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Healthcare is Hard: A Podcast for Insiders

Business & Economics Podcasts

Healthcare is Hard: A Podcast for Insiders views healthcare transformation through the lens of prominent leaders across the industry. Through intimate one-on-one discussions with executives, policy advisors, and other “insiders,” each episode dives deep into the pressing challenges that come with changing how we care for people. Hear the unique perspectives of these industry leaders to get a better understanding of what is happening today, the challenges across the healthcare ecosystem, and how innovation is really shaping the future of healthcare delivery.

Location:

United States

Description:

Healthcare is Hard: A Podcast for Insiders views healthcare transformation through the lens of prominent leaders across the industry. Through intimate one-on-one discussions with executives, policy advisors, and other “insiders,” each episode dives deep into the pressing challenges that come with changing how we care for people. Hear the unique perspectives of these industry leaders to get a better understanding of what is happening today, the challenges across the healthcare ecosystem, and how innovation is really shaping the future of healthcare delivery.

Twitter:

@LRVHealth

Language:

English


Episodes
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Lessons from Public Sector Leadership: Former CMS Administrator and FDA Commissioner, Dr. Mark McClellan

10/16/2025
Dr. Mark McClellan has served as a Member of the President’s Council of Economic Advisors, Administrator of the Centers for Medicare & Medicaid Services (CMS), and Commissioner of the U.S. Food and Drug Administration (FDA). But his experiences before, and accomplishments following these leadership roles at the highest levels of government health policy are equally important to his perspective on the healthcare ecosystem – especially during a time of rapid policy change. Dr. McClellan always intended on pursuing a medical degree and entered a joint Harvard-MIT program that took him in a slightly different direction. He ended up studying economics and the rising cost of healthcare at MIT. He ultimately earned a medical degree from the Harvard-MIT Division of Health Sciences and Technology, a Ph.D. in economics from MIT, and a master’s in public administration from Harvard’s Kennedy School. Dr. McClellan began his career at the Treasury Department in the Clinton Administration, and returned to public service under the George W. Bush Administration where he led the FDA and CMS. Today, Dr. McClellan is the Robert J. Margolis, M.D., Professor of Business, Medicine and Policy at Duke University and the founding Director of the Duke-Margolis Institute for Health Policy. His work centers on improving health care through policy and research, with a focus on payment reforms, quality, value, and biomedical innovation. With his expertise in medicine, economics and public policy, Dr. McClellan talked to Keith Figlioli in this episode of Healthcare is Hard to share his perspective on adapting to rapid change in the current healthcare landscape. Topics they discussed include: Misalignment of innovation and outcomesThe evolution of value-based careMobilizing private capital for public healthTo hear Dr. McClellan and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:48:10

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Emerging Technologies (Part 3): Microsoft’s Chief Architect for Health on the Saga of Interoperability and AI

9/18/2025
Dr. Josh Mandel says his first love was software. But on a whim, while studying computer science and software engineering at MIT, he took a course that opened his eyes to the world of medicine and genetics. It changed the trajectory of his career away from software – but only temporarily. He entered medical school after earning a bachelor’s degree in computer science and began rotating through Boston-area hospitals at the same time Meaningful Use accelerated adoption of electronic health records. With a background in computer science and training as a physician, Josh understood the promise of EHRs, how medical professionals would actually use them, and how to make them better. Based on his unique combination of expertise, Josh took it upon himself to begin making improvements to the systems at the hospital where he worked. Nearly two decades later, Josh is now Chief Architect for Health at Microsoft Research. In this role, he focuses on developing an ecosystem for health apps with access to clinical and research data, leading standards development for data access, authorization, and app integration. For the third and last episode in this Healthcare is Hard series, Keith Figlioli spoke to Josh about data interoperability and emerging technologies. This conversation follows previous episodes with Epic’s head of R&D, Seth Hain in Part 1, and the Interoperability Practice Lead at HTD Health, Brendan Keeler – also known as the “Health API Guy” – in Part 2. Some of the topics Keith and Josh discussed include: The standards landscapeHow AI flips the script on standardsAdvice for startupsTo hear Dr. Mandel and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:48:06

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Emerging Technologies (Part 2): Past, Present & Future of Healthcare Interoperability with HTD Health's Brendan Keeler

