Mostafa Kamal Talks Prime Therapeutics, Magellan Rx Integration, the Organization's Trajectory, More
September 13th 2023Managed Healthcare Executive's Managing Editor Peter Wehrwein, and Editor Briana Contreras, had a discussion in July with Mostafa Kamal, president and CEO of Prime Therapeutics, an organization in which Kamal acquired this position that same month.
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In the Scope of Virtual Health and the Future of “Website” Manner, Per Ateev Mehrotra
August 10th 2023Briana Contreras, an editor of Managed Healthcare Executive, had the pleasure of catching up with MHE Editorial Advisory Board Member, Ateev Mehrotra, MD, MPH, who is a professor of healthcare policy at Harvard Medical School and an Associate Professor of Medicine and Hospitalist at Beth Israel Deaconess Medical Center.
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Extending the Capabilities of the EHR Through Automation
August 2nd 2023Welcome back to another episode of "Tuning In to the C-Suite," where Briana Contreras, an editor of Managed Healthcare Executive, had the pleasure of chatting with Cindy Gaines, chief clinical transformation officer at Lumeon.
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What's On the Mind of Eric Hunter? The Network of CareOregon and the Members They Serve
May 10th 2023This month’s episode of the "What's On Your Mind" podcast series features Eric Hunter, president and CEO of CareOregon. MHE Managing Editor Peter Wehrwein, Editor Briana Contreras and Hunter discuss Medicaid redetermination and merger of CareOregon and the California-based insurer, SCAN Group.
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The Don'ts of Kicking Off Your Digital Health Startup
May 5th 2023This month's episode of Tuning In to the C-Suite features Erica Jain, CEO & co-founder of digital health company, Healthie. In this discussion, Jain shared some of the challenges or things to avoid when creating a digital health startup, based on her journey with starting Healthie in 2016. She also addressed some best practices and tools that can help those working toward a digital health startup.
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David Calabrese of OptumRx Talks New Role, Market Insulin Prices and Other Topics 'On His Mind'
April 13th 2023In this month’s episode of the "What's On Your Mind podcast," Peter Wehrwein, managing editor of MHE connects with the now Chief Clinical Officer of OptumRx Integrated Pharmacies, David Calabrese. In this conversation, David touches on his transition in January as OptumRx’s former chief pharmacy officer and market president of health plans and PBMs to his new role as Chief Clinical Officer where he now focuses more on things such as specialty pharmacy to home delivery — with an overall goal of creating whole-patient care. Throughout the conversation, Calabrese also touched on the market’s hot topic of insulin prices and behavioral health services within the OptumRx community, among other topics.
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How Adopting AI Combats Fraud, Waste and Abuse Caused by Overpayment
April 7th 2023Briana Contreras, an editor with Managed Healthcare Executive, had a chat with Clay Wilemon, CEO of 4L Data Intelligence, in this month’s episode of Tuning In to the C-Suite. The discussion was on the subject of fraud, waste, and abuse within the healthcare industry and how much of it stems from issues like overpayment. Clay addressed how the adoption of artificial intelligence can help combat fraud, waste and abuse and shared how much the industry can save by using AI.
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The senior vice president of health services and chief medical officer at Independence Blue Cross in Philadelphia discusses the spotlight that the COVID-19 pandemic put on behavioral health and Independence's integration of behavioral health into its coverage and care management in this month's episode of “What's on Your Mind?" podcast.
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What’s on the Mind of Margaret “Meg” Murray of the Association for Community Affiliated Plans?
February 10th 2023Our guest on this month’s episode of the “What's on Your Mind” podcast is Margaret Murray, M.P.A., founding CEO of the Association for Community Affiliated Plans (ACAP) and a longtime member of Managed Healthcare Executive® editorial advisory board. Murray is an expert on Medicaid and healthcare policies that affect people with low incomes. In the interview with Managing Editor of MHE, Peter Wehrwein, she discusses ACAP’s growth and its legislative wins, Medicaid redetermination, “junk insurance,” and state Medicaid programs carving out pharmacy benefits.
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In this month’s episode of Tuning In to the C-Suite, Managing Editor Peter Wehrwein talks with Rick Bates, MBA, president and CEO of RxSense. In his conversation with Wehrwein, Bates described RxSense as a “technology platform company that has expertise in the direct-to-consumer business.” He emphasized that RxSense is not a pharmacy benefit manager (PBM) — but, rather, a company that supplies PBMs with technology, including some of the up-and-coming PBMs, such as EmsanaRx and Vivid Clear Rx. Bates and Wehrwein also discussed the Mark Cuban Cost Plus Drug and RxSense launching a standalone business intelligence product called Rx IQ.
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What's on the Mind of Perry Cohen of The Pharmacy Group?
January 11th 2023In this debut podcast series of What's on Your Mind podcast, Perry Cohen, Pharm.D., CEO of The Pharmacy Group, recently shared his thoughts on the current state of healthcare and especially the management of pharmacy costs. This new monthly series brings listeners into the minds of Managed Healthcare Executive's® Editorial Advisory Board members. Cohen has decades of experience in managed care and has been on the editorial advisory board since 1994.
