Coffee with Coker: Recent Episodes
Coker Group
As healthcare business consultants, we are committed to helping healthcare organizations and professionals navigate the healthcare industry. Our discussion will focus on current events in the healthcare industry and how leaders in healthcare organizations can effectively overcome challenges.
Discover how Coker’s DataRise platform is transforming healthcare strategy through powerful data-driven insights. In this episode of Coffee with Coker, Mark Reiboldt interviews Nick Newsad, VP of Innovation at Coker, to explore how DataRise is helping hospitals, health systems, and physician groups make smarter business decisions.
DataRise offers unmatched access to:
- Commercial reimbursement rates across every U.S. market
- Physician and medical director compensation benchmarks
- Malpractice premium data, Form 990 records, and more
From contract negotiations to fair market value justification and new market expansion, DataRise delivers real-time, actionable intelligence that healthcare organizations can use to benchmark, plan, and grow.
Whether you’re evaluating a joint venture, planning a new service line, or negotiating payer contracts, this is a game-changing tool designed to give you the upper hand.
Learn more about DataRise: https://datarise.cokergroup.com/?utm_source=youtube&utm_medium=podcast&utm_term=episode-128&utm_content=unlocking-healthcare-payer-data-how-datarise-is-changing-the-game &utm_campaign=performance-transformation
In this episode of Digital Pioneers, host Michael O'Toole explores how digital transformation is reshaping healthcare by addressing one of its most persistent challenges: improving patient experience in real time.
Joining the conversation is Bryan Graven, Executive Director and CIO of Waterbury Health and Eastern Connecticut Health Network. Bryan shares how his health systems implemented an innovative text-based patient feedback system to proactively address concerns before discharge—enhancing satisfaction, boosting star ratings, and improving Press Ganey scores.
Key takeaways:
- How real-time patient feedback drives service recovery in hospitals
- The role of technology in bridging gaps between patients and healthcare providers
- Lessons from Waterbury Health’s successful implementation and adoption strategy
If you're a healthcare leader looking for practical tech solutions to enhance patient care, this episode is packed with valuable insights.
Don’t forget to subscribe for more conversations with trailblazers in digital healthcare innovation!
Welcome to the first episode of Digital Pioneers, a healthcare podcast series presented by Coker, where we explore groundbreaking technological innovations reshaping the healthcare landscape.
In this episode, host Michael O'Toole dives into the transformative world of Virtual Nursing with special guests Stacey McGriff and Grant Reed from Piedmont Healthcare. Discover how Piedmont Healthcare implemented a virtual nursing program across its 23-hospital network in just over a year, addressing critical challenges like staffing shortages and improving patient and nurse satisfaction.
Key takeaways:
· How virtual nursing supports bedside staff and enhances patient care.
· Insights into Piedmont's rapid implementation and scaling process.
· Real-world advice for healthcare leaders considering virtual nursing.
Whether you're a healthcare leader, technology enthusiast, or just curious about the future of healthcare, this episode is packed with valuable insights.
Don’t forget to subscribe for more episodes featuring trailblazers in digital healthcare innovation!
In this episode of Coffee with Coker, Gabriel Harry, Vice President at Coker, and Tim Harper, Senior Manager at Coker, sit down with Gary Noseworthy, CEO of Community Health Access Network (CHAN), for an in-depth conversation about CHAN's efforts to modernize health information technology in community health centers. They dive into the collaborative projects they've worked on, reflecting on both the obstacles and successes they've encountered.
The discussion covers key topics such as vendor selection strategies, the critical role of strategic partnerships, and the importance of individual assessments for health centers. Gary also shares how CHAN's team has grown and evolved, offering insights into the transformative impact of their initiatives. He looks ahead to CHAN’s future, envisioning an expansion of participating health centers and exploring new business opportunities.
- 00:32 Background on Community Health Access Network (CHAN)
- 02:08 Vendor Vetting and Selection Process
- 09:48 Implementation and Unique Requirements
- 12:00 Project Success and Team Contributions
- 15:18 Challenges and Lessons Learned
- 29:47 Future Growth and Strategic Partnerships
- 34:38 Conclusion and Closing Remarks
Podcast Information
Follow our feed in Apple Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
In this episode of Coffee with Coker, Mark Reiboldt, EVP at Coker, and Vinson Do discuss the impactful role of AI in the business side of healthcare. They delve into how AI is transforming claims processing, medical coding, and healthcare reimbursement.
The conversation highlights real-world examples, such as the AI implementation at Community Medical Centers of Fresno and Mass General Brigham, which have shown significant improvements in reducing denials and enhancing coding accuracy. Ethical considerations and future prospects for AI in healthcare are also examined.
- 00:25 The Role of AI in Healthcare
- 00:53 Introducing Vinson Do and AI's Impact
- 01:51 Understanding Artificial Intelligence
- 04:43 AI in Claims Processing
- 11:37 AI in Medical Coding
- 16:32 AI in Healthcare Reimbursement
- 23:14 Ethical Considerations and Future Prospects
- 30:53 Conclusion and Final Thoughts
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
This episode of Coffee with Coker delves into the complex and nuanced topic of Modifier 25, a coding nuance critical for healthcare professionals to understand for billing and documentation.
Hosts Erika and Jaci unpack the definition, significance, and proper application of Modifier 25, emphasizing its opinion-based nature and the importance of clear, detailed documentation. They provide examples from healthcare scenarios, including preventive visits, urgent care, and procedures like cerumen removal, discussing the implications for billing and compliance.
The conversation highlights how insurance companies' interpretations can vary, impacting the application of Modifier 25. Further, they explore the challenges healthcare providers face in ensuring their documentation supports the use of Modifier 25, pointing out common pitfalls and offering guidance on best practices.
This discussion underscores the vital role of accurate coding and documentation in healthcare billing and the ongoing need for education and dialogue among practitioners.
- 00:32 Diving Deep into Modifier 25
- 01:49 Understanding the Definition and Application of Modifier 25
- 05:33 Exploring Real-World Scenarios and Challenges with Modifier 25
- 08:33 Navigating Documentation and Billing Challenges
- 15:04 Specific Cases and Auditing Insights
- 27:36 Concluding Thoughts and Future Topics
- 29:54 Engaging the Audience and Closing Remarks
Links to other resources:
- AMA | Reporting CPT Modifier 25 (https://www.ama-assn.org/system/files/reporting-CPT-modifier-25.pdf)
- Podcast covering Medicare Annual Wellness Visits (https://www.cokergroup.com/podcasts/episode-122-understanding-annual-wellness-visits-for-healthcare-organizations/)
In this episode, the discussion focuses on annual wellness visits, IPPE, and their implications for healthcare organizations. The conversation covers the requirements, coding, documentation, and common audit findings related to annual wellness visits. The speakers emphasize the importance of proper documentation, the use of resources, and a team approach to ensure compliance and successful reimbursement.
· Jaci Kipreos and Erika Fisch discuss annual wellness visits (00:18)
· Medicare's yearly benefit for beneficiaries called annual wellness visits (01:25)
· Initial Preventative Physical Exam (IPPE) and annual wellness visits (02:32)
· Difference between annual wellness visits and preventative physical exams (05:34)
· Resources for understanding annual wellness visits (08:06)
· Common audit findings for IPPE and annual wellness visits (14:16)
· Handling patient refusal to answer questions during the visit (18:57)
· Separate coding for additional services during the visit (22:58)
· Screening EKG and its requirements (25:12)
· Importance of a team approach to ensure proper documentation and billing (28:58)
· Checking with your MAC for additional requirements or recommendations (32:52)
· Next episode to cover the 25 modifier (34:55)
Extras
· Medicare Learning Network – Medicare Annual Wellness Visits (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/preventive-services/medicare-wellness-visits.html)
· Medicare Preventive Services Quick Reference Chart (https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html)
· Medicare Claims Processing Manual (https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf)
· Streamline Workflow to Perform a Thorough AWV (https://edhub.ama-assn.org/steps-forward/module/2757861)
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
In this insightful podcast for leaders of physician enterprises, we delve into the dynamic landscape of staffing trends within the healthcare sector. The discussion kicks off with a comprehensive exploration of both physician and non-provider staffing trends, providing valuable insights into the evolving workforce dynamics. The conversation then navigates through the intricate factors that contribute to staff turnover, shedding light on the challenges faced by physician enterprises in retaining their crucial personnel.
Episode Synopsis
The podcast guides leaders in analyzing their physician enterprises with a data-driven approach, offering practical strategies to create staffing targets aligned with the unique characteristics of their practices. As the discussion progresses, listeners gain actionable solutions to common staffing challenges, including addressing salary increases in a declining market and handling healthcare turnover amidst current market conditions. The podcast also explores staff retention tactics and best practices essential for physician enterprise success.
The latter part of the podcast delves into the impact of various technologies on staffing for physician enterprises, exploring the integration of AI and workforce automation. The discussion concludes by highlighting the crucial link between staffing, ROI, and the overall functionality of physician enterprises, providing valuable insights for leaders navigating the intricate landscape of healthcare management.
· Physician and non-provider staffing trends (2:05)
· Factors contributing to staff turnover (4:20)
· How to analyze your physician enterprise using a data-driven approach (4:50)
· How certain practice characteristics impact staffing levels (6:30)
· Create staffing targets that make sense for your practice (7:22)
· Solutions to staffing challenges (8:14)
· Addressing salary increases in a declining market (8:30)
· How to handle healthcare turnover in the current market (11:02)
· Staff retention tactics (13:39)
· Best practices for physician enterprise success (16:35)
· Critical issues plaguing independent medical practices (20:12)
· Embracing new trends and adjusting to patient expectations (21:30)
· Other technologies affecting staffing for physician enterprises (23:45)
· Addressing AI and workforce automation for your practice (25:00)
· How staffing impacts the ROI and functionality of the physician enterprise (26:40)
Extras
· Address Community Need with Physician Income Guarantee Arrangements (https://cokergroup.com/physician-income-guarantee-arrangements/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-121&utm_content=physician-income-guarantee&utm_campaign=performance-transformation&utm_source_platform=&utm_creative_format=&utm_marketing_tactic=)
· Lawmakers Grapple with Artificial Intelligence Regulation as Popularity and Utilization Grow (https://cokergroup.com/lawmakers-grapple-with-artificial-intelligence-regulation-as-popularity-and-utilization-grow/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-121&utm_content=ai&utm_campaign=performance-transformation&utm_source_platform=&utm_creative_format=&utm_marketing_tactic=)
· Quantifying Patient Access: Utilize Data to Identify Improvement Opportunities and Monitor Performance (https://cokergroup.com/quantifying-patient-access-utilize-data-to-identify-improvement-opportunities-and-monitor-performance/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-121&utm_content=performance-improvement&utm_campaign=performance-transformation&utm_source_platform=&utm_creative_format=&utm_marketing_tactic=)
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
Chris Torregosa interviews Louis Sallerson, the CEO of Converse Health, about their generative AI assistant for orthopedic surgery clinics.
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
Episode Synopsis
Throughout the interview, Louis shares his passion for the healthcare industry and dedication to improving medical practice operations using generative AI. The heart of their product is communication, and their goal is to streamline patient navigation and communication for orthopedic surgeons.
Click to listen to the episode.
Extras
Learn More about Converse Health (https://www.converse.health/)
In this podcast episode, we delve into the critical topic of patient access and operational throughput. With growing demand for medical services and a looming physician shortage, it's essential to reframe patient access as a pivotal aspect of healthcare production, not merely patient satisfaction.
Episode Synopsis
Join us as we discuss current patient access challenges, highlight key focus areas for effective management, and explore the differentiation between patient access and operational throughput, emphasizing role clarity, optimizing staff utilization, and improving communication.
The episode also delves into trends in patient access management, including the role of Advanced Practice Providers and the strategic integration of technology to enhance access. Patient access has never been more vital, as patient demand is projected to exceed provider supply. We offer practical strategies for healthcare organizations to excel in patient access and operational throughput.
· Patient access and throughput in healthcare (0:11)
· Patient access and physician shortages in U.S. healthcare (4:37)
· Streamlining patient access and scheduling (9:20)
· Patient access and appointment metrics (12:01)
· Improving patient access and organizational performance (15:52)
· Improving medical practice efficiency (20:15)
· Improving patient access in healthcare (26:16)
· Improving patient access and reducing no-shows (32:03)
Extras
· Overcoming Obstacles with Performance Improvement for Critical Access Hospitals (https://cokergroup.com/overcoming-obstacles-with-performance-improvement-for-critical-access-hospitals/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-119-navigating-patient-demand-and-physician-shortages&utm_content=patient-access&utm_campaign=physician-services&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=solution)
· Quantifying Patient Access: Utilize Data to Identify Improvement Opportunities and Monitor Performance (https://cokergroup.com/quantifying-patient-access-utilize-data-to-identify-improvement-opportunities-and-monitor-performance/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-119-navigating-patient-demand-and-physician-shortages&utm_content=patient-access&utm_campaign=physician-services&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=solution)
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
This episode delves into the complex world of compensation design within the healthcare industry, focusing on traditional hospital/employed provider models. We explore the common pain points experienced by clients of all types when incentivizing strategic goals.
Episode Synopsis
Join us as we discuss the various considerations hospitals and health systems face, including concerns about provider compensation spending and fair market value. We also examine incentive structures designed to foster growth and meet strategic objectives, all while ensuring that compensation plans remain competitive in the challenging recruitment landscape.
But it's not just about the financial aspect. We'll also explore how compensation design can be a powerful tool, acting as a 'carrot' to drive productivity and achieve organizational goals. And when compensation design isn't enough, we'll delve into the other factors influencing low provider productivity.
Tune in for an insightful conversation on the critical intersection of compensation design and healthcare strategy.
· Aligning physician incentives with organizational goals (4:25)
· Designing physician compensation models (8:54)
· Analyzing audio transcript for insights (14:39)
· Redesigning physician compensation models (19:48)
· Designing and implementing fair and equitable compensation (26:30)
· Physician compensation model design (33:37)
· Provider compensation and performance improvement (37:15)
Extras
· Episode 111: The Intersection of Provider Compensation and Value-Based Reimbursement (https://cokergroup.com/episode-111-the-intersection-of-provider-compensation-and-value-based-reimbursement/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=podcast&utm_marketing_tactic=awareness)
· Case Study: Provider Compensation Misalignment (https://cokergroup.com/case-study-provider-compensation-misalignment/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=case-study&utm_marketing_tactic=solution)
· Compensation Best Practices for Physician Enterprises (https://cokergroup.com/compensation-best-practices-for-physician-enterprises/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=white-paper&utm_marketing_tactic=solution)
· Compensation Methodology Best Practices: True-Up Payments (https://cokergroup.com/compensation-methodology-best-practices-true-up-payments/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness)
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
The speakers will break down various areas they review when evaluating the revenue cycle and give examples of how they evaluated and helped clients achieve success around revenue cycle improvement. They will discuss some of the key pitfalls and areas where physician enterprises struggle, and offer advice, regardless of type and size, to consider as you optimize your revenue cycle processes and performance.
Episode Synopsis
In the context of revenue cycle management, it's essential to emphasize that the scope extends far beyond the billing office alone. The notion of "outsourcing the revenue cycle" often requires clarification, as it commonly refers to selectively outsourcing certain components, like billing or specific front-end operations. It's rare for an organization to entrust the entirety of its revenue cycle, spanning from initial patient intake and service provision to claims processing, payment reconciliation, collection endeavors, and comprehensive follow-up, to an external entity. This podcast episode delves into the intricacies of this comprehensive revenue cycle management process.
· Opening Introduction (0:11)
· Key pitfalls and areas to avoid when evaluating the revenue cycle (1:02)
· The interaction between each functional area (6:05)
· Why are we seeing more and more issues occur (9:28)
· How to diagnose billing and billing issues (12:13)
· Solutions and recommendations (18:37)
· What do the leaders and managers think of the reports? (24:26)
· Sustainability measures to help with implementation (27:40)
· Using dashboard reporting for key performance indicators (33:16)
· Question the status quo on revenue cycle management (38:07)
Extras
· How Is Inflation Affecting the Reimbursement in Your Managed Care Agreements?
· Revenue Cycle Management – Look Our for the Red Flags!
· Avoiding Four Common Pitfalls in Revenue Cycle Management
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
This series aims to help physicians and practice administrators enhance their financial and operational performance across various domains.
Episode Synopsis
In this podcast series designed for physicians and practice administrators, our speakers will provide a deep dive into the reasons behind this series. They will emphasize the significance of performance improvement in healthcare organizations and specifically focus on physician enterprise performance improvement. Listeners will gain insights into how organizations can effectively evaluate their performance in relation to expectations, goals, and targets.
Building upon these fundamental concepts, our speakers will explore the creation of a framework for achieving high performance. They will discuss practical methods for developing a data-driven culture that permeates throughout the organization, from leadership to staff to providers. Throughout the series, we will cover a range of important domains, including revenue cycle management, operational efficiency, physician compensation, and quality outcomes. By addressing these crucial topics, we aim to provide physicians and practice administrators with valuable strategies and knowledge to enhance performance and drive success in their healthcare practices.
Extras
· Overcoming Obstacles with Performance Improvement for Critical Access Hospitals
· How Is Inflation Affecting the Reimbursement in Your Managed Care Agreements?
· Invest in Developing Your Physician Practice Leaders While Helping Them Achieve Organizational Objectives
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
Alex Kirkland joins Mark Reiboldt to discuss the state of physician compensation and what the future may hold. Hospitals have competed for physician market share in the post-pandemic world, and the influx of private equity investment alongside rising costs has pushed the survey data approach of funding physician compensation models to unsustainable levels.
