Healthcare Strategies: Recent Episodes
Xtelligent Healthcare Media
A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost. Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
Preparing for the future of technology starts with a flexible strategy. Organizations can ensure efficient strategies by emphasizing communication and collaboration, so they are evaluated from different perspectives. Keith Duemling, senior director of cybersecurity technology protection at Cleveland Clinic, shares his thoughts on the future of the cybersecurity policy space, and best practices for building cybersecurity strategies that ensure organizations are ready for future challenges.
UnitedHealth Group is still reviewing the impact of a Change Healthcare cybersecurity attack, providers have grown less wary of artificial intelligence, and more on today's episode of Headlines.
The consequential nature of healthcare calls for tools and technology that are fair, equitable, and useful to both patients and caregivers. With the rise of AI comes ethical questions surrounding its use in healthcare, and how it can be used in the most responsible and efficient ways possible. Brian Anderson, MD, CEO and co-founder of the Coalition for Health AI (CHAI), emphasizes the importance of transparency in training AI models, the need for AI innovators and regulators to work together, risk assessment in healthcare technology adoption, and more.
For providers, digital quality measure adoption and the ongoing shift to value-based care in the healthcare industry often simply mean more tasks to add to their plates. How can policymakers, payers, and other stakeholders better align quality measures with the provider experience and what needs to change about communication around quality measure adjustments? In this discussion, Brad Ryan, MD, chief growth officer at NCQA, lays out how to maximize efficiency in data collection, what constitutes meaningful data, and how to support providers through shifts in digital quality measures.
Bringing APIs into healthcare has been no small task and this Industry Perspectives guest should know. Don Rucker, MD, is currently the chief strategy officer at 1upHealth, but his former role as the National Coordinator National Coordinator for Health Information Technology gave him insight into how healthcare organizations can better collaborate and leverage resources to improve API adoption.
With persistent health data usability challenges across the industry, The Sequoia Project's Data Usability Taking Root Initiative is looking to drive interoperability through existing data standards. Holly Miller, MD, chief medical officer at MedAllies, a health IT network participating in the initiative, discusses the main data usability issues impacting providers and how the cross-industry community of practice is working to address them.
CMS produced a new tool to help hospitals comply with price transparency rules, the Food and Drug Administration (FDA) approved an artificial intelligence tool that assesses patients' risk for sepsis, and more on today's episode.
How can Google make healthcare information more useful and accessible? What is the best role for the cloud in healthcare data management? Aashima Gupta, Global Director of Healthcare at Google, and Kalyan Pamarthy, Group Project Manager for Generative AI and Search at Google, address these questions and share their thoughts on the potential for cloud innovation in a healthcare context.
Widespread consolidation in healthcare is threatening the independence of most private practices. However, private practices are vital to the healthcare ecosystem, delivering the high-quality, personalized care that patients need. Moshe Chasky, MD, FACP of Alliance Cancer Specialists, shares what happened when a health system came knocking at his door and how the group is maintaining autonomy amid changes in market dynamics, health policy and regulation, and more.
With cyberattacks on the rise--including the advent of the largest cyber event in American healthcare history, the Change Healthcare event--healthcare leaders are scrambling to refortify their health IT security protocols. Matt DeFrain, managing director of MorganFranklin Cyber, and Tamara Nolan, senior director of Cyber & Operational Resilience at MorganFranklin Cyber, share their insights on how healthcare organizations can better prepare for inevitable cyberattacks.
FDA approves an artificial intelligence (AI) tool that identifies heart failure in seconds, the American College of Surgeons shares the best uses for telehealth in surgical practices along with guidelines for integration, and more on today's episode.
In this episode, Janpaul Portal, Esq, Managing Director of pharmaceutical and medical device litigation at MSP Recovery Law Firm, sheds light on the complex realm of recent legal challenges surrounding medical devices and pharmaceutical drugs. With a particular focus on sleep apnea devices and insulin pricing, Portal provides valuable insights into the intricate litigation landscape within the healthcare industry.
In this episode, Rich Birhanzel, senior managing director and global health lead at Accenture, shares the highlights from HIMSS 2024. Specifically, he dives into workforce management and generative AI trends which were the main topics of conversation at the conference.
Diabetes management tools attract a lot of physician and patient attention, but some do not live up to their promises. Epic is adding ambient intelligence to its EHRs. Medicaid disenrollments rocket past HHS projections. A proposal in the Senate would offer financial relief to providers affected by cybersecurity crises.
In this episode, we talk to Kayla Monfort, the co-director of Activate Allen County, a public health initiative in Ohio that created a database to fuel its health improvement efforts. Monfort discusses how to use data for public health and engage local partners to pool community health data.
Is healthcare technology helping or hurting provider burnout? And what can healthcare systems do to offer healthcare professionals more opportunities for work-life balance? These are the million-dollar--or more--questions that healthcare leaders face as they work with a shrinking pool of providers and heavy administrative burdens. Michelle Flemmings, MD, industry executive and market development director for healthcare in North America’s cloud infrastructure at Oracle Health, addresses these questions and shares what brings her hope amid these challenges.
For more on navigating provider burnout, visit PatientEngagementHIT.com.
A cyberattack at Change Healthcare has crippled large segments of the healthcare industry. Also, a new AI app might detect a certain pediatric ear infection better than humans.
Pharmacy benefit managers and payers have a lot of influence over prescription drug affordability, but does their traditional working model actually benefit health plan members? Alison Lum, vice president of pharmacy services at Blue Shield of California, shares what needs to change about the PBM-payer relationship to improve prescription drug costs and access to care.
The mental health crisis in the United States has contributed to an increase in suicide deaths in recent years. Kimberly Roaten, PhD, ABPP, professor in the Department of Psychiatry at University of Texas Southwestern Medical Center and associate chief quality and safety officer for Behavioral Health - Parkland Health, and Jacqueline Naeem, MD, senior medical director at Parkland Center for Clinical Innovation (PCCI), share how health systems can help prevent suicides in their populations using a data-informed risk stratification approach.
In this episode, Stephanie Page, MD, PhD, Co-Director of the University of Washington Medicine Diabetes Institute, Robert B. McMillen Professor of Medicine in Lipid Research and head of the Division of Metabolism, Endocrinology, and Nutrition, discusses the role of male birth control in the global unplanned pregnancy epidemic. Page describes existing and developing male contraceptive methods with Healthcare Strategies.
Cigna is shedding its Medicare plans, selling them to HCSC. Meanwhile, the White House is eyeing sickle cell therapies and their high price tags.
Remote patient monitoring tools are increasingly used to deliver cancer care in patient homes. However, the success of these programs depends on various factors, including patient engagement. Glen Peterson, NP, an associate professor of hematology at the University of Colorado Medicine, discusses study findings on the efficacy of an RPM-based outpatient care model for high-risk cancer patients and the implementation strategies to ensure success.
Large payer organizations reported around 10.1 million averted surprise bills and accountable care organizations are flocking to Medicare's Shared Savings program.
CMS has finalized prior authorization policies that please most major provider organizations and a new survey shows that EHR transformation is one key strategy for reducing provider burnout.
In this episode, Alivia Kaylor, MSc, senior editor, and Veronica Salib, associate editor at Xtelligent Healthcare Media, provide in-depth insights into the revolutionary strides defining the landscape of the life sciences and pharmaceutical industry in 2024. Unveiling transformative breakthroughs — including pioneering achievements in gene therapy, advancements in targeted oncology treatments, and cutting-edge progress in male birth control options — the discussion explores how these innovations are reshaping the healthcare landscape and carrying immense promise for the future.
The cost of delivering quality care is higher than ever, while payers are looking to downsize reimbursement rates as much as possible. As a result, many rural hospitals have closed or are on the brink of closure, exacerbating access to care challenges. Our editors discuss what is causing rural hospitals to shutter their doors and what some providers are doing to prevent it.
Amazon has added a health benefits check to its growing range of healthcare capabilities. Meanwhile, value-based purchasing might not be the best solution to health disparities in some care settings.
With the start of a new year, healthcare executives assess the state of the industry and set expectations for top trends and key strategies that will be widely implemented. Join four Xtelligent Healthcare Media senior staff members as we share what we have been hearing from healthcare leaders about 2024.
Automation could take many mundane yet demanding tasks off of providers' to-do lists. Russ Richmond, co-founder and chief executive officer of Laudio, shares why providers should embrace automation and what next steps they can take toward adopting the technology in this final episode of Industry Perspectives.
CMS has announced a new maternal health model. Some US healthcare spending trends dropped to pre-pandemic levels in 2022. Additionally, Medicare opioid use disorder treatment falls behind and the US Supreme Court will review an abortion pill.
With the increased frequency and intensity of extreme weather events, awareness of climate change and its health effects is growing. Titus Schleyer, DMD, PhD, Regenstrief Institute research scientist, discusses how health informatics can help enhance resilience against the evolving threats of a changing climate.
Technology has become crucial to the nursing profession, but how can healthcare organizations implement new technologies while maintaining personal nurse-patient interactions? Dusti Browning, vice president of growth and client solutions for Conduit Health Partners, shed some light on potential solutions.
Cigna and Humana have called off their planned merger in the wake of shareholder backlash. Remote patient monitoring offers a healthy return on investment, according to early estimates. Additionally, CVS Health introduces a new app to integrate healthcare tools for patients and external payer audits quadruple in 2023.
