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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!"
Stronger communities begin with good health — for everyone. And good health means caring for both the body and the mind. In Season 2 of Good Health, Better World, you’ll hear from experts about the ways we can improve our overall health when we uncover, deliver, and destigmatize the support needed to manage emotions, handle stress, and build healthy relationships. You’ll hear independent viewpoints from community and government leaders, and from experts and clinicians from UPMC Health Plan. ...
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Bright Spots in Healthcare
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Improve CAHPS through Enhanced Benefits Navigation
1:01:13
1:01:13
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1:01:13
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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Bright Spots in Healthcare
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Success Stories in Virtual Care Enrollment & Engagement
1:01:03
1:01:03
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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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Bright Spots in Healthcare
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Mitigating Social Risk to Achieve Higher Star Ratings
1:01:07
1:01:07
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1:01:07
Senior leaders from Cigna, Independent Health, Regence, and Socially Determined join Eric to discuss how minimizing social risk helps plans garner higher quality and performance scores. Learn successful strategies for identifying, engaging, and addressing members with elevated social risks to drive gap closure and member retention. The session is f…
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Bright Spots in Healthcare
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Sell with a Story in Healthcare with Paul Smith
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56:16
A well-crafted story can pack the emotional punch to turn routine presentations into productive relationships. Organizational storytelling expert and author Paul Smith joins Eric to share his popular and proven formula for telling a story. Paul discusses the following: What is the optimal structure of a story? What different types of stories should…
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Bright Spots in Healthcare
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Equity & Timely Access as a Stars Strategy
1:02:29
1:02:29
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1:02:29
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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Bright Spots in Healthcare
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Novel Approaches to Care Coordination: The Key to Profitable Risk Models
1:02:58
1:02:58
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1:02:58
Carle Health, Cedars-Sinai, Cleveland Clinic, and CarePort, powered by WellSky, discuss innovative and novel approaches to care coordination. Topics include: real-time transparency, streamlining and improving communication, and Interoperability between partner organizations. Panelists: Cynthia Deculus, Chief Population Health Officer and Vice Presi…
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Bright Spots in Healthcare
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ACO REACH: Advancing Equity and Optimizing Performance
1:00:23
1:00:23
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CareMount Health Solutions, VillageMD and Socially Determined leaders discuss the incentives and requirements laid out by the new ACO REACH model and how organizations can develop action plans to identify differences or disparities in their members' health status. CMS replaced the Global and Professional Direct Contracting (GPDC) Model with the red…
Dr. Errol L. Pierre, Senior Vice President, State Programs at Healthfirst, joins Eric to discuss how health plans, providers and other organizations can create a culture of health equity. He notes the challenges of obtaining the data necessary to understand where to start. Errol advises organizations to gain the patient's or member's trust to get t…
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Bright Spots in Healthcare
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2023 Strategy Session: Member Redetermination, CAHPS, and Social Needs
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1:01:31
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1:01:31
Leaders from Blue Cross Blue Shield Association; Horizon Blue Cross Blue Shield of New Jersey, and Icario, offer insights on the priorities to focus on as we enter 2023. As we turn the page from 2022, health plans are facing new challenges impacting member experience, retention, and, most importantly, their member’s health. Topics include: the new …
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Bright Spots in Healthcare
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How to Add Innovation to Whole-Person Care
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Healthcare leaders from Blue Cross NC, KC Blue, Blue Cross MN and MOBE explore how leading health plans can leverage innovations in clinical, wellness and medication management to build and expand a whole-person care framework. Topics include: building digital care models for Whole-Person Care, developing an integrated whole-person solution; Levera…
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Bright Spots in Healthcare
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Proactively Managing Risk via Innovations in Last Mile Care
1:00:58
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Health leaders from Network Health, Health Net, Priority Health, and Health.io discuss how top health plans improve risk assessment and quality measures through innovations and at-home testing. Topics include: Strategies for deploying novel solutions to drive member engagement and reduce costs for members, especially among traditionally unengaged p…
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Bright Spots in Healthcare
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Peer Support to Improve Medicare Advantage Outcomes
