Why Health Plan Innovation Fails, And What Actually Scales | Healthworx

Why do so many healthcare innovation efforts stall after pilots? In this Bright Spots in Healthcare episode, host Eric Glazer sits down with leaders from Healthworx,  the investment and innovation arm of CareFirst, for a candid discussion on what actually allows innovation to scale inside complex healthcare organizations. As health plans invest heavily in AI, digital transformation, startup partnerships, and new care models, many still struggle to operationalize innovation in meaningful ways. This conversation explores why innovation often breaks down between idea and implementation,  and what organizations can do differently. Guests include: Emily Durfee, Director, Corporate Venture Capital, Healthworx Soo Jeon, Head, Healthworx Accelerator Mike Batista, Managing Partner, Healthworx Studio Together, they explore: Why health plan innovation efforts often fail to scale The operational barriers that prevent ideas from gaining traction Why healthcare struggles to move beyond pilots and experimentation What startups misunderstand about working with health plans Why incremental operational evolution often beats transformational change How Healthworx approaches innovation through investing, accelerating, and building What separates organizations that successfully scale innovation from those that don't This episode offers a practical look at the operational realities of healthcare innovation and what it takes to turn new ideas into measurable impact Panelist Bios: https://www.brightspotsinhealthcare.com/events/why-health-plan-innovation-fails-and-what-actually-scales-healthworx/ 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 Medicare Advantage and operational leaders to explore a growing challenge facing health plans: why identifying risk is no longer enough to improve outcomes. As organizations invest heavily in HRAs, predictive analytics, and member insight platforms, many still struggle to convert those insights into timely, coordinated action. This discussion focuses on where execution is breaking down between identification and intervention, and what leading plans are doing differently to reduce friction, align teams, and engage members while the opportunity to act still exists. This is a candid discussion for executives navigating increasing pressure around Stars, affordability, member engagement, and operational efficiency, while trying to turn insight into measurable performance improvement. Our guests include: Vanita Pindolia, PharmD, MBA, Vice President, Stars Program, Blue Cross Blue Shield of Michigan Chuck Palermo, Vice President, Operations, Health Alliance Plan Linda Isham, Former Vice President, Operations & Clinical Support, Humana Cory Busse, Vice President, Strategic Solutions, Icario  Together, they explore: Why insight without operational coordination often fails to improve outcomes How leading plans are identifying the small populations that disproportionately impact performance What changes when organizations shift from retrospective reporting to real time intervention How plans are reducing friction by coordinating Stars, quality, operations, and engagement efforts around a shared action plan Why understanding behavioral, social, and operational barriers is becoming critical to improving adherence, experience, and quality outcomes How organizations are designing outreach and engagement strategies that reflect real member behavior, not just clinical gaps This episode offers a practical look at how leading organizations are closing the gap between insight and action, and what it takes to operationalize engagement in a way that consistently improves quality, cost, and member experience.   Panelist Bios: https://www.brightspotsinhealthcare.com/events/closing-the-gap-between-insight-and-action-data-informed-tech-enabled-strategies-for-health-plans/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download guide: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/05/Final_May7_Episode_Guide.pdf Key Insights Summary: Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation, https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/05/May_7_2026_KIS.docx.pdf Resources:  Report: Health Plan Playbook for 2027, Part 1: From HRA Completion to Real Action This first report in Icario's Health Plan Playbook for 2027 series examines why Medicare Advantage plans need to rethink the HRA as more than a requirement or data collection exercise. The issue is not that plans lack information. It is that the handoff between what members report and what happens next is often too slow, fragmented, or manual to drive meaningful action. The report focuses on a core shift facing plans heading into 2027: completing an HRA is no longer the goal. Acting on it is. When a member is engaged, self reporting, and open, plans have a short window to intervene. If nothing happens in real time, that moment is lost. Drawing on practical examples, the report shows how real time intervention, automatic enrollment into barrier removal programs, and proactive identification of risk patterns can help plans reduce delays, support care teams, and close the gap between insight and action. Inside, you'll find insights on: Why HRAs should be treated as a moment of influence, not just a compliance requirement Where plans lose momentum between member reported needs and follow up action How automatic enrollment can reduce manual handoffs and connect members to support faster Why delayed intervention creates hidden costs across ED utilization, inpatient stays, Stars