Healthcare Strategies

Care Coordination: How AI, ML Tools Support Coordinated Care

Artificial intelligence (AI) and machine learning (ML) tools have the power to synthesize data into actionable information. Stephen Friedhoff, MD, senior vice president of health care services at Blue Cross and Blue Shield of North Carolina (Blue Cross NC), explains how payers can use these tools to improve care coordination and quality of care.

Care Coordination: Improving Chronic Disease Management through Coordinated Care

Patients with complex conditions including chronic diseases require highly efficient, collaborative treatment from their health insurers and providers. Julie Bietsch, senior vice president of clinical operations at Aetna, and Eric Fennel, vice president of network strategy and value-based solutions at Aetna, describe how Aetna uses care coordination strategies and tools to improve payer-provider partnership in chronic disease management.

Leveraging Machine Learning to Hone Treatment Planning, Real-Time Clinical Feedback

The proliferation of artificial intelligence in healthcare has led to increased interest in more advanced computing and analytics technologies, such as machine learning, for medical research and clinical care. Machine learning, in particular, may help researchers gain insights into human diseases through the use of biomedical simulation and high-performance computing. Amanda Randles, an Assistant Professor of Biomedical Sciences at Duke University, discusses these applications and how machine learning can help improve treatment planning and allow real-time feedback for physicians.

Improving Pharmaceutical Partnerships: Specialty Pharmacies Personalizing Care

By employing personalized care strategies and solidifying partnerships, specialty pharmacies can improve patient outcomes, enhance satisfaction, and improve the quality of life for patients with rare or chronic conditions. In the second part of this two-part episode, Lisa Mymo, Vice President of Pharma and Financial Services, and Kathy Kokoski, RPh, CSP, Director of Pharma Operations, at AllianceRx Walgreens Pharmacy, explain how specialty pharmacies can improve and personalize patient care.

Improving Pharmaceutical Partnerships: Specialty Pharmacy and Digital Tools

By leveraging several tailored communication methods, specialty pharmacies can improve patient engagement and outcomes using digital tools. Digital-driven tools such as patient portals, mobile apps, and portable devices effectively streamline communication between patients, providers, and pharmacies. In this episode, Lisa Mymo, Vice President of Pharma and Financial Services, and Kathy Kokoski, RPh, CSP, Director of Pharma Operations, at AllianceRx Walgreens Pharmacy, explain how digital patient engagement tools can support specialty pharmacies by improving patient outcomes and increasing medication adherence and retention.

Improving Philanthropic Efforts to Address Social Determinants of Health

Social determinants of health philanthropy can have an impact, but it can also injure the very communities it is intended to support. Tiffany Benjamin, chief executive officer of the Humana Foundation, shares how payers and healthcare organizations can approach social determinants of health philanthropy in an effective, community-oriented way.

Overcoming Data, Workforce Challenges of Value-Based Care

Transitioning to value-based care has been a marathon, not a sprint. Providers have experimented with different care delivery and payment models to improve care quality and coordination while earning savings. Scott Anders, MD, MBA, FAAGP, CPE, chief medical officer of value-based care and ambulatory quality at Providence, shares the top lessons learned from Providence’s long journey with value-based care and the strategy the health system uses to keep the momentum going.

Pursuing Digital Health Transformation in the Health Payer Space

Health insurers face a couple of key obstacles as they implement digital health solutions, such as the lack of payer alignment around digital quality measures and the slow development of interoperability. Peter Long, executive vice president of strategy and health solutions at Blue Shield of California and co-author of a National Academy of Medicine article on digital health, explains how payers can refine their digital health efforts and how an integrated health record can overcome digital health barriers.

2023 Predictions: Insights from HIT Analytics, mHealth, EHR, HITS Leaders

In 2023, leaders in health IT analytics, mHealth, EHR, and health IT security will see innovation around healthcare consumerism and provider burden. Experts from HITRUST, Surescripts, Mass General Brigham Health System, and Mayo Clinic Platform share their projections for the new year.
Multimedia Manager's Note (1/17/2023): This is an updated version of the podcast episode that went live on January 16, 2023. The original version misattributed some of the guests. The guests in order of appearance are:
- Frank Harvey, chief executive officer of Surescripts,
- John Halamka, MD, president of Mayo Clinic Platform
- Lee Schwamm, MD, vice president of digital patient experience at Mass General Brigham Health System
- Robert Booker, chief strategy officer and executive vice president of the center of excellence at HITRUST

2023 Predictions: Insights from Payers, Providers, Revenue Cycle, Life Sciences Leaders

In 2023, payers, providers, revenue cycle, life sciences leaders will face extreme financial pressures that will shape their decisionmaking but that may also open their eyes to new opportunities in value-based care and other areas of healthcare. Healthcare leaders from Blue Shield of California, Cook Medical, Forrester Research, and Providence Health & Services – Washington share their projections for the new year.