Eileen McAnenny, the driving force behind the Employer Coalition on Health in Massachusetts shares her journey from a typical Irish Catholic home in Somerville (before it was fashionable) to a leader in healthcare policy and cost management.

Discover how her roots and influential figures like Tip O'Neill and the Kennedys shaped her passion for public service, leading to a law career and roles at the Bank of New England, the Joint Committee on Taxation, and beyond. Eileen's insights on employer engagement in healthcare costs and her work with the Massachusetts Taxpayers Foundation illuminate the challenges and opportunities in controlling this major business expense.

As healthcare costs in Massachusetts continue to balloon, smaller businesses are feeling the pinch more than ever.

This episode delves into the complexities of managing healthcare costs, especially in a state where large healthcare employers wield significant political influence. We explore the role of employer coalitions in bringing balance to the conversation, representing the needs of those tasked with purchasing healthcare, and striving for sustainability against the backdrop of inflation and workforce shortages. Eileen's experience at Fidelity and her focus on employer-related policy issues provide a compelling narrative on the interplay between businesses and healthcare providers.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Explore the professional journey of BK Nyak, the innovative leader behind Spikewell, whose advancements are revolutionizing hospital IT solutions. In this conversation, we examine BK's progression from his early days in India to becoming an influential entrepreneur who is reshaping healthcare technology.

He discusses the significant impact of his upbringing, his educational achievements at IIT, the University of Virginia, and MIT's Sloan School, and the key moments that shifted his focus from academia to pioneering entrepreneurship. BK's story highlights the importance of curiosity and adaptability in navigating career paths and leveraging early patents and grants as a foundation for success.

This episode also explores Spikewell's mission to customize IT systems for hospitals, utilizing AI to enhance efficiency and adaptability. BK explains how his company's solutions address clinician burnout and improve clinical decision support and financial operations—essential elements in the rapidly changing healthcare industry.

We analyze the critical roles of mobile platforms, cloud computing, and AI, and how a strong emphasis on customer needs informs tech partnerships with healthcare facilities. Discussing the transformative impact of these technologies, particularly in response to challenges like the COVID-19 pandemic, BK's commitment to innovation and the future of healthcare technology is evident.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

In this episode, Dr. Tamir Aldad, founder and CEO of Mindful Care, joins me to discuss strategies for addressing the challenges in mental health accessibility and costs. Dr. Aldad brings a unique blend of medical insight and business expertise, advocating for and implementing a model that integrates social impact with economic viability. He shares a tragic experience from his residency that exposed significant shortcomings in our mental healthcare system, which motivated the creation of Mindful Care.

Our discussion delves into the current issues faced by mental health providers, such as complex insurance reimbursement processes and the issue of patient selectivity due to high demand. We discuss the impact of social media and the role of virtual and hybrid care.

We discuss Mindful Care's success to date, plans for expansion, and how input from referral partners and community feedback is crucial in reaching underserved populations.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Menthol cigarettes, the FTC's attempts to boost competition in healthcare, the mental health of Jewish college students, and the TikTok ban. What do they all have in common?

Not much, except that they were all in the news this week and I chose to discuss them on a rare solo episode.

Don't like what you hear? Don't worry, I'll be back next week with a fresh guest.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Massachusetts Association of Health Plans (MAHP) leader Lora Pellegrini got interested in policy and politics at a young age. She had the opportunity to work with luminaries like Ted Kennedy and John Kerry early in her career, as she rose to prominence in healthcare policy.

Our discussion focuses on critical issues such as pharmaceutical pricing and hospital efficiency in Massachusetts. We explore the regulatory challenges in drug pricing and the necessity for hospital systems to innovate and enhance performance. Lora provides expert analysis on the impact of major players like Steward Healthcare and Optum in the Massachusetts healthcare sector.

She also shares the historical perspective on healthcare reform in Massachusetts, and issues a call for employers to re-engage in support of affordability as they did back in the days of RomneyCare.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Ironically, patient care coordination itself is often uncoordinated. It's spread across multiple providers and administrators, causing frustration for care teams and patients.

Lumeon founder and CEO Robbie Hughes has developed an approach that makes the care journey more reliable rather than settling for the current craziness, where patients are expected to be satisfied as long as they get some time with a doctor.

One of the really interesting elements of this interview was the discussion of whether we should be willing to trade off some efficacy for reliability. For example, if we had a treatment path that was 80 percent as good but could be followed by 100 percent of the patients, would that be better than striving for the perfect solution that only 1 percent can attain?

From a population health perspective, the 80/100 calculus is probably correct, but most of us want to be in that 1 percent. I've certainly had that experience myself of navigating the system with help from well-placed insiders plus my own knowledge of how things work.

Robbie is an avid reader who recommends The Experience Machine, Chip Wars, and Ultra-Processed People.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Matthias Hoffman first became conscious of his vision as a teenager. He and his friends in Switzerland dreamed of becoming pilots (none actually did) but Matthias's hopes were dashed early on due to inadequate vision.

While pursuing electrical engineering degrees, he realized his strength was in building things. So he left academia and worked in a variety of vision and optical startups, eventually leading significant teams.

Many people who could benefit skip their eye exams, and for more than a decade entrepreneurs have been trying smartphone based eye exams and online eyeglass sales, often with virtual try-ons. But those have been failures. The exam interface is too complex and burdensome, and people want to try on their glasses at retail.

Eyebot is an automated eye exam designed to produce a prescription at the point of sale, i.e., retail stores. It takes 90 seconds and doesn't require the person being examined to do anything special. Eyebot has developed its own technology and eventually plans to expand beyond the basic exam to more advanced screening for things like glaucoma.

But Matthias stresses that Eyebot has no intention of taking away the jobs of eye care professionals.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Most medical bills contain errors. Over-billing and outright fraud are far too common. What's a consumer to do?

In this episode, CEO Scott Speranza shares how HealthLock performs automated audits of medical bills by seamlessly connecting with the patient's health plan portal. We also discuss an exciting new partnership with MasterCard that gives many cardholders (including me) free access.

I connected my insurance to HealthLock and soon got a helpful audit of my claims (which turned out to be clean --thanks Harvard Pilgrim!)

Scott unravels the complexities of coordination of benefits --where he offers reflection on my experience with my dependents--, the significance of automated HIPAA authorizations, and provides practical insights for managing family healthcare. And he shares his views on the delicate balance of privacy and oversight.

One thing he recommends (which providers hate) is to wait for a while to pay your medical bills since charges initially attributed to the patient may actually be covered in the end.

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.