Bright Spots in Healthcare

Eric Glazer
  • 4.8 (59)
  • Medicine
  • Updated Weekly

Each episode, I interview innovators in the healthcare industry to extract the strategies, tactics, tools, and/or routines they utilize to generate extraordinary, positive outcomes. We highlight and breakdown these bright spots so you can apply them at your organization. "See a bright spot .... and clone it!"

  1. 3d ago

    From High Risk to Movable Risk: Where Health Plans Can Change the Cardiometabolic Trajectory

    In this Bright Spots in Healthcare episode, host Eric Glazer brings together health plan, provider, and cardiometabolic care leaders to examine a challenge becoming increasingly important to healthcare organizations: how to move beyond identifying high-risk members and determine which risks are actually movable. The discussion explores what it takes to turn cardiometabolic risk information into action. Across health plans, provider networks, and care models, the conversation looks at how organizations are thinking about clinical strategy, GLP-1s, individualized risk, provider performance, meaningful engagement, care delivery systems, and the operational integration needed to make effective interventions work at scale. This is a practical discussion for health plan and provider leaders navigating rising cardiometabolic risk, complex treatment decisions, evolving GLP-1 strategies, variable provider performance, and the growing need to demonstrate meaningful clinical and economic outcomes. Our guests include: Daniel Knecht, MD, Chief Medical Officer & SVP, EmblemHealth Thomas Graf, MD, Vice President & Chief Medical Officer, Health Services, Florida Blue Lisa Shah, MD, Chief Medical Officer, Twin Health Together, they explore: How health plans can move beyond identifying high-risk members to understand what is actually driving risk and what may be movable at the individual level How health plans are approaching GLP-1 strategy, including formulary decisions, clinical criteria, lifestyle support, and the need to keep clinical considerations at the center How provider networks can identify "pockets of excellence," co-create standards with physicians, and build systems of care that make better performance more reliable Why successful cardiometabolic programs need to fit into existing clinical, pharmacy, provider, and operational workflows rather than becoming another disconnected solution This episode offers an inside look at how leading organizations are rethinking cardiometabolic care by asking a more useful question: Where is risk actually movable, what can change it, and what does it take to make that change happen reliably at scale? Panelist Bios here: https://www.brightspotsinhealthcare.com/events/from-high-risk-to-movable-risk-can-health-plans-change-the-cardiometabolic-trajectory/ 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/2026/10/Episode-Guide-Bright-Spots-in-Health-Care-10-01-26.pdf  Key Insights Summary: Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation.  [Place PDF LINK HERE] Thank You to Our Episode Partner, Twin Health Twin Health is focused on helping people improve their metabolic health through a highly personalized approach that combines technology, clinical support, and individual health data. The company's approach reflects several themes explored throughout this episode, including the importance of understanding what is driving risk at the individual level, distinguishing meaningful engagement from activity, and measuring outcomes that go beyond a single clinical metric. The conversation also highlights a broader challenge for health plans: identifying the interventions most likely to change a member's trajectory and integrating those interventions into a model of care that can support sustained improvement over time. To learn more about Twin Health, visit TwinHealth.com Schedule a Meeting with Twin Health To explore how Twin Health can help your organization approach cardiometabolic health through a more personalized, data-driven model, reach out to show producer Vekonda Luangaphay at vluangaphay@brightspotsventures.com to schedule a conversation with the Twin Health 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.