NewYork-Presbyterian is home to an innovative maternal mental health program that enlists the work of a multidisciplinary care team centered around doula care to support birthing people in the postpartum period. By employing this community-centered approach, NYP works to make maternal mental healthcare more accessible, closing the gap in the number of people able to access treatment for postpartum depression. In this episode, Davina Prabhu, vice president of the Ambulatory Care Network at NYP, discusses the NYP Postpartum Doula Program.
Sexual health is laden with stigma across our society, but the solution starts with reducing stigma among providers. Daphne Chen, co-founder and co-chief executive officer of TBD Health, explains how one hybrid sexual health clinic--originally designed to serve vagina owners but now open to penis-owning partners as well--seeks to improve access to women's health and sexual health.
As artificial intelligence continues to gain traction in healthcare, clinicians will be expected to engage with these technologies more and more. In this episode of Healthcare Strategies, Ronald Rodriguez, MD, PhD, professor of medical education at The University of Texas Health Science Center at San Antonio, details how he and other stakeholders helped design a dual degree program to prepare the next generation of doctors to be leaders in the healthcare AI space.
Genomics is a burgeoning field, with advancements that affect gene therapies and personalized medicine. Kamal Obbad, chief executive officer and co-founder of Nebula Genomics, offered some context for the field's prominence and recent evolution and provided some insight into what the future might hold for genomics.
Researchers from multiple institutions collaborate to create an ingestible, wireless remote patient monitoring device. Healthcare is fourth highest on the list of targets for the world's most dangerous malware.
Hybrid care and new technology partnerships are growing trends in the healthcare industry. Frank McGillin, chief executive office at The Clinic by Cleaveland Clinic, gives an inside peek at developing hybrid care models and choosing the right technology partners.
The healthcare sector faces cyber threats on a daily basis, sometimes resulting in disruptions to operations and decreases in quality of care. To ease the risk of cyberattacks and ensure that healthcare organizations are taking steps to safeguard sensitive data, a patchwork of state and federal laws exist. Elizabeth Hodge, partner in the Healthcare Practice Group at Akerman, discusses the healthcare cybersecurity regulatory landscape and how to maintain compliance.
When the coronavirus pandemic put society on hold, Americans had to rearrange their priorities and adopt various methods to cope, some healthier than others. Georgia Gaveras, DO, co-founder and chief medical officer at Talkiatry, explains how the pandemic affected mental health in the US, the pros and cons of telemental health, and more.
In the aftermath of the 2022 Dobbs vs Jackson Women’s Health Organization decision, patients find themselves navigating a variable legal landscape. While abortion care access may be legal in one state, it may not be in another, and that leaves those in abortion-restriction states, in some cases, traveling out of state for the procedure and putting themselves at risk for civil or criminal penalties. Shield laws have begun to crop up in abortion-legal states to protect these patients—and anyone involved in abortion access—from those legal consequences. In this episode, Manatt Health Partner Randi Seigel and Counsel Alice Leiter outline trends in shield laws.
Healthcare technology innovation and digital health tools have become the backbone of many healthcare processes. How can healthcare leaders best wield these tools in order to make care more affordable and more efficient? With two decades of experience in the healthcare space, Glen Tullman, chief executive officer at Transcarent, shares his insights on how healthcare can catch up with other industries and seamlessly integrate digital health tools.
The American Hospitals Association (AHA) is suing the Department of Health and Human Services (HHS) for a bulletin on hospital use of tracking technologies. Meanwhile, CMS cut Medicare reimbursement to physicians.
Virtual reality solutions can enhance clinical outcomes and patient experience, particularly in the pain management arena, but there are numerous challenges to widespread adoption. In a Healthcare Strategies episode, Dr. Henry Xiang, director of the Center for Pediatric Trauma Research at Nationwide Children's Hospital, discussed the research into healthcare VR use cases for pain management as well as the benefits and challenges of VR use in healthcare.
Healthcare stakeholders have a wealth of digital health tools to choose from, but some tools do not delivery on their promises. On this Industry Perspectives episode, Caroline Pearson, executive director of the Peterson Center on Healthcare, shares how the Peterson Center on Healthcare's newly-released framework can support stakeholders with digital health tool assessment.
Employees at CVS Health and Walgreens are going on strike over working conditions, and most patients want to send their wearable data to their doctors. Also, the White House released an executive order on artificial intelligence and a proposal to refine the independent dispute resolution process to reduce surprise billing.
While artificial intelligence (AI) is not new to the payer industry, generative AI has generated quite the buzz. Ginny Whitman, senior manager of public policy at Alliance of Community Health Plans (ACHP), discusses how payers have reacted to the new tool, how regulatory trends might shape its future, and more.
Moving through the value-based care world can be difficult for providers. Jean-Claude Saghbini, president of value-based care enablement at Lumeris, shared what value-based care enablement looks like and how improving data-sharing between stakeholders can reinforce the relationships that are indispensable to value-based care success.
Today on Healthcare Strategies | Headlines: Physician-owned hospitals see huge savings compared to traditional hospitals. Average employee premiums and deductibles increased substantially in 2023. Meanwhile, eLearning for electronic health records training could reduce provider burnout, and one hospital is prescribing--and delivering--lower utility bills.
In this episode of Healthcare Strategies, Senior Editor Alivia Kaylor chats with Tina Platania, PharmD, Director of Clinical Services at CCS and a certified diabetes care and education specialist, about the role of healthcare providers in continuous glucose monitoring (CGM) coaching and education. CGM has emerged as an essential tool in diabetes management, revolutionizing how healthcare professionals and patients approach the disease. Platania offers valuable insights into the significance of CGMs and their impact on personalized diabetes care.
Kaiser Permanente and striking unions reached a tentative deal after the country's largest healthcare strike. Also, the FDA will set up a Digital Health Advisory Committee, HC3 warned of a new ransomware targeting healthcare, and Medicare Advantage plans' 2024 star ratings dropped again.
The transition to value-based care has been a marathon, not a sprint. However, health systems like Advocate Health have seen success by diving into the world of value-based care. Megan Reyna, MSN, RN, system vice president for enterprise population health at Advocate Health, discusses how to overcome barriers to adoption, technology’s role, and the opportunities of value-based care.
Kaiser Permanente employees are preparing to strike as workforce shortages, clinician burnout, and low wages drive healthcare workers to extreme measures. Meanwhile, hospitals have seen six months of an upward trend in median operating margins, and NIH invests in AI research for kidney transplants.
For women, health benefits are worth over $1.3 billion less than for men. This results in higher out-of-pocket spending among women and increases the financial gap between the sexes. Andy Davis, principal for Deloitte Consulting LLP’s Health Care practice, and Marielle Farina, senior manager at Deloitte Consulting, discuss this imbalance in health benefits equity and what employers and health insurers can do about it.
On the federal level, the Biden administration is proposing banning medical debt from credit scores, CMS paused Medicaid redeterminations for 30 states, and the Federal Trade Commission is cracking down on major anesthesiologists in Texas. Meanwhile, Costco is entering the virtual care space with a new partnership and the Texas Tech University Health Sciences Center will launch an institute dedicated to rural health and digital health.
As US healthcare continues to move away from fee-for-service and toward value-based care, accountable care organizations are tasked with driving much of that shift through high-quality care management and population health management initiatives. Sheila Magoon, MD, executive director of Buena Vida y Salud ACO and the South Texas Physician Alliance, and David Clain, chief product officer at the Health Data Analytics Institute, explore how predictive analytics and digital twins can help ACOs achieve their value-based care goals.
In an ever-evolving healthcare system, some organizations are responding with new technology, such as Oracle’s new generative AI for EHRs and the rise of virtual nursing. Others have entered new partnerships, such as Dana-Farber’s decision to leave Brigham and Women’s and create a new cancer hospital with Beth Israel Deaconess Medical Center and Blue Shield of California’s partnership with Salesforce. But despite these efforts, barriers to positive patient outcomes are a constant, as recent data showed that coordinated care and SDOH interventions rely heavily on patient engagement.
As the maternal mental health crisis in the US progresses, comprehensive reproductive psychiatry may improve outcomes. Sarah Oreck, MD, a reproductive psychiatrist, CEO, and co-founder of Mavida Health, a comprehensive maternal mental health app, explores possible solutions to ongoing problems.
As healthcare continues its push toward health equity, it is crucial not to exclude people with disabilities from the conversation. Colin O’Reilly, DO, FAAP, FACOP, FCCM, of Children’s Specialized Hospital outlines communication and advocacy strategies for designing a health equity platform that accounts for populations with disabilities.
As payers and providers seek to reduce care disparities, health equity quality measures—like NCQA’s—may guide their efforts. Bryan Buckley, DrPH, director of health equity initiatives at the National Committee for Quality Assurance (NCQA), explains how organizations can shape partnerships and internal processes to align with their health equity quality measures.
In this episode, Liz Beatty, co-founder and chief strategy officer at Inato, emphasizes the significance of empowering community research centers to choose trials that cater to their unique needs and patient populations as a pivotal approach to enhance clinical trial diversity and access in the United States, thereby bringing care to those in need and transforming the clinical trial ecosystem.
As healthcare organizations strive to address the needs of diverse patient populations, they are taking steps to align internal goals and workforce management strategies with this aim. Kimberly Williams, DNP, MSN, RN, NE-BC, and the administrative director at Stanford’s Bass Center for Childhood Cancer and Blood Diseases Hematology/Oncology, CAR-T, Stem Cell Transplant, and Center for Definitive and Curative Medicine, shares how a team of stakeholders at Stanford Medicine Children’s Health is working toward health equity improvement.