performance, and unresolved care gaps How plans can act on SDoH, ADL, and behavioral signals while members are still engaged What changes when real time decisioning is embedded directly into the member experience The broader lesson is operational: plans that improve performance are not just collecting better data. They are reducing the time between signal and action, removing broken handoffs, and helping members get to the right support while the opportunity still exists. To request your copy of the report, please contact show producer Nicole Roberts at [email protected]. Thank You to Our Episode Partner, Icario: Icario is a healthcare engagement platform designed to help health plans move beyond disconnected outreach and fragmented member experiences toward more coordinated, action oriented engagement. By combining behavioral science, real time data, and personalized engagement strategies, Icario helps plans identify where members are most likely to disengage, what barriers may prevent action, and how to intervene at the right moment to drive meaningful outcomes. Rather than simply increasing touchpoints, the focus is on reducing friction, improving coordination across teams and programs, and helping members take the next best step. The result is stronger performance across quality, adherence, cost, and member experience. Schedule a Meeting with a Senior Leader at Icario: To explore how Icario is helping health plans improve engagement, reduce friction, and drive more coordinated action across the member journey, reach out to show producer Nicole Roberts at [email protected] to schedule a conversation with a member of the Icario leadership team. 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 if the most effective care model isn't built inside the hospital at all? This episode features the opening presentation from the recent Home Care Innovation Summit, a half-day virtual summit produced by Bright Spots Ventures in partnership with TytoCare, focused on how leading organizations are redesigning care to reach patients where they are. Kelly McCabe, Director of Community Health Innovations, Sinai Chicago and the Sinai Urban Health Institute (SUHI) shares a practical, equity-driven model: clinically integrating community health workers (CHWs) into care delivery to bridge the gap between hospital, home, and community. She's joined briefly by Jeanette Avila, Manager of Community Health Innovations at SUHI offering a frontline perspective on what this model looks like in practice and how it builds trust with patients day-to-day. Serving one of the most complex patient populations in the country, with roughly 90% uninsured or covered by Medicare/Medicaid, Sinai Chicago has built a model that doesn't just acknowledge social needs, but operationalizes them.  You'll hear how Sinai Chicago: Integrates community health workers directly into clinical teams, not as an add-on, but as core infrastructure Extends care beyond hospital walls through home visits and community-based engagement Tracks social determinants and community interactions to shape real-time interventions Builds trust with patients in underserved neighborhoods through culturally aligned care Uses a hybrid model of in-person outreach and centralized coordination to improve outcomes while reducing burnout  Key topics covered: Why community health workers are essential, not optional, for high-need populations Turning social determinants from "insight" into actionable care interventions How to operationalize a community-based care model inside a hospital system The role of trust, proximity, and lived experience in improving engagement Blending home-based care with clinical oversight to scale impact If you're a health system leader, population health executive, or payer/provider partner working to close equity gaps and deliver care beyond traditional settings, this is a real-world blueprint for making it work. Presentation Link: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/05/Kelly-McCabe_Sinai-Chicago_2.19.26.pdf  About Our Presenters: https://www.sinaichicago.org/en/suhi/suhi-staff/ Thank You to Our Episode Partner, TytoCare: TytoCare enables health systems and plans to deliver high-quality remote exams anytime, anywhere. Their FDA-cleared devices and AI-powered diagnostic platform support virtual specialty care, school-based programs, and home health models—reducing unnecessary ED visits and improving patient experience. To learn more, visit tytocare.com. Schedule a Meeting with a Senior Leader at TytoCare: To explore how TytoCare can help your organization expand virtual specialty access and improve care coordination, reach out to [email protected]  to schedule a 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 episode of Bright Spots in Healthcare, recorded live at the ViVE 2026 conference, Eric Glazer sits down with Dr. Pavitra Krishnamani from MD Anderson Cancer Center to explore what it actually takes to build scalable digital health systems. As both a practicing emergency physician and digital health innovator, Dr. Krishnamani brings a frontline perspective to one of healthcare's biggest challenges: why so many digital health tools fail to scale, and what separates technologies that succeed from those that don't. While the industry continues to invest heavily in AI, wearables, telehealth, and other digital tools, many health systems are still struggling with fragmented solutions, low adoption, and limited real-world impact. The path forward isn't more tools, it's better systems.  