Bright Spots in Healthcare

 

Alec Peterson, MD, Chief Medical Officer of Acute and Specialty Care at Devoted Health, joins Eric to explore the innovative care delivery model that sets Devoted Health apart from other Medicare Advantage plans. Devoted Health uniquely integrates healthcare coverage with its in-house, virtual, and in-home care provider, Devoted Medical, in partnership with leading healthcare providers to offer comprehensive care for older Americans.

 

Alec shares the key strategies behind Devoted Health’s impressive success and delves into how Devoted Medical’s groundbreaking model has driven high member satisfaction and improved clinical outcomes. He also unveils the roadmap for achieving a 5-star rating from CMS for their Medicare Advantage plans in Florida and Ohio.

About Alec

Alec Petersen, MD, is an internal medicine physician and Chief Medical Officer, Acute & Specialty Care with the Devoted Medical team of Devoted Health. In his role, Petersen leads Devoted Health’s Care on Demand program and focuses on maximizing the potential of innovative at-home care delivery without overstressing an already maxed-out healthcare workforce.

 

After receiving his medical degree from Vanderbilt University School of Medicine, Alec completed a clinical fellowship and MBA at Harvard. Before his career in medicine, he served as a military intelligence officer. 

 

About Devoted Health

Founded in 2017 by brothers Todd and Ed Park, Devoted Health is a new kind of healthcare company providing all-in-one care for older Americans. Members of the company’s best-in-class insurance plans can receive care through their trusted PCP and complementary preventative care services through Devoted Medical, the first virtual and in-home medical group built from the ground up to serve the specific needs of the Medicare population. The Devoted Medical team of mission-oriented clinicians works closely with members’ primary care physicians and Devoted’s full-service Guides to deliver a new model of advanced primary care, powered by deeply specialized clinical programs and proprietary technology that enables intensive care coordination.

Rachel Winokur, CEO, TailorCare and Alex Bateman, CEO, United Musculoskeletal

Partners (UMP) join Eric to discuss the evolution and adoption of specialty value-based care, highlighting the significant improvements in patient care, customer satisfaction scores, cost reduction and value creation.

 

Hear how their two organizations partner with a commercial payer to manage musculoskeletal cases, ensuring they assess patients, understand their needs, and match them with the best providers in the market.

 

Rachel and Alex also touched on the keys to implementing a successful value-based care strategy and underscored the transformative power of data analytics in shaping the future of healthcare.

 

Segments

1. Origin Story

2. Payer Experience

3. Patient Experience

4. Pitfalls

5. Strategy/Building

An episode of The Bear, is referenced in the interview. Here is a link to a summary of the episode (Season 2, Ep. 2) https://www.imdb.com/title/tt26230348/

 

About Alex

Alex  is an accomplished, results-driven healthcare leader with 20 years of development and operations experience in multi-state, multi-site healthcare services organizations. He is a proven talent and team builder who adapts and thrives in the changing healthcare space. He is analytical, confident in challenging environments, and regarded as a top company performer in both leadership and growth/development.

 

About Rachel

Rachel is the co-founder and CEO of TailorCare, a risk-based care navigation and health management company that provides deeply personal, data-driven support and clinical access to patients living with joint, back, and muscle pain. Prior to founding TailorCare, Rachel launched Bright Health Group, a value-based healthcare company committed to managing population risk. She served as Chief Business Officer of Bright before serving as the CEO of NeueHealth, the risk-based primary care delivery, provider enablement, and network management company she created within Bright. Rachel built her career in executive and leadership roles at Aetna, where she helped start the health plan’s population health management division, The Carlyle Group, as a healthcare investor, and at Datascope, a public medical device company she helped take private. Rachel has previously held positions at Bertelsmann and Goldman Sachs.

 

About United Musculoskeletal Partners

United Musculoskeletal Partners (UMP) was formed in December 2021 by Resurgens Orthopaedics, one of the nation's largest orthopedic practices. UMP partners with entrepreneurial, physician-owned orthopedic practices to deliver exceptional clinical care to patients around the country while simplifying the management functions of the practices under one umbrella company. Website: www.umpartners.com

This episode is sponsored by TailorCare

TailorCare is a risk-based care navigation program that provides deeply personal support to patients living with joint, back, and muscle pain. By combining a careful assessment of patients’ symptoms, health history, preferences and goals with predictive data and the latest evidence-based guidelines, TailorCare helps patients choose—and navigate—the most effective treatment pathway for them, every step of the way. Website: www.tailorcare.com

BlueCross BlueShield of Tennessee, Cambia Health Solutions, Health Plan of San Joaquin/Mountain Valley Health Plan and Pager Health discuss how technology and innovation transform the member experience, improving clinical outcomes and consumer engagement.