8/21/2025
Brendan Keeler’s path into healthcare interoperability has been anything but straightforward. After early stints implementing Epic in the U.S. and Europe, he helped hundreds of startups connect to provider and payer systems at Redox, Zus Health and Flexpa before taking the reins of the Interoperability Practice at HTD Health. Along the way, his Health API Guy blog turned dense policy updates into plain-language guides, earning a following among developers, executives and regulators. In this episode, Keith Figlioli sits down with Keeler to examine the “post-Meaningful-Use” moment. They discuss how national networks like Carequality and CommonWell solved much of the provider-to-provider exchange problem, only to expose new gaps for payers, life-science firms and patients. Keeler says the real action right now is in three places where the biggest, most dramatic changes are about to happen: Antitrust pressure on dominant EHRs.Information-blocking enforcementA CMS-led shift from policy to executionKeeler’s optimism is pragmatic. AI agents may someday chip away at entrenched EHR “data gravity,” but real progress, he says, will come from steady, bipartisan layering of HIPAA, Cures Act and TEFCA foundations. He also pushes back on venture capital’s “system-of-action” thesis. Enterprise EHRs remain sticky because switching costs—massive data migration and workflow retraining—are measured in decades, not funding cycles. AI could reduce these problems, but only slowly and only if underpinned by trusted exchange standards. Zooming out, Keeler describes a policy arc that starts with provider-to-provider exchange, widens to payer and patient access, and ultimately points toward a nationwide digital ID that could streamline consent and credentialing. For innovators, his north star is clear: build for identity-verified, standards-based exchange; assume open APIs will become table stakes; and judge success by the friction you subtract from everyday care—not by how flashy the demo is. To hear Brendan Keeler and Keith unpack these issues, listen to this episode of Healthcare is Hard: A Podcast for Insiders. Please note that this episode was recorded earlier this summer, before the CMS meeting, and that some developments have occurred since then.

Duration:00:49:12

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Emerging Technologies (Part 1): Inside Perspectives from Epic’s Seth Hain

7/17/2025
Seth Hain has spent two decades at Epic, watching the electronic health record evolve from digital filing cabinet to care-delivery platform. Now he thinks the entire stack of software is being re-imagined, only this time it isn’t mobile or cloud driving the change, but generative AI. In a conversation with Keith Figlioli, Hain explains how new tooling, cheaper compute and larger context windows are pushing healthcare toward an “agentic” era, where software can collect context, ask clarifying questions, and tee up next-best actions before the clinician even walks into the room. He argues that the real breakthrough isn’t documentation speed-ups, but the chance to embed a learning health system directly into daily workflows. Central to that vision is Cosmos—a dataset of 15 billion encounters from more than 250 health systems that is already powering condition-specific growth charts and real-world evidence studies. The next step: piping those insights back to the bedside at scale. Yet technology alone won’t deliver. Hain and Figlioli dig into: A real “health grid” is starting to formAgentic AI is rewriting the user interface, not just speeding up notesAI as a Force Multiplier for a Shrinking Workforce. Throughout, Hain balances optimism with realism: the models are improving fast, but value will hinge on measurable outcomes, thoughtful deployment, and collaboration across an industry that often works in silos. To hear Seth Hain and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:49:02

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How a Tech-Minded CEO Sees the Future: CareFirst’s Brian D. Pieninck on Medicare, Medicaid & the AI-Driven Inflection Point in Healthcare

6/19/2025
Brian D. Pieninck didn’t take a conventional path to healthcare leadership. He started his career as an 18-year-old IT contractor and spent two decades working across the industry before becoming President and CEO of CareFirst Blue Cross Blue Shield. He now also serves as Chair of the Blue Cross Blue Shield Association, bringing both local and national perspective to the role. In this episode, Keith Figlioli speaks with Pieninck about what it means to lead a not-for-profit regional payer at a time of seismic change. With 3.6 million members and coverage that spans commercial, Medicare, and Medicaid, CareFirst has become a vital part of healthcare access and infrastructure across the Mid-Atlantic. Pieninck reflects how demographic shifts, rising costs, and policy uncertainty are challenging how healthcare organizations evolve, while staying focused on long-term outcomes. Pieninck and Keith discuss: Advancing health equity as part of the community.Medicaid coverage and its downstream impactThe balloon effect in healthcare financingInnovation that simplifies the systemAI and infrastructure: opportunity meets readinessThis episode offers a look at how one regional plan is thinking through the tensions between access, affordability and innovation, and what that means for the broader system. To hear Brian D. Pieninck and Keith discuss these challenges in depth, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:45:17