In this episode, you'll learn: Why workflow integration matters more than features in digital health adoption How AI, wearables, telehealth, VR, and EHRs must work together as a connected ecosystem What health systems should evaluate before bringing in new technology, including ROI, maintenance, and unintended consequences The role of human-centered design in building solutions clinicians will actually use  Why adoption fails without clinician buy-in, flexibility, and cultural alignment How to design more effective pilots and avoid common implementation pitfalls Why education and mindset are critical to scaling AI and digital health What it takes to move from siloed tools to scalable, system-level transformation Key Takeaway: "Education begets innovation" - Pavitra P. Krishnamani, MD. Scalable digital health isn't about deploying more technology, it's about aligning technology, workflows, and people into systems that actually work in practice. Learn More from Dr. Krishnamani: http://pavitramd.com/. Dr. Krishnamani expands on many of these ideas in her upcoming book: Home is Where the Health Is: How Digital Innovation and Technological Advances are Transforming Healthcare and Wellness. The book explores how technologies like AI, wearables, telehealth, and data systems are coming together to reshape healthcare delivery and move care closer to where patients live their daily lives. Connect with Dr. Krishnamani: Instagram: https://www.instagram.com/docpavitra  LinkedIn: https://www.linkedin.com/in/pavitra-krishnamani   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 through credibility building content and trusted executive 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 payer and strategy leaders to explore a fundamental challenge in Medicare Advantage: why improving experience is not about measuring more, but managing better. This conversation focuses on where performance is actually being lost across the member journey, not within individual programs, but in the gaps between them. Plans continue to invest in outreach, pharmacy, provider engagement, and member services, yet still struggle to translate those efforts into consistent member action and measurable outcomes. This is a candid discussion for executives navigating rising expectations around experience, increasing pressure on Stars performance, and the need to deliver results through coordination, not just activity.   Our guests include: Dan Knecht, MD, Chief Medical Officer, EmblemHealth Stacey Friedman, Senior Director, Quality & HEDIS/Stars, Doctors HealthCare Plans Paula Jacobson, Director, Quality and Population Health, Security Health Plan Dave Burianek, Chief Strategy Officer, MedOrion    Together, they explore: Where member experience breaks down across the journey, especially in the moments immediately following enrollment Why campaign-based outreach is no longer sufficient to drive engagement or outcomes How leading plans are shifting from volume to sequencing, focusing on the next best action rather than multiple simultaneous asks What it takes to align pharmacy, quality, and member experience into a coordinated system How organizations are improving performance by reducing friction, increasing clarity, and guiding members toward action  This episode offers a practical look at how leading plans are rethinking CAHPS as a reflection of the full member journey, and what it takes to design that experience in a way that consistently drives performance.  Panelist Bios: https://www.brightspotsinhealthcare.com/events/beyond-the-survey-how-medicare-advantage-plans-are-rethinking-cahps-and-member-experience/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download guide: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/04/April_16_Episode_Guide.docx.pdf Key Insights Summary: Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation, https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/04/04-16-26-KIS-Beyond-the-Survey-Session.pdf Resources:  Report: Redesigning Experience: Why CAHPS Performance Is Won or Lost in the Member Journey This report examines why Medicare Advantage plans often see CAHPS results that don't reflect the effort they put in. The issue is not a lack of activity. It's that CAHPS reflects a year's worth of member experience, shaped by care access, coordination, navigation, and follow-through, not isolated interactions or last-minute interventions. Drawing on real-world examples, the report shows how improving underlying care events like annual wellness visits, redirecting care to the right setting, and strengthening member understanding directly influences CAHPS performance, and why results cannot be changed at the end of the measurement year. Inside, you'll find insights on: Why CAHPS questions act as proxies for clinical events like annual wellness visits and care coordination Where campaign-based engagement models fall short in shaping member experience How friction accumulates across touchpoints and impacts perception long before the survey is fielded What changes when plans shift from disconnected outreach to coordinated, journey-based design How aligning Stars, quality, and care delivery reduces fragmentation and improves outcomes Why understanding member barriers, including access, confusion, and behavioral factors, is critical to driving action The broader lesson is operational: plans that consistently perform on CAHPS are not doing more outreach. They are designing member journeys that reduce friction, coordinate care and communication, and naturally produce better experiences over time. To request your copy of the report, please contact show producer Jessica Tenzer at [email protected]. Thank You to Our Episode Partner, MedOrion: MedOrion helps health plans move beyond static segmentation by using real-time clinical, situational, and behavioral signals to drive meaningful member action. By identifying who to engage, what barriers exist, and when to intervene, MedOrion enables more precise prioritization and coordination of outreach. This approach helps close care gaps, improve adherence, reduce avoidable utilization, and drive more consistent performance across cost, quality, and experience. Learn more at medorion.com.  