Episode Synopsis
Many external factors have impacted physician compensation over the past several years. The extensive list includes pandemic-era volume reductions, volatile survey data, Medicare Physician Fee Schedule changes, rising inflation, and the list goes on!
If there is any constant, it is that change is inevitable.
With so much uncertainty, how can healthcare systems possibly plan for the future in terms of a sound physician compensation strategy? The answer lies in understanding expected shifts in the physician workforce, and the need for a nimble compensation structure that can adapt to market forces.
Extras
· Survey Says… What to Expect from the 2021 Market Survey Data (https://cokergroup.com/survey-says-what-to-expect-from-the-2021-market-survey-data/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-115&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=article&utm_marketing_tactic=awareness)
· Compensation Best Practices for Physician Enterprises (https://cokergroup.com/compensation-best-practices-for-physician-enterprises/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-115&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=white-paper&utm_marketing_tactic=solution)
· How do we address provider compensation misalignment? (https://cokergroup.com/case-study-provider-compensation-misalignment/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-115&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=case-study&utm_marketing_tactic=solution)
· How are the 2023 E/M guideline changes impacting your organization? (https://cokergroup.com/2023-e-m-impact-calculator/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-115&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=calculator&utm_marketing_tactic=tool)
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
Justin Chamblee presented this webinar for the American Health Law Association. He analyzes the current state of the healthcare industry and take an objective look at options for physicians/physician enterprises, assessing some of the positives and drawbacks from each and what it may mean for the future.
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
Episode Synopsis
In the not-too-distant past, the majority of physicians were in private practice. Then, the market experienced a shift wherein a number of physicians chose to be hospital affiliated, with either private practice or hospital affiliation seemingly being the only options. In recent years, the market has shifted again. Private equity money has created options for physicians that have not existed in the past, entities like VillageMD and Privia Health are rapidly developing employment models providing additional options, and health systems are assessing the financial viability of maintaining their physician enterprises in the legacy state, looking for future potential alternatives.
Learning Objectives
- Survey the evolution of alignment options for physicians/physician enterprises over the past several decades.
- Dive deep into the current market, looking at current alignment trends and the positives/drawbacks from each.
- Ponder what the current alignment options may mean for the future of the healthcare industry.
Extras
· Is employment the only option to keep physician practices alive?
· What’s next in the evolution of professional services agreements?
· How do we address provider compensation misalignment?
· What’s the value of the non-compete agreement?
· How are the 2023 E/M guideline changes impacting your organization?
Jana Sizemore joins Mark Reiboldt to discuss clinical co-management arrangements as an alternative alignment model for healthcare organizations and physician groups. Clinical co-management allows physician groups to align with hospitals and health systems without becoming employed or implementing a professional services agreement.
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
· Please email us: feedback@cokergroup.com
· Connect with us on LinkedIn: Coker Group Company Page
· Follow us on Twitter: @cokergroup
· Follow us on Instagram: @cokergroup
· Follow us on Facebook: @cokerconsulting
Episode Synopsis
Primarily used with surgical specialties, a hospital will partner with independent physician groups to support or grow the service line. While each situation is unique and different, Jana highlights why hospitals should consider a clinical co-management agreement, how they differ from other forms of alignment, and when to use the co-management structure.
Retaining autonomy and independence is a big selling point for independent physician groups considering clinical co-management. The physicians can affect changes to the service line that would improve quality outcomes and patient care at the hospital by developing the service line and improving staff and patient satisfaction.
Extras
· Physicians in Practice: Ways to Align and Remain Independent
· Aligning Hospitals and Physicians with Clinical Co-Management Agreements
· Hospital/Physician Alignment and Clinical Integration
· Episode 102: How do you Align Provider Compensation with Health System Goals?
Jaci Kipreos, Alex Kirkland, and Matt Jensen join Mark Reiboldt to discuss the evaluation and management coding section changes and announce the update to our popular E/M Impact Calculator. What does your organization need to do to address these changes?
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
Alex, Jaci, and Matt present what the road map looks like and what prompted CMS to give a directive. Outpatient changes started in 2021, and the inpatient changes were effective on January 1, 2023. Their advice is to treat 2023 as a preparation year, measuring high volume codes and conducting operational reviews by the provider to determine if the documentation will meet the new guidelines. These changes will also affect your compensation plans because there are material changes to the wRVUs.
The impact calculator estimates the potential economic impact your organization may face with a partial listing of changing codes. Please note that the results of the calculations include the national Medicare reimbursement impact based on the volume input. As such, the calculation results are meant for planning purposes only and do not represent an estimation of value. For a more in-depth assessment of your providers’ payment calculations and how this may affect your commercial and other payers, please contact us to speak with one of our physician compensation experts.
Estimate the impact on key E/M codes
https://cokergroup.com/2023-e-m-coding-calculator/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-112&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=calculator&utm_marketing_tactic=tool
Extras
· Keeping up with the Changes: A Review of 2023 E/M Guidelines (https://cokergroup.com/keeping-up-with-the-changes-a-review-of-2023-e-m-guidelines/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-112&utm_content=link-website&utm_campaign=coding-assessments&utm_source_platform=podcast-app&utm_creative_format=white-paper&utm_marketing_tactic=solution)
· Major Changes to Split/Shared Billing Affect Advanced Practice Providers and Physicians (https://cokergroup.com/major-changes-to-split-shared-billing-affect-advanced-practice-providers-and-physicians/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-112&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness)
· The Intersection of Compliance and Fair Market Value: Are You Sure Your Arrangements Coincide? (https://cokergroup.com/the-intersection-of-compliance-and-fair-market-value-are-you-sure-your-arrangements-coincide/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-112&utm_content=link-website&utm_campaign=fmv-cr&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness)
· Case Study: Provider Compensation Misalignment (https://cokergroup.com/case-study-provider-compensation-misalignment/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-112&utm_content=link-website&utm_campaign=fmv-cr&utm_source_platform=podcast-app&utm_creative_format=case-study&utm_marketing_tactic=solution)
Justin Chamblee joins Mark Reiboldt to discuss value-based reimbursement and provider compensation. He recently presented this topic at the MGMA conference with the goal of answering questions that naturally arise when considering the intersection of value-based reimbursement and provider compensation.
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
- Please email us: feedback@cokergroup.com
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Episode Synopsis
Government programs initially led value-based reimbursement (VBR) initiatives, but commercial payers are making the shift. CMS proposes to expand access to ACOs, modernize coverage for behavioral health services, colon screening, and dental services. There are also new and exciting value-based care programs being announced outside of CMS.
Justin and Mark look ahead at the value-based care initiatives on the horizon, and how these programs should intersect with provider compensation.
Learning Objectives
- Further understanding of how value-based reimbursement is manifesting itself in the market
- Answer questions that naturally arise when considering the intersection of value-based reimbursement and provider compensation
- Equip attendees with practical steps to further align their provider compensation strategies with current reimbursement environment
Extras
- Major Changes to Split/Shared Billing Affect Advanced Practice Providers and Physicians (https://cokergroup.com/major-changes-to-split-shared-billing-affect-advanced-practice-providers-and-physicians/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-111&utm_content=the-intersection-of-provider-compensation-and-value-based-reimbursement&utm_campaign=value-based-strategies&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness)
- The Intersection of Compliance and Fair Market Value: Are You Sure Your Arrangements Coincide? (https://cokergroup.com/the-intersection-of-compliance-and-fair-market-value-are-you-sure-your-arrangements-coincide/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-111&utm_content=link-website&utm_campaign=fmv-cr&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness)
- Case Study: Provider Compensation Misalignment (https://cokergroup.com/case-study-provider-compensation-misalignment/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-111&utm_content=link-website&utm_campaign=provider-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=case-study&utm_marketing_tactic=solution)
Beth Balcom, Brandt Jewell, Alex Kirkland, and Richard Romero presented this webinar for the American Health Law Association. Our team will cover upcoming billing and coding changes affecting healthcare organizations in three areas: coding and compliance, operations, and finance.
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
Upcoming billing and coding changes will affect healthcare organizations in three areas: coding and compliance, operations, and finance. Our team will cover these areas as they discuss how billing changes will impact physician practice operations and economics, including provider compensation and fair market value considerations.
Learning Objectives
- Understand the financial impact of critical changes within the Medicare Physician Fee Schedule proposed rule and what they may mean from a valuation perspective.
- Discuss the operational implications and considerations resulting from the Medicare Physician Fee Schedule proposed rule.
- Provide an overview of the expected coding changes and associated compliance considerations.
We recommend you speak with your key stakeholders about performing three actions to prepare for the upcoming changes which go into effect on January 1, 2023:
- Develop a coding communication plan that considers tools and checklists to help front-line resources acclimate to the changes
- Audit current EHR scheduling templates to ensure they consider the changes
- Conduct a chart audit to verify the accuracy of coding and documentation
If Coker Group can assist you with developing a plan or implementation for any of the above, please get in touch with us to schedule a free consultation to discuss the specific needs of your client(s) or organization.
Book Your Free Consultation ---> https://cokergroup.com/contact/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-110&utm_content=book-your-free-consultation&utm_campaign=coding-assessments&utm_source_platform=podcast-app&utm_creative_format=link&utm_marketing_tactic=contact Extras
- Major Changes to Split/Shared Billing Affect Advanced Practice Providers and Physicians (https://cokergroup.com/major-changes-to-split-shared-billing-affect-advanced-practice-providers-and-physicians/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-110&utm_content=major-changes-to-split-shared-billing-affect-advanced-practice-providers-and-physicians&utm_campaign=physician-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness)
- How the CY 2022 PFS Final Rule Affects Split/Shared Visits and Critical Care Services (https://cokergroup.com/how-the-cy-2022-pfs-final-rule-affects-split-shared-visits-and-critical-care-services/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-110&utm_content=how-the-cy-2022-pfs-final-rule-affects-split-shared-visits-and-critical-care-services&utm_campaign=physician-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness)
- Episode 107: How will Split/Shared Visits Change Between APPs and Physicians? (https://cokergroup.com/episode-107-how-will-split-shared-visits-change-between-apps-and-physicians/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-110&utm_content=how-will-split-shared-visits-change-between-apps-and-physicians&utm_campaign=physician-comp-strategy&utm_source_platform=podcast-app&utm_creative_format=podcast&utm_marketing_tactic=awareness)
Alex Kirkland and Matt Jensen join Mark Reiboldt to discuss the results of our inaugural advanced practice provider strategy and oversight survey. The survey contains insight from 60 organizations employing 3,067 advanced practice providers and represents 4,356 physicians and 28 states.
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
Advanced Practice Providers (APPs) are at the forefront of healthcare delivery. They directly impact organizational goals, such as patient access, care coordination, care outcomes, and population health initiatives.
A straightforward APP compensation framework that recognizes market rates, specialization, and experience is essential to an organization's success in retaining and growing its APPs. Aligning APP compensation models with physician compensation model structures promotes team cohesiveness and enables providers to maximize their unique value to meet strategic goals and objectives.
Do you want to learn more about APP strategies and oversight? Listen to the episode and learn how APP strategies and oversight are changing.
Extras
- Download the 2022 survey results
- Major Changes to Split/Shared Billing Affect Advanced Practice Providers and Physicians
- How the CY 2022 PFS Final Rule Affects Split/Shared Visits and Critical Care Services
- Episode 107: How will Split/Shared Visits Change Between APPs and Physicians?
- Episode 102: How do you Align Provider Compensation with Health System Goals?
Jack Liu and Dr. Hamlet Benyamin join Mark Reiboldt to discuss the shift from a one size fits all approach to precision medicine which is individualized to each person. Dr. Benyamin defines precision experience as the unique experience a person needs as they enter the healthcare workforce.
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
- Please email us: feedback@cokergroup.com
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Episode Synopsis
How do we assess the barriers and processes for the healthcare workforce so we can deliver better care for everyone?
Covid-19 shed light on the healthcare delivery process, particularly within the patient and provider dynamic. Precision experience is essential to all aspects of the healthcare delivery process, from physicians and advanced practice providers to supporting staff.
Healthcare can use the insights as a jumping-off point to leap forward and improve processes that have been problematic for years. An opportunity arises from a crisis to improve the system for the people it serves.
Click to listen to the episode and learn more about the precision experience for healthcare.
Extras
- Precision Experience: What it is and Why it Matters to Healthcare Now?
- Learn more about ProCARE Portal
- Precision Experience: The Solution to Creating a Shared Vision
Alex Kirkland and Chris Marrs join Mark Reiboldt to discuss changes to the split or shared billing between advanced practice providers and physicians. Alex and Chris encourage healthcare organizations to understand these changes and update processes before the changes take effect in 2024.
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
A split/shared visit, defined as “an E/M visit in a facility setting that is performed in part by a Physician and an NPP who are in the same group,” is billed based on which provider performed the “substantive portion” of the service.
For non-critical care split/shared visits in 2022, a “substantive portion” is considered “all or some portion of the history, exam or medical decision-making key components of an E/M service.” However, for critical care visits in 2022 and all applicable visits beginning January 1, 2023, a “substantive portion” is more specifically defined as greater than 50% of the time spent on the encounter.
If the physician spends more than 50% of the time with the patient, CMS will reimburse the visit at 100%. However, if the advanced practice provider spends more than 50% of the time with the patient, they will reimburse the visit at 85%. The provider attached to the service will also receive the wRVU credit for those professional services.
Listen to the episode and learn how these changes could impact how your providers are reimbursed and compensated for their professional services.
Extras
- Major Changes to Split/Shared Billing Affect Advanced Practice Providers and Physicians
- American Medical Association Releases 2023 E/M Updates
- How the CY 2022 PFS Final Rule Affects Split/Shared Visits and Critical Care Services
Brandt Jewell joins Mark Reiboldt to explain the management principles for developing a data-driven culture. Brandt walks through examples of utilizing data to manage staff and engage providers as leaders, mentors, and champions with common group-level objectives.
Podcast Information
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Episode Synopsis
Data validation is essential to gain buy-in and consensus from all stakeholders, particularly providers. Sharing data with providers and staff establishes consistent communication and dissemination of information.
When developing a data-driven culture, you should:
- Simplify the data to focus on key metrics and actionable information
- Provide clear and actionable direction regarding how daily responsibilities of all roles can impact the metrics
- Communicate performance expectations to meet operational objectives
- Build realistic near and long-term goals
- Use consistent metrics across the group to avoid making exceptions
A strategic direction coupled with a shared vision, aligned incentives, operational support, and peer accountability through data and communication will develop a high-performing culture.
Extras
- Building a High-Performing Physician Enterprise
- Developing a High-Performing Physician Enterprise
- Submit your information to request a 30-minute consultation
Jeffery Daigrepont interviews Dan Stewart, the president of Jackson Health Tech Advisors, one of our partners providing cybersecurity advisory services. Dan has been in the healthcare information technology and services industry for more than 30 years, with the last ten years focused on cybersecurity risk management and mitigation services. That includes a Cyber Liability Insurance Services program we will discuss today.
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
The last two years have seen a new era of cyber-attacks with increased hacker sophistication, a propensity to pay in ransomware cases, and a geopolitical environment that has upended the cyber insurance market in general, particularly in healthcare.
In 2020, healthcare-related cyber-attacks increased by more than 55%, of which ransomware attacks comprised 28% of the total. According to Cybersecurity Ventures, in 2021, the US healthcare system lost $21 billion caused by ransomware attacks alone.
Covid-19 further exposed the weaknesses in healthcare cybersecurity systems as the industry was forced to institute or expand telehealth services and remote working functions rapidly. These factors caused significant losses for the insurance carriers that were providing cyber insurance resulting in several major market changes that are affecting healthcare providers.
Extras
- Key Elements of a Cyber Liability Insurance Policy for Healthcare Providers
- Cybersecurity Tips
- Episode 57: HCIT: Security Risk Assessment
- Episode 103: What is a Security Risk Analysis, and Why Do I Need One?
- Contact Jeffery Daigrepont
Richard Romero joins Mark Reiboldt to explore non-compete and other restrictive covenants in the healthcare industry. Richard explains the purpose and the value of these restrictive covenants.
Podcast Information
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Episode Synopsis
There are three types of restrictive covenants: non-compete agreements, non-solicitation agreements, and non-disclosure agreements. Depending on who you ask, these covenants can be a tool to protect the business or perceived as a way to limit a physician’s ability to choose their employer.
No matter how they are perceived, if a restrictive covenant does not protect a legitimate business interest, it may be unenforceable. The law does not prohibit ordinary competition.
Extras
- Physician Employment Non-Compete Agreements: The Value Behind the Valuation
- Where’s the Value in Physician Practice Valuations?
DeAnn Tucker and Roz Cordini join Mark Reiboldt to explain the need for a security risk analysis within healthcare organizations. Many organizations are missing one critical component when performing a security risk analysis. Learn what elements organizations usually miss and how to conduct a security risk analysis properly.
Podcast Information
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Episode Synopsis
Did you know Health and Human Services requires an annual security risk analysis? If a breach of information occurs, OCR will request the last 2-3 years of security risk analyses to verify your organization has performed the analysis and taken steps to implement the remediation plan.
Aside from the requirement, performing a security risk analysis also safeguards electronic protected health information (ePHI) by identifying potential vulnerabilities before a criminal exploits them.
Click to listen to the episode.
Extras
- Security Rule 45 CFR 164.308
- Guidance on Risk Analysis Requirements under the HIPAA Security Rule
- 5 Mistakes Covered Entities and Business Associates Made During a Security Risk Analysis
Alex Kirkland and Andy Sobczyk join Mark Reiboldt to explore a prevalent provider compensation trend. As health systems continue to acquire private practices, they also inherit differing compensation structures with each acquisition. Alex and Andy unpack the concept of provider compensation misalignment.
