Inside Credentialing: Where AI Delivers Measurable ROI for Health Plans

In this Bright Spots in Healthcare episode, host Eric Glazer sits down with three leaders reshaping one of healthcare's most overlooked — yet mission-critical — functions: provider credentialing. Credentialing is the quiet infrastructure of trust in healthcare. When it's done right, patients get timely access to high-quality care, providers get paid faster, and health plans stay compliant. When it fails, backlogs grow, compliance risk skyrockets, provider satisfaction plummets, and member access suffers. Joining Eric for this discussion: Sandra Clarke, Former CFO & COO, Blue Shield of California Brett Dooies, Head of Product, Verifiable Janan Dave, VP of Operations, Verifiable Together, they explore how AI and automation are transforming credentialing from a slow, manual compliance task into a strategic capability that improves efficiency, trust, and network readiness. In this episode, you'll learn: Why credentialing sits at the intersection of compliance, provider experience, and member access How legacy processes, staffing limits, and messy data create hidden risk, and why backlogs can grow like quicksand Practical ways health plans are applying AI to reduce verification time, speed onboarding, and triage high-risk cases Why the most successful plans treat credentialing as infrastructure, not paperwork Key metrics to track when modernizing credentialing, including turnaround time, backlog clearance, audit readiness, and provider experience What to automate first,  and why humans still play a critical oversight role Bright Spots include: 97% automated verification in seconds across millions of records monthly New staffing and automation models that increase speed without compromising compliance Real-world examples where AI prevented risk exposure and accelerated network growth Leadership lessons in adopting AI responsibly and avoiding the "lift-and-shift" trap   This conversation offers payer leaders a real-world playbook to modernize credentialing and strengthen the foundation of your healthcare organization. Panelist Bios: Sandra Clarke is a healthcare executive and board advisor with over 25 years of experience leading finance, operations, and large-scale transformation across payer, provider, and life sciences organizations. As former CFO and COO of Blue Shield of California, she oversaw $25B in annual revenue and spearheaded initiatives delivering $700M in annualized savings while reimagining the company's pharmacy care model. Clarke has also held senior leadership roles at Daiichi Sankyo and Philips Healthcare and serves on multiple healthcare boards. She holds degrees from MIT, Bentley University, and Seton Hall University School of Law. Janan Dave is the VP of Operations at Verifiable, a start-up offering software and services solutions for healthcare organizations to ease the challenges surrounding provider network management. Janan has a background in public health and health policy, and has spent the last decade helping scale operations at various healthcare startups. She is passionate about building smart solutions to reduce waste in the healthcare system, and promote better care especially for the aging population, family caregivers, and women. Janan studied public health at the University of Pennsylvania, and lives in Brooklyn, NY. Brett Dooies is the Head of Product at Verifiable, where he leads the development of AI-powered solutions to simplify healthcare credentialing and monitoring. With a decade of experience building enterprise software, he specializes in applying advanced AI and analytics to enhance the customer experience and deliver transformative solutions. Drawing on his background in modernizing banking software, Brett is dedicated to creating products that drive operational excellence, uphold regulatory compliance, and improve data accuracy for Verifiable's partners, helping them scale with confidence in a complex ecosystem. Resources: MIT Sloan "Internet of AI Agents: State of AI in Business 2025" report finds that although over 80 % of organizations have piloted generative AI tools, only around 5 % have achieved meaningful business transformation—a gap dubbed the "GenAI Divide". It highlights that the primary barrier isn't model technology or regulation, but rather the failure of AI systems to integrate deeply into workflows, learn from feedback, and scale beyond the pilot stage. https://mlq.ai/media/quarterly_decks/v0.1_State_of_AI_in_Business_2025_Report.pdf Thank you to our Episode Partner, Verifiable: Verifiable is a credentialing and network monitoring platform built to help healthcare organizations optimize operations with error-free, fast verifications and to stay compliant with ease. Backed by their in-house NCQA certified credentialing team that bring a combined 60+ years of experience, Verifiable's innovation supports managing trusted networks at scale through 97% verification automation in seconds with millions processing each month. Verifiable works with leading healthcare organizations such as Humana Dental, Zelis, Talkspace, Headway, Empower Pharmacy, and many others.   