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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Unlocking Success Through Specialty Value Based Models
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1:00:34
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 pract…
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Innovations in Medicare Advantage and Beyond: How Devoted Health is Transforming Care
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56:31
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 partner…
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The Blueprint for Speciality Value-Based Care
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53:32
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 commer…
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Revolutionizing Health Plans: The Connected Member Experience
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1:00:36
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 Pan…
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From the Sidelines to the Boardroom: Leadership lessons with Michael Lombardi
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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 heal…
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Convergence of Pharmacy & the Health Equity Index in 2024 and Beyond
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1:03:29
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 soc…
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Everything You Thought about Value-Based Care Is Wrong: A Plan CEO Tells You Why
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34:52
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 fir…
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Investor Insights: Strategies to Drive Transformative Growth in Healthcare
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1:00:52
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 Grow…
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Storytelling to Build Medical Trust: How Boston Medical Center is Crushing Outcomes via Empathy and Trust
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51:26
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 par…
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Innovative Strategies for Health Plans to Mitigate Social Risk
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1:02:10
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, finan…
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How Mass General Brigham is Innovating around Equitable Access
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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 i…
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Navigating the Intersection of Health Equity and Chronic Care
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1:01:20
Esteemed leaders from CVS Health, Florida Blue, Highmark, and Vori Health delved into the impact of health equity on chronic care. They not only shared strategies and solutions to enhance healthcare accessibility but also shed light on specific programs they have successfully implemented to bridge the health equity gap in chronic disease prevention…
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How Sun Life is Rethinking Mental Health
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59:32
Dan Fishbein, President of Sun Life U.S., joins Eric to discuss Sun Life’s commitment to supporting holistic care for mental health and how it leverages digital technology to enhance the overall delivery of mental health and caregiver support to all clients. The conversation also touches on how Sun Life is helping patients navigate a challenging he…
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How Top Hospital Systems are Capturing New Patients
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Leaders from Ballad Health, Baystate Health, Stony Brook Medicine and Purple Lab share how health systems can take a more sophisticated and consumer-focused approach to attracting new patients. Our expert panel leads a thought-provoking discussion on the importance of seeing patients as healthcare consumers and understanding how they make decisions…
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Differentiating Your Product and Benefit Design to Drive Enrollment
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Leaders from Independence Blue Cross, Oscar Health and TytoCare explore how health plans can leverage various solutions effectively to optimize pricing structures; exploring technology adoption, cost-effectiveness, and market competitiveness. Our panel of industry experts will share successful strategies and real-world examples you can implement in…
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Innovations in Mental Health: A Conversation with Kody Kinsley, North Carolina’s Secretary of Health & Human Services
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Kody Kinsley, Secretary of North Carolina’s Department of Health and Human Services, joins Eric to discuss how his state is improving the lives of families and children by expanding Medicaid and improving the mental health system. Secretary Kinsley shares strategies for improving behavioral healthcare access and benefit design for North Carolina’s …
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The Evolution of Specialty Value Based Care
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1:00:51
Leaders from Humana, Blue Cross, and Blue Shield of Rhode Island delve into the dynamic landscape of specialty value-based care, sharing valuable insights and actionable strategies for navigating its complexities. Show Guests: Alexander Ding, MD, MS, MBA, Associate Vice President for Physician Strategy and Medical Affairs, Humana Nick Lefeber, Seni…
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Important and Innovative Approaches to Leveraging the Health Equity Index
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49:51
