Bright Spots in Healthcare Podcast Por Eric Glazer arte de portada

Bright Spots in Healthcare

Bright Spots in Healthcare

De: Eric Glazer
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Each episode, I interview innovators in the healthcare industry to extract the strategies, tactics, tools, and/or routines they utilize to generate extraordinary, positive outcomes. We highlight and breakdown these bright spots so you can apply them at your organization. "See a bright spot .... and clone it!" Enfermedades Físicas Higiene y Vida Saludable
Episodios
  • Inside Credentialing: Where AI Delivers Measurable ROI for Health Plans

    Inside Credentialing: Where AI Delivers Measurable ROI for Health Plans
    Nov 4 2025
    In this Bright Spots in Healthcare episode, host Eric Glazer sits down with three leaders reshaping one of healthcare's most overlooked — yet mission-critical — functions: provider credentialing. Credentialing is the quiet infrastructure of trust in healthcare. When it's done right, patients get timely access to high-quality care, providers get paid faster, and health plans stay compliant. When it fails, backlogs grow, compliance risk skyrockets, provider satisfaction plummets, and member access suffers. Joining Eric for this discussion: Sandra Clarke, Former CFO & COO, Blue Shield of California Brett Dooies, Head of Product, Verifiable Janan Dave, VP of Operations, Verifiable Together, they explore how AI and automation are transforming credentialing from a slow, manual compliance task into a strategic capability that improves efficiency, trust, and network readiness. In this episode, you'll learn: Why credentialing sits at the intersection of compliance, provider experience, and member access How legacy processes, staffing limits, and messy data create hidden risk, and why backlogs can grow like quicksand Practical ways health plans are applying AI to reduce verification time, speed onboarding, and triage high-risk cases Why the most successful plans treat credentialing as infrastructure, not paperwork Key metrics to track when modernizing credentialing, including turnaround time, backlog clearance, audit readiness, and provider experience What to automate first, and why humans still play a critical oversight role Bright Spots include: 97% automated verification in seconds across millions of records monthly New staffing and automation models that increase speed without compromising compliance Real-world examples where AI prevented risk exposure and accelerated network growth Leadership lessons in adopting AI responsibly and avoiding the "lift-and-shift" trap This conversation offers payer leaders a real-world playbook to modernize credentialing and strengthen the foundation of your healthcare organization. Panelist Bios: Sandra Clarke is a healthcare executive and board advisor with over 25 years of experience leading finance, operations, and large-scale transformation across payer, provider, and life sciences organizations. As former CFO and COO of Blue Shield of California, she oversaw $25B in annual revenue and spearheaded initiatives delivering $700M in annualized savings while reimagining the company's pharmacy care model. Clarke has also held senior leadership roles at Daiichi Sankyo and Philips Healthcare and serves on multiple healthcare boards. She holds degrees from MIT, Bentley University, and Seton Hall University School of Law. Janan Dave is the VP of Operations at Verifiable, a start-up offering software and services solutions for healthcare organizations to ease the challenges surrounding provider network management. Janan has a background in public health and health policy, and has spent the last decade helping scale operations at various healthcare startups. She is passionate about building smart solutions to reduce waste in the healthcare system, and promote better care especially for the aging population, family caregivers, and women. Janan studied public health at the University of Pennsylvania, and lives in Brooklyn, NY. Brett Dooies is the Head of Product at Verifiable, where he leads the development of AI-powered solutions to simplify healthcare credentialing and monitoring. With a decade of experience building enterprise software, he specializes in applying advanced AI and analytics to enhance the customer experience and deliver transformative solutions. Drawing on his background in modernizing banking software, Brett is dedicated to creating products that drive operational excellence, uphold regulatory compliance, and improve data accuracy for Verifiable's partners, helping them scale with confidence in a complex ecosystem. Resources: MIT Sloan "Internet of AI Agents: State of AI in Business 2025" report finds that although over 80 % of organizations have piloted generative AI tools, only around 5 % have achieved meaningful business transformation—a gap dubbed the "GenAI Divide". It highlights that the primary barrier isn't model technology or regulation, but rather the failure of AI systems to integrate deeply into workflows, learn from feedback, and scale beyond the pilot stage. https://mlq.ai/media/quarterly_decks/v0.1_State_of_AI_in_Business_2025_Report.pdf Thank you to our Episode Partner, Verifiable: Verifiable is a credentialing and network monitoring platform built to help healthcare organizations optimize operations with error-free, fast verifications and to stay compliant with ease. Backed by their in-house NCQA certified credentialing team that bring a combined 60+ years of experience, Verifiable's innovation supports managing trusted networks at scale through 97% verification automation in seconds with millions processing each ...
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    58 m
  • Dr. Kristian Olson, Vice President of Design Impact, Mass General Brigham | Finding Healthcare's Hidden Solutions Through Human-Centered Design

    Dr. Kristian Olson, Vice President of Design Impact, Mass General Brigham | Finding Healthcare's Hidden Solutions Through Human-Centered Design
    Oct 21 2025

    In this episode of Bright Spots in Healthcare, we explore how human-centered design can uncover breakthrough solutions already hiding in plain sight. Dr. Kristian Olson, Vice President of Design Impact at Mass General Brigham and leader of the Springboard Studio, shares how slowing down to understand problems leads to faster, more effective innovation.

    The conversation dives into:

    • The four pillars of effective healthcare innovation: design research, prototyping, supported implementation, and impact measurement

    • How "stupidest ideas" exercises and question storming unlock creative solutions in frontline staff meetings

    • Real results from Salem Hospital's mobility speedometer (300% increase in patient movement, reduced length of stay)

    • The COVID testing booth prototype that saved $1 million per year while reducing gown usage by 97%

    • Developing low-cost neonatal resuscitation devices in Uganda and India that improved ventilation skills

    • Why frontline staff must be co-creators, not just implementers, of healthcare solutions

    This discussion offers practical frameworks for health plans, hospitals, and healthcare leaders looking to harness their teams' ingenuity and drive measurable improvement.

