Improving Medicare Advantage Star Ratings Through Care Management and Data Sharing with Dr. Sanjiv Shah

In this episode, Dr. Sanjiv Shah, Chief Medical Officer, MetroPlusHealth, discusses how care management, provider partnerships, and timely information exchange have helped MetroPlusHealth earn consecutive four star Medicare Advantage ratings. He also shares strategies for closing care gaps, improving transitions after hospital stays, and preparing providers for digital quality reporting requirements.

In this episode, Dr. Alice Chen, Chief Health Officer at Centene, discusses how health plans can use evidence based prevention frameworks to improve outcomes, guide investments, and reduce waste. She shares lessons from food as medicine initiatives and explains why interventions must be supported by rigorous data, tailored to underserved populations, and proven effective before scaling.

In this episode, Moshim Kukar, MD FACS FSSO, Professor and Chair, Surgical Oncology, Program Director, Complex General Surgical Oncology Fellowship, Roswell Park Comprehensive Cancer Center, discusses how specialized teams, robotic surgery, and structured training improve surgical outcomes.

In this episode, Penny Jefferson, RN, Director of Clinical Documentation Integrity Services in the HIM Division of Patient Financial Services at UC Davis Medical Center, joins the podcast to discuss whether AI is truly improving workflows and the importance of supporting the entire patient journey. She also shares insights on the growing need for clinical documentation integrity within workflows and how she defines success as a leader.

In this episode, Kevin Neese, MD, Co-owner, Helix Advanced Medicine, discusses building a prevention focused primary care model, improving healthspan, and using early risk detection to keep patients healthier and out of the hospital.

In this episode, Dr. Daniel Sun, Orthopedic Surgeon at Tufts Medical Center, discusses advances in hip replacement, implant longevity, robotics and AI, and the growing shift toward outpatient procedures. He also explores balancing faster recovery and cost savings with patient safety and complication prevention.

In this episode, Tieraona Low Dog, MD, ABOIM, Founding Director of the Integrative and Functional Medicine Fellowship and pioneer in integrative medicine, and Shaista Malik, MD, PhD, MPH, Executive Director of the Susan Samueli Integrative Health Institute and Vice President of Integrative Health at UCI Health, join the podcast to discuss acupuncture and the integration of integrative and functional medicine into patient care. They also share insights on addressing skepticism, fostering an open-minded approach to healthcare, and the leadership principles that guide the fellowship.

This episode recorded live at the Becker's 11th Annual Health IT + Digital Health + RCM Conference features Marola Kraczek, MA, Senior Change Enablement Specialist, HCA Healthcare, who discusses the role of change management in turning healthcare data into actionable insights, reducing workflow fragmentation and supporting clinician adoption.In collaboration with Philips.

In this episode, Phoebe L. Yang. a former C-suite executive across four public companies, an appointee in two Presidential Administrations, and a Fortune 250/S&P 500 board director (GE HealthCare, Doximity, CommonSpirit Health, JudiHealth), most recently General Manager of Amazon Web Services Healthcare, and faculty of Stanford Law School, where she designed and teaches a popular course, "Business Leadership in the Age of AI”, discusses AI governance, cybersecurity, and responsible AI adoption. The views and opinions expressed by Phoebe Yang in this program are her own at the time of the recording of this podcast and do not necessarily reflect the views or positions of any organization with which she may be affiliated

In this episode, Jason Hinkle, CFO, Deaconess Illinois, discusses the system’s rapid growth, expansion of oncology and outpatient surgery services, and financial pressures facing rural hospitals. He also shares how rolling forecasts, enterprise wide data governance, and reliable data can strengthen financial decision making and prepare health systems for broader AI adoption.