Learn more about them at https://verifiable.com/ Want to go deeper or schedule a briefing with Verifiable? Email [email protected] and we'll coordinate time with the Verifiable team to discuss how their approach can help your plan reduce costs, accelerate onboarding, and strengthen network integrity. 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 episode of Bright Spots in Healthcare, we explore how human-centered design can uncover breakthrough solutions already hiding in plain sight. Dr. Kristian Olson, Vice President of Design Impact at Mass General Brigham and leader of the Springboard Studio, shares how slowing down to understand problems leads to faster, more effective innovation. The conversation dives into: The four pillars of effective healthcare innovation: design research, prototyping, supported implementation, and impact measurement How "stupidest ideas" exercises and question storming unlock creative solutions in frontline staff meetings Real results from Salem Hospital's mobility speedometer (300% increase in patient movement, reduced length of stay) The COVID testing booth prototype that saved $1 million per year while reducing gown usage by 97% Developing low-cost neonatal resuscitation devices in Uganda and India that improved ventilation skills Why frontline staff must be co-creators, not just implementers, of healthcare solutions This discussion offers practical frameworks for health plans, hospitals, and healthcare leaders looking to harness their teams' ingenuity and drive measurable improvement. Guest Bio: https://www.massgeneral.org/doctors/17235/kris-olson Resources & References MGB Springboard Studio: www.mgbspringboardstudio.org Augmented Infant Resuscitator: ebinnovations.net Positive Deviance approach to solving malnutrition in Vietnam (referenced as inspiration) Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email [email protected] 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.

Host Eric Glazer convenes senior leaders from Humana, Noom, and Blue Shield of California to explore how payers are integrating GLP-1 therapies into comprehensive cardio-metabolic care strategies. The conversation outlines how digital, behavioral, and clinical interventions can align to deliver sustainable outcomes, lower costs, and strengthen member engagement. Panelists share real-world playbooks on scaling GLP-1 programs responsibly—balancing access, affordability, and long-term adherence through consumer-centric design and data-driven clinical support. 📘 What You'll Learn How Humana's CenterWell Pharmacy is transforming outcomes through AI-enabled automation, disease-specific Centers of Excellence, and a high-touch consumer experience. How Noom and forward-thinking health plans are using trust as currency to deepen engagement and sustain lifestyle change. How Blue Shield of California is implementing a step-therapy model that balances GLP-1 access with lifestyle interventions and clinical oversight. Why integration across benefit design, behavior change, and pharmacology is redefining obesity management. What future models look like for holistic, clinician-guided weight management and cardiometabolic care. 💬 Quotable Moments "Trust isn't optional—it's the currency that earns you the right to guide someone through change." – Cody Fair, Chief Commercial Officer, Noom "You can have efficiency and still be high-touch. AI and automation don't replace pharmacists—they empower them." – Bethanie Stein, President of Pharmacy, Humana "GLP-1s are a tool, not the strategy. Success means combining medication with behavioral, nutritional, and clinical support." – Angie Kalousek, Ebrahimi Senior Director, Lifestyle Medicine, Blue Shield of California "Culture—caring, curious, and committed—is the foundation of transformation." – Bethanie Stein, President of Pharmacy, Humana ⏱️ Timestamped Hooks 00:08:00 – 00:09:00: Eric introduces the GLP-1 integration playbook and the challenge of turning high-cost therapies into sustainable value. 00:12:30 – 00:14:00: Humana's digital transformation: from internal pharmacy to 95% retention and NPS of 87. 00:15:20 – 00:17:40: Noom on building trust through "Your Ultimate Why." 00:20:00 – 00:25:00: Blue Shield of California on managing GLP-1 demand and step-therapy protocols. 00:31:00 – 00:33:00: Noom's opt-out model driving 90% employer participation. 