On this special edition of PopHealth Week Fred Goldstein and Gregg Masters discuss critical healthcare issues, systemic challenges, and political developments. The episode opens with the tragic news of Brian Thompson, the United Healthcare CEO's death and its potential implications on the healthcare landscape. Key themes include:

Healthcare System Challenges: A critique of the managed care model's failure to meet its promises and the burden it places on individuals, highlighting inefficiencies, rising costs, and access disparities.

Political Forecasting: Exploration of the incoming administration's healthcare policies, including potential changes to Medicaid, privatization of Medicare, and efforts to repeal the Affordable Care Act, coupled with skepticism about the lack of a coherent replacement plan.

Public Health and Policy Appointments: Commentary on controversial nominations for federal healthcare leadership roles, raising concerns about public health direction under individuals with anti-vaccine sentiments or alternative scientific stances.

Structural Reform Needs: Advocacy for a shift towards addressing systemic inefficiencies, such as the dominance of large healthcare entities, and a call for reimagined care delivery to align with the Triple Aim of improved outcomes, patient experience, and cost efficiency.

Personal Reflections: The hosts reflect on their professional and personal encounters with healthcare's operational challenges, emphasizing the system's inability to support mission-driven healthcare professionals.

The conversation is rich with professional insights and underscores the urgency of addressing longstanding issues within the U.S. healthcare system while navigating political and industry dynamics.

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This week on PopHealth Week, Fred Goldstein had the pleasure of hosting Dr. Ashley Reynolds, Chief Product and Experience Officer at Glytec, a health tech company revolutionizing the management of glycemic control in healthcare settings. With a dynamic career path that began in the Navy as a corpsman and evolved through nursing, emergency care, and a Ph.D. in digital health, Ashley brings a unique perspective to the healthcare industry. His journey is a testament to his passion for transforming patient care through technology.

Ashley’s journey into healthcare began in an unexpected way. Originally a pre-med student, financial constraints led him to join the military, where he served as a Navy corpsman—essentially a combat medic. This early experience laid the foundation for his nursing career, where he worked in intensive and critical care settings. It was here that he discovered a passion for understanding the "why" behind patients' health conditions. This curiosity led him to pivot into population health and eventually to pursue a Ph.D. focused on how digital tools can drive behavioral change in healthcare.

Over the years, Ashley has held leadership roles in health tech startups and healthcare systems, leading to her current role at Glytec, where he oversees product and customer experience with a focus on leveraging technology for better clinical outcomes.

In this edition of PopHealth Week, we're excited to spotlight Dr. Mike Edgeworth, MD, MS, a distinguished neurologist and the Chief Population Health Officer at Octave Bioscience. Octave is at the forefront of transforming the care and treatment landscape for Multiple Sclerosis (MS), offering a groundbreaking precision care approach for those living with this condition. With a rich background that spans over two decades, Dr. Edgeworth has held roles ranging from academic and clinical settings to hospital administration and medical executive positions within a national health plan, before making his mark at Octave in 2021.

Dr. Edgeworth's educational journey includes completing his neurology residency and fellowship at Vanderbilt University, where he also earned a Master of Science in Clinical Investigation. He embarked on his medical career after graduating from the University of Mississippi Medical School and holds a Bachelor of Science in Chemistry from Mississippi State University. Today, he resides in Nashville, TN, contributing significantly to the field of MS through his work at Octave Bioscience.

Stay connected with Dr. Edgeworth's pioneering work in MS care by visiting Octave Bioscience online at www.octavebio.com and following him on Twitter @OctaveBio. Don't miss this insightful episode!

In this episode of Pophealth Week, we are honored to feature Cliff Frank, President of Healthcare Management Solutions. With over three decades of experience in the managed care sector, Cliff has worked across the spectrum, from payers and hospitals to IPAs, PHOs, and Clinically Integrated Networks (CINs). Our conversation delves into the current landscape of the managed care industry, focusing on the evolution of value-based healthcare and the potential implications of upcoming CMS risk adjustment updates for Medicare Advantage operators.

Cliff's career has been dedicated to minimizing inefficiencies and enhancing the quality of patient care. He has consistently championed the cause of fostering clinical and financial harmony between providers and payers, contributing his expertise in diverse healthcare environments. Leading CINs in managing shared savings arrangements with payers and Medicare, Cliff also offers strategic consultation to organizations navigating managed care contracts, risk transfer preparation, and the creation of innovative provider-payer partnerships. Join us for an insightful exploration of managed care's future and strategies for achieving optimal healthcare delivery.

In this edition of Pophealth Week, we welcome David Muhlestein, PhD, JD, an influential figure in healthcare research and entrepreneurship with a passion for reforming healthcare payment and delivery systems. Our conversation centers on the advancement and, potentially, the maturation of the market towards value-based care models, spanning from HMOs to ACOs and including a variety of initiatives in both public (Medicare, Medicaid) and private sectors. David offers his expertise to define the landscape, shedding light on the hurdles and prospects facing practitioners in this evolving space.