 

Segments: 

1. Strategy & Culture

2. Data & Decision-Making

3. Personalization 

4. Right Care, Right Time

Panelists:

• Laurent Rotival, EVP & CIO, Cambia Health Solutions

• Victoria Worthy, CIO, Health Plan of San Joaquin | Mountain Valley Health Plan

• Sherri Zink, SVP, Chief Data & Engagement Officer, BlueCross BlueShield of Tennessee

• Rita Sharma, Chief Product Officer, Pager Health

Bios: https://www.brightspotsinhealthcare.com/events/revolutionizing-health-plans-the-connected-member-experience/#url

 

This episode is sponsored by Pager Health

Pager Health is a connected health platform company that enables healthcare enterprises to deliver high-engagement, intelligent health experiences for their patients, members and teams through integrated technology, AI and concierge services. Our solutions help people get the right care at the right time and in the right place and stay healthy while simultaneously reducing system friction and fragmentation, powering engagement, and orchestrating the enterprise. Pager Health partners with leading payers, providers and employers representing more than 28 million individuals across the United States and Latin America.

Former NFL general manager and three-time Super Bowl winner Mike Lombardi joins Eric to share what he learned working with coaching legends Bill Walsh of the 49ers, Al Davis of the Raiders, and Bill Belichick of the Patriots, among others, during his three decades in football and how those core leadership lessons directly translate to managing health plans and hospital systems.

 

He discusses building a winning team, handling high-pressure situations, adapting to change, decision-making under uncertainty, and cultivating a winning culture.

  The Daily Coach Network is accepting applications for 15 new members starting in August. If you submit your application before July 29th and write "Bright Spots" in the referral section you'll receive an extra month on your first membership. Submit your application at apply.thedailycoachnetwork.com    To receive The Daily Coach newsletter, visit https://www.thedaily.coach/subscribe   Books mentioned during episode: Jocko Willink, Dichotomy of Leadership: Balancing the Challenges of Extreme Ownership to Lead and Win; Extreme Ownership: How U.S. Navy Seals Lead and Win David Goggins, Never Finished: Unshackle Your Mind and Win the War Within James Clear, Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones

 

CareSource, Independent Health, and AdhereHealth outline strategies for the upcoming Medicare Advantage Star Rating changes, focusing on medication adherence and the Health Equity Index (HEI) starting in measurement years 2024-2025 for the 2027 Medicare Advantage Star Rating Period. 

 

Under HEI, plans must identify disparities in populations with social risks and create intervention strategies to address these inequities. Tune in and gain insights on leveraging policy changes, predictive analytics, and strategic implementation to meet these new standards and reach or maintain 4+ Stars.

 

Panelists:

Amin Serehali, Senior Vice President, Chief Data & Analytics Officer, Independent Health

Logan Fox, PharmD, MBA, Director, Enterprise Quality

Improvement, Programs, CareSource

Kempton Presley, MPH, MS, Chief Strategy Officer, AdhereHealth

 

https://www.brightspotsinhealthcare.com/events/convergence-of-pharmacy-the-health-equity-index-in-2024-and-beyond/

 

This episode is sponsored by AdhereHealth

AdhereHealth is at the forefront of delivering purpose-built, innovative technology solutions designed to elevate pay-for-performance achievement for government-sponsored lines of business. This includes improved Star Ratings for Medicare, plus enhanced patient experience scores, improved patient health outcomes, and optimized cost outcomes for clients. The company’s pioneering efforts are particularly noteworthy for addressing social determinants of health (SDOH) and significantly improving patient experiences as a mechanism for improved Star Ratings performance through multi-modal outreach capabilities.

 

Powered by the industry-leading Adhere Platform™, AdhereHealth integrates predictive analytics, intelligent clinical workflow software, and proactive multi-channel outreach. This combination, executed by a nationwide team of licensed clinicians, effectively drives health equity and adherence outcomes that improve quality of care for patients and boost financial results for clients.

