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 Medicaid and Medicare members, including peer support programs, mental health crisis lines, and data systems to track the availability of beds and individuals in need. The conversation also explores the importance of improving healthcare infrastructure through Medicaid, focusing on preventative measures and addressing social determinants of health. About Secretary Kinsley Kody Kinsley serves as North Carolina’s Secretary of Health & Human Services, overseeing a department with over 18,000 staff and a $38 billion budget. With experience centered on health policy and operations, Kinsley worked on digital healthcare transformation, national education, and labor policies and served as the COO and CFO of the U.S. Treasury. Secretary Kinsley’s three priorities for the department include Investing in behavioral health and resilience, improving child and family well-being, and building a solid and inclusive workforce. Under his leadership, North Carolina expanded Medicaid and received the most significant investment to bolster the mental health system in over a decade. Kinsley grew up in Wilmington, earning his bachelor’s degree from Brevard College and his master’s in Public Policy from the University of California at Berkeley.

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, Senior Vice President, Value-Based Care, Contracting, Data & Analytics, Blue Cross Blue Shield of Rhode Island Rachel Winokur, Chief Executive Officer, TailorCare https://www.brightspotsinhealthcare.com/events/the-evolution-of-specialty-value-based-care/ 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.

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 and impact revenue associated with Star Ratings. Melissa and Keslie share success stories from plans preparing for the change. Links "Associations Between Annual Medicare Part D Low-Income Subsidy Loss and Prescription Drug Spending and Use": https://jamanetwork.com/journals/jama-health-forum/fullarticle/2814604 Book Links $2.00 a Day: Living on Almost Nothing in America: https://www.amazon.com/2-00-Day-audiobook/dp/B012E8RDS2/ref=sr_1_1?crid=29MW28TUOFAG0&keywords=%242+a+day&qid=1708126201&s=books&sprefix=2+a+day%2Cstripbooks%2C125&sr=1-1 Because I Said I Would: https://store.becauseisaidiwould.org/store/thebook/?_gl=1*qfwy3p*_ga*OTY3NTIzNTYzLjE3MDgxMjYyNDc.*_ga_9YFXHXM1VK*MTcwODEyNjI0Ny4xLjAuMTcwODEyNjI1NC41My4wLjA. The Ethical Case Manager: https://www.amazon.com/dp/194388918X/ref=cm_sw_r_apin_dp_GVBYY6XZGAK9RK9VRHE8 About Melissa Melissa is the founder of Newton Smith. She brings over 25 years of experience in Star Ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. Most recently, she served as Chief Consulting Officer at Healthmine. Melissa is a well-known healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, quality performance, health outcomes, and the member experience. About Keslie Keslie has worked in managed care for over 25 years, focusing on SDoH solutions that improve members' lives and provide a return on investment for our clients. Keslie drives enterprise growth and innovative partnerships to improve outreach strategies and health outcomes for our client’s members. Keslie works closely with BeneLynk’s product team to offer differentiated services and capabilities to maintain its market leader position. This episode is sponsored by BeneLynk BeneLynk is a national provider of Social Care solutions for Medicare Advantage and Managed Medicaid health plans. They serve plans and their members by creating a human-to-human connection and providing the assistance a member needs to get the benefits they deserve.

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 opportunity to learn about strategic solutions tailored to the unique challenges of Medicaid and Medicare health plans. Panelists: Robert Groves, MD, Chief Medical Officer & Executive Vice President, Banner| Aetna Reetika Kumar, MD, FACP, Vice President, Market Clinical Solutions and Pharmacy Services, Independence Blue Cross Sebastian Seiguer, CEO & Co-Founder, Scene Health Bios: https://www.brightspotsinhealthcare.com/events/meeting-goals-for-chronic-condition-management-with-fewer-resources/ This episode is sponsored by Scene Health Meet Scene Health, the industry leader in MedEngagement. They are going beyond traditional medication adherence to transform disease management. Scene’s MedEngagement approach uses 1:1 async video to deliver medication support at scale. Scene helps members get better fast—getting to the doctor, getting their meds, taking them as prescribed, and getting labs and vitals—driving cost-effective utilization and improving multiple clinical and quality measures in as little as 90 days. Scene was commercialized out of Johns Hopkins, and has developed the most extensive catalog of peer-reviewed publications among medication adherence companies. Visit its website at www.scene.health for more information.