Melissa Newton Smith, Founder of Newton Smith, and Keslie Crichton, Chief Sales Officer of BeneLynk, join Eric to discuss the introduction of the CMS Health Equity Index, which will replace the reward factor within the Medicare Advantage Star Rating program measurement. The Health Equity Index will be a seismic change for Medicare Advantage plans a…
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Meeting Goals for Chronic Condition Management With Fewer Resources
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Leaders from Independence Blue Cross, Banner| Aetna, and Scene Health share exclusive insights on successfully accomplishing chronic condition management success with fewer resources. Our expert panel explores patient-centered and technology-enabled approaches that elevate chronic care management efficiency and effectiveness. Don't miss the opportu…
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How Innovators Are Addressing GLP-1s, Obesity and MSK
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1:01:27
Leaders from Blue Cross and Blue Shield of Illinois, Independent Health, Evry Health and Vori Health discuss GP-1s and their role in addressing the global challenge of obesity. The panel shares innovative, multidisciplinary strategies you can implement to complement lifestyle interventions and other therapeutic approaches in your organization. * Im…
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Supporting Innovation and AI in Healthcare
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Seema Kumar, CEO of Cure, an innovation campus in New York City, joins Eric to discuss how artificial intelligence can positively impact healthcare and lead to more innovation. She shares how AI has been used in healthcare and the promise it holds for the future. The conversation also highlights the Cure Xchange Challenge: Health AI For Good, an in…
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Lifestyle Modification Strategies to Support Those Living with Obesity and Diabetes
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Blue Shield of California, Highmark, Intellihealth and NourishedRX discuss how they are mitigating the high costs of GLP-1s with lifestyle interventions such as behavior change, physical exercise, nutritional counseling and coaching to optimize outcomes for members living with obesity and diabetes. Hear real-life examples and best practices to equi…
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Differentiating Your Health Plan: Reimagining Your Provider Network Strategy
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Leaders from Blue Cross and Blue Shield of Michigan, Highmark and Quest Analytics discuss how health plans are examining and reimagining their provider strategies to stay competitive and meet their members' evolving needs. By focusing on areas such as compliance, network adequacy, data integrity, and performance metrics, plans are redefining their …
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A Conversation with Blue Cross and Blue Shield of North Carolina’s Chief Strategy Officer
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Sonny Goyal, Senior Vice President of Diversified Business Group and Chief Strategy Officer of Blue Cross Blue Shield of North Carolina (Blue Cross NC), joins Eric to share some of Blue Cross NC’s successful initiatives to help members live their best lives. Sonny discussed Blue Cross NC’s approach to mitigating social determinants of health, expla…
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Talking Bright Spots with Former Congressman Robert Andrews
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Former New Jersey Congressman and Health Transformation Alliance (HTA) CEO, Robert Andrews, joins Eric to discuss how HTA – a cooperative of more than 60 of America’s leading employers –and its members employers are fixing our broken healthcare system by sharing data, challenging the status quo and implementing innovative solutions. Robert shares m…
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Safe Babies Safe Moms: Rethinking Equitable Access and Maternity Care
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Angela D. Thomas, DrPH, MPH, MBA, Vice President, Healthcare Delivery Research, MedStar Health Research Institute, joins Eric to discuss D.C. Safe Babies Safe Moms, a community-driven collaborative launched in 2020 to improve the health and well-being of mothers and infants in Washington, D.C., and reduce racial disparities in maternal and infant h…
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Beyond Medication Adherence: Unleashing the Power of Member Engagement to Elevate Outcomes
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Leaders from CareFirst, CareSource, UPMC Health Plan and Scene Health explore how proper medication adherence ensures a higher quality of life, improves health outcomes and reduces healthcare costs. Many health plans saw their overall Medicare Star Ratings drop this year due to one particular area – medication adherence. Our expert panel from top-r…
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Why the ACA Consumer Experience Sucks and How Select Health Fixed It
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Kim Barrus, MSN, RN, PMP, Director, Clinical Outcomes Management of SelectHealth, joins Eric to discuss how her plan reinvented the consumer experience for ACA Marketplace health plans. With almost half of ACA Marketplace customers complaining about making appointments with providers and other process challenges, SelectHealth committed to reversing…
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Medicare Advantage and the Next Generation in Home Health Strategies
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1:01:25
Leaders from Humana, Healthfirst, Health Leads and Vesta Healthcare join Eric to discuss the future of home healthcare for Medicare Advantage plans. As care delivery strategies evolve, the home is critical in achieving clinical and customer satisfaction ratings that drive business success. Home health is also vital to providing equitable care to al…
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Can Your Social Care Strategy Drive You to Five Stars?
