Episodes

  • CDPHP's Commitment to Community Care and Affordable Health with Nicholas Kraft, Chief Growth Officer at CDPHP

    CDPHP's Commitment to Community Care and Affordable Health with Nicholas Kraft, Chief Growth Officer at CDPHP
    Jul 24 2024
    A holistic approach to healthcare involves engaging members in preventive care rather than waiting for them to become sick. In this episode of the AHIP 2024 series, Nicholas Kraft, Chief Growth Officer at CDPHP, discusses the health plan's dedication to innovation and quality in healthcare. CDPHP, a physician-led nonprofit serving 400,000 members in New York's Capital District, prioritizes community care, challenges high healthcare costs, and promotes collaboration among leaders to improve healthcare access and affordability. Nicholas highlights the potential of fee-for-service 2.0, emphasizing the need for openness and trust among providers, payers, and members, advocating a holistic approach that prioritizes preventive care and early member engagement. He also urges listeners to join their mission to enable patients to spend more time with their families. Tune in and learn how innovative strategies are shaping the future of healthcare! Resources: Watch the entire interview here. Connect and follow Nicholas Kraft on LinkedIn. Learn more about CDPHP on their LinkedIn, Instagram, Facebook, and website.
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    11 mins
  • Reducing Misdiagnosis with Advanced Telehealth with Frank McGillin, CEO of The Clinic by Cleveland Clinic

    Reducing Misdiagnosis with Advanced Telehealth with Frank McGillin, CEO of The Clinic by Cleveland Clinic
    Jul 23 2024
    The Clinic by Cleveland Clinic and Amwell’s collaboration bridges geographical gaps in specialist care. In this episode of the AHIP 2024 series, Frank McGillin, CEO of The Clinic by Cleveland Clinic, explores how their joint venture with Amwell is transforming healthcare by providing virtual access to over 3,500 specialists. This innovative platform, available through various channels like direct visits, health plans, and employers, helps users better understand their diagnosis and treatment, significantly reducing the risk of misdiagnosis and saving about $8,700 per second opinion. Throughout this conversation, Frank explains how The Clinic's nurse care managers ensure patients are matched with the right specialists, improving outcomes and maintaining in-network care. He also highlights the platform's impact on chronic disease management and medication optimization, emphasizing that the service makes it convenient for patients to access top-tier care, whether locally or at Cleveland Clinic. Tune in and learn how this collaboration is making a significant difference in healthcare delivery! Resources: Watch the entire interview here. Connect and follow Frank McGillin on LinkedIn. Learn more about The Clinic by Cleveland Clinic on their LinkedIn and website. Listen to Frank’s previous episode on our podcast here.
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    8 mins
  • The Power Of FHIR APIs In Healthcare with Donald Rucker, the Chief Strategy Officer at 1upHealth

    The Power Of FHIR APIs In Healthcare with Donald Rucker, the Chief Strategy Officer at 1upHealth
    Jul 22 2024
    Real-time access to patient data through electronic medical records' APIs is a game-changer for healthcare analytics. In this episode of the AHIP 2024 series, Donald Rucker, the Chief Strategy Officer at 1upHealth, discusses the critical role of modern data representations and FHIR APIs for payers and providers. He highlights the significance of electronic medical records and their APIs for real-time patient data access and analytics, explaining how payers can utilize the Bulk FHIR API for core data and how advancements in JSON and RESTful APIs have made clinical data access smarter and more efficient. Donald emphasizes the importance of building a quality FHIR data pipeline for modern analytics and AI while also delving into the re-architecting of healthcare through data science, stressing the need to involve consumers in the process. He also explains how he and his team are focused on improving industry processes like quality measurement, network design, prior authorization, case management, and payer-to-patient outreach, expressing excitement for the industry's future and involving consumers in healthcare data processes. Tune in and learn how healthcare is evolving with the power of data! Resources: Watch the entire interview here. Connect and follow Donald Rucker on LinkedIn. Learn more about 1upHealth on their LinkedIn and website.
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    10 mins
  • The Power of Payer Partnerships In Behavioral Health with Solome Tibebu, founder and CEO of Behavioral Health Tech

    The Power of Payer Partnerships In Behavioral Health with Solome Tibebu, founder and CEO of Behavioral Health Tech
    Jul 19 2024
    The demand for mental health and substance use services is growing, requiring more clinicians and alternative support roles like coaches and peers. In this episode of the AHIP 2024 series, Solome Tibebu, founder and CEO of Behavioral Health Tech, discusses the importance of payer partnerships with digital health innovators in behavioral health. She emphasizes the need for collaboration to ensure members are directed to the right services, particularly for specialized conditions like eating disorders and OCD, while also highlighting the role of technology, health equity, and innovation in expanding access to mental health, substance use, and IDD care. Solome underscores the success of pioneering plans like NovaWell in reaching underserved populations, including young people and people of color, but notes the ongoing challenges with payment codes and reimbursement. She also stresses the need for more clinicians to meet the rising demand for mental health services and suggests that coaches and peers can help fill this gap, though many payers are not yet reimbursing for these roles. Tune in and learn how collaboration and innovation are shaping the future of behavioral health! Resources: Watch the entire interview here. Follow and connect with Solome Tibebu on LinkedIn. Learn more about Behavioral Health Tech on their LinkedIn and website. Subscribe to the Behavioral Health Tech newsletter here. Book a ticket to the Annual Behavioral Health Conference here.
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    8 mins
  • Empowering Employers as Changemakers: Transforming Healthcare Through Direct Partnerships with Nick Stefanizzi, CEO of Northwell Direct

