Integrating GLP-1 Therapies: Building the New Playbook for Cardio-Metabolic Care

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.” – Bethany Stein, President of Pharmacy, Humana “GLP-1s are a tool, not the strategy. Success means combining medication with behavioral, nutritional, and clinical support.” – Angie Okaloosa-Ibrahimi, Senior Director, Lifestyle Medicine, Blue Shield of California “Culture—caring, curious, and committed—is the foundation of transformation.” – Bethany Stein, 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 Bethany Stein, President of Pharmacy, Humana Cody Fair, Chief Commercial Officer, Noom Angie Okaloosa-Ibrahimi, 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. Resources Mentioned The GLP-1 Integration Playbook (Noom, 2025) Evolution program, Blue Shield of California CenterWell Pharmacy patient experience data Bright Spots Ventures Partner Acknowledgment Special thanks to Noom for supporting this episode. Noom combines behavioral science, technology, and clinical guidance to deliver measurable results in metabolic health. Learn more at noom.com/health.

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.

Artificial intelligence is no longer just a buzzword, it’s a practical tool transforming how healthcare organizations prepare for the future. From evaluating and pricing risk with greater accuracy to identifying rising-risk members and strengthening long-term financial strategies, AI is reshaping the very foundations of forecasting in healthcare. In this episode, leaders from Florida Blue, Premera Blue Cross, Blue Shield of California, and Prealize Health share how they’re applying AI across actuarial, clinical, and data science domains to optimize decisions, improve outcomes, and drive organizational sustainability. In this episode, you’ll learn: How health plans are evaluating and scaling AI models to improve accuracy in forecasting and underwriting Real-world examples of AI identifying rising-risk populations and transforming engagement strategies Why “next best action” models are becoming central to member engagement and population health How generative AI and workflow optimization are streamlining operations and reducing costs What it takes to embed AI into financial planning, provider contracting, and long-term ROI strategies Panelists: Romilla Batra, MD, MBA, SVP & Chief Medical Officer, Premera Blue Cross Ratnik Gandhi, Senior Director, AI, Florida Blue Emily Allred, Senior Director & Actuary, Large Group Pricing, Blue Shield of California Dean Noble-Tolla, PhD, Chief Product & Analytics Officer, Prealize Health Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here.

Learn how AI is already working to close the member engagement gap, transforming intent into impact, personalizing care at scale, and creating the connected experiences members now expect. Leaders from Highmark Health, Ovatient, Cigna, and League share proven strategies, bright spots, and lessons learned in applying AI to drive measurable outcomes, lower costs, and improve the member experience. In this episode, you’ll learn: How AI is turning digital intent into meaningful health actions Real-world examples of personalized engagement that improved outcomes and savings Why the future of digital health is shifting from mobile-first to AI-first What it takes to build a scalable, purpose-built AI platform for healthcare How payers and providers can unite around the member with AI-powered engagement Panelists: Ian Blunt, VP Advanced Analytics, Highmark Health Michael Dalton, Founder & CEO, Ovatient Charles DeShazer, MD, Former Chief Quality Officer, The Cigna Group         Andrew Dubowec, Chief Growth Officer, League       Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here. Resources Here’s the podcast Eric Glazer referenced during the show: Acquired/ACQ2 Episode: How is AI Different Than Other Technology Waves? (With Bret Taylor and Clay Bavor), August 18, 2025 Thank you to League for supporting this episode. League is the leading healthcare consumer experience platform, reaching more than 40 million people around the world and delivering the highest level of personalization in the industry. Payers, providers, and consumer health partners build on League’s platform to deliver high-engagement healthcare solutions proven to improve health outcomes. Learn more at www.league.com. How to Engage: Chat with Us: Share your thoughts with Producer Jessica Tenzer at [email protected]