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Leaders from Network Health, UPMC Health Plan, Healthmine and Benelynk explore how Medicare Advantage plans can attain 5-Stars and share bright spots on improving outcomes for members with social risk factors. Learn how closing gaps in care and reducing health disparities can help your plan reach 5 Stars! Topics include: CMS Health Equity Index Pro…
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The Future of Senior Health: Equitable Access & Open Enrollment
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Healthcare leaders from Humana, myPlace Health, Mom’s Meals, and SCAN explore the latest product and benefit design trends for the aging population. Our expert panel shares strategies and best practices your plan can implement to bridge the social and clinical care gap and empower seniors to create a lifetime of healthy habits. Topics include: Prod…
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Last-Minute Gaps in Care Strategies
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1:01:51
If your plan is struggling to meet performance and quality goals for 2023, there's still plenty of time to turn things around and ensure members get the preventative care they need while raising your plan’s quality scores by closing care gaps across the healthcare ecosystem. Annually, gaps in care cost the U.S. healthcare system a staggering amount…
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Driving Innovation at Nashville General Hospital
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Nashville General Hospital CEO Joseph Webb, D.Sc., MSHA, FACHE, joins Eric to discuss how the hospital is using innovation to fulfill its mission and vision to improve the health and wellness of Nashville – one neighbor at a time. During the conversation, Dr. Webb shares details on two innovative initiatives Nashville General implemented to address…
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AI is Advancing The Member Journey and Improving Lives TODAY
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1:01:25
Healthcare leaders from Geisinger, Intermountain Health, UNC Health and TytoCare join Eric to discuss how AI and machine learning transform the member journey and empower members to take a more active role in their health. Our experts share successful strategies and best practices your healthcare organization can implement to change the member expe…
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The Disenrollment Tsunami: How to Enhance Your Medicaid Redetermination
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This year's end of the Public Health Emergency and the Medicaid continuous coverage provision kicked off a 12-month unwinding period, which is expected to bring an unprecedented churn in Medicaid programs across the country. Redetermination could cause 18 million Americans to lose health coverage, creating care gaps for the most vulnerable and wide…
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How Blue Cross Blue Shield of Arizona is Reinventing the Member Journey
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Phylicia Schroeder, Manager, Provider Engagement and Quality Analytics at Blue Cross Blue Shield of Arizona Medicare Advantage and Janine Wakim, Head of Operations at ReferWell, join Eric to discuss how the plan is transforming the member journey by instituting a cultural shift putting the member’s needs above the plan’s needs, adding that to accom…
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How Psychedelics Can Bend the Mental Health Cost Curve
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Psychedelic Researcher and Psychologist Alex Belser, PhD, joins Eric to discuss the efficacy and safety of psychedelics, how they are being applied in practice and the potential pharmacoeconomic and business impact this category of medications can have on patients with severe mental illness. Alex shares information on the latest research and develo…
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Equity, Engagement & Nutrition: Innovations Empowering the Underserved
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1:00:59
Leaders from Humana, SCAN and NourishedRx discuss the link between food, nutrition security and health and the idea that food and nutrition programs can improve health. Many Americans lack access to nutritious food due to food insecurity, contributing to high rates of chronic disease, poor health outcomes and health disparities, especially among un…
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How Digital Mental Health is Making an Impact
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1:01:15
Healthcare leaders from AmeriHealth Caritas, Cigna Healthcare, Highmark, Reliant Medical Group and Corporate Insight share innovations in mental health, including how their organizations are incorporating and maximizing digital mental health tools and platforms. Learn strategies and approaches you can implement in your organization. Panelists Yavar…
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How Healthfirst is Partnering with a Health System to Make Providers’ Jobs Easier
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G.T. Sweeney, Chief Information Officer of Healthfirst and Sami Boshut, Chief Information Officer of MediSys Health Network, Inc., join Eric to discuss how their organizations collaborated with a technology company to create a cloud-based platform that enables seamless sharing of patient data across the care continuum. The platform connects longitu…