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Medicaid Uncovered (Part 1): Decoding the System

5/15/2025
Kody Kinsley has been called many things—operator, innovator, Medicaid “nerd”—but above all, he’s a fierce advocate for the health and well-being of the populations Medicaid serves. Now a senior advisor at the Milken Institute and recently North Carolina’s Secretary of Health and Human Services, Kinsley joins Keith Figlioli for a wide-ranging conversation about how Medicaid works, why it matters, and where innovation is reshaping its future. A native of North Carolina, Kinsley brings personal experience and professional depth to his perspective. Growing up uninsured, he watched his mother navigate pediatric clinics, sliding-scale providers, and supply closets offering free samples to keep her kids healthy. That formative exposure ultimately propelled him into a career spanning healthcare operations, behavioral health, public policy, and government leadership. As North Carolina’s health secretary, Kinsley led one of the country’s largest and most complex human services agencies, overseeing everything from Medicaid operations and public health to psychiatric hospitals and child welfare. He played a central role in advancing Medicaid expansion in the state—an achievement shaped by bipartisan negotiation, careful balancing of federal and state resources, and a deep understanding of the healthcare landscape. In this episode, Kinsley and Keith cover: To hear Kody Kinsley and Keith Figlioli unpack these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:44:57

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Where Medicare Stands—And Where It’s Headed with Aetna’s Dr. Ali Khan

4/29/2025
Dr. Ali Khan has spent his career at the intersection of medicine, public policy, and value-based care. He’s also been at the forefront of some of the country's most innovative care delivery models—from Iora Health and CareMore to Oak Street Health and now Aetna, where he serves as Chief Medical Officer of Medicare at Aetna, a CVS Health company. In this episode, Keith Figlioli sits down with Dr. Khan for a conversation about Medicare’s future—and what it will take to make the promise of better, more affordable healthcare a reality. A general internist by training, Dr. Khan’s path into healthcare began with a deep curiosity about the broader systems shaping people’s health. That curiosity took him from Harvard Kennedy School to the exam room to health plans and startups focused on reimagining the primary care experience for complex, underserved populations. Throughout his career, he’s gravitated toward organizations trying to solve public-sector problems with private-sector solutions—building care models that prioritize trust, access, and long-term outcomes. Now at the helm of a Medicare Advantage program serving 4.2 million members, Dr. Khan brings a unique vantage point. In this conversation, he shares hard-earned lessons on care model design, what payers and providers need from each other, and why Medicare is at an inflection point. He makes a compelling case for a renewed focus on the fundamentals—not just risk adjustment or benefit design, but operational follow-through, last-mile care coordination, and culturally grounded team-based models that scale. Dr. Khan and Keith discuss: As Dr. Khan notes, we’re entering a “put up or shut up” era for Medicare Advantage, where scrutiny is high and proof points matter. Yet within that pressure lies opportunity—particularly for those willing to do the unglamorous work of identifying barriers, building connective tissue, and supporting clinical teams in the trenches.

Duration:00:49:25

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Opportunities in Oncology (Part 3): Getting Deep Into Patient Care with Mass General Brigham’s Head of Radiation Oncology

3/20/2025
The first two episodes in this Healthcare is Hard podcast series on “Opportunities in Oncology” explored the relationship between academic medical centers and community care, with guests Dr. Stephen Schleicher from Tennessee Oncology, and Dr. Harlan Levine from City of Hope. For the third and final episode in the series, Dr. Daphne Haas-Kogan joined Keith Figlioli for a conversation that dives more deeply into patient care, innovations in care delivery and the opportunities for entrepreneurs. Dr. Haas-Kogan is Chair of the Department of Radiation Oncology at Mass General Hospital, Brigham and Women’s Hospital, and Boston Children’s Hospital. She is also the Willem and Corrie Hees Family Professor of Radiation Oncology at Harvard Medical School. Dr. Haas-Kogan received her undergraduate degree in biochemistry and molecular biology from Harvard University and her medical degree at UCSF. She completed her residency in radiation oncology at UCSF in 1997 and became vice-chair for research at UCSF in 2003, and educational program director in 2008. Dr. Haas-Kogan’s laboratory research focuses on molecular underpinnings of brain tumors and pediatric cancers. She leads large multi-institutional initiatives funded by NIH/NCI, philanthropic organizations, and industry collaborators. For this episode of Healthcare is Hard, some of the topics Dr. Haas-Kogan discussed with Keith include: The collaborative approach to careThe precision of radiation oncology.AI in oncologyTo hear Dr. Haas-Kogan and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:37:19