As the US mental epidemic rages on, direct-to-consumer virtual mental healthcare apps have multiplied. CVS Health Chief Psychiatric Officer Dr. Taft Parsons III joined the podcast to discuss the current mental healthcare landscape and how technology use has impacted it, as well as the rise of consumer-facing digital tools for mental health and their pros and cons.
In this episode, Colin Banas, MD, MSHA, Chief Medical Officer at DrFirst, sheds light on the difficulties of adhering to mental health treatment and emphasizes the role of technology in enhancing care. By identifying obstacles and harnessing the power of technology, healthcare professionals and patients can explore innovative solutions to overcome these challenges and improve the effectiveness of mental health methods.
An analysis published by McKinsey & Company analyzing gender diversity in the healthcare workforce found that female representation drops off in higher-level positions. Gretchen Berlin, RN, Senior Partner at McKinsey & Company, discussed the analysis and improvement strategies on this episode of Healthcare Strategies.
A recent study published in Health Affairs found third-party tracking technology present on nearly all US nonfederal acute care hospital websites. Two of the study’s authors, Ari B. Friedman, assistant professor of emergency medicine at the University of Pennsylvania, and Matthew McCoy, assistant professor of medical ethics and health policy at the University of Pennsylvania discussed their findings on Healthcare Strategies.
Healthcare stakeholders have been leaning on remote patient monitoring tools to provide chronic disease management support, care management, and adverse event reduction. The coronavirus pandemic honed remote patient monitoring skills and forced higher uptake, but stakeholders continue to face challenges around accessibility and reimbursement. Xtelligent Healthcare Media’s Anuja Vaidya, senior editor of mHealthIntelligence and special events lead, Hayden Schmidt, associate researcher, and Kyle Murphy, vice president of Editorial, chat about a recent Insights report detailing the opportunities and barriers for remote patient monitoring and what the future holds for these tools.
Funding, workforce diversity, and health equity challenges impede medical research advancement. Mary Woolley, president of Research!America, expounds upon the impact of these challenges and how the healthcare industry can rectify issues in these areas.
Healthcare is at a primary care crossroads, soon to find itself with 100 million people lacking access. That problem is driven in part by a primary care workforce stretched too thin. Nurse practitioners, the majority of whom are trained in primary care, could help fill in that gap, according to April Kapu, president of the American Association of Nurse Practitioners. States will need to reconsider their scope of practice laws in order to let NPs realize their full practice authority and fill in primary care access gaps.
Diversity is critically important for the healthcare workforce because it helps ensure that the workforce reflects the communities they serve, which leads to better outcomes for patients and families. In this episode, Nancy Maldonado, chief diversity and inclusion officer at Rady Children's Hospital in San Diego, California, shares how a diverse healthcare workforce brings a range of perspectives and experiences that allow for better communication and understanding between providers and patients of different backgrounds.
The healthcare industry is in crisis mode as staff shortages and burnout reach record highs. Healthcare organizations are striving to maintain an adequate workforce to preserve patient access to care, but leaders must change their recruitment and retention strategies to achieve that goal. Northern Light Health’s SVP and chief people officer Paul Bolin, MBA, SPHR, SHRM-SCP, shares how the rural health system in Maine has not only minimized turnover over the last three years but created a diverse team of staff members who stay at the organization.
Cultivating medical workforce diversity—a key component of health equity—will require upstream efforts at the medical college level. Ideally, medical schools would have a diverse student population that would then create for a diverse hospital or health system applicant pool. Robert Cain, DO, and Helene Cameron, PhD, outline how the American Academy of Colleges of Osteopathic Medicine (AACOM) is working to create medical workforce diversity at the medical school level.
Clinician access to advanced care planning documents is key for meeting patients' end-of-life care wishes. However, industry silos can limit interoperability of these documents, leaving providers without crucial information to guide treatment decisions. Maria D. Moen, senior vice president of innovation and external affairs at ADVault, joins the podcast to discuss how the Post-Acute Care Interoperability Project (PACIO) is working to streamline PAC data exchange through FHIR implementation guides.
The role of the home healthcare nursing workforce expanded during the coronavirus pandemic and became a pivotal part of the healthcare delivery system. Kathy Driscoll, senior vice president and chief nursing officer at Humana Inc., offers her recommendations on supporting the home healthcare nursing workforce—both current nursing staff and future home healthcare nurses.
The COVID-19 pandemic worsened a growing mental health crisis among American youth. Atrium Health’s Donnie Mitchem, director of outpatient therapy, and Christine Zazzaro, vice president, facility executive, joined the podcast to discuss how the health system is combating this issue through school-based telehealth programs, which can significantly expand access to behavioral healthcare for children.
Male infertility is a growing concern that affects a significant number of couples around the world, but unfortunately, due to a lack of awareness and clinical support, infertility is often wrongfully seen as a women's issue. As a result, men may be reluctant to seek treatment. In this episode, Philip J. Cheng, MD, a male fertility specialist and urologist at Reproductive Medicine Associates of New Jersey, shares how patients and healthcare specialists can spread awareness and help end the stigma that surrounds male infertility.
Artificial intelligence (AI) and machine learning (ML) tools have the power to synthesize data into actionable information. Stephen Friedhoff, MD, senior vice president of health care services at Blue Cross and Blue Shield of North Carolina (Blue Cross NC), explains how payers can use these tools to improve care coordination and quality of care.
Patients with complex conditions including chronic diseases require highly efficient, collaborative treatment from their health insurers and providers. Julie Bietsch, senior vice president of clinical operations at Aetna, and Eric Fennel, vice president of network strategy and value-based solutions at Aetna, describe how Aetna uses care coordination strategies and tools to improve payer-provider partnership in chronic disease management.
The proliferation of artificial intelligence in healthcare has led to increased interest in more advanced computing and analytics technologies, such as machine learning, for medical research and clinical care. Machine learning, in particular, may help researchers gain insights into human diseases through the use of biomedical simulation and high-performance computing. Amanda Randles, an Assistant Professor of Biomedical Sciences at Duke University, discusses these applications and how machine learning can help improve treatment planning and allow real-time feedback for physicians.
By employing personalized care strategies and solidifying partnerships, specialty pharmacies can improve patient outcomes, enhance satisfaction, and improve the quality of life for patients with rare or chronic conditions. In the second part of this two-part episode, Lisa Mymo, Vice President of Pharma and Financial Services, and Kathy Kokoski, RPh, CSP, Director of Pharma Operations, at AllianceRx Walgreens Pharmacy, explain how specialty pharmacies can improve and personalize patient care.
By leveraging several tailored communication methods, specialty pharmacies can improve patient engagement and outcomes using digital tools. Digital-driven tools such as patient portals, mobile apps, and portable devices effectively streamline communication between patients, providers, and pharmacies. In this episode, Lisa Mymo, Vice President of Pharma and Financial Services, and Kathy Kokoski, RPh, CSP, Director of Pharma Operations, at AllianceRx Walgreens Pharmacy, explain how digital patient engagement tools can support specialty pharmacies by improving patient outcomes and increasing medication adherence and retention.
Social determinants of health philanthropy can have an impact, but it can also injure the very communities it is intended to support. Tiffany Benjamin, chief executive officer of the Humana Foundation, shares how payers and healthcare organizations can approach social determinants of health philanthropy in an effective, community-oriented way.
Transitioning to value-based care has been a marathon, not a sprint. Providers have experimented with different care delivery and payment models to improve care quality and coordination while earning savings. Scott Anders, MD, MBA, FAAGP, CPE, chief medical officer of value-based care and ambulatory quality at Providence, shares the top lessons learned from Providence’s long journey with value-based care and the strategy the health system uses to keep the momentum going.
Health insurers face a couple of key obstacles as they implement digital health solutions, such as the lack of payer alignment around digital quality measures and the slow development of interoperability. Peter Long, executive vice president of strategy and health solutions at Blue Shield of California and co-author of a National Academy of Medicine article on digital health, explains how payers can refine their digital health efforts and how an integrated health record can overcome digital health barriers.
In 2023, leaders in health IT analytics, mHealth, EHR, and health IT security will see innovation around healthcare consumerism and provider burden. Experts from HITRUST, Surescripts, Mass General Brigham Health System, Mayo Clinic Platform share their projections for the new year.
In 2023, payers, providers, revenue cycle, life sciences leaders will face extreme financial pressures that will shape their decisionmaking but that may also open their eyes to new opportunities in value-based care and other areas of healthcare. Healthcare leaders from Blue Shield of California, Cook Medical, Forrester Research, and Providence Health & Services – Washington share their projections for the new year.
Gender-affirming care, including social, psychological, behavioral, and medical interventions, is supportive healthcare that affirms a person’s gender identity when it conflicts with their assigned birth gender. Though proven to result in overwhelmingly positive outcomes, such as reducing suicide ideation and attempts, gender-affirming care access can be hard to come by, especially in primary care settings. In this episode, Kate Steinle, nurse practitioner, chief clinical officer at FOLX Health, and former Planned Parenthood employee, discusses ways to break down the barriers to gender-affirming care and expand access to patients.