Schedule a Meeting with a Senior Leader at MedOrion: To explore how MedOrion can support your organization in moving from campaign-based outreach to coordinated, signal-driven engagement, reach out to show producer Nicole Roberts at [email protected] to schedule a conversation with a member of the MedOrion leadership team.    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 payer leaders to explore a fundamental challenge in Medicare Advantage: why strong strategies often fail to translate into sustained performance. This conversation focuses on the gap between intention and execution, where plans invest heavily in programs, outreach, and data, yet still struggle to drive the member actions that ultimately determine cost, quality, and experience. This is a candid discussion for executives navigating rising pressure on margins, increasing complexity in member populations, and the growing need to prove performance beyond activity alone. Our guests include: Mike Rapach, President & CEO, CareFirst Community Health Plan Maryland Joshua Meeks, Vice President, Medicare Advantage Individual Business, Blue Cross Blue Shield of Michigan Jen Cohen-Smith, SVP Medicare, Healthfirst Kathleen Faulk, Chief Strategy Officer, Drips Together, they explore: Where Medicare Advantage strategies break down, not in design, but in execution Why member engagement alone is no longer sufficient to drive outcomes How leading plans are shifting from outreach to activation by addressing barriers to action in real time What it takes to align product design, pharmacy strategy, and operational workflows to support long-term sustainability How organizations are translating insight into action to improve adherence, reduce avoidable utilization, and drive measurable ROI This episode offers a practical look at how leading plans are redefining performance in Medicare Advantage, and what it takes to ensure that strategy actually delivers results at scale. Panelist Bios: https://www.brightspotsinhealthcare.com/events/ma-strategy-session-what-actually-drives-long-term-viability/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download guide here: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/04/Episode-Guide-MA-Strategy-Session-04-09-26.docx.pdf  Key Insights Summary: Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation, https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/04/04-09-26-KIS-MA-Strategy-Session_-What-Actually-Drives-Long-Term-Viability-Drips.docx.pdf  Resources:  Report: Stop Engaging, Start Activating; The New Architecture of Medicare Advantage Performance This companion report examines how health plans can close the gap between strategy and execution by focusing on what actually drives performance: whether members take action. Drawing on real-world implementation and emerging activation models, the report shows how identifying friction, understanding barriers, and guiding behavior in real time can improve adherence, reduce avoidable utilization, and strengthen outcomes across cost, quality, and experience. Inside, you'll find insights on: Identifying where outreach breaks down and why engagement alone fails to drive meaningful outcomes Understanding the root causes of non-adherence, including confusion, access barriers, competing priorities, and system design gaps Shifting from one-way communication to two-way, real-time conversations that surface and resolve barriers to action Designing activation models that guide members through next steps and increase completion of key actions Aligning engagement strategies with operational workflows to reduce friction and improve performance at scale Why moving from activity-based metrics to action-based outcomes is critical as financial pressure, regulatory changes, and member complexity increase The broader lesson is operational: the strongest Medicare Advantage models are not defined by how much outreach occurs, but by how effectively plans convert insight into action and ensure follow-through on the moments that matter most. To request your copy of the report, please contact show producer Jessica Tenzer at [email protected]. Thank You to Our Episode Partner, Drips: Drips helps health plans and providers drive meaningful member action through AI-powered, two-way communication at scale. By engaging members through familiar channels like text and phone, Drips enables real-time conversations that surface barriers, guide next steps, and improve adherence. Its approach shifts organizations from outreach to activation, helping close care gaps, reduce friction, and deliver more consistent performance across cost, quality, and experience. Learn more at drips.com. Schedule a Meeting with a Senior Leader at Drips: To explore how Drips can support your organization in moving from engagement to activation and improving member follow-through, reach out to show producer Jessica Tenzer at [email protected] to schedule a conversation with a member of the Drips leadership team.   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.

