Soaring to New Health

The Medicare Stars program is changing and the strategies that worked in the past may not be enough moving forward. In this episode, Bill Rayball of Highmark Health and ProspHire’s Andrew Bell discuss the program’s evolution, the growing importance of clinical outcomes and what health plans must do now to protect performance in an increasingly complex environment

Healthcare organizations don’t struggle because they lack strategy. They struggle because change doesn’t stick. In this episode of Soaring to New Health, we sit down with Michael Meadows, Managing Partner for Strategy & Performance at Limetree, to explore why healthcare transformation efforts fail and what behavioral science can teach leaders about designing change people actually adopt.

Compliance isn’t just a checkbox—it’s the foundation that determines how healthcare organizations grow, scale, and withstand scrutiny. In this episode, we explore what breaks when compliance is reactive, and how embedding it into operations from the start can accelerate performance, reduce risk, and enable smarter transformation.

In the season wrap-up of Soaring to New Health, host Dan Crogan joins Lauren and Chris Miladinovich, ProspHire’s co-founders, to reflect on a season filled with innovation, collaboration and real-world impact from Medicaid and Medicare Stars to ACA strategy, risk adjustment and dental transformation.They share key takeaways from a challenging year in healthcare and introduce Tenavi Staffing, ProspHire’s new sister company expanding workforce solutions beyond healthcare and look ahead to 2026 with insights on cost optimization, leadership resilience and the evolving role of AI. 

Join Chris Vermilya of Loom Security and Joe Wynn of Seiso as they discuss the evolving threats, cutting-edge solutions and essential strategies for protecting patient data and healthcare systems. 

Join Chris Vermilya of Loom Security and Joe Wynn of Seiso as they discuss the evolving threats, cutting-edge solutions and essential strategies for protecting patient data and healthcare systems. 

In this episode of Soaring to New Health, part of our Medicaid Momentum: Managing Change in a Shifting System series, we sit down with Brendan Harris, President of UPMC for You, to explore how Medicaid has evolved over the past five years and where it’s headed next. Brendan shares how UPMC is transforming care through community engagement, workforce development and creative solutions that address social determinants of health. From innovative employment pathways for Medicaid recipients to strategies for managing long-term care costs, this conversation dives into the opportunities and challenges shaping the future of Medicaid. 

Welcome to our Medicaid Momentum series. In this episode, we delve into the dynamic evolution of Medicaid over the last five years with Brendan Harris, President of UPMC for You. Brendan offers valuable insights into how Medicaid has transformed, navigating challenges, embracing innovations accelerated by the pandemic and addressing the shifting winds that will shape its future. Join us as we explore the next chapter for Medicaid and the strategic priorities for leaders navigating this ever-evolving landscape. 

In this powerful episode of Soaring to New Health, hosts Chris Miladinovich and Dan Crogan explore the intersection of equity, innovation and access in two vital areas of care: IVF and home and community-based health services. Joined by healthcare trailblazers Dr. Joe Sanfilippo and Arnie Burchianti, the conversation dives into the systemic barriers facing underserved populations – and the bold solutions needed to drive meaningful change across the care continuum.

In this powerful episode of Soaring to New Health, hosts Chris Miladinovich and Dan Crogan explore the intersection of equity, innovation and access in two vital areas of care: IVF and home and community-based health services. Joined by healthcare trailblazers Dr. Joe Sanfilippo and Arnie Burchianti, the conversation dives into the systemic barriers facing underserved populations – and the bold solutions needed to drive meaningful change across the care continuum. 

The latest mini-series of Soaring to New Health explores the innovations and trends shaping the future of Medicaid operations. Featuring insights from Jim Burgess, Senior Vice President of Operations at Highmark Wholecare, and Julie Evans, Medicaid Practice Leader at ProspHire, the discussion covers the impact of technology, policy changes and best practices for improving efficiency and care delivery. This conversation highlights key strategies for navigating the evolving Medicaid landscape.

The latest mini-series of Soaring to New Health explores the innovations and trends shaping the future of Medicaid operations. Featuring insights from Jim Burgess, Senior Vice President of Operations at Highmark Wholecare, and Julie Evans, Medicaid Practice Leader at ProspHire, the discussion covers the impact of technology, policy changes and best practices for improving efficiency and care delivery. This conversation highlights key strategies for navigating the evolving Medicaid landscape.