Seniors in the LGBTQ+ community today are aging in a country that is much more open to conversation about LGBTQ+ care and wellness than when they were young, but they still face barriers to care and coverage. Sachin Jain, MD, president and chief executive officer of SCAN Group and SCAN Health Plan, and Jill Selby, senior vice president of product development, marketing, and market expansion for SCAN Health Plan, share how the health insurance industry can facilitate coverage and cultural change to reduce barriers to care for LGBTQ+ seniors.
Because the effects of fertility treatment such as in vitro fertilization can often be traumatic and taxing, patients see many disruptions in their daily lives and have rated the stress of undergoing this procedure as more stressful than or almost as stressful as any other major life event, including the death of a family member or divorce. In this episode, Dr. Maria Costantini-Ferrando, clinical director and reproductive endocrinologist with Reproductive Medicine Associates of New Jersey and a licensed clinical psychologist, shares how in vitro fertilization impacts patients personally, financially, and emotionally and how healthcare providers can lend support.
Third-party health apps can help patients manage chronic diseases, log vital signs, and take charge of their health. But these apps often fall outside of HIPAA's purview, leaving them in a regulatory gray area. Tina Grande, executive vice president for policy at the Healthcare Leadership Council and chair of the Confidentiality Coalition, Robert Tennant, vice president of federal affairs at the WEDI, and Marilyn Zigmund Luke, vice president at AHIP, discuss third-party health app privacy and security risks.
Supporting care coordination for incarcerated individuals is challenging due to fragmented care systems and data sharing barriers. Kim Dong, DrPH, RD, assistant professor in the Department of Public Health and Community Medicine at Tufts University School of Medicine, and Lynda Rowe, senior advisor of value-based systems at InterSystems, share findings from a study evaluating HIV care transition processes at a Massachusetts jail.
In the second part of a two-part series on specialty pharmacies, Shaunte Law Rhames, RN, BSN, an infusion care nurse supervisor working in inpatient management services, and Nichol Marrero Nieves, PharmD CSP, a patient management service pharmacist who specializes in neurology, behavioral health, and chronic inflammatory diseases at AllianceRx Walgreens Pharmacy, one of the nation's largest home delivery and specialty pharmacies for patients with rare and chronic diseases, share how pharmacy team members can purposefully support patients manage and prevent chronic diseases.
Considering specialty pharmacies provide highly accessible healthcare to patients, pharmacies have the chance to extend their role by advocating for better patient outcomes and supporting patients in navigating the complexities of dealing with a chronic disease. Shaunte Law Rhames, RN, BSN, an infusion care nurse supervisor working in inpatient management services, and Nichol Marrero Nieves, PharmD CSP, a patient management service pharmacist who specializes in neurology, behavioral health, and chronic inflammatory diseases at AllianceRx Walgreens Pharmacy, one of the nation's largest home delivery and specialty pharmacies for patients with rare and chronic diseases, share how the pharmaceutical community can purposefully empower patients and prevent future illnesses.
The nation’s progress toward value-based care is impeded by the siloed nature of the healthcare industry. Joe Castiglione, principal program manager of Industry Initiatives at Blue Shield of California, shares how Blue Shield implemented an industry collaboration team to increase momentum in value-based care progress.
To meet the needs of an increasingly independent senior population, primary care organization Heal leverages in-person and virtual care services to provide care in the home. Justin Zaghi, MD, Heal's chief medical officer, joined the podcast to discuss Heal's model, how it uses telehealth and RPM to supplement in-person care, and how care in the home can support value-based care delivery.
Global capitation models are the most high-risk form of advanced payment model that a health system could adopt, but they have proven advantageous for promoting alignment around value-based care. Michael Weiss, MD, vice president of population health for Children’s Hospital of Orange County (CHOC), shares how his health system moved toward global capitation and offers recommendations for other organizations hoping to do the same.
The accountable care organizations (ACO) model is one of the greatest tools in the value-based care toolbox, with ACOs in the Medicare Shared Savings Program producing savings five years in a row. Sam Starbuck, VP and GM at Privia Quality Network, shares how physician engagement, patient access, and data transparency are all key to savings and quality improvements.
One of the key challenges in value-based care is achieving collaboration between healthcare stakeholders who would normal be in competition with each other. Crystal Eubanks, senior director of care redesign at the Purchaser Business Group on Health (PBGH), shares how the California Quality Collaborative programs pursued effective collaboration on value-based care.
From the patient’s perspective, physical and behavioral healthcare are already integrated in their wellness experience, but the healthcare industry has a long way to go in matching this reality in patients’ treatment journeys. Ewa Matuszewski, chief executive officer and co-founder of MedNetOne Health Solutions, explains how healthcare stakeholders can work toward a more integrated behavioral-physical healthcare experience within the value-based care framework.
Artificial intelligence and machine learning are increasingly integral to value-based care models, which rely heavily on data and data analytics. However, these resources can also work against value-based care if they introduce or perpetuate negative biases. Marzyeh Ghassemi, a principal investigator at MIT’s Jameel Clinic, shares how to avoid negative biases in artificial intelligence and machine learning in the value-based care context.
Cancer treatment is full of challenges for patients and their families. A lack of patient-centered care can amplify these existing challenges and introduce new ones. André Dahinden, managing director at Accenture, shares how healthcare providers can make their oncology treatment processes more patient-centered in order to facilitate better patient experience and improve outcomes.
To support business growth and promote the shift to patient-centric care, health system CEOs are implementing digital tools and diversifying their workforce. Jiban Khuntia, PhD, director of the University of Colorado, Denver's Health Administration Research Consortium, shares the results of a health system CEO survey highlighting these trends and discusses how they support the digital transformation journey in healthcare.
Artificial intelligence has a variety of useful applications in healthcare. But algorithmic bias, along with data privacy and security concerns, have prompted significant ethical and legal concerns. Linda Malek, partner at Moses & Singer and chair of the firm’s healthcare, privacy, and cybersecurity practice group, discusses the risks associated with AI in healthcare.
Many unknowns surround Alzheimer’s Disease prevention and management, but blood testing might pave a way forward. Michael Racke, MD, Medical Director of Neurology at Quest Diagnostics, shares how a new type of diagnostic testing might help identify Alzheimer’s Disease early and change the healthcare system’s approach to the disease.
Investing in primary care services can be key to the success of organizations’ value-based care and health equity efforts. Vivek Garg, MD, chief medical officer for Humana’s Primary Care Organization, shares how organizations can invest strategically to support primary care, from investing in more sustainable EHRs to aligning around health equity.
Amid evolving telehealth policy and regulations, federal agencies are working to prevent fraud and abuse. In part two of a two-part series on telehealth, Jacob Harper, an associate with law firm Morgan, Lewis & Bockius, Christa Natoli, executive director of the Center for Telehealth and E-Health Law (CTeL), and Ben Steinhafel, policy director of CTeL, discuss fraud enforcement actions related to telehealth and why providers must remain vigilant.
In part one of a two-part series on telehealth, to ensure access to telehealth after the public health emergency has ended will require lawmakers to pass new legislation extending or making permanent regulatory flexibilities enacted during the pandemic. Jacob Harper, an associate with law firm Morgan, Lewis & Bockius, Christa Natoli, executive director of the Center for Telehealth and E-Health Law (CTeL), and Ben Steinhafel, policy director of CTeL, discuss the bills currently introduced in Congress and trends in state telehealth legislation.
By bringing primary care services into the home through in-home primary care, providers can improve patient satisfaction while lowering healthcare costs. Chris Dodd, MD, chief medical officer at Emcara Health, sheds light on how in-home advanced primary care interacts with the rest of the healthcare system to lower costs and boost patient experience.
Access to comprehensive patient health data at the point of care is critical for care coordination. Holly Miller, MD, chief medical officer of MedAllies, shares how 360X specifications can help healthcare organizations streamline data sharing to support patient-centered care during care transitions.
Broader uptake of virtual care has broken down many of the geographic- and stigma-related barriers of the past, but has also erected new barriers in their stead. Adam Hornung, executive director of telehealth operations at Intermountain Healthcare, shares how his organization has tackled barriers to virtual care access and involved patients in the solution.
Pharmacogenomics and precision medicine are evolving fields that are full of opportunities for advancement and improving patient outcomes, but seizing these opportunities may require a concerted effort from healthcare stakeholders. Cynthia Yu, PharmD, director of precision medicine at The Profero Team, and Scott Betzelos, MD, chief medical officer and vice president of HMO strategy and affordability at Blue Care Network, offer their perspectives on the challenges and opportunities of precision medicine and pharmacogenomics and its future.
Since chronic disease management has a significant impact on patient outcomes and spending, it is often a central focus of healthcare stakeholders' value-based care efforts. Hayden Schmidt, assistant editorial researcher of Insights at Xtelligent Healthcare Media, dives into the recent Insights report which sheds light on value-based care efforts related to chronic disease.
To access the report, visit our corporate website: https://www.xtelligentmedia.com/insights.
The new DOJ Civil Cyber-Fraud Initiative includes provisions related to whistleblowers and may change the way that healthcare providers are viewed in cybersecurity cases. Lisa Rivera, a member of the law firm Bass Berry & Sims, and co-chair of the firm's compliance and government investigations practice group, delves into how the initiative might impact the healthcare industry.
Despite the high demand for healthcare workers during a years-long workforce shortage and the demonstrated benefits of workforce diversity, large disparities exist between women and men in the medical field including leadership transitions and promotions. Shikha Jain, MD, a hematologist and oncologist at UIC Cancer Center and the founder of Women in Medicine (WIM), and Eve Bloomgarden, MD, an endocrinologist and chief development officer for WIM, shared their nonprofit's goals and efforts to reverse gender gaps in the healthcare workforce.