Chronic care isn't failing because of strategy. It's breaking down in execution. In this episode of Bright Spots in Healthcare, host Eric Glazer brings together provider leaders to explore a critical issue: the loss of time, attention, and clinical capacity to inefficient workflows instead of patient care. This conversation highlights how organizations are making structural changes to reduce friction, improve follow-up, and build more sustainable chronic care models. 🎯 What you'll learn: Why chronic care breaks down in workflow, not strategy How leading providers reduce administrative burden What changes when documentation stops dominating care How follow-up systems are redesigned to close care gaps How augmented care models expand capacity without replacing human care 👥 Featured Leaders: Francis Mercado, MD – Board Chair, CommonSpirit Health ACO Danielle Whitacre, MD – Chief Medical Officer, Bloom Healthcare Lilian Alevato, MD – Chief Medical Officer, White-Wilson Medical Center Ava Johnson – Director, Ambulatory CDQI, Mount Sinai Hospital Carol Roeder, MD – Chief Medical Officer, Nightingale.MD 📥 Resources & Links: 👉 Panelist Bios: https://www.brightspotsinhealthcare.com/events/how-leading-providers-are-reclaiming-time-value-in-chronic-care/ 👉 Download the Episode Guide: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/04/Episode-Guide-Bright-Spots-in-Health-Care-04-02-26.pdf 👉 Key Insights Summary: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/04/Key-Takeaways_-Reclaiming-Time-Value-in-Chronic-Care-04-02-26.docx.pdf 📩 Request the full reports: [email protected] 📊 Featured Reports: Chronic Care Breaks Down in Workflow, Not Strategy Learn how redesigning workflows and automating low-value tasks improves capacity and patient outcomes. What an Augmented Care Manager Model Looks Like in Practice See how AI-assisted care models extend reach while preserving human interaction and clinical judgment. 🤝 Episode Partner: Nightingale.MD Nightingale.MD helps provider organizations redesign chronic care workflows using an augmented care model. Their AI assistant, Florence™, supports outreach, follow-up, and documentation while allowing clinical teams to focus on high-value patient care. 🌐 Learn more: https://www.nightingale.md 📩 Schedule a meeting with Carol Roeder, MD: Contact Vekonda Luangaphay at [email protected] 🧠 About Bright Spots Ventures Bright Spots Ventures is a healthcare strategy and engagement company focused on scaling proven innovations. They connect healthcare leaders through podcasts, executive councils, and private events to accelerate measurable impact. 🌐 Visit: https://www.brightspotsinhealthcare.com

In this Bright Spots in Healthcare episode, host Eric Glazer brought together payer and provider leaders to examine a major shift underway in specialty care. Historically, specialty models have been built around episodic intervention, stepping in after a condition has progressed. But as organizations take on greater accountability for outcomes and cost, that model is becoming harder to sustain. The conversation explored how AI, earlier signal detection, and more connected care models can help organizations identify risk sooner, guide members more effectively, and support better outcomes over time. Our guests include: Saria Saccocio, MD, Chief Medical Officer, Essence Healthcare  Ross Lagerblade, Vice President, Value Based Strategies, Humana Mary O'Connor, MD, Chief Medical Officer & Co-Founder, Vori Health   Together, they explored: How specialty care is evolving from reactive, episode-based intervention to models built around continuous visibility and earlier action How organizations are identifying risk that never shows up in traditional data, and what it takes to surface and act on those blind spots How leading plans are redesigning the member experience to create clearer, more guided pathways through complex specialty care journeys What it looks like to use AI and new data sources to scale outreach, triage, and coordination without increasing operational burden How clinically grounded models are ensuring members are directed to the right level of care at the right time, avoiding unnecessary escalation What it takes to align care delivery, incentives, and measurement around sustained outcomes rather than isolated interventions This episode offers an inside look at how leaders are building more proactive, coordinated specialty care models, and what it takes to make them work in practice. Panelist Bios: https://www.brightspotsinhealthcare.com/events/ai-and-specialty-vbc-moving-from-episodic-care-to-longitudinal-outcomes/   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/2026/03/EpisodeGuideBrightSpotsinHealthCare032626.pdf Key