Episodes

  • Episode 306: Accelerating Health Equity in the Rio Grande Valley

    Episode 306: Accelerating Health Equity in the Rio Grande Valley
    Sep 4 2024
    Today Ashley sat down and talked with Dr. Edwin Estavez. Edwin is the founder of the Altacair Foundation. He Previously, served as Market President of Value Based Care at Prominence Health, a leading health care company that provides high quality, cost-effective care to diverse populations. Edwin, has over 30 years of experience in health care and higher education administration, risk management, and business development, with a PhD in Administration and an MSW. He is passionate about organizational transformation. From health care delivery and outcomes through value-based care tactics, to patient engagement programs, and care coordination models. Join as we chat about the mission of Altacair, how he ensures the foundation stays true to its mission and vision, and the collaboration between Altacair and The Leavitt School of Health on the Accelerator Conference. Altacair Foundation: About Us – Altacair Foundation Accelerator 2024: https://www.eventbrite.com/e/accelerator2024-advancing-value-for-health-equity-tickets-951490021267?aff=oddtdtcreator
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    31 mins
  • Episode 205: The DEI Blueprint: Building Inclusivity in Healthcare and Education Featuring Dr. Melissa McLaren

    Episode 205: The DEI Blueprint: Building Inclusivity in Healthcare and Education Featuring Dr. Melissa McLaren
    Aug 21 2024
    On today’s episode of The Race to Value, Ashley sits down with her colleague and friend, Dr. Melissa McLaren to discuss the importance of DEI in Healthcare and Education, and why building inclusivity is not just a buzzword, but something that is vital for the future. Dr. McLaren is an Associate Dean and Academic Program Director at the Leavitt School of Health at Western Governors University. She graduated with her BSN from The Ohio State University and her Doctor of Nursing Practice from the University of Minnesota. She received her master’s in management and leadership and an MBA from Western Governors University. Melissa and her family have engaged with lawmakers at the local and state level, as well as the Congressional LGBTQ Equality Caucus and the US Department of Health and Human Services in support of gender-affirming care and other LGBTQIA+ rights. They have spoken at state and national conferences to educate on the importance of family support when raising a transgender child. Dr. McLaren has partnered with organizations such as the Human Rights Campaign, Welcoming Schools, PFLAG, the ACLU, TransOhio, Equality Ohio, and many others to advocate for transgender youth. Dr. McLaren currently serves on the Human Rights Campaign Parents for Transgender Equality National Council. She is a board officer for Equality Ohio and was an inaugural board member of her local LGBTQ+ organization. She is a member of the AACN DEI Leadership Network Communications Committee. She lives in Ohio with her husband of 20 years, 19-year old twins, 2 dogs, and several entitled cats. Previous Episode: Ep 137 – Authentic Truth, Love, and Compassion: A Family’s Journey in Gender-Affirming Care, with Melissa and Conner McLaren – The Race to Value Podcast™ 0:50: Defining Diversity and Inclusion 4:52 Why is diversity and inclusion so important in today’s society? 9:34: How the impacts of disparities and health inequities affects absolutely everyone 13:30: How treatment of patients differs based on insurance status 21:00: Education related healthcare burdens, and how education has an impact. 24:00: How diversity enriches the learning experiences in educations settings 33:24 Stories about successful inclusive educational initiatives 38:00 Shifting policies and practices 39:30: Dr. McLaren’s personal story
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    51 mins
  • Ep. 204: Mark Young, CEO of MyCHN

