 With today’s runaway costs, finding and controlling fraud and abuse is more important than ever. On today’s show, we have special guest Bill Lucia, the CEO, President and Chairman for HMS. They are a leader in the cost containment space, serving over 40 states Medicaid programs, Medicare, 325+ commercial health plans, as well as many large employers nationally. In this episode, Dr. Steve and Bill Lucia discuss: - Reducing healthcare waste is more than a technology fix - Understanding how current and future risk bear on costs - Telehealth as an engagement tool - HMS' acquisition of Eliza for consumer engagement - The power of investing into behavioral & advertising science  

Episode 55 - Changing Times and Changing Minds

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"Steve, I think in the near future, patients will need to be informed when doctors refuse to use AI—not WHEN they're using it." The "Red Hot" candor of today's guest, Dr. Robert Pearl. One of the most outspoken advocates for the use of generative artificial intelligence in healthcare. He pulls no punches when he states that ChatGPT and other generative AI tools will be as essential to medical practice as the stethoscope has been for centuries! It's another sizzling episode of Red Hot Healthcare, where we delve into cutting-edge topics, widely-felt challenges, and the latest innovation in healthcare.   Dr. Pearl is a thought leader powerhouse. As the former CEO of the Permanente Group, he was responsible for a team of 10,000 physicians and 40,000 care team members, delivering care to more than 5 million patients nationwide. A best-selling author, he wrote Uncaring: How the Culture of Medicine Kills Doctors and Patients, and he is also a regular contributor to Forbes. He has been named one of Modern Healthcare's 50 most influencial physician leaders. Dr. Pearl brings his candor and leadership, sharing thoughts on the following:     How accurate are AI diagnoses versus human clinicians? Is your doctor already being outperformed?   What are the liabilities to consider with chatbots integrating into clinical care? Where should the line be drawn?   How can healthcare overcome biases identified in algorithms that help drive generative AI and its responses?   A hardline comparative: Generative AI benefits vs. annual deaths from medical mistakes   In 5 short years, we'll see major improvement in 4 key areas. What are they?   Is keeping patients in the dark today about AI involvement ethical? Should their informed consent for AI use in medical care be mandatory?   What happens when AI gets something wrong—really wrong—in healthcare?  How will generative AI be a key part of moving from fee-for-service to value-based care?  ———— The Red Hot Healthcare podcast delivers engaging thought leadership—from healthcare leaders and luminaries across the industry. Thanks in advance for your positive, 5-star reviews given on your chosen podcast outlet. And we're always looking for future guest recommendations. Just visit Red Hot Healthcare podcast page and fill out the inquiry form.

Episode 81:  Risks and Liabilities of Generative AI in Healthcare

HIMSS recognizes Didi Davis as one of the most influential women in health IT. She serves as the vice president of informatics, conformance, and interoperability at The Sequoia Project, a non-profit organization selected as the Recognized Coordinating Entity (RCE) to support the implementation of the Trusted Exchange Framework and Common Agreement (TEFCA). With over 30 years of healthcare experience, Didi is a nationally-recognized expert for healthcare standards, interoperability design and strategy for healthcare stakeholders, as well as vendors deploying health information technology to improve patient safety and quality of care. In this show, she joins host Dr. Steve Ambrose in discussing the latest, and perhaps most impactful initiative yet in the success of interoperability across all stakeholders in healthcare.  Listen in, as Didi and Steve share a riveting discussion on: •  What's in a name? Plenty for this interoperability initiative—and Didi explains why •  The pervasive challenges that led the initiative being created •  What this new initiative could mean for retail entrants to healthcare  •  350 million and 40—the meaning behind those numbers •  Stepping up interoperability: What does success look like in this initiative •  What's the role of the Sequoia Group—and its well-known "partner" (revealed in the show) •  Onward & Upward:   Didi's shares 3 tips for improving success when adopting this initiative   The Red Hot Healthcare podcast delivers engaging thought leadership—from healthcare leaders and luminaries across the industry. Thanks in advance for your positive, 5-star reviews given on your chosen podcast outlet. And we're always looking for future guest recommendations. Just visit Red Hot Healthcare podcast page and fill out the inquiry form. ABOUT STEVE: The type and quality of content your company develops, and shares with its target market, helps to drive awareness, engagement, and decisions. Steve Ambrose is a senior-level content strategist whose C-suite recommended written, audio, and video assets help healthcare and health IT companies improve messaging and marketing to those they serve. You can learn more about how organizations and leaders work with Steve by visiting the home page.