    Guest Bio: https://www.massgeneral.org/doctors/17235/kris-olson

    Resources & References

    • MGB Springboard Studio: www.mgbspringboardstudio.org

    • Augmented Infant Resuscitator: ebinnovations.net

    • Positive Deviance approach to solving malnutrition in Vietnam (referenced as inspiration)

    Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business via content and relationships, email hkrish@brightspotsventures.com

    About Bright Spots Ventures:

    Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation. We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the "bright spots" in healthcare—proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.
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    1 h y 1 m
  • How Humana, Blue Shield of CA, and Noom Are Reimagining GLP-1 Integration and Obesity Care

    How Humana, Blue Shield of CA, and Noom Are Reimagining GLP-1 Integration and Obesity Care
    Oct 14 2025
    Host Eric Glazer convenes senior leaders from Humana, Noom, and Blue Shield of California to explore how payers are integrating GLP-1 therapies into comprehensive cardio-metabolic care strategies. The conversation outlines how digital, behavioral, and clinical interventions can align to deliver sustainable outcomes, lower costs, and strengthen member engagement. Panelists share real-world playbooks on scaling GLP-1 programs responsibly—balancing access, affordability, and long-term adherence through consumer-centric design and data-driven clinical support. 📘 What You'll Learn How Humana's CenterWell Pharmacy is transforming outcomes through AI-enabled automation, disease-specific Centers of Excellence, and a high-touch consumer experience. How Noom and forward-thinking health plans are using trust as currency to deepen engagement and sustain lifestyle change. How Blue Shield of California is implementing a step-therapy model that balances GLP-1 access with lifestyle interventions and clinical oversight. Why integration across benefit design, behavior change, and pharmacology is redefining obesity management. What future models look like for holistic, clinician-guided weight management and cardiometabolic care. 💬 Quotable Moments "Trust isn't optional—it's the currency that earns you the right to guide someone through change." – Cody Fair, Chief Commercial Officer, Noom "You can have efficiency and still be high-touch. AI and automation don't replace pharmacists—they empower them." – Bethanie Stein, President of Pharmacy, Humana "GLP-1s are a tool, not the strategy. Success means combining medication with behavioral, nutritional, and clinical support." – Angie Kalousek, Ebrahimi Senior Director, Lifestyle Medicine, Blue Shield of California "Culture—caring, curious, and committed—is the foundation of transformation." – Bethanie Stein, President of Pharmacy, Humana ⏱️ Timestamped Hooks 00:08:00 – 00:09:00: Eric introduces the GLP-1 integration playbook and the challenge of turning high-cost therapies into sustainable value. 00:12:30 – 00:14:00: Humana's digital transformation: from internal pharmacy to 95% retention and NPS of 87. 00:15:20 – 00:17:40: Noom on building trust through "Your Ultimate Why." 00:20:00 – 00:25:00: Blue Shield of California on managing GLP-1 demand and step-therapy protocols. 00:31:00 – 00:33:00: Noom's opt-out model driving 90% employer participation. 00:44:00 – 00:47:00: Humana partners with pharma to deliver GLP-1s at up to 70% lower cash prices. 00:55:00 – 00:57:00: "Caring, Curious, and Committed" – the cultural foundation for consumer-centric care. 01:03:30 – 01:04:50: Blue Shield on building Netflix-style personalization for obesity and MSK programs. 🗒️ Show Notes Featured Guests Bethanie Stein, President of Pharmacy, Humana Cody Fair, Chief Commercial Officer, Noom Angie Kalousek Ebrahimi, Senior Director, Lifestyle Medicine, Blue Shield of California Discussion Highlights Integrating GLP-1 therapies within holistic benefit design frameworks. Leveraging AI and automation in pharmacy operations to enhance adherence and experience. The role of behavior-based engagement models in long-term weight management. Data-driven approaches to affordability, utilization, and trust-based engagement. Creating digital ecosystems that mirror personalized consumer experiences in other industries. Panelist Bios: https://www.brightspotsinhealthcare.com/events/the-glp-1-integration-playbook-smarter-plan-design-to-drive-member-engagement-and-outcomes/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Episode_Guide_GLP1_Integration_Playbook.docx.pdf Key Insights Summary: Key Takeaways - Noom The GLP-1 Integration Playbook_ Smarter Plan Design to Drive Member Engagement and Outcomes 10.09.25.docx.pdf Resources: Benefits beyond weight loss: The expanding impact of GLP-1s in modern healthcare This resource explores how leading health plans are integrating GLP-1 therapies into holistic care pathways—connecting behavioral support, nutrition, and digital engagement to sustain results. It also highlights Noom's evidence-based approach, showing a 48% greater weight loss and over 4x ROI when GLP-1s are combined with behavioral coaching and mindset support. To request your copy, email jtenzer@brightspotsventures.com. Thank You to Our Episode Partner, Noom Noom is a digital health company transforming how people achieve lasting health improvements through psychology, technology, and coaching. Their scalable cardiometabolic solutions—including weight management, diabetes prevention, and GLP-1 support through Noom Med—help employers, health plans, and health systems balance affordability with outcomes. To learn more, visit noom.com/health. Schedule a meeting with Cody Fair, Chief Commercial Officer, Noom: To dive deeper into how Noom can help your plan ...
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    1 h
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This podcast consistently offers great information and ideas for healthcare improvement through interviews with people who work in different aspects of healthcare. I always learn something new.

great information and ideas

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