Move to Value Podcast

In this episode we revisit our conversation with Josh Vire, Vice President of Value-based Operations at CHESS Health Solutions, where he talks about North Carolina’s move to managed Medicaid and the work CHESS put into building a complete all-patient solution. Josh explains what managed Medicaid is, how AMH tiers operate, and the real-world hurdles practices face when entering this space. He also...

In this episode of Move to Value, Emily Volk, Director of Quality, Risk, and Compliance at Northern Regional Hospital, returns to share how her team is navigating the operational realities of Medicaid managed care. From the early challenges of inconsistent documentation and payer confusion to building smarter EMR templates and leveraging care coordination through CHESS, Emily offers a grounded loo...

In this episode, we hear from Emily Volk, Director of Quality, Risk, and Compliance at Northern Regional, headquartered in Mount Airy, North Carolina. With nearly a decade of experience driving high performance in value-based care, Emily shares how her team is now navigating the shift into Medicaid managed care. Learn how a small rural hospital is leveraging strategic partnerships, expanding care...

Discover how clinically integrated networks (CINs) empower physicians, specialists, and pharmacy partners to deliver coordinated, patient-centered care. In this episode, Debi Hueter of WakeMed Key Community Care joins Rebecca Grandy from CHESS Health Solutions to discuss collaboration, trust, and innovation in value-based care. Learn how team-based care models reduce administrative burden, improve...

Today, we're hear a conversation between Rebecca Grandy, Director of Pharmacy at CHESS and Debi Hueter, Executive Director of WakeMed Key Community Care , a clinically integrated network focused solely on primary care. Discover how integrating pharmacy services is transforming provider workflows, reducing emergency visits, and improving patient outcomes.

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 uninsure...

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...

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 metri...

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—eve...

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 downs...

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...

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...

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 anti...

CMS Changes and the Future of Value-Based Care Jennifer Houlihan and Jennifer Gasperini of Advocate Health discuss the impact of new CMS and CMMI leadership, current challenges in value-based care, and the future of ACOs, ECQMs, and Medicare Advantage. A timely conversation for anyone navigating the evolving policy landscape. Welcome to the Move to Value Podcast, powered by CHESS Health Solutions....

In this episode, Kari Curry , Medicaid Care Coordination Hub Supervisor at CHESS Health Solutions, shares how CHESS delivers high-touch, high-impact care management within a Medicaid Clinically Integrated Network (CIN) . Kari walks us through a patient journey that highlights how CHESS uses real-time data from NCHIE , comprehensive social determinants of health (SDOH) screening , and structured ca...

In today’s episode we continue our conversation with  @American_Heart  Senior Advocacy Advisor of Health System Transformation Melanie Phelps, who was integral in the recently published study on the benefit of Accountable Care Organizations. The findings support that managed care provided by ACOs not only improves outcomes for the medically complex patient, but also benefits every patien...

Today we hear from Melanie Phelps, Senior Advocacy Advisor of Health System Transformation for the American Heart Association, who shares with CHESS President, Dr. Yates Lennon, the motivation and detailed findings of a new study conducted by the AHA which found that ACOs provide better care and outcomes for patients and a better practice experience for members of the health care team than traditi...

Today we continue our ACO REACH conversation with Kim Williams, who discusses how this model facilitates enhanced care for the patient. She also shares insights on measuring success, engaging providers, and the broader impact of ACO REACH on healthcare equity and value-based care Thomas Royal Kim Williams, welcome back. Thanks for sticking around so we could continue our conversation here today. K...

In this episode we hear from Kim Williams, Senior Manager of Government Programs at CHESS Health Solutions about the value of ACO REACH. She shares her expertise on what it is, why it was created, and how it benefits the patient and provider by being a care collaboration model that improves quality while incentivizing health equity. Kim Williams, welcome to the Move to Value podcast. Kim Williams...

In today’s episode, we revisit our episode with Josh Vire, Vice President of Value-based Operations at CHESS Health Solutions, where he discussed what has been learned during the move to managed Medicaid in North Carolina and what CHESS brings to the table with its all-patient solution. Josh Vire, welcome to the Move to Value podcast. Thank you, Thomas. Thanks for having me. Pleasure to be here. S...

So as you are well aware, at CHESS we often refer to the seven pillars of value-based care. What are these pillars and how does each impact fee-for-value? So, we’ve tended to use these pillars, if you will, to think about the process. Really, it follows our implementation process in many ways. So, I would start with practice transformation. So, that involves ensuring that physicians, advanced prac...

Let’s start at the very beginning. What is value-based care and why does it matter? So, what is value-based care. I tend to think about population health and value-based care side by side. And, in some ways, it’s value-based care is population health plus a payment structure that you find in value-based care models to create sustainability for those pop health efforts. So, when you think about pop...

Today we’re talking to CHESS Health Solutions own Tammy Yount who shares her experience as a former practice manager and AHEC practice support coordinator to provide insight on why independent primary care providers, their practices, and especially their patients, will benefit from partnering with the right clinically integrated network. Tammy Yount, welcome to the Move to Value podcast. Glad to b...

Today on the podcast, we talk with Rebecca Grandy, Directory of Pharmacy at CHESS Health Solutions, about the connection between diabetes and chronic kidney disease, the populations who are at risk, how to address any concerns, and what tests and interventions are available to the provider. OK, so, Rebecca Grandy, welcome to the move to Value podcast. Could you start by explaining the connection b...

In this episode we hear more from NCAHEC’s Chris Weathington about the inevitable integration of behavioral health and primary care and the need to realign incentives and alleviate some regulatory burdens so practices can find service enhancement opportunities to remain viable and more accessible to the patients they serve. I promised you we would get back to the behavioral health. And so I want t...