Bright Spots in Healthcare Eric Glazer

G.T. Sweeney, Chief Information Officer, Healthfirst and Sami Boshut, Chief Information Officer, MediSys Health Network, Inc., join Eric to discuss how their organizations collaborated with a technology company to create a cloud-based platform that enables seamless sharing of patient data across the care continuum.  
The platform connects longitudinal data from claims, quality measures and electronic health records (EHRs) to identify gaps in care, making it easier for providers to address patient needs in real-time. The two discuss how the platform supports the next phase of value-based care by ensuring providers have the right information at the right time to address the needs of patients. 
Sweeney and Boshut also provide a blueprint to help other organizations implement similar provider-centric technology systems.  
About Our Guests:
G.T. Sweeney has been Healthfirst’s Chief Information Officer since 2014, leading the Information Services department to help transform the insurer's business and tightly integrate information systems to further strategic goals.

Sami Bosurt has a demonstrated history of working in the hospital & healthcare industry with a proven track record and expertise in Healthcare Consulting, Infrastructure Installations, Software Implementation and Vendor Management.

 
John Petito, Corporate Vice President, Transformation, SCAN Health and Ashish V. Shah, CEO, Dina, discuss the power of benefits navigation in attracting and retaining members for Medicare Advantage plans and other government programs. 
 
The average Medicare beneficiary has access to over 43 Medicare Advantage plans, and offering supplemental benefits such as home-centered care enables plans to compete and differentiate in the marketplace. But plans must ensure members understand the benefits and that the navigation experience is seamless – and painless. 
 
John and Ashish share successful strategies and best practices plans can implement to improve member experience and ensure members receive the care they need.
 
 Topics include:
 
How the Medicare Advantage market is shifting
New opportunities for risk-bearing entities 
Why navigation is so hard and how to enhance it
Measuring navigation strategy
Improving CAHPS and STAR Ratings through enhanced benefit navigation
 
This episode is sponsored by Dina
Dina provides benefits and care coordination solutions to support health plans and providers as they extend care management into the home. Customers use our SaaS technology to digitize their network of community and home-centered providers; transform coordination workflows so they spend less time with phone calls and faxes; collect performance data to improve their network continuously; and capture meaningful data directly from home. Last year, Dina was named to the Inc. 5000 list of fastest-growing companies and CB Insights Digital Health 150 list of companies transforming healthcare with digital technology.

Healthcare leaders from Blue Shield of California, CareSource, UT Health Austin and Vori Health discuss the importance of adopting a whole-person approach across the broader healthcare experience to maximize value, drive healthy behavior change and ensure more equitable care. 
 
Learn how to develop an integrated whole-person solution framework and implement strategies to support members with chronic and high-risk conditions. Topics include:
Adopting self-service digital tools and applications to engage members
Providing access to resources, health coaches, medication, and mental/behavioral health support
Leveraging medical and SDoH data to determine unique needs, tailor care, and sustain healthy behavior change
 
Panelists: Judith Davis, Vice President Clinical Operations, Ohio Market, CareSource, Angie Kalousek Ebrahimi, Senior Director, Lifestyle Medicine, Blue Shield of California, Karl Koenig, M.D., M.S., Executive Director, Musculoskeletal Institute; Division Chief of Orthopaedic Surgery, Associate Professor of Surgery and Perioperative Care, Dell Medical School, Ryan A. Grant, MD, MBA, FAANS, Founder and Chief Executive Officer, Vori Health
Bios: https://www.brightspotsinhealthcare.com/events/reduce-total-cost-of-care-innovative-whole-person-models-for-high-cost-conditions/
 
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This episode is sponsored by Vori Health
Vori Health is a specialty medical practice delivering a virtual-first musculoskeletal (MSK) solution to help members return to their lives faster. As the only nationwide MSK practice with doctor-led care teams, Vori Health is the most convenient way to access appropriate care for back, neck, and joint pain without bouncing around the healthcare system. Whether members need a diagnosis, non-opioid prescription, personalized physical therapy, or health coaching, they can turn to Vori Health for evidence-based care and effective end-to-end support. This holistic model reduces unnecessary surgeries, enables faster recoveries, and lowers MSK spending with up to a 4:1 ROI, for more information, visit www.vorihealth.com.

