The Collective Voice of Health IT, A WEDI Podcast

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/

Episode 219- Rethinking Value-Based Care: Why Children Can’t Be Left Behind. Taylor Beery, Imagine Pediatrics

Children make up nearly half of all Medicaid enrollees—37 million nationwide—yet their unique needs are too often overlooked in value-based care models. In this episode, Michael sits down with Taylor Beery, Chief Innovation & Administrative Officer and Co-Founder at Imagine Pediatrics, to explore why pediatric value-based care requires its own distinct strategy. From addressing the needs of 14.5 million children with special health care needs to building trust with families and caregivers, Taylor makes the case that centering children in healthcare reform not only improves outcomes for vulnerable populations but also strengthens the foundation for broader Medicaid and commercial models.

Episode 218- Solving National Data Exchange Issues at the State Level: A Civitas Networks for Health Conversation

From WEDI's 2025 Spring Conference, Civitas Networks for Health Interim CEO Jolie Ritzo welcomes three HIE leaders to discuss how they are addressing various data exchange use cases from their unique state and regional perspectives. The panelists:

Melissa Kotrys, Chief Executive Officer, Contexture (Colorado and Arizona)

Phil Beckett, Chief Executive Officer, Texas Health Services Authority

Stephanie Brown, Executive Director, CRISP DC

Jolie returns to moderate another interesting HIE panel at WEDI's National Conference, November 3-6 in Washington DC and Zoom (virtual pre-conference on October 31). Visit https://members.wedi.org/event-calendar for more information

Episode 217- What's Next? Moving Forward with CMS-0057F

From WEDI's recently concluded Summer Forum, the association's Prior Authorization Sub Workgorup Co-Chairs- Heather McComas (AMA), Janice Bakos (Aetna) adn Michael Lunzer (Itiliti Health)- offer their thoughts on educational resources and open items related to industry implementation of CMS-0057F. WEDI's Executive Director Robert Tennant moderates the conversation. 

Episode 216- Addressing Public/ Private Cybersecurity Collaboration. HCSS Cybersecurity Leadership

From a WEDI virtual spotlight earlier this summer, hosts and WEDI Privacy & Security Work Group Co-Chairs Lesley Berkeyheiser (DirectTrust) and Thanh-Thien Nguyen (Kaiser Permanente) moderate a conversation with Healthcare Sector Coordinating Council Cybersecurity Leadership and cut through the noise on healthcare cybersecurity. The guests, Healthcare Sector Coordinating Council Executive Director of Cybersecurity Greg Garcia and HSCC Cybersecurity Working Group Chair and Vice Chair Chris Tyberg (Abbott) and Dr. Samantha Jacques (McLaren), share the most valuable resources from HSCC, HHS, and others that every organization should prioritize, with practical advice for small providers on staying vigilant and maintaining strong cyber hygiene. We’ll also explore the current healthcare threat landscape, the biggest opportunities and risks on the horizon, and how new legislative efforts may shape the future. Finally, we’ll highlight the urgent need to grow a diverse pipeline of skilled cybersecurity professionals to protect the sector moving forward.

Episode 215: Interoperability Beyond Compliance. Sponsored by Edifecs, a Cotiviti Business

This podcast episode is sponsored by Edifecs, a Cotiviti Business. For over 25 years, Edifecs has been a market leader in healthcare data interchange. Hundreds of health plans, providers, and government agencies rely on their interoperability solutions to unify, normalize, and exchange clinical and financial data. As the healthcare industry has evolved, Edifecs’ solutions have evolved with it. Their cloud-native, AI-powered solutions are designed to help healthcare organizations thrive in value-based care. Learn more about Edifecs at www.edifecs.com

Michael welcomes Matt Spielman, Senior Director of Product Management with Edifecs, to discuss the latest and greatest regarding the industry's ongoing progress with CMS-0057F, the rule aimed at improving prior authorization and interoperability. What is Matt seeing from his customers and others, and what is the present and future of FHIR?

Episode 214: The 411 on LED; Legitimacy, Efficiency, and Development- The Solution to Healthcare Fraud, Waste, and Abuse. Patrick Lane, Health Gorilla

Guest host Denny Brennan (Executive Director, Massachusetts Health Data Consortium and WEDI Board Chair-Elect, welcomes Patrick Lane, President and COO of Health Gorilla. Patrick discusses his recent White House visit for the Make Health Tech Great Again event and addresses the issue of FWA: Fraud, Waste, and Abuse. Patrick sees the solution in the industry embracing LED: Legitimacy, Efficiency, and Development, and offers thoughts on tools and resources that can best be leveraged to achieve this healthcare dream. 

Episode 213- Checklist to Action: How Sequoia Project is Supporting Payers' Preparation for CMS-0057-F

Learn more about the Sequoia Project's CMS0057F Implementation checklist here- https://sequoiaproject.org/interoperability-matters/payer-to-payer-api-workgroup/ 

Michael welcomes back (Episode 174, Oct 2024) the co-chairs of the Sequoia Project's Payer to Payer API Implementation Workgroup, Nancy Beavin (Medica) and Bob Oakley (Evernorth), to discuss their new work product, a downloadable tool designed to help payers assess their readiness for compliance with the payer-to-payer components of CMS-0057-F. Along with the workgroup's project manager, Jim Adamson (Point of Care Partners), Nancy and Bob offer updates on the workgroup meetings, the origin of the checklist, and their plans for the future.