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Ilene MacDonald
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RISE Radio
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 program faces unprecedented scrutiny from lawmakers, regulators, and beneficiaries themselves. During this 40-minute podcast, MA policy experts Carrie Graham and Neil Patil dissect the changing political and regulatory climate surrounding MA and offer crucial insights for health plans navigating these turbulent waters. They explore how the Trump administration is approaching MA reform through payment adjustments, increased oversight, and technological innovation.Graham and Patil delve into hot-button issues driving the reform conversation: prior authorization practices that frustrate...
2025-08-08
39 min
RISE Radio
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 faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health.Special thanks to DUOS for sponsoring this episode, which features Ana Handshuh, principal of CAT5 Strategies, and Jenn Kerfoot, chief strategy and growth officer, DUOS, discussing the impact of the election on Medicare Advantage and the potential changes ahead under President-elect Donald Trump’s nominees: Robert F. Kennedy Jr. as HHS secretary and Dr. Mehmet Oz...
2024-11-26
55 min
RISE Radio
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 faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health.Katie Devlin, DHSc, MS, CPHIMS, vice president of interoperability at Cotiviti, returns to RISE Radio and is joined by Adam Gilbert, director of interoperability operations and partnerships at Cotiviti, for this 23-minute episode. They discuss the latest regulatory requirements, what to expect for 2025, challenges, and best practices to implement a...
2024-11-08
23 min
RISE Radio
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 coders, auditors, coding managers, senior leaders, chief financial officers, and chief executive officers. She discusses the latest news; technology, such as AI, that can assist Medicare Advantage organizations with audit preparation and project management; and the best strategies to prepare for audits.About Melissa James Melissa James, CPC, CPMA, CRC, risk adjustment SME, senior consultant, Wolters Kluwer, Health Language, supports the company's Health Language solutions with content maintenance. She has more than 20 years of health...
2024-10-04
20 min
RISE Radio
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 that focuses on issues that impact policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health.In this 23-minute podcast, recorded on April 18, Carter discusses the shift from the V24 to V28 risk model, the coding changes, and its risk adjustment applications. About Dawn Carter Dawn Carter, BSBA, CPC, CRC, CPMA, CDEO, CPC...
2024-05-09
23 min
RISE Radio
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 faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health.Our guests are Ana Handshuh, principal of CAT5 Strategies, Melissa Smith, founder and senior advisor of the Newton Smith Group, and Rex Wallace, founder & principal of Rex Wallace Consulting. During this 70-minute podcast, they discuss the major changes in the 2025 Medicare Advantage Final Rule that the Centers for Medicare & Medicaid Services released on A...
2024-04-23
1h 10
Silver and Strong
Transform Your Life at Any Age!
In the first inspiring episode of the "Silver and Strong" podcast, host Ilene Block kicks things off with the awe-inspiring stories of two dynamic women, Susan Guidi and Renee Landers, who are redefining what it means to age with grace, strength, and determination. Susan, a fierce 66-year-old competitive bodybuilder, shares her incredible journey of transforming her health, mindset, and physique, proving that age is just a number when it comes to living your best life. Alongside her, Renee recounts her own path to rebirth as a fitness competitor at the age of 69 years young! The e...
2024-01-22
49 min
RISE Radio
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 episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health.Pierre will be a featured speaker at RISE’s Medicaid Managed Care Leadership Summit, a virtual event, that will take place April 2-3. The virtual summit will explore how Medicaid managed care organizations can pr...
2024-01-08
22 min
Stronger by Design for Women with Michelle MacDonald
The Transformation Roundtable
If inspiration is what you seek, Episode 5 of The Wonder Women podcast has your fix. Four amazing TWW members join Michelle and share their journeys to jaw dropping fitness transformations, beginning in their 40s, 50s and 60s. They all prove that when you reach a point in your life when your need for change is greater than your resistance to it, anything is possible!Our amazing roundtable of athletes in this episode include:Ilene BlockFollow Ilene on Instagram at:https://www.instagram.com/silverandstrong/Or visit her website: https://silverandstrong...
