The Collective Voice of Health IT, A WEDI Podcast

Episode 229- Bridging Payers and Providers: Policy, Innovation, and Collaboration for the Future of Care

This episode, from our November National Conference, explores one of healthcare’s most persistent challenges: how hospitals and health plans can move from operating at cross-purposes to truly rowing in the same direction. Our guests are Danielle Lloyd, SVP of Private Market Innovations and Quality Initiatives, AHIP and Molly Smith, Group VP for Public Policy, American Hospital Association.

Led by moderator Stephan Rubin from Optum, Danielle and Molly dig into the misconceptions that providers and payers often hold about each other and discuss how better data transparency, shared incentives, and policy alignment — including recent CMS rules such as 0057F — can help bridge long-standing divides. The 3 examine the future of prior authorization, the promise and limits of interoperability initiatives like TEFCA and the CMS Aligned Network, and why value-based care still struggles to scale despite years of policy focus. Finally, they look ahead to the role of AI, automation, and emerging data standards in reshaping care delivery and payment, and ask what real payer-provider collaboration must look like to deliver a more seamless, efficient, and patient-centered healthcare system.

Episode 228- People, Process, and Performance: Building Resilient RCM Teams, Todd Van Meter, CEO, Accuity

Michael welcomes Todd Van Meter, CEO of Accuity and a 30-year healthcare RCM veteran. Todd shares insights on navigating change in revenue cycle management. From separating AI hype from real ROI to building resilient teams and redefining the patient–provider–payer relationship, Todd offers practical lessons from decades of leading large-scale healthcare operations. A must-listen for anyone shaping the future of healthcare finance.

Episdoe 227- SDOH, Risk Stratification, and the Road to Proactive Care. Mike Hoxter, Lightbeam

In this episode, Michael welcomes Lightbeam Health CTO Mike Hoxter to discuss how advanced analytics and social determinants of health (SDOH) data are reshaping population health management. As organizations deepen their commitment to value-based care, Mike explains how modern risk stratification tools help identify at-risk populations earlier, reduce avoidable costs, and drive more equitable, proactive care. With real-world examples and practical insights, this conversation offers a clear look at what’s working—and what’s next—in population health innovation.

Episode 226- Understanding AI Governance and the Boardroom Through Six Dimensions. JaeLynn Williams

Michael welcomes Jaelynn Williams, former CEO of Air Methods and a respected healthcare and business thought leader. Jaelynn has developed the Board AI Governance Index™, a groundbreaking framework that helps boards assess and strengthen their AI readiness—balancing innovation with accountability.

They explore how this 100-point model gives leaders a structured way to oversee AI risk, capture opportunity, and ensure responsible use of technology in complex, high-stakes environments like healthcare.

Episode 225- WEDI Workgroup Introduction: Patient Experience

From WEDI’s recently concluded National Conference in Washington DC, co-chairs Emma Andelson from the American Medical Association and Anna Hyde from the Arthritis Foundation introduce WEDI’s newest workgroup, Patient Experience.

The workgroup’s primary aim is to embed the patient perspective into healthcare business processes and workflows while elevating the patient voice across WEDI’s broader workgroups and initiatives

Episode 224- Talking AI: Eliminating Administrative Noise and Restoring the Human Connection of Health Care. Ben Scharfe, Altera Digital Health

Michael sits down with Ben Scharfe, EVP of AI at Altera Digital Health, to explore how artificial intelligence is reshaping healthcare. From ambient listening that lightens documentation load to specialty-trained AI agents enhancing decision-making, Ben shares practical examples of what’s working today—and where challenges like clinician resistance and AI “hallucinations” remain. Hear why he believes AI, when implemented thoughtfully, can deliver what clinicians want most: more time with patients and less time with paperwork.

Episode 223- Understanding the Story of the Patient Through Synthetic Data. University of Chicago's Julie Johnson, RN

Michael interviews Julie Johnson, Executive Director of the Center for Research Informatics at the University of Chicago, about synthetic data in healthcare. Julie shares her unconventional career path, which included studying nursing at Georgetown and conducting video game research to improve surgical skills. They discuss the definition, creation, and potential of synthetic data in accelerating research and improving efficiencies, while addressing challenges such as trust and privacy concerns. Julie emphasizes the importance of validating findings with real-world data and explores the future of synthetic data in reshaping medical research and decision-making.

Episode 222- Beyond the Chair: Empowering Patients and Providers Through Dental Data Sharing. Steve Roberts, Vyne

What happens when dental data becomes as accessible and actionable as medical data? Steve Roberts, CEO of Vyne, explores how interoperability can transform the patient experience, equip providers with deeper insights, and strengthen the connection between oral health and overall health.

Episode 221- From Compliance to Intelligence: CMS-0057-F Progress and the Future of AI in Healthcare: Sponsored by MCG Health

This podcast is sponsored by MCG Health, which offers evidence-based clinical guidelines and software tools for healthcare providers and payers. These resources aim to optimize patient care and support care management. Learn more about them at https://www.mcg.com/ 

 

Michael welcomes Raj Godavarthi, MCG’s AVP of Technology and Interoperability to discuss industry progress on payer-provider compliance work on the CMS Final Rule (CMS-0057-F). After that, Michael addresses artificial intelligence with Dr. Jason Gillman, MCG’s Director of Clinical Informatics. Dr. Gillman is currently involved in the NCQA AI Governance workgroup, and he’s MCG’s representative in the “Clinical Decision Support” workgroup at the Coalition of Health AI (or CHAI).

Episode 220- Your DNA, Their Data: Privacy at the Crossroads of Consumer Genetic Testing, WEDI Genomics and Privacy & Security Workgroup Chairs

Michael welcomes 

• Dr. Sandy Rolfe, WEDI’s Genomics Workgroup Chair Clinical Content Lead, InterQual, Optum Insight
• Lesley Berkeyheiser, WEDI's Privacy & Security Workgroup Co-Chair, Assessor with DirectTrust
• Thanh Thien Nguyen, WEDI's Privacy & Security Workgroup Co-Chair, Executive Director, Kaiser Permanente

to discuss their workgroups working together to spotlight the intersection between direct to consumer (DTC) genetic tests and some different privacy and security issues associated with these types of tests. The two workgroups collaborated to develop a Fact Sheet to help consumers take action to protect their data, available here- https://www.wedi.org/2025/07/12/direct-to-consumer-genetic-dna-testing-actions-consumers-can-take-to-protect-their-health-data/ 

Current regulations and requirements Thanh Thien references in the episode

• HIPAA Privacy Rule- https://www.hhs.gov/hipaa/for-professionals/privacy/index.html
• HIPAA Security Rule- https://www.hhs.gov/hipaa/for-professionals/security/index.html
• Genetic Information Nondiscrimination Act of 2008- https://www.govinfo.gov/content/pkg/PLAW-110publ233/pdf/PLAW-110publ233.pdf
• Federal Trade Commission Act- https://www.ftc.gov/legal-library/browse/statutes/federal-trade-commission-act
• California Consumer Privacy Act of 2018- https://oag.ca.gov/privacy/ccpa
• California Privacy Rights Act- https://thecpra.org/
• State Privacy Law Tracker- https://iapp.org/resources/article/us-state-privacy-legislation-tracker/