Value-Based Care Insights

Electronic health record (EHR) systems can be powerful management tools, but using them improperly can present challenges for both physicians and patients. In this episode, we dive into the role of EHR systems in value-based care. Our guest, Dr. Kim Furry, a seasoned orthopedic surgeon and an Epic-certified Physician Builder, unveils the intricate challenges physicians encounter while building and...

Today, medical groups are grappling with financial challenges due to the pressures from limited access to providers, private equity, declining reimbursements and rising costs. On this episode of Value-Based Care Insights, Daniel J. Marino sits down with colleague Lucy Zielinski to discuss the opportunities associated with forming strategic partnerships for clinical service lines. Learn about the n...

The added pressures for medical groups, coupled with the limited resources and high demands, require an intentional, strategic roadmap to success. On this episode of Value-Based Care Insights, we sit down with Jeff Peters to discuss the evolving healthcare landscape and what medical groups should be thinking about to position themselves for the future. Gain valuable insights into innovative strate...

With the adoption of capitation models and the growing demand for coordinated care, healthcare providers continue to shift away from traditional payment models. On this episode of Value-Based Care Insights, Lynn Carroll, COO of HSBlox, sheds light on this transition. Learn about the evolution from performance-based to risk-based contracts, the value of sub-caps within capitation models, and the pi...

In the world of academic service lines, the alignment of physician executives and physician assistants is paramount. On this episode of Value-Based Care Insights, Jason Raidbard, Executive Administrator at the University of Chicago, unveils the challenges and strategies of crafting a dyad partnership of leaders within academic service lines. Gain insights on the importance of a shared patient-cent...

From its humble origins as an academic gathering of a few attendees, the Population Health Colloquium has evolved into a diverse gathering of brilliant minds in the field of population health and value-based care. In this episode of Value-Based Care Insights, we sit down with Dr. David B. Nash as he discusses the Population Health Colloquium taking place September 18-20th in Philadelphia. We dive...

When it comes to making big decisions, strategic plans often overshadow the critical aspect of leadership culture. This episode of Value-Based Care Insights welcomes Keith Hadley, whose expertise lies in building healthy organizations and improving organizational decision-making through building high-performing teams. Discover the roots of misalignments in leadership teams and the significance of...

Risk-based contracts are revolutionizing the healthcare industry, prompting a transition to value-based care. In this episode of Value-Based Care Insights, guests Cliff Frank and Dr. George Mayzell explore the key aspects of risk-based contracts and provide actionable insights for physicians and practitioners navigating this transformative shift.

Rising prices and sky-high interest rates are posing significant operational and care delivery challenges for hospitals. In our latest episode of  Value-Based Care Insights , Nillie Djassemi, CFO of Houston Physician’s Hospital, shares valuable insights on navigating these challenges. Together, Dan and Nillie explore the importance of investing in vendor management and capital expansion to thrive...

To provide value-based care, providers need to address their process, their technology, and their people. But stakeholder priorities don’t always align. Knowing where and how to start can be the difference between a successful implementation and one that falls short.   Tune into the latest episode of Value-Based Care Insights featuring host Daniel J. Marino as he welcomes Sarah Hartley and Dr. Pur...

Many issues are impacting today’s clinical service lines, especially cardiovascular services. Health systems, hospitals and physician groups are focusing on growing their cardiovascular service lines to address shifts in site-of-service, improve patient access and position themselves for enhanced financial performance under value-based contracts.  In this episode of Value-Based Care Insights, Dani...

As more and more provider organizations engage in risk-based contracts, including Medicare Advantage, understanding quality and performance along with clinical workflow integration is critical to contract success. On our third episode of our three-part series focusing on risk-based contract and performance, we invited two special guests from QRC to join the show to  dive deeper into Risk Adjustmen...

For the second part of our three-part series, we invited Cliff Frank back to discuss the changes among risk-based contracts. Daniel and Cliff explore the pushback with RAF scores, new CMS announcements with potential health equity indicators, and much more. Listen now to our latest episode of Value-Based Care Insights, as our host Daniel J. Marino and guest, Cliff Frank, dive further into value-ba...

Many hospitals are experiencing increasing workflow challenges due to high inflation rates. As a result, government and commercial payers are responding in unique ways.   On this episode of Value-Based Care Insights, host Daniel J. Marino discusses economic challenges in health care, particularly hospitals and physicians. We’re joined by commercial insurance and government reimbursement expert, Cl...

Since the pandemic, many healthcare provider organizations find themselves re-instituting empowerment initiatives initially created pre-COVID, however, the recent circumstances had a vast impact on the workforce culture. Today, organizations must focus on a transformative culture which allows the workforce members to prosper in their current roles while the fundamental needs of the employees are m...

Today, most hospital physicians are experiencing some level of burnout due to increased challenges with greater work activities, high levels of patient needs, and low staffing levels. These challenges lead to a desire for early retirement and physicians looking for new medical-related career options. This has placed increased pressures on hospitals to either ramp-up their recruiting efforts or con...

As hospitals and medical groups continue to focus on financial performance, optimizing their revenue cycle through denial management drives results. To effectively reduce denial rates, revenue cycle leaders must first discover the root cause of denials. A focused approach to denial management can provide health care leaders considerable financial and operational improvements. In this episode of Va...

Over the past year, we have seen substantial investments in healthcare made by non-traditional health care providers such as CVS, Walgreens and Amazon and others as they position themselves as strong participants in healthcare delivery.  Last year, 2022, was one of the highest years for health care deal-making with private equity investing considerable resources into technology, physician ser...

As health systems, integrated provider networks, clinically integrated networks (CINs), and accountable care organizations (ACOs) engage in population health initiatives, aligning technology with value-based contracts' performance goals is a key success factor. The lack