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59:55
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Our panel of experts from Humana, Regence, SCAN Health Plan and Wisdo discuss how incorporating peer support programs in your MA plans can improve clinical outcomes, lower costs, and boost engagement for members with chronic diseases, behavioral health issues and other social determinants of health. Hear "bright spots" and practical strategies you …
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Bright Spots in Healthcare
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Staying Ahead of Star Ratings: Planning & Execution Strategies
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58:31
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Julianne Eckert, Senior Director of Clinical Quality, Clover Health, Andre Bliss, Director of Medicare STARs, UPMC Health Plan and Marisa Howard, Senior Director, MA Operations, Evolent Health, share practical strategies and best practices to help Medicare Advantage plans to execute a successful star rating strategy. Learn significant trends and ga…
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Good Health, Better World
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Season 2, Episode 8: Innovation in behavioral health treatment
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37:55
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What’s the new frontier in behavioral health? That great frontier might not always mean being in a doctor’s office. Learn more about how telehealth, new therapies, and whole person care — where you live and play — affect well-being. Hear from Dr. Matthew Hurford and Dr. Geoffrey Neimark of Community Care Behavioral Health, a not-for-profit behavior…
Omolara Thomas Uwemedimo, MD, MPH joins Eric to discuss place-based interventions and how they are used to address health inequities. The place-based model focuses on improving health that aligns with community members, businesses, schools, churches and other institutions in a specific geographic location (a specific community or zip code). Omolara…
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Season 2, Episode 7: Aging gracefully: Supporting the mental health of older adults
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As we age, mental and physical changes can leave some people feeling left behind — perhaps even more isolated as a result of the pandemic, and other life changes. It doesn’t have to be that way. Listen in for a discussion about special considerations affecting the mental health of older adults, and how to recognize signs of depression. In this epis…
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Bright Spots in Healthcare
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How Hybrid Models Transform Value-Based Care
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Experts from Centene, Humana, UnitedHealthcare and TytoCare discuss leveraging hybrid-care models to improve access to care, close gaps in care and improve outcomes. Learn successful strategies and best practices you can implement in your organization. Hybrid care models provide a more personalized, flexible, and seamless patient journey, improving…
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Good Health, Better World
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Seaseon 2, Episode 6: What is integrated care?
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Integrated care helps bring together care for the body and mind. In this episode, our guests discuss this body-mind approach and how doctors are implementing this model. How could it benefit you or a loved one? Hear insights from Dr. Alin Severance, medical director of Behavioral Health Services at UPMC Health Plan and University of Pittsburgh prof…
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Bright Spots in Healthcare
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Co-Designing Social Care: Payers and Providers
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Featuring Blue Shield of California, CommonSpirit, Kaiser Permanente, and Partnership to Align Social Care. The delivery of social care services in connection with healthcare requires new systems to organize the relationships and activities of healthcare payers, providers, community-based organizations (CBOs), and community members. This panel will…
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Good Health, Better World
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Season 2, Episode 5: Behavioral health and resilience in the workplace
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Healthy, happy employees mean a better workplace. What can employers do? Guests James Kinville and Nancy Mckee of UPMC Health Plan’s LifeSolutions discuss why behavioral health care should be an important area of focus for employers and how an employee assistance program can support resilience and a culture of wellness. The views and opinions expre…
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Bright Spots in Healthcare
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Activating Today’s Medicare Member: Effective Engagement Strategies
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Featuring: Blue Cross and Blue Shield of Michigan, Blue Cross and Blue Shield of Kansas City, Johns Hopkins HealthCare and Linkwell. Motivating Medicare members to take action to improve their health is a high priority for health plans. Our panel explores how health plans can meet members where they are at the right time and with the right message.…
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Season 2, Episode 4: Opening up about addiction
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In this episode, we hear from behavioral health experts who discuss different types of addictions, the impact, and how to get support on a path to recovery. Hear insights from Dr. Michael Lynch, associate professor of Emergency Medicine, Toxicology, Pediatrics, and Addiction Medicine at the University of Pittsburgh and Dr. Antoine Douaihy, who spec…
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Bright Spots in Healthcare
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How One Value-Based Care Company Became Profitable!