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. * Improving outcomes by pairing GLP-1s with evidence-based behavior change * Considering musculoskeletal (MSK) health in obesity treatment * Understanding the role of GLP-1s in delivering value-based care Panelists: Shelley Turk, Divisional Senior Vice President of Health Care Delivery, Blue Cross and Blue Shield of Illinois Martin Burruano, Vice President, Pharmacy Services, Independent Health Mamata Majmundar, MD, Chief Medical Officer, Evry Health Mary O'Connor, MD, FAAOS, Co-Founder & Chief Medical Officer, Vori Health https://www.brightspotsinhealthcare.com/events/how-innovators-are-addressing-glp-1s-obesity-and-msk/ This episode is sponsored by Vori Health Vori Health is a specialty medical practice delivering a virtual-first musculoskeletal (MSK) solution to help members get back to their lives faster. As the only nationwide MSK practice with doctor-led care teams, Vori Health is the most convenient way to access appropriate care for back, neck, and joint pain without bouncing around the healthcare system. Whether members need a diagnosis, non-opioid prescription, personalized physical therapy, or health coaching, they can turn to Vori Health for evidence-based care and effective end-to-end support. This holistic model reduces unnecessary surgeries, enables faster recoveries, and lowers MSK spend with up to a 4:1 ROI. For more information visit www.vorihealth.com.

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 initiative to incubate innovations by healthcare startups and entrepreneurs across disciplines and sectors to use artificial intelligence (AI) responsibly and equitably. Cure collaborated with MIT Solve for the Challenge and an independent board of judges selected the ten finalists. The winners will be announced later in the First Quarter of 2024. Seema shares the stories of several finalists, including Oben Health, an AI-enabled platform that facilitates the delivery of healthcare screenings, education, and treatment via barbershops and salons, and Nutrible, artificially intelligent social workers. This episode is part of a series of episodes featuring the Clinton Global Initiative Commitments to Action from the Clinton Global Initiative. Please listen to the previous episode, Safe Babies Safe Moms: Rethinking Equitable Access and Maternity Care. About Cure Cure is an innovation campus in NYC boasting laboratories, lecture, and office space, as well as technology and other amenities to set up innovators for success across the healthcare industry, including academic institutions and other nonprofits. Visit the website at: https://cure.345pas.com/

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 equip your members with the tools and strategies to achieve lasting success in managing obesity and diabetes beyond the limitations of GLP-1s. This episode is sponsored by NourishedRX NourishedRx is a leading digital health and nutrition company specializing in comprehensive nutrition solutions for consumer and health plan members living with diabetes, obesity and other diet-related conditions. NourishedRx recognized food's healing and connective power, and partners with healthcare organizations nationwide to address the nutritional needs of their most vulnerable populations. The NourishedRx B:B:C health and nutrition platform facilitates and optimizes personalized, culturally concordant food in addition to the tools necessary to drive lasting behavior change – leveraging technology so YOU can all deliver at scale. Beyond diet, NourishedRx engages with health plan members and patients to support their whole health and lifestyle more broadly. They engage consumers with omnichannel wrap-around support and education, enabling individuals to make informed choices and gain a deeper understanding of the impact of their diet and lifestyle on their overall well-being, empowering them for the long term. NourishedRx is well suited as an early alternative and/or companion therapy to specialized obesity treatment, including GLP-1 and other Anti-Obesity Medication therapies.