Electronic medical records (EMRs) and electronic health records (EHRs) are essential tools that allow the storage and maintenance of protected health information (PHI). Unfortunately, PHI is also extremely valuable to threat actors. Salwa Rafee, global managing director for healthcare security at Accenture Security, discusses EMR security risk factors and the pros and cons of in-house and cloud-based EMR systems.
In part two of this introduction to the life sciences, Alivia Kaylor, senior editor of LifeSciencesIntelligence, addresses the other three categories of life sciences: medical devices, medical imaging, and reproductive health. Each of these categories is prime for growth and presents many opportunities and challenges to the healthcare industry as a whole.
Life sciences is a broad field of study, but it has significant implications for stakeholders across the healthcare industry. Alivia Kaylor, senior editor of LifeSciencesIntelligence, explains how being knowledgeable about biotechnology, genetics, genomics, and other aspects of the life sciences can be valuable for healthcare professionals.
Predictive analytics covers a broad range of functions and tools. Tom Selva, chief medical information officer of University of Missouri Health Care, shares how his healthcare system implemented a a predictive analytics-powered early intervention tool for sepsis and what the future of predictive analytics could hold.
Thanks to our sponsor: Lark utilizes proprietary A.I technology to simplify the prevention and management of chronic illnesses. Its expanding platform provides users 24/7 access to a virtual care coach through an engaging and personalized text-like interface. Lark currently works with 2 of the 3 largest health plans.
Providers know that preventive care services are critical to achieving positive patient outcomes, but how do they educate patients about the need for preventive care and encourage patients to follow through on preventive care appointments? Sara Heath, managing editor at Xtelligent Healthcare Media, covers how healthcare organizations have been improving their patient engagement strategies around preventive care services.
We are celebrating 100 episodes of Healthcare Strategies with 100 seconds capturing a couple of highlights. Thank you to all of our guests, hosts, sponsors, and--of course--a big thank you to you, our listeners, for making this possible!
When hospitals and healthcare systems require an EHR enterprise solution that will meet a variety of unique needs, EHR vendor solutions may fall short. Jessica Cox, director of product solutions at Holy Name Medical Center, explains how Holy Name Medical Center designed and implemented a customized EHR enterprise solution, offering lessons learned from this experience.
The legal debate around the coronavirus vaccine mandate that CMS issued in November 2021 has surfaced many questions around workforce management and drew attention to the nation’s clinician labor shortage. Sarah Coyne, partner at Quarles and Brady and adjunct professor at the University of Wisconsin-Madison School of Law, and Jon Kammerzelt, partner at Quarles and Brady and Chair of the Health and Life Sciences Group in the Firm's Madison Office, share their insights into the legal proceedings and the impact that this debate could have on the healthcare workforce.
As the healthcare industry seeks to improve health equity and reduce care disparities, Healthfirst has introduced seven principles for orienting an organization around health equity. Susan Beane, executive medical director of partnerships for medical outcomes at Healthfirst, and her colleagues Rashi Kumar, director research and policy in partnerships for medical outcomes, and Tom Wang, manager of research and evaluation in partnerships for medical outcomes, share the ADVANCE principles and how they guide Healthfirst's health equity efforts.
What responsibility do employers have to address social determinants of health among their employees and how should they act on that responsibility? Mike Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions (National Alliance), and Christa-Marie Singleton, chief medical officer of the Office of the Associate Director for Policy and Strategy at the Centers for Disease Control and Prevention (CDC), share how employers can use demographic data to better address employees’ social risks.
Thanks to our sponsor: Lark utilizes proprietary AI technology to simplify the prevention and management of chronic illnesses. Its expanding platform provides users 24/7 access to a virtual care coach through an engaging and personalized text-like interface. Lark currently works with 2 of the 3 largest health plans.
When a crisis disrupts claims volume and payments processes, what can payers and providers do to adjust? April Todd, senior vice president of CORE and explorations for CAQH, explores the coronavirus pandemic's impact on administrative transactions and how the past two years can inform healthcare stakeholders' reactions to future crises.
The coronavirus pandemic has sparked an increase in substance abuse, but many Americans who struggle with substance abuse do not seek out mental healthcare support. Jasleen Chhatwal, MD, chief medical officer at Sierra Tucson, shares the findings of Sierra Tucson's survey on substance abuse in the US and dives into how those results can inform healthcare professionals at the patient engagement level and the strategic level.
As ransomware attacks continue to overwhelm the healthcare sector, organizations will have to decide whether to pay the ransom or potentially risk patient safety. Erik Weinick, a seasoned litigator and co-founder of Manhattan-based law firm Otterbourg's privacy and cybersecurity practice, discusses the consequences of paying or not paying the ransom in the event of a healthcare cyberattack, and how organizations can mitigate risk.
As the national conversation around interoperability moves forward, it is time to progress beyond defining what interoperability is and instead make sure that all of the impacted stakeholders' voices are represented, including patients' and payers' perspectives. Alan Swenson, executive director for Carequality, shares how to better engage payers and patients in discussions around health data exchange.
After a couple of years of rapid healthcare technology innovation and uptake, healthcare professionals want to know what 2022 might have in store. Executives from the HIT security space, legal advisors, leaders in digital and artificial intelligence strategy, and HIT consultants share their perspectives on key 2022 trends in telehealth, remote patient monitoring, security, and more so that healthcare professionals can prepare for the new year.
2020 and 2021 highlighted the critical need for more consumer-centered strategies. Health insurance plan leaders, healthcare nonprofit founders, and industry consultants share how healthcare organizations will rally around the consumer in 2022, both independently and across sectors.
As the number of urgent care clinics around the country continues to grow, their role in helping communities access care perpetually evolves. Jackie McDevitt, PA-C, lead advanced practitioner at Northwell Health-GoHealth Urgent Care, explains how urgent care clinics help patients navigate the healthcare system and utilize appropriate care at a lower cost.
As stakeholders strive to prepare for surprise billing regulation compliance—building off of interoperability progress—one thing is clear: payers and providers alike will need to find a common approach. Erin Weber, director of the Committee on Operating Rules for Information Exchange (CORE) at the Council for Affordable Quality Healthcare (CAQH), shared how the healthcare industry can standardize its approach to surprise billing.
As healthcare systems move toward greater interoperability, they have leveraged various strategies including cloud-based technology implementation and stakeholder partnerships. Nevertheless, they continue to confront barriers in their efforts. Kristian Feterik, medical director of interoperability and clinical associate professor of medicine at University of Pittsburgh Medical Center (UPMC), explains how widespread adoption of FHIR would advance the healthcare industry's interoperability--and intraoperability--goals as well as how cloud-based technologies factor into this effort.
Medical device security vulnerabilities have the potential to impact patient safety and serve as an open door to hackers. Elizabeth Butwin Mann, Americas Life Sciences and Health Cybersecurity Leader at EY, explains what makes medical devices so susceptible to security vulnerabilities, and what healthcare organizations can do to mitigate risk.
Virtual-first health plans have the potential to improve quality of care, patient experience, and access to care, but they can present complications as they involve typically-siloed technologies and care teams. Donna O'Shea, MD, national chief medical officer and vice president of population health and value-based care at UnitedHealthcare, dives into the benefits of virtual-first health plans and how payers can effectively implement virtual-first models.
Each year during Medicare open enrollment season, payers face both challenges and opportunities as they seek to address beneficiaries' individual needs and provide the best assistance to enrollees. Christopher Ciano, president of Aetna Medicare, divulges the key aims that payers should keep at the center of their strategies around Medicare open enrollment season and how Aetna tackles each of these goals.
Provider-sponsored health plans have a capacity for strong provider engagement and health plan-provider alignment. Robert Gluckman, MD, chief medical officer of Providence Health Plan, shares the ways in which the provider-sponsored health plan model can further value-based care goals.
Veterans who have PTSD may struggle to access care due to a variety of barriers. David Shulkin, MD, the former, ninth secretary for VA, explains how the VA has leveraged digital solutions historically and what barriers remain between veterans and PTSD treatment.
Population health data is essential to the forward movement of value-based care. But what is the status of providers' population health strategies? Emily Sokol, director of research at Xtelligent Healthcare Media, shares the results of a recent Insights report and explains how predictive analytics capabilities play a role in the future of both population health and value-based care.
To access the report, visit our corporate website: https://www.xtelligentmedia.com/insights/population-health-and-data-analytic-strategies-for-value-based-care
In order to move more decisively toward a value-based care system, the healthcare industry will need to scale its value-based care efforts. But it is hard enough transitioning a single provider from fee-for-service into value-based contracts, much less all of a payer’s provider partners. Troy Smith, vice president of cost of care and value programs at Blue Cross NC, explains how Blue Cross NC overcame providers’ value-based care challenges and scaled its value-based contracts across multiple lines of business.
CMS uses the Medicare Shared Savings Program to encourage providers to enter into accountable care organizations, in which they take on greater responsibility for reducing low-value care and high healthcare spending. Gary Stuck, DO, chief medical officer at Advocate Aurora Health, shares how Advocate Aurora Health has leveraged the ACO model to achieve strong cost savings and high-quality performance in the Medicare Shared Savings Program.