CDPHP, Johns Hopkins Medicine, Priority Health, ATRIO Health Plans and Vatica Health share successful strategies and best practices for provider-centric risk adjustment programs, which enable health plans to enjoy higher compliance, enhanced quality of care, improved risk score accuracy, higher Star and quality ratings and better financial performance. Learn how your plan can empower physicians to close care gaps, avoid common pitfalls and maintain compliant record documentation proactively.
 
Panelists: Gregg Kimmer, President & CEO, ATRIO Health Plans; Michelle Ilitch, MPH, Vice President, Vice President of Network Solutions and Value-Based Programming, Priority Health,; Colleen Gianatasio MHS, CPC, CPC-P, CPMA, CRC, CPCO, CDEO, CPPM, CCDS-0, CCS, and AAPC Approved Instructor, Director Clinical Documentation Integrity and Coding Compliance, Capital District Physician’s Health Plan (CDPHP);  Frank Shipp, FACHE, MBA, Executive Director, Johns Hopkins Clinical Alliance, Johns Hopkins Medicine; Hassan Rifaat, MD, CEO, Vatica
https://www.sharedpurposeconnect.com/events/boosting-plan-performance-improving-provider-centric-risk-adjustment-staying-compliant/
 
For more information on our Payer & Provider Roundtable Summit:
https://brightspotssummit.eventbrite.com
 
This episode is sponsored by Vatica Health
Vatica Health is the #1 rated risk adjustment and quality of care solution for health plans and health systems. By pairing expert clinical teams with cutting-edge technology, Vatica increases patient engagement and improves coding accuracy and completeness. It helps identify and facilitate closure of care gaps and enhances communication and collaboration between providers and health plans. The company’s unique provider-centric solution helps payers, providers and patients achieve better outcomes, together.
 
Vatica is trusted by many leading health plans and thousands of providers nationwide. Healthcare research firm KLAS named Vatica “Best in KLAS” for risk adjustment in 2023. KLAS also named Vatica to its Emerging Solutions Top 20 list for innovative companies that have the greatest potential to impact and disrupt the healthcare market. For more information, visit VaticaHealth.com.

AmeriHealth Caritas, Blue Cross Blue Shield, Optum at Home & Reema Health share bright spots and novel tactics for engaging dual eligible beneficiaries. Discussion topics include: building a foundation of trust through a community approach, engaging hard-to-reach or historically unreachable members, and addressing health-related social needs to improve clinical outcomes
 
Panelists Include:
Christopher McDade, Vice President, Medicare Integrated Health Plans and Revenue Management, AmeriHealth Caritas, 
Leanna Moran, Managing Director of the Duals Market, Blue Cross Blue Shield of Rhode Island
Catherine Mitchell, Chief Strategy Officer, Optum at Home
Melissa Kjolsing, Head of Engagement Strategy, Reema Health
Bios: https://www.sharedpurposeconnect.com/events/unique-approaches-to-building-trust-with-dual-eligible-members/



This episode is sponsored by Reema Health
Reema is transforming how people navigate the gaps between health care and social care using technology and Community Guides who share their identity with the members they serve. Reema’s approach improves healthcare experiences, leading to higher member engagement and reduced costs. 
 
Reema’s breakthrough health platform uses proprietary technology and predictive data modeling to identify people with the highest level of unmet social needs, power Community Guides with the right information to engage them meaningfully, connect them with the most relevant resources, and improve their health and lives. Because they believe in guiding all members to better health. Learn more at reemahealth.com

Joanne Mizell, Chief Operating Officer,  Banner|Aetna – a joint venture between CVS Health’s insurance arm, Aetna, and health system Banner Health – joins Eric to discuss what makes Banner|Aetna unique from other health insurers and its approach to whole person care. 
 
She shared how the company uses MultiDisciplinary Care Teams to provide high-risk patients with a localized, high-touch, intensive care management strategy with a unique care approach to meet patients face-to-face.
In addition to sharing numerous bright spots, including a Type 2 Diabetes Reversal program, Joanne lays out a blueprint for building innovative, whole person care programs.
 
About Joanne
Joanne joined Banner|Aetna in February 2018 with over 20 years of Aetna experience and nearly 30 years in the Employee Benefits industry. In this role, and as a member of the executive leadership team, Joanne oversees the organization's operations. She supports the execution of the strategic goals set by Banner|Aetna’s Board of Directors and Chief Executive Officer.
 
Bright Spots in Healthcare has a new website! Please visit: https://www.brightspotsinhealthcare.com/
 
Register for our Payer & Provider Executive Summit on August 24 & 25 in Boston.: https://www.eventbrite.com/e/469644799237