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
Many healthcare provider practices lack an overarching provider compensation philosophy that aligns the health system's goals with the incentives for the providers. While there are many reasons this occurs, the solution is the same: develop a compensation philosophy for your organization to govern the compensation plans.
Alex and Andy use a physician compensation scatterplot (see page 5 of the case study) to illustrate how a decentralized compensation approach contributes to misalignment and variability.
Click to listen to the episode.
Extras
- Case Study: Provider Compensation Misalignment
- Access the E/M Calculator
- Learn more about provider compensation best practices
Mark Massey, a vice president with the Southern Medical Association Services, Inc., joins Mark Reiboldt to explore the concept of cash balance plans for medical practices. Mark explains cash balance plans, who is a prospect for cash balance plans, and how they work. Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
A Cash Balance plan is a type of retirement plan that allows business owners to contribute over $200,000 per year in many cases. Contribution limits are based on the age of the owner. The plan is entirely employer-funded, and the plan clearly defines the contribution/benefit formula for participants.
A Cash Balance Plan takes advantage of a business expense that an owner can keep, deduct from profits, and let grow tax-deferred. Owners can fund a sizable portion of retirement savings using money they would have paid in taxes.
Click to listen to the episode.
Extras
- Southern Medical Association Insurance
- About the Southern Medical Association
Jeffery Daigrepont interviews Dr. Neil Baum, an early pioneer in the healthcare IT industry. They discuss patient care ethics and how artificial intelligence impacts the provider-patient dynamic. Podcast Information Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
As healthcare technology has evolved, healthcare providers are spending less time focusing on the patient, and more time focusing on their computer or tablet screens. The rise of telemedicine has furthered that barrier, putting a screen between the provider and the patient and removing empathy from the patient visit.
For this reason, Dr. Baum and Jeffery believe artificial intelligence will never replace the provider-patient interaction. A patient entrusts a healthcare provider with sensitive, personal information, and in turn, the provider connects with the patient, providing personalized care.
In which instances do you think artificial intelligence could take over and improve the patient experience?
Extras
- Artificial Intelligence: Perhaps More Intelligent Than You Think!
- Is Information Technology a Competitive Necessity or a Competitive Advantage?
- Connect with Dr. Baum
Lee Perrett and Richard Ballard join Mark to talk about the latest hiring and HR trends the pandemic inspired. They contemplate hybrid and remote workforces, workforce health, DEI initiatives, and the benefits of interim leadership. Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
Did you know 95% of HR leaders expect that at least some of their employees will work remotely after the pandemic? The shift to hybrid work will be a massive driver of transformation, and leaders must prepare to support it.
Workforce health is a growing concern, especially in the healthcare field. Employees are leaving companies at an alarming rate for new opportunities that address their needs in the wake of the pandemic.
How do you bridge the gap and attract suitable candidates?
Click to listen to the episode.
Extras
- Invest in Developing Your Physician Practice Leaders While Helping Them Achieve Organizational Objectives
- 12 Mistakes Executives Make on Resumes (and How to Avoid Them)
- Episode 93: What are Interim Management Services, and Do You Need Them?
- Episode 31: Performing a Healthcare Organization Executive Search
Alex Kirkland and Matt Jensen join Mark to talk about the latest evaluation and management code updates to the Medicare Physician Fee Schedule. The Centers for Medicare and Medicaid Services (CMS) decreased the conversion factor for evaluation and management (E/M) codes for 2022. Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
CMS increased the RVUs for which they reimburse outpatient E/M services and decreased the conversion factor to remain budget neutral. The conversion factor cuts will affect reimbursement for all services in the fee schedule to increase reimbursement for more cognitive E/M services.
Organizations with RVU-based compensation plans need to revalue their wRVU rates to remain economically aligned with the fee schedule, especially if their provider compensation plans tie to wRVU values in the most recent Medicare Physician Fee Schedule.
Click to listen to the episode.
Extras
2022 E/M Coding Calculator
How the CY 2022 PFS Final Rule Affects Split/Shared Visits and Critical Care Services
Rick Hindmand, an attorney with McDonald Hopkins, and Andy Sobczyk, a senior manager with Coker Group, join Mark to talk about the No Surprises Act. They focus their discussion on implications and action steps for healthcare providers and facilities.
Podcast Information
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Episode Synopsis
Rick explains the No Surprises Act. The legislation protects patients from surprise billing by prohibiting balance billing unless the patient is notified and consents and protects patients from cost-sharing obligations that exceed in-network amounts.
Rick and Andy focus their discussion on the impact on healthcare providers (facilities and providers that are out of network) and the act's key provisions impacting their revenue stream.
Extras
CMS Releases New Rules for No Surprise Act
Surprise billing regulations establish procedures to determine out-of-network rates
Emergency Physicians Recover A Higher Share Of Charges From Out-Of-Network Care Than From In-Network Care
The Six Provider Lawsuits Over The No Surprises Act: Latest Developments
Connect with Rick
Connect with Andy
Rob Mendoza and Roz Cordini join Mark to talk about the compliance risk assessment process. Now more than ever, these organizations must maintain an effective compliance program. The industry recognizes conducting a compliance risk assessment regularly as one of the key elements of an effective compliance program.
Podcast Information
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We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.
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Episode Synopsis
A compliance risk assessment is a structured process for identifying, evaluating, and prioritizing legal and regulatory risks that could negatively impact the organization. It allows the organization to focus essential resources on the most significant risks and areas lacking adequate controls.
There can certainly be a level of ambiguity when one hears the term compliance risk assessment. It can easily be confused with other reviews or examinations an organization conducts. Rob and Roz also share what is not considered a compliance risk assessment.
Click to listen to the episode.
Extras
How to Conduct a Compliance Risk Assessment (and Why You Should)
What is Compliance Program Effectiveness?
Episode 44: Compliance Program Effectiveness
Mark interviews Dr. Kelly Firesheets, VP Community Business, and Cam Teems, Senior Director Healthcare Business, about Cordata Health. Cordata Health is continuously innovating in comprehensive SaaS solutions to partner with our clients to reach the highest need populations and connect them to the care and support they need. Podcast Information
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Episode Synopsis
Throughout the interview, they discuss the intersection of healthcare and the community and how systems can work together to create healthy people. The ongoing pandemic has brought the prevalence of specific community health issues to light, such as mental health and addiction. Cordata strives to connect hospitals and health systems technologically with the community they serve.
Extras
Learn more about Cordata Health
The Significance of a Physician Needs Assessment
Is Information Technology a Competitive Necessity or a Competitive Advantage?
Mark Reiboldt and Richard Romero chat with Chris Pusey (Rural Partners in Medicine) about healthcare challenges in rural communities. Chris shares his company’s experience building specialty surgical programs in rural America. Podcast Information
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Episode Synopsis
Chris, Mark, and Richard discuss their shared passion for rural healthcare. Chris discusses Rural Partners in Medicine's unique approach to providing surgical services locally to smaller communities. Patients within these communities prefer to receive care near their homes instead of traveling 100 miles away from their support systems.
Listen to the episode and learn how Rural Partners in Medicine keep rural healthcare local.
Extras
Learn more about Rural Partners in Medicine
Physicians in Practice: Ways to Align and Remain Independent
Expanded Guidance from CMS for Telehealth Services Provided at Rural Health Clinics and Federally Qualified Health Centers During the COVID-19 Public Health Emergency
Mark interviews Rick Langosch, an independent contractor with Coker Group, about his experience providing interim CFO and CEO services for hospitals. Rick shares his experience over the years and talks about how he handled a challenging situation recently. Podcast Information Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
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Episode Synopsis
Perhaps your organization recently experience a sudden transition, leaving a C-suite position vacant, or your organization is adding a new position no one has traditionally held. Hiring an interim executive to fill the job while you search for a permanent placement helps stabilize the hospital during a turbulent time.
Click the play button to listen to the episode.
Extras
Interim Management: Allow your Organization Time to Find Expert Leadership
Episode 31: Performing a Healthcare Organization Executive Search
Interim Management in Healthcare
Mark interviews Dr. Caesar Richburg, Chairman of Regional Medical Center, about chairing a board of trustees during turbulent times. Dr. Richburg shares how he came to be a board member and his experience navigating leadership transitions. Podcast Information
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Episode Synopsis
Rural hospitals continue to face challenges the pandemic brought to the forefront. As a board chairman of a rural facility, Dr. Richburg works with colleagues from different backgrounds and levels of business experience. As chairman, he ensures the Board applies sound business principles for the betterment of the community.
Click the play button to listen to the episode.
Extras
Interim Management: Allow your Organization Time to Find Expert Leadership
Episode 31: Performing a Healthcare Organization Executive Search
Interim Management in Healthcare
Matt BonDurant with ProCARE Portal joins Mark to discuss how to make provider compensation scalable. Matt explains the advantages of compensation automation and how streamlining compensation models is detrimental to your strategic plan and goals. Podcast Information
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Episode Synopsis
Every provider compensation model is unique. While there may be certain structural areas of overlap, the details of the methodology, data process, exceptions, timing needs, and business rules are all different. ProCARE Portal is a compensation automation framework configured in a user interface (UI) to manage and adapt to ongoing complexities.
Mark and Matt talk about the advantages of ProCARE Portal and how healthcare organizations are using it to make their provider compensation models scalable, regardless of how complex they are.
Click the play button to listen to the episode.
Extras
Learn more about ProCARE Portal
Provider Compensation Management: Solving the Compensation Conundrum
Compensation Best Practices for Physician Enterprises
Brandt Jewell joins Mark to discuss how to start building a high-performing physician enterprise. Brandt and Mark discuss a recent case study and white paper Brandt published this year. While each physician enterprise is unique, one can learn a lot from this successful project.
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Episode Synopsis
Brandt and Mark discuss today’s healthcare place, which offers significantly more strategic opportunities than existed ten years ago, and the confusion of where to focus when developing a high-performing physician enterprise. In many cases, physician enterprises will focus on one area (usually financial) and unravel the underlying operational issues affecting the bottom line.
Click the play button to listen to the episode.
Extras
Case Study: Developing a High-Performing Physician Enterprise
White Paper: Building a High-Performing Physician Enterprise
Learn more about our performance improvement services
Max Reiboldt joins Mark to discuss the economic terms to consider when pursuing a private equity deal. Max and Mark provide a high-level overview of the financial terms of private equity deals, including determining up-front value and the future sale of the practice.
Podcast Information
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Episode Synopsis
Max and Mark discuss their experience with private equity transactions and which economic terms to consider when pursuing a private equity deal. Normally, the practice retains all profits and distributes them to the partners within the practice annually. Therefore, when reviewing an income statement, there is little to no EBITDA. As part of a private equity deal, the practice needs to create upfront value through other means.
Max and Mark discuss how to create upfront value and the various approaches to the valuation of a medical practice for a private equity transaction.
Click the play button to listen to the episode.
Extras
Episode 85: Non-Economic Considerations for Private Equity Transactions
Episode 56: Private Equity Deals: Operational Components of the Transaction
The Role of Management Services in Private Equity Transactions
Episode 55: Private Equity Deals: Approaching a Deal Strategically
Defining Private Equity Transactions in Healthcare and Understanding Deal Options for Medical Groups
Max Reiboldt and Tom Anthony (Frost Brown Todd LLC) join Mark to discuss gainsharing as an affiliation strategy. Max and Tom define gainsharing with a high-level legal overview, talk about a scenario where gainsharing works, and share their observations from Advisory Opinion 17-09.
Podcast Information
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Episode Synopsis
Max and Tom review the positive outcome of Advisory Opinion 17-09 and how to use gainsharing as a physician-hospital affiliation strategy. They define gainsharing and its objectives, discuss how a gainsharing arrangement is applicable for a joint replacement, and offer their insight on using gainsharing arrangements as an affiliation strategy.
Click the play button to listen to the episode.
Extras
OIG Advisory Opinion No. 17-09
Why is a Fair Market Value/Commercial Reasonableness Opinion Important for Value-Based Enterprises?
Learn more about Fair Market Value and Commercial Reasonableness
Justin Chamblee and Alex Kirkland join Mark to review the status of value-based models, evaluate the potential impacts of recent events on value-based models, and reflect on real-world implementation challenges and practical strategies.
Podcast Information
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Episode Synopsis
Justin and Alex discuss new developments in value-based reimbursement and how the different administrations have viewed the shift to value-based reimbursement. Much change has occurred in the healthcare industry with the pandemic and healthcare regulation changes. Justin and Alex discuss how these changes will affect value-based compensation.
Click the play button to listen to the episode.
Extras
Request a call with Justin or Alex to discuss your value-based compensation approach
Will Innovation Capture Value-Based Market Share?
Incorporating Value-Based Metrics into a Physician Compensation Plan
Max Reiboldt and Andy Sobczyk join Mark to discuss the next generation of management service organizations (MSOs) and business service organizations (BSOs). The presence of MSOs, entities that provide an array of administrative support services to physician practices, has grown significantly in recent years. This trend is linked to private equity (PE) entry in the physician practice space because many PE transactions include an MSO.
Podcast Information
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Episode Synopsis
Max and Andy discuss the differences between MSOs and BSOs, and their goals and services. MSOs are not unique to private equity deals, and they are growing in popularity. Max and Andy discuss how to use an MSO or BSO as a growth strategy for your healthcare organization.
Click the play button to listen to the episode.
Extras
Request a copy of the detailed presentation with organizational structure examples!
Next Generation MSOs: Strategies to Grow beyond Traditional Practice Management Services
Affiliation Options for Physicians: Current and Future Strategies
Max Reiboldt joins Mark to discuss the non-economic terms to consider when pursuing a private equity deal. The non-economic components are often more important than the economic terms because they dictate the day-to-day after closing the deal.
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Episode Synopsis
Max and Mark discuss their experience with private equity transactions and which non-economic terms to consider when pursuing a private equity deal. One of the lessons we impart to medical practice and hospital clients contemplating a private equity (PE) transaction is that both the economic and non-economic terms carry weight. They should receive equal consideration before signing on the dotted line.
Click the play button to listen to the episode.
Extras
Episode 56: Private Equity Deals: Operational Components of the Transaction
The Role of Management Services in Private Equity Transactions
Episode 55: Private Equity Deals: Approaching a Deal Strategically
Defining Private Equity Transactions in Healthcare and Understanding Deal Options for Medical Groups
Michele Madison, a partner in the healthcare practice at Morris, Manning & Martin, LLP, joins Mark to discuss hospital pain points and challenges in the wake of 2020. They touch on compliance, transactions, E/M coding changes, financial challenges, telehealth, and handling the various hardships that have grown over the last year of COVID.
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Episode Synopsis
Michele and Mark discuss maintaining physician relationships and focusing on value-based care and cost-reducing strategies. Hospitals are also exploring how to develop and expand outpatient healthcare delivery to patients.
They also discuss the implications of the weighting changes to the work RVU values and how these changes affect commercial reasonableness and fair market value. How will these changes affect the upcoming survey data that many physician enterprises rely on?
Click the play button to listen to the episode.
Extras
Learn more about Michele
2021 Offers New Opportunities Amid Healthcare Regulation Changes
Episode 82: How the MPFS Final Rule Impacts Medical Practices (and What to Do about It)
Webinar Replay: 2021 E/M Coding Changes: What Healthcare Professionals Need to Know
Alex Kirkland joins Mark to discuss changes to the Medicare Physician Fee Schedule (MPFS) final rule. On December 27, 2020, Congress passed and the President signed into law the Consolidated Appropriations Act. The stimulus bill provided temporary relief by partially mitigating cuts to the conversion factor in 2021.
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Episode Synopsis
Many payers use the Physician Fee Schedule (PFS) as the foundation for their rates and how they set their conversion factor. Although the stimulus bill only affects Medicare reimbursement for physician professional services, the impact will extend beyond Medicare. The stimulus package provides support only during 2021, so the full 10% cut to the conversion factor is still expected in 2022.
Medical groups need to analyze their financial impact through a CPT level revenue and wRVU compensation analysis. The important concept is compensation increases should not outpace reimbursement, meaning you can’t afford to pay more than your revenue allows.
There are also fair market value (FMV) and commercially reasonable (CR) implications and issues to consider. The new regulations state that a hospital may not value a physician’s services at a higher rate than a private equity investor or another physician practice.
Click the play button to listen to the episode.
Extras
Estimate the Financial Impact of 2021 E/M Coding Changes
Episode 82: How the MPFS Final Rule Impacts Medical Practices (and What to Do about It)
Webinar Replay: 2021 E/M Coding Changes: What Healthcare Professionals Need to Know
Aimee Greeter and Taylor Cowart join Mark to unpack how the Medicare Physician Fee Schedule (MPFS) final rule impacts medical practices (both employed and private), and offer suggestions to handle the 2021 changes to wRVUs and Medicare reimbursement for professional services.
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Episode Synopsis
COVID-19 drew everyone’s focus in 2020, and the surges around the holidays have moved the battlefront and center. In the fray, the Centers for Medicare and Medicaid Services announced big changes to evaluation and management codes that few are prepared for. Budget neutrality dictates there will be “winners” and “losers” throughout 2021.
Aimee and Taylor provide an overview of how the final rule will affect certain specialties, and what hospitals and private medical practices need to do.
Click the play button to listen to the episode.
Extras
E/M and ME: How Will the 2021 E/M Coding Changes Impact Medical Practices?
Estimate the Financial Impact of 2021 E/M Coding Changes
PSA Progression: What’s Next in the Evolution of Professional Services Agreements?
Richard Romero and Jeremy Johnson join Mark to discuss the Polsinelli|TrBK Distress Indices, which track bankruptcy statistics. The Distress Index is designed to capture distress in the market place and quantitatively present market place stress for healthcare valuators.
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Episode Synopsis
Jeremy provides an overview of the Distress Index and how one could use the index to understand distress in the healthcare market. The Distress Index tracks all Chapter 11 bankruptcies, and there are two sub-indices for real estate and healthcare.