    Ep. 204: Mark Young, CEO of MyCHN
    Aug 7 2024
    On today’s episode of Race to Value, Ashley sits down with Mark Young, CEO of MyCHN to discuss how MyCHN launched a partnership with Wysa, an AI-driven mental health platform. We discuss how this collaboration aims to bolster the well-being and mental health of MyCHN’s Crisis and Behavioral Health patients by providing them access to Wysa’s innovative AI personal mental health companion at no cost. Mark Young has worked in health services since 1989 and in community health since 1998. He has a Master's in Business Administration from Trident University and a Master's in Organization Management from the University of Phoenix. Over his career of 30-plus years, Mr. Young has worked with initiatives in the Rio Grande Valley, northeast Texas, and south Texas. Projects he has developed include outreach and engagement with colonia residents, residential treatment services for pregnant women and children, a tuberculosis intervention program, multiple chemical and alcohol dependency programs, behavioral health programs, and many outreach, education, and intervention projects. Timestamps: 3:00: Discussion on how MyCHN created this partnership with WYSA and the benefits it has brought to their patients. 6:00: How this tool is used to help patients 7:30: Tools and Resources that WYSA offers 11:30: Breaking the Stigma around using AI in Healthcare 16:00: Discussion on the current state of Behavioral Health 19:00: Discussion on younger populations and if they are more likely to opt into utilizing AI for healthcare
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    26 mins
  • Ep. 203: The Nursing Workforce in a Post Covid Landscape

    Ep. 203: The Nursing Workforce in a Post Covid Landscape
    Jul 24 2024
    In today’s episode we chat with Geoffrey Roche, MPA. Geoffrey is the son of a nurse, future of work and education expert, diversity, equity, inclusion, and belonging advocate, champion for transforming health equity, and the host of the Ed Up Health Up podcast. His professional career includes over nine years in hospital administration as a strategic advisor to the President and CEO and department director of various departments, including Business Development and Planning, Government Affairs, Community Health, and Public Relations, for Lehigh Valley Hospital-Pocono. At Lebanon Valley College and Harrisburg University of Science and Technology he held senior leadership roles focused on strategic partnerships, organizational strategy, and business development. As Senior Vice President, Business & Workforce Development at Dignity Health Global Education, he led a diverse team focused on developing institutional relationships with leading health systems while simultaneously championing national conversations and initiatives to develop innovative diversity, equity, and inclusion solutions for the healthcare workforce. “We expected to see a drop in enrollment before the pandemic for all healthcare programs. Why did Healthcare and Education not come together to combat this?” - Geoffrey Roche “We have made bad decisions as a society when taking care of our healthcare workforce.” - Geoffrey Roche“We have five generations of people in the workforce, and this is the first time we have had this.” - Geoffrey Roche“As Leaders we need to harness the creativity and passion for all generations in the workforce.” - Geoffrey Roche 2:25: What is happening in the nursing workforce? 4:30: The Supply and Demand Gap Challenge and addressing culture in healthcare organizations. 5:30: The Gig Economy is now in healthcare, and we have to get used to this model. 8:00: Millennials in the workforce and creating a culture that allows people to be the best they can be by creating a community and culture that allows them to thrive. This means they must be valued and heard. 14:00: What do we need to do as healthcare leaders to invest in our people? 17:30: Why you need to listen to your workforce, instead of just hiring consultants. 20:30: If we do not have a healthcare workforce, it will impact education, clinical placements and preceptorships. 22:50: Apprenticeships, why they are important and why healthcare has been slow to implement them 29:27: We need to do more work in the K-12 Landscape to promote and encourage people to go into healthcare careers. It is important to learn that there are jobs in healthcare that aren’t being a doctor or a nurse.
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    34 mins
  • Ep. 202 – Upcoming Changes to the Institute for Advancing Health Value

