprise Quality Improvement, Programs, CareSource Kempton Presley, MPH, MS, Chief Strategy Officer, AdhereHealth https://www.brightspotsinhealthcare.com/events/convergence-of-pharmacy-the-health-equity-index-in-2024-and-beyond/ This episode is sponsored by AdhereHealth AdhereHealth is at the forefront of delivering purpose-built, innovative technology solutions designed to elevate pay-for-performance achievement for government-sponsored lines of business. This includes improved Star Ratings for Medicare, plus enhanced patient experience scores, improved patient health outcomes, and optimized cost outcomes for clients. The company’s pioneering efforts are particularly noteworthy for addressing social determinants of health (SDOH) and significantly improving patient experiences as a mechanism for improved Star Ratings performance through multi-modal outreach capabilities. Powered by the industry-leading Adhere Platform™, AdhereHealth integrates predictive analytics, intelligent clinical workflow software, and proactive multi-channel outreach. This combination, executed by a nationwide team of licensed clinicians, effectively drives health equity and adherence outcomes that improve quality of care for patients and boost financial results for clients. The impact of AdhereHealth's comprehensive solutions is far-reaching, touching tens of millions of patients across over 100 health plans, self-insured employers and other risk-bearing entities. Since its inception in 2006, AdhereHealth, headquartered in Franklin, Tennessee, has grown into a robust organization with hundreds of dedicated professionals nationwide, all committed to their mission of improving healthcare outcomes. Visit for more information.
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Everything You Thought about Value-Based Care Is Wrong: A Plan CEO Tells You Why
06/12/2024
Everything You Thought about Value-Based Care Is Wrong: A Plan CEO Tells You Why
Fred Turner, co-founder and chief executive officer of Curative, joins Eric to discuss how Curative is reinventing health insurance by adopting a more preventative approach to drive better results and lead to a more affordable delivery of plans. Fred shares Curative’s journey from a pandemic testing company to a health insurance provider with a first-of-its-kind plan that eliminates copays and deductibles and advocates that the most effective approach to promote early preventive care is ensuring accessible and cost-free access to top-tier healthcare providers. Fred underlines the significance of simplifying the healthcare system and the positive impact of Curative's approach. The innovative health insurance plan offers unmatched transparency into healthcare costs, providing reassurance to both employees and employers about the affordability and accessibility of healthcare. Tune in and learn what makes Curative different from other plans and how it makes health care affordable, accessible and engaging for members. About Fred Fred Turner is the Chief Executive Officer and co-founder of Curative. A British scientist from West Yorkshire, Turner attended the University of Oxford. Fred was named one of the top 100 practicing scientists in the UK by the Science Council in 2013. Turner was included in Forbes “30 Under 30” list and ranked first in the European Union Contest for Young Scientists. About Curative Curative has been critical and a national leader in bringing COVID-19 testing and vaccine-administration resources in response to the pandemic, providing more than 32 million tests and two million vaccines across thousands of locations in 40+ states. Concurrently, Curative has created and launched a first-of-its-kind health insurance plan offering that offers unmatched transparency into health care costs.
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Investor Insights: Strategies to Drive Transformative Growth in Healthcare
06/07/2024
Investor Insights: Strategies to Drive Transformative Growth in Healthcare
Leading healthcare investors and strategists discuss how to rethink capital in healthcare and share unique ways to grow and scale companies to improve health outcomes, cost savings, and operational efficiencies. Topics include: Components investors look for in 2024 Healthcare sectors with the highest growth projections Human capital strategies Growth strategies to scale your company Bright spots that have been attracting people and capital Anna Haghgooie, Managing Director at Valtruis, a WCAS Company Steven Klopfer, Founder & Managing Partner, Kamyn Search Shayan Masoudpour, Director, Bow River Capital Naimish Patel, President, Healthcare Practice, Red Cell Partners Feedback survey:
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Storytelling to Build Medical Trust: How Boston Medical Center is Crushing Outcomes via Empathy and Trust
05/30/2024
Storytelling to Build Medical Trust: How Boston Medical Center is Crushing Outcomes via Empathy and Trust
Katherine Gergen Barnett, MD, Vice Chair of Primary Care Innovation and Transformation in the Department of Family Medicine at Boston Medical Center (BMC) and Cheryl Harding, patient and community advocate, join Eric to share how Boston Medical Center is utilizing storytelling to build trust and connection between the hospital and its community partners. Katherine and Cheryl discuss the impact medical mistrusts has on health outcomes and health disparities. They also tell how the "Storytelling to Build Medical Trust" project was born out of the desire of BMC to improve the health and well-being of Black and brown community members. The project puts a face to the statistics and allow community members to explain why they lack trust in the overall healthcare system. Hear how this unique project has brought the medical and local communities together and how empathy and trust can help advance health equity and narrow health