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52:43
Landmark Health CEO Chris Johnson joins Eric to share his vision for the aging health system of tomorrow and his organization’s mission to help seniors age in place by extending primary and urgent care into the homes of patients with challenging illnesses. Finally, Chris talks about the shift to value-based care and how providers can navigate the n…
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Good Health, Better World
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Season 2, Episode 3: Childhood, interrupted: Adolescent and pediatric behavioral health
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The pandemic disrupted childhood routines in ways that experts are still seeking to understand. In this episode, UPMC Children’s Hospital of Pittsburgh pediatrician Dr. Johanna Vidal-Phelan and psychiatrist Dr. Abigail Schlesinger talk about common behavioral health issues children and teens can have and what adults can do to support the health and…
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Good Health, Better World
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Season 2, Episode 2: Building resilience through trauma-informed care
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In this episode, Dr. Kimberly Blair, a psychologist at Western Psychiatric Hospital, and Dr. Lyndra Bills, senior medical director at Community Care Behavioral Health Organization, discuss the ways that trauma and anxiety have affected people as our lives shifted as a result of the pandemic. How can trauma-informed care and trauma-informed systems …
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Redetermination Strategies to Maximize Continuous Medicaid Coverage
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Featuring Healthfirst, Colorado Access and Icario. The impending need for state Medicaid agencies and plans to administer redeterminations for Medicaid beneficiaries poses a risk of lost coverage for nearly 15 million individuals, especially for the vulnerable D-SNP population. Our expert panel provides insights into the groundwork needed to educat…
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Good Health, Better World
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Season 2, Episode 1: Laying the Foundation for Behavioral Health
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In this season’s inaugural episode, our guests discuss what behavioral health means and share resources to help us get back on track as we move forward from COVID-19. We hear from Diane Holder, president and CEO of UPMC Health Plan, and Dr. James Schuster, chief medical officer of the UPMC Insurance Services Division. Listen in! For show notes and …
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Payer and Provider Strategies for Last Mile Care
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59:06
Healthcare leaders from Avera, Blue Shield of California, Renown Health and the Partners in Care Foundation discuss solving the last mile In healthcare, the link between the consumer and where care is delivered. When consumers can’t pass through the last mile connection to the healthcare delivery system, they never even get an opportunity to engage…
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Bright Spots in Healthcare
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How to Conquer the Transition of Care Journey
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Dina CEO Ashish V. Shah joins Eric to discuss the advantages and challenges in transitioning care from the hospital to the home. He shares what it takes to replicate the facility-based experience outside of the hospital and deliver measurable quality improvements cost-effectively. Ashish provides a step-by-step blueprint for creating an exceptional…
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Bright Spots in Healthcare
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Why You Shouldn't Settle for Partial Duals
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Josh Weisbrod from Network Health and Keslie Crichton and Sean Libby from BeneLynk join Eric to discuss opportunities and challenges in identifying and converting members to full dual status, including specific examples and an outlined roadmap into this additional revenue stream. After listening to this episode, you will understand: Why identifying…
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Bright Spots in Healthcare
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Reducing Chronic Condition Readmissions
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Preventable hospital readmissions cost the healthcare system approximately $25 billion annually, and it is estimated that one of every five Medicare patients is readmitted to the hospital within 30 days of discharge. Our panel of experts shares insights and best practices on lowering readmission rates for patients with chronic health conditions thr…
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Bright Spots in Healthcare
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How Digital Technologies are Advancing Health Equity
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Digital technology can give organizations more data, giving them more visibility not only into patients’ clinical profiles but also population health profiles and socioeconomic profiles. Our panel of experts will discuss how health plans can effectively tap the potential of digital technologies to improve care delivery, outcomes and equity for trad…
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Bright Spots in Healthcare
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Elevate Risk Adjustment by Activating Providing Participation
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Risk adjustment is much more than a regulatory requirement for Medicare Advantage plans – it can improve the quality of care by providing an accurate picture of each member’s health status and ensuring each member receives the right interventions and treatment. Providers play an important role in risk adjustment, too. An engaged partnership between…
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The Playbook for Local as a Healthcare Strategy
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58:20
Engaging high-needs Medicare and Medicaid members can be a huge barrier to better health and a consistent challenge for even the most innovative health plans. In order to successfully engage these members, health plans must meet them in the communities they live and work and provide the right solutions and resources. Our expert panel of leaders fro…
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Bright Spots in Healthcare
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How CareFirst and Socially Determined are Taking an Analytic Approach to Drive Precision
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Socially Determined Co-Founder and CEO Trenor Williams, MD, talks with Eric about the importance of accessing and unlocking the potential of member demographic data, including race, ethnicity and language, to identify social risk. Specifically, he shared details of his organization’s partnership with CareFirst BlueCross BlueShield to optimize inter…
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Bright Spots in Healthcare
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How Conquering Loneliness is A Key to Your Medicare & Medicaid Businesses
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Loneliness is associated with worsening health-related quality of life, increased mortality, higher risk for a variety of physical and mental health conditions, and other poor health outcomes. While loneliness is typically applied to seniors, it can apply at any age. Michelle Bentzien-Purrington, SVP, Senior Vice President, MLTSS, Molina Healthcare…
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Bright Spots in Healthcare
