Tuning in to the C-Suite

Briana Contreras, an editor with Managed Healthcare Executive, spoke with Harsha Rajasimha, MD, founder and executive chairman of IndoUSrare, in this month's episode of Tuning in to the C-Suite podcast. The conversation was about how the disparity in diversity and ethnicity in rare disease clinical trials in the U.S. has led to gaps in understanding diseases and conditions, jeopardizing universal health, and increasing the economic burden of healthcare.

This 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.

Briana 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.

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.

In 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.

In 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.

In 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.

Back 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.

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.

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.

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.

Briana Contreras, editor of Managed Healthcare Executive spoke with Jason Warrelmann, global director of Healthcare and Life Sciences at UiPath, in this week's episode of Tuning In to the C-Suite podcast. In the discussion Jason addressed the incline of automation in healthcare, why it's necessary for patients and providers and how other healthcare organizations can better overcome the challenges of adopting automation within their health system.

Briana Contreras, editor of Managed Healthcare Executive spoke with Luis Mosquera, CEO of Health Network One, a provider of specialty benefit management services for health insurers, in this week's episode. In this discussion, Luis and Briana talked about how value-driven decisions in a more value-based market can not only better manage costs for health plans, but create a plan of care to best meet patient’s needs. In order to do this, Luis strongly encouraged healthcare executives to experience alternative payment models and shared what payers should check off their list with a new model.