 

The impact of AdhereHealth's comprehensive solutions is far-reaching, touching tens of millions of patients across over 100 health plans, self-insured employers and other risk-bearing entities. Since its inception in 2006, AdhereHealth, headquartered in Franklin, Tennessee, has grown into a robust organization with hundreds of dedicated professionals nationwide, all committed to their mission of improving healthcare outcomes. Visit www.adherehealth.com for more information.

Fred Turner, co-founder and chief executive officer of Curative, joins Eric to discuss how Curative is reinventing health insurance by adopting a more preventative approach to drive better results and lead to a more affordable delivery of plans.

 

Fred shares Curative’s journey from a pandemic testing company to a health insurance provider with a first-of-its-kind plan that eliminates copays and deductibles and advocates that the most effective approach to promote early preventive care is ensuring accessible and cost-free access to top-tier healthcare providers.

 

Fred underlines the significance of simplifying the healthcare system and the positive impact of Curative's approach. The innovative health insurance plan offers unmatched transparency into healthcare costs, providing reassurance to both employees and employers about the affordability and accessibility of healthcare. 

 

Tune in and learn what makes Curative different from other plans and how it makes health care affordable, accessible and engaging for members.

About Fred

Fred Turner is the Chief Executive Officer and co-founder of Curative. A British scientist from West Yorkshire, Turner attended the University of Oxford. Fred was named one of the top 100 practicing scientists in the UK by the Science Council in 2013. Turner was included in Forbes “30 Under 30” list and ranked first in the European Union Contest for Young Scientists. 

 

About Curative

Curative has been critical and a national leader in bringing COVID-19 testing and vaccine-administration resources in response to the pandemic, providing more than 32 million tests and two million vaccines across thousands of locations in 40+ states. Concurrently, Curative has created and launched a first-of-its-kind health insurance plan offering that offers unmatched transparency into health care costs.

 

Leading healthcare investors and strategists discuss how to rethink capital in healthcare and share unique ways to grow and scale companies to improve health outcomes, cost savings, and operational efficiencies.

 

Topics include:

• Components investors look for in 2024

• Healthcare sectors with the highest growth projections

• Human capital strategies

• Growth strategies to scale your company

• Bright spots that have been attracting people and capital

 

Anna Haghgooie, Managing Director at Valtruis, a WCAS Company

Steven Klopfer, Founder & Managing Partner, Kamyn Search

Shayan Masoudpour, Director, Bow River Capital

Naimish Patel, President, Healthcare Practice, Red Cell Partners

 

https://www.brightspotsinhealthcare.com/events/investor-insights-strategies-to-drive-transformative-growth-in-healthcare

 

Feedback survey: https://www.surveymonkey.com/r/VGMVMWB

 

Katherine Gergen Barnett, MD, Vice Chair of Primary Care Innovation and Transformation in the Department of Family Medicine at Boston Medical Center (BMC) and Cheryl Harding, patient and community advocate, join Eric to share how Boston Medical Center is utilizing storytelling to build trust and connection between the hospital and its community partners. Katherine and Cheryl discuss the impact medical mistrusts has on health outcomes and health disparities.

 

They also tell how the "Storytelling to Build Medical Trust" project was born out of the desire of BMC to improve the health and well-being of Black and brown community members. The project puts a face to the statistics and allow community members to explain why they lack trust in the overall healthcare system.

Hear how this unique project has brought the medical and local communities together and how empathy and trust can help advance health equity and narrow health disparities.

 

About Katherine

Katherine Gergen Barnett, MD, is a family medicine physician and the Vice Chair of Primary Care Innovation and Transformation in the Department of Family Medicine at Boston Medical Center (BMC). Dr. Gergen Barnett is also a clinical associate professor at Boston University Chobanian & Avedisian School of Medicine. Her primary clinical interests are behavioral health, preventive medicine, nutrition, trauma-informed care, gender-affirming care, women’s health, reproductive care, mindfulness-based stress reduction, and group medical care. Dr. Gergen Barnett’s research focuses on innovative models of care to address chronic medical conditions and physician burnout and engaging community partners in creating feasible solutions to increase health and wellness and to address medical distrust in traditionally marginalized communities. Dr. Gergen Barnett is involved in local and state health policy addressing health inequities and national policy addressing primary care delivery and is a regular contributor to The Boston Globe, Boston Public Radio, and various television outlets.