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, coaching to optimize outcomes for members living with obesity and diabetes. Hear real-life examples and best practices to equip your members with the tools and strategies to achieve lasting success in managing obesity and diabetes beyond the limitations of GLP-1s. PANELISTS Angie Kalousek Ebrahimi, Senior Director of Lifestyle Medicine, Blue Shield of California Timothy Law, DO, Chief Medical Officer, Highmark Health Katherine H. Saunders, M.D., Executive Vice President & Co-Founder, Intellihealth Lauren Driscoll, Founder & CEO, NourishedRx https://www.brightspotsinhealthcare.com/events/lifestyle-modification-strategies-to-support-those-living-with-obesity-and-diabetes/ This episode is sponsored by NourishedRX NourishedRx is a leading digital health and nutrition company specializing in comprehensive nutrition solutions for consumer and health plan members living with diabetes, obesity and other diet-related conditions. NourishedRx recognized food's healing and connective power, and partners with healthcare organizations nationwide to address the nutritional needs of their most vulnerable populations. The NourishedRx B:B:C health and nutrition platform facilitates and optimizes personalized, culturally concordant food in addition to the tools necessary to drive lasting behavior change – leveraging technology so YOU can all deliver at scale. Beyond diet, NourishedRx engages with health plan members and patients to support their whole health and lifestyle more broadly. They engage consumers with omnichannel wrap-around support and education, enabling individuals to make informed choices and gain a deeper understanding of the impact of their diet and lifestyle on their overall well-being, empowering them for the long term. NourishedRx is well suited as an early alternative and/or companion therapy to specialized obesity treatment, including GLP-1 and other Anti-Obesity Medication therapies.

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 own roles and enhancing quality and affordability for their members. Our panel of experts will share their insights and experiences. Possible topics of discussion: Compliance Network adequacy Data integrity Performance metrics & goals https://www.brightspotsinhealthcare.com/events/differentiating-your-health-plan-reimagining-your-provider-network-strategy/ Quest Analytics sponsors this episode Quest Analytics’ software platform empowers you to analyze, expertly manage meticulously, and impeccably report on your provider network‘s adequacy and the provider data accuracy across your entire organization and all lines of business. You can trust them! CMS does, and they are among eight of the nation’s largest health plans that leverage its software and services, not to mention multiple state regulatory agencies and many of the nation’s leading health systems and provider groups. They manage, measure and monitor health plan network performance so that together, we can elevate the health of communities nationwide. They also enable health plans to differentiate their position in the marketplace through a vastly superior provider network. My words, not theirs, and I know I am simplifying things a bit …but think of them as the Kayak for physician quality and accessibility data. For more information, please visit the Quest Analytics website at http://www.questanalytics.com./ Connect with us on social media: Facebook: facebook.com/brightspotshc Instagram: instagram.com/brightspotshc LinkedIn: linkedin.com/company/shared-purpose-connect Twitter: twitter.com/BrightSpotsinHC TikTok: tiktok.com/@brightspotshc

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, explaining the insurer is utilizing test-and-learn models to build quantifiable evidence, scale up successful models and, eventually, expand those ideas through its benefit offerings across the state. Sonny and Eric touch on several topics, including Blue Cross NC’s recent food insecurity pilot program, value-based care, provider relationships and community health initiatives. After listening, you’ll have many bright spots to consider implementing in your organization! Links to articles mentioned during the discussion: https://www.bluecrossnc.com/blog/expert-takes/transforming-health-care/food-is-medicine https://catalyst.nejm.org/doi/full/10.1056/CAT.22.0351 https://mediacenter.bcbsnc.com/news/blue-cross-nc-donates-500-000-to-the-forward-fund-established-to-support-transition-efforts-following-mill-closure About Sonny Sonny leads the diversified business group at Blue Cross and Blue Shield of North Carolina (Blue Cross NC) while also serving as their chief strategy officer, He is responsible for thoughtfully guiding the company as it seeks to achieve sustainable long-term growth by enhancing its existing business and identifying opportunities to expand beyond via inorganic growth. Among other responsibilities, Sonny is accountable for managing and maturing the company’s best-in-class business partnerships and assets, shaping Blue Cross NC’s short-term goals and long-term strategy, portfolio planning and prioritization, corporate development and utilizing strategic intelligence to improve the experience of key stakeholders across the state. Before joining Blue Cross NC, Sonny served in leadership roles at several other leading companies in the healthcare, venture capital and finance sectors. Most recently, he was Executive Director for Corporate Strategy and Development for the Advisory Board Company in Washington, DC. Before that, Sonny led Mergers and Acquisitions for Highmark Blue Cross and Blue Shield; brokered acquisitions, divestitures and capital raises ranging from $250 million to $12 billion at Wells Fargo; and assisted in assessing venture capital investments for Garage Technology Ventures in Silicon Valley. Connect with us on social media: Facebook: facebook.com/brightspotshc Instagram: instagram.com/brightspotshc LinkedIn: linkedin.com/company/shared-purpose-connect Twitter: twitter.com/BrightSpotsinHC TikTok: tiktok.com/@brightspotshc