The latest mini-series of Soaring to New Health explores the innovations and trends shaping the future of Medicaid operations. Featuring insights from Jim Burgess, Senior Vice President of Operations at Highmark Wholecare, and Julie Evans, Medicaid Practice Leader at ProspHire, the discussion covers the impact of technology, policy changes and best practices for improving efficiency and care delivery. This conversation highlights key strategies for navigating the evolving Medicaid landscape.

In our discussion with Caitlin Nicklow, Practice Leader at ProspHire, we explore the evolving landscape of the Affordable Care Act (ACA). With impending policy changes under the new administration, concerns about affordability and access to ACA plans loom large. Caitlin highlights challenges such as potential premium increases and reduced marketing outreach, emphasizing the need for health plans to remain agile and proactive in adapting their strategies. 

ProspHire’s Medicaid leader, Julie Evans, discusses the biggest challenges facing Medicaid health plans, from regulatory shifts to cost management and provider accessibility. Tune in as we explore how ProspHire helps health plans navigate these complexities and drive better health outcomes.

In this episode of Healthcare Uncovered, Andrew Bell, ProspHire’s Medicare Stars Leader, breaks down the latest regulatory shifts impacting health plans, including the Health Equity Index and Inflation Reduction Act changes. Learn how ProspHire’s expertise helps organizations navigate these challenges and optimize their Stars performance for long-term success.

In this episode, ProspHire's Luke Laurin discusses the challenges faced by dental service organizations (DSOs) and dental practice organizations (DPOs) in consolidating practice management systems. He explores strategies for implementing efficient tech stacks and optimizing workflows to enhance operational and clinical efficiencies, ultimately leading to significant cost savings and improved data utilization across dental clinics.

At ProspHire, we understand that successful project delivery is the cornerstone of impactful healthcare initiatives. Our expert approach focuses on optimizing benefits, ensuring compliance with government regulations, integrating innovative clinical care solutions and reducing administrative costs – all while expertly managing tasks. Join us as we dive into ProspHire’s proven methodology and discover how we help healthcare organizations achieve measurable results and drive meaningful change. 

The Modern Dental Practice - Something to Believe In. This episode dives into the world of dental practice management software and the transformative power of cloud-based solutions. We’ll talk about the benefits, challenges and future trends of adopting cutting edge technology in the dental healthcare sector.

We are exploring the intersection of innovation and healthcare – diving deep into the realm of data analytics in healthcare, a field poised to revolutionize the way we understand and deliver medical services. 

We're talking about how environmental factors have a profound impact on overall development and future health. That results in the critical need to help our youth develop the necessary skills to create positive opportunities for themselves and future generations.

We’re talking about the pivotal role that Quality Measures and Star Ratings play in shaping the landscape of healthcare, particularly in Medicare Stars. These stars are far more than mere ratings; they symbolize a dedication to excellence in healthcare provision. From educating, motivating and collaborating with internal teams to the paramount importance of actively listening to the needs and experiences of plan members, we’ll highlight the intricate web of efforts and commitments that contribute to sustaining stelar healthcare standards. 

We are diving deep into the world of healthcare and performance improvement.  Medicare Stars and its far-reaching implications - what it is, why it’s important for health plans and members, common challenges and successful strategies. 

Season 1 | Episode 5Social Determinants of Health (SDOH) are a hot topic in the healthcare industry. And rightfully so. In this episode, we talk about what they are, why they are important to measure and how they can play a role in more efficient care with better patient outcomes.

Season 1 | Episode 4There is a new culture of dentistry and it’s being led by a premier, national dental group with a commitment to industry-leading service and care for every patient at every visit. We’re talking with NADG about innovative technologies and AI platforms being leveraged by their affiliated dentists that enable them to focus on the best care for their patients.  

Bonus Episode It was our very first podcast conversation… never before told stories about creating the name ProspHire, the core of our healthcare consulting focus and why we believe our client relationships are so important and our dedication to the Boys and Girls Clubs in our local communities. This episode is in memoriam of Lauren and Chris’s pet Juliana Pig Nola who sadly crossed the Rainbow Bridge in summer 2023.

Season 1 | Episode 2The Next Generation Pharmacist is a health care provider and change agent personalizing medication use, managing safe and effective medication systems and creating healthier communities. The pharmacist’s role has rapidly changed since the pandemic and we’re talking about new ways to deliver patient care and how medication management has evolved.  

Season 1 | Episode 1The Affordable Care Act:  From how does it affect healthcare to what health systems, providers and plans need to do to increase their plan membership. ProspHire’s ACA experts share stories about what goes right when organizations make ACA compliance and regulations a priority.