The hospital care setting can pose many risks to seniors. To improve patient experience in acute care, some experts are urging payers and healthcare systems to facilitate moving acute care to the home. Amal Agarwal, DO, vice president of home solutions for Humana and emergency room physician, explains how acute home healthcare can reduce risks for seniors and how payer and provider organizations can expand access to these services.
Advanced payment model uptake received a boost from the coronavirus pandemic as providers shifted away from wholly volume-based, fee-for-service models into value-based care contracts. However, fee-for-service remains strongly present in the healthcare system today and, according to some healthcare professionals, it will persist as a key reimbursement model for the foreseeable future. Emily Sokol, director of research at Xtelligent Healthcare Media, provides an overview of providers' advanced payment model adoption and offers strategies for shifting away from fee-for-service reimbursement models.
To access the report, visit our corporate website: https://www.xtelligentmedia.com/insights/choosing-the-right-alternative-payment-model
Americans are experiencing a spike in mental health diagnoses. However, even as mental health challenges become more visible and widespread, mental health stigmas remain. Lana Seiler, LCSW, primary therapist at All Points North Lodge, shares how healthcare stakeholders can combat mental health stigmas and encourage treatment among patients, within their own communities, and within themselves.
The lack of health equity in the current healthcare system is starkly evident in maternal care. Black patients who are pregnant are at higher risk than their White counterparts for a highly preventable disease called preeclampsia. Joanne Armstrong, MD, executive medical director and chief medical officer for women’s health and genomics at CVS Health, explains how provider and payer organizations can improve patient education to combat care disparities in maternal care.
As the nation emerges from the coronavirus pandemic, healthcare professionals can work to keep health equity as central to their strategies going forward. Sara Heath, managing editor at Xtelligent Healthcare Media, reviews how to define health equity, how the pandemic impacted the industrywide discussion around this topic, and how steps that organizations can take toward improving health equity.
Healthcare Strategies will return with Season 3 on September 6, 2021.
Nurse practitioners are trained not to take risks in care delivery, but when it comes to starting their own practices they have to accept financial risk and prove their value. Lorraine Bock, co-founder of National Nurse Practitioner Entrepreneur Network (NNPEN), shares her experience starting her own practice as a nurse practitioner, the value that nurse practitioners add to the healthcare system, and how nurse practitioners can engage in value-based contracting.
Community-based paramedics have a unique role in the local healthcare system. By going into individuals’ homes to provide healthcare support, they can gain insight into potential social determinants of health barriers that other healthcare providers may never see. Ken Peach, executive director of the Health Council of East Central Florida, shares how his organization is using community-based paramedicine to improve value-based care in Florida.
Remote patient monitoring received a lot of attention when healthcare was forced homeward during the coronavirus pandemic out of necessity. But what does the future hold for these technologies? Are remote patient monitoring technologies worth keeping around and, if so, what is the next step in integrating them into the healthcare system at large, including incorporating them into evolving artificial intelligence strategies? Eric Wicklund, senior editor of mHealthIntelligence at Xtelligent Healthcare Media, leverages his extensive background covering mHealth technologies to project the road ahead for remote patient monitoring technologies.
Pediatric primary care practices often lack the bandwidth to implement value-based care solutions at the level that childrens' hospitals and health systems can achieve. What is the next step toward value-based care in this setting? Larry Epstein, chief executive officer of Pediatric Urology Associates, shares his perspective on the state of value-based care in pediatric primary care and how to make progress.
As the dangers of the coronavirus pandemic subside in the US, how will providers leverage telehealth in the "new normal"? What challenges prevent providers from implementing telehealth effectively? Emily Sokol, director of research at Xtelligent Healthcare Media, shares the results of a recent Insights report on telehealth and the outlook on telehealth's future.
To access the report, visit our corporate website: https://www.xtelligentmedia.com/insights/telehealth-growth-and-development-telehealths-place-in-the-industry-beyond-the-pandemic
Making progress on specific interoperability goals is a key aim for payers in 2021. But what is the overall vision for interoperability? And how does interoperability engage with the other major changes occurring in the industry? Danielle Lloyd, senior vice president of private market innovations and quality initiatives for Clinical Affairs at AHIP, returned to Healthcare Strategies to share her perspective on the overarching goals of interoperability in the payer industry.
The industrywide movement toward interoperability involves multiple steps and factors. As payers prepare to conform to CMS deadlines, how can they juggle all of these pieces without losing site of the big picture? In the first of our two-part conversation on the subject, Danielle Lloyd, senior vice president of private market innovations and quality initiatives for clinical affairs at AHIP, covers how payers can prepare for the immediate July 1 deadline and touches on next steps toward interoperability.
Seniors have been a particularly vulnerable population during the coronavirus pandemic, estimated to account for approximately eight in ten coronavirus-related deaths in the US. Providers experienced many challenges as they tried to serve this population during this uncertain time. Emily Sokol, director of research at Xtelligent Healthcare Media, shares the results of an Insights report on providers engaged in senior care, exploring how the pandemic impacted senior care--including access to care and technology use--and how it will shape senior care strategies in the future.
To access the report, visit our corporate website: https://www.xtelligentmedia.com/insights/senior-care-report
Pharmacy benefits managers (PBMs) offer one method of delivering pharmaceutical benefits to members, but Highmark Inc. and payers like it have developed an alternative that they argue may boost member engagement and improve drug spending. Sarah Marche, senior vice president of Pharmacy Services at Highmark Inc, discusses how Highmark has implemented integrated pharmacy benefits and the outcomes that the payer saw as a result of greater drug price transparency.
While views on the definition of "value" in value-based care may vary, healthcare professionals can rally around prioritizing patient experience in value-based care. LeChauncy Woodard, MD, director of Humana Integrated Health System Sciences Institute and professor at the University of Houston, and Tray Cockerell, a strategic relationship executive at Humana, explain how value is perceived today and how the industry can unify around patient-centered, value-based care.
Healthcare industry leaders have emphasized the need for physical, behavioral healthcare integration, but what actions do payers and healthcare organizations need to take to meaningfully move in the right direction? Brett Hart, Centene’s Chief Behavioral Health Officer, and Indira Paharia, Centene’s Chief Operating Officer for Behavioral Health, discuss barriers to integration and how to best leverage telehealth and value-based care to empower primary care services and achieve integration.
Payers eliminated cost-sharing for coronavirus treatment when the pandemic hit the US in March 2020. Now they have the opportunity to use those waivers as a model for reducing low-value care spending and investing in high-value care across the industry. Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design and professor of the division of general medicine, department of internal medicine and department of health management and policy at The University of Michigan, shares how payers can make that transition.
How can practices that engage in collaborative care transition from in-person care to virtual care? What does the future hold for integrating these two forms of care delivery? Sudhir Rao, MD, medical director at Pain and Spine Specialists of Maryland, shares how his practice shifted from in-person to virtual care in just a week during the coronavirus pandemic and how he increased his patients’ access to behavioral healthcare specialists using virtual care.
The patient’s experience of care has an impact beyond rankings and retention; it can affect the patient-provider relationship and the patient’s wellbeing overall. Emily Sokol, director of research at Xtelligent Healthcare Media, shares the results of the latest Insights report on patient experience, covering care coordination strategies, relevant technologies, and the influence of the coronavirus pandemic on healthcare organizations’ strategies.
To access the report, visit our corporate website: https://www.xtelligentmedia.com/insights/overcoming-challenges-to-effective-patient-experience
Progress in mHealth, connected health, and telehealth can be evaluated from multiple angles, including regulatory changes and technological advancements. Eric Wicklund, senior editor of mHealthIntelligence, explains how mHealth technologies and regulations have evolved and what needs to happen for that evolution to continue. He also reviews the conversations at the Telehealth21 Virtual Summit.
Home-based healthcare was once the primary nature of healthcare. It took the coronavirus pandemic to bring this care setting back into the spotlight. Kristen McGovern, convener at Moving Health Home, and Chris Johnson, vice president and head of corporate development at Landmark Health, discuss the impact of the coronavirus pandemic on home-based care, how value-based care can bolster home-based care, the barriers to home-based care, and more.
All high-value providers will aim for cost-savings, but advanced primary care practices recognize that population health data is key to lowering healthcare spending. John Collier, president and chief executive officer of Proactive MD, and Jeremy VanderKnyff, executive vice president of health data science, value, and validation at Proactive MD, share about the role that population health data plays in advanced primary care.
As the healthcare system pivots towards value-based care, some healthcare professionals may now take it for granted that quality measures are essential to high-quality care. But how can healthcare organizations design quality measures with both the provider and the patient in mind? Anthony Romeo, MD, an orthopedic surgeon and chief medical editor of Orthopedics Today, details how healthcare organizations can collaborate with providers to develop effective quality of care measurements.
Throughout 2020, speculations abounded as to the impact that the coronavirus pandemic would have on the progress of value-based care. Emily Sokol, director of research at Xtelligent Healthcare, reveals the trends that emerged through the most recent Value-Based Care Assessment.
To access the report, visit our corporate website: https://www.xtelligentmedia.com/insights/value-based-care-assessment-2020
With their member data and member engagement capabilities, payers are uniquely positioned to reduce healthcare disparities. Kedar Mate, president and chief executive officer at the Institute for Healthcare Improvement, and Mark Friedberg, senior vice president of performance measurement and improvement at Blue Cross Blue Shield of Massachusetts (BCBSMA), describe areas in which the payer industry has historically failed to eliminate racial care disparities and they explain steps that payers can take to eliminate disparities in their communities and companies.