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The Next Wave of Benefits Navigation for Government Programs
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John Petito, Corporate Vice President, Transformation of SCAN Health and Ashish V. Shah, CEO of Dina, discuss the power of benefits navigation in attracting and retaining members for Medicare Advantage plans and other government programs. The average Medicare beneficiary has access to over 43 Medicare Advantage plans, and offering supplemental bene…
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Reduce Total Cost of Care: Innovative Whole Person Models for High-Cost Conditions
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1:00:41
Healthcare leaders from Blue Shield of California, CareSource, UT Health Austin and Vori Health discuss the importance of adopting a whole-person approach across the broader healthcare experience to maximize value, drive healthy behavior change and ensure more equitable care. Learn how to develop an integrated whole-person solution framework and im…
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Boosting Plan Performance: Improving Provider-Centric Risk Adjustment & Staying Compliant
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1:00:06
CDPHP, Johns Hopkins Medicine, Priority Health, ATRIO Health Plans and Vatica Health share successful strategies and best practices for provider-centric risk adjustment programs, which enable health plans to enjoy higher compliance, enhanced quality of care, improved risk score accuracy, higher Star and quality ratings and better financial performa…
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Unique Approaches to Building Trust with Dual Eligible Members
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AmeriHealth Caritas, Blue Cross Blue Shield, Optum at Home & Reema Health share bright spots and novel tactics for engaging dual eligible beneficiaries. Discussion topics include: building a foundation of trust through a community approach, engaging hard-to-reach or historically unreachable members, and addressing health-related social needs to imp…
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How Banner|Aetna is Rethinking Whole Person Care
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Joanne Mizell, Chief Operating Officer, Banner|Aetna – a joint venture between CVS Health’s insurance arm, Aetna, and health system Banner Health – joins Eric to discuss what makes Banner|Aetna unique from other health insurers and its approach to whole person care. She shared how the company uses MultiDisciplinary Care Teams to provide high-risk p…
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Improve CAHPS through Enhanced Benefits Navigation
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Healthcare leaders from Alignment Health, SCAN, ATI Advisory and Dina discuss the importance of MA plans to ensure members understand available non-medical benefits. Making the experience painless is essential to attracting and retaining members – and improving CAHPS and Star Ratings. Learn successful strategies and best practices your plan can imp…
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Success Stories in Virtual Care Enrollment & Engagement
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Healthcare leaders from United Health Group, Blue Shield of California, Highmark, Oklahoma Complete Health (Centene) and TytoCare share real-world, virtual care success stories. Gain insight into how virtual care boosts outcomes improves equity and reduces costs. Hear case studies, lessons learned, and best practices you can implement in your organ…
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Mitigating Social Risk to Achieve Higher Star Ratings
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1:01:07
In its Advance Notice, CMS indicates health equity and social needs will be a major focus in Star Ratings shortly, with new measures in these areas expected by 2026. To prepare, plans need to start planning on effectively intervening with members with social needs factors. Our expert panel will share successful strategies for identifying, engaging,…
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Sell with a Story in Healthcare with Paul Smith
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Paul Smith is one of the world’s leading experts in business storytelling. He’s one of Inc. Magazine’s Top 100 Leadership Speakers of 2018, a storytelling coach, and the bestselling author of several books on the art and science of storytelling. During the hour-long session, Paul will discuss the following: What is the optimal structure of a story?…
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Equity & Timely Access as a Stars Strategy
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Industry leaders from MetroPlusHealth, Network Health, Priority Health and ReferWell discuss strategies to advance health equity and improve care access to achieve higher Star Ratings. As health equity initiatives play an increasingly important role in CMS programs, Medicare Advantage plans must commit to addressing social factors hindering access …
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