Episode 127: The ins and outs of Providers becoming Payer/Providers with Kris Smith, MD MPP and Chief Medical Officer of CareConnect, Sr VP of PHM, and Medical Director of Northwell Health
March 06, 201730:05

Episode 127: The ins and outs of Providers becoming Payer/Providers with Kris Smith, MD MPP and Chief Medical Officer of CareConnect, Sr VP of PHM, and Medical Director of Northwell Health

As Senior Vice President in the Office of Population Health Management, Dr. Smith provides clinical leadership for all of Northwell’s population health activities. He is also the Medical Director for Health Solutions, Northwell’s care management organization and is the Chief Medical Officer for CareConnect, Northwell’s insurance company. Prior to these responsibilities he led system-wide care continuum initiatives in the post-acute setting as medical director for Post-Acute Care Services.

Dr. Smith is board certified in Internal Medicine as well as Hospice and Palliative care. He maintains an active clinical practice as a house call physician in Northwell’s nationally recognized home-based primary care program.

Dr. Smith, an associate professor at Hofstra Northwell School of Medicine, has published a number of papers on advanced care models for the frail elderly and has been a co-investigator on a number of grants investigating the outcomes of high-intensity primary care programs. He has been invited to give regional and national talks on health policy, the frail elderly and the intersection of payment reform and clinical redesign.

Dr. Smith has worked with regional and national associations such as the Greater New York Hospital Association, the American College of Physicians, Center to Advance Palliative Care, the Coalition to Transform Advanced Care and the American Association of Home Care Medicine on health care reform. He is the executive sponsor for a number of governmental demonstration projects including Medicare’s Independence at Home, Bundled Payment for Care Improvement and the New York State Health Home.

Dr. Smith graduated with a degree in sociology from Princeton University and received a Master of Public Policy in health policy from Harvard University, JFK School of Government. He received his Medical Degree from Boston University School of Medicine and completed a residency and chief residency in Internal Medicine at the Mount Sinai Medical Center. Prior to joining Northwell he was an assistant professor at the Mount Sinai School of Medicine and an assistant program director for the Internal Medicine Residency Program.


00:00 How CareConnect came into being.
04:50 Who CareConnect is aimed at.
05:10 The ultimate goal of CareConnect.
05:30 How becoming a Payer/Provider benefits the Consumer.
07:40 The efficiencies of being part of a Payer/Provider organization.
09:15 The classic Payer difficulties that go away by becoming a Payer/Provider.
12:30 “The work of a partnership between a Payer and a Provider is never done.”
13:00 “How do you have a process to make sure your standards allow for the unexpected?”
15:00 Folding in Precision Medicine into Standard of Care.
15:30 “You have to think of Population Health as a tool for getting a more precise plan for individual patients.”
17:40 “We need to be vigilant that exceptions should be exceptional.”
21:30 “Patients really trust their Providers.”
21:45 “When it comes to Medical Care and Clinical Decision Making, it’s best if that’s spearheaded by the Provider side.”
22:30 What working with Providers looks like.
25:25 How CareConnect is aligning with Physicians.

healthcare,health,pharma,marketing,provider,payer,northwell health,
|

Episode Support Provided By

Special Thanks to Our 2026 Sustaining Monthly Donors

Kimberly Carleson, Dylan Yahn, Benjamin Light, Matt McQuideAnn Kempski, Spencer Allen, Scott TromanhauserMarilyn Bartlett, 
Steven Elkins, Matthew Bunte, and Lori Smith.

Recent Episodes

EP511: The Tension When Clinical Teams Take On Risk for Policymakers and Others Looking to Rustle Up Future Perverse Incentives, With Dr. Siva and Monica Lypson, MD, MHPE
Relentless Health ValueMay 14, 2026
511
29:3727.1 MB

EP511: The Tension When Clinical Teams Take On Risk for Policymakers and Others Looking to Rustle Up Future Perverse Incentives, With Dr. Siva and Monica Lypson, MD, MHPE

Listen on Your Favorite App Last week, we talked Medicare Advantage with Betsy Seals ( EP510 ), and we talked about finding members who a plan can serve well. This makes sense because Medicare Advantage is a capitated program. In other words, Medicare Advantage plans get paid by CMS a per member per...

EP510: The Impact on You of Medicare Advantage Goings-on (2026 Edition), With Betsy Seals
Relentless Health ValueMay 07, 2026
510
35:3032.5 MB

EP510: The Impact on You of Medicare Advantage Goings-on (2026 Edition), With Betsy Seals

Listen on Your Favorite App I came up with at least one way to tell the difference between making a fair profit and profiteering. If someone makes more money when the patients or members they serve are worse off, yeah, call that profiteering. For a full transcript of this episode, click here . If yo...

EP509: The 7.7% Wake-Up Call: A Roadmap to Align Finance Teams With Non-complacent Benefit Design, With Patrick Nelli
Relentless Health ValueApril 30, 2026
509
37:4834.6 MB

EP509: The 7.7% Wake-Up Call: A Roadmap to Align Finance Teams With Non-complacent Benefit Design, With Patrick Nelli

Listen on Your Favorite App Sarah Monroe: Hi. This is Sarah Monroe in Chicago, and I'm a benefits procurement leader. And I'm curious why you think so few executives take proactive bold action in health benefits strategy given the magnitude of opportunity. Stacey: Isn't that a great question? For a ...

EP508: Why Don't More Self-insured CEOs Take Bold Action in Health Benefits Strategy? With Lee Lewis
Relentless Health ValueApril 23, 2026
508
44:0240.31 MB

EP508: Why Don't More Self-insured CEOs Take Bold Action in Health Benefits Strategy? With Lee Lewis

Listen on Your Favorite App This episode is the very first episode that we have done that is an AMA—an Ask Me Anything—and here is our very first question. Sarah Monroe: Hi. This is Sarah Monroe in Chicago, and I'm a benefits procurement leader. And I'm curious why you think so few executives take p...

EP507: 4 Core Concepts to Buy or Deliver the Highest-Value Healthcare—A Review
Relentless Health ValueApril 16, 2026
507
33:5831.09 MB

EP507: 4 Core Concepts to Buy or Deliver the Highest-Value Healthcare—A Review

Listen on Your Favorite App Look, we wonks, meaning you and me, you're listening to this, so I am on to you. But we wonks in the Relentless Tribe, we move like lightning on Relentless Health Value. We tend to cover lots of ground pretty fast. So, sometimes I like to, with great intention, sum up wha...

EP506: How Other Employers, Shareholders, and Clinics Are Using Price Transparency Data—And It's an Arms Race, With Jerry DiMaso
Relentless Health ValueApril 09, 2026
506
35:5132.81 MB

EP506: How Other Employers, Shareholders, and Clinics Are Using Price Transparency Data—And It's an Arms Race, With Jerry DiMaso

Listen on Your Favorite App, So, we have a few miniseries afoot here on Relentless Health Value right now, and one of them is "The Inches That Are All Around Us"—finding the hidden fees, the hidden friction for plans and members and clinics themselves a lot of times in those inches. For a full trans...

EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD
Relentless Health ValueApril 02, 2026
505
44:0240.31 MB

EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD

Listen On Your Favorite App Hello, Relentless Tribe. Thank you so much for showing up today. All right … to start, let me lay out the goal of the episode today. This episode is for you if you are a self-funded employer looking to ensure your members are steered and tiered to real high-value care and...

Listen and Follow

Sponsored by Aventria Health Group
©2026 BD Bridges LLC. All Rights Reserved.