Throughout this episode, Mark, Richard, and Jeremy explain how consultants and valuators use this data to understand the healthcare market and apply it to healthcare valuation. Risk is a significant factor in healthcare valuation and transaction advisory services. The Distress Index helps quantify the level of industry risk.
Click the play button to listen to Richard and Jeremy discuss the Distress Index.
Extras
The Distress Index
Blog: Recognizing and Mitigating Key Areas of Risk
Blog: The Impact of COVID-19 on Business Valuation
Taylor Cowart and Max Reiboldt join Mark to discuss the top five trends they expect to see during 2021. COVID-19 changed the entire world in just a matter of weeks, completely upending the status quo. Max and Taylor discuss how these changes will affect the healthcare industry in 2021 and beyond.
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Episode Synopsis
Top Five Healthcare Trends for 2021
- Post-COVID Transactions
- Political Transition
- Value-Based Arrangements
- Operations and Efficiencies
- Telehealth
Click the play button to listen to Max and Taylor discuss these five trends.
Extras
Blog Post: Top Five Healthcare Trends for 2021
2020 Telehealth Survey – Summary of Results
2020 Telehealth Survey – Summary of Results, Part 2
Coffee with Coker host, Mark Reiboldt, reviews the lessons we learned from the pandemic in 2020 and considers how to apply these lessons to a crisis moving forward.
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Episode Synopsis
Mark discusses the weaknesses and vulnerabilities the pandemic exposed in healthcare organizations. Ideally, if we can identify and address these vulnerable areas pre-crisis, we can mitigate the severity once a crisis arises.
Mark reviews three categories: financial planning and performance, technology and compliance, and operations.
Extras
COVID-19 Pandemic Exposes Vulnerabilities in Healthcare Organizations (Part 1)
COVID-19 Pandemic Exposes Vulnerabilities in Healthcare Organizations (Part 2)
COVID-19 Pandemic Exposes Vulnerabilities in Healthcare Organizations (Part 3)
Coffee with Coker host, Mark Reiboldt, provides an answer to frequently asked questions over the years. What is healthcare consulting? What do healthcare consultants do? Why would I need to hire a healthcare consultant?
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Episode Synopsis
In general, consulting firms provide a professional service by advising their clients on a specific matter. Healthcare consultants could focus on healthcare technology implementation and improvement, medical group business operations, or strategic planning for a health system, to name a few.
As a firm, Coker Group focuses on all aspects of healthcare business. Our goal is to optimize the business of healthcare for each of our clients, focusing on five core areas: strategy, operations, finance, technology, and compliance. Our main focal point is the healthcare providers and their specific needs within their healthcare practice. We customize our approach to every project to ensure our clients receive the best value.
Extras
Learn more about Coker Group
Lee Perrett joins Mark Reiboldt to discuss telehealth and virtual care leadership positions for large healthcare organizations. Lee and Mark discuss the advantages of telehealth during a pandemic and why healthcare organizations want healthcare executives and physician leaders who are uniquely qualified to run a telehealth program.
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Episode Synopsis
As telehealth continues to gain popularity among patients, healthcare organizations need versatile leaders to run their telehealth programs. Telehealth offers many advantages, including increased access to healthcare, especially in rural areas, and the ability to screen patients at home and determine if an in-person visit is necessary.
The individuals suited for this position should have a clinical background with experience in operations and health business administration. A telehealth and virtual care leader’s goal is to help the organization meet its goals and objectives for the telemedicine program.
Extras
Is Telehealth Past the Tipping Point?
Should You Use a Non-Medical Grade Telemedicine Platform?
Case Study: Leveraging Technology during a Pandemic
Jeffery Daigrepont joins Mark Reiboldt to discuss Coker’s latest book, Beyond EHR. Today, it is not uncommon for practices and hospitals to be on their second or third EHR or contemplating a transition from the traditional on-premise model to a cloud-based system. As a follow-up to Complete Guide and Toolkit to Successful EHR Adoption (©2011 HIMSS), this book builds on the best practices of the first edition, fast-forwarding to the latest innovations that are currently leveraged and adopted by providers and hospitals.
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Episode Synopsis
In this new book, we examine the role that artificial intelligence (AI) is now playing in and around EHR technology. We also address the advances in analytics and deep learning (also known as deep structured or hierarchical learning) and explain this topic in practical ways for even the most novice reader to comprehend and apply.
The book also covers the challenges of EHR to EHR migrations and data conversions, including the unethical practice of data blocking some vendors use as a tactic to hold data hostage. Further, we explore innovations related to interoperability, cloud computing, cybersecurity, and electronic patient/consumer engagement.
Finally, this book will deal with what to do with aging technology and databases, which is an issue rarely considered in any of the early publications on healthcare technology. What is the proper way to retire a legacy system, and what are the legal obligations of data archiving?
Extras
Order the Book!
Case Study: Leveraging Technology During a Pandemic
Dr. Brent Lacey joins Mark Reiboldt to discuss healthcare business and financial success. Dr. Lacey is a gastroenterologist who is passionate about helping physicians succeed with business and personal finances. His goal is to help physicians learn how to manage their businesses successfully and master their personal finances.
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Episode Synopsis
As a physician, Dr. Lacey understands how overwhelming it can be to step out of clinical training and into a career. He has seen firsthand the lack of education on how to run a practice and manage finances.
Mark and Dr. Lacey discuss the dynamics of physicians delivering care during a pandemic and the necessity for strong physician leadership within any medical group. They also discuss how patients are accessing medical care and how a pandemic could change healthcare delivery in the future.
Extras
Learn more about The Scope of Practice
The Scope of Practice Reading List
COVID-19 Pandemic Exposes Vulnerabilities in Healthcare Organizations
Leading in Crisis: How to Prepare, How to Execute, How to Thrive
Dr. Michael Sherling joins Mark Reiboldt to describe practicing in a pandemic. Dr. Sherling is Co-founder and Chief Medical and Strategy Officer of Modernizing Medicine. Modernizing Medicine helps physicians save time in their medical practices while improving the quality of care and business outcomes through their specialty-specific EHR technology.
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Episode Synopsis
Mark and Dr. Sherling describe what it is like for healthcare providers on the pandemic's front lines. They discuss patient care barriers during the pandemic, the challenges medical practices are experiencing, and the ways medical groups can innovate to meet these challenges.
Mark and Dr. Sherling also look to the future and identify the positive trends of practicing in a pandemic and which ones medical groups should continue to practice in the future.
Extras
Learn more about Modernizing Medicine
Major E/M Coding Changes Coming in 2021: Here’s What You Need to Know
Three Quick Tips to Get You Started with the New E/M Guidelines
Impact Calculator for the 2021 E/M Code Changes
Max Reiboldt joins Mark Reiboldt to discuss Coker’s latest book, Affiliation Options for Physicians. The number of available affiliation options can be nearly as daunting and confusing as the uncertainty surrounding which model is the best fit for any organization. Choosing the correct model is best achieved through foundational knowledge – and with an eye on what you can expect the future of healthcare to bring.
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Episode Synopsis
In this new book, Max Reiboldt, CPA, equips physicians, physician leaders, health system administrators, and private investors with an abundance of knowledge and effective strategies for making sound decisions based on the current and future environment of healthcare practice and delivery.
Max and our editorial team present those myriad possibilities in an organized and easy-to-digest format that explores the “what” and “how-to” applications of each option, and by providing a historical review of various physician affiliation transactions over the past 20 years, including:
- Physician to physician
- Private group to private group
- Private group to hospital-health systems
- Private group to private equity/outside investors, and more
Extras
Order the Book!
Episode 34: Private Equity: The Next Stage in Physician Practice Transactions
Justin Chamblee, Alex Kirkland, and Amit Vaishampayan join Mark Reiboldt to discuss the proposed changes to the Medicare Physician Fee Schedule (MPFS). There are three noteworthy changes proposed, including evaluation and management (E/M) coding and payment changes, permanent telehealth changes implemented in response to the pandemic, and updates to the Quality Payment Program (QPP).
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Episode Synopsis
E/M Coding and Payment Changes
Due to increasing RVU amounts, the statutory budget neutrality mandate comes into play to reduce the conversion factor by $3.83 to $32.2605 to prevent an increase in healthcare costs. The Budget Neutrality Act requires that increases or decreases in RVUs may not cause the value of expenditures for the year to change more than $20 million in the absence of changes. If this threshold is exceeded, adjustments are made to preserve budget neutrality.
Telehealth Changes
The Centers for Medicare and Medicaid Services (CMS) are adding several telehealth CPT codes that are similar to existing consultations and office visits. They also added temporary codes during the pandemic that will continue to be evaluated. CMS is seeking comments to determine future usage as well as additional temporary codes.
QPP Updates
We see ACO scoring and policy changes to acknowledge that providers will not immediately recover from COVID-19, and they will need support throughout their recovery. The Merit-based Incentive Payment System (MIPS) category weightings will shift to reduce the quality weight by five percent (to a total weight of 40 percent) and increase cost by five percent (to a total weight of 20 percent).
Extras
Three Quick Tips to Get You Started with the New E/M Guidelines
Is Telehealth Past the Tipping Point?
Episode 71: The Ongoing Battle of Site Neutral Payments
Episode 70: Major E/M Coding Changes Coming in 2021: Here’s What You Need to Know
Brandt Jewell and Taylor Cowart join Mark Reiboldt to discuss the latest news for site neutrality. Hospitals have historically benefited from the Outpatient Prospective Payment System (OPPS), the reimbursement mechanism for Hospital Outpatient Departments (HOPD) facility fees, in comparison to their private practice peers functioning under the Medicare Physician Fee Schedule.
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Episode Synopsis
The procedures performed in a freestanding clinic versus an HOPD received 75% less reimbursement. Hospitals were highly incentivized to acquire independent sites, switch the designation to HOPD and begin increasing their reimbursement for the same procedures. This strategy caused HOPD billings to effectively double over the last decade.
Both Medicare and its beneficiaries were under pressure to find a solution.
Between 2018 and 2020, the Centers for Medicare and Medicaid Services (CMS) updated the OPPS rate and proposed to phase in a 60 percent reduction over two years. They believe site neutral payments will give patients more options for their care.
Alternatively, hospitals predicted a massive loss under the site neutral payments into the millions for many organizations. The American Hospital Association (“AHA”), the Association of American Medical Colleges (“AAMC”) and various other private groups took up arms against CMS, arguing that hospitals should receive additional reimbursement as it is inherently more expensive to run HOPDs based on the standards they are required to uphold.
Extras
Another Blow for Hospitals: The Ongoing Battle of Site Neutral Payments
Bonus Episode: Three Key Objectives from the 2019 State of the Union Address
Episode 21: Q&A Episode – December 2018
Jeannie Cagle joins Mark Reiboldt to share the good news about evaluation and management (E/M) coding changes for 2021! Although telehealth and COVID-19 impacts received the most attention in the Proposed Rule, the E/M coding changes are still coming, and CMS will release the Final Rule by the end of 2020.
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Episode Synopsis
As part of the Patients over Paperwork initiative, the Centers for Medicare & Medicaid Services (CMS) is simplifying the documentation to support billing outpatient E/M professional services.
In summary, the new guidelines affect only new and established office/outpatient E/M codes (99201-99215); however, they will significantly alter documentation of the patient visit. These changes will remove the history and exam as key components, and base code-level selection on either Medical Decision Making (MDM) or time. Also, the proposed increase in RVU value will create a financial boost.
Coding education and audits are more important than ever. Medical decision making is moving to the core of medical coding with less emphasis on technicalities to support the level of coding. An educated physician is our number one priority!
Coker Group is offering either a turn-key solution or a customized approach based on each client’s individual needs. Our extensive coding team, including certified professional coders and RNs, will complete these services with our in-house coding and compliance senior vice president, Roz Cordini, JD, MSN, RN, CHC, CHPC, overseeing Coker’s coding team.
The components of these services include:
- Assessment of education and training needs for both providers and in-house coders
- Discussion with EMR template managers to determine internal policies for new requirements and necessary template revisions
- Development of a go-forward audit plan for provider documentation and coding audits
- 2021 follow-up education and audits
Contact us today and use promo code EM2021 to receive a free checklist to assess the training needs for your healthcare providers and staff.
Send me the checklist!
Aimee Greeter joins Mark Reiboldt to discuss pursuing strategic affiliations and partnerships during times of crisis. As the pandemic continues to affect the healthcare industry, physicians will need strong partnerships to survive. Aimee and Mark discuss the importance of healthcare transactions in crisis, whether as a strategy or out of necessity.
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Episode Synopsis
According to a recent study, 1 in 5 primary care physician practices will not reopen post-pandemic for a few reasons.
- Physicians in small or solo private practices could decide to retire.
- Individual physicians could pursue other opportunities, such as employment or another form of affiliation with another healthcare entity.
- The entire group could pursue an affiliation strategy with another healthcare entity.
Aimee and Mark discuss strategic affiliations and partnerships during a crisis, and the role leadership plays in closing the deal.
Extras
Episode 66: Affiliation Options for Physicians and Hospitals Post-Pandemic
Leading in Crisis: How to Prepare, How to Execute, How to Thrive (Part 1)
Leading in Crisis: How to Prepare, How to Execute, How to Thrive (Part 2)
Leading in Crisis: How to Prepare, How to Execute, How to Thrive (Part 3)
Post-Pandemic Crisis Affiliation: Which Way is Up?
Mark Reiboldt facilitates a discussion with Jim Bowling, Charlie Caperton, and Van Willis from PREMEDEX about the role of patient engagement and communications programs during a public health emergency. They discuss the impact of the COVID-19 pandemic, and what reopening parts of a healthcare system could look like. PREMEDEX provides technology and services to meet patient communications needs.
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Episode Synopsis
We could never have imagined the challenges of a modern-day pandemic, yet the effects upon the healthcare system are genuine. Hospitals postponed elective procedures, freed outpatient facilities and equipment for COVID-19 needs, furloughed employees, and enacted measures to keep their employees safe. As states across the country relaxed restrictions, parts of the healthcare system were able to reopen.
Mark, Jim, Charlie, and Van discuss reopening and how things may have changed because of the public health emergency.
Extras
Learn more about PREMEDEX
PREMEDEX Leadership
Gabriel Harry and Chris Torregosa take over the podcast to discuss remote consultative support and leadership for healthcare technology implementations. They discuss the state of the healthcare industry and the opportunities a remote workforce offers healthcare organizations.
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Episode Synopsis
As various states begin to relax restrictions and re-open, healthcare providers remain on the frontlines of the ongoing pandemic. It is critical to continue efficient, lean operations, and many healthcare organizations are looking for new opportunities with remote workforces. A poll from HIMSS revealed healthcare organizations predominantly use consultancies for information technology (IT) system setup, redesign, or deployment, helpdesk or other managed IT services, and financial management or billing.
Gabriel and Chris discuss the opportunities available for remote IT implementations and the reasons many healthcare organizations were starting to transition to remote deployments pre-pandemic.
Figure 1:
Extras
Our Remote Workforce is Here for You
Case Study: Leveraging Technology During a Pandemic
Should You Use a Non-Medical Grade Telemedicine Platform?
Aimee Greeter, Max Reiboldt, and Richard Romero join Mark Reiboldt to discuss changes the healthcare industry is experiencing during a pandemic crisis. The group discusses leading through a crisis, affiliation options for hospitals and physicians, and how the pandemic will affect practice valuations and compensation packages.
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Episode Synopsis
The COVID-19 pandemic has, in essence, turned the world upside-down. Healthcare in the United States and around the world will never be the same. At its core, this transformation applies to all aspects of clinical care, especially with the rapid adoption of telehealth as a viable alternative to a significant portion of in-office patient-physician visits and a greater focus on remote monitoring as an alternative to in-hospital observation. Likewise, we believe that the economic and transactional sides of the U.S. healthcare system will change as well, both in temporary and permanent ways.
As we begin to plow our way out of this crisis, Aimee, Max, and Richard consider affiliation strategies as we emerge from the pandemic and reestablish life under our “new normal.”
Extras
Leading in Crisis: How to Prepare, How to Execute, How to Thrive
Navigating the New Normal of a Post-Pandemic World
Post-Pandemic Crisis Affiliation: Which Way is Up?
Today’s episode is an interview with Jeffery Daigrepont, a senior vice president in our Healthcare IT Services division, conducted with Leah Jones, senior vice president and general manager of the ambulatory business unit at Allscripts. Our discussion will explore the innovative ways the market is responding to the financial challenges COVID-19 caused and consider a path forward for healthcare organizations.
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Episode Synopsis
COVID-19 has hit practices hard on many fronts and especially financially. The first, and most obvious, has been the costly response to the outbreak itself. Second, the patient volume has dramatically reduced, and all elective procedures postponed. While some relief has been provided, it is not enough. Practices must come up with a plan to rebound financially.
Jeffery and Leah discuss the innovative ways Allscripts is helping practices respond to COVID-19 and rebound from financial distress.
Extras
Allscripts Website
Allscripts Leadership
Coker Group COVID-19 Resource Center
Case Study: Leveraging Technology during a Pandemic
COVID-19 Telehealth Privacy and Security Concerns
Justin Chamblee and Alex Kirkland join Mark Reiboldt to discuss COVID-19 interim rules and waivers that change shared savings and other value-based strategies. Justin and Alex discuss how these changes will affect accountable care organizations (ACOs) and clinically integrated networks (CINs) taking on risk, the opportunity for shared savings, and how capitated models are faring throughout the pandemic.
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Episode Synopsis
Many healthcare providers are struggling as expenses skyrocket and elective procedures are deferred or canceled altogether, eliminating major revenue sources. Value-based initiatives are on-hold because most value-based arrangements require a significant financial commitment to start and healthcare providers are less likely to put more money at risk. Providers have shifted their focus to sustaining losses from the outbreak.
