Healthcare Without Blind Spots

Socially Determined
  • 5.0 (9)
  • Health & Fitness
  • Biweekly

Most healthcare decisions are shaped by what happens in the exam room. But patients spend 525,000+ minutes a year outside of clinical care, and what happens in those minutes matters just as much. Healthcare Without Blind Spots brings together healthcare leaders, innovators, and practitioners who are redefining what it means to care for the whole person. Each episode explores how organizations can quantify social risk, close health equity gaps, and measure real impact by understanding the full context of patients' lives, not just their diagnoses.

Episodes

  1. Oct 1

    Social risk doesn't skip the people with insurance | Rebecca Anderson

    Social risk gets filed as a Medicaid or Medicare story. Rebecca Anderson, Director of Community Health at Blue Cross and Blue Shield of Kansas City, makes the case that it runs just as deep in commercial populations, among the members with jobs, benefits, and rising costs that no one connects to unmet needs. She joins Trenor Williams to trace how a community health worker team built for commercially insured members became one of the only programs of its kind in the country. Rebecca walks through the patient whose six-figure medication lapsed over a deductible, the federal employee population that delivers some of her highest return on investment, and the shift from medical-spend-only reviews to conversations where social data sits next to claims. She and Trenor get into measuring what is hard to measure, the mental health gains her team sees most consistently, and why real engagement happens in grocery stores, pharmacies, and churches long before it happens in a clinic.   Topics discussed: ·       Why social risk is just as present in commercially insured populations as it is in Medicare and Medicaid, and why that gets overlooked ·       How Rebecca built a community health worker team inside a commercial health plan, one of the only programs of its kind in the country ·       The rheumatoid arthritis patient who stopped a six-figure medication because the deductible meant choosing between treatment and feeding his family ·       Why the members labeled high cost and noncompliant are so often carrying unmet social needs underneath ·       How linking social risk to medical spend became the missing piece that lets employers and plans justify the investment ·       Why federal employee populations can deliver some of the highest return on investment for upstream work ·       How member churn changes the math and the evaluation when you try to prove savings ·       The move from medical-spend-only business reviews to conversations where social data sits alongside claims ·       Leading measures versus lagging measures, and why mental health improvement is the most consistent signal her team sees ·       Layering data to reach people who are pre-diabetic and high social risk before they ever become diabetic ·       Mental health and youth sports through the Shut Out the Stigma project and partnerships like the KC Current ·       Why engagement is a privilege, and how grocery stores, pharmacies, and churches reach people the clinic never will ·       Why whole person care is becoming a market differentiator for a commercial health plan ·       Where social determinants work needs to go over the next five years

    Social risk doesn't skip the people with insurance | Rebecca Anderson

  2. Sep 15

    The blind spot in maternal health is what happens after the baby | Dr. Adaeze Enekwechi

    Adaeze Enekwechi, PhD, MPP, has spent her career moving between the rooms where healthcare decisions get made: academia, the White House Office of Management and Budget, private equity, and now the CEO seat at Nadia Care. That range is what makes her read on maternal health hard to dismiss. She argues the system pours its resources into pregnancy and delivery, then loses interest at the exact moment a new mother is most exposed. After discharge, moms on Medicaid are often sent home to low-wage jobs with no leave, unstable housing, and postpartum depression that goes unnamed, with a single six-week visit most of them never attend. Nadia Care is built to fill that gap with wraparound support delivered by maternity navigators and nurses hired from the same communities they serve, alongside dietitians and lactation consultants, in person and by video and text. Adaeze and Trenor get into why context shapes outcomes more than any single clinical visit, why a navigator who can say “I was you five years ago” changes the entire relationship, how she thinks about proving return on investment to skeptical health plans, and why she has come to believe that storytelling, not another data set, is what actually moves policy. Her throughline is that maternal health is a team sport, and no one should be playing it alone. Topics Discussed: - How Adaeze's upbringing between Iowa and Nigeria, and her habit of reading health as a student of history, shaped the way she sees care - Why the postpartum period is a blind spot, and what happens to moms between hospital discharge and a six-week visit most never attend - The wraparound model behind Nadia Care, and why the company screens navigators for empathy before anything else - Why hiring navigators and nurses from the same community changes the relationship with Medicaid moms in a way a clinical setting cannot - Adaeze's own postpartum experience, and what it revealed about the support most mothers simply do not have - Why moving health plans off fee-for-service is such a steep climb, even with value-based care on the table - The discipline of proving return on investment, and the damage done by companies selling interventions with no evidence behind them - Why addressing social determinants is a fiscal imperative rather than a soft nice to have - The lesson storytelling taught her during the fight to save the ACA, and why data alone never becomes a movement - Why maternal health is a team sport, and how Nadia Care works to empower the physician relationship instead of replacing it