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SDOH and DE&I: Knowing Your Veteran Population
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Featuring: David Shulkin, MD, Former U.S. Secretary of Veterans Affairs Kacey L. Serrano, MPA, CPC, CRC, Director, Medicare Stars and Risk Adjustment, Arkansas Blue Cross and Blue Shield Sean Libby, President, BeneLynk Today, 22% of Medicare Advantage members are veterans of the United States Armed Forces and 5% of Medicare Advantage members use th…
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Bright Spots in Healthcare
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Creating a More Human, Holistic Approach to SDoH: Reaching the Unreachable with Anthem, Optima Health, UnitedHealthcare & Icario
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Reaching hard-to-reach populations takes heart, determination, and support. And it’s hard. Just because you’re communicating, doesn’t mean you’re connecting. Our panel explores ways health plans can make sure they meet their members where they're at and how to navigate the complicated outreach process. Panelists: Merrill Friedman, RVP, Inclusive Po…
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Your New SDOH Roadmap: Integrating Social Care into Healthcare
1:01:47
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In order to implement an effective SDOH strategy, healthcare organizations must develop an infrastructure to integrate both clinical and social interventions. Our panel of experts from Melanin & Medicine, MetroPlus Health, Priority Health, ProMedica, and Socially Determined shares best practices, lessons learned, and key considerations to help you …
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True Value-Based Care Starts with an Action
27:24
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27:24
Dr. Jonah Mink, Medical Director of Health.io discusses how health plans can convert data into actionable insights by leveraging focused chronic care service providers with at-home or last-mile care or diagnostics. Jonah also shares how health plans are generating clinical results and revenue from partnerships with service providers and offers guid…
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Bright Spots in Healthcare
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Health Equity and SDOH: Leveraging Data and Measures with Anthem, CareSource, Nationwide Children’s Hospital and Evolent
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59:43
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Achieving health equity begins with an ability to identify health disparities and their causes Without adequate data and measures, inequities remain unseen and unaddressed. Our expert panel discusses the importance of leveraging data and analytics to understand, measure, and support equity improvement efforts. They will share successful strategies …
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Consumer Centricity and the Power of PAM®
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Eric goes one-on-one with Chris Delaney, Founder, and CEO of Insignia Health. During the episode, Chris talks about consumer centricity and the importance of the patient activation measure (PAM) for health plans and providers. He provides various case studies and overall guidance on how to successfully implement activation programs that work. This …
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Bright Spots in Healthcare
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Medicare Advantage: Novel Approaches to Whole Person Care
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Experts from Cigna, SCAN Health Plan and UPMC Health plan share strategies and best practices for generating higher HEDIS and STAR ratings by advancing a holistic approach to their members’ care including “last mile” strategies and caregiver support coupled with physical, behavioral and social needs. Panelists include Ellen Bjeckford, PhD, MPH, Ass…
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A Conversation with Cynthia Brandt, PhD, Chief Executive Officer & President, Lucile Packard Foundation for Children’s Health
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42:52
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42:52
Dr. Cynthia Brandt joins Eric to discuss her mission to unlock philanthropy to improve health for children and mothers around the world through the foundation, which directs all fundraising for the Lucile Lucile Packard Children’s Hospital Stanford and for the maternal and child health programs at Stanford University School of Medicine. Cynthia sha…
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Leverage SDOH Outreach to Increase Dual Eligible Penetration
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Our panel of experts from Commonwealth Care Alliance, Molina Healthcare of Ohio and BeneLynk share best practices for addressing the SDOH needs of your dual eligible members. Walk away with ideas you can implement in your own organization to close gaps in care, improve outcomes, and reduce costs. Topics include: Topics include: Combining technology…
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Bright Spots in Healthcare
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A Conversation with Dr. Shantanu Agrawal, Chief Health Officer, Anthem
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Anthem’s Chief Health Officer Shantanu Agrawal, MD, talks to Eric about what the insurer is doing to lessen the effect of social determinants of health (SDOH). He shares the results from Anthem’s recently released report, Driving Our Health: A study exploring health perceptions in America, a national survey of 5,000 U.S. adults. Anthem conducted th…
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Health Plan Case Studies: Strengthen the Member Experience to Improve Quality Ratings
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Health plans today are facing simultaneous pressures to improve member experience, increase healthcare quality and reduce costs. Hear how leading health plans are designing and implementing exceptional member experiences, boosting quality rating and helping members achieve better health outcomes! Also, learn how looking at the member experience thr…
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Closing Gaps in Care: Innovative Approaches to Achieving Quality Goals
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As healthcare works toward value-based care, closing care gaps and engaging consumers in preventive health is a high priority among payers and providers as it reduces costs and improves health outcomes. In this podcast, leaders from Blue Cross Blue Shield of Illinois, Clover Health, Health.io and Humana share successful strategies for closing gaps …
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A Conversation with Cyrus Batheja, National Vice President, UnitedHealth Group
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55:21
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In this episode, UnitedHealth Group National Vice President Cyrus Batheja joins Eric to share his inspirational personal story and how it motivates his desire to break down the barriers to healthcare. During the conversation, it becomes clear Cryus is a remarkable individual. He details his family’s journey to America and his experience growing up …
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A Conversation with the CIO of Blue Shield Of California, Lisa Davis
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In this episode, Lisa Davis, Senior Vice President and Chief Information Officer at Blue Shield of California (BSC) sits down with Eric to talk about BSC's overall Health Reimagined strategy, BSC's Portfolio Product Models, and their new partnership with Google Cloud. In addition, Lisa dives into criminal and counterintelligence and how the overall…