Justin and Alex explain what is happening in the industry to mitigate total shared losses and reduce the burden on providers. They also discuss their opinions on how COVID-19 will impact value-based strategies.
Extras
Blog: Understanding Value-Based Compensation Models
Article: Five Questions to Consider when Evaluating Readiness for Value-Based Care
Blog: ValuePath™: Supporting Organizations Making the Transition to Value-Based Reimbursement
Brandt Jewell, Alex Kirkland, and Richard Romero join Mark Reiboldt to discuss the changes to healthcare delivery during a public health emergency. Brandt, Alex, Richard, and Mark discuss the results of our recent survey on telehealth adoption and utilization.
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Episode Synopsis
Patients are changing the way they are consuming healthcare and telehealth will continue to be a viable, preferred platform for healthcare. Practices will have to incorporate telehealth into their patient access strategy to continue being successful. However, for telehealth to become a long-term strategy, there are other options to consider.
According to the survey, operations workflow was ranked as the number one challenge while compliance was ranked as the lowest. Although compliance remains on everyone’s mind, the first hurdle to overcome is the ability to interact with patients and operate efficiently.
Alex, Brandt, Richard, and Mark discuss these and other key points from Coker’s recent telehealth survey of healthcare leaders.
Extras
Case Study: Leveraging Technology During a Pandemic
Blog: Expanded Guidance from CMS for Telehealth Services Provided at RHCs and FQHCs
White Paper: Telehealth: A Crucial Solution in Uncertain Times
Blog: Implementing Sustainable Telehealth Strategy and Operations with PREMEDEX
Blog: Telemedicine and COVID-19: Develop an Urgent Response with Sustainable Operational Value
Blog: The Role of Telehealth in the Fight Against COVID-19
Matt BonDurant and Jack Liu join Mark Reiboldt to continue the compensation automation discussion and why providers need to drive strategy and alignment. Matt, Jack, and Mark discuss the opportunity costs of compensation management, effective compensation models that will drive results, and how telehealth is impacting provider compensation plans.
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Episode Synopsis
Matt, Jack, and Mark discuss the importance of aligning physician compensation to a hospital or medical group’s goals and the existing gaps between strategy and operations. Most healthcare providers manually calculate provider compensation to administer compensation plans, resulting in several manual business processes that are prone to human error or interpretation.
Matt and Jack explain common issues they find when reviewing provider compensation plans, and they discuss effective compensation practices to achieve strategic goals.
Extras
Physician Compensation Partnership Redefines Value
Blog: Solving the Compensation Conundrum
Episode 18: Physician Compensation: Automation Solutions with ProCARE Portal
Senior healthcare industry experts from Coker Group and Frost Brown Todd hosted a panel discussion with guidance for hospitals and medical groups during the coronavirus disease pandemic.
The panel discussed important concepts executives of healthcare services entities should be aware of as the industry continues to navigate the COVID-19 global health emergency.
The topics covered during the panel discussion are:
- Using telehealth during the COVID-19 pandemic with specific examples.
- Overview of the CARES Act, including SBA loan programs, tax assistance provisions, and hospital support programs.
- Guidelines on Stark regulations, fair market value, and commercial reasonableness.
- Physician compensation dynamics during COVID-19.
- Hospital and practice operational factors in an expanded telehealth environment.
- What is our new normal after COVID-19?
The webinar was a live version of our Coffee with Coker podcast featuring Mark Reiboldt, Senior Vice President of Coker Group, Max Reiboldt, President/CEO of Coker Group, Chad Eckhardt of Frost Brown Todd, and Andrew Johnson of Frost Brown Todd.
Download the slides with links to our COVID-19 resources.
Justin Chamblee joins Mark Reiboldt to discuss compensation arrangements for physicians during the COVID-19 global health emergency. Mark and Justin discuss different compensation arrangements for healthcare providers working on the frontlines.
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Episode Synopsis
As the coronavirus disease continues to spread, healthcare providers are adapting faster than ever to slow down the virus. Justin and Mark discuss how compensation policies play a role in the COVID-19 battle.
As social distancing continues and providers stop providing elective procedures, healthcare entities will need to adapt and find different ways to care for their patients. Justin and Mark discuss specific ways to compensate physicians during these uncertain times and document the methodology and reason should it be needed in the future.
Extras
COVID-19 Resource Center
Responsive Compensation Arrangements to Battle COVID-19
Jeff Kline, Jeffery Daigrepont, and Andy Sobczyk join Mark Reiboldt to continue the digital transformation discussion and how technological innovation is changing the healthcare industry. Today’s episode is a timely discussion on the coronavirus COVID-19 pandemic and technology to encourage handwashing.
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Episode Synopsis
Jeff Kline is the CEO of HanGenix, a technological solution that promotes hand hygiene compliance for healthcare professionals. Jeff joins the Coker team to discuss the importance of hand hygiene and society’s now acute awareness of the importance of handwashing with the COVID-19 pandemic.
Jeff, Jeffery, Andy, and Mark discuss the latest news in the healthcare industry related to digital transformation and the continued importance of a digital focus for healthcare organizations. As technology continues to evolve, now is the time for the healthcare industry to embrace the change and use new technology to improve clinical care.
Extras
HanGenix Website
WHO – Five Moments for Hand Hygiene
List of Current Emergencies from CMS
CDC – What you need to know about COVID-19
Frances Dare joins Aimee Greeter to discuss healthcare mergers and acquisitions and why the majority of these transactions fail to deliver the intended outcomes. Frances and Aimee explore the success rate of mergers and acquisitions as well as the factors to consider to improve the success rate.
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Episode Synopsis
Frances and Aimee explore why the research (and their experience) shows more than 70% of change initiatives fail to deliver the intended outcomes. Behind this is a failure to fully consider the psychology of human systems and a belief that people respond to change rationally.
Their discussion explores the human experience of change and reasons people both fear and seek it out. They consider the ways in which the unconscious can shape responses to change and focus on ways organizations can effectively engage employees and how leaders can support the change process. With healthcare M&A activity predicted to continue at pace and other change drivers at play, a deeper understanding of human responses to change can help healthcare organizations more effectively navigate turbulent times.
Extras
How to Be Better at M&A Marriage
Post-Merger Integration Strategy Starts Early
Strategic Variables in Private Equity Transactions
Jeffery Daigrepont and Dan Stewart join Mark to discuss healthcare information technology (HCIT) and the current state of cybersecurity for the healthcare industry. Jeffery and Dan describe the cybersecurity landscape in healthcare, why cybercriminals are targeting healthcare providers, and the importance of security risk assessments and security programs.
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Episode Synopsis
Jeffery and Dan cover ten questions about healthcare cybersecurity and security risk assessments for healthcare providers.
- What is the current state of cybersecurity in the healthcare industry?
- Why is healthcare so attractive to cybercriminals?
- What are the top cybersecurity threats in healthcare?
- What is the real cost of a data breach in healthcare?
- What are the primary obstacles for a provider to develop and maintain an adequate security program?
- Where should healthcare providers start? On what key areas should they focus?
- Why is it essential to have a strategy at the boardroom level to succeed in achieving a high-level cybersecurity program?
- How do providers protect their critical assets as cyber threats continue to evolve?
- What does an organization do when a data breach occurs?
- When does it make sense for an organization to use a managed services approach to cybersecurity?
Cybersecurity Extras
What is Your Battle Plan to Fight Cybercrime?
Podcast: How to Adopt Cybersecurity Best Practices
Blog: Five Tips to Keep Your Data Safe
Blog: 3 Critical Elements for Building an Effective Human Firewall
Brandt Jewell joins Mark to discuss private equity (PE) deals for healthcare entities and the operational considerations PE firms and medical groups alike should consider during the transaction. Brandt and Mark identify opportunities to discuss during due diligence, medical group optimization opportunities after the deal is complete, and the critical characteristics of attractive provider groups.
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Episode Synopsis
Brandt and Mark review how to identify opportunities during the due diligence phase of the transaction. The specialty or specialty mix of a medical group is a key decision factor when considering a PE deal because a financial return is the primary objective of that type of deal. They also discuss developing a consistent and scalable infrastructure, the pitfalls of aggregating physician operations, and continuing status quo operations after the agreement.
PE Deal Extras
Blog: Post-Merger Integration Strategy Starts Early
Blog: The Role of Management Services in Private Equity Transactions
Blog: Defining Private Equity Transactions in Healthcare and Understanding Deal Options for Medical Groups
Blog: Strategic Variables in Private Equity Transactions
Podcast: Episode 51: Forming a Management Services Organization
Podcast: Episode 34: Private Equity: The Next Stage in Physician Practice Transactions
Article: The Private Equity Model for Medical Group Transactions
Max Reiboldt and Aimee Greeter join Mark to discuss private equity deals for healthcare entities and how to approach a healthcare transaction strategically. Max, Aimee, and Mark consider how the governance of the deal and non-economic considerations during the due diligence period will affect the daily life of the providers involved.
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Episode Synopsis
Why do so many transactions focus heavily on economic terms? The economics of any deal, especially the more attractive private equity deals, only affect one day of the providers involved within the deal. There are numerous non-economic factors that will continue to affect every day of the providers involved for years to come.
Max, Aimee, and Mark discuss the strategic, non-economic terms that should receive equal consideration before finalizing any healthcare transaction.
Extras
Blog: Strategic Variables in Private Equity Transactions
Podcast: Episode 51: Forming a Management Services Organization
Podcast: Episode 34: Private Equity: The Next Stage in Physician Practice Transactions
Article: The Private Equity Model for Medical Group Transactions
Dr. Stephanie Cross, Roz Cordini, and Michele Madison join Mark for a panel discussion on the healthcare industry. Mark moderates the conversation as Dr. Cross, Roz, and Michele outline current trends in the healthcare industry and how those trends will continue to evolve throughout 2020. The discussion focuses on rural health and access to healthcare, telemedicine, physician reimbursement, and the opioid crisis.
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About the Panelists
- Stephanie Cross is an assistant professor at the University of Tennessee and specializes in OB/GYN. Dr. Cross has been engaged as a part of the teaching faculty at UT and private practice throughout her career.
- Roz Cordini, JD, MSN, RN, CHC, CHPC, is a senior vice present and director of coding and compliance services at Coker Group. Ms. Cordini leads the coding and compliance service line, which focuses on Office of Inspector General program compliance, compliance effectiveness reviews, physician compensation governance procedures, and governance education. She provides advisory services to boards of directors regarding compliance, virtual compliance officer services, provider documentation and coding audits, and other compliance-related services.
- Michele Person Madison is a Partner in the Healthcare Practice of Morris, Manning, and Martin, LLP, where she provides general legal advice to health systems in various regulatory and business matters. Ms. Madison is highly experienced in managing legal issues arising in hospitals, physician offices, or integrated health systems, including employment, investigations, risk management assessment, and corporation management. Also, she provides legal education for health systems’ medical staff, management team, and employees in these areas.
Anna Grizzle joins Mark to discuss the U.S. Court of Appeals for the Third Circuit False Claims Act (FCA) decision calling into question productivity-based physician compensation structures under the Stark Law. Mark interviews Anna to hear her perspective on the U.S. ex rel. Bookwalter v. UPMC and the Third Circuit’s decision.
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Episode Synopsis
The case involved employment arrangements between the medical center’s subsidiary physician practice entities and neurosurgeons who performed procedures at affiliated hospitals. The Third Circuit’s decision appears to call into question a common compensation methodology for physician professional services.
Continue reading: Inside the FCA: Third Circuit Holds Allegations of Improper Compensation Methodologies under the Stark Law Survive Motion to Dismiss
Extras
Bio: Anna Grizzle
Mark Reiboldt discusses frequently asked questions related to healthcare business valuations, private equity transactions in the healthcare industry, and the adoption of telehealth services.
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Episode Synopsis
With private equity transactions on the rise, we are receiving more questions on the structure of these deals and the valuation of healthcare enterprises. Medical practices have no intangible value, as all of their profits are distributed to the physician owners and partners, and the fair market value of medical practices is limited to tangible assets.
Telehealth is another popular topic as enterprises try to understand how (or if) to incorporate these services into their practice. Telemedicine has seen a sharp increase throughout 2019 because government and commercial payers now provide fee-for-service reimbursement.
Extras
Podcast: Episode 42: What is Business Valuation and Why Would I Need One?
Podcast: Episode 41: Telehealth: Helping your Health System Move Forward
Blog: Will Providers be Reimbursed for Telehealth Services?
Podcast: Episode 34: Private Equity: The Next Stage in Physician Practice Transactions
Article: The Private Equity Model for Medical Group Transactions
Max Reiboldt joins Mark to discuss private equity deals for healthcare entities and how management services organizations create value. Max and Mark consider how the management services organization is valued, how the sale proceeds are distributed, and the different scenarios for determining and allocating the management fee.
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Episode Synopsis
Private equity deals are a popular topic in the healthcare industry today. Many healthcare organizations are looking seriously at private equity options as an alternative to more traditional forms of hospital alignment or employment. Throughout 2019, many healthcare entities have seen success with the private equity option, and it seems like a good time for healthcare organizations to consider private equity alternatives.
Max and Mark discuss the various facets of private equity options, specifically about management services organizations.
Extras
Blog: Developing Management Services Organizations for Private Practices: The Newest Version of Strength in Numbers?
Podcast: Episode 34: Private Equity: The Next Stage in Physician Practice Transactions
Article: The Private Equity Model for Medical Group Transactions
Andy Sobczyk and Jeffery Daigrepont join Mark to discuss digital transformation and its application specifically to the healthcare industry. Andy and Jeffery discuss what technologies are currently changing or could potentially change the way healthcare is managed and delivered.
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Episode Synopsis
As data quickly becomes the new currency, Andy, Jeffery, and Mark discuss how contemporary technologies are impacting the healthcare industry and how artificial intelligence could revolutionize the way physicians practice medicine. With the year 2020 fast approaching, they emphasize the need to consider (at the least) a digital strategy and understand how rapidly evolving technology could help your healthcare organization achieve cost savings, improve outcomes, and allow better access to healthcare.
Extras
White Paper: The Use and Ethics of Artificial Intelligence in Healthcare
Article: Doctor Alexa will see you now: Is Amazon primed to come to your rescue?
Blog: When is the Time to Switch your EHR?
Today’s episode is an interview with Jeffery Daigrepont, a senior vice president in our Healthcare IT Services division, conducted with Jon-Michial Carter, Co-Founder and CEO of ChartSpan, and Angela Stokes, vice president of quality services. ChartSpan is a chronic care management company offering turnkey, fully managed care coordination programs for physician practices. Jeffery, Jon-Michial, and Angela discuss ChartSpan’s mission to improve patient health outcomes through innovative and life-changing health technology solutions.
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Episode Synopsis
Jeffery, Jon-Michial, and Angela explain the need to focus on chronic care management and how this focus will move the needle to provide truly preventative healthcare. ChartSpan proactively engages patients to manage their healthcare and prevent patients from becoming high-utilizers of costly hospital services.
Extras
ChartSpan website
Contact ChartSpan
Today’s episode is an interview with Chris Torregosa, a vice president in our Healthcare IT Services division, conducted with Patrick Randolph, Founder and CEO of QueueDr. QueueDr is a healthcare technology company offering online scheduling automation to maximize patient access and physician utilization. Chris and Patrick discuss the benefits of an automated system to help manage physician schedules and patient waitlists, boost staff productivity, and increase physician utilization.
Contact Information
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Episode Synopsis
Patrick and Chris discuss how QueueDr integrates with an organization’s electronic health record system to automatically fill canceled appointments while maintaining each physician’s established schedule. The automation is designed to lift the burden of rescheduling and optimizing schedules from medical group staff to increase their productivity and the medical group’s return on investment.
Extras
QueueDr website
Request a Demo
Aimee Greeter and Jhaymee Tynan join producer Jessica Combs to discuss their time at the Modern Healthcare Women’s Leadership Conference earlier this year. Aimee and Jhaymee recount their experiences at the conference and their thoughts on the future of leadership roles in this dynamic industry.
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Episode Synopsis
Aimee and Jhaymee discuss their experiences at the conference and the lessons they learned. As leaders within their respective organizations, they plan to apply these insights and continue to further their leadership knowledge. Both women strongly believe that diversity within a team or organization is crucial to success, and kindness is the most underused leadership skill.
Extras
White Paper: Top 5 Current Trends in Healthcare Executives' Compensation
How much does money matter? Using multiple methods for attracting and retaining top talent
Christopher Kunney joins Mark to discuss the state of cybersecurity in the healthcare industry. Although cybercrime has been impacting other sectors for over 20 years, it has recently begun attacking the healthcare industry extensively. Christopher explains the most common types of cybercrime, why cybercrime occurs, and what questions healthcare organizations need to ask when implementing a cybersecurity solution.
Contact Information
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Episode Synopsis
Daily, we read about security breaches in small-, medium-, and large-scale healthcare organizations that often affect hundreds, thousands, or even millions of people and their private information. Christopher outlines the most common types of breaches that could be avoided through employee education. He also discusses the reasons that cybercrimes occur and the specific types of cybercrime that are targeting health systems, hospitals, and medical groups.
6 Questions Healthcare Organizations Should Ask about Cybersecurity
- What is your organization doing to protect your vital data and financial assets from cybersecurity attacks?
- Do you have a written plan that outlines strategies and tactics for preventing, detecting, and responding to these attacks?
- What governance structure do you have in place to oversee the accountability for implementing your cybersecurity plan?
- How aware are your employees of the organizational and personal risks associated with cybercrime?
- Do you have an ongoing training program to increase this awareness?