    Ep. 202 – Upcoming Changes to the Institute for Advancing Health Value
    Jul 10 2024
    Welcome back to Race to Value! In this episode we introduce our new host, Ashley Schwartz and discuss the rebranding of the Institute for Advancing Health Value and how we are expanding our work. Today’s guest is Dr. Keith Smith (M.A., Ed.D., MBA, L.M., RMHC (ret.)) serves as the Executive Dean and Senior Vice President for Michael O. Leavitt School of Health at Western Governors University. He has strategic leadership experience in the business, nonprofit, and higher education sectors. His 26-year career in higher education comprises holding faculty, dean, vice-provost, vice-president, and now senior vice-president positions, at five universities prior to coming to WGU, inclusive of leading schools of health, business and IT, and arts and sciences. He has taught courses and given presentations domestically and internationally on leadership and organizational change, higher education innovation, and personal growth and development. Smith has supervised educational programs in Europe, the Middle East, and Asia. He has played a lead role in both regional and programmatic accreditations. His teams have developed a wide spread of programs from the microcredential through doctoral levels, as well as partnerships with business, government, military, and community colleges across the nation. 0:19: Introduction to Keith Smith, SVP of WGU’s Leavitt School of Health. 1:42: Upcoming changes you can expect to see with the Institute for Advancing Health Value and it’s rebrand. 2:52: Expansion in content- we will be continuing our work in Value Based Care, but are expanding into workforce, health equity, diversity and inclusion and workforce development. 4:50: Health Equity Convening in the Rio Grande Valley of Texas. This is a new area of work that we are continuing to expand and explore in different areas of the United States 8:00: Discussion of the Programs that the Leavitt School of Health currently offers. 11:40: Discussion of WGU’s strategic pillars and how they will benefit the general public and the current workforce. “We want to set a greater tone out in the Healthcare Industry, in terms of thought leaderships and opportunities to partner with those in different systems, and opportunities to be a resource center for them.” - Dr. Keith Smith “Educational Equity feeds into Health Equity. By providing education to everyone, it opens the door for health equity and having trained, qualified and a culturally competent workforce that mirrors the diverse population that they are caring for.” – Ashley Schwartz
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    19 mins
  • Ep 201 – Value-Based Change Management: Navigating the Human Side of Healthcare Economics, with Philip Eaves, MBA

    Ep 201 – Value-Based Change Management: Navigating the Human Side of Healthcare Economics, with Philip Eaves, MBA
    Feb 14 2024
    In this episode of the Race to Value podcast, we are sharing inspiration for a more optimistic future in the value transformation of our country. This week’s interview brings a message of hope, compassion, and human connection balanced with the business success of value-based care within a national leading health system. Albert Einstein once said that “Only a life lived for others is a life worthwhile” and no one better captures that spirit of servant leadership than our guest this week. Philip Eaves is the President and CEO of Ascension Seton ACO | Ascension Seton Health Alliance and the Vice President of Population Health at Ascension Texas, and he is a leader in the value movement that you should know about. In this interview we focus on change management, leadership, and the human side of healthcare economics. Overseeing the value-based care strategy and operations for one of the largest clinically integrated networks in Texas, Philip is leading the ACO to outstanding success…and transforming the lives of people along the way. Bookmarks: 01:30 The human side of healthcare economics – compassion is the currency; empathy is the language. 02:00 Introduction to Philip Eaves, President and CEO, Ascension Seton ACO and VP of Population Health, Ascension Texas 02:30 Ascension Seton ACO is the largest clinically integrated network in Texas with 3,600 providers with 300K value-based lives. 04:45 “Only a life lived for others is a life worthwhile” -- Albert Einstein 05:30 Philip shares how a humble, faith-based upbringing fueled his ambition, work ethic, and compassion as a healthcare leader. 07:30 “Healthcare is about serving others.” 08:30 Occupational medicine as a stepping stone to value-based care. 09:45 Team-based care that enables providers so they can build meaningful patient relationships. 11:00 $24M in MSSP Shared Savings for 23,000 Medicare beneficiaries to achieve a top 7% performance ranking of all ACOs in the country (#32 out of #482). 12:45 Valuable partnerships with independent practices (e.g. Austin Regional Clinic, Capital Medical Clinic). 13:00 “Physician engagement is the overall key to ACO success.” 14:00 The impact of Annual Wellness Visits (AWVs) in practice transformation. 15:00 HCC recapture for documentation accuracy as an area of educational focus. 15:45 Centralized versus Embedded Care Management. 16:30 Analytical insights to drive high risk CM interventions. 17:15 Quality campaigns to close care gaps and improve population health outcomes. 18:00 Refining a Post-Acute Care network for optimal transitional care. 18:30 An after hours program as an effective ED diversion strategy. 20:00 Change management to improve team culture and reinvent the business model for VBC. 22:00 Phillip shares his experience leading an inflection point for the ACO business. 23:30 Applying the principles of the Kübler Ross Change Curve in organizational change. 24:30 Inspiration from John Kotter (“Leading Change”) – Leadership versus Management. 25:00 Recognizing the need for change in shifting a new strategic direction. 26:00 Communicating the vision and creating short-term wins. 26:45 New initiatives: a new ACO for early adopters, Medicare Advantage risk, and Direct-to-Employer partnerships. 28:00 Financial toxicity as a driver of Direct Contracting between employers and providers in value-based care. 30:00 Employer frustration with rising medical spend and the lack of solutions from their brokers. 30:45 Designing an ACO value proposition based on employer pain points. 31:00 Leveraging network adequacy and CIN care infrastructure for commercially insured populations. 32:45 PBM transparency to reduce extreme spending on pharmacy drugs. 34:00 Forging a new partnership with Signify/CVS to support practice transformation. 37:00 Accessing capital within a landscape where there is mass provider consolida...
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    52 mins
  • Ep 200 – Belief in the Possible: Navigating the Successful Transition from Volume to Value, with Melanie Matthews

