Manage episode 512272300 series 2556560
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 [email protected].
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 [email protected] 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.
99 episodes