- Do you have the necessary (or any) insurance coverage for cybercrime events like ransomware?
Extras
White Paper: The State of Cybersecurity in Healthcare: Still Much Ground to Cover
Podcast: Episode 28: How to Adopt Cybersecurity Best Practices
Blog: Five Tips to Keep your Data Safe
Blog: 3 Critical Elements for Building an Effective Human Firewall
Jeannie Cagle joins Mark to discuss the basics of medical coding for healthcare practitioners. Proper medical coding is essential for both compliance and reimbursement for professional services. Jeannie explains medical coding at the highest level and identifies common problem areas.
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Episode Synopsis
Throughout the discussion, Jeannie explains the following concepts:
- What types of codes are used to bill professional medical services?
- Which sources are considered “gospel” when coding?
- What are the most common problem areas in coding?
Jeannie also explains the benefits of a coding review and how it can be used to educate healthcare providers on proper medical coding practices.
Extras
White Paper: An Effective Approach to Coding and Compliance Auditing and Education
Blog: Will Providers be Reimbursed for Telehealth Services?
Roz Cordini joins Mark to discuss compliance program effectiveness and the reasons to have a compliance program in place. There continue to be significant compliance concerns across the healthcare industry as evidenced by ongoing DOJ settlements, new corporate integrity agreements, and other findings and activity.
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Episode Synopsis
Throughout the discussion, Roz and Mark touch on the following concepts:
- What constitutes a well-designed compliance program?
- Does the corporation’s compliance program work in practice?
- Barriers to implementing an effective compliance program
- Compliance effectiveness red flags
Roz walks through what it means to have a truly effective compliance program and why compliance programs are essential for healthcare organizations of any size. One of the most critical factors in establishing an effective plan is the “tone-at-the-top” of a healthcare organization, or more simply put, how an organization’s board or executive leaders position a compliance program and its compliance officer.
Extras
White Paper: Compliance Program Effectiveness
Blog: EHR Documentation Integrity Risks: Ten Ways to Stay Compliant
Today’s episode is an interview with Aimee Greeter, SVP in our Financial Services division, conducted with Matt Yagey, Founder and CEO, and Graeme Keith, Investor and COO of MedChat, a HIPAA-compliant live-chat application for patient communication. Aimee, Matt, and Graeme discuss the need to evolve patient communications in the 21st century and how text-based communications are improving patient access to healthcare.
Contact Information
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Episode Synopsis
Matt, Graeme, and Aimee discuss MedChat’s mission and their software solution, which brings a new level of engagement to healthcare patient communications. MedChat is simple to install and easy to use for all generations.
Patients use MedChat to:
- Manage appointment scheduling and rescheduling
- Assist with billing and coordinate payments
- Advise on care-related inquires
- Coach for population health
- Distribute and refill medications
- Manage referrals
- Communicate pre- and post-appointment
- Convert website visitors into new patients
Extras
MedChat Website
Contact MedChat
Bio: Aimee Greeter
David Walline and Yong Zhang join Mark to discuss performing healthcare business valuations and explain their purpose in the healthcare industry. Although a request for a healthcare business valuation can be for a multitude of reasons, most of the valuations Coker Group performs are associated with a pending transaction between two healthcare entities.
Contact Information
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- Email us: feedback@cokergroup.com
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Episode Synopsis
In a highly regulated industry, such as healthcare, it is imperative to have an accurate business valuation. A business valuation, in the most basic sense, is the act or process of determining the value of a business enterprise or an ownership interest within an enterprise.
David and Yong address frequently asked questions on healthcare business valuations such as:
- Why would a healthcare business valuation need to be performed?
- What is the typical process when a client requests a healthcare business valuation?
- Why is it important to establish the scope of services at the onset of the engagement?
- What approaches are used when performing a healthcare business valuation?
- How does Coker Group value specific assets of a healthcare business?
Extras
Blog: What is Business Valuation and Why Would I Need One?
Blog: Could I Benefit from an Appraisal Review?
Blog: Business Valuation to Fit Your Needs
Podcast: Private Equity: The Next Stage in Physician Practice Transactions
Bio: David Walline, ASA
Bio: Yong Zhang, CPA, ASA
Richard Romero joins Mark to discuss the impact telehealth could have on access to healthcare in rural markets as well as recent telehealth policies from Washington, D.C. Telehealth is one of the most significant trends in healthcare, serving as a way to ensure that people can get care when and where they need it. It is dramatically changing the delivery of healthcare and has the potential to be disruptive and transformative.
Contact Information
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Episode Synopsis
Richard discusses the practical applications of telehealth and how it differs from more traditional physician visits. As with many new services, new questions arise on how telemedicine impacts healthcare services and reimbursement. Telehealth requires a significant investment in technology and equipment that decision-makers should consider when determining if telehealth is a good fit for their healthcare organization.
Richard recently attended the CTeL Summit in Washington, D.C. and provides a brief update of policies to follow throughout 2019.
Extras
White Paper: Telehealth: Helping your Health System Move Forward
Maximizing Reimbursement in the Telemedicine Environment
CONNECT for Health Act of 2017
Justin Chamblee, Alex Kirkland, and Stephen Ross join Mark to discuss designing an innovative physician compensation strategy to adapt to continual changes within the healthcare industry. Justin, Alex, and Stephen often speak to audiences on the topic and receive many questions on best practices for physician compensation model design and structure.
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Episode Synopsis
Justin, Alex, and Stephen discuss the dynamics currently affecting physician compensation and offer an in-depth analysis of the new model structures that are being contemplated within the industry. They consider the key challenges associated with innovation and recommend best practices for designing physician compensation models.
The primary considerations and pressures within the healthcare market today include the push for value-based healthcare initiatives, the growth and scalability of the compensation structure, and the affordability of the compensation model for the healthcare organization.
Extras
White Paper: The Perpetual (Upward) Shift of the Median
Myth of the Median
Compensation Best Practices for Physician Enterprises
Justin Chamblee joins Mark to discuss how to evaluate and structure hospitalist compensation models. Justin walks through what Coker Group considers best practices for hospital-based physician compensation structures.
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Episode Synopsis
Typically, hospitalists are not measured or compensated based on their wRVUs for a couple of reasons. First, most hospitals see the essential goal of a hospitalist program as enhancing throughput (timely discharges, reduced length-of-stay, etc.). Paying hospitalists based on their productivity can be counter to these key goals, as it incentivizes them to do more. Second, the market data for hospitalist wRVU production is imprecise, given that hospitalists vary significantly in their productivity levels as a result of staffing/census dynamics. We believe the best measure of productivity for hospitalists is the patient census, not wRVUs.
Key Trends from Industry Data
- The majority of hospitalist groups work 12-hour shifts (day and night).
- Working additional hours per day equates to the need for fewer shifts per year to equal a 1.0 FTE.
- The market norm for hospitalists working a 7-on/7-off model and a 12-hour shift is 2,184 hours annually (182 shifts per year).
Extras
Physician Compensation Strategy
Bio: Justin Chamblee
Today’s episode is an interview with Jeffery Daigrepont, SVP in our Healthcare IT Services division, conducted with Baha Zeidan, Cofounder and CEO of Azalea Health, a healthcare technology company offering a fully integrated, cloud-based EHR, RCM, telehealth, and consulting services. Jeffery and Baha discuss the advantages of cloud-based technology and how Azalea Health enables community hospitals, rural health clinics, and practices of all sizes to customize a solution to their business needs.
Contact Information
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Episode Synopsis
Baha and Jeffery discuss the benefits of using a cloud-based technology system and the versatility of Azalea Health’s system. Azalea Health tailors healthcare solutions for rural healthcare providers to help meet their business needs with an affordable solution.
Extras
Azalea Health website
Azalea Health Demo
Follow Jeffery (@daigrepont)
Connect on LinkedIn (/jeffery-daigrepont-822a853/)
Aimee Greeter and Toni Peck join Mark to recap their May 2019 presentation at the American Health Lawyers Association Health Care Transactions conference. They focus on new ways to drive physician engagement to help ensure that an organization realizes its clinical integration goals.
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- Email us: feedback@cokergroup.com
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Episode Synopsis
While active physician leaders are needed more than ever, some are reticent to step into these roles – including seasoned clinical professionals and physicians newly out of training. Aimee and Toni discuss why engaging physicians is critical to the success of any organization, particularly now with the establishment of clinical integration within the industry.
They discuss Coker Group’s 12-point assessment tool to differentiate between low- and active-engagement physicians and the drivers for their behaviors; interpret and use assessment data to customize one of five new approaches to improve physician engagement; delineate, track, and advance provider engagement through involvement, decision-making, and leadership; and, understand how to involve physicians in quality improvement processes to guide successful clinical integration initiatives.
The views and comments of the presenters are their own and do not reflect the opinions and positions of their respective employers. Further, any comments made by attorneys are not intended to be, nor should they be construed as legal advice.
Extras
AHLA eProgram: 2019 Health Care Transactions Conference
White Paper: Physician Engagement: A Crucial Component of a Healthy Organization
Podcast: Maximizing Physician Engagement
Bio: Aimee Greeter
Bio: Antonia (Toni) Peck
Justin Chamblee, Priya Bathija, and Tom Donohoe join Mark to recap their May 2019 presentation at the American Health Lawyers Association Health Care Transactions conference. They explore the driving forces causing rural hospitals to consider affiliations with larger health systems, such as rising costs, limited access, commitment to rural populations, and management expertise.
Contact Information
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Episode Synopsis
Justin, Priya, and Tom discuss the meaning of alignment for rural hospitals and explore viable alignment model options to offer needed healthcare services in the right areas, including historical affiliation models that have been used and may still be appropriate in certain circumstances (full acquisition, management, lease and joint operating arrangements).
Evolving and less formal models could be considered to accommodate rural identity and independence, including preferred services arrangements, EPIC hosting, visiting specialists, and other need-specific arrangements. They briefly address common legal issues associated with both historical and evolving models.
The views and comments of the presenters are their own and do not reflect the opinions and positions of their respective employers. Further, any comments made by attorneys are not intended to be, nor should they be construed as legal advice.
Extras
AHLA eProgram: 2019 Health Care Transactions Conference
AHA 2019 Rural Report
White Paper: Modern PSAs: A Stable Alignment Model in an Unstable Healthcare Environment
Bio: Justin Chamblee
LinkedIn: Priya Bathija
LinkedIn: Tom Donohoe
Today’s episode is an interview Jeffery Daigrepont, SVP in our Healthcare IT Services division, conducted with Jose Valero, President and CEO of dashboardMD, a healthcare analytics company. Jeffery and Jose discuss the importance of healthcare analytics and using dashboardMD for population health management and clinical, financial, and operational analytics.
Contact Information
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Episode Synopsis
As we move well into the 21st century, data has become the new currency in many ways. It is imperative to not only capture relevant and meaningful data but to use that data to make impactful business decisions. Clinical and patient outcomes are now affecting reimbursement for professional services, and understanding these outcomes is paramount to the success (or failure) of healthcare organizations.
Extras
dashboardMD website
dashboardMD Contact Information
Follow Jeffery (@daigrepont)
Connect on LinkedIn (/jeffery-daigrepont-822a853/)
Max Reiboldt joins Mark to discuss private equity deals in the healthcare industry. Max and Mark review the recent private equity activity in healthcare and how these deals impact the market.
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Episode Synopsis
In recent years, several private equity firms have been involved with hospital and/or physician transactions. Mark and Max examine the reasons private equity firms are attracted to the healthcare industry, which leads to the question, how are these deals impacting the healthcare market?
With private equity involvement, the idea is to maximize downstream value. Mark and Max discuss why these deals are attractive to healthcare organizations and certain characteristics with which healthcare organizations should be familiar.
Extras
Article: Private equity infuses healthcare with $63B investment
Article: The Next Stage of Evolution in Physician Practice Transactions: Can hospitals compete with private equity in attracting physician group deals?
Bio: Mark Reiboldt
Bio: Max Reiboldt
Brandt Jewell and Stephen Ross join Mark to discuss the concept of investment per physician for employed provider networks. Brandt, Stephen, and Mark review the market movement from independent practices to employed practices.
Contact Information
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Episode Synopsis
Mark, Brandt, and Stephen discuss the differences between independent and employed practices, including treatment of overhead and other financial considerations. Because of these differences, employed provider networks usually require some form of financial assistance.
Ultimately, each organization should consider the value they receive for their investment in the employed provider network. Mark, Brandt and Stephen discuss the different types of analyses that can be performed, what to consider when using market data, measuring the investment in the network, and improving financial performance.
Extras
Article: Health System Practice Investment: What's the Cost?
Alex Kirkland and Stephen Ross join Mark to discuss best practices for physician enterprise compensation plans. Alex, Stephen, and Mark evaluate the most common components of physician compensation plans and offer best-practice insights on them.
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Episode Synopsis
Mark, Alex, and Stephen discuss the importance of a clear compensation strategy with appropriate governance protocols for employed physicians. Compensation design and redesign is a delicate process that encompasses both scientific reasoning to support the economics of the physician enterprise as well as artful politicking to engage physicians properly throughout the process.
No universal compensation plan fits every physician enterprise, and each will have unique nuances to consider. Though there are many different models, the best compensation plans will consider various factors and have a principled approach. The prevailing philosophy on compensation throughout the organization should be one that is physician-led, considerate of local economics, and layered on top of an established vision.
Extras
White Paper: Compensation Best Practices for Physician Enterprises
Blog: Physician Compensation Plan Design: The Basics Make a Difference
Blog: Best Practices for Developing Employed Provider Compensation Plans
Blog: Compensation in a Value-Based World—It’s Well Underway
Max Reiboldt and Lee Perrett join Mark to discuss the executive search process for healthcare organizations. Max, Lee, and Mark talk about the benefits of using an executive search firm, the questions to ask before engaging a firm, and the processes used within the executive search.
Contact Information
Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!
We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
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- Follow us on Instagram: @cokergroup
Episode Synopsis
Mark, Max, and Lee discuss the differences between using internal personnel for recruitment and a firm that specializes in executive searches. Organizations can leverage the knowledge of a third-party firm, especially one that specializes in healthcare executive recruitment.
Max and Lee discuss the entire executive search process as well as provide tips for selecting an organization to complete the executive search.
Extras
Interim Executive Leadership Options for Filling Crucial Executive Roles
Is Your Talent Pipeline Full, Half Empty, or Dry? Developing Internal and External Talent Pipelines
Randy Gott joins Mark to discuss physician community needs assessments and medical staff planning. Randy and Mark talk about the drivers of medical staff planning and recruitment, and the compliance purpose of a physician community needs assessment.
Contact Information
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We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
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Episode Synopsis
Mark and Randy discuss how a healthcare organization should document the need for physicians within the community as well as the main drivers of medical staff planning. At its core, the physician community needs assessment is a quantitative, statistical analysis; however, there are also many qualitative aspects that must also be considered.
Randy outlines his approach to assessing physician need for communities as well as compliance considerations for physician recruitment.
Extras
The Intersection of Compliance and Fair Market Value
Follow Randy on Twitter (@RandyGott_CG)
Connect with Randy on LinkedIn
Christopher Kunney joins Mark to provide a review of healthcare IT themes from the 2019 HIMSS conference. The HIMSS Global Conference & Exhibition brings together 45,000+ health information and technology professionals, clinicians, executives, and market suppliers from around the world.
Contact Information
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We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
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Episode Synopsis
Mark and Christopher discuss the latest trends and topics in the healthcare IT space including telehealth and physician burnout. These topics are at the forefront of industry discussions as healthcare organizations look to leverage technology platforms to address these changes to the delivery of care.
Christopher is very active within the HIMSS organization and has recently joined Coker Group.
Extras
Follow Christopher on Twitter (@HealthITProf)
Connect with Christopher on LinkedIn
Marissa Maldonado joins Mark to discuss preventing data breaches by adopting cybersecurity best practices. Marissa and Mark talk about the motivation of malicious groups, recent data breaches, and the Health Industry Cybersecurity Practices (HICP) for healthcare providers.
Contact Information
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We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
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Episode Synopsis
Mark and Marissa discuss the different types of cybercriminals and hackers, their motivations, and recent attacks affecting both hospitals and independent practices. Medical practices, small or large, are a wealth of information and often behind the times in the technology realm, which makes them perfect targets for cybercriminals.
The U.S. Department of Health and Human Services (HHS) recently published the article, “Health Industry Cybersecurity Practices: Managing Threats and Protecting Patients,” which identifies five threats affecting physician practices and ten technical best practices to mitigate these threats. Marissa and Mark discuss the difference between threats, vulnerabilities, impact, and best practices for cybersecurity.
Extras
Health Industry Cybersecurity Practices (HICP)
Blog: The Dangers of an Unstable IT Infrastructure
Blog: Why IT Assessments are Beneficial
Twitter: Cybersecurity Information and Tips
Follow Marissa on Twitter (@marissanado)
Connect with Marissa on LinkedIn
Today’s episode is an interview with Jeffery Daigrepont, SVP in our Healthcare IT Services division, conducted with Morgan Hefner, VP of Sales at MobileSmith Health, a healthcare technology mobile solution. Jeffery and Morgan discuss the advantages of using a mobile platform to disrupt healthcare in your system before someone else does.
Contact Information
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Episode Synopsis
Disruption in healthcare is a trend that has received much media coverage in the past year, in particular with the recent entry of large corporate companies such as Amazon and Apple into the healthcare space. Consumerism is finally catching up to healthcare delivery, and it’s an important time to adopt newer technologies to transform healthcare in the United States.
Extras
MobileSmith Health website
MobileSmith Health Contact Information
Follow Jeffery (@daigrepont)
Connect on LinkedIn (/jeffery-daigrepont-822a853/)
During the 2019 State of the Union Address, much was said about the state of healthcare in the country and President Trump’s agenda for lowering costs across various sectors of the industry. One item will be critical for hospitals and providers moving forward: the call for price transparency. Taylor Harrison and Mark Reiboldt present three key objectives for price transparency taken from the State of the Union Address.