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 many bright spots from HTA, including initiatives in medication management and infant mortality. He explains how the cooperative has saved its member companies well over $2 billion in healthcare costs to date. About Robert As CEO of the HTA, Robert oversees the strategic direction of approximately 60+ major corporations that have come together in an alliance to fix the broken healthcare system. He is also the Chairman of the Board of Lolo Health, a health tech company that connects consumers to a high-value health experience. Andrews previously led the Government Affairs practice at Dilworth Paxson law firm for two years before joining the HTA. Before private practice, Andrews served as a Member of the United States House of Representatives for nearly 24 years. Upon his departure from Congress, President Barack Obama praised Andrews’ service as “an original author of the Affordable Care Act…and a vital partner in its passage and implementation” and cited his “tenacity and skill” in representing the people of New Jersey. About HTA The Health Transformation Alliance (HTA) is a cooperative of more than 60 of America’s leading employers coming together to fix the broken healthcare system. Formed by four founding members in September 2015, the HTA member companies collectively are responsible for over 8 million employees, dependents, and retirees with an annual healthcare spend of $30+ billion. Some members include Walgreens, 3M, Marriott, Shell, Coca-Cola and NextEra Energy.

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 health outcomes – one of the most urgent challenges facing the District of Columbia. Combining the expertise of MedStar Health, evidence-based healthcare, and proven community-centric support services, Safe Babies Safe Moms offers services to support birthing individuals before, during, and after pregnancy and until their child reaches age three. Angela shares success stories from families supported by the initiative and discusses the program's impact. For health systems interested in implementing a similar program, she outlines MedStar Health's steps in building and sustaining the initiative. She also speaks about the role technology plays in the initiative. Safe Babies and Safe Moms recently launched a Clinton Global Initiative (CGI) Commitment to Action project to use artificial intelligence and machine learning to help reduce disparities in maternal and infant health. About Safe Babies Safe Moms Made possible by the A. James & Alice B. Clark Foundation, D.C. Safe Babies Safe Moms is a partnership between MedStar Health, Community of Hope, and Mamatoto Village to address critical maternal and infant care disparities in Washington, D.C., which has among the highest rates of maternal and infant mortality in the nation. In FY22, 15,346 mothers and babies received care through the program. Services offered include on-site mental health support during prenatal and postpartum visits, assessments for high-risk or complicated pregnancies, social support services for mothers and families who may be experiencing food or housing insecurity, pro-bono legal services, and other counseling on securing public benefits, transportation to and from appointments, infant care supplies, culturally-aware breastfeeding support, and more. About Angela Angela is responsible for leading a team of experts to apply rigorous scientific methods to enable next-generation healthcare delivery through quality, safety, innovation, health economics, payment reform, outcomes, health services research, data science, and health equity. She also ensures that these research activities leverage the collective leadership and unique strengths of MedStar Health and Georgetown University. Her research interests focus on health equity and patient safety. As the Executive Leader of Safe Babies Safe Moms, Angela is responsible for ensuring the development, implementation, and evaluation of an evidence-based program that will reduce disparities in maternal and infant mortality in Washington, DC. In addition, she contributes her research expertise in disparities, health equity, and patient safety to the initiative to uncover the contributing factors leading to disparities in maternal and infant harm. Connect with us on social media: Facebook: facebook.com/brightspotshc Instagram: instagram.com/brightspotshc LinkedIn: linkedin.com/company/shared-purpose-connect Twitter: twitter.com/BrightSpotsinHC TikTok: tiktok.com/@brightspotshc