  2. Sep 29

    2027 Medicare Advantage Strategy: What Plans Are Changing Now for 2029 Stars

    What should Medicare Advantage plans change now to improve performance in 2027 and prepare for the 2029 Star Ratings? In this episode of Bright Spots in Healthcare, leaders from Zing Health, CDPHP, UPMC Health Plan and MedOrionshare how MA plans are acting earlier, prioritizing limited resources, improving Stars and quality performance, and reducing reliance on the traditional fourth-quarter scramble. The discussion gets practical: how plans are using existing data sooner, turning clinical insights into action, coordinating with providers, reaching harder-to-engage members, and deciding where limited engagement resources can have the greatest impact. Download the Episode Resources Episode Guide Key takeaways and practical lessons from the conversation: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/09/Podcast-Episode-Guide-Bright-Spots-in-Health-Care-Medorion-09-24-26.pdf Key Insights Summary Guest takeaways, discussion highlights and Eric Glazer's moderator notes: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/09/Key-Insights-Summary-Bright-Spots-09-24-26.pdf Request MedOrion's report: Removing the Blindspot: Making HOS and CAHPS the Advantage Contact Nicole Roberts at nroberts@brightspotsventures.com. Featured Medicare Advantage Leaders Daniel Weaver, Senior Vice President, Stars and Quality, Zing Health Michael Farina, Vice President, Healthcare Quality, CDPHP Mariah Osborn, Director, Medicare Stars, UPMC Health Plan David Burianek, Chief Strategy Officer, MedOrion What You'll Learn This conversation explores how Medicare Advantage plans are rethinking the operating model behind Stars, quality and member engagement for 2027 and beyond, including: How existing knowledge about returning members can support action before the first HEDIS results arrive How CDPHP uses natural language processing to reduce clinical review time while expanding the number of measures reviewed What it takes to identify time-sensitive member events, coordinate follow-up and reduce duplicate outreach Why addressing a member's immediate need can build the trust required for future engagement How community relationships and member feedback help plans understand why care is not happening How benefit communications can help resolve questions before changes disrupt care or increase service demand Featured Resource: Removing the Blindspot MedOrion's report, Removing the Blindspot: Making HOS and CAHPS the Advantage, explores how Medicare Advantage plans can build a more coordinated approach to member engagement across the year. The report examines: HOS and CAHPS strategy Harder-to-engage Medicare Advantage members Earlier clinical information Member barriers including access, transportation, confusion and trust Annual Notices of Change Annual wellness visits Next-best-action strategies Governance across Stars, quality and member engagement How plans can make limited resources go further To request a copy, contact Nicole Roberts at nroberts@brightspotsventures.com. About MedOrion MedOrion combines technology with hands-on expertise to help health plans improve Medicare Advantage, Stars, HEDIS and quality performance with limited resources. Its approach helps plans determine where additional engagement can make a difference, where it may not be needed, and how to turn those decisions into action. Learn more: https://medorion.com/ Connect With MedOrion To explore how MedOrion can help your team prioritize engagement resources and build a more coordinated approach to Stars and quality performance, contact Nicole Roberts at nroberts@brightspotsventures.com to schedule a conversation with a senior MedOrion leader. Panelist Bios https://www.brightspotsinhealthcare.com/events/from-chart-chase-to-competitive-advantage-the-2027-medicare-advantage-playbook/   About Bright Spots in Healthcare Bright Spots in Healthcare brings together health plan, health system and healthcare innovation leaders to share practical examples of what is working — and how others can apply and scale those ideas. Bright Spots Ventures creates healthcare content, executive communities, private peer discussions and go-to-market programs designed to accelerate meaningful change. Learn more: https://www.brightspotsinhealthcare.com/ Subscribe for more conversations with Medicare Advantage, Stars, quality, health plan and healthcare leaders.

  3. Sep 24

    Missed Data, Missed Dollars: The Member Insights That Risk Models Are Blind To (Repost)

    Bright Spots in Healthcare

  4. Sep 15

    Stars, Savings, and Satisfaction with BCBS Michigan, Aetna, MVP & Vori (RePost)

    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 nroberts@brightspotsventures.com. 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 nroberts@brightspsotsventures.com  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.

  5. Sep 10

    Yale New Haven's Thomas Balcezak, MD | How to Make What Works Stick, Spread and Scale