As telehealth continues to expand, healthcare professionals must confront a repercussive question: how should healthcare organizations conduct quality measurement in telehealth? Sheri Winsper, senior vice president of quality measurement at the National Quality Forum (NQF), explains why quality measurement for telehealth is critical to patient-centered care and shares elements that healthcare organizations should consider in telehealth quality measurement.
It is well known that housing is a social determinant of health factor, but the implications of poor housing for children's health have gone under-explored until recently. Kelly Kelleher, MD, vice president of Community Health at Nationwide Children’s Hospital and senior author of a recent study on the subject, explains the pediatric implications and shares how hospitals and health systems can take action to support communities with poor housing.
During infectious disease outbreaks, data needs shift. Providers want to see heat mapping, total case count, points of transmission and other data points that are not typically evident in an electronic health record (EHR). April Diaz, vice president of clinical services at Marquis Companies, and Vicki Nordby, nurse consultant at Marquis Companies, share about their health system's experience adapting EHR tools to meet the demands of an infectious disease outbreak.
The coronavirus pandemic has exposed the value of genomic data for population health efforts. However, the US lags behind other nations in sequencing genetic data. David Relman, MD—professor of Microbiology at Stanford University and member of the standing committee on Emerging Infectious Diseases and 21st Century Threats at the National Academies of Science, Engineering and Medicine—explains the benefits of genomic sequencing and explores ways that the US can catch up in this field.
Hospitals often struggle to manage the flow of patients through their intensive care units (ICUs) and the coronavirus pandemic has only exacerbated this issue. Jamie Nordhagen, Director of Capacity Management at University of Colorado Hospital, describes an advanced analytics tool that her team uses to identify when the hospital's ICU is nearing maximum capacity. This gives the team the opportunity to move patients to areas where the staff are less strained.
Healthcare entities face a difficult task: eliminating information blocking while preserving patients' privacy. Dan Golder, principal at Impact Advisors, discusses how healthcare leaders can ensure that they are complying with the Office of the National Coordinator's rules on information blocking. He also shares his expectations for the next step in the industry's pursuit of interoperability.
This special episode features insights from each of Healthcare Strategies's hosts from the editorial and research staff at Xtelligent Healthcare Media. From value-based reimbursement trends to mHealth breakthroughs and regulatory changes, we take a look at what professionals across the healthcare industry can expect in 2021.
Technology and nimbleness are key to coronavirus vaccine distribution, according to Daniel Durand, MD, chief innovation officer at LifeBridge Health. He explains how his health system developed and adapted its coronavirus vaccine distribution tools and strategy.
The right digital health technologies can address many of the challenges that healthcare systems face, but implementing new technologies can be daunting and complicated. Cheryl Eck, associate vice president of strategy and planning at Edward-Elmhurst Health, shares how hospitals and health systems can leverage new technologies and improve the digital health experience for their patients.
With the healthcare landscape constantly evolving, how can payers and other healthcare organizations help train healthcare leaders to be prepared? LeChauncy Woodard, MD, director of Humana Integrated Health System Sciences Institute and professor at the University of Houston, shares from her experience bridging the divide between payers and the academic setting. She explains how healthcare organizations can train healthcare leaders to be collaborative in care coordination and aware of social determinants of health.
As seniors continue to adapt to telehealth modalities, how can health systems best leverage these technologies to empower senior-focused care? Renee Buckingham, president of Partners in Primary Care, discusses her practice’s technology solutions and how technology use in senior care might evolve in the future.
As healthcare organizations become more experienced in gathering social determinants of health data, they face the question of how to best utilize it. Shantanu Agrawal, president and chief executive officer of the National Quality Forum, shares how organizations can strategize around SDOH, transition to implementation, and how frontline workers can help move the needle.
Evergreen issues with affordability and quality of care have become even more apparent in light of the coronavirus pandemic. Jason Wolf, president and chief executive officer of The Beryl Institute, shares how the pandemic has shaped patient experience, both financially and clinically, and how healthcare organizations can build on industry successes in patient experience.
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Brian Dixon, director of public health informatics at Regenstrief Institute, Inc. and Indiana University Richard M. Fairbanks School of Public Health at IUPUI, details how sharing social determinants of health data can help improve population health. Specifically, he shares about Regenstrief Institute's Indiana Network for Population Health and how it expanded on previous efforts to share patients' clinical data in order to include social determinants of health information.
Nicole Caputo, senior director of experience and innovation at UCHealth, and Matt Andazola, project manager for experience and innovation at UCHealth, describe Livi, their artificial intelligence chatbot. They cover factors that motivated the development of their virtual assistant, the chatbot's capabilities in improving patient engagement and patient experience, as well as recommendations for organizations seeking to do the same.
Digital therapeutics is both new and old. It is new in that it is a novel form of care delivery with the capacity to solve problems in healthcare, but it is also old in that its building blocks are technologies that many practices already use. Megan Coder, executive director of Digital Therapeutics Alliance, walks through what digital therapeutics is, the challenges it faces in reimbursement and regulations, and its future in our rapidly changing healthcare environment.
With the healthcare industry experiencing a period of rapid change, whole person health has never been more important. Caraline Coats, vice president of Bold Goal and population health strategy at Humana, explains how payers and other healthcare professionals can engage in value-based, whole person care in a couple of different settings including telehealth and population health.
With the recent surge in telehealth services utilization, Chris Waugh, chief innovation officer at Sutter Health, has been facing a question that many leading health professionals are asking: how can providers strike a balance between telehealth and in-person care? Waugh offers his perspective on this and how to appropriately and innovatively leverage telehealth, data analytics, and remote monitoring to prioritize the best patient outcomes.
Steve Miff, president and chief executive officer of Parkland Center for Clinical Innovation, shares how to use data analytics to identify at-risk individuals. He describes how the center’s proximity risk index can help physicians decide when to direct patients to telehealth, identify patients facing social determinants of health and health disparities, and provide evidence to guide policy measures.
How can healthcare organizations protect their passwords and prevent credential theft? Jessica Davis, senior editor of HealthITSecurity.com, details common misconceptions around password protection. She gives an overview of the dangers of credential theft and explains how multi-factor authentication can dramatically decrease healthcare organizations' risk.
During a major disruption to the healthcare system, gathering quality measurement data can prove challenging for payers and providers. Frank Micciche, vice president of public policy and external relations at the National Committee for Quality Assurance (NCQA), describes a system of digital quality measures that can make quality measurement data more accessible remotely in a crisis.
Sri Bharadwaj, vice president of digital innovation and applications at Franciscan Health Information Services, shares a new solution to conducting multi-specialty rounding in the hospital setting. He describes how to improve provider collaboration, increase quality of care, and boost providers’ efficiency through telehealth.
Julie Smithwick, executive director for the Center for Community Health Alignment, shares from her over 25 years of experience in helping communities build more equitable healthcare systems. She defines and distinguishes between health disparities and health inequities. Additionally, Smithwick offers steps that healthcare organizations can take to reduce the existence of both in their communities.
Lori Baker, director of ambulatory care management and senior services/post-acute care at TriHealth, describes how her health system transformed its digital strategy in the post-acute care setting. She explores how this digital transformation--which includes progress into telemedicine--can extend providers’ productivity and she offers her projections of the industry’s trajectory for digital transformation.
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Andrew Selesnick, shareholder in Buchalter Law Firms's Los Angeles office, breaks down the upcoming hospital price transparency rule and the ongoing battle to stop CMS from mandating public disclosure of payer-negotiated rates, slated to go into effect on January 1, 2021. In light of this policy, he reviews the aims and effects of price transparency measures. Selesnick also shares price transparency compliance strategies for hospitals.
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Emily Sokol, senior researcher and editor at Xtelligent Healthcare Media, dives into Xtelligent’s Insights report, “The Future of Healthcare: Moving Beyond 2020.” As the lead researcher on this report, Sokol offers an invaluable perspective on the study’s findings, uncovering the industry’s coronavirus response and recovery and value-based care progress. The study balances data with experience, bringing together survey responses and interviews with industry leaders to develop a comprehensive overview of perspectives.
To access the report, visit www.xtelligentmedia.com/insights.
Sierra Christensen, PT, DPT, ATC, a pediatric physical therapist based in Texas, launched a telehealth service to improve her practice. The results she’s seen with her young patients, their families and her own work-life balance have convinced her to go all-virtual.
Christina Severin, president and chief executive officer of Community Care Cooperative (C3), shares how C3 uses its model as an accountable care organization made up of federally qualified health centers (FQHCs) to its advantage for population health management. She touches on how to communicate well with FQHCs, tools for managing social determinants of health data, and the difference between social determinants of health and health-related social needs.
Thanks to our sponsor: Vivify Health, developer of the nation’s leading remote patient monitoring platform, provides the best-connected care management and patient engagement solutions for better outcomes and ROI. Our virtual visit platform provides patients with the utmost care and empowers our clinicians to work seamlessly. We service more than 900 hospitals, home care agencies, and health plans. Vivify Pathways, the company’s mobile cloud-based platform, powers holistic remote care management through personalized care plans, biometric data monitoring, multi-channel patient education, and functionality configured to each patient’s unique needs.
Craig Settles brings together broadband and healthcare stakeholders to launch telehealth initiatives, and says success depends on both of those parties working together. One such example is his own project to deliver connected health services through local barbershops in urban areas. To contact Craig Settles, email him at craig@cjspeaks.com.