    Ep 200 – Belief in the Possible: Navigating the Successful Transition from Volume to Value, with Melanie Matthews
    Jan 30 2024
    The transformation of healthcare is a seemingly insurmountable challenge, yet overcoming any obstacle in the journey begins with the belief that it is possible to win!  It's not about the magnitude of the task; it is about the collective will to prioritize the wellbeing of every person we serve in our population.  Perhaps when approached with the audacity to imagine a healthier and more equitable future for all, we'll actually get there.  And that is just what the Physicians of Southwest Washington (PSW) is realizing as they navigate a successful transition from volume to value. Our guest on the Race to Value this week is Melanie Matthews, the dynamic, creative, and innovative CEO of PSW. She leads a population health company that has been around for three decades. Melanie is not only leading their ACO and managing their progression in the adoption of full-risk Medicare Advantage delegation; she has become a nationally recognized voice for value-based health policy.  In listening to this interview, you will hear from a leader that has a real personal capacity for leadership and a clear focus on excellence. If you want to hear from someone that is at the absolute forefront of risk-based contracting and innovation, who understands the issues at a granular level, this episode with Melanie is a must-listen! Episode Bookmarks: 01:30 Introduction to Melanie Matthews and the Physicians of Southwest Washington (PSW) 04:30 PSW has evolved over the last three decades from an IPA to a diverse business that includes a national leading ACO and risk-bearing entity for MA. 06:00 "PSW is a story of independent physicians who, in a time of market consolidation, want to remain independent and focus on the patient relationship." 06:45 Achieving success in delegated risk and taking accountability for both quality and total cost of care. 07:00 The impact of MACRA on the long-term value-based care strategy of PSW. 08:30 Building an infrastructure and developing capabilities to move a value-based agenda. 09:00 Developing a business model for agility in responding to new rules ("a kayak in a sea of cruise ships") and engaging all types of physicians in the landscape. 09:30 "The value-based movement is important as the fee-for-service chassis is not realistic, has poor quality and outcomes, and rising costs." 10:00 Taking risk with physician partners and providing them with MSO services, leveraging a technical infrastructure and population health platform. 10:45 The glacial pace of scaling payment model transformation at CMS and CMMI's bold goal for 2030. 12:00 The increasing shift to home-based care delivery and the use of generative AI in reshaping care delivery. 13:00 How the flawed economic design of the fee-for-service system creates industry inertia. 14:00 Diverting to the known (i.e. fee-for-service care delivery) in times of stress is an unsustainable path forward. 15:00 Convincing the Board room on the tenets of VBC when it hasn't historically delivered on its promises. 16:00 Trends in consumer cost-shifting and the challenges of private insurers cross-subsidizing provider losses from public payers. 16:30 Unsustainable economics in employer-based healthcare and the looming insolvency of Medicare. 17:00 What does the CMMI 2030 Goal mean for future of the value movement? 18:30 An overview of the extensive services offered by PSW that empowers success in VBC. 19:30 The explosive growth of strategic transactions of physician groups and how mass consolidation is impacting the landscape. 21:00 Aligned incentives and access to a population health platform as keys to VBC success. 22:00 PE investment impacts on competition in an independent physician ecosystem. 23:00 Generational differences in the approach to the business of practicing medicine. 23:30 "Organizations that are convened with independent physicians are able to show better costs of care." (vs. employed or vertically integrated systems)
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    1 hr and 3 mins
  • Ep 199 – Translating Truth: Overcoming Misunderstanding to Champion Accountable Care, with Mara McDermott