    Healthcare doesn't have a shortage of good ideas. The harder problem is turning what works into the way care is actually delivered. In this episode of Bright Spots in Healthcare, Eric Glazer sits down with Dr. Thomas Balcezak, Executive Vice President and Chief Clinical Officer at Yale New Haven Health, to explore why proven ideas can take years to become everyday practice, and what healthcare leaders can do differently. Dr. Balcezak shares how Yale New Haven is using more than 2,500 Care Signature pathways to bring current clinical guidance directly into physician workflows, reduce unwanted variation, and improve outcomes, efficiency and equity. He also reflects on an early-career experience in Tanzania that shaped how he thinks about positive deviance: finding people or teams achieving exceptional results under the same constraints as everyone else, understanding what they do differently, and spreading it. The conversation also explores the changing economics of physician practice, what health systems often misunderstand about physician employment, and how technologies such as ambient documentation can reduce administrative burden when implemented well. In this episode: Why healthcare struggles to close the gap between what works and what actually happens How Yale New Haven is scaling Care Signature across clinical workflows What positive deviance can teach leaders about innovation How physician practice models are changing What Yale has learned from ambient documentation Why frontline teams may hold the key to scaling what works   Referenced Research: JAMA Network Open: Hospital System Acquisition of Physician Practices https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2850132 About Dr. Thomas Balcezak: Thomas J. Balcezak, MD, MPH, is Executive Vice President and Chief Clinical Officer for Yale New Haven Health. In this position, Dr. Balcezak focuses on enhancing the provision of reliably safe, patient-centered, and cost-effective care of the highest quality. Over the course of his career, he has transformed the clinical enterprise around the core precepts of High Reliability, aligned operational and clinical care processes across the growing geographies of Yale New Haven Health, and built an exceptional team dedicated to accelerating the creation of a signature of care across the academic health system. About Bright Spots Ventures Bright Spots Ventures helps healthcare leaders discover what's working—and how to scale it. Through our podcast, executive councils, private events, and strategic advisory work, we bring together health plan, provider, and healthcare innovation leaders to exchange practical ideas that improve care, lower costs, and accelerate innovation. Learn more: https://www.brightspotsinhealthcare.com

  6. Sep 1

    The Forecasting Frontier: How AI is Reshaping Risk, Revenue, and ROI (Repost)

    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.

  7. Aug 25

    One Member, Five Open Gaps: How Leading Medicare Advantage Plans Are Coordinating Member Action

    In this episode of Bright Spots in Healthcare, host Eric Glazer brings together Medicare Advantage leaders from Drips, Johns Hopkins Health Plans, MMM Holdings, myPlace Health, and Independent Health to tackle a challenge every plan knows well: what happens when the same member has multiple open needs, and who decides what should happen first? The conversation moves beyond measure-by-measure outreach to explore how plans can coordinate action around the whole member. Panelists discuss how to weigh Stars, claims cost, risk adjustment, member context, social barriers, provider workflows, and likelihood to act when determining the next best action. Through practical examples, the group examines how plans are building shared views of the member, connecting plan and provider teams, using technology to recognize moments of influence, and giving frontline teams more room to listen and respond to what members actually need. Our guests include: Kathleen Faulk, Chief Strategy Officer, Drips Brendan Generelli, Director, Medicare Stars & Quality, Johns Hopkins Health Plans Nilda González, Vice President, Quality Management & Stars, MMM Holdings, LLC Rob Schreiber, MD, Vice President and National Medical Director of Care Model Strategy, myPlace Health, part of SCAN Group Amin Serehali, SVP, Chief Data and Analytics Officer, Independent Health   Together, they explore: How plans can prioritize when one member has multiple legitimate care, quality, pharmacy, and risk needs Why enterprise impact, including claims cost and risk adjustment, can change which gap deserves attention first How member barriers and personal priorities should shape the next best action How MMM Holdings uses INNOV-A MD, Smart Profile, and its Office Advantage Quality Program to connect plan and provider workflows How Independent Health built Member 360 to bring fragmented clinical, pharmacy, utilization, and member information into one actionable view How plans can use real-time "moments of influence" to reprioritize outreach when a member is most ready to act Why frontline listening can sometimes create more value than completing every item on a checklist How more deliberate targeting can improve results while using outreach resources more efficiently   Whether you lead Stars, quality, risk adjustment, analytics, care management, member engagement, or Medicare strategy, this episode offers practical ideas for closing more gaps without creating more noise for members. Panelist Bios: https://www.brightspotsinhealthcare.com/events/one-member-five-open-gaps-how-leading-medicare-advantage-plans-are-coordinating-member-action/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download guide: https://docs.google.com/document/d/1pZErXDEfncqTI-1yoB3yJAv7_Ox-JiqNJsmKep2OK4o/edit?tab=t.0 Key Insights Summary: Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation, https://docs.google.com/document/d/1V4mxERrmHf_IEWcUWzfPKwuRlY2dVV21/edit Thank You to Our Episode Partner, Drips: Drips helps Medicare Advantage and Medicaid plans turn member conversations into completed actions across annual wellness visits, care gaps, medication adherence, and other priority programs. By helping plans connect outreach across programs, respond to member context in real time, and focus on the next action a member is most ready to take, Drips supports a more coordinated member journey with fewer disconnected touchpoints and greater follow-through. Schedule a Meeting with a Senior Leader at Drips: Interested in learning how health plans are coordinating outreach around the member and turning conversations into completed actions? To connect with Kathleen Faulk or another member of the Drips leadership team, contact show producer Jessica Tenzer at jtenzer@brightspotsventures.com to schedule a conversation. 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.

