In this episode of The Move to Value Podcast, we revisit the conversation between CHESS President Dr. Yates Lennon and Randy Jordan, Chief Advisor of Impact for Health at Next Stage Consulting and former CEO of North Carolina’s Association of Free and Charitable Clinics. Together, they unpack the evolving landscape of Managed Medicaid, explore innovative approaches to funding care for the uninsured, and examine how healthcare organizations—free clinics, FQHCs, rural health centers, hospitals—can collaborate in a financially sustainable way. From real-world examples in North Carolina to insights drawn from global experience, this conversation sheds light on what it takes to build a true system of care for those often left out.

In this episode of the Move to Value Podcast, we continue our conversation with Julie Quisenberry of Coastal Horizons about what care management looks like on the front lines. Julie shares how her team supports patients facing housing insecurity, food insecurity, substance use, and behavioral health challenges, while also navigating language barriers and limited resources.

From expanding Hepatitis C treatment programs to building bilingual services and training staff in cultural competency and trauma-informed care, Julie offers a candid look at the realities of delivering whole-person care. She emphasizes the importance of celebrating small wins, collaborating with community partners, and adapting to constant change in Medicaid and tailored care plans.

This episode shines a light on both the challenges and the resilience of care managers working to improve outcomes and support their communities—one patient at a time.

In this episode of Move to Value, we talk with Julie Quisenberry, Director of Care Integration at Coastal Horizons. Serving 56 counties across North Carolina, Coastal Horizons delivers whole-person care by integrating primary care, behavioral health, substance use treatment, and community resources. Julie explains how her team navigates Medicaid standard plans and tailored plans, uses HEDIS metrics to improve outcomes, and works closely with partners like CHESS to keep patients’ needs front and center.

In this episode, Dr. Rob Fields and Rebecca Grandy continue their conversation and focus on data. What’s useful and what’s a waste of time? What data truly drives value and why do so many predictive tools fall flat? You’ll also hear practical strategies such as where to direct focus when resources are tight, how to build an ideal care team, and how to make your value-based programs sustainable—even in a broken fee-for-service world.

In this episode of the Move to Value Podcast, Dr. Rob Fields, EVP and Chief Clinical Officer at Beth Israel Lahey Health, joins host Rebecca Grandy, Director of Pharmacy at CHESS Health Solutions, to unpack the realities of value-based care.

They explore why good intentions aren't enough, what data actually drives impact, and how to build sustainable care models with limited resources. From downside risk readiness to team-based care and chronic disease management, this conversation is full of practical insights for anyone navigating healthcare transformation.

Today we revisit an interview with Tim Gallagher, a leading voice in Medicaid transformation and value-based care. With Medicaid policy currently dominating headlines, it is important to hear from someone with firsthand experience as both a policy expert and a parent navigating the system. Tim offers sharp insight into how managed Medicaid can drive equity, improve outcomes, and create sustainable partnerships.

In this episode of the Move to Value Podcast, we take a deep dive into one of the most impactful updates in healthcare risk adjustment: the transition from CMS-HCC Version 24 to Version 28. Our guest, TaSonya Hughes, CHESS Health Solutions’ Manager of Coding and Documentation Education, explains what the shift means for providers, coding teams, and care managers—and why now is the critical time to prepare.

CMS-HCC Version 28 introduces new disease classification categories, retires thousands of existing diagnosis codes, and emphasizes greater specificity in clinical documentation. TaSonya walks us through how these changes affect Medicare risk adjustment, the financial sustainability of value-based care, and ultimately, the ability to deliver accurate, coordinated care for patients with complex chronic conditions.

In this episode of The Move to Value Podcast, guests Jennifer Houlihan and Jennifer Gasperini join us for a deep and wide-ranging conversation on the evolving landscape of value-based care. We explore North Carolina’s leadership in Medicaid transformation, the critical role of provider voice, and the infrastructure needed to support long-term success.

From navigating administrative burdens to anticipating federal policy shifts, we also discuss how health systems can stay nimble, build smarter data strategies, and engage patients in more meaningful ways. Whether you're a provider, policymaker, or system leader, this episode offers timely insight into where healthcare is headed—and what it will take to get there.