Ken Wheat, senior vice president and chief financial officer (CFO) at Eisenhower Health, describes how the nonprofit hospital managed its financial strategy during the height of the pandemic and its plans for reopening. He covers the roles that telehealth and virtual care could play going forward as restrictions on nonurgent care and elective surgeries lift and offers advice on advancing efficiency journeys through automation.
Thanks to our sponsor: Change Healthcare offers end-to-end revenue cycle management software solutions for physician practices, labs, home health, DME, medical billing services and other providers wanting to simplify workflows, reduce denials, optimize revenue, and improve the patient experience.
Amy Witt, MD, licensed, board-certified dermatologist at Derrow Dermatology, discusses the process of introducing telehealth to her dermatology practice at the beginning of the coronavirus. She shares how she generated buy-in from her existing and new patients, how coronavirus has impacted telehealth utilization, and what the future holds for telehealth in dermatology.
Shefali Mookencherry, Impact Advisors' Principal Advisor and Solution Leader of Information Security, Privacy, and Disaster Recovery, outlines key elements for drafting solid business associate agreements and potential red flags to avoid when negotiating with business associates. Mookencherry also lays to rest some misconceptions about breach protocols and HIPAA compliance.
Amy Andrade, former assistant vice president of research at Meharry Medical College and founding director of Meharry Medical College’s Data Science Center, discusses the importance of having access to complete and accurate social determinants of health data, especially for minority and underserved patient populations. She also emphasizes the role AI and machine learning can play in helping healthcare institutions collect and utilize this information.
David Moen, MD, president of Prospero Health Partners, describes the process of transferring in-person, integrated care to a virtual healthcare platform, a process that many practices are becoming familiar with during the coronavirus pandemic. He gives insight into rolling out the product, selecting early adopter patients, and securing provider buy-in.
Alan Lotvin, president of CVS Caremark, discusses how pharmacy benefit managers are handling the drug supply chain and managing patient needs during the coronavirus pandemic, including preventing stockpiling and providing digital solutions. He describes new PBM practices that will continue when the country moves into the “new normal.” He also touches on CVS Health’s approach to testing.
Mark Lurie, Associate Professor of Epidemiology at Brown University, digs into his experience tracking the spread of infectious diseases to provide a perspective on the coronavirus outbreak. He covers effective intervention, contact tracing, and offers his outlook on the pandemic’s trajectory.
Christa Natoli, executive director of the Center for Telehealth and eHealth Law (CTeL), notes common provider questions about the telehealth regulatory landscape and gives her perspective on the state of telehealth during the coronavirus pandemic. She discusses emerging trends in acute, behavioral, and mental healthcare and previews CTeL’s virtual conference in June 2020.
Thanks to our sponsor: Vivify Health, developer of the nation’s leading remote patient monitoring platform, provides the best-connected care management and patient engagement solutions for better outcomes and ROI. Our virtual visit platform provides patients with the utmost care and empowers our clinicians to work seamlessly. We service more than 800 hospitals, home care agencies, and health plans. Vivify Pathways, the company’s mobile cloud-based platform, powers holistic remote care management through personalized care plans, biometric data monitoring, multi-channel patient education, and functionality configured to each patient’s unique needs. www.vivifyhealth.com
Christian Rubio, vice president of Strategic Advancement for Global Genes, explains why supporting more diversity in clinical trials is both good science and good morals and outlines how researchers can take strides towards greater inclusion of underrepresented populations. He also delves into the current state of rare disease research and COVID-19’s impact on the field.
Kurt Herzer, MD, head of population health at Oscar Health, explains how payers are maintaining strong member engagement during the coronavirus. He details how population segmentation and deploying existing channels of communication can help address patient needs and uphold high quality member experience. He also describes how to partner with and support providers and community-based organizations as they assist members.
Brendan Carr, a commissioner with the Federal Communications Commission, explains how hospitals and health systems can take advantage of new funding opportunities initiated by the FCC to expand broadband connectivity and improve telehealth adoption. Carr details how the $100 million Connected Health Pilot Program and, more recently, the $200 million COVID-19 Telehealth Program are giving healthcare providers much-needed support to launch and expand innovative telehealth programs tackling both coronavirus and non-coronavirus care. He also explains how programs like this will position rural and urban providers for telehealth momentum after the emergency.
Vanessa Guzman, Associate Vice President at Montefiore Health System, defines population health as “everyone’s responsibility.” She describes how to build a culture that views the patient as a person, focusing on whole person health by leveraging appropriate technologies and community-based partnerships. She also addresses how the New York-based healthcare system is applying these strategies to the coronavirus pandemic.
Mariann Yeager, chief executive officer of The Sequoia Project, describes the current state of interoperability in light of the recent ONC final interoperability rule. She covers what stakeholders need to be involved, the challenges that the pandemic poses to interoperability, and how circumstances could accelerate the shift toward interoperability
Ann Mond Johnson, chief executive officer of the American Telemedicine Association, gives an overview of the telehealth landscape, in light of the pandemic. She explores areas where telehealth use could be expanded, explains how momentum can continue once the pandemic ends, and provides details on the ATA’s 2020 conference.
Thanks to our sponsor: Vivify Health, developer of the nation’s leading remote patient monitoring platform, provides the best-connected care management and patient engagement solutions for better outcomes and ROI. Our virtual visit platform provides patients with the utmost care and empowers our clinicians to work seamlessly. We service more than 800 hospitals, home care agencies, and health plans. Vivify Pathways, the company’s mobile cloud-based platform, powers holistic remote care management through personalized care plans, biometric data monitoring, multi-channel patient education, and functionality configured to each patient’s unique needs. https://www.vivifyhealth.com/
Caleb Barlow, president and chief executive officer of Cynergistek, shares best practice VPN strategies, in the wake of the COVID-19 pandemic and the increase in telehealth and remote work. He outlines recommended tech and policies, as well as the current threat landscape as hackers seek to profit from the national emergency.
Roger Shapiro, MD, MPH provides an update on the coronavirus pandemic, diving into the global and United States response to the outbreak. He shares insights into identifying misinformation and provides best practices for individuals and healthcare organizations to help flatten the curve.
Katherine Andriole, PhD, director of research strategy and operations at the MGH & BWH Center for Clinical Data Science, discusses the impact of artificial intelligence on clinical decision support. She also addresses some major challenges of using the technology to enhance care delivery, and highlights key considerations for organizations seeking to use AI in clinical decision support systems.
Bruce Chernoff, MD, the president and chief executive officer of the SCAN Foundation, discusses the social determinants of health barriers that America’s seniors face. He also addresses the challenges that the healthcare industry experiences in trying to solve them and how partnerships with community-based organizations can be a key to the solution.
Gary Price, MD, president of The Physicians Foundation, talks about how EHR usability affects physician burnout, physician suicide, and patient engagement. He calls for a mindset realignment that prioritizes patient satisfaction and endorses EHR usage in which the EHR tools and regulations serve the patient-physician relationship instead of burdening it.
Anita Ravi, MD, co-founder of the PurpLE Health Foundation, exhorts healthcare organizations to provide care that is trauma-informed and social determinants of health aware. Drawing from her own encounters treating patients who have experienced abuse, she discusses practical ways to reshape healthcare systems’ approach to mental healthcare screenings and describes how cartooning has helped breach communication barriers.
Ryan Schmid, MBA, CEO and president of Vera Whole Health, outlines his organization’s advanced primary care model and discusses how this differs from traditional primary care. Vera Whole Health's model emphasizes the need for a transition from fee-for-service to value-based reimbursement in order to promote more holistic, patient-centered care.
Healthcare Strategies talks to Amy Lerman, a member of the Health Care and Life Sciences team at Epstein Becker Green, about the challenges and benefits of launching a telemental health service. With the growing need for mental health care bumping up against barriers to access and a shortage of specialists, hospitals and health systems are turning to telehealth to put patients in front of providers when and where they’re needed. Lerman talks about best practices for launching such a platform as well as strategies for delivering quality virtual care.
Dr. Saif Abed, Clinical Cyber Defense Systems CEO shares insights on cybersecurity trends of 2019, one of the most disruptive years in terms of cyberattacks and big breaches. Abed also dives into ways providers can begin tackling some of healthcare’s greatest privacy and security challenges, including constricted resources and an ever-increasing list of endpoints, while looking into what the healthcare sector can expect in the new year.
As an attorney at Hall, Render, Killian, Heath & Lyman, Christian Puff explains to Healthcare Strategies the legal and technical barriers preventing truly value-based behavioral healthcare reform. As a behavioral health patient, Puff shares how payers and providers need to combine medical and behavioral healthcare.
The Director of the Office of Preventive Health and Health Equity at the Mississippi Department of Health, Victor Sutton, PhD, MPPA, discusses challenges to overcoming rural care disparities. Through their work with community partners, Sutton and his team are developing evidence-based population health management programs that are sustainable and scalable to improve patient outcomes.
Worthe Holt, Jr., MD, vice president and deputy CMO with Humana, discusses the benefits and challenges of using mHealth tools and platforms to improve member engagement and foster better health and wellness outcomes. Humana is one of several payers turning to connected health to improve its relationship with members and reduce healthcare expenses.
Healthcare Strategies talks to Steve Miff, PhD, CEO and President of the Parkland Center for Clinical Innovation, about the challenge of incorporating social determinants of health into patient care, the task of creating a new form of integrated health, the need to better manage high utilizers, and the future of social determinants of health.