00:44:00 – 00:47:00: Humana partners with pharma to deliver GLP-1s at up to 70% lower cash prices. 00:55:00 – 00:57:00: "Caring, Curious, and Committed" – the cultural foundation for consumer-centric care. 01:03:30 – 01:04:50: Blue Shield on building Netflix-style personalization for obesity and MSK programs. 🗒️ Show Notes Featured Guests Bethanie Stein, President of Pharmacy, Humana Cody Fair, Chief Commercial Officer, Noom Angie Kalousek Ebrahimi, Senior Director, Lifestyle Medicine, Blue Shield of California Discussion Highlights Integrating GLP-1 therapies within holistic benefit design frameworks. Leveraging AI and automation in pharmacy operations to enhance adherence and experience. The role of behavior-based engagement models in long-term weight management. Data-driven approaches to affordability, utilization, and trust-based engagement. Creating digital ecosystems that mirror personalized consumer experiences in other industries. Panelist Bios: https://www.brightspotsinhealthcare.com/events/the-glp-1-integration-playbook-smarter-plan-design-to-drive-member-engagement-and-outcomes/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Episode_Guide_GLP1_Integration_Playbook.docx.pdf Key Insights Summary: Key Takeaways - Noom The GLP-1 Integration Playbook_ Smarter Plan Design to Drive Member Engagement and Outcomes 10.09.25.docx.pdf Resources:  Benefits beyond weight loss: The expanding impact of GLP-1s in modern healthcare This resource explores how leading health plans are integrating GLP-1 therapies into holistic care pathways—connecting behavioral support, nutrition, and digital engagement to sustain results. It also highlights Noom's evidence-based approach, showing a 48% greater weight loss and over 4x ROI when GLP-1s are combined with behavioral coaching and mindset support. To request your copy, email [email protected]. Thank You to Our Episode Partner, Noom Noom is a digital health company transforming how people achieve lasting health improvements through psychology, technology, and coaching. Their scalable cardiometabolic solutions—including weight management, diabetes prevention, and GLP-1 support through Noom Med—help employers, health plans, and health systems balance affordability with outcomes. To learn more, visit noom.com/health. Schedule a meeting with Cody Fair, Chief Commercial Officer, Noom: To dive deeper into how Noom can help your plan improve outcomes, reduce costs, and strengthen member engagement, or to schedule a meeting with Cody Fair. Reach out to [email protected] to schedule the meeting. 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 Bright Spots in Healthcare episode, host Eric Glazer brings together an all-star panel of leaders who are reshaping the future of Medicaid and social care. Our guests include: Vanita Pindolia, Vice President, Medicare Star Ratings, Emergent Holdings (BlueCross BlueShield Michigan) Jason Merola, MD, Chief Medical Officer, MVP Health Care Charlotta Eriksson, Lead Director, National VBC Partnerships (Specialty), Aetna Mary O'Connor, MD, Chief Medical Officer & Co-Founder, Vori Together, they explore: How Medicare Advantage plans are embedding Stars, CAHPS, and adherence metrics directly into provider contracts to drive accountability, improve quality, and sustain year-over-year performance gains. How payers like Aetna are expanding value-based care into specialty domains—from CKD and oncology to musculoskeletal and cardiology—by partnering with specialty-aligned organizations rather than converting individual specialists to risk models. How MVP Health Care is designing hybrid incentive structures that reward specialists for closing quality gaps and improving outcomes, without requiring full downside risk. Why MSK care is becoming pivotal to Stars success, as physical and mental health measures grow in weight through 2027, and how holistic, physician-led models are improving activity, satisfaction, and cost savings simultaneously. How digital-first specialty networks are solving access challenges, reducing "ghost network" exposure, and creating new opportunities for plans to meet CMS adequacy standards while improving the member experience. How collaboration across utilization management, Stars, and member experience teams helps avoid trade-offs, ensuring that cost controls don't come at the expense of satisfaction or CAHPS performance. Panelist Bios: https://www.brightspotsinhealthcare.com/events/stars-savings-and-satisfaction-unlocking-msk-and-specialty-care-strategies-for-medicare-advantage-success/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://drive.google.com/file/d/1a_rX23Ev5VRrJKqb8_UwAYBd9tUBIfWA/view?usp=sharing Resources:  Maximizing 2026 Medicare Advantage Performance with Physician-Led MSK Care This report outlines how Vori's