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Opportunities in Oncology (Part 2): Balancing Cutting-Edge Research and Community Care

2/20/2025
Dr. Harlan Levine began his career practicing internal medicine but soon moved into business leadership roles at national healthcare organizations to help improve the dysfunction with payer-provider relationships that he experienced firsthand as a physician. At United Health Group, Dr. Levine joined as clinical lead of the team that launched Optum, where he subsequently served as chief medical officer for more than six years. He also led the health management practice at Towers Watson and served as executive vice president of comprehensive health solutions at WellPoint, among other roles. In 2013, Dr. Levine joined City of Hope, one of the country’s largest and most advanced cancer research and treatment organizations. City of Hope’s uniquely integrated model spans cancer care, research and development, academics and training, and a broad philanthropy program that powers its work. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and cancer treatment centers and outpatient facilities in the Atlanta, Chicago and Phoenix areas. In addition to currently serving as president of health innovation and policy at City of Hope, Dr. Levine is also chair of the board of AccessHope. A spinout from City of Hope, AccessHope partners with the nation’s most prestigious cancer research centers to help make leading-edge cancer care available to all, regardless of geographical location. Dr. Levine joined Keith Figlioli for the second episode of a Healthcare is Hard series exploring opportunities in oncology. Some of the topics they discussed include: Community practice vs. academic medical centersfirst episode of this series, Dr. Stephen Schleicher from Tennessee OncologyDefining value in oncologyAI in oncologyTo hear Dr. Levine and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:40:47

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Opportunities in Oncology (Part 1): The Intersection of Clinical Care, Business and Policy

1/23/2025
There’s been a massive gap in oncology where people who have been responsible for a dramatic increase in the standard of care have lacked a solid understanding of the business, payment and policy constructs required to deliver it. Dr. Stephen Schleicher has spent the early part of his career working to fill that gap. Dr. Schleicher entered medical school with an interest in oncology, anchored by an appreciation for the psychological toll cancer can have on a person, their family and caregivers that he gained from parents who were both psychologists. During his internal medicine residency at Brigham and Women’s Hospital, Dr. Schleicher also worked at McKinsey and earned his MBA at Harvard Business School as part of a fully-funded fellowship. Through this combined experience, he started to develop a niche in the oncology space where clinical, business and policy decisions intersect, at a time when value-based care was just starting to gain momentum. After a fellowship at Memorial Sloan Kettering Cancer Center, Dr. Schleicher joined Tennessee Oncology, one of the nation’s largest community-based cancer care practices, and shortly after became medical director of value-based care at OneOncology, a large community oncology network founded by Tennessee Oncology that spans multiple states. He subsequently returned his focus to Tennessee Oncology where he served as chief medical officer for two years and still practices as a breast cancer medical oncologist. Dr. Schleicher is also a board member and executive committee member at the Community Oncology Alliance. To set the stage for a Healthcare is Hard series focused on Oncology, Dr. Schleicher talked to Keith Figlioli about both the clinical and business trends influencing cancer care. Topics they discussed include: Community providers vs. health systemsOncology’s cost center.The value based care dilemma. To hear Stephen and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:48:19

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Election Implications (Part 4): Forecasting For Healthcare As The Second Trump Administration Takes Shape

12/12/2024
Elements of the new Trump administration are coming into focus as announcements of key healthcare appointments and nominations provide indications for what the market can expect starting in January. To dissect the impact these changes might have, Wall Street Analyst Jeff Garro joined Keith Figlioli to wrap up a four-part series of episodes on election implications. Previous episodes featured conversations with JP Morgan’s Lisa Gill, Canaccord Genuity’s Richard Close, and Maverick Health Policy’s Julie Barnes. Jeff Garro is Managing Director and an equity research analyst covering Healthcare IT for Stephens, a family of privately held, independent financial services firms founded in 1933 that’s focused on building value for companies, state and local governments, institutions and high-net-worth investors. Prior to joining Stephens in September 2022 Jeff held research analyst roles at Piper Sandler and William Blair. During this conversation, Jeff discussed the policy changes and broader market signals he’s watching to advise clients on investments in the healthcare IT market. Some of the topics he discussed with Keith include: Balance in management teamsPredictions by payer typePublic vs. private marketsThe post-COVID resetTo hear Jeff and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A