Episode 80:  The Initiative to Improve Interoperability

Value-based care (VBC) expert and healthcare transformation executive Lisa White shares her insights on the common and costly misalignment between value program design and real-world operations. It's a crucial challenge that stakeholders must address, if VBC is ever to become more widely adopted and successful. Lisa shares a riveting conversation with show host Dr. Steve Ambrose on the importance of value-based care alignment across physician operations, stakeholder interests, consumerism, retail health entrants, secondary care services, and much more! In this interview:  A history lesson of VBC: from the 1930's to today Which challenges in VBC alignment would Lisa choose to fix first? How retailers and surging consumerism fit into VBC success The three words that IT vendors should be most focused on with payers and providers How stakeholder distrust is hurting VBC growth and necessary alignment Learning from the failure of Haven and successes of Covera and Moxe Health A tale of two data: How perspective and selectivity fuel inefficiency and misalignment  The Red Hot Healthcare podcast delivers engaging thought leadership—from healthcare leaders and luminaries across the industry. Thanks in advance for your positive, 5-star reviews given on your chosen podcast outlet. And we're always looking for future guest recommendations. Just visit Red Hot Healthcare podcast page and fill out the inquiry form.   ABOUT STEVE: The type and quality of content your company develops, and shares with its target market, helps to drive awareness, engagement, and decisions. Steve Ambrose is a senior-level content strategist whose C-suite recommended written, audio, and video assets help healthcare and health IT companies improve messaging and marketing to those they serve.  You can learn more about how to work with Steve by visiting the Red Hot Healthcare home page.

Episode 79: Misalignments in Value-Based Care

Host Steve Ambrose engages in a captivating back-and-forth dialogue with best-selling author and highly-esteemed digital health leader Rajeev Ronanki. They discuss, in just 20 packed minutes, topics including affordability in healthcare, ChatGPT, and the growing challenge of balancing healthcare transparency with physician time and autonomy. In this interview:  The healthare challenge that's impacting 43% of American adults today Grading healthcare—through a key Gallup poll Rajeev's key prescriptives to help drive down high costs and waste The means to better scale blockchain in healthcare Guardrails or acceleration: the way forward with ChatGPT in healthcare How the Cures Act fueled a transparency paradox for providers  The Red Hot Healthcare podcast delivers thought leadership—from healthcare leaders and luminaries. We're always open to suggestions for guests for the longer form show, or the 15-min "Hot Takes" series. Visit Red Hot Healthcare and fill out the inquiry form.

Episode 78:  Digital health leader and best-selling author Rajeev Ronanki

On today’s show, host Dr. Steve Ambrose shared candid thoughts about one of the biggest taboo topics in healthcare. A subject that is rarely addressed by many in healthcare—at least, not in any public conversations. This topic is the growing epidemic of mass unaffordability in healthcare. A challenge existing at epidemic levels across America, and linked to systemic challenges such as pricing. Unaffordability happens in whispers, and it's a very real social determinant of health—a vulnerability impacting millions of people across race, age, including those with and without health insurance.  This "hot take" should leave you with deep questions and greater awareness. Perhaps you'll be the one to figure out this very real and longstanding challenge for healthcare—and the health of our nation.   ———— The Hot Takes show on Red Hot Healthcare delivers thought leadership—from healthcare leaders and luminaries—and shares value with our audience in under 15 minutes. Want to suggest a guest? Visit Red Hot Healthcare and fill out the inquiry form.

Episode 55 - Changing Times and Changing Minds

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