Massachusetts Association of Health Plans (MAHP) leader Lora Pellegrini got interested in policy and politics at a young age. She had the opportunity to work with luminaries like Ted Kennedy and John Kerry early in her career, as she rose to prominence in healthcare policy.

Our discussion focuses on critical issues such as pharmaceutical pricing and hospital efficiency in Massachusetts. We explore the regulatory challenges in drug pricing and the necessity for hospital systems to innovate and enhance performance. Lora provides expert analysis on the impact of major players like Steward Healthcare and Optum in the Massachusetts healthcare sector.

She also shares the historical perspective on healthcare reform in Massachusetts, and issues a call for employers to re-engage in support of affordability as they did back in the days of RomneyCare.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Ironically, patient care coordination itself is often uncoordinated. It's spread across multiple providers and administrators, causing frustration for care teams and patients.

Lumeon founder and CEO Robbie Hughes has developed an approach that makes the care journey more reliable rather than settling for the current craziness, where patients are expected to be satisfied as long as they get some time with a doctor.

One of the really interesting elements of this interview was the discussion of whether we should be willing to trade off some efficacy for reliability. For example, if we had a treatment path that was 80 percent as good but could be followed by 100 percent of the patients, would that be better than striving for the perfect solution that only 1 percent can attain?

From a population health perspective, the 80/100 calculus is probably correct, but most of us want to be in that 1 percent. I've certainly had that experience myself of navigating the system with help from well-placed insiders plus my own knowledge of how things work.

Robbie is an avid reader who recommends The Experience Machine, Chip Wars, and Ultra-Processed People.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Matthias Hoffman first became conscious of his vision as a teenager. He and his friends in Switzerland dreamed of becoming pilots (none actually did) but Matthias's hopes were dashed early on due to inadequate vision.

While pursuing electrical engineering degrees, he realized his strength was in building things. So he left academia and worked in a variety of vision and optical startups, eventually leading significant teams.

Many people who could benefit skip their eye exams, and for more than a decade entrepreneurs have been trying smartphone based eye exams and online eyeglass sales, often with virtual try-ons. But those have been failures. The exam interface is too complex and burdensome, and people want to try on their glasses at retail.

Eyebot is an automated eye exam designed to produce a prescription at the point of sale, i.e., retail stores. It takes 90 seconds and doesn't require the person being examined to do anything special. Eyebot has developed its own technology and eventually plans to expand beyond the basic exam to more advanced screening for things like glaucoma.

But Matthias stresses that Eyebot has no intention of taking away the jobs of eye care professionals.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Most medical bills contain errors. Over-billing and outright fraud are far too common. What's a consumer to do?

In this episode, CEO Scott Speranza shares how HealthLock performs automated audits of medical bills by seamlessly connecting with the patient's health plan portal. We also discuss an exciting new partnership with MasterCard that gives many cardholders (including me) free access.

I connected my insurance to HealthLock and soon got a helpful audit of my claims (which turned out to be clean --thanks Harvard Pilgrim!)

Scott unravels the complexities of coordination of benefits --where he offers reflection on my experience with my dependents--, the significance of automated HIPAA authorizations, and provides practical insights for managing family healthcare. And he shares his views on the delicate balance of privacy and oversight.

One thing he recommends (which providers hate) is to wait for a while to pay your medical bills since charges initially attributed to the patient may actually be covered in the end.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Caresyntax CEO Dennis Kogan wants to introduce value based care to the operating room. It's a tall order but Caresyntax thinks they have a formula to benefit the patient, provider and payer.

Kogan's parents are surgeons from the former Soviet Union, which gave him a foundational perspective. He studied technology and then business at Carnegie Mellon and Harvard Business School. One of his key takeaways is that quality and efficiency are highly related.

Unlike many healthcare entrepreneurs I interview, Dennis's company is active all over the world. There are geographic differences, but they're not as profound as I imagined.

The episode explores the impact of AI, including generative AI, on value-based care and the potential for surgical Accountable Care Organizations to more effectively manage quality and total cost of care. It also covers the challenges of entrepreneurship in the healthcare sector, referencing insights from Ben Horowitz's "The Hard Thing About Hard Things," and discusses Caresyntax's efforts to leverage AI in clinical decision-making to transform healthcare delivery.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Growing up with a father whose academic dreams were cut short, and a mother whose resilience in the face of disability was inspiring, Julia Paget's story is not just about her own path but also a tribute to those who shaped her. This seasoned clinical embryologist from the Isle of Wight shares the rich tapestry of experiences that led her from a zoology degree to the forefront of IVF technology. Julia's journey is a compelling narrative of personal growth, family influence, and the pursuit of a career that intertwines human emotion with scientific rigor.

Navigating the world of IVF is no small feat, and Julia offers an honest look at the highs and lows of working within the fertility sector. From New Jersey to New Zealand to the stark differences in practice she encountered upon her return to the UK, her insights reveal the impact that culture, teamwork, and innovation have on patient outcomes.

Julia's transition from clinician to entrepreneur, facing resistance and complacency head-on, is a testament to the perseverance required in this field. Her stories of building and selling an IVF clinic on the UK's South Coast resonate with anyone who has strived to create something meaningful amidst adversity.

Julia casts a visionary eye toward the future of reproductive medicine with her concept for a global IVF network. This innovative approach seeks to connect patients with remote embryologists and fertility nurses, offering guidance and support outside the traditional clinic setting.

The recent legal challenges faced by the fertility community, including a significant court ruling in Alabama, also come under scrutiny. Julia Paget's experience as both founder and CEO of The IVF Guide serves as a beacon, guiding listeners through the ethical and practical complexities of a field that is as challenging as it is rewarding.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Explore the transformative art of storytelling in healthcare, featuring Outcomes Rocket founder Saul Marquez. Uncover the compelling journey from Saul's immigrant family roots to his rise as a healthcare influencer, where optimism and a robust work ethic forge a path that challenges the conventional. Our discussion brings to life the nuances of personal narratives in healthcare branding, and how these stories bridge the gap between industry professionals and the communities they serve.

Join us as Saul describes his voyage in healthcare marketing, from the classical influences of Cicero and Aristotle stirring a passion for the persuasive arts, to the birth of Outcomes Rocket—a platform for celebrating contemporary healthcare innovation. Saul shares his formative experiences at leading med tech companies and delves into the strategic leap to a podcasting venture that elevates the craft of storytelling to inspire change.

Tune in for a thought-provoking discussion on the broader impact of storytelling in healthcare, as Saul and I analyze practical strategies for raising awareness on pivotal issues like transparent healthcare costs and the No Surprises Act. We'll reflect on how data-backed, right thinking in storytelling can foster connection and serve as a catalyst for meaningful progress.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Clinical registries can provide profound insights into disease patterns and treatment effectiveness, and ultimately improve patient outcomes. New technology, including AI enables faster and better data collection and analysis.

Today’s guest, Matt Hollingsworth is co-founder of Carta Healthcare, which fuses technology, data, and human expertise in a quest to radically improve outcomes.

Matt shares how his mother's battle with cancer ignited his quest to marry tech prowess with a heartfelt mission to improve patient outcomes.

I like it when he says he didn't actually plan to start a company.!

Matt strongly recommends the book “The Worlds I See” by Fei-Fei Li.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.