disparities. About Katherine Katherine Gergen Barnett, MD, is a family medicine physician and the Vice Chair of Primary Care Innovation and Transformation in the Department of Family Medicine at Boston Medical Center (BMC). Dr. Gergen Barnett is also a clinical associate professor at Boston University Chobanian & Avedisian School of Medicine. Her primary clinical interests are behavioral health, preventive medicine, nutrition, trauma-informed care, gender-affirming care, women’s health, reproductive care, mindfulness-based stress reduction, and group medical care. Dr. Gergen Barnett’s research focuses on innovative models of care to address chronic medical conditions and physician burnout and engaging community partners in creating feasible solutions to increase health and wellness and to address medical distrust in traditionally marginalized communities. Dr. Gergen Barnett is involved in local and state health policy addressing health inequities and national policy addressing primary care delivery and is a regular contributor to The Boston Globe, Boston Public Radio, and various television outlets. About Cheryl The founder of a Boston nonprofit, From Roots to Wings, Cheryl continues to be a strong voice for the underserved and underrepresented to ensure that everyone gets access to information, services and opportunities. About the Project “Storytelling to Build Medical Trust” focuses on highlighting the experience and wisdom of community members, who shared in video interviews their negative interactions with the healthcare system in the hope that the healthcare industry would finally listen. The project is jointly led by , , and , in partnership with , , and . The project was funded by Boston University and Learn more at . About Boston Medical Center Boston Medical Center is a non-profit 514-bed academic medical center and safety-net hospital in the South End neighborhood of Boston, Massachusetts. As part of the Boston Medical Center Health System, the hospital provides primary and specialty care to residents of the Greater Boston area. Boston Medical Center is a founding partner of the Boston Medical Center Health System, which is focused on creating a coordinated, equitable, value-based continuum of care to deliver world-class care to patients and health plan members. Find out more at .
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Innovative Strategies for Health Plans to Mitigate Social Risk
05/24/2024
Innovative Strategies for Health Plans to Mitigate Social Risk
Elevance Health, Blue Cross Blue Shield of South Carolina, and the Business Group on Health and Socially Determined discuss how plans can provide a more holistic and effective healthcare journey for members by gaining insight into all barriers to caring for your members, including social risks such as food insecurities, housing instabilities, financial strain, health literacy challenges, and lack of transportation. Our expert panel explores the value of quantifying the impact of social risks and shares strategies and actions that health plans can take to improve health outcomes, reduce health disparities, decrease costs, and track measurable results. Link to report on Elevance's Whole Health Index (WHI) mentioned during show: Guests: Shantanu Agrawal, MD, MPhil, Chief Health Officer, Elevance Health April Richardson, MD, Vice President, Clinical Services, Blue Cross Blue Shield of South Carolina Ellen Kelsay, President & CEO, Business Group on Health Trenor Williams, MD, CEO & Co-Founder, Socially Determined https://www.brightspotsinhealthcare.com/events/innovative-strategies-for-health-plans-to-mitigate-social-risk/ This episode is sponsored by Socially Determined Socially Determined provides social risk data, analytics, and expertise to healthcare organizations seeking to understand how Social Determinants of Health and social risk factors impact the communities they serve. Our analytics platform, SocialScape, provides actionable insights into community-level SDOH risk exposure and individual-level social risk factors, and their impact on health care utilization, cost, outcomes, and equity.
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How Mass General Brigham is Innovating around Equitable Access
05/16/2024
How Mass General Brigham is Innovating around Equitable Access
Allison Bryant, MD, MPH, Associate Chief Health Equity Officer, Mass General Brigham (MGB), joins Eric to discuss how the health system ensures its innovations are accessible to everyone, particularly those from marginalized communities. Allison elaborates on MGB's unique approach, viewing its mission as providing healthcare and as a catalyst for improving equity of outcomes for patients and the communities it serves. Topics covered include: Community health Bridging the digital divide Equity in maternal health United Against Racism (MGB’s Diversity, Equity and Inclusion statement) About Allison In her role at MGB, Allison works to eliminate longstanding inequities in patient care and outcomes. She is a maternal-fetal medicine subspecialist, an associate professor of obstetrics, gynecology and reproductive sciences at Harvard Medical School and is the Frederic D. Frigoletto, MD Endowed Chair in the Department of Obstetrics and Gynecology at Massachusetts General Hospital. She received degrees in biology, public health and medicine from Harvard University, where she also completed residency training in obstetrics and gynecology and fellowships in maternal/fetal medicine and the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy. She previously served as the vice chair for quality, equity and safety for the Department of Obstetrics and Gynecology at Mass General. About Mass General Brigham Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals. Mass General Brigham United Against Racism:
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