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- Email us: feedback@cokergroup.com
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Episode Synopsis
Price transparency is not a new initiative, and one that has significant bipartisan support – in fact, it was one of the few items last night that received applause from both sides of the aisle. Price transparency is a trend we have seen increase greatly as a strategic initiative for hospitals and practices alike over the last few years. Not only does this have bipartisan support and has been a key initiative for CMS in recent years, it is also a strong indicator of the push toward more consumer-driven healthcare. Patients are no longer uninformed consumers and are doing their part to demand transparency in their care – both in terms of price and quality.
Three Key Objectives for Price Transparency
- IT Infrastructure Needs
- ASC/Outpatient Potential
- Participation in Value-Based Reimbursement (VBR)
At Coker, we help our clients respond to VBR and the associated price transparency demands. Through our ValuePath™ services, Coker Group is dedicated to helping our clients navigate the world of VBR, which spans a wide range of potential solutions, including overarching strategic planning, vetting of software, financial analysis, and operational performance improvements. Value-based care is imminent and important, regardless of how it gets there. Whether through government-sponsored programs such as MACRA and MIPS or consumer pressure, it will affect healthcare organizations.
It's never too early to take measures to prepare for an industry trend that will inevitably affect your organization in the long run. If your organization is in need of assistance, please contact us today and we will be happy to discuss how Coker Group will help you work towards a solution.
Roz Cordini and Jeannie Cagle join Mark to discuss the importance of coding and documentation. Roz, Jeannie, and Mark talk about the need for an effective compliance program and the use of a coding audit as an educational tool for healthcare providers.
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- Email us: feedback@cokergroup.com
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Episode Synopsis
Mark, Roz and Jeannie discuss the purpose of incorporating regular coding audits into a comprehensive compliance plan. Investing in the time and energy to create an atmosphere of proactive education and support will lead to more accurate billing and coding which reduces the risk of fraud and abuse concerns.
Roz and Jeannie highlight the importance of defining a compliance plan and the common issues discovered when performing a coding audit. They also emphasize the importance of continually educating providers and the changes to documentation after the 2019 Medicare Physician Fee Schedule Final Rule.
Extras
White Paper: An Effective Approach to Coding and Compliance Auditing and Education
Article: The Tone at the Top Sets the Standard for an Effective Compliance Program
Article: Just When You Think You’ve Heard It All: CMS’s Proposal for an E/M Makeover
Podcast: Changes to Reimbursement from CMS for CY 2019
Follow Roz on Twitter (@RozCordini_CG)
Connect with Roz on LinkedIn
Connect with Jeannie on LinkedIn
Roz Cordini, Brandt Jewell, and Alex Kirkland join Mark for a webinar to discuss the Medicare Quality Payment Program (QPP). The discussion was recorded live during its presentation on January 24, 2019.
Contact Information
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- Email us: feedback@cokergroup.com
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Webinar Description
As part of the Medicare Access and CHIP Reauthorization Act (MACRA), the Medicare Quality Payment Program (QPP) was established and consists of two participation pathways for clinicians: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). CMS has been gradually implementing the full scope of MACRA over the past three years, and January 1, 2019, marks the beginning of MIPS adjustments to Medicare Part B fee-for-service revenue. The panel discussion will focus on identifying potential pain points for healthcare organizations as a result of MACRA and review key changes for CY 2019 as outlined in the final rule.
Learning Objectives
- Identify the potential pain points of full MACRA implementation and outline the first steps organizations should take to alleviate issues.
- Review the final rule for the quality payment program and how these changes impact APMs and MIPS.
- Discuss the impact E/M changes will have on reimbursement and physician compensation.
Extras
Webinar Recording
Handout - Presentation Slides
Roz Cordini, Aimee Greeter, Brandt Jewell, Stephen Ross, and Chris Torregosa join Mark to share their thoughts on current healthcare industry trends and where the industry is heading in 2019. The discussion was recorded live during its presentation to the company as part of the 2018 Coker Group annual meeting.
Contact Information
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We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
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About the Panelists
- Roz focuses on coding, clinical documentation and compliance services for hospitals, health systems and physician practices, and helps organizations develop or update their compliance programs and establish remote compliance officer services for smaller facilities.
- Aimee specializes in hospital-physician alignment, accountable care responsiveness, hospital service line development, clinical integration initiatives, strategic planning, executive compensation, mergers and collaborations, operational issues, and financial management.
- Brandt's concentration is on delivering value across the ambulatory enterprise and has extensive experience assessing executive leadership, physician alignment strategies, operational efficiency, financial stability, organizational structures, and competitive landscapes for health systems across the country.
- Stephen specializes in assisting healthcare organizations in the areas of hospital-physician alignment transactions, compensation valuation work, compensation plan redesign, strategic business planning and operational/financial performance improvement.
- Chris works on a variety of high-level consulting projects assisting clients in technology assessments and selection, providing guidance and solutions and execution of strategic project deliverables to coordinate, guide, and advance EHR adoption and use.
Extras
Follow Roz on Twitter (@RozCordini_CG)
Connect with Roz on LinkedIn
Follow Aimee on Twitter (@AimeeGreeter_CG)
Connect with Aimee on LinkedIn
Follow Brandt on Twitter (@brandtjewell)
Connect with Brandt on LinkedIn
Connect with Stephen on LinkedIn
Connect with Chris on LinkedIn
Aimee Greeter and Taylor Harrison join Mark to discuss the importance of prioritizing new strategic initiatives as the healthcare industry continues to evolve. Aimee, Taylor, and Mark talk about the importance of strategic planning—and the process for strategic planning--as the healthcare industry changes.
Contact Information
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We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
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Talking Points
- Evolution of the Healthcare Industry
- Volume-to-Value
- Consolidation
- Consumerism
- Goals of Strategic Planning
- Review current issues
- Develop a SWOT analysis
- Establish a vision
- Identify strategies and tactics for achieving the vision
- Communicate the goals of the organization
- Primary Focus Areas for Strategic Planning
- Macro-Environment Factors
- Market Factors
- Internal Factors
- The Strategic Planning Process
Extras
Follow Aimee on Twitter (@AimeeGreeter_CG)
Connect with Aimee on LinkedIn
Connect with Taylor on LinkedIn
Craig Hunter, Jeannie Cagle, Kay Stanley, and Max Reiboldt join Mark to share the history of Coker Group and how the firm was founded. The discussion was recorded live during its presentation to the company as part of the 2018 Coker Group annual meeting.
Contact Information
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- Email us: feedback@cokergroup.com
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The History
Established by Jackson C. Coker in 1987, Coker Group began as a physician relations firm whose purpose was to develop and enhance the relationships between hospitals and their medical staffs. The newly founded company moved into its first offices in 1988 with a small team from Atlanta and California. With extraordinary success and a growing list of hospital clients, Coker strengthened its footing through a focus on building hospital and physician relations through educating physicians and their staffs to improve their operational processes and enhance their business models. Delivering educational programs and assistance with medical practice management became the business model for this young company. Coker began to memorialize its expertise in the mid-‘90s through the publication of materials to enhance practice operations and financial management. Through the years, Coker has worked with national associations and other healthcare societies and entities to complement the work of its consultants with hospitals and physicians.
Under the strong leadership of Max Reiboldt, upon Jack Coker’s retirement in the mid-1990s, Coker Group continued to respond to the needs of hospitals and physicians as healthcare transitioned from one reimbursement paradigm to another through the late 1990s and beyond. During this period, the firm shifted its emphasis from the original physician relations’ services to become a full-fledged healthcare advisory firm. Through its history, the firm has met the complexity and expansion in healthcare that has occurred into the 21st Century. Coker Group holds a notable position as leading business advisors to the healthcare industry, assisting with complex negotiations between hospitals and physicians. Through five main services areas--strategy, operations, finance, technology, and compliance--the firm’s mission is still to provide healthcare organizations with innovative, principled solutions to achieve their optimum level of productivity.
Join us on January 24, 2019, at 2:00 pm, for the live panel discussion, One Month into MACRA!
As part of the Medicare Access and CHIP Reauthorization Act (MACRA), the Medicare Quality Payment Program (QPP) was established and consists of two participation pathways for clinicians: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). CMS has gradually implemented the full scope of MACRA over the past three years, and January 1, 2019, marks the beginning of MIPS adjustments to Medicare Part B fee-for-service revenue. The panel discussion will focus on identifying potential pain points for healthcare organizations as a result of MACRA and review key changes for CY2019 as outlined in the final rule.
Learning Objectives
- Identify the potential pain points of full MACRA implementation and outline the first steps organizations should take to alleviate issues.
- Review the final rule for the quality payment program and how these changes impact APMs and MIPS.
- Discuss the impact E/M changes will have on reimbursement and physician compensation.
Sign-Up for the Live Event today!
Extras
Pictures and Tweets from #CokerLive2018
Follow Craig on Twitter
Follow Max on Twitter
Connect with Craig on LinkedIn
Connect with Jeannie on LinkedIn
Connect with Kay on LinkedIn
Connect with Max on LinkedIn
Brandt Jewell and Alex Kirkland join Mark to discuss the final rule from CMS last month announcing changes to the physician fee schedule for 2019. Brandt and Alex provide their input on the changes that have been announced and what it means for physician practices.
Contact Information
Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!
We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
- Connect with us on LinkedIn: Coker Group Company Page
- Follow us on Twitter: @cokergroup
- Follow us on Instagram: @cokergroup
Episode Synopsis
On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019.
Key Points from the Final Rule
- One of the payment provisions announced involved streamlining evaluation and management payment and reducing clinician burden.
- Beginning in CY 2021, payment for E/M office/outpatient visits will be simplified and payment would vary primarily based on attributes that do not require separate, complex documentation.
- After consideration of concerns raised by commenters in response to the proposed rule, CMS is not finalizing aspects of the proposal that would have:
- Reduced payment when E/M office/outpatient visits are furnished on the same day as procedures;
- Established separate coding and payment for podiatric E/M visits;
- Standardized the allocation of practice expense RVUs for the codes that describe these services.
Brandt and Alex will also be hosting a webinar on January 24, 2019 that will cover, in part, the potential ramifications for physicians and healthcare organizations. Learn more and sign-up for the live event today!
Extras
Final Policy on Payment and Quality Provision Changes to the Medicare Physician Fee Schedule for CY 2019
Follow Brandt on Twitter
Connect with Brandt on LinkedIn
Follow Alex on Twitter
Connect with Alex on LinkedIn
Jessica Combs joins Mark to in a Q&A style discussion to address recent questions on healthcare trends. Mark addresses each question on various topics including private equity interest in healthcare, the opioid crisis, neutral site payments, healthcare technology, and revenue cycle management.
Questions
- We have heard much discussion in the media and throughout this election season on the opioid crisis, but I’m curious if this is something of a significant impact yet on physicians and medical groups or hospitals. Have you observed any specific instances where the talk in the media and Washington has resulted in major changes – positive or negative – for healthcare entities?
- We have been monitoring the issue of “neutral site payments” all year, as this could have a significant impact on hospital payments for those entities that have spent a lot of time and dollars investing in outpatient services. Can you comment on what has happened with this matter and perhaps make any predictions for how the results of the midterm elections could influence the outcome on this issue?
- In listening to your episode on what hospital boards should be thinking about concerning healthcare technology, we have been paying a lot of attention to the frequent stories that emerge about fines and legal issues (not to mention PR concerns) that many hospitals are dealing with in protecting records, maintaining security in the information systems, and lacking appropriate documentation. However, there are so many facets of protecting data that an organization like a hospital – even a relatively small, rural community hospital – must consider that it’s challenging to think about where to start. How would you suggest a leadership team begin to confront this issue to ensure we have as much protection as possible from some of those risks?
- Our organization has been struggling from revenue stagnation (and even drops in some cases) that we know are not tied to negative changes in payer contracts, fee schedule changes, expense management, or even the billing and collections component of the revenue cycle. So, we think the issue could be related to coding; however, in the past, our focus on coding has mainly been to ensure our providers are not up-coding. How could coding issues play into the broader revenue cycle management procedures?
- As it has become commonplace to see hospitals buying physician groups, some local markets have seen significant shifts as a result of larger groups selling to hospitals. Meanwhile, new players, such as large corporate systems or groups backed by private equity investors are entering markets and competing with the hospitals for acquiring major physician groups, which can significantly shake up the dynamic between the physicians within those groups and the hospitals they interact with on a regular basis at a local level. My question is twofold: 1) Have you seen this take place; and, 2) how might this trend potentially shake up local healthcare markets more in the future? Can hospitals compete with outside players that bring significant financial resources to invest in such deals?
Extras
The Next Stage of Evolution in Physician Practice Transactions
Coffee with Coker Episode 17: Executives Beware: Five Questions Astute Boards are Asking about Healthcare IT
Follow Mark on Twitter
Connect with Mark on LinkedIn
Connect with Jessica on LinkedIn
Join us on January 24, 2019, at 2:00 pm for the live panel discussion One Month into MACRA!
As part of the Medicare Access and CHIP Reauthorization Act (MACRA), the Medicare Quality Payment Program (QPP) was established and consists of two participation pathways for clinicians: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). CMS has been gradually implementing the full scope of MACRA over the past three years, and January 1, 2019, marks the beginning of MIPS adjustments to Medicare Part B fee-for-service revenue. The panel discussion will focus on identifying potential pain points for healthcare organizations as a result of MACRA and review key changes for CY 2019 as outlined in the final rule.
Learning Objectives
- Identify the potential pain points of full MACRA implementation and outline the first steps organizations should take to alleviate issues.
- Review the final rule for the quality payment program and how these changes impact APMs and MIPS.
- Discuss the impact E/M changes will have on reimbursement and physician compensation.
Sign-Up for the Live Event today!
Contact Information
Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!
We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
- Connect with us on LinkedIn: Coker Group Company Page
- Follow us on Twitter: @cokergroup
- Follow us on Instagram: @cokergroup
Max Reiboldt and Tom Anthony join Mark to discuss what lies ahead for physicians and hospitals in America. Max, Tom, and Mark talk about the changes in the healthcare market and the transformation of the marketplace over recent years.
Episode Synopsis
As the end of 2018 approaches, Max and Tom talk about how the healthcare industry has undergone tremendous change, and they discuss patient expectations, technology, regulatory adjustments, value-based care, models of care, and concerns about the industry.
Recent Healthcare Industry Trends
- Affordability/Value
- Disruption
- Reduced Regulatory Burden
- Ensuring Access to Care
- Alignment/Integration
- Value-Based Programs
Extras
Contact Tom Anthony (Frost Brown Todd)
Follow Max on Twitter (@mreiboldt)
Connect with Max on LinkedIn
Contact Information
Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!
We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
- Connect with us on LinkedIn: Coker Group Company Page
- Follow us on Twitter: @cokergroup
- Follow us on Instagram: @cokergroup
Ellis Knight, MD, and Mark Stabile join Mark to discuss the ValuePath™ approach to value-based care and the benefits of technology solutions. Mark, Dr. Knight, and Mark talk about the changes in the healthcare market and the transition to value-based care as a delivery model and business model.
Episode Synopsis
Mark Stabile is the CEO of TEAM of Care Solutions, a company that combines best-practice operational processes with the most advanced healthcare technology platform in the world to deliver real-time, evidence-based care coordination workflow across a diverse team of providers. Dr. Knight and TEAM of Care Solutions work together to provide the suite of services known as ValuePath™.
Dr. Knight and Mark Stabile join Mark to discuss the key features of ValuePath™ and how their approach differs from others within the industry.
Extras
Episode 12: ValuePath™: Transitioning to a Value-Based Care Delivery Model
Blog: Key Points about Risk Adjustment of Quality and Cost Data
TEAM of Care Solutions Website
Contact TEAM of Care Solutions
Follow TEAM of Care Solutions on Twitter
ValuePath™ Twitter Moment
Follow Dr. Knight on Twitter
Connect with Dr. Knight on LinkedIn
Contact Information
Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!
We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
- Follow us on Twitter: @cokergroup
- Connect with us on LinkedIn: Coker Group Company Page
Justin Chamblee, Jack Liu, and Matt BonDurant join Mark to discuss the evolution of physician compensation and the benefits of a software solution. Mark, Justin, Jack, and Matt talk about the changes in the healthcare market and how these changes have affected compensation.
Episode Synopsis
Jack and Matt are managing partners with ProCARE Portal, a software-as-a-service platform built around a rules-based engine to automate the administration of physician compensation plans. Coker Group has teamed up with ProCARE Portal as an advisory partner for consulting and strategic services.
Jack and Matt join Justin and Mark to discuss how the shift toward fee-for-value reimbursement has changed the way physicians are compensated and how compensation plans are managed and administered. Fee-for-service provided a simple calculation to determine compensation (wRVUs multiplied by a rate), and fee-for-value has added a myriad of other potential metrics to the calculations, making it difficult to manage and administer compensation plans.
They introduce the concept of compensation automation as a solution for increasingly complex compensation plans.
Extras
ProCARE Portal Website
Contact ProCARE Portal
ProCARE Portal Company Page on LinkedIn
Follow Justin on Twitter
Connect with Justin on LinkedIn
Contact Information
Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!
We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
- Follow us on Twitter: @cokergroup
- Connect with us on LinkedIn: Coker Group Company Page
Terry Wilk joins Mark to discuss the use and management of a healthcare organization’s information resources, systems, technologies, and staff. For their discussion, Mark and Terry pose five critical questions that Boards should be asking concerning the use of IT throughout their organizations.
