Medecision Podcast

Many current utilization management processes lack the transparency, speed and interoperability needed to meet current requirements — and the stakes for health plans are rising as CMS-0057 deadlines loom. This podcast breaks down new national research on UM practices across payer organizations, offering a clear-eyed view of what’s working, what’s not and where change is most needed. Leaders will a...

Traditional care management strategies are struggling to keep pace with rising administrative burdens, workforce shortages and increasingly complex member needs. Outdated processes — like relying on phone calls — fail to scale engagement and leave care teams overwhelmed. Health plans are turning to AI-driven technologies, such as co-pilots, to modernize care management. These tools enhance traditi...

As healthcare evolves, the demand for connected, data-driven, and member- and patient-centric systems is at an all-time high. By 2027, 70% of healthcare organizations are projected to adopt digital-first care management strategies, interoperable workflows, and advanced consumer data platforms to empower individuals, enhance experiences, and build trust, according to IDC. When providers are seamles...

While traditional telephonic and modern digital self-service care management approaches are necessary for health plans, what both programs need now are data and insights to create deep contextual awareness of health plan members. To be effective at scale, health plans need the technology and automation to strategically leverage all their data to optimize medical costs, reduce administrative expens...

Discover The importance of platform thinking in overcoming healthcare data challenges Strategies for real-time and flexible data ingestion and integration (the toughest nut to crack) Considerations for building in care intelligence The critical role of sub-second analytics for immediate access to data The benefits of integrating all clinical data sources Solutions for incorporating non-clinical da...

As election year dynamics unfold, the impact on healthcare policy will be significant. This exclusive webinar, presented by Maverick Health Policy and hosted by Medecision, offers you a front-row seat to understand these changes. Our panel of Washington, D.C.-based experts will dissect the latest developments and forecast what these mean for the future of healthcare. Election Year Insights: Gain a...

To manage costs and advance value-based care models, health plans and health systems that take on risk need effective care management and population health programs. However, many legacy tools involved in these efforts are frustrating to use and produce fragmented data, hindering successful cost and quality management. This conversation will examine the current state of care management, including...

The executives examined independent market research that surveyed health plan leaders about the current state of UM and what organizations need to transform both Utilization Management and Care Management. Key findings relative to UM include: - More than half of survey respondents say fragmented data (57%), data that doesn’t flow into UM workflows (55%), and burdensome data integration are the top...

Did you know that, despite 95% of health plan executives stressing the importance of personalization, only a third consider their operations highly personalized? This podcast will examine the results of Medecision's exclusive market research. We will explore the current state of utilization management and care management, the value of a contextually-aware view of members, how personalized exp...

The 2021 Star Ratings Power Hour: Bottom-Line Impact and Strategies was recorded on June 30, 2021. In this episode, Julie Barnes, JD, Founder and Principal of Maverick Health Policy, and Kimberly Swanson, Vice President of Quality and Clinical Integration at Network Health Plan share valuable insights on the new measures and weighting, and ideas for optimizing your technology tools while implement...

In this episode, Julie Barnes, JD, Founder and Principal of Maverick Health Policy, shares valuable insight into the prior authorization rule affecting utilization management and what health plans and healthcare providers should be considering as policies evolve. 

In this episode, we bring together healthcare leaders with vast experience in caring for and engaging underserved and vulnerable populations.  Our experts include Dr. Jan Berger, founder and CEO of Health Intelligence Partners, Jesse Thomas, CEO of Healthy Blue, and Dr. Terri Steinberg, Medecision’s group senior vice president of analytics and population health and chief medical officer.  Facilita...

In this episode, we bring together some of the most thoughtful and visionary healthcare policy experts for an engaging executive-level discussion about post-election policy implications for the healthcare industry.   Our expert guests include Colin Roskey, Principal and Partner at Lincoln Policy Group, and Krista Drobac, the founder of Sirona Strategies.  Facilitated by Julie Barnes, founder and P...

In this episode, we speak with health economist, advisor, trend weaver, and author, Jane Sarasohn-Kahn. Jane shares the major trends she’s seeing as COVID reshapes health consumer behavior, including virtual health adoption, digital transformation in all aspects of our lives, and keeping “health at home.” She also analyzes some of the toxic side effects of the pandemic, such as rises in loneliness...

In this episode, we invite Lynne Dunbrack, Group Vice President at IDC Health Insights, and ChristianaCare CareVio leaders Nicole Masci and Barb Gillis to share their expert insight into virtual care in the “new normal” and best practices for creating and optimizing a patient or member virtual engagement program. Click here to download your complimentary Guide to Starting or Accelerating Your Virt...

In this episode, Medecision President and CEO Deb Gage facilitates a roundtable discussion about virtual health with healthcare leaders Dr. Janice E. Nevin, President and CEO of ChristianaCare, and Karen L. Hanlon, Executive Vice President and Chief Operating Officer of Highmark Health. Our guests discuss the value-based care and virtual health programs that they have created, and how the pandemic...

Game Changing Strategies for Virtual Health was recorded on September 21st, two-thousand-twenty during the Modern Healthcare Virtual Health Summit. In this episode, Medecision leaders Deb Gage and Rick Koloski , along with Dr. Terri Steinberg, the Chief Health Information Officer and Vice President of Population Health Informatics at ChristianaCare, share practical business advice for transforming...

In this episode, special guest Dr. Terry McInnis joins us to talk about what we’ve learned about the coronavirus, since she spoke with us back in April.  Terry began her career as a physician in the Air Force, and has since held many roles as chief medical director and chief medical officer at large and small companies, including GE, Michelin, Glaxo, and most recently, leading the value-based care...

Facilitated by Ellen Dalton, Medecision’s Executive Vice President and Chief Marketing and Customer Experience Officer, and our special guest, Dr. Shoshana Ungerleider, this episode explores how the COVID-19 pandemic is affecting and changing end-of-life decisions, patient and care team dynamics, palliative care choices, and grief and mourning. Dr. Ungerleider is an internal medicine physician foc...

In this episode, we spoke with Babette Apland, the Managing Director of Call to Mind, the initiative from American Public Media and Minnesota Public Radio focused on fostering an open conversation about the importance of mental health, particularly during this time of unprecedented change and unknowns.  At Call to Mind, Babette leads a national initiative to measurably raise the public’s awareness...

In this episode, Julie Barnes, Founder and Principal of Maverick Health Policy, and a health care policy expert with years of experience helping the private sector navigate federal government activities that impact the health care system, discusses the evolving CMS quality measurement guidance due to the COVID-19 pandemic, and the implications it may have for all of the stakeholders in healthcare.

In this episode, Dr. Carolyn Smith discusses the principles of bioethics during the COVID-19 pandemic, the public health code of ethics, and triage and the allocation of scare resources. She examines the ethics of research, end of life issues, and moral distress facing everyone involved in this pandemic. 

In this episode, Medecision Advisory Board Chair, Dr. Richard Popiel, examines some of the early trends that may define our new normal, and highlight how the healthcare industry - and society at large - are likely to look fundamentally different in a post-COVID world.

In this episode, A Discussion About Novel Coronavirus – Facts, Lessons and a New Revolution, our Executive Vice President and Chief Marketing and Customer Experience Officer Ellen Dalton facilitates a conversation with Medecision Advisory Board member, Doctor Terry McInnis.

Doctor Jan Berger gives us some thought-provoking perspectives around what Population Health looks like during, as well as after the COVID-19 pandemic, and what that may mean for the healthcare ecosystem.