Insights Summary: Find key insights from the discussion and guest takeaways from the conversation. https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/03/Key-Insights-03-26-26.docx.pdf Resources:  Report: Moving Specialty Care Upstream: From Episodic Intervention to Longitudinal Outcomes This companion report from Vori Health explores how physician-led, longitudinal care models are helping organizations identify risk earlier, guide members more effectively, and improve outcomes over time. Drawing on real-world implementation, it highlights how combining clinical expertise with data, AI, and coordinated care pathways can shift specialty care from reactive treatment to continuous management. Inside, you'll find insights on: Extending specialty care beyond traditional encounters to support members earlier in their journey Designing clinically grounded care pathways that guide members to the right level of care at the right time Using data, wearables, and AI to surface risk that is not visible in traditional workflows Reducing unnecessary escalation, procedures, and downstream cost through earlier intervention Building scalable models that combine centralized coordination with physician-led care delivery Why longitudinal accountability is becoming essential as expectations for outcomes, experience, and cost continue to rise To request your copy, reach out to show producer Nicole Roberts at [email protected] Thank You to Our Episode Partner,  Vori Health By combining a physician-led care model with data-driven insights and longitudinal support, Vori Health is helping extend specialty care beyond episodic encounters and into continuous, whole-person care. In addition to improving access, Vori Health drives better outcomes, stronger member engagement, and meaningful reductions in unnecessary procedures and total cost of care. You can learn more at vorihealth.com. Schedule a Meeting with a Vori Health Leader: To explore how Vori Health can support your organization in delivering physician-led, longitudinal specialty care and guiding members earlier to the right level of care, reach out to show producer Nicole Roberts at [email protected] to schedule a conversation with a senior leader from Vori Health. 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 convenes provider and health system leaders working at the front lines of rural healthcare transformation across Texas. The conversation explores what it actually takes to extend clinical expertise across distance, workforce shortages, and infrastructure gaps, and how organizations are redesigning care delivery to meet patients where they are. This is a candid discussion for leaders navigating real operational constraints while building models that can scale. Together, the panel explores how hybrid care, digital infrastructure, and new collaboration models are reshaping access across some of the most complex care environments in the country. Our guests include: Pothik Chatterjee, MBA, Executive Director, Digital Health Institute, Rice University & Houston Methodist Reyann Davis, MPH, Director of Value-Based Care, Rural and Community Health Institute, Texas A&M Health Indira Vadlamani, MD, Division Medical Director, Gulf Coast Division, HCA Houston Healthcare Together, they explore: How rural health systems are addressing structural barriers including workforce shortages, transportation challenges, and limited broadband access What it takes to redesign workflows and build repeatable operational playbooks that can scale across rural hospitals How virtual care models such as Virtual ICUs, remote monitoring, and multidisciplinary collaboration are extending clinical expertise beyond traditional settings What actually works when organizations combine centralized support, local care teams, and hybrid care models to improve access and outcomes How emerging technologies including AI, wearables, and remote diagnostics are enabling earlier intervention, improving efficiency, and reducing strain on clinicians This episode offers an inside look at how leaders are building practical, scalable models to close rural care gaps, and what it takes to make those models work in real-world conditions. Panelist Bios: https://www.brightspotsinhealthcare.com/events/the-texas-access-playbook-how-innovation-is-closing-rural-care-gaps/   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/2026/03/Episode-Guide-Bright-Spots-in-Health-Care-TytoCare-03-19-26.pdf Key Insights Summary: Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation. https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/03/Key-Takeaways_-The-Texas-Access-Playbook_-How-Innovation-Is-Closing-Rural-Care-Gaps-03-19-26.pdf  Resources:  Report: Expanding