Medicare Advantage Market Disruption and the Future of Risk Adjustment with Ceci Connolly

In this episode, Dr. Andy Anderson, Chief Medical Officer and Chief Quality Officer at RWJBarnabas Healh, shares how the system is improving mortality outcomes and patient experience through rapid response teams, standardized best practices, and a strong culture of accountability. He discusses strategies for scaling success, coordinating care, and fostering growth across the health system.

In this episode, Scott Becker discusses physician shortages, the role of AI and advanced practice providers, and why shortening the lengthy medical education and training pathway could help bring more doctors into the workforce.

In this episode, Jakob Emerson, Associate News Director, Becker’s Healthcare, discusses Medicare Advantage insurers exiting markets, plan and benefit changes heading into 2027, and how major payers are using AI to simplify healthcare navigation and gain a competitive edge.

This episode recorded live at the Becker's 11th Annual Health IT + Digital Health + RCM Conference features Katherine Adams, MS, Director, Clinical Operations, Primary Care, CommonSpirit, who discusses using ambient listening, unified health records and remote patient monitoring to reduce administrative burden and support better clinical decision making.In collaboration with Philips.

In this episode, Ceci Connolly, President and CEO, Alliance of Community Health Plans (ACHP), discusses Medicare Advantage market disruption, plan exits, beneficiary impacts, and the need for risk adjustment reform to support sustainable coverage in local communities.

In this episode, Nick Barcellona, Chief Financial Officer at West Virginia University Health System, joins the podcast to discuss creating a seamless experience for patients and identifying opportunities for growth across the health system. He also shares insights on balancing operational priorities with the evolving needs of patients and the organization.

In this episode, Peggy Norton-Rosko, DNP, RN, NEA-BC, SVP, Chief Nursing Officer, Trinity Health, discusses strengthening shared nursing governance, using nurse input and data to improve patient outcomes, and addressing workforce challenges through academic partnerships, residency programs, career development, and thoughtful technology investments.

In this episode, Chase McGrath, Vice President, Product, Aspirion, and Nikki Ritchson, Senior Director, Payment Variance, Aspirion, discuss the latest federal IDR changes, the new CMS gateway portal and the technology infrastructure providers need to manage deadlines, compliance and submissions at scale.This episode is sponsored by Aspirion.

In this episode, Greg Castle, U.S. Power & Grid Commercial Leader, Schneider Electric, and James Vun Cannon, Healthcare Segment Manager for Strategic Accounts and U.S. Digital Power, Schneider Electric, discuss rising power demand from AI, grid constraints and why health systems need to align IT, facilities, clinical and finance teams around long-term infrastructure and energy planning.Learn more: https://www.se.com/us/en/work/solutions/healthcare/This episode is sponsored by Schneider Electric.

In this episode, Dr. Sheila Bond, Head of Clinical AI, Wolters Kluwer Health, discusses the pillars of trustworthy clinical AI, including governance, validation, accountability and post-use monitoring. She also explores how healthcare organizations can build strong AI foundations while using technology to transform clinical workflows and help patients better understand their care.This episode is sponsored by Wolters Kluwer.