physician-led, virtual-first musculoskeletal (MSK) model helps Medicare Advantage plans:Improve up to 12 Star measures across preventive care, chronic condition management, and member experience Deliver faster access to care—appointments available within 48 hours Enhance outcomes for pain, fall prevention, and osteoporosis care while achieving an NPS of 87 Align with the new 2026 Star measures for Improving and Maintaining Physical and Mental Health To request your copy, email [email protected]. Clinical Quality Performance of Value-Based and Fee-for-Service Models for Medicare Advantage: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2839238 This JAMA Health Forum article compares clinical quality outcomes for Medicare Advantage patients whose care is delivered under value-based payment (VBP) models versus traditional fee-for-service (FFS). It finds that VBP arrangements, especially those with two-sided financial risk—in general are associated with better performance on standardized clinical quality measures than FFS. Thank you to our Episode Partner, Vori: Vori partners with health plans and providers to improve musculoskeletal (MSK) care through data-driven, physician-led solutions. Their approach helps reduce unnecessary surgeries, improve recovery outcomes, and enhance patient satisfaction—supporting plans in achieving better Stars performance and overall member experience. To learn more, visit vorihealth.com. Schedule a meeting with Mary O'Connor Chief Medical Officer, Vori: To dive deeper into how Vori can help your plan improve outcomes, reduce costs, and strengthen Medicare Advantage Star Ratings,or to schedule a meeting with Mary O'Connor. Reach out to [email protected]  to schedule the meeting. 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.  

GLP-1 therapies are transforming pharmacy benefits, and Express Scripts is leading the way. Harold Carter, PharmD, SVP of Trade Relations, joins host Eric Glazer to discuss how one of the nation's largest PBMs is navigating this disruptive moment in healthcare. Harold shares how Express Scripts is: Capping costs of GLP-1 therapies to expand patient access while keeping plan spending predictable. Redesigning funding models to strike a balance between affordability, predictability, and outcomes. Leveraging digital tools and AI to reduce friction in the member experience and support long-term adherence. Rethinking formularies not just as cost-control tools but as part of a broader population health and behavioral change ecosystem. You'll also hear his forward-looking perspective on how PBMs will evolve over the next three to five years, and the key questions health plans and employers should be asking today to prepare for the future of pharmacy benefits. About Dr. Harold Carter:   Harold Carter, PharmD, is responsible for leading all interactions and contracting with pharmaceutical manufacturers and oversees strategy and management of Express Scripts' drug formularies, data & insights, client underwriting, and product strategy and development. In his nearly 14 years with the organization, Harold has held numerous leadership roles oriented around critical efforts to lower the cost of prescription drugs and ensuring medication access for Express Scripts clients and members. Harold's previous responsibilities include oversight of the organization's medical pharma contracting and drug procurement teams, as well as leading the strategy, development and execution of Express Scripts' wholesale market, value-based solutions and generic strategy, and development of Express Scripts' advanced utilization management solutions.  In addition to his work at Express Scripts, Harold serves on numerous boards including LifeWise Stl Board of Directors, St. Louis University High School Board of Trustees and IVI Board of Directors. Harold earned his doctorate in pharmacy from St. Louis College of Pharmacy.   Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email [email protected]  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 Part Two of our special HLTH 2025 series, Bright Spots in Healthcare host Eric Glazer continues his conversation with Rich Scarfo, President of HLTH, to explore how the event has become a true growth engine for healthcare solution providers. Rich shares why HLTH is more than a conference - it's a platform intentionally designed to foster meaningful connections, drive measurable ROI, and accelerate innovation across the ecosystem. He breaks down how Market Connect and Investor Connect differ from traditional conference networking, best practices for making the most of those high-value 15-minute meetings, and strategies for effective follow-up that turn introductions into lasting partnerships. You'll also hear how HLTH creates an environment