    The blind spot in maternal health is what happens after the baby | Dr. Adaeze Enekwechi

  3. Sep 1

    Why the chronic disease epidemic is ending, and healthcare is the last to notice | Ellen Brown

    Ellen Brown spent 30 years inside billion-dollar health plans, launching and restructuring plans and shaping national policy, and she started out as an underwriter learning what it actually costs to insure people. That background is what makes her read on healthcare's blind spot hard to wave off. She thinks the chronic disease epidemic is ending, and that the industry is the last to notice, because its money and its attention are locked downstream, waiting 20 years for disease the food system is manufacturing right now. Her framework is a redesign rather than a tweak. System A was inherent health, System B scaled cheap calories and built an acute-care industry to manage the fallout, and System C realigns the incentives so the money follows health instead of volume. The shift is already visible. GLP-1s are bending the economics of food, snack sales are down 6 to 7 percent, and consumers are moving upstream faster than the system expects. Along the way she and Trenor get into why you can't insure a condition that was never insurable, what employers keep getting wrong about benefits, and why the real blind spot in health is the grocery store. Topics Discussed- Why Ellen believes the chronic disease epidemic is ending, and why healthcare is the last to notice - The System A, B, and C framework, and how each system reshaped food and health - Why the industry keeps insuring chronic disease that was never insurable in the first place - How GLP-1s are bending the economics of food, with snack sales already down 6 to 7 percent - The $9 trillion human health market and why most of it still flows to acute care - What employers get wrong about wellness benefits, and a different way to think about what's insurable - The reusable rocket, and using System B dollars to build System C - Why primary prevention happens at the grocery store, where 75 percent of shelf space delivers chronic disease

    Why the chronic disease epidemic is ending, and healthcare is the last to notice | Ellen Brown

  4. Aug 18

    Data rich, context poor: what healthcare keeps missing about patients | Shoshanah Brown

    Shoshanah Brown has spent more than 25 years closer to the frontline of health than most executives ever get. She started as a Peace Corps community health worker in a rural village in Burkina Faso, founded and ran AIRnyc for 13 years sending community health workers into the homes of families battling asthma, and now leads population health at Popai Health. That arc is why her read on healthcare’s blind spot is hard to argue with. The problem was never a shortage of data. It’s that no one is capturing what the patient actually says. Popai works with FQHCs and the safety net, where the social side of a person’s life is even more fragmented than the clinical side. Brown makes the case that the signals predicting a missed appointment or a trip to the ED are already being spoken, to a receptionist, a navigator, a care manager, and then lost in systems that don’t talk to each other. Her conviction is that AI’s highest use here is amplification, not automation. Strip away the documentation burden, keep the human community health worker in the workflow, and let them do the trust-building and listening only a person can do. Topics Discussed Why healthcare is data rich and context poor, and what patient context actually means The signals patients already speak that get lost across fragmented, disconnected systems Popai’s model: orchestrating information to drive the next best action before a crisis hits Why the non-clinical frontline workforce has been healthcare’s invisible backbone Removing the documentation burden, including the translation load workers carry between patient conversations and English-language systems AI as amplification, not automation: keeping the human in the workflow and working at the top of their license Building trust by ending the repeat screening that forces vulnerable patients to restate stigmatized needs Lessons from AIRnyc: how being data-driven and tech-enabled early earned a seat at the table when value-based care arrived The case for a single social and clinical care plan built at the level of the individual What the community health worker role could look like in three to five years

    Data rich, context poor: what healthcare keeps missing about patients | Shoshanah Brown

  5. Aug 4

    "Sleep is a privilege": what healthcare keeps getting wrong about patients | Judith Brown Clarke