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-rated plans shares innovative and actionable strategies for overcoming barriers to medication adherence. Topics for discussion include: Reasons traditional approaches to medication adherence are not effective Best ways to speed up intervention with a personalized, member-centric approach Financial and ratings impacts of medication adherence measures Confirmed Panelists Tom Manetti, Associate Vice President, Quality Products, CareSource Molly McGraw, PharmD, BCPS, Manager, Clinical Pharmacy, UPMC Health Plan Suzanne Moxham, Director, Quality, Accreditation, & Government Programs at CareFirst BlueCross BlueShield Sebastian Seiguer, CEO & Co-Founder, Scene Health Bios: https://www.brightspotsinhealthcare.com/events/how-medication-adherence-can-be-much-more-than-medication-adherence/ Connect with us on social media: Facebook: facebook.com/brightspotshc Instagram: https://www.instagram.com/brightspotshc/https://www.instagram.com/brightspotshc/ LinkedIn: https://www.linkedin.com/company/shared-purpose-connect/ Twitter: https://twitter.com/BrightSpotsinHChttps://twitter.com/BrightSpotsinHC TikTok: https://www.tiktok.com/@brightspotshchttps://www.tiktok.com/@brightspotshc This episode is sponsored by Scene Health Meet Scene Health, the medication engagement company that's taking on the colossal $500 billion problem of medication nonadherence. But here's the twist – they're doing it in a novel way by leveraging asynchronous video engagement. Scene's model of care enhances the CDC-endorsed gold standard for ensuring medication adherence, Directly Observed Therapy. Their team of pharmacists, nurses, and health coaches engage with members via back-and-forth videos to build trust through person-to-person connections and empower every patient to take every dose of medication properly. And they're not just all talk. Scene Health has been clinically validated in 20 peer-reviewed publications and is already teaming up with Medicaid and Medicare health plans, public health departments, and life science organizations to tackle a range of conditions, from diabetes & asthma to sickle cell disease.

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 the trend and implementing a complete, end-to-end consumer experience. Kim shares the results of SelectHealth’s efforts and outlines the plan’s strategy giving members the seamless experience they want. Listen and get the roadmap for remaking your plan’s ACA consumer experience! About Kim Kim Barrus began her career with SelectHealth 26 years ago and has worked in various capacities. She developed the SelectHealth Advanced Primary Care (a.k.a. patient-centered medical home) program. She facilitated the initial pilots of the program in 2010. Today the program has 1,240 participating providers at 222 participating clinics. In her current role, Kim oversees quality, medical home, NCQA accreditation, HEDIS and CMS Stars. Kim is a registered nurse who received her Bachelor of Science in Computer Information Systems and maintains a Project Management Professional (PMP) certification from the Project Management Institute (PMI). This episode is sponsored by ReferWell Health plans must be acutely aware of their progress towards achieving their Care Gap Closure targets. Their most significant obstacle is to directly impact those specific areas, even though they have limited capabilities to do so. ReferWell helps health plans improve access to care by efficiently scheduling members for the care they need. ReferWell care navigators find the "Perfect Match" provider right at the referable moment when the member is saying yes to their care. They then seamlessly schedule the member's appointment while still on the call. It’s a proven process that provides better access, experience and outcomes for members and better quality performance, which affects the health plan’s bottom line.