that blends serious business with immersive, memorable experiences ensuring that startups, investors, payers, and providers leave with actionable opportunities. With HLTH 2025 taking place October 19–22 in Las Vegas, this episode is a must-listen for solution providers and innovators looking to maximize their presence and impact at the year's most influential healthcare event. Resources: Take a look at what's in store at HLTH 2025 - https://hlth.com/events/usa Attend HLTH using discount code H25_BSV for $250 off the General Attendee ticket - https://hlth.com/events/usa/register/ Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email [email protected]  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 first episode of a special two-part series, Bright Spots in Healthcare host Eric Glazer sits down with Rich Scarfo, President of HLTH, to explore how one of the most influential healthcare events in the world continues to evolve. With HLTH 2025 taking place this October 19–22 in Las Vegas, Rich reveals what's new this year—from immersive zones on AI and diagnostics, to physician and nurse engagement programs, to the expanded startup pavilions and Investor Connect opportunities. He also shares a blueprint for payers, providers, pharma, and innovators on how to get the most value out of their time at HLTH, including can't-miss sessions, networking strategies, and hidden gems across the show floor. Whether you're a health plan executive, provider leader, startup founder, or healthcare innovator, this episode offers a practical guide to navigating HLTH 2025 and turning conversations into action. Stay tuned for Part Two, where the discussion shifts to how HLTH serves as a growth engine for solution providers. Resources: Take a look at what's in store at HLTH 2025 - https://hlth.com/events/usa Attend HLTH using discount code H25_BSV for $250 off the General Attendee ticket - https://hlth.com/events/usa/register/ Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email [email protected]  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 episode of Bright Spots in Healthcare, we explore The Next Frontier in Self-Funded Benefits. Don Antonucci, CEO of Providence Health Plan and Ali Diab, CEO of Collective Health share how their new partnership is reshaping the employer-sponsored benefits landscape. The conversation dives into: Why aligning provider and member needs is essential for a truly seamless healthcare experience How transparency and simplicity can unlock smarter healthcare decisions The role of innovation and technology in reducing complexity for both employers and employees How strategic partnerships can accelerate growth and deliver more affordable, high-quality care This discussion offers practical insights for health plans, employers, and healthcare leaders looking to design benefits that drive satisfaction, savings, and long-term success. Panelist Bios: https://www.brightspotsinhealthcare.com/events/the-next-frontier-in-self-funded-benefits-inside-providence-health-plans-new-partnership-with-collective-health/ Resources & References Start with Why by Simon Sinek (Book) - https://simonsinek.com/books/start-with-why/  How Great Leaders Inspire Action – TED Talk by Simon Sinek - https://www.ted.com/talks/simon_sinek_how_great_leaders_inspire_action Healthcare Models to Explore: Kaiser Permanente (U.S.) – cited as effective at integrating coverage and care into one user experience Israel – highlighted as having a national health service with user-friendly, electronic front doors for care and transparency in costs Japan – also noted for its efficient, transparent national health service with easy access and clear financial responsibility for patients Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email [email protected]  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 Bright Spots in Healthcare episode, host Eric Glazer brings together an all-star panel of leaders who are reshaping the future of Medicaid and social care. Our guests include: Laurie Stradley, CEO, Impact Health Lori Andrade, EVP, Health Equity Alliance of Long Island (HEALI) Joneigh Khaldun, MD, President & CEO, Public Health Accreditation Board (PHAB) Evan Jones, Chief Strategy Officer, Vircho Together, they explore: How community-based organizations (CBOs) are evolving into trusted healthcare partners Practical strategies for bridging healthcare and social care at scale The role of technology, data, and community health workers in building sustainable Medicaid networks Real-world success stories—from disaster recovery in North Carolina to integrated care models in New York and beyond You'll hear how leaders are overcoming compliance, billing, and operational challenges while keeping people, not just systems, at the