Duration:00:36:09

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Election Implications (Part 3): JP Morgan’s Read on Trump 2.0 and What’s Next for Healthcare

11/21/2024
Healthcare was not a major focus during the 2024 election where other key issues drove most of the discussion. This left a vacuum around specific healthcare policies and what to expect from a second Trump Administration. With few details available and political capital to spend from the ‘red sweep’ this election, healthcare stakeholders are pondering how much of the incoming administration’s preference for disrupting the status quo will extend to the healthcare industry. For the third episode in a four part series on election implications – and the first one since votes were counted and winners declared – JP Morgan analyst Lisa Gill joined Keith Figlioli on the Healthcare is Hard podcast to analyze the outcome. Lisa has more than three decades of healthcare industry experience and has spent most of her career at JP Morgan where she has been covering the healthcare services industry for the last 27 years. In this episode, Keith talked to Lisa about the lessons she’s learned covering healthcare for several decades, and asked her to share her outlook for what to expect in the months and years ahead. A few of the topics they discussed include: Cycles of innovationConsolidation and diversificationOptimism for managed carePreviewing the 43rd Annual JP Morgan Healthcare ConferenceTo hear Lisa and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:45:44

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Election Implications (Part 2): This Wall Street Analyst Agrees, “Healthcare is Hard”

10/30/2024
With the White House and Congress up for grabs this election, anticipation in the healthcare industry is high. Shifts in healthcare policy will influence how care is paid for and delivered, which will of course influence the flow of investment dollars in both public and private markets. During the first episode of a four-part series on election implications, beltway insider Julie Barnes laid out potential scenarios for the direction healthcare policy might take depending on election outcomes. With that background, Part 2 of the series zooms in on healthcare investing. For more than 20 years – and now six presidential election cycles – Richard Close has covered the healthcare space as a Wall Street analyst. He was one of the first analysts covering healthcare technology and as Managing Director, Digital and Tech-Enabled Health Equity Research at Canaccord Genuity, he focuses on introducing the investment community to disruptive and innovative companies that are leading the digital transformation in healthcare. In this episode of Healthcare is Hard, Richard talked to Keith Figlioli about the election and how it could impact investments in the healthcare sector. A few of the topics they discussed include: Predictions on prioritiesContrasts in public vs. private marketsOptimism for health techTo hear Richard and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:30:42

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Election Implications (Part 1): Angst, Uncertainty and an Urge for Calm from Maverick Health Policy’s Julie Barnes

9/26/2024
Julie Barnes has made a career helping health plans, tech vendors, investors and others in the healthcare space decipher health policy. She’s a former Hill staffer who earned her law degree and spent a decade in corporate law serving healthcare clients before moving to policy think tanks, business consulting, and founding Maverick Health Policy. At Maverick, she provides strategic advice on federal health policy to private companies and industry coalitions, with particular focus on health data and value-based care. With the U.S. presidential election less than two months away, Julie is kicking off a series of Healthcare is Hard episodes that will explore the implications of the shifting power structure in Washington. Next year, there will be a new administration and a new makeup of the U.S. Congress – that much is certain. How these changes will impact health policy and healthcare investing in public and private markets is a much bigger question. During the next few episodes, both before and after votes are cast in November, Keith Figlioli will shed light on these topics with an expert panel of guests. A few of the topics Keith and Julie discussed during the first episode of this series include: The alphabet soup of healthcare policyAI changing everythingWhite House hysteriaTo hear Julie and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:45:42

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What’s the Difference Between Innovation and Performance Improvement?