    Empowering Employers as Changemakers: Transforming Healthcare Through Direct Partnerships with Nick Stefanizzi, CEO of Northwell Direct
    Jul 18 2024
    How can integrated delivery systems leverage emerging technologies like data analytics, AI, and machine learning without losing the human touch in patient-provider relationships? In this groundbreaking episode, Nick Stefanizzi explores how employers can drive healthcare system change, emphasizing data analytics, AI, and maintaining human touch in patient care. He highlights employers' pivotal role in healthcare transformation through data-driven strategies and innovative partnerships with providers, reshaping health plans to enhance care access, quality, and affordability. Join us as we uncover the untapped potential of employer-led initiatives and their ability to reshape the future of healthcare delivery! Resources: Connect with and follow Nick Stefanizzi on LinkedIn. Learn more about Northwell Health on their LinkedIn and website. Check out healthcare-specific sources of information mentioned by Nick Stefanizzi, like Modern Healthcare, Becker’s Hospital Review, Fierce Healthcare, SIIA, and Dr. Eric Bricker’s LinkedIn.
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    39 mins
  • Discover the Future of Dentistry with Innovative AI Technology with Dr. Miguel Stanley, dentist and director of the White Clinic in Lisbon, and CEO and founder of Missing Link AI

    Discover the Future of Dentistry with Innovative AI Technology with Dr. Miguel Stanley, dentist and director of the White Clinic in Lisbon, and CEO and founder of Missing Link AI
    Jul 18 2024
    No chronic inflammation in the body is the foundation of longevity. In this episode, Dr. Miguel Stanley discusses the critical connection between dentistry and overall health, stressing the need for better communication between doctors and dentists, integrating medical and dental records, and understanding the systemic impact of oral health. Highlighting his innovative approach to interdisciplinary dental practices and Missing Link AI's ability to identify hidden dental diseases through X-ray scans, he shares his mission to revolutionize dentistry with a focus on patient well-being and advanced diagnostics. Tune in and learn why bridging the gap between medicine and dentistry can improve patient outcomes by addressing systemic health issues related to oral health! Resources: Connect with and follow Dr. Miguel Stanley on LinkedIn and Instagram. Visit Dr. Stanley’s website! Follow the White Clinic on LinkedIn and discover their website! Follow Missing Link AI on LinkedIn and visit their website! Watch the entire episode on YouTube and get more details at Think Oral Health.
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    37 mins
  • Reducing Administrative Waste in Healthcare Systems with Eric Demers, CEO of Madaket Health

    Reducing Administrative Waste in Healthcare Systems with Eric Demers, CEO of Madaket Health
    Jul 16 2024
    Synchronizing provider data between health organizations and insurance companies ensures accurate information and reduces costs. In this episode of the AHIP 2024 series, Eric Demers, CEO of Madaket Health, discusses his company’s role in benefitting patients through reducing administrative waste and enhancing efficiencies for providers and payers. By streamlining and automating functions, Madaket Health helps synchronize provider data between health organizations and insurance companies, ensuring accurate information flow and reducing costs. Eric stresses the importance of accurate provider data managed by organizations like insurance companies, which supports initiatives like the No Surprises Act and enhances provider network management, member satisfaction, and quality. He highlights the challenges of misinformation in healthcare and the need for accurate directories, emphasizing that improving provider directories can enhance quality, reduce costs, and increase revenues. He also explains that using platforms like Madaket Health can prevent revenue loss and create business opportunities. Tune in and learn how to navigate the complexities of the healthcare industry and improve your organization's operations! Resources: Watch the entire interview here. Connect and follow Eric Demers on LinkedIn. Learn more about Madaket Health on their LinkedIn and website. Listen to Eric’s previous episode on our podcast here.
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    8 mins
  • Improving Accessibility And Transparency In Home-Based Services with Ashish Shah, Co-Founder and CEO of Dina Care

    Improving Accessibility And Transparency In Home-Based Services with Ashish Shah, Co-Founder and CEO of Dina Care
    Jul 15 2024
    Care delivery is shifting towards home and community settings to improve accessibility and reliability. In this episode of the AHIP 2024 series, Ashish Shah, Co-Founder and CEO of Dina Care, centers the discussion on the shift in care delivery to the home and community, focusing on improving accessibility, reliability, and transparency. Ashish highlights organizing care logistics for services like skilled nursing and physical therapy at home and emphasizes the need for health plans and providers to improve access to essential services suitable for home and community delivery. He discusses the benefits of Dina's technology in quickly confirming requests and establishing strong connectivity, reducing friction, and enhancing well-being, especially for Medicare Advantage members, while also addressing health equity challenges and the value of nonmedical benefits. Additionally, he emphasizes the importance of collaboration among providers, payers, solution providers, and vendors, mentioning how Dina Care’s platform ensures members get the necessary services, positively impacting outcomes Tune in and learn how home-based care is transforming healthcare and why collaboration among providers, payers, solution providers, and vendors is essential for this initiative’s success. Resources: Watch the entire interview here. Connect and follow Ashish Shah on LinkedIn. Learn more about Dina Care on their LinkedIn, X, and website.
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    9 mins