Episode Synopsis
Mark and Terry discuss the need for executives and boards to ask the right questions to help their organizations make the appropriate decisions. They explain why executives and boards must understand and govern IT based on the business implications of IT investments.
Common Business Issues for Healthcare Organizations
- High ongoing IT capital and operating costs;
- Major IT system implementation, conversion, or outsourcing initiatives;
- Leveraging emerging technologies;
- Legal, regulatory, and operational compliance issues; and
- Business recovery and continuity.
The Five Questions
- What is the strategic importance of IT to the organization?
- What role should executives and the Board have in governing IT assets?
- What competencies do executives and the Board need to govern IT effectively?
- How and when are IT-related matters reported to the Board?
- How should the Board leverage IT to improve its value to the organization?
Extras
White Paper: Executives Beware: Five Questions Astute Boards are Asking about Healthcare IT
Cybersecurity Twitter Moment
Follow Terry on Twitter
Connect with Terry on LinkedIn
Contact Information
Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know!
We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on topics for future episodes.
- Email us: feedback@cokergroup.com
- Follow us on Twitter: @cokergroup
- Connect with us on LinkedIn: Coker Group Company Page
Brandt Jewell joins Mark to discuss improving access to care for patients which has many different interpretations. For their discussion, Mark and Brandt define patient access as the ability for patients to access care promptly, and how a provider practice manages patient touch points and schedules to coordinate service access and minimize wait times.
Episode Synopsis
Mark and Brandt discuss how to improve access to care for patients by reducing patient wait times, better managing provider schedules and templates, and enhancing visit slot utilization.
They explain the primary challenges and common barriers when addressing patient access to care with a focus on why it is essential to improve.
Key Performance Indicators (KPIs)
- 3rd Next Available appointment by visit type (short/long and new patient/follow up)
- Visit slot utilization
- Un-booked hours/slots
- No-shows and cancelations
- Provider productivity (wRVUs and visit volumes)
- Provider time away from practice (true clinical FTE)
Extras
Pursuing Patient Access: Explore strategies to maximize value for patients, providers, and health systems
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Justin Chamblee joins Mark to explain physician compensation market data and the correlation between wRVUs, total cash compensation and the total cash compensation per wRVU ratio.
Episode Synopsis
Mark and Justin discuss the foundational premise of alignment between compensation and wRVU productivity. They provide examples illustrating the corresponding compensation per wRVU ratio which allows alignment to occur.
Figure
Extras
Episode 5: Espresso Shot #1: The Perpetual Upward Shift of the Median
Episode 10: Physician Compensation Round Table Discussion
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Dr. Mac Knight and Brandt Jewell join Mark to discuss preparing a physician practice for MACRA participation. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) becomes effective January 1, 2019.
Episode Synopsis
Mark, Dr. Knight and Brandt discuss how MACRA and other pay for performance reimbursement models are shaping the healthcare industry and how these changes are affecting the physician practice.
They explain key data points to review while preparing for the changes to reimbursement on January 1, 2019. They also present different types of costs to consider in concert with reviewing past quality data to evaluate a practice’s return on investment when participating in MACRA.
Extras
White Paper: Preparing a Physician Practice for MACRA Participation
MACRA Implementation: Have you Established a Plan to Succeed?
Making the Most of Your MACRA Reporting
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Brandt Jewell joins Mark to discuss various services available to physician practices and healthcare organizations working with physician groups. Coker’s physician services focus on a myriad of factors affecting the “physician enterprise.”
Episode Synopsis
Mark introduces Brandt and his expertise within the physician services realm. They provide an overview of key areas to consider during the volume-to-value shift including process improvement, operational considerations, and physician engagement.
Extras
Follow Brandt on Twitter
Connect with Brandt on LinkedIn
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Dr. Mac Knight joins Mark to discuss Coker’s approach of transitioning to a value-based care delivery model. ValuePath™ is a suite of services designed to aid physicians and healthcare organizations with improving their quality of care and lowering the cost of services.
Episode Synopsis
Mark and Dr. Knight outline the key success factors for performance under value-based care, including clinical integration, care process design, contracting for value-based care delivery, operational performance management, and revenue assurance.
They explain how CMS uses the risk adjustment factor (RAF) scores to measure the complexity of patients as well as how physician practices and healthcare organizations can use RAF scores to prioritize and focus their efforts to best serve their patient population.
Extras
Risk adjustment in healthcare: Essentials that all providers should know
Managing Financial Risk through a Value-Based Clinical Care Delivery System
Twitter Moments: #ValuePathTM
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Dr. Mac Knight joins Mark to discuss Coker’s comprehensive approach to coding, compliance and clinical documentation known as revenue and quality integrity (RQI). As a former clinician, Dr. Knight is familiar with the challenges physicians face during the clinical documentation process and importance of proper coding from both a compliance and billing standpoint.
Episode Synopsis
Mark and Dr. Knight explain the RQI process and discuss the importance of accurately coding and completing clinical documentation. They examine the different types of coding (procedural, outpatient, inpatient, technical, etc.) and regulatory compliance as well as discuss the importance of regular coding audits.
They explain how clinical documentation plays a role in due diligence processes, value-based healthcare reimbursement and a comprehensive compliance strategy. Mark and Dr. Knight provide insight on how RQI ultimately affects all facets of any healthcare organization.
Extras
Revenue and Quality Integrity: A Comprehensive Approach to Coding, Compliance, and Clinical Documentation
Clinical Documentation: 10 means for compliance and convenience
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Justin Chamblee, Jon Morris and Stephen Ross join Mark for a round table discussion on physician compensation strategies. Mark moderates the discussion as Justin, Jon and Stephen outline current trends in designing and managing physician compensation plans, the strategic elements of physician compensation plan design, and the impact of value-based reimbursement on physician compensation and fair market value/commercially reasonable analyses.
About the Panelists
- Justin frequently presents at national conferences where physician leaders, healthcare legal counsel, and health system administrators gather to gain knowledge in the areas of physician compensation and hospital-physician integration. He is a recognized thought leader and subject matter expert on physician compensation.
- Jon currently focuses his practice on designing and implementing system-wide physician compensation plans that help organizations navigate the shift from volume to value.
- Stephen specializes in assisting healthcare organizations in the areas of hospital-physician alignment transactions, compensation valuation work, compensation plan redesign, strategic business planning and operational/financial performance improvement.
Extras
White Paper: Using Patient Panel as a Principle Element in Primary Care Physician Compensation
Fair Market Value: Assessing Compensation Arrangements in the Healthcare Industry
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Connect with Jon on LinkedIn
Connect with Stephen on LinkedIn
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Max Reiboldt and Michael Barry join Mark to discuss the Top 10 Lessons Learned from First-to-Second Generation Transactions. Max oversees Coker Group’s services and the general operations of the firm, and provides sound financial, strategic and tactical solutions to hospitals, medical practices, health systems, and other healthcare entities through keen analysis and problem solving. Michael is a partner in the Corporate Practice and the Healthcare Practice at Arnall Golden Gregory, LLP and focuses his practice on health care transactional and regulatory law – specifically for hospital, health systems and other institutional providers.
Episode Synopsis
Mark, Max and Michael discuss transitioning from a first-to-second generation transaction and industry trends affecting hospital-physician transactions. Throughout their discussion, they touch-on the top 10 lessons they have learned from these types of alignment initiatives.
Top 10 Lessons Learned from First-to-Second Generation Transactions
- Physician market share does not mean success, so health systems have become more selective relative to transactions. (PSAs are much more popular now than 3 years ago.)
- Incurring losses in physician transactions may not be offset by downstream revenue (increased site-neutral payments).
- Ensure organization’s productivity and revenue goals are being met. (Fee-For-Service still prevails.)
- Consider infrastructure required to support non-productivity incentives. (Fee-For-Value payments must exist to require such.)
- Gradually begin tapering off productivity goals and replace with alternative incentives. (Mirror reimbursement trends.)
- Tie new incentives to organizational goals, such as cost-savings, quality, etc. and prepare to respond to MACRA/MIPS requirements.
- Begin tying incentives to reimbursement changes, such as shared savings and/or the quality/CPIA/ACI metrics being measured for MIPS.
- Leverage newly prioritized metrics to reap additional reimbursement incentives (i.e., commercial or MIPS increases).
- Continually reassess compensation structures in light of regulatory and industry trends.
- Payment reform is here and real (MACRA); healthcare providers are unable to ignore the value-based reimbursement world.
Extras
Second Generation Compensation Plans - Is this Alignment Armageddon? Part 1
Second Generation Compensation Plans - Is this Alignment Armageddon? Part 2
Contact Michal Barry (Arnall Golden Gregory)
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Jeffery Daigrepont joins Mark to discuss the fatal mistakes of healthcare IT vendor contracting. Jeffery speaks often on this subject and is intimately familiar with the potential pitfalls of electronic health record vendor contracts.
Episode Synopsis
Jeffery provides his insight on the top five mistakes committed during vendor contract negotiations and what to avoid, even if you are already under contract with a vendor. Jeffery walks Mark through the common inclusions within contracts that can be removed or modified.
Extras
White Paper: Five Fatal Healthcare IT Decisions to Avoid
Understanding and Negotiating IT Vendor Contracts
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Aimee Greeter and Taylor Harrison join Mark to discuss Five New Approaches to Maximize Physician Engagement. Aimee and Taylor specialize in hospital/physician alignment, accountable care responsiveness, hospital service line development, clinical integration initiatives, strategic planning, mergers and collaborations, operational issues, and financial management.
Episode Synopsis
Mark, Aimee and Taylor discuss strategies to better engage with healthcare providers and maximize their engagement to drive change for an organization. Throughout their discussion, they walk through strategies to assess physician engagement and drive change within an organization.
Three Primary Drivers of Change
- Impact of Reimbursement Changes
- Authority of Decisions
- Relationships with Other Providers and Organizations
Five Approaches to Increase Physician Engagement
- Increase transparency and create a collective mission/vision.
- Ask questions of providers and ensure that any grievances are quickly addressed.
- Use multiple forms of communication, multiple times.
- Manage physicians by walking around—listen and learn.
- Determine the motivation behind physicians and work to create incentives that match.
- Develop a philosophy of mutual benefit and shared vision.
- Strive to be extremely transparent from upper management down.
- Solicit meaningful physician input early and often, and then act on it.
- Engage physicians in balancing business and clinical priorities.
- Set realistic goals together and go for early wins.
- Nurture physician leaders.
- Identify, mentor, and educate physician leaders.
- Invest in physician leaders.
- Reward physicians in ways they value.
- Attend a leadership conference together or hire a coach to complete leadership training on-site.
- Get to know physicians on a personal level—meet one-on-one.
- Capture and share data.
- Implement processes that help determine what data is to be collected and how.
- Use data as the platform for discussions on improving care and lowering costs.
- Foster trusting relationships by sharing data frequently and broadly.
- Encourage physicians to use data to make decisions.
- Develop metrics and hold physicians accountable.
- Ensure that physicians are a part of creating the metrics (quality, cost, patient satisfaction, etc.).
- Make metrics specific to each individual specialty and/or sub-specialty (depending upon the size of the organization).
- Utilize physicians to meet with colleagues that fail to meet these measures.
- Tie certain incentives to these metrics (i.e. compensation, service line improvement initiatives, medical directorships, etc.)
- Work toward clinical integration.
- Regardless of the format in which you pursue clinical integration, establish a collaborative method of delivering care.
- Involve as many physicians as possible (employed, community, etc.).
- Determine a method that best meets your needs – not all organizations should immediately pursue an ACO or CIN.
Extras
White Paper on Maximizing Physician Engagement (includes survey and case studies referenced)
Follow Aimee on Twitter
Connect with Aimee on LinkedIn
Connect with Taylor on LinkedIn
Contact Information
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Jeffery Daigrepont joins Mark to discuss the healthcare IT market and provide his thoughts on the current and future trends. Jeffery specializes in healthcare automation, IT system integration, operations, and deployment of enterprise information systems for large integrated delivery networks.
Episode Synopsis
Mark and Jeffery look at the evolution of the healthcare IT market over the past two decades and discuss what is on the horizon for healthcare technology. Throughout their discussion, they walk through what has driven changes in the healthcare IT realm, current trends, and how best to prepare for the future.
They discuss everything from legacy electronic health records to cloud-based technology and the use of artificial intelligence in the healthcare delivery process. Mark and Jeffery provide insight on how to adapt to the ever-changing world of healthcare technology.
Extras
Learn More about Healthcare IT Consulting
Healthcare Cybersecurity Threats and Trends for 2018
Top Health IT Trends and Innovations
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Contact Information
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Justin Chamblee and Jon Morris join Mark to discuss the recent release of the 2018 MGMA provider compensation market data and Coker’s observations of market data trends. Coker has been observing the data for the past five-to-ten years, noticing the increases that have been occurring.
Episode Synopsis
Justin and Jon discuss the reasons behind the continual upward shift of the market median despite an industry-wide decline in reimbursement. On May 16, 2018, MGMA released their annual Provider Compensation and Productivity Survey Report and Coker noticed (again) an upward trend in the reported total cash compensation to wRVU ratio.
Justin, Jon and Mark provide insight as to the cause of the continual increases year after year and what these increases mean for the future.
Figures
Figure 1: Total Cash Compensation to wRVU Ratio 10-Year Trend (Table)
Figure 2: Total Cash Compensation to wRVU Ratio 10-Year Trend (Chart)
Extras
White Paper on The Upward Shift of the Median (2014)
The Myth of the Median
Contact Information
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Michele Madison from Morris, Manning & Martin, LLP, joins Mark to discuss how to create long-term value from transactions through effective post-merger integration. Michele is highly experienced in managing legal issues arising in hospitals, physician offices, or integrated health systems.
Episode Synopsis
Mark and Michele recently presented at the American Health Lawyers Association Healthcare Transactions conference on the topic of post-merger integration. Throughout their discussion, they walk through why it is critical to consider the goal of effective integration after a merger throughout the entire transaction process.
The foundation is to first define what we mean by “makes a transaction work”; that is, a deal that results in long-term value creation for all stakeholders. Measuring the true success of a transaction requires a look far beyond the initial perspective of fit and financial returns, focusing instead on whether the affiliation resulted in compelling value realized over an extended period.
Topics covered in this episode include strategic validation, due diligence, regulatory risks, deal structure, integration structure, and implementation. Mark and Michele offer their advice on how to structure deals while considering the long-term effects of integration.
Extras
Michele Madison - Martin, Manning & Morris, LLP
White Paper on Effective Post Merger Integration
Contact Information
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Jeff Gorke joins Mark to discuss operational issues and challenges medical practices face in the physician services realm. Jeff has expertise in optimizing the strategic and operational aspects of outpatient care to enhance processes and programs, drive efficiencies, and improve profitability.
Episode Synopsis
Mark and Jeff explore the greatest challenges hospitals and physicians face today and the importance of a strong relationship between the physicians and administration. As providers of healthcare, physicians need a seat at the table to help change the delivery of care.
The focus of healthcare is shifting from volume to value, and many physicians are struggling to remain in private practice. Small independent groups will continue to face challenges as costs rise. Further, we have already seen a significant uptick in hospital employment over the last 10 years.
Another factor impacting medical practices and hospitals alike is technology. Telehealth is gaining popularity, and, love them or hate them, electronic medical records (EMRs) are essential to the modern medical practice.
Mark and Jeff provide their insight on these topics and other operational issues in employed and private medical practices.
Extras
AMA Study Reveals Practice Owners No longer Physician Majority
White Paper on Revenue Cycle Turnaround
White Paper on Employed Physician Turnaround
Contact Information
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Dr. Ellis “Mac” Knight joins Mark to discuss value-based healthcare and its impact on the healthcare industry. They cover financing as a driving force in the healthcare landscape and why it continues to become more complex with the shift from pay for service to value-based care.
Episode Synopsis
With budgetary pressures on Medicare and Medicaid, pay for performance and federal expectations for investment in technology without regard to costs, executives must continuously monitor the financing landscape. The most significant factor in healthcare reimbursement today is the industry-wide shift to value-based care.
So, what is value-based care? One of the more common buzz phrases in the healthcare industry, value-based care, is a shift in focus. For the past two decades, healthcare providers have focused their efforts on the volume of services they are providing, not on the quality of services they are delivering. The reason is simple: physicians were paid only for the volume of professional services.
In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed and ushered in a dramatic change in the way CMS will pay healthcare professionals. MACRA consolidated multiple pay-for-performance initiatives (PQRS, VPM, and MU) into two quality payment programs (QPPs), the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).
Dr. Knight and Mark provide their views on the move toward value-based reimbursement and the reality of healthcare for the past 15 years.
Extras
MACRA, what IS it?
White Paper on Value-Based Reimbursement
White Paper on MACRA
Connect with Dr. Knight on LinkedIn
Follow Dr. Knight on Twitter
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Welcome to the inaugural episode of Coffee with Coker, a healthcare business podcast published by Coker Group. In this episode, we will introduce the Coker team and lay the groundwork for the podcast moving forward.
The Coker Team
- Mark Reiboldt, Senior Vice President and Director of Strategy -- Lead Host
- Jessica Combs, Senior Associate and Social Media Manager -- Producer/Guest Host
Episode Synopsis
Coker Group is a national healthcare consulting firm with over 30 years of experience in the industry. We advise healthcare organizations and physicians on all business matters including hospital and practice operations, financial advisory, hospital and health system strategic initiatives, and healthcare technology.
Our discussions each episode will focus on current events, market trends, and significant developments that impact the healthcare industry. Our goal is to inform our audience on the present-day and upcoming developments and best practices for healthcare professionals.
The main episodes of the podcast will be released twice per month, with shorter “espresso-shot” episodes released periodically to address hot topics. Each episode will feature a guest host who will discuss his or her area of expertise with Mark.
Contact Information
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