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
  • Integrating GLP-1 Therapies: Building the New Playbook for Cardio-Metabolic Care

    Integrating GLP-1 Therapies: Building the New Playbook for Cardio-Metabolic 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.” – Bethany Stein, President of Pharmacy, Humana “GLP-1s are a tool, not the strategy. Success means combining medication with behavioral, nutritional, and clinical support.” – Angie Okaloosa-Ibrahimi, Senior Director, Lifestyle Medicine, Blue Shield of California “Culture—caring, curious, and committed—is the foundation of transformation.” – Bethany Stein, 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 Bethany Stein, President of Pharmacy, Humana Cody Fair, Chief Commercial Officer, Noom Angie Okaloosa-Ibrahimi, 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. Resources Mentioned The GLP-1 Integration Playbook (Noom, 2025) Evolution program, Blue Shield of California CenterWell Pharmacy patient experience data Bright Spots Ventures Partner Acknowledgment Special thanks to Noom for supporting this episode. Noom combines behavioral science, technology, and clinical guidance to deliver measurable results in metabolic health. Learn more at noom.com/health.
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    1 h
  • Savings, and Satisfaction with BCBS Michigan, Aetna, MVP & Vori

    Savings, and Satisfaction with BCBS Michigan, Aetna, MVP & Vori
    Oct 7 2025
    Duration: 1 hr In this Bright Spots in Healthcare episode, host Eric Glazer brings together an all-star panel of leaders who are reshaping the future of Medicaid and social care. Our guests include: Vanita Pindolia, Vice President, Medicare Star Ratings, Emergent Holdings (BlueCross BlueShield Michigan) Jason Merola, MD, Chief Medical Officer, MVP Health Care Charlotta Eriksson, Lead Director, National VBC Partnerships (Specialty), Aetna Mary O’Connor, MD, Chief Medical Officer & Co-Founder, Vori Together, they explore: How Medicare Advantage plans are embedding Stars, CAHPS, and adherence metrics directly into provider contracts to drive accountability, improve quality, and sustain year-over-year performance gains. How payers like Aetna are expanding value-based care into specialty domains—from CKD and oncology to musculoskeletal and cardiology—by partnering with specialty-aligned organizations rather than converting individual specialists to risk models. How MVP Health Care is designing hybrid incentive structures that reward specialists for closing quality gaps and improving outcomes, without requiring full downside risk. Why MSK care is becoming pivotal to Stars success, as physical and mental health measures grow in weight through 2027, and how holistic, physician-led models are improving activity, satisfaction, and cost savings simultaneously. How digital-first specialty networks are solving access challenges, reducing “ghost network” exposure, and creating new opportunities for plans to meet CMS adequacy standards while improving the member experience. How collaboration across utilization management, Stars, and member experience teams helps avoid trade-offs, ensuring that cost controls don’t come at the expense of satisfaction or CAHPS performance. Panelist Bios: https://www.brightspotsinhealthcare.com/events/stars-savings-and-satisfaction-unlocking-msk-and-specialty-care-strategies-for-medicare-advantage-success/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://drive.google.com/file/d/1a_rX23Ev5VRrJKqb8_UwAYBd9tUBIfWA/view?usp=sharing Resources: Maximizing 2026 Medicare Advantage Performance with Physician-Led MSK Care This report outlines how Vori’s physician-led, virtual-first musculoskeletal (MSK) model helps Medicare Advantage plans:Improve up to 12 Star measures across preventive care, chronic condition management, and member experience Deliver faster access to care—appointments available within 48 hours Enhance outcomes for pain, fall prevention, and osteoporosis care while achieving an NPS of 87 Align with the new 2026 Star measures for Improving and Maintaining Physical and Mental Health To request your copy, email nroberts@brightspotsventures.com. Clinical Quality Performance of Value-Based and Fee-for-Service Models for Medicare Advantage: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2839238 This JAMA Health Forum article compares clinical quality outcomes for Medicare Advantage patients whose care is delivered under value-based payment (VBP) models versus traditional fee-for-service (FFS). It finds that VBP arrangements, especially those with two-sided financial risk—in general are associated with better performance on standardized clinical quality measures than FFS. Thank you to our Episode Partner, Vori: Vori partners with health plans and providers to improve musculoskeletal (MSK) care through data-driven, physician-led solutions. Their approach helps reduce unnecessary surgeries, improve recovery outcomes, and enhance patient satisfaction—supporting plans in achieving better Stars performance and overall member experience. To learn more, visit vorihealth.com. Schedule a meeting with Mary O’Connor Chief Medical Officer, Vori: To dive deeper into how Vori can help your plan improve outcomes, reduce costs, and strengthen Medicare Advantage Star Ratings,or to schedule a meeting with Mary O’Connor. Reach out to nroberts@brightspsotsventures.com to schedule the meeting. 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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    59 m
  • Express Scripts SVP Harold Carter on GLP-1s & the Future of Pharmacy Benefits

    Express Scripts SVP Harold Carter on GLP-1s & the Future of Pharmacy Benefits
    Oct 3 2025

    GLP-1 therapies are transforming pharmacy benefits, and Express Scripts is leading the way. Harold Carter, PharmD, SVP of Trade Relations, joins host Eric Glazer to discuss how one of the nation’s largest PBMs is navigating this disruptive moment in healthcare.

    Harold shares how Express Scripts is:

    • Capping costs of GLP-1 therapies to expand patient access while keeping plan spending predictable.

    • Redesigning funding models to strike a balance between affordability, predictability, and outcomes.

    • Leveraging digital tools and AI to reduce friction in the member experience and support long-term adherence.

    • Rethinking formularies not just as cost-control tools but as part of a broader population health and behavioral change ecosystem.

    You’ll also hear his forward-looking perspective on how PBMs will evolve over the next three to five years, and the key questions health plans and employers should be asking today to prepare for the future of pharmacy benefits.

    About Dr. Harold Carter:

    Harold Carter, PharmD, is responsible for leading all interactions and contracting with pharmaceutical manufacturers and oversees strategy and management of Express Scripts’ drug formularies, data & insights, client underwriting, and product strategy and development. In his nearly 14 years with the organization, Harold has held numerous leadership roles oriented around critical efforts to lower the cost of prescription drugs and ensuring medication access for Express Scripts clients and members. Harold’s previous responsibilities include oversight of the organization’s medical pharma contracting and drug procurement teams, as well as leading the strategy, development and execution of Express Scripts’ wholesale market, value-based solutions and generic strategy, and development of Express Scripts’ advanced utilization management solutions.

    In addition to his work at Express Scripts, Harold serves on numerous boards including LifeWise Stl Board of Directors, St. Louis University High School Board of Trustees and IVI Board of Directors. Harold earned his doctorate in pharmacy from St. Louis College of Pharmacy.

    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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    41 m
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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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