Bright Spots in Healthcare

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 we all have at our fingertips for our meetings with health plans and provider organizations? How do we leverage these stories to make a sales pitch? How do we use storytelling to close a sale?   At the end of the episode, you’ll have a blueprint for a new storytelling strategy for their sales organization!   About Paul Paul Smith is one of the world’s leading experts on organizational storytelling. He’s one of Inc. Magazine’s “Top 100 Leadership Speakers of 2018” and the author of three Amazon #1 bestsellers: Lead with a Story (now in its 11th printing, and published in 7 languages around the world), Sell with a Story, and The 10 Stories Great Leaders Tell; in addition to Parenting with a Story and his newest work, Four Days with Kenny Tedford. He’s a former executive at The Procter & Gamble Company and a consultant with Accenture before that.   Buy Paul’s book, Sell with a Story: https://www.amazon.com/Sell-Story-Capture-Attention-Build/dp/0814437117 Paul’s website: https://leadwithastory.com/

As health equity initiatives play an increasingly important role in CMS programs, Medicare Advantage plans must commit to addressing social factors hindering access to care and driving members to take action to improve their health, such as scheduling a preventive care visit or completing a missed screening. Industry leaders from 4 & 5-Star plans discuss strategies to advance health equity and improve care access to achieve higher Star Ratings.   Topics include: Creating a true health equity strategy   Using a personalized approach to reaching the unreachable members Creating a trustworthy, comfortable approach to care access Navigation and scheduling Partnering with CBOs   Panelists: Elizabeth Benz, Vice President of Quality and Clinical Integration, Network Health; Gene Huang, Executive Chairman, ReferWell; Brindha Sridhar, Vice President, Customer Experience Strategy, MetroPlusHealth; Alexandria Tusek, Director, HEDIS & Data Analytics, Priority Health   Panelist Bios: https://www.sharedpurposeconnect.com/events/equity-timely-access-as-a-stars-strategy/   Bright Spots in Healthcare is hosting our first in-person event on August 24 & 25, 2023, in Boston.  The Executive Roundtable Summit is a unique and transformative gathering, bringing together like-minded leaders from health plans, ACOs, health systems, hospitals, government agencies and community-based organizations for large-scale conversations that matter to the future of healthcare.   Payer & Provider Roundtable Summit brochure:  https://images.magnetmail.net/images/clients/SPC_/attach/SPCEventBrochure3.pdf   Summit Registration:  https://brightspotssummit.eventbrite.com   This episode is sponsored by ReferWell ReferWell helps health plans advance health equity by scheduling underserved members for the care they need, be it medical, care gap appointments or — through your community partnerships — appointments for services like transportation assistance, nutritional counseling, mental health services and other community-based organization offerings.  

The residual impact of the COVID-19 pandemic is a change in the way care is delivered in the U.S.  With a growing demand for post-acute care, coupled with staffing challenges, providers face challenges and opportunities in care transition and coordination along the continuum of care. Hear our panel of experts 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 President, Population Health, Cedars Sinai; Margie Zeglen, MBA, RHIA, Vice President, Population Health, Carle Health; Jessica Hohman, MD, MSc, MSc, President and Medical Director, Cleveland Clinic Medicare Accountable Care Organization; Lissy Hu, M.D., MBA, President, Connected Networks, CarePort, powered by WellSky Bios: https://www.sharedpurposeconnect.com/events/novel-approaches-to-care-coordination-the-key-to-profitable-risk-models/   This episode is sponsored by CarePort, powered by WellSky CarePort is the leading care coordination network of 2,000 hospitals and 130,000 post-acute and community providers. The end-to-end platform bridges acute and post-acute EHRs, providing visibility into the patient journey for providers, physicians, payers and risk-bearing entities.    With CarePort, healthcare professionals can efficiently and effectively coordinate patient care with visibility and intelligence to manage patients as they move through the continuum. Visit website at: www.careporthealth.com

CMS replaced the Global and Professional Direct Contracting (GPDC) Model with the redesigned ACO Realizing Equity, Access, and Community Health (REACH) Model in 2023. ACO REACH is the first accountable care model to directly address health equity and access to care, with a specific directive to meet the needs of patients from marginalized and underserved communities.    Whether you are participating in ACO REACH, the model provides vital insights into the future of value-based care and care collaboration. This panel will 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.   Panelists: Gary Jacobs, Executive Director, Center for Government Relations and Public Policy, VillageMD; Kate Casaday, MPH, Director of Market Operations, CareMount Health Solutions; Ashley Perry, MPH, Chief Solutions Officer, Socially Determined   Bios: https://www.sharedpurposeconnect.com/events/aco-reach-advancing-equity-and-optimizing-performance/   This episode is sponsored by Socially Determined Socially Determined is leading the transformation of healthcare delivery and payment through social risk analytics and solutions. Our SocialScapeⓇ SaaS platform, data and industry-leading expertise empower health systems, plans and other risk-bearing organizations to manage risk better, improve outcomes and advance equity at scale. Recently named by Fierce Healthcare as one of the 15 most promising healthcare companies, Socially Determined is headquartered in Washington, DC. Visit the website at www.sociallydetermined.com.