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 all members. Our expert panel lays a blueprint for implementing a successful home care model that your plan can use. Confirmed Panelists: Susan Beane, MD, FACP, Executive Medical Director, Clinical Partnerships, Healthfirst Chase Dailey, Principal, Home Solutions, Humana Randy Klein, CEO, Vesta Health Dominique Morgan, Chief Operating Officer, Health Leads https://www.brightspotsinhealthcare.com/events/medicare-advantage-and-the-next-generation-in-home-health-strategies/ This episode is sponsored by Vesta Healthcare Vesta Healthcare is a specialized virtual medical group providing high-touch medical support to patients with chronic conditions. Our program uses technology and patient and caregiver engagement to act on insights gleaned from the first mile of patient care: the home. We connect the entire care team - patients, family, caregivers, insurance plans, agencies, doctors, and nurses - to support the best care at home. The ancient Roman goddess of hearth and home inspired our name, Vesta, because our mission is to ensure that people stay in the comfort of their homes as long as possible. Connect with us on social media: Facebook: facebook.com/brightspotshc Instagram: https://www.instagram.com/brightspotshc/ LinkedIn: https://www.linkedin.com/company/shared-purpose-connect/ Twitter: https://twitter.com/BrightSpotsinHC TikTok: https://www.tiktok.com/@brightspotshc

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 Product Enhancement Member Activation and Engagement Payer/Provider Collaboration Social Care Strategy Blueprint Panelists: Andre Bliss, Ph.D., MBA, Director, Medicare STARs, UPMC Health Plan Mallory Mueller, (she/her/hers) Director Quality Health Integration, Network Health Cherie Shortridge, Senior Advisor, Healthmine Sean Libby, President, BeneLynk Bios: https://www.brightspotsinhealthcare.com/events/evolution-of-sdoh-2024-and-beyond/ BeneLynk sponsors this episode BeneLynk is a national provider of Social Care solutions for Medicare Advantage and Managed Medicaid health plans. We serve plans and their members by creating a human-to-human connection and providing the assistance a member needs to get the benefits they deserve. We build stronger human connections supported by innovative technology by employing one dynamic conversation that flows organically to meet Social Determinants of Health challenges. All of our services are customized to the specific geography, where we provide the members with the specific information they need to keep their benefits in place. Our mission is to improve lives and positively impact Social Determinants of Health barriers by providing our healthcare partners with the information they need and people with the advocacy they deserve.

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: Product Segmentation SDOH/Supplemental Benefits Care Models Payer and Provider Collaboration Panelists: Catherine Macpherson, MS, RDN, Senior Vice President of Healthcare Strategy & Development, Mom’s Meals Erika Pabo, MD, MBA, Chief Transformation Officer & Central Operations, Centerwell & Conviva, Humana Lena Perelman, Senior Director, Product Development, Market Expansion, SCAN Health Plan Robert Schreiber, MD, AGSF, Vice President and National Medical Director, myPlace Health Bios: https://www.brightspotsinhealthcare.com/events/the-future-of-senior-health-equitable-access-open-enrollment/ The Episode is Sponsored by Mom’s Meals Getting the right nutrition is essential to achieving and maintaining good health – yet accessing balanced meals that also support health challenges and fulfill personal tastes is not always as easy as it should be. At Mom’s Meals, our passion is to provide nourishment and deliver wholesome meals to the homes of those who need better nutrition to support their health and wellness, no matter where they live. It’s the reason we’ve built our business from our own personal roots, caring for our clients as we do our own family and loved ones. Our menus are designed by professional chefs and registered dieticians to taste great and support the nutritional needs of common chronic conditions. Clients get to choose every meal, every order. Meals are delivered to any address, no matter how remote. To learn more visit momsmeals.com.