    Dr. Judith Brown Clarke has held more unusual vantage points than most healthcare leaders will ever see: Olympic silver medalist, CPS investigator, city council member, now  Vice President of Equity & Inclusion and Chief Health Equity Officer at Stony Brook University and Health System. That career path isn't a curiosity, it's the source of some of the sharpest thinking in this conversation. She watched the downstream consequences of unmet social need show up as child neglect cases long before healthcare had language for any of it, which is why her read on what the system keeps missing is harder to dismiss than most. Topics Discussed: Why "non-compliant" signals clinician incuriosity, not patient failure Sleep as a clinical recommendation that assumes privilege The arrogance of the single-intervention fix: why chemo doesn't work when the patient goes home to chronic toxic exposure Stony Brook's community presence model: mobile dental, mammography, and cardiac care as a patient trust and retention strategy, not charity Why oral and vision health are the canary in the cave for systemic disease, and why carving them out of insurance coverage is clinically indefensible Training providers in humility by embedding dental students in communities treating patients they would never otherwise encounter, including a 45-year-old who had never had their teeth cleaned The stone soup framework for multi-stakeholder care: intentional handoffs where the system navigates on behalf of the patient, not the reverse Imposter syndrome reframed: you have permission to feel it, not to stay in it, and your obligation in the room is to represent every voice that isn't there

    "Sleep is a privilege": what healthcare keeps getting wrong about patients | Judith Brown Clarke

  6. Jul 14

    "We created our own beast": how point solutions fragmented the patient experience | Ellen Kelsay

    Ellen Kelsay represents 460+ employers and more than  60 million people globally at the Business Group on Health. She's watching the same cost crisis play out across her entire member base in real time, which makes her read on what's working and what isn't worth paying close attention to. The uncomfortable through-line of this conversation: the industry built a massive ecosystem of point solutions with good intentions, but stitch a dozen together and the patient experience fragments, costs keep rising, and ROI becomes impossible to attribute. Ellen sees AI heading down the same road. Efficiencies are being claimed but not passed through, and she puts a number on it: roughly 1.5% of current healthcare trend may already be attributable to the negative effects of AI, including up-coding and inflationary revenue cycle applications. Trend is already running 6.5–9.5% depending on the firm. The math isn't hard. The more actionable half of the episode covers what leading employers are actually doing differently, including vendor summits that put every partner in the same room, aligned on shared outcomes and collective ROI for the same patient populations. Topics discussed Why the status quo is already the most disruptive option employers have right now Directly asking the workforce what's blocking care access and what that two-way conversation actually surfaces Vendor accountability: what employers are demanding from health plans and benefits partners that isn't being delivered How vendor summits work as an operating model for shared outcomes and collective ROI attribution The 1.5% AI tax: how up-coding and unreturned efficiency gains are contributing to trend AI bot wars between health plans and providers and who is absorbing the cost Why AI is deploying too fast for the change management that made EHR adoption work Imposter syndrome as a permanent fixture in senior leadership and how to reframe it without dismissing it

    "We created our own beast": how point solutions fragmented the patient experience | Ellen Kelsay

  7. Jun 29

    600 resources, 3% used: the benefits access problem | Ashley Reid

    Most employee benefit programs aren't underfunded. They're just invisible. Ashley Reid, Founder and CEO of Wellist, has spent a decade proving that access is the real problem, not investment. One client had 17 vendor partners sitting on over 600 embedded resources. Their HR team estimated 50. Ashley shares how Wellist built an e-commerce-style navigation experience that gets employees connecting with an average of 11 resources per visit, how she identified the exact C-suite conversation that unlocked scalable sales, and why assumption-based personalization, AI-driven or otherwise, is structurally guaranteed to leave most employees behind. Topics discussed:  The 600-resource problem buried inside 17 vendor partners Why two employees with the same life event share only 20-30% of the same support needs How assumption-based benefits models connect just 30% of employees to support Using real-time behavioral data to replace annual benefits market studies The childcare vendor case study: 40% assumed need, 13% actual demand, 3% utilization How to structure a CHRO conversation when benefits waste is already on their agenda The three CFO-certified ROI proof points that close enterprise deals Why selling to everyone's problem is selling to no one: the 45-stakeholder hospital lesson Building early adopter momentum outside healthcare to get to scale faster

    600 resources, 3% used: the benefits access problem | Ashley Reid
  • 7 Episodes

Ratings & Reviews

5
out of 5
9 Ratings

About

Most healthcare decisions are shaped by what happens in the exam room. But patients spend 525,000+ minutes a year outside of clinical care, and what happens in those minutes matters just as much. Healthcare Without Blind Spots brings together healthcare leaders, innovators, and practitioners who are redefining what it means to care for the whole person. Each episode explores how organizations can quantify social risk, close health equity gaps, and measure real impact by understanding the full context of patients' lives, not just their diagnoses.

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