  8. Aug 18

    Anthem's West Region Commercial President Beth Keyser | Making Healthcare Easier Before It Gets Expensive

    "Healthcare becomes more affordable when we make the better choice the easy choice." In this episode of Bright Spots in Healthcare, Eric Glazer sits down with Beth Keyser, President of Anthem Blue Cross and Blue Shield's West Region Commercial Health Benefits business, to explore why healthcare affordability isn't just about lowering prices, it's about helping people make better decisions earlier. Throughout the conversation, Beth shares how Anthem is redesigning the member journey by combining data, navigation, provider collaboration, and whole-person care to guide members toward the right care at the right time and in the right setting. Rather than focusing on healthcare after the bill arrives, Beth explains why the greatest opportunity to improve affordability happens long before treatment begins. In this episode: Why healthcare affordability starts before anyone receives a medical bill Helping members choose the right site of care without sacrificing quality Moving beyond price transparency to true care navigation How Sydney Health and HealthOS are helping members and providers make better decisions together Why whole-person care is also an affordability strategy What the industry's strongest payer-provider partnerships are doing differently Why healthcare leaders should focus less on protecting data, and more on using it The opportunity healthcare may still be underestimating over the next five years If you're leading a health plan, provider organization, employer health strategy, or healthcare company, this conversation offers practical ideas for improving affordability by making healthcare easier to navigate, not simply cheaper. Resource: Anthem Blue Cross and Blue Shield and USA TODAY Network's in-house branded content studio launched a new five-part video series designed to help Americans better understand their health plan benefits, make informed care decisions and manage costs with greater confidence. https://www.usatoday.com/interactives/sponsor-story/anthem-blue-cross-blue-shield/5-key-health-insurance-terms-made-simple/ About Beth Keyser: Beth Keyser is a 30-year healthcare industry veteran with a passion for leading organizations that are on a mission to make people healthier.  Beth was named president of the Anthem Blue Cross and Blue Shield West Region for the Commercial Health Benefits division in 2025, which includes Colorado, Indiana, Kentucky, Missouri, Nevada, Ohio and Wisconsin. She is also responsible for Sales Enablement and Centralized Sales Support within the Commercial Health Benefits division. Previously, Beth served as president of Anthem Blue Cross and Blue Shield of Indiana from 2020 to 2025. The Anthem health plan in Indiana is the largest in the state with nearly 5,000 Indiana-based associates, serving more than four million members. Before joining Anthem, Beth focused on improving doctor-patient relationships as the president of Create® health plans in New York City. Prior to her time at Create®, Beth held several leadership roles at Healthways where she was accountable for domestic and international revenue growth, customer experience, call center operations and establishing partnerships with health plans, employers, physician organizations and hospitals. Early in her career she helped stand up Gordian Health Solutions, a Nashville start-up, that was eventually sold to Blue Cross Blue Shield of Tennessee. Beth currently serves on the Board of Directors of Women in Health Care Leadership at University of Alabama at Birmingham, which provides mentoring and training programs to develop tomorrow's leaders. She also serves on the board of directors of the Indiana Sports Corp, Neuraxis and the WellPoint Holding Corporation. Beth is also a proud member of the Red Cross Tiffany Circle. Keyser is a graduate of the University of Southern Mississippi and earned a master's degree from the University of Alabama at Birmingham. Connect with Beth: https://www.linkedin.com/in/beth-keyser-589a184/     About Bright Spots Ventures Bright Spots Ventures helps healthcare leaders discover what's working—and how to scale it. Through our podcast, executive councils, private events, and strategic advisory work, we bring together health plan, provider, and healthcare innovation leaders to exchange practical ideas that improve care, lower costs, and accelerate innovation. Learn more: https://www.brightspotsinhealthcare.com

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4.8
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About

Each episode, I interview innovators in the healthcare industry to extract the strategies, tactics, tools, and/or routines they utilize to generate extraordinary, positive outcomes. We highlight and breakdown these bright spots so you can apply them at your organization. "See a bright spot .... and clone it!"

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