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 the information. He also touches on setting ROI expectations for health equity programs, defining terms to normalize the discussion of health disparities within the organization and the business imperative of diversity.  Errol shares his identity-defining moments and experience as an executive of color in the healthcare industry. He talks about his new book,  The Way Up: Climbing the Corporate Mountain as a Professional of Color,  which profiles Errol’s career journey from working in a beauty salon warehouse to being a health insurance executive. The book also offers guidance from prominent executives of color and delivers a pragmatic and actionable guide to help underrepresented individuals from all ethnic backgrounds uncover their passion for achieving their professional goals and elevating their careers.   About Errol   Dr. Errol L. Pierre is a business executive, healthcare strategist, public speaker, professor, and author. He currently serves as a senior executive of Healthfirst, the largest nonprofit health plan in New York. He is also the former Chief Operating Officer of Empire BlueCross BlueShield, the largest for-profit health plan in New York.   Errol graduated from Fordham University with a bachelor’s degree in Business Administration. He later obtained a master’s degree in Health Policy and Financial Management from New York University. He completed his Doctorate in Business Administration from the Zicklin School of Business at Baruch College, focusing on Health Economics. He is a professor at Baruch College, Columbia University, and New York University, teaching Health Economics and Health Transformation and serves on several boards, including the Arthur Ashe Institute for Urban Health and MediNova.                                      

As we turn the page from 2022, health plans are facing new challenges impacting member experience, retention, and, most importantly, their member’s health. This panel will offer insights on the priorities to focus on as we enter 2023. Topics include: the new reality health plans and members will face once the PHE ends and how getting ahead will avoid significant membership losses; CMS’ increased weight on CAHPS surveys will lead to more focus on member satisfaction; New Social Need Screening and Intervention (SNS-E) requirement means that plans will need to get more serious about members’ social needs by 2025 Panel: Mikal Sutton, Managing Director, Medicaid Policy, Blue Cross Blue Shield Association; Mildred Menos, Director of Member Advocacy and Community Outreach Transformation, Horizon Blue Cross Blue Shield of New Jersey; Steve Wigginton, CEO, Icario Link to bios: https://www.sharedpurposeconnect.com/events/2023-strategy-session-member-redetermination-cahps-and-social-needs/ This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through extrinsic and intrinsic motivations. Learn more at icariohealth.com.

Healthcare is moving to a whole-person approach, and rapid innovation connects the dots. 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; Leveraging pharmacy and medical claims data; and coordinating physical, behavioral and SDOH care Panelists: Angela Lynn, Director of Care Management, NC Blue Cross; Laurie Gehrt, MSN, MBA, RN, CSMC, FACHE, Department Vice President, Care Management, KC Blue; Amy Bloomquist, Director of Population Health Design, Blue Cross MN; and Leslie Helou, PharmD, Vice President, Medication Strategies, MOBE Bios: https://www.sharedpurposeconnect.com/events/how-to-add-innovation-to-whole-person-care/ This episode is sponsored by MOBE MOBE is a health outcomes company. They improve health by providing a high-touch one-to-one coaching program focused on lifestyle, emotional well-being, and comprehensive medication management. Using advanced analytics, MOBE identifies populations where they can make a real difference in both individual health status and expense reduction for large employers and health plans. For more information, visit www.mobeforlife.com.   

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 populations Why removing barriers to testing with at-home solutions is a boon to health equity How accurate staging improves health outcomes for members with chronic conditions Working with provider networks for better management of members’ health   Panelists: Pooja Mittal, MD, Vice President, Chief Health Equity Officer, Health Net, Inc.; Megan Schmidt, Sr. Vice President, Employer Solutions, Priority Health; Mushir Hassan, MD, Chief Medical Officer, Network Health; Jonah Mink, MD, Medical Director, Healthy.io   This episode is sponsored by Healthy.io Healthy.io is the global leader in turning the smartphone camera into a clinical-grade medical device for an at-home urinalysis and digital wound management.    Their at-home kidney test, Minuteful Kidney, aids in the early detection of chronic kidney disease and helps close gaps in access and care for over 500,000 patients worldwide. It is the first and only smartphone-powered home kidney test to receive FDA clearance and the first digital health test to obtain FDA clearance across all smartphone devices.    Healthy IO is partnered with some of the nation's leading health plans and the National Health Service in the United Kingdom b/c of the test’s ease of use, high completion rates, and huge potential savings.   They are the first company to convert your smartphone into a clinical-grade medical device to allow patients to take the test – and receive results – in the comfort of their homes.  

Motivating Medicare Advantage members to take the clinical actions needed to promote and support their care is a high priority for health plans. Data shows that talking to peers with whom they can relate and share common health issues benefits members and engages them more in their health   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 can implement in your health plan.   Panelists: Mike Franz, MD, Senior Medical Director of Behavioral Health, Regence; Lisbeth Briones-Roberts, Chief Togetherness Officer, SCAN Health Plan; Jennifer Spear, Associate Director, Population Health, Humana; Boaz Goan, Founder & CEO, Wisdo Health.   This episode is sponsored by Wisdo Wisdo is a peer support and clinical referral platform designed to address the harmful consequences of loneliness, social isolation, and lack of engagement on health and medical costs.  Founded in 2018, over 500,000 adults ages  18-80 have joined Wisdo, making it one of the market's largest and most diverse peer support platforms. Wisdo clients include health plans, gov’t agencies, behavioral health providers, and SDOH services. https://www.wisdo.com/

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 gain critical insights to help your plan earn and sustain a 4+ star rating in an era of rapid change!   This episode is sponsored by Evolent Health Services Evolent Health Services is disrupting healthcare administration, generating exceptional clinical efficacy and better risk adjustment for health organizations while simplifying the overall administration process. Similar to what Tesla did with automobiles and Amazon did with retail, Evolent Health Services is helping to transform our healthcare industry from antiquated to innovative. The uniqueness of Evolent is TECH: they have the industry’s only trustworthy end-to-end integrated platform, along with  TOUCH: some of the most innovative people in the business know how to operate the solution for and with every type of health plan.or risk-bearing provider org