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 of time and money. In the complex world of healthcare management and care coordination, closing gaps in care is critical to improving health outcomes and reduce costs. In addition, improving quality metrics directly correlates to identifying and addressing care gaps. Our expert panel will share strategies health plans can use to understand gaps in care throughout the member journey. Hear how plans leverage data and real-time analytics to effectively and efficiently close time-sensitive care gaps to improve HEDIS, Stars and other quality scores. Topics include: Create actionable quality programs to eliminate barriers to care Capture and exchange new data sources to close time-sensitive care gaps Ensure better care collaboration between providers and health plans Enhance follow-up care to boost member engagement

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 health equity and transform care delivery. Food Pharmacy: In 2018, Nashville General launched the Food Pharmacy to provide access to food for individuals living with food insecurity and to educate those individuals about which foods best fit within the care plan based on their chronic conditions. Congregational Health and Education Network (CHEN): Launched in 2017, CHEN is a 501(c)(3) faith-based initiative with local churches and educational institutions, with a primary focus on reducing health disparities for communities of color through education attainment, access to healthcare, and health literacy. Currently, CHEN includes 100 faith-based organizations of all denominations throughout Nashville. In addition, Dr. Webb provides a blueprint to help other health organizations implement similar, innovative programs to promote healthy communities and reduce health disparities. In addition, Dr. Webb provides a blueprint to help other health organizations implement similar, innovative programs to promote healthy communities and reduce health disparities. About Dr. Webb Since joining Nashville General in 2015, Dr. Webb has successfully led efforts to improve patient outcomes, enhance the patient experience and grow revenues. Before joining Nashville General Hospital, Dr. Webb served as chief operating officer for Common Table Health Alliance in Memphis, Tennessee. As a former chief executive operating officer for Methodist Le Bonheur South Hospital in Memphis, Tennessee, he held additional chief executive roles for Healthcare Services of America at Coastal Carolina Hospital and Northwest Mississippi Regional Medical Center. Dr. Webb is board certified in Healthcare Management and is a Fellow of the American College of Healthcare Executives. Nationally, he serves as a board member of America’s Essential Hospitals and as chairman of the Governance Committee. He serves on the board of the Nashville chapter of the American Heart Association and as a board member of NashvilleHealth. Dr. Webb is a member of Omega Psi Phi, Incorporated. Dr. Webb earned a Doctorate of Science in Health Services Administration and a Master of Science in Hospital and Health Services Administration from the University of Alabama at Birmingham. He also holds a Bachelor of Science and Master of Science in Health and Physical Education from Tennessee State University. About Nashville General Hospital A leading safety net hospital with 150 beds and more than 22 clinics. Nashville General Hospital serves as the index teaching hospital for the historic Meharry Medical College. Nashville General has earned multiple accreditations for its evidence-based measures and practices that provide quality healthcare. These include The Joint Commission’s Gold Seal of Approval accreditation, NCQA PatientCentered Medical Home accreditation, the NCQA Diabetes Recognition Program, accreditation by the Commission on Cancer for Nashville General’s Robert E. Hardy Cancer Center, and Level 3 TNCPE Performance Excellence Award. The hospital also has increased its revenue sources through expanded healthcare services and launched initiatives to attract new commercially insured patients. These efforts ensure that every patient receives high-quality care at Nashville General Hospital regardless of their ability to pay.

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 experience. Hear the following case studies and learn how: Intermountain Health physicians use AI to diagnose pneumonia Geisinger leverages AI and machine learning to identify patients at higher risk for colon cancer to ensure they go for a colonoscopy UNC Health determines which patients are best suited for home health care vs. the hospital with AI and machine learning TytoCare drives better patient adoption of virtual care technologies with AI Panelists: Nathan Dean, MD, Section Chief of Pulmonary and Critical Care Medicine, Intermountain Medical Center Rachini Moosavi, Chief Analytics Officer, UNC Health Karen M. Murphy, PhD, RN, EVP/Chief Innovation and Digital Transformation Officer, Geisinger Ohad Pollak, Chief Marketing Officer, TytoCare Bios: https://www.brightspotsinhealthcare.com/events/how-ai-is-changing-patient-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 five 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 successfully deploying and adopting 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 220 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.