Bright Spots in Healthcare

OSF HealthCare, Providence, UMass Memorial Medical Center, and TytoCare share actionable strategies and best practices to transform hybrid care and offer patients personalized, flexible and accessible care.  Our expert panel also explores how virtual care reduces costs and addresses healthcare challenges like staff shortages.

 

Key topics include: 

• Maximizing Hybrid Care Models: Panelists explore how hybrid and home-based care models – supported by technology, are revolutionizing how providers deliver care – making it more accessible, efficient, and impactful.

• Home-Based Healthcare Innovations: Real-world success stories highlighted how providers make healthcare accessible from the comfort of home, schools, and community centers.

• Technology-Driven Solutions: Technical tools enable immersive primary care experiences remotely, enhancing connectivity and care delivery for families.

Highlights:

• Providence: Kate Baars shared how remote patient monitoring helps achieve compelling clinical and financial outcomes

• OSF OnCall: Jennie Van Antwerp walked us through innovations in acute and digital care delivery at OSF.

• UMass Memorial Medical Center: Dr. John Broach discussed how the medical center utilizes technology to drive efficient responses and care, eliminating ED visits.

• TytoCare: Tina Nelson highlighted strategic partnerships that enable healthcare access for underserved communities through remote technology.

Panelists:

Kate Baars, Executive Director, Product Development, Virtual Care & Digital Health, Providence

Jennie Van Antwerp, MSN, RN, Director, Digital Acute Care/ Digital Care Division, OSF OnCall

(Colleen Reynolds)

John Broach, MD, Division Direction for EMS and DIsaters Medicine, UMASS Medical Center Christina (Tina) Nelson, Strategic Partnership Manager, TytoCare

 

https://www.brightspotsinhealthcare.com/events/how-providers-are-maximizing-hybrid-care-and-home-based-interventions

 

This episode is sponsored by TytoCare

 

TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are six times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for the successful deployment and adoption of the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 250 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.

Healthfirst, myPlace Health and Wellsky share their successful strategies for reducing readmissions, improving health outcomes and reducing costs through post-acute and home care.

 

Topics covered include:

Building your provider partnerships beyond the traditional transition of care program

Reducing readmissions among higher-risk Medicare Advantage members? 

Ensuring members receive high-quality home health care after being discharged from skilled nursing facilities, and what made this approach stand out in terms of impact

• Susan J. Beane, MD FACP, Executive Medical Director, Health System Transformation, Healthfirst

• Robert Schreiber, MD, Vice President & National Medical Director, myPlace Health

• Andy Eilert, President, Payer & Emerging Markets, WellSky

Bios: https://www.brightspotsinhealthcare.com/events/how-to-create-more-bright-spots-in-post-acute-and-home-care/

 

This episode is sponsored by Wellsky

WellSky is one of America’s largest and most innovative healthcare technology companies leading the movement for intelligent, coordinated care. Our proven software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations scale processes, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care. WellSky serves more than 20,000 client sites — including the largest hospital systems, blood banks, cell therapy labs, home health and hospice franchises, post-acute providers, government agencies, and human services organizations. Informed by more than 40 years of providing software and expertise, WellSky anticipates clients’ needs and innovates relentlessly to build healthy, thriving communities.

 

AmeriHealth Caritas, Health Alliance Plan, Highmark Health and Icario discuss how AI transforms healthcare by creating personalized experiences that drive performance improvements and enhance member engagement. Learn how high-ranking health plans reinvent their approach to member experience to elevate your HEDIS scores, improve health outcomes and streamline data processes.

 

Guests:

• Vandna Bhrany, MPH, Vice President, HEDIS Strategy and Analytics, AmeriHealth Caritas 

• Tracy Saula. Senior Vice President, Chief Product and Experience Officer, Highmark Health 

• Cory Busse, VP, Strategy, Icario

• Mike Treash, Senior Vice President and Chief Operating Officer, Health Alliance Plan

 

Bios: https://www.brightspotsinhealthcare.com/events/a-new-era-for-consumer-engagement-and-hedis-combining-the-human-touch-with-ai/

 

This episode is sponsored by Icario

Icario serves health plans by using powerful whole-person data, predictive behavioral science, and a proprietary engagement platform to offer personalized experiences that meet members where they are in their health journey. Icario combines the industry's largest member data repository with unparalleled industry expertise to implement health action programs that deliver personalized member engagement, reduce abrasion and encourage positive health behaviors.

Banner|Aetna, Blue Shield of California, Healthfirst and TytoCare explore innovative strategies that health plans can leverage to drive meaningful lifestyle modifications among members, improve health outcomes and reduce the rising costs of chronic disease. 

 

Our expert panel also discusses the role of primary care in empowering members to adopt healthier behaviors.

 

Topics include:

• Building a culture that fosters habit formation for long-term success

• Supporting members using GLP-1s for weight management

• Addressing Social Determinants of Health (SDOH) to improve outcomes

• Leveraging technology to encourage sustainable lifestyle modifications

 

Panelists:

Joe Brennan, Vice President, TytoCare

Robert Groves, MD, Executive Vice President and Chief Medical Officer, Banner|Aetna

Eric Glazer, Host (moderator)

Angie Kalousek, Senior Director, Lifestyle Medicine, Blue Shield of California

Amanda Parsons, MD, MBA, Vice President, Clinical Management, Healthfirst

Bios: https://www.brightspotsinhealthcare.com/events/innovations-in-lifestyle-change-the-role-of-primary-care-2/

 

This episode is sponsored by TytoCare

 

TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are six times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for the successful deployment and adoption of the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 250 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.

Value-based care leaders from Kaiser Permanente, Premera, UnitedHealthcare and TailorCare discuss the evolving landscape of specialty value-based care. They explain how their plans drive success with innovative approaches designed to optimize care and improve outcomes—even with their most complex, high-cost members.

 

Our expert panelists share practical strategies for navigating the most effective treatment pathways, from leveraging predictive data and the latest evidence-based guidelines to assessing members’ symptoms and goals.

 

Topics covered include:

1. Strategie Planning

2. Technology Enablement

3. Solutions in Action

Featured Guests

• Romilla Batra, MD, Senior Vice President, Chief Medical Officer – Clinical Strategy & Solutions, Premera Blue Cross

• Hemant Keny, MD, Lead for Senior Surgical Care Program, Kaiser Permanente Northern California

• Donna Laliberte O’Shea, MD, MBA, CPE, National Vice President, Operations and Chief Medical Officer, UCS Population Health and VBC, UnitedHealthcare

• Rachel Winokur, Chief Executive Officer, TailorCare

 

Guest Bios: https://www.brightspotsinhealthcare.com/events/unlocking-success-through-specialty-value-based-models/

 

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

 

 

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.