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The Merging Market Today in Healthcare, According to Chuck Salvo of ToneyKorf Partners
December 15th 2022In this week's episode, Briana Contreras, an editor of Managed Healthcare Executive, spoke with Chuck Salvo managing director of ToneyKorf Partners. The pair touched on topics involving mergers between healthcare organizations, the question whether CEO's are being replaced and the importance of a board in a healthcare organization.
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How to Save Medicare Home Healthcare Per Tim Ashe of WellSky
November 23rd 2022In this week's episode, Editor of Managed Healthcare Executive, Briana Contreras, had the pleasure of speaking with Chief Clinical Officer of WellSky, Tim Ashe, about the issue of Centers for Medicare and Medicaid Services cutting rates for Medicare home health. Tim addressed the solutions that are either underway or those that can potentially preserve access to these services.
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Using the 'Pathway' Approach to Shorten the Time Between Cancer Diagnosis and Treatment
November 16th 2022In this episode of Tuning In to the C-Suite, Briana Contreras, editor with Managed Healthcare Executive spoke with Dr. Yuri Fesko, oncologist and vice president of Medical Affairs at Quest Diagnostics. In the conversation, Dr. Fesko addressed the ongoing issue of long gaps of times between receiving a diagnosis for a type of cancer and finally getting the treatment for it. Dr. Fesko shared the benefits a number of sectors receive when treating patients sooner and the steps to get there.
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Doug Chaet of Value Evolutions Discusses Value-based Payment Models, Where They Stand and More
September 29th 2022In this episode of Tuning In to the C-Suite, Managing Editor of Managed Healthcare Executive, Peter Wehrwein, speaks with President of Value Evolutions and MHE Editorial Advisory Board Member, Doug Chaet, FACHE, about value-based care's current standing, the status of select payment models like bundled and episodic, and more.
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Jim Graham of Prime Therapeutics Discusses a Digital Transformation Management System in Healthcare
August 31st 2022In this week's episode, MHE Editor Briana Contreras and Managing Editor Peter Wehrwein met with CIO of Prime Therapeutics, Jim Graham to discuss the process of an organization’s digital transformation from a traditional Pharmacy Benefit Manager to a complete data-driven drug management system. Graham addressed the risks an organization may come across to successfully transition to this system, but also mentioned the benefits to come.
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Lissy Hu of Connected Care Networks at WellSky Talks Home-based Care as New Norm
August 25th 2022Back from a brief hiatus, MHE brings you a brand new episode of Tuning In to the C-Suite podcast where Editor Briana Contreras had the pleasure of speaking with Lissy Hu, president of Connected Care Networks at WellSky. Lissy and Briana discussed the shift to home-based care and where it stands after becoming much more of a norm three years into COVID-19. They also addressed the benefits and challenges of home-based care from a payer and patient’s perspective, as well as the cost of this service as its demand rises.
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Choice, Value and Long-term Acute Care Hospitals
May 4th 2022In this special sponsored podcast, Audra Early, senior vice president of strategy and managed care at Kindred Hospitals, and Tina Pickett, M.P.H., director, at ATI Advisory, discuss the role of long-term acute care hospitals in post-acute care and recent research showing the contribution they can make to value-based care. They were interviewed by Peter Wehrwein, managing editor of Managed Healthcare Executive.®
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Briana Contreras, editor of Managed Healthcare Executive, spoke with Nancy Lurker, CEO and president of EyePoint Pharmaceuticals. Nancy shared a bit about EyePoint and how the organization’s innovative therapies are addressing patient needs through eye care, and most importantly, she addressed C-Suite positions like the CEO role. Nancy shared advice for those seeking to reach the CEO level, especially toward women in healthcare and other roles, and what it takes to run a biopharma company.
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In this week's episode, Briana Contreras, editor of Managed Healthcare Executive, spoke with Dr. Paige Kilian, chief medical officer at Inovalon. In the discussion, Dr. Kilian broke down the current issues health plans are facing when it comes to risk adjustment and how it’s affecting members of these plans. She also shared some solutions that can help plans improve risk adjustment and quality programs with one in particular being health plans identifying care gaps through data and analytics.
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Briana Contreras, editor of Managed Healthcare Executive spoke with Emad Rizk, M.D., chairman, president, and CEO of Cotiviti in this week's episode of Tuning In to the C-Suite. In the discussion, they talked about the issues of risk in healthcare and how they have led to inequalities in care. They also addressed how adopting risk assessment tools that expand access to data around social determinants of health can help reduce bias and improve care.
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In this episode of the "Meet the Board" podcast series, Briana Contreras, Managed Healthcare Executive editor, speaks with Ateev Mehrotra, a member of the MHE editorial advisory board and a professor of healthcare policy and medicine at Harvard Medical School. Mehtrotra is also a hospitalist at the Beth Israel Deaconess Medical Center in Boston. In the discussion, Contreras gets to know Mehrotra more on a personal level and picks his brain on some of his research interests including telehealth, alternative payment models and price transparency.
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Peter Durlach of Nuance Talks on How Artificial Intelligence Drives Value for Patients and Providers
March 16th 2022In this week's episode, Briana Contreras, editor of Managed Healthcare Executive, spoke with Peter Durlach, chief strategy officer of Nuance. The two discussed how artificial intelligence drives value for patients and providers and how AI tools and solutions are helping health systems reach the quadruple aim of care.
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