8/29/2024
OSF HealthCare stands as a model health system for those who want to do innovation right. One of the defining characteristics of the Peoria, Illinois-based system is how it aligns innovation with operations for everyone – all 24,000 employees across 159 locations, including 16 hospitals. Becky Buchen is responsible for driving innovation at OSF HealthCare. As SVP of Innovation Operations she works to engage and educate people on the innovation process, leveraging the eco-system for innovation built at OSF, including simulation, analytics, OSF Ventures, Innovation Studio, Digital Innovation Development and Performance Improvement. Becky’s background in performance improvement has been a major influence in OSF HealthCare’s approach to innovation. Prior to her role leading innovation, she served as VP of Performance Improvement where she focused on implementing methodologies to monitor, assess and improve patient experience, patient outcomes, and overall operations. In this episode of Healthcare is Hard, Becky talked to Keith Figlioli about how OSF HealthCare formalized its vision for innovation more than a decade ago and the thoughtful approach to ensuring that it would be fully integrated – not simply a “bolt on.” The goal was to truly make an impact and transform how care was delivered across the organization, and to do so, OSF HealthCare recognized that it had to apply the same level of rigor for exploring, testing and measuring innovation initiatives as it historically had to performance improvement. In her conversation with Keith, Becky discussed specifics about OSF HealthCare’s approach to innovation that both digital health entrepreneurs and other health systems can learn from. Some of the topics they discussed include: Integrating innovation into cultureWhat health systems are getting wrong (and right)Retooling and reskilling due to artificial intelligenceTo hear Becky and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:38:00

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Help or Harm? How CHAI is Mitigating the Risk of AI in Healthcare

7/18/2024
With great power comes great responsibility and in healthcare, those words may have never held more meaning than they do with the advent of artificial intelligence. AI most certainly has the power to transform healthcare, and those in the industry working to develop and use it have an immense responsibility to shape principles that ensure these technologies help, not harm. The Coalition for Health AI (CHAI) was created with a mission to be the trusted source of responsible AI in health that serves all. CHAI was founded in early 2021 by a small group of industry stakeholders and has quickly grown to now encompass more than 2,500 participants representing health systems, technology providers, government agencies, advocacy groups and others. Dr. Brian Anderson is one of CHAI’s co-founders and now serves as its first CEO. Before CHAI, Dr. Anderson was the Chief Digital Health Physician at MITRE, a nonprofit corporation that manages federally funded research and development centers (FFRDCs) supporting various U.S. government agencies. At MITRE he led research and development efforts across major strategic initiatives in digital health alongside industry partners and the U. S. Government. Prior to MITRE, Dr. Anderson led the Informatics and Network Medicine Division at athenahealth. He has also served on several national, and international, health information technology committees in partnership with the Office of the National Coordinator (ONC), the National Institutes of Health (NIH) and the Organization for Economic Cooperation and Development (OECD). In this episode of Healthcare is Hard, Keith Figlioli spoke with Dr. Anderson about the origins of CHAI, its intended role ensuring responsible use of AI in healthcare, and the complex issues already emerging as the industry navigates the early stages of AI adoption. Some of the topics they discussed include: Aligning AI with valuesAI assurance.Giving everyone a voiceTo hear Dr. Anderson and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:54:30

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Live from DHIS East: Mass General Brigham CIO, Christopher Coburn

6/20/2024
Chris Coburn has been driving health system innovation for decades. He is currently chief innovation officer at Mass General Brigham (MGB), the nation’s largest academic research enterprise with over $16 billion in annual revenue, 1.5 million patient visits and more than $2.4 billion in research expenditures. MGB also has a managed care organization, out-patient facilities and community hospitals. 7,000 of its faculty are appointed at Harvard Medical School. As head of innovation, Chris leads a team of nearly 150 people tasked with the worldwide commercial application of the unique capabilities and discoveries of Mass General Brigham’s 85,000 employees. His unit’s business development responsibilities include investing, company creation, international consulting, innovation management, industry collaborations, and licensing. Commercialization revenue exceeds $160 million annually and more than 300 companies have been spun-off from Mass General Brigham in the last decade. Prior to joining Mass General Brigham, Chris was founding director of Cleveland Clinic Innovations and served for 13 years as its executive leader. During his tenure, Cleveland Clinic spun off 57 companies that raised more than $700 million in equity financing. There were none before his arrival. In this special episode of Healthcare is Hard, recorded live at the Digital Health Innovation Summit (DHIS) in Boston, Keith Figlioli led a keynote discussion with Chris about the current state of healthcare innovation. Some of the topics they discussed include: Embracing innovation from inside and outside of MGBCorporate venture capital in healthcareGetting operators to embrace digital innovationTo hear Chris and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:44:17

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Reinventing Pharmacy (Part 3): Optum Rx CEO, Dr. Patrick Conway, Brings the PBM, Provider and Payer POV