    Ep 199 – Translating Truth: Overcoming Misunderstanding to Champion Accountable Care, with Mara McDermott
    Jan 16 2024
    We have a broken healthcare system. Too often, individuals today experience care that is fragmented, duplicative, wasteful, and confusing.  Through value-based care, we can improve the health care experience by coordinating care, creating care teams that communicate with one another, and supporting individuals in their care journey with services that address their medical and non-medical needs. Accountable for Health is a nonpartisan national advocacy and policy analysis organization accelerating the adoption of effective accountable care. Their members are advocating for value-based care on Capitol Hill so policymakers can understand how best to move American healthcare towards a model that achieves better outcomes, improved care experiences, increased access, and lower costs. Joining us on the podcast this week is Mara McDermott, the Chief Executive Officer for Accountable for Health.  She is an accomplished healthcare executive with deep expertise in federal healthcare law and policy, including delivery system reform, physician payment and payment models. Take this opportunity to learn from a leading expert on accountable care as she translates the truth in building a bridge towards a more broad-based understanding of health value.  And make sure to tune in to Mara's special announcement about Health Care Value Week at the end of the interview so you don't miss out on important educational events occurring January 29th thru February 2nd. Episode Bookmarks: 01:30  The need for accountable care policies that create better health outcomes and patient experiences. 02:00  Introduction to Accountable for Health (A4H) and its Founder/CEO Mara McDermott, JD, MPH 03:00  Interview topics discussed (e.g. the meaning of VBC, MSSP vs. MA, MACRA 2.0, advanced APMs, integrated specialty care, Medicaid transformation, and the upcoming Health Care Value Week event). 06:00  How A4H is translating thought leadership to action in the advocacy arena. 06:30  Accountable care as the solution to fragmented, uncoordinated care. 07:00  Political turnover in D.C. has made VBC a "new" health policy solution. 07:30  Educating the Hill comes down to conveying enthusiasm for health care transformation. 08:00  Accountable for Health Members are shaping the national conversation for payment and delivery system reform. 09:00  The health policy controversy of the Global and Professional Direct Contracting model (the precursor to ACO REACH). 11:30  If Direct Contracting was the natural evolution of a series of advanced ACO options, why was there such strong criticism? 12:00  The need to overcome misunderstandings about what ACOs are trying to achieve. 13:00  Providing education to dispel the myth that ACOs can actually limit services. 14:00  How uninformed policy decisions could potentially create a catastrophic blow to the value movement. 14:45  "Accountable care is integral to care delivery system reform." 15:45  Confusion with the term "value-based care" and why it will fail unless people understand the truest aims of the movement. 17:00  The need for effective storytelling to advance care delivery transformation. 18:00  Prioritizing care experience over cost reforms (delivery innovation will address costs!) 20:00  The topline takeaways from CMS model evaluations and whether or not programs should be expanded. 21:00  What do most people think when they hear the word "value"? (the need to reframe the conversation with more precise language) 22:00  The MSSP and the Medicare Advantage programs as two distinct approaches to healthcare delivery and reimbursement. 24:00  Mara provides a brief comparison between MSSP and MA (e.g. beneficiary assignment, risk adjustment, benchmarking). 25:30  How strong relationships between MA plans and provider networks (underpinned by capitation) drive value. 26:30  Understanding provider compensation in MA value-based payment and the synergies between managing MSSP and MA populations.
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    52 mins