center of care. If you're looking for bright spots you can replicate to drive innovation, equity, and efficiency in Medicaid, this episode is packed with lessons and inspiration. Panelist Bios: https://www.brightspotsinhealthcare.com/events/doubling-down-on-medicaid-innovation-in-a-post-obbb-world/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://www.brightspotsinhealthcare.com/wp-content/uploads/2025/09/Episode-Guide_Doubling-Down-on-Medicaid-Innovation.pdf  Resources: 2025 HRSN Innovations Learning Lab Conference, Oct. 23-24, 2025, Asheville NC Guided by Impact Health and the WNC Health Policy Initiative, participants will navigate hands-on workshops, build teams through peer networking, and discover practical paths to success beyond Medicaid—all while connecting with trailblazing experts from across the country. Learn more and register here - https://ihorg.jotform.com/251884444887979 Check out PHAB's new podcast In Service of Health with Dr. Joneigh Khaldun, which explores what it really takes to build healthier communities. Learn more and subscribe here - https://in-service-of-health.podcastpage.io/ Thank you to our Episode Partner, Vircho: Vircho partners with health plans, Government, and Community Care Hubs to connect healthcare with the social needs that impact health. Their tools make it easier to deliver community-based services efficiently and improve outcomes for the people we all serve. To learn more, visit https://vircho.com/ Schedule a meeting with Evan Jones, Chief Strategy Officer, Vircho: To dive deeper into how social care networks are optimizing capacity and outcomes, schedule a meeting with Evan Jones. Reach out to [email protected] to schedule the meeting. 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.

What does it really take to challenge the status quo in healthcare, and win? Dr. Imamu "Mu" Tomlinson, CEO of Vituity and author of Less Than One Percent: How Disruptors Defy the Odds, joins host Eric Glazer to share hard-won lessons on leadership, resilience, and breaking barriers. In this energizing conversation, Mu discusses: How to turn "you can't" into the fuel that drives innovation. Why being disagreeable, optimistic, and relentless are the core traits of true disruptors. Lessons healthcare can borrow from sports icons like Steph Curry and leaders in entertainment. Why moments of victory - not defeat - are the best opportunities to spark lasting change. You'll come away with a fresh perspective on leadership, culture, and how to build teams that defy expectations and achieve more. About Dr. Imamu (Mu) Tomlinson: Imamu Tomlinson, MD, MBA, is the Chief Executive Officer at Vituity, a physician-led and -owned multispecialty partnership. With decades of clinical leadership and practice management experience, Dr. Tomlinson brings deep operational and clinical knowledge to foster Vituity's mission to be at the heart of better care. In his role, Dr. Tomlinson oversees Vituity's 500+ communities, focusing on clinical and cultural integration, and strategies that improve patient satisfaction and drive operational efficiency. Since his appointment as CEO in 2017, Vituity has doubled its footprint. Additionally, during his tenure, Dr. Tomlinson formalized two disciplines within Vituity to support improved patient care: an innovation team, including the appointment of the organization's first Chief Innovation Officer, and a community impact initiative. He also champions physician engagement initiatives, including fellowship programs and innovation grants, to further empower Vituity's healthcare providers to deliver exceptional care and collaborate across the care continuum. Prior to Vituity, Dr. Tomlinson was the Chief of Staff for the Adventist Health Central Valley Network, where he continues to practice as an emergency physician. He previously served as Medical Director for Adventist Health's Hanford and Selma Emergency Departments. At Adventist Health, he spearheaded an effort to create the network's Department of Emergency and Diagnostic Medicine and later served as the department's chair.  Outside of his work at Vituity, Dr. Tomlinson is devoted to making a difference in his local community through the 24/7 Foundation, which works with kids in the Central Valley Youth to inspire mental toughness, athletic competition, and resilience through basketball.  Dr. Tomlinson is the author of Less Than One Percent: How Disruptors Defy the Odds. In this book, he thoughtfully explores the lives of those who dare to defy the odds and disrupt a world of contradictions. Through vivid narratives and deep insights, he reveals powerful strategies for challenging the status quo and driving transformative change.  Order your copy today. 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.