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RISE Radio

Ilene MacDonald

Join the RISE team as we chat with industry leaders and explore ever-changing policies, regulations, and challenges faced by health care professionals in our three communities: Quality & Rev...

Episodes

20 of 34 episodes

Episode 34: The health care quality shift: Always-on, digital, and connected

The rules of health care quality are changing fast, and the biggest shift is simple to say but harder to execute. Our latest episode focuses...

33:14Sep 10, 2026

Episode 33: 5 trends shaping value-based care in 2026

In our latest episode, we break down the biggest findings from Reveleer's "The State of Technology in Value-Based Care 2026," a report based...

26:48Aug 31, 2026

Episode 32: Flex cards and SSBCI changes under the 2027 MA Final Rule

In this episode of RISE Radio, we share an excerpt from the April 29 RISE webinar featuring Ana Handshuh, principal at CAT5 Strategies, and...

25:06May 12, 2026

Episode 31: The 5 skills every health leader needs to succeed in value-based care

Dawn Carter, senior director of health policy and regulatory affairs at Centauri Health Solutions, joins RISE Radio for a lively discussion...

60:02Mar 12, 2026

Episode 30: Navigating the shift to prospective risk adjustment with hybrid AI

In this 20-minute episode of RISE Radio, Editorial Director Ilene MacDonald sits down with Dr. Matt Lambert, the former chief medical office...

20:11Feb 13, 2026

Episode 29: Agile Engagement: A Cost-Effective Path to Better Member Behavior

Join RISE Radio Editorial Director Ilene MacDonald for this 15-minute episode that explores how agile engagement replaces slow, campaign-cen...

15:51Feb 5, 2026

Episode 28: Inside the 2027 MA and Part D Proposed Rule: Star ratings, equity, and what plans must do next

In this hour-long episode of RISE Radio, Editorial Director Ilene MacDonald sits down with industry experts to break down the changes in CMS...

57:36Dec 5, 2025

Episode 27: Innovation roadmap: Cotiviti on a proactive approach to risk adjustment

As regulatory pressures intensify and the demand for measurable ROI grows, health care organizations are rethinking how they approach risk a...

38:20Nov 20, 2025

Episode 26: What to know about the new era of RADV audits

Medicare Advantage plans are about to face unprecedented scrutiny as the Centers for Medicare & Medicaid Services (CMS) implements a dramati...

17:10Sep 9, 2025

Episode 25: The political shift: How Medicare Advantage plans can navigate coming changes

The Medicare Advantage (MA) landscape is shifting dramatically. With over half of all Medicare beneficiaries now enrolled in MA plans, the p...

39:40Aug 8, 2025

Episode 24: Post-Election Insights for Medicare Advantage

Welcome to the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges fac...

55:05Nov 26, 2024

Episode 23: Staying ahead of interoperability to drive lasting impact

Join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges fa...

23:51Nov 8, 2024

Episode 22: Wolters Kluwer’s Melissa James offers strategies to survive a RADV audit in 2024 and beyond

During this 20-minute podcast, Melissa James, senior consultant at Wolters Kluwer, Health Language, provides insight into RADV audits for co...

20:42Oct 4, 2024

Episode 21: Centauri Health Solutions’ Dawn Carter offers insights into the transition of risk adjustment model V24 to V28

Dawn Carter, director of product strategy at Centauri Health Solutions, joins us for the latest episode of RISE Radio, our podcast series th...

23:09May 9, 2024

Episode 20: Navigating the 2025 Medicare Advantage Final Rule: Expert Analysis and Strategic Insights

Welcome to the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges fac...

70:48Apr 23, 2024

Episode 19: Healthfirst’s Errol Pierre on the end of continuous enrollment, restart of Medicaid redeterminations, and lessons learned

Errol Pierre, senior vice president of state programs at Healthfirst, the largest nonprofit health plan in New York, joins us for the latest...

22:10Jan 8, 2024

Episode 18: IQVIA’s Dr. Calum Yacoubian on empowering payers in risk, quality, and health equity with clinical NLP

Calum Yacoubian, M.D., director of NLP health care strategy at IQVIA, joins us for the latest episode of RISE Radio, our podcast series that...

21:16Oct 24, 2023

Episode 17: Cotiviti’s Katie Devlin on navigating the health care interoperability landscape

Katie Devlin, DHSc, MS, CPHIMS, vice president, interoperability, Cotiviti, joins us for the latest episode of RISE Radio, our podcast serie...

21:14Sep 5, 2023

Episode 16: Ciox Health’s Lyle Mioduszewski on SDoH, Z codes, and use of member data to close gaps, reduce costs, and optimize utilization

Lyle Mioduszewski, vice president of population health and payer growth for Ciox Health, is our guest for the latest episode of RISE Radio....

26:58Jul 5, 2023

Episode 15: Veradigm’s Lesley Weir and Kate Wormington on risk adjustment and quality changes in the 2024 MA and Part D Rate Announcement and 2024 MA Final Rule

Lesley Weir, senior director, customer and product success at Veradigm, and Kate Wormington director, product management, analytics at Verad...

31:12May 3, 2023