 

About Cheryl

The founder of a Boston nonprofit, From Roots to Wings, Cheryl continues to be a strong voice for the underserved and underrepresented to ensure that everyone gets access to information, services and opportunities. 

 

About the Project

“Storytelling to Build Medical Trust” focuses on highlighting the experience and wisdom of community members, who shared in video interviews their negative interactions with the healthcare system in the hope that the healthcare industry would finally listen. The project is jointly led by Boston Medical Center, Everyday Boston, and the B.L.A.C Project, in partnership with Transformational Prison Project, We Got Us, and EmVision Productions. The project was funded by Boston University Clinical and Translational Science Institute and MA-CEAL. Learn more at https://www.storiesformedicaltrust.org.

 

About Boston Medical Center

Boston Medical Center is a non-profit 514-bed academic medical center and safety-net hospital in the South End neighborhood of Boston, Massachusetts. As part of the Boston Medical Center Health System, the hospital provides primary and specialty care to residents of the Greater Boston area. Boston Medical Center is a founding partner of the Boston Medical Center Health System, which is focused on creating a coordinated, equitable, value-based continuum of care to deliver world-class care to patients and health plan members. Find out more at www.bmc.org.

 

Elevance Health, Blue Cross Blue Shield of South Carolina, and the Business Group on Health and Socially Determined discuss how plans can provide a more holistic and effective healthcare journey for members by gaining insight into all barriers to caring for your members, including social risks such as food insecurities, housing instabilities, financial strain, health literacy challenges, and lack of transportation.

 

Our expert panel explores the value of quantifying the impact of social risks and shares strategies and actions that health plans can take to improve health outcomes, reduce health disparities, decrease costs, and track measurable results. 

Link to report on Elevance's Whole Health Index (WHI) mentioned during show: https://catalyst.nejm.org/doi/full/10.1056/CAT.23.0015

Guests:

Shantanu Agrawal, MD, MPhil, Chief Health Officer, Elevance Health

April Richardson, MD, Vice President, Clinical Services, Blue Cross Blue Shield of South Carolina

Ellen Kelsay, President & CEO, Business Group on Health

Trenor Williams, MD, CEO & Co-Founder, Socially Determined

 

https://www.brightspotsinhealthcare.com/events/innovative-strategies-for-health-plans-to-mitigate-social-risk/

This episode is sponsored by Socially Determined

Socially Determined provides social risk data, analytics, and expertise to healthcare organizations seeking to understand how Social Determinants of Health and social risk factors impact the communities they serve. Our analytics platform, SocialScape, provides actionable insights into community-level SDOH risk exposure and individual-level social risk factors, and their impact on health care utilization, cost, outcomes, and equity.

Allison Bryant, MD, MPH, Associate Chief Health Equity Officer, Mass General Brigham (MGB), joins Eric to discuss how the health system ensures its innovations are accessible to everyone, particularly those from marginalized communities. Allison elaborates on MGB's unique approach, viewing its mission as providing healthcare and as a catalyst for improving equity of outcomes for patients and the communities it serves.

 

Topics covered include:

• Community health

• Bridging the digital divide

• Equity in maternal health

• United Against Racism (MGB’s Diversity, Equity and Inclusion statement)

 

About Allison

In her role at MGB, Allison works to eliminate longstanding inequities in patient care and outcomes. She is a maternal-fetal medicine subspecialist, an associate professor of obstetrics, gynecology and reproductive sciences at Harvard Medical School and is the Frederic D. Frigoletto, MD Endowed Chair in the Department of Obstetrics and Gynecology at Massachusetts General Hospital. She received degrees in biology, public health and medicine from Harvard University, where she also completed residency training in obstetrics and gynecology and fellowships in maternal/fetal medicine and the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy. She previously served as the vice chair for quality, equity and safety for the Department of Obstetrics and Gynecology at Mass General.

 

About Mass General Brigham

Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals.

Mass General Brigham

https://www.massgeneralbrigham.org/

 

United Against Racism: https://www.massgeneralbrigham.org/en/about/diversity-equity-and-inclusion/united-against-racism