Access to High-Quality School Health Services Across the U.S. This companion report from Avel eCare explores how school-based virtual care models can expand access to timely, high-quality care for students, particularly in rural and underserved communities. Drawing on real-world implementation, the report shows how connecting schools with remote clinicians and equipping them with diagnostic tools can reduce care delays, improve outcomes, and bring clinical expertise directly into the classroom. Inside, you'll find insights on: Extending care into schools to overcome barriers related to transportation, workforce shortages, and limited access to providers Designing hybrid care models that combine school staff with remote clinicians to deliver real-time medical evaluations Using connected diagnostic tools to enable in-school exams that replicate in-clinic care Reducing unnecessary emergency department visits while keeping students in school and engaged in learning Building scalable models that leverage centralized clinical expertise while maintaining local presence and trust Why school-based care is becoming a critical access point as pediatric care gaps continue to widen To request your copy from show producer, Jessica Tenzer at email [email protected]. Thank You to Our Episode Partner, TytoCare: TytoCare is transforming how providers and health plans deliver care by enabling remote, medical-grade exams from home and community settings. Through its Home Smart Clinic and Pro Smart Clinic, TytoCare combines FDA-cleared diagnostic tools with AI-powered guidance to help clinicians deliver real-time diagnosis and care beyond traditional settings. This approach drives higher utilization, improves access, reduces unnecessary emergency department visits, and delivers measurable impact across diverse populations. Learn more at tytocare.com Schedule a Meeting with a TytoCare Leader: To explore how TytoCare can support your organization in extending care into homes, schools, and community settings, reach out to show producer Jessica Tenzer at [email protected] to schedule a meeting with a senior leader from TytoCare. 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, recorded live at the ViVE 2026 conference, Eric Glazer sits down with Dr. Reshma Gupta from UC Davis Health to explore how health systems can translate artificial intelligence and predictive analytics into real operational improvement. As Chief of Population Health and Accountable Care, Reshma focuses on turning data and predictive insight into measurable outcomes across prevention, care management, and accountable care programs. Her work highlights a central challenge facing healthcare leaders today: many organizations have the models, but far fewer have built the workflows, governance, and operational alignment needed to turn those insights into action. The conversation dives into: Why successful AI initiatives connect predictions directly to clinical workflows, incentives, and operational ownership How UC Davis Health expanded its high risk population health strategy into the Emergency Department Approaches to measuring the value of prevention including avoided admissions and downstream outcomes Where predictive analytics supports prevention and population health within accountable care models How UC Davis developed the BE FAIR framework to evaluate predictive models for bias and equity The governance structures that help health systems move quickly with AI while maintaining trust and accountability Practical lessons for moving AI from isolated pilots into measurable performance improvement This discussion offers a practical blueprint for health system leaders working to strengthen prevention, population health, and accountable care through data driven insight. The organizations seeing real results are those aligning data, workflow, incentives, and governance so predictive insight translates into better decisions and measurable outcomes. References: BE FAIR Framework: UC Davis Health's framework for assessing, implementing, and redesigning predictive models to reduce bias and improve equity in healthcare. https://pmc.ncbi.nlm.nih.gov/articles/PMC12405130/ UC Davis Health AI for Population Health: How UC Davis Health uses predictive analytics to identify patients at risk and support earlier intervention in population health programs. https://health.ucdavis.edu/news/headlines/uc-davis-health-uses-ai-models-to-leave-no-patient-behind/2025/04 Reshma Gupta Bio: https://health.ucdavis.edu/population-health/leadership/reshma-gupta.html   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 through credibility building content and trusted executive 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.