Scale Matters: Making Data Work in Value-Based Care with Rob Fields MD

In this episode we revisit our conversation with Josh Vire, Vice President of Value-based Operations at CHESS Health Solutions, where he talks about North Carolina’s move to managed Medicaid and the work CHESS put into building a complete all-patient solution.Josh explains what managed Medicaid is, how AMH tiers operate, and the real-world hurdles practices face when entering this space. He also outlines the three core services CHESS offers, the population health tools behind them, and the engagement options available for groups seeking support. Josh closes with practical advice for practices preparing for managed Medicaid or value-based care in general. A clear, useful conversation for anyone navigating Medicaid transformation or working to improve care delivery in North Carolina.

In this episode of Move to Value, Emily Volk, Director of Quality, Risk, and Compliance at Northern Regional Hospital, returns to share how her team is navigating the operational realities of Medicaid managed care. From the early challenges of inconsistent documentation and payer confusion to building smarter EMR templates and leveraging care coordination through CHESS, Emily offers a grounded look at how one small hospital is tackling big problems. She discusses the importance of automation, proactive outreach, and the power of partnerships to streamline workflows, reduce hospitalizations, and improve continuity of care especially in a rural setting.

In this episode, we hear from Emily Volk, Director of Quality, Risk, and Compliance at Northern Regional, headquartered in Mount Airy, North Carolina. With nearly a decade of experience driving high performance in value-based care, Emily shares how her team is now navigating the shift into Medicaid managed care. Learn how a small rural hospital is leveraging strategic partnerships, expanding care coordination, and breaking down access barriers, all while staying focused on what matters most: better outcomes for patients.

Discover how clinically integrated networks (CINs) empower physicians, specialists, and pharmacy partners to deliver coordinated, patient-centered care. In this episode, Debi Hueter of WakeMed Key Community Care joins Rebecca Grandy from CHESS Health Solutions to discuss collaboration, trust, and innovation in value-based care. Learn how team-based care models reduce administrative burden, improve outcomes, and support providers at the top of their license.

Today, we're hear a conversation between Rebecca Grandy, Director of Pharmacy at CHESS and Debi Hueter, Executive Director of WakeMed Key Community Care, a clinically integrated network focused solely on primary care. Discover how integrating pharmacy services is transforming provider workflows, reducing emergency visits, and improving patient outcomes.

In this episode of The Move to Value Podcast, we revisit the conversation between CHESS President Dr. Yates Lennon and Randy Jordan, Chief Advisor of Impact for Health at Next Stage Consulting and former CEO of North Carolina’s Association of Free and Charitable Clinics. Together, they unpack the evolving landscape of Managed Medicaid, explore innovative approaches to funding care for the uninsured, and examine how healthcare organizations—free clinics, FQHCs, rural health centers, hospitals—can collaborate in a financially sustainable way. From real-world examples in North Carolina to insights drawn from global experience, this conversation sheds light on what it takes to build a true system of care for those often left out.

In this episode of the Move to Value Podcast, we continue our conversation with Julie Quisenberry of Coastal Horizons about what care management looks like on the front lines. Julie shares how her team supports patients facing housing insecurity, food insecurity, substance use, and behavioral health challenges, while also navigating language barriers and limited resources.From expanding Hepatitis C treatment programs to building bilingual services and training staff in cultural competency and trauma-informed care, Julie offers a candid look at the realities of delivering whole-person care. She emphasizes the importance of celebrating small wins, collaborating with community partners, and adapting to constant change in Medicaid and tailored care plans.This episode shines a light on both the challenges and the resilience of care managers working to improve outcomes and support their communities—one patient at a time.

In this episode of Move to Value, we talk with Julie Quisenberry, Director of Care Integration at Coastal Horizons. Serving 56 counties across North Carolina, Coastal Horizons delivers whole-person care by integrating primary care, behavioral health, substance use treatment, and community resources. Julie explains how her team navigates Medicaid standard plans and tailored plans, uses HEDIS metrics to improve outcomes, and works closely with partners like CHESS to keep patients’ needs front and center.

In this episode, Dr. Rob Fields and Rebecca Grandy continue their conversation and focus on data. What’s useful and what’s a waste of time? What data truly drives value and why do so many predictive tools fall flat? You’ll also hear practical strategies such as where to direct focus when resources are tight, how to build an ideal care team, and how to make your value-based programs sustainable—even in a broken fee-for-service world.

In this episode of the Move to Value Podcast, Dr. Rob Fields, EVP and Chief Clinical Officer at Beth Israel Lahey Health, joins host Rebecca Grandy, Director of Pharmacy at CHESS Health Solutions, to unpack the realities of value-based care.They explore why good intentions aren't enough, what data actually drives impact, and how to build sustainable care models with limited resources. From downside risk readiness to team-based care and chronic disease management, this conversation is full of practical insights for anyone navigating healthcare transformation.