5/23/2024
Optum Rx serves more than 62 million people, processes 1.6 billion prescriptions and generates more than $110 billion of revenue annually. Dr. Patrick Conway, CEO of Optum Rx, is the third and final guest in a series of Healthcare is Hard episodes exploring the transformation of the pharmacy business – following conversations with Mark Cuban and Dr. Troyen Brennan. Dr. Conway brings an expansive view of the healthcare system to this discussion and his role leading one of the most influential organizations in the pharmacy space. He became CEO of Optum Rx in August 2023 and before that, served as CEO of Care Solutions at Optum for more than three years. He was president and CEO of Blue Cross and Blue Shield of North Carolina for two years and spent more than six years at the Centers for Medicare and Medicaid Services where he held several positions including Chief Medical Officer, Director of CMMI, and Deputy Administrator for Innovation and Quality. Before joining CMS, he oversaw clinical operations and quality improvement at Cincinnati Children’s Hospital Medical Center, and he is still a practicing pediatrician in Boston where he occasionally works at an area medical center on weekends. Some of the topics Dr. Conway discussed with Keith Figlioli in this episode of Healthcare is Hard include: VBC – A way or THE wayAffordable innovationChoice and transparencyTo hear Dr. Conway and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:40:32

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Reinventing Pharmacy (Part 2): Dr. Troyen Brennan Disputes the False Narrative of Good vs. Bad Actors

4/18/2024
In the first of a series of episodes exploring opportunities for innovation in the pharmacy space, Mark Cuban offered perspective from an outsider intent on disrupting the status quo. In this, the second episode, Dr. Troyen Brennan gives an insider point-of-view from someone who has studied and worked in the space for decades. Dr. Brennan was Chief Medical Officer at CVS Health for nearly 14 years, and before that, Chief Medical Officer at Aetna for two years. He was also a practicing physician at Brigham and Women’s Hospital for 15 years where he was president of Brigham and Women’s Physician Organization. During that time, he was also Professor of Medicine at Harvard Medical School and Professor of Law and Public Health at the Harvard T.H. Chan School of Public Health. He is the former Chair of the American Board of Internal Medicine and has published six books and more than 600 articles offering his insight into the American healthcare system, and his ideas on how to improve it. With extensive knowledge of how the industry has evolved, and an understanding for why many of the complexities in the industry exist, Dr. Brennan offers a unique viewpoint about where and how disruption in the pharmacy space can succeed. In his eyes, the idea of good and bad actors in the pharmacy space is a false narrative. With an historical perspective, he explains how industry processes were all sensible when they were first implemented, and how that viewpoint is critical to understanding and addressing some that may have become seemingly senseless over time. A few of the topics he discussed with Keith Figlioli in this Healthcare is Hard episode include: Six ways PBMs have lowered cost.Flexibility of PBMs. The path to greater affordability.To hear Dr. Brennan and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:42:49

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Reinventing Pharmacy: Mark Cuban Says Trust Is Missing Across Healthcare. Here’s What He’s Doing About It

3/21/2024
Mark Cuban built a career disrupting industries and creating new ones. Now, his sights are set on healthcare. There’s no secret ingredient to Mark’s success. As the world sees very publicly on Shark Tank, his style is the opposite of keeping secrets. It’s based on providing respectful, but direct, honest and unvarnished opinions. He’s bringing that style to healthcare in order to inject what he says the industry is lacking most. Trust. To kick-off a series of Healthcare is Hard podcast episodes that will dive deep into all aspects of reinventing the pharmacy space, Keith Figlioli sat down with Mark to discuss his vision and strategy behind Mark Cuban Cost Plus Drug Company, and many other healthcare-related topics. With Cost Plus Drug Company, Mark is bringing radical transparency to what he says is the most opaque industry he’s ever been involved in. He’s doing it by pricing every single product the same way – the cost of a drug, plus 15% markup, plus pharmacy fee (if any), plus shipping – and publishing these details for everyone to see. Through this model, Mark aims reduce costs and improve access to drugs, while rebuilding trust in the industry. With 2,400+ drugs now available, he’s off to a fast start and talked to Keith about other evolving elements of the business including wholesale operations for providers, partnerships with grocery and pharmacy chains, and more. Some of the other topics Keith and Mark discussed include: The Netflix model for specialty drugs.Transparent, direct contracting. Millions of AI models.To hear Mark and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Duration:00:43:34