2023-11-14
57 min
RISE Radio
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 focuses on issues that impact policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health.In this 21-minute podcast, Dr. Yacoubian discusses natural language processing (NLP) and why it’s vital to use in health care for risk adjustment, quality, social determinants of health, and health equity. About Calum Yacoubian, director of NLP health care...
2023-10-24
21 min
RISE Radio
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 series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health. In this 21-minute podcast, Devlin, author of the new white paper, Implementing a digital quality strategy, discusses interoperability, federal requirements, challenges, and how it supports improved risk adjustment and quality programs. About Katie DevlinKatie De...
2023-09-05
21 min
RISE Radio
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.In this 26-minute podcast, Mioduszewski discusses social determinants of health (SDoH), data collection and sharing, and best practices for capturing SDoH codes in the medical record.About Lyle Mioduszewski Lyle Mioduszewski is vice president of population health and payer growth for Ciox Health, where he works with risk-bearing entities to understand the utility of social determinants of health data factors, with the goal of improved and equitable outcomes f...
2023-07-05
26 min
RISE Radio
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 Veradigm Payer Analytics, join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Medicare Member Acquisition & Experience; and Social Determinants of Health.In this 31-minute podcast, they discuss the risk adjustment and quality changes in the final rules and their recommendations and strategies for organizations going forward. About Lesley WeirLesley Weir, senior director of customer a...
2023-05-03
31 min
RISE Radio
Episode 14: Apixio’s Breanna Krebs on how to prepare for the 2023 Medicare Advantage sweep season
Breanna Krebs, the director of customer success at Apixio, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Medicare Member Acquisition & Experience; and Social Determinants of Health.In this 11-minute podcast, Krebs discusses the impact of the double sweeps occurring this July and next January related to the extension deadline for submitting risk adjustment data for use in the risk score calculation run that the Centers for Medicare & Medicaid Services (CMS) implemented due to the COVID-19 pandemic; what the end of the extension...
2023-01-11
11 min
RISE Radio
Episode 13: Dr. Jasmine Zapata on the importance of self-care, empowerment, and pursuing your passion
Dr. Jasmine Zapata joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Medicare Member Acquisition & Experience; and Social Determinants of Health.“Dr. Jaz,” a keynote speaker at the upcoming RISE Women in Health Care Leadership Summit, Dec. 14-15 at the InterContinental San Diego, will discuss finding and pursuing your passion.In this 20-minute podcast, Dr. Jaz discusses how to find time to take care of yourself to lead at a high level in all other areas of your...
2022-11-07
20 min
RISE Radio
EPISODE 12: RISE West 2022 panelists on the most pressing policy issues facing health plans this year
Five panelists who will speak about health policy at the upcoming RISE West 2022 conference join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.They’ll speak on the first day of RISE West 2022, September 1, at the InterContinental Los Angeles Downtown.Our guests include:· Sean Creighton, managing director of Avalere· Michael Adelberg, providers and plans lead, Faegre Drinker Consulting· Dav...
2022-08-02
36 min
Love4musicals
Oscar HAMMERSTEIN
Oscar Hammerstein está reconocido como uno de los mayores libretistas y letristas del musical americano. Su mayor éxito le llegó con Jerome Kern en 1925 y el musical "Show Boat", que hemos revisado en el podcast de “Cuéntame un musical” de este mes. Estableció las bases de lo que hoy entendemos como “musical”, donde guion, canciones y bailes deben estar integrados y ayudar a avanzar la acción. Trabajó en Hollywood en películas como “Swing time” con Fred Astaire y Ginger Rogers y ganó dos Oscar a la mejor canción original por “The last time I saw Paris” (1941) y “It might as well be spr...
2022-02-15
2h 33
RISE Radio
Episode 11: RISE National 2022 Keynote Ryan Avery on how to take your leadership to the next level
Ryan Avery, a world record holder, two-time best-selling author, Emmy award winning journalist, and world champion, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.Avery will be one of the keynote speakers at RISE National 2022, March 7-9, at the Gaylord Opryland in Nashville, Tenn. At the age of 25, Avery became the youngest world champion of public speaking in history. Remarkably, he had never given a professional speech prior t...
2021-12-10
18 min
RISE Radio
Episode 10: Liz Haynes & Melissa Smith on 2022 Medicare Star ratings and what plans must do to maintain those scores
Liz Haynes, director of risk adjustment and stars for government programs at Blue Cross and Blue Shield of Kansas City, and Melissa Smith, executive vice president of consulting and professional services at HealthMine, join us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.They’ll be the keynote speakers at RISE’s 12th annual Star Ratings Master Class, Dec. 14-15, at the Manchester Grand Hyatt, San Diego. During this...
2021-10-28
27 min
Hot Line
Les mythes autour du sexe à l’écran avec Marion Séclin
Entre érotisme à l'eau de rose et intrigue sillonnée, il n'est pas évident de distinguer réalisme et fantaisie dans les scènes de sexe au cinéma. Aujourd'hui, avec toutes les prises de consciences sur les scènes intimes problématiques et les conditions des acteur.ices, il existe des coordinatrices d'intimité afin de veiller à ce que toustes soient à l'aise lors des scènes de sexe. Naya, accompagnée de Laetitia, Rosa, Elvire Duvelle-Charles et de notre nouvelle invitée Marion Seclin, va décortiquer tous les clichés sur les scènes de sexe dans la pop-culture. Naya : Twitter @misundergi...
2021-09-24
1h 50
RISE Radio
Episode 9: Dr. Angela Huskey on emerging drug threats, the rise in substance use among the elderly
Angela G. Huskey, PharmD, CPE, senior vice president and chief clinical officer at Millennium Health, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.During this 21-minute podcast, we talk to Dr. Huskey about her work on identifying drug trends, emerging threats, substance use disorder, and the increase in drug overdose deaths since the COVID-19 pandemic. Dr. Huskey will be discussing these findings in greater detail during a special presentation about preventing overdoses at...
2021-07-15
21 min
RISE Radio
Episode 8: Dr. Abdullah Albeyatti on the acceleration of telemedicine during COVID
During this 15-minute podcast, Dr. Abdullah Albeyatti, a family physician in the UK and an advocate for digitalization in health care, talks about practicing medicine during the pandemic, audio-only visits, the challenges and opportunities of telemedicine, and how to get the most from the technology.Dr. Albeyatti is the CEO and cofounder of Medicalchain, a company that uses blockchain technology to store health records securely, and MyClinic, a telemedicine platform that allows patients to connect with their doctors remotely for free. The platform is now used by health care practitioners in 78 countries.
2021-06-17
15 min
RISE Radio
Episode 7: Colleen Gianatasio & Dean Ratzlaff on managing a remote workforce
Our latest episode of our new podcast series, RISE Radio, explores the positive aspects of working from home as well as the challenges of managing a remote workforce.During this 18-minute podcast, Colleen Gianatasio, director, ambulatory CDQI at Devoted Health in Waltham, Mass., and Dean Ratzlaff, director, actuary/revenue management for Sentara Health Plans in Virginia Beach, Va., share tips on how to get the most out of your remote workforce while maintaining a work-life balance and staying connected to your team. Both will be presenting at RISE’s upcoming Risk Adjustment Forum...
2021-06-03
18 min
RISE Radio
Episode 6: Kristy Smith and Joshua Edwards on how to maintain a 5-Star plan rating
During this 30-minute podcast, Kristy Smith, HEDIS program manager, and Joshua Edwards, Stars program manager, explain how they’ve been continuing to build a culture of quality and service excellence at Martin’s Point that has helped them achieve and maintain a 5-Star rating. Martin’s Point is a not-for-profit organization with primary care health centers in Maine and New Hampshire as well as health insurance plans for Medicare beneficiaries, military retirees, and families. It has achieved a 5-Star plan rating seven times in the past 12 years. Smith and Edwards talk about the impact of COVID-19...
2021-05-27
30 min
RISE Radio
Episode 5: Dr. Heather O’Toole on population health, quality efforts, and so much more
During this 36-minute podcast, we talk to Heather O’Toole, M.D., chief medical officer at Innovation Care Partners, a clinically integrated network and an accountable care organization in Arizona.Dr. O'Toole, this year’s recipient of RISE’s Martin L. Block Award, discusses the quality initiatives that have inspired her, including opioid safety in the ambulatory setting and training physicians on advance directives, as well as how the projects changed during COVID.
2021-04-14
36 min
RISE Radio
Episode 4: Ana Handshuh on takeaways from RISE National 2021
Our guest is Ana Handshuh, principal of CAT5 Strategies and the chair of the RISE Association's Quality and Revenue Community. Handshuh, who served as the chair of this year's RISE National, shares her key takeaways from the virtual event, and thoughts on COVID, behavioral health, and why broadband access should be a social determinant of health.
2021-04-06
30 min
RISE Radio
Episode 3: RISE Managing Director Ellen Wofford on how RISE evolved during COVID
In this podcast, we talk to RISE Managing Director Ellen Wofford about the evolution of RISE during COVID, converting live events to virtual ones, and upcoming plans to host hybrid events that offer both a live-stream option and in-person learning. We also discuss RISE Association communities and opportunities to network via user groups.
2021-03-05
22 min
RISE Radio
Episode 1: RISE Risk Adjustment Policy Committee on issues to watch in 2021
RISE Editorial Director Ilene MacDonald talks to members of the RISE Risk Adjustment Policy Committee about the Biden administration's health care priorities, mechanisms the administration can use to achieve these priorities given a split Senate, and regulatory issues that Medicare Advantage plans need to watch in 2021.
2021-02-17
38 min
RISE Radio
Episode 2: Regulatory issues that commercial ACA plans need to watch in 2021
In this podcast, we explore some of the regulatory issues that commercial ACA plans needs to watch in 2021. Our guests are Gabriel McGlamery of Florida Blue's marketplace business and Josh Weisbrod of Network Health in Wisconsin, both members of the RISE Risk Adjustment Policy Committee.
2021-02-17
16 min
Off My Shelf
Episode 33 - Chonicles of Riddick and Cinderella
The week we are back to our regularly scheduled programming with Shayna Fine as we talk about the Chronicles of Riddick and Cinderella. Chronicles of Riddick Release: 2004 Director: David Twohy Stars: Vin Diesel, Judi Dench, Colm Feore, Karl Urban, Thandie Newton Cinderella Release: 1950 Director: Clyde Geronimi, Wilfred Jackson, Hamilton Luske Stars: Ilene Woods, James MacDonald, Eleanor Audley Definition of Necromancer A person who practices necromancy; a wizard or magician. Conjuration of the spirits of the dead for purposes of magically revealing the future or influencing the c...
2019-11-18
1h 14
Microphone Therapy
13 Things You Didn't Know About Walt Disney's Cinderella
Cinderella (1950) G | 1h 14min | Animation, Family, Fantasy | 4 March 1950 (USA) When Cinderella's cruel stepmother prevents her from attending the Royal Ball, she gets some unexpected help from the lovable mice Gus and Jaq, and from her Fairy Godmother. Directors: Clyde Geronimi, Wilfred Jackson Writers: Charles Perrault (from the original classic by), Bill Peet (story) (as William Peed) Stars: Ilene Woods, James MacDonald, Eleanor Audley Check us out on Facebook https://www.facebook.com/acoupleofaveragejoes Our Website https://www.acoupleofaveragejoes
2019-06-20
04 min
Spiraken Review Podcast
Spiraken Movie Review Ep 106: Cinderella (or A Good Pair of Shoes Can Take You Anywhere)
In this episode of the Spiraken movie review, Xan and Jaxie continue the theme Month of Family, Fantasy, and Fantastic Pixie Dust, with a magical film about fairy godmothers, glass slippers and true love. So let out your inner child and relax as we review the Walt Disney Classic, Cinderella directed by Clyde Geronimi and starring Ilene Woods, Eleanor Audley, Verna Felton, Rhoda Williams, James MacDonald, Luis van Rooten, Don Barclay, Mike Douglas and Lucille Bliss Our hosts talk about the origins of this masterpiece and how is compares to the source material and its predecessor, Sn...
2016-03-12
33 min