A proclaimed data and policy enthusiast, David is renowned for his contributions to discussions on value-based care and the progression of healthcare systems. His roles include Visiting Policy Fellow at the Margolis Center for Health Policy at Duke University and Adjunct Assistant Professor at The Ohio State University College of Public Health. His previous positions have seen him as the Chief Research and Innovation Officer for Health Management Associates, and Chief Strategy and Chief Research Officer for Leavitt Partners, along with a tenure as Adjunct Assistant Professor of The Dartmouth Institute (TDI) at Dartmouth College. David's academic credentials are comprehensive, holding a PhD in Health Services Management and Policy, JD, MHA, and MS from The Ohio State University, alongside a BA from Brigham Young University. Dive into a thought-provoking discussion on the future of healthcare with us!

In this week's episode of Pophealth Week, we're excited to showcase Michelle Bounce, the Chief Operating Officer at The J.P. Farley Corporation. Since joining the team in 2007, Michelle has consistently excelled across various roles within the company, demonstrating a deep understanding and innovative approach to the operations of a Third-Party Administrator (TPA). Her initiatives to revamp the conventional TPA structure through automation, cutting-edge technology, and process enhancements across the board have significantly increased efficiency. Michelle's passion for innovation extends to her collaborations with key vendors, fostering relationships that are rooted in a shared enthusiasm for transformative change.

As an esteemed member of the Health Care Administrators Association (HCAA) and holding licenses in life and health in Ohio, Michelle brings a wealth of knowledge and expertise to the conversation. Our discussion will delve into the role of TPAs in promoting value-based healthcare, moving beyond the traditional emphasis on cost reduction to explore how Care Management vendors can deliver the real value that self-funded employers seek. Join us for an insightful conversation about the future of healthcare administration and the pivotal role of TPAs in shaping it.

On this episode of Pophealth Week, we feature Kehlin Swain,CEO and Co-founder of Xplosion Technology, a software engineer who has created a suite of digital health products in the rehabilitation, diabetes, and obesity management sector, and Dr. Zeev Neuwirth a healthcare executive whose most recent role was Chief Clinical Executive for Care Transformation at Atrium Health. Dr. Neuwirth has over 15 years of clinical practice experience and 15 years in clinical operations, population health and strategic services. In 2017, he launched the award-winning 'Creating a New Healthcare' podcast. In 2019 he published his first book, Reframing Healthcare - a Roadmap for Creating Disruptive Change. In September 2023, he published a second book, Beyond the Walls - the Megatrends, Movements & Market Disruptions Transforming American Healthcare. We discuss the state of tranformation of the U.S. ecosystem and the upside impact of digital health on chronic disease.

On this episode of Pophealth Week, we feature Hesham Hessaballa MD, a pulumonary and critical care medicine specialist practicing for more than 20 years. Dr. Hassaballa is board certified in internal medicine, pulmonary medicine, critical care medicine and sleep medicine, serves as Assistant Professor Rush University & Medical Center, and Editor of the popular blog @MedikaLife keep up with Dr. Hassaballa's work on Twitter profile @HAHassaballaMD or on linkedIn, or on the web via www.drhassaballa.com. We discuss his journey into critical care medicine and explore his '11 rules for the ICU' recommendations outlined in 'How Not to Kill Someone in the ICU'. Follow Dr. Hassaballa's work on Twitter via @HAHassaballaMD, on linkedIn, or on the web via www.drhassaballa.com.

On the latest episode of PopHealth Week, we're joined by Dr. Mike Edgeworth, who brings over two decades of diversified experience in healthcare. Dr. Edgeworth's expertise as a neurologist has been honed through his time in academic and clinical practice, hospital leadership, and his role as a medical executive for a national health plan. Currently, he is at the forefront of innovative healthcare solutions as the Chief Population Health Officer at Octave Bioscience. At Octave, he is a pivotal figure in revolutionizing the management and treatment of Multiple Sclerosis (MS) with precision care approaches.

His impressive academic background includes completing a neurology residency and fellowship at Vanderbilt University, where he also earned a Master of Science in Clinical Investigation. His foundational medical education was attained at the University of Mississippi, and he holds a Bachelor of Science in Chemistry from Mississippi State University. Nashville, TN, is where he calls home today.

To learn more about Dr. Edgeworth's contributions to the transformation of MS care, visit Octave Bioscience at www.octavebio.com. Keep abreast of the latest developments and insights by following @OctaveBio on Twitter.

Tune in to gain valuable insights from Dr. Edgeworth's extensive knowledge and experience in the field of population health and neurological care.

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This episode of PopHealth Week features Lauren Barca, MHA, RN, BSN, VP of Quality and Stars at 86Borders, a technology platform and care coordination company that connects health plans with their inactive, unable to reach, and underserved members.

With over a decade of experience at United Healthcare, Lauren boasts a proven track record in driving success across Stars, HEDIS, CAHPS, and HOS initiatives. Recognized for her versatility and innovation in healthcare and clinical operations, she is an expert in navigating and fulfilling regulatory requirements. Lauren is deeply passionate about public health and is committed to enhancing the quality of care for economically disadvantaged and medically underserved populations.

We discuss the challenges of member engagement and the need to focus on problems in living in order to optimize health care outcomes for plan members