Rodolfo Parra

Michael Capriotti, MBA, Virtua’s SVP of advanced care operations and logistics, is among 13 professionals named to South Jersey Biz’s “Who’s Who in Health Care 2025.”   Michael provides strategic oversight for multiple initiatives designed to improve patient access, affordability, and experience. They include Virtua’s Access Center (call center) and innovative Enterprise Care Logistics Center. The latter is a high-tech hub that uses real-time data to enhance Virtua’s capacity and improve patient outcomes. It includes Virtua’s Hospital at Home and Care After Discharge programs. Read in South Jersey Biz: https://bit.ly/3FSd2hb

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The Moving Massachusetts Upstream (MassUP) investment program funds partnerships between health care providers and community organizations to address social determinants of health and root causes of health inequities. Recently, MassUP awardee Heywood Healthcare's partnership with HEAL Winchendon was featured on GBH’s All Things Considered. They discussed the HEAL Collaborative’s impactful initiatives to address inequities in food security and economic stability in Central Massachusetts. 📻Listen to the full GBH interview: https://lnkd.in/eQxphM6r 🎥Watch the HPC's latest video highlighting the work of HEAL Winchendon: https://lnkd.in/eW8PB2nd  #HealthEquity

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Recently, MacroHealth’s Chief Growth Officer, Aarti Karamchandani, sat down with Providence Health Plan's Chief Growth Officer, Brad Garrigues, to discuss their growth-focused partnership and the critical role of innovation.    Watch the full interview to learn more about how Providence Health Plan is leveraging MacroHealth’s Intelligent Health Marketplace solution to:   • Optimize provider networks for better access and affordability   • Leverage data-driven insights to improve cost efficiency   • Enable sales teams and drive strategic market expansion   • Enhance member experience  https://lnkd.in/g3HmrWfr

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Star Ratings as a Strategic Imperative and Why Alignment Sets the Benchmark   Today, star ratings in Medicare Advantage show how well plans deliver quality, build trust, and stay sustainable. CMS reviews these ratings based on clinical results, member experience, complaint handling, retention, and access to care. Managing these areas takes focus and commitment.   This is why Alignment Health Plan’s latest results stand out. For the second year in a row, 100% of members are enrolled in plans rated 4 stars or higher. Two Nevada HMO contracts earned 5 stars, and a Texas plan earned 4.5 stars. These results demonstrate that a member-first care model can be replicated and scaled, rather than being a one-time achievement.   Why This Matters   1. Sustained reliability Many plans aim for high star ratings but struggle to maintain them as CMS raises the bar. Alignment’s California HMO has held 4 or more stars for nine years in a row, which is rare. This steady performance leads to better risk management, stronger member loyalty, and more reliable bonus incentives. 2. Clear market differentiation. Medicare’s Plan Finder clearly displays star ratings, which directly impact consumers' choices. High ratings give plans a real edge over competitors, not just a mark of honor. 3. Quality as a business driver, not just compliance.   The most successful plans prioritize quality by closing care gaps, retaining valuable services, and responding promptly to members, rather than merely meeting minimum requirements.   The New Age of Medicare Advantage   New carriers are transforming the industry through flexibility, data-driven insights, digital engagement, and a focus on members. Here’s what makes them different:   * Flexible modular care models delivering individualized quality care * Bold benefit innovation that differentiates * Relentless measurement and iteration, where analytics feed continuous quality improvement * Culture-driven execution, where clinical leaders, operations, and member services act with alignment   Alignment demonstrates how these strengths can be leveraged on a large scale to consistently deliver great results across different markets.   Our Dedication to Long-Term Quality   * We invest in quality to achieve lasting results that can be replicated across different markets, yielding clear benefits from the first year. * Our benefits are tied to clear clinical and satisfaction goals, as shown by our star ratings and member feedback. * All of our members are enrolled in high-rated plans, not just a select few.   The future of Medicare Advantage will favor those who pair strong performance with new ideas that put members first. Alignment is already leading the way and setting the standard for the next generation of plans.   #AlignmentHealthPlan #AlignmentHealth #Duals #HealthcareLeadership #AdvocacyMatters #ValueBasedCare #FreedomOfChoice #LeadershipInAction #MedicareAdvantage #HealthPolicy

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For too long, our system has focused on the volume of services provided, rather than the quality of care delivered. This approach has led to higher costs and inconsistent outcomes.     I recently participated in a CEO Panel at the AHIP Medicare, Medicaid, Duals & Commercial Markets Forum, where we discussed the future of health care delivery innovations. One of the key takeaways from our conversation was the importance of shifting toward rewarding quality over quantity to improve health outcomes, reduce unnecessary costs, and create a more sustainable health care system.      By incentivizing providers based on quality rather than quantity, we can create a more sustainable and effective health care system. This approach, which we've implemented through strong partnerships in our provider networks, has led to improved health outcomes and reduced costs for our members.     For example, the value-based Sanitas care model at our Florida Blue | Sanitas Medical Centers creates more seamless and coordinated care for our members that prioritizes prevention and early intervention. As a result, we've seen measurable reductions in avoidable hospitalizations and improvements in chronic disease management.      I'm proud of the work we're doing at GuideWell to create a more sustainable and effective health care system. By working together with providers and prioritizing the needs of our members, we can create a better future for health care.     #HealthCare #HealthCareOnLinkedIn #Innovation #Sustainability 

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If SB 11 moves forward, Connecticut businesses could lose flexibility, employees may face rising costs, and large insurers stand to gain even more control.   Self-funding is one of the few tools businesses have to manage healthcare costs and provide better coverage.   SB 11 threatens that tool—and with it, the ability for small and mid-sized businesses to offer high-quality, affordable plans.   Here’s what happens if SB 11 passes: ⚠️ A $250,000 blanket aggregate attachment point, forcing all self-funded employers—regardless of size—to cover the first $250,000 in claims before stop-loss coverage begins ⚠️ Higher premiums and less transparency ⚠️ More control for big insurers, less for employers If lawmakers want real reform, they should be encouraging self-funding—not killing it.   Read my full breakdown of SB 11 in the Hartford Business Journal: https://lnkd.in/ebxk7U_B   #SelfFunding #Healthcare #EmployeeBenefits #CTBiz

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