Advancing Specialty Care in Medicare Advantage: Physician led, AI-Enabled

  How can health systems move from AI experimentation to AI execution at scale, without losing sight of what matters most: patients and providers? In this two-part episode of Bright Spots in Healthcare, Kiran Mysore, Chief Data and Analytics Officer at Sutter Health, joins host Eric Glazer to explore how Sutter is turning the promise of AI into measurable impact.  In Part 1, Kiran Mysore, Chief Data & Analytics Officer at Sutter Health, shares how his team is building clinical AI solutions that actually work—because they’re built with empathy, trust, and a clear focus on impact. He walks us through: The strategic approach Sutter takes to choosing AI use cases How the team launched an ambient documentation program that reduced charting time by up to 30% The keys to earning clinician trust and enabling adoption Why ROI isn't always about dollars—but about doing the right thing for providers and patients Whether you’re just starting your AI journey or looking to scale, this episode offers lessons on building a human-centered AI strategy that providers will actually embrace.  

Brindha Sridhar, Vice President, Customer Experience Strategy, MetroPlusHealth, discusses how one of New York City’s largest public health plans is transforming the healthcare experience for its diverse and underserved populations. Brindha shares how her team is working to improve member and provider engagement across a city where 90% of members are Medicaid beneficiaries and 30% report a preferred language other than English. Brindha dives into initiatives aimed at addressing care disparities, including multilingual communication strategies, culturally aligned member onboarding, and integrated provider support. She also outlines how MetroPlusHealth is using real-time member feedback to fuel continuous improvement and why building a high-touch, relationship-driven experience, especially for vulnerable communities, requires both systemic change and frontline empathy. This conversation offers practical ideas and replicable strategies for any health plan seeking to improve equity, access, and engagement.   This session was recorded as part of the Healthcare Engagement Virtual Summit: Strategies for Plans to Engage Consumers and Providers on May 8, 2025, co-sponsored by Bright Spots in Healthcare, TytoCare and Navina. For more information on the summit and to see the full video, please go to: https://www.tytocare.com/virtual-summit-healthcare-engagement-strategies-for-plans-to-engage-consumers-and-providers/   About Bright Spots Ventures Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation. We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.

  In this insightful episode, Kim Barrus, AVP of Quality and Accreditation at Select Health, shares three compelling case studies showcasing how her team is improving care access, streamlining provider engagement, and addressing health disparities across four states. Kim walks us through:   A groundbreaking hybrid clinic model in rural Nevada, created in partnership with the city of Wells and Intermountain Health, to bring primary, urgent, and behavioral care to medically underserved communities. The development of Select Health’s Quality Provider Plus Program, which consolidates risk adjustment and quality initiatives into a unified, less burdensome experience for provider partners—improving data sharing, reporting, and overall engagement. A remote blood pressure monitoring initiative targeting rural members with hypertension, using disparity analytics to identify high-need populations and improve outcomes through education, mailed BP cuffs, and clinician collaboration.   If you're exploring ways to improve access to care, streamline provider relationships, and address social and geographic health disparities—this session is a must-listen.   This session was part of the the Healthcare Engagement Virtual Summit: Strategies for Plans to Engage Consumers and Providers on May 8, 2025, co-sponsored by Bright Spots in Healthcare, TytoCare and Navina. For more information on the summit and to see the full video, please go to: https://www.tytocare.com/virtual-summit-healthcare-engagement-strategies-for-plans-to-engage-consumers-and-providers/  

In this episode of Bright Spots in Healthcare, host Eric Glazer explores how leading healthcare organizations are transforming specialty care in Medicare Advantage through physician leadership and AI innovation. Hear from Julia McDowell (Highmark Health), Chuck Palermo (HAP), Dr. Mary O’Connor (Vori Health), and Dr. Krystal Revai (Health Alliance) as they share pragmatic strategies for improving care quality, enhancing member engagement, reducing administrative burden, and delivering meaningful clinical outcomes. Discover how AI is being used to streamline prior authorization, enable real-time gap closure, personalize care management, and deepen shared decision-making between providers and patients.   Thank you to Vori Health for supporting this episode.  Vori Health is the only nationwide MSK medical practice with doctor-led care teams – driving better outcomes. Vori helps with pain reduction in MSK issues, through their holistic approach, and by creating a personalized treatment plan from the convenience of your own home through their  virtual-first platform.  Their doctor-led team tailors care programs to reduce surgery by as much as 78%, avoiding pain, imaging, and injections and saving your organization the cost burden of unnecessary surgeries and increasing productivity. And all from the comfort of home!  Vori is on a mission to empower humanity to lead a healthier life. Visit them at www.vorihealth.com/

In this standout episode, three healthcare leaders unpack how they're transforming regulatory pressure into real-world impact. Melissa Skelton Duke (Banner Health), Dina Homer (HealthTeam Advantage), and Bita Farrokhroo (MedWatchers) share practical strategies for driving medication adherence, optimizing Part D performance, and bridging digital and cultural gaps to better serve diverse member populations. Learn how Banner is reframing adherence through member empathy, how HealthTeam Advantage aligns every employee to Stars performance, and how MedWatchers is consolidating fragmented workflows for a 29% lift in gap closure. With an NPS of 93, this is one of our highest-rated episodes in over 11 years. Download the Episode Guide: We’re piloting a brand-new Episode Guide summarizing key insights and speaker highlights. Download the Guide to follow along and deepen your understanding of today’s discussion. Thank you to MedWatchers for supporting this episode. With 180 pharmacists on staff, they’re a trusted clinical partner to more than 300 health plan contracts—delivering over 2.7 million pharmacist-led interventions annually across Medicare, Medicaid, and Commercial populations. Learn how they’re helping plans improve adherence, reduce readmissions, and scale Stars-aligned strategies at www.medwatchers.com.

In this engaging session, Eric Glazer sits down with Jessica Vander Zanden, VP of Operations at Network Health, a Wisconsin-based plan known for its top-tier CMS ratings and commitment to exceptional provider and member experiences. Jessica shares two standout strategies driving the organization’s success: a unique approach to treating providers as valued customers and transforming their call center into a powerful engine for improving CAHPS and Star Ratings. Discover how Network Health redefines healthcare engagement through operational excellence, provider partnership, and member-centric service design.   This session was part of the the Healthcare Engagement Virtual Summit: Strategies for Plans to Engage Consumers and Providers on May 8, 2025, co-sponsored by Bright Spots in Healthcare, TytoCare and Navina. For more information on the summit and to see the full video, please go to: https://www.tytocare.com/virtual-summit-healthcare-engagement-strategies-for-plans-to-engage-consumers-and-providers/  

The most powerful person in the world is the storyteller. Steve Jobs believed this, and it's never been more accurate, especially in healthcare. Renowned storytelling expert Craig Wortmann—Professor at Northwestern’s Kellogg School of Management and CEO of Sales Engine joins Eric Glazer to discuss one of the most underutilized leadership tools in healthcare: storytelling. During the episode, Craig shares a practical framework—Collect, Categorize, Construct, Convey—to help healthcare leaders use storytelling to drive action, inspire change, and connect more deeply with teams and stakeholders. You’ll learn: Why stories persuade better than data The four types of stories every leader should tell How to embed storytelling into your leadership routine Plus, Craig explains how failure stories can actually build trust—and why storytelling is a leadership discipline, not just an art. About Craig One of the most respected voices in storytelling and leadership, Craig Wortmann is an award-winning educator, three-time entrepreneur, author and CEO. Craig is also  Clinical Professor of Innovation & Entrepreneurship at Northwestern’s Kellogg School of Management and the Founder & Academic Director of the Kellogg Sales Institute.  He founded Sales Engine, a tools and services firm founded on the principle that leaders should treat sales as the engine of their business, in 2009. Craig and his team consult to the world’s largest and most successful companies, as well as some of the world’s fastest-growing entrepreneurial companies. Craig is author of What’s Your Story™? a book that helps people tell the right story at the right time for the right reasons. You can learn more about Craig here: https://www.linkedin.com/in/craigwortmann/ About Bright Spots in Healthcare Bright Spots in Healthcare is produced by Bright Spots Ventures Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime. Visit our website at www.brightspotsinhealthcare.com

Visionary healthcare leaders from The Permanente Medical Group, UC Davis Health, UNC Health, Summit Medical Group and Navina joined Eric Glazer to explore how artificial intelligence transforms clinical workflows and enables better value-based care. Discover how AI-driven chart prep, ambient scribe technology, and risk models streamline provider workflows, improve patient outcomes, and reduce clinician burnout. From overcoming implementation roadblocks to building cross-functional frameworks that promote trust and equity, this episode is packed with strategic insights and real-world success stories you can apply at your organization. Panelists Include: Brian Hoberman, MD, EVP & CIO, The Permanente Medical Group Reshma Gupta, MD, Chief of Population Health and Accountable Care, UC Davis Health Ram Rimel, Manager of Data Science Engineering, UNC Health Eric Penniman, D.O. Executive Medical Director, Summit Medical Group Dana McCalley, VP of Value-Based Care, Navina https://www.brightspotsinhealthcare.com/events/the-new-physician-playbook-ai-workflows-value-based-care-in-action/#url This episode is sponsored by Navina Navina is the clinician-first AI copilot for value-based care. Recently named Best in KLAS for clinician digital workflows, Navina turns fragmented patient data into actionable clinical insights right at the point of care. Natively integrated into the clinical workflow, their AI copilot helps improve risk adjustment, quality metrics, and population health – while significantly easing the administrative burden. Navina has earned the trust of more than 10,000 clinicians and care team members across 1,300 clinics, from some of the leading value-based care organizations in the country like Privia Health, Agilon Health, and Millennium Physician Group. About Bright Spots in Healthcare Bright Spots in Healthcare is produced by Bright Spots Ventures Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime. Visit our website at www.brightspotsinhealthcare.com

As CMS regulations shift, how can you continue to impact complex members? Join us as we explore innovative approaches to member engagement that drive better health outcomes and reduce costs. In this episode, we will hear how plans are leveraging social support, in-home care, and tailored services to reach vulnerable members. Don’t miss this timely conversation: hear how you can be reaching the unreachable and personalizing Medicare engagement in a shifting CMS landscape.   Panelists:  Sheila Yahyazadeh, Chief External Operations Officer, CareFirst Community Health Plan Maryland Eve Gelb, Chief Innovation Officer, Gold Coast Health Plan Andrew Parker, Founder & CEO, Papa   This episode is sponsored by Papa: Papa is your trusted partner in the home. Since 2017, its vetted Papa Pals has completed millions of companion care visits across 7,300 cities — 10x that of Lyft. Papa Pals come from the same communities as the members they serve, build trust in person, and provide tailored support proven to reduce hospitalizations and emergency department visits, increase preventive care trends, and lower costs. But that’s not all Papa Pals do... As an extension of your care team in the home, Papa Pals can now conduct in-home assessments, educate and help members learn new skills, like digital health literacy, and so much more.   Visit papa.com to learn more. Bright Spots in Healthcare is produced by Bright Spots Ventures   Bright Spots Ventures brings healthcare leaders together to share working solutions or "bright spots" to common challenges. We build valuable and meaningful relationships through our Bright Spots in Healthcare podcast, webinar series, leadership councils, customized peer events, and sales and go-to-market consulting. We believe that finding a bright spot and cloning it is the most effective strategy to improve healthcare in our lifetime.   Visit our website at www.brightspotsinhealthcare.com  

Welcome to the debut episode of Executive Briefs—a new short-form series from Bright Spots in Healthcare designed to deliver fast, actionable insights for healthcare leaders. In under 10 minutes, host Eric Glazer shares 10 powerful storytelling takeaways from bestselling author Michael Lewis (Moneyball, The Big Short, The Blind Side) from his keynote address at League Connect 2025. Whether you're a health plan executive, provider leader, or innovator in digital health, these tips will help you better engage your team, inspire change, and drive results. Takeaways 00:50 – Why Michael Lewis and storytelling matter to healthcare leaders 01:42 – 1: Start with a question 02:15 – 2: Stories are about people 02:45 – 3: Good characters are great teachers 03:18 – 4: Find a fresh angle 03:55 – 5: Make data emotional 04:30 – 6: Tension drives the narrative 05:10 – 7: Keep it moving 05:50 – 8: Authenticity over polish 06:25 – 9: End with meaning 07:00 – 10: Tell stories that move people 08:10 – How leaders can apply these lesson 🔗Register for the League Connect Digital Summit 2025 on May 7 at https://connect.league.com/digital-summit/ to see the Michael Lewis keynote. Learn more about League’s digital-first healthcare platform: https://league.com About Bright Spots in Healthcare Bright Spots in Healthcare spotlights real-world “bright spots” from health plans and providers to help leaders scale innovation and drive measurable improvement. We believe that finding and replicating bright spots is the most effective strategy to improve healthcare in our lifetime. Produced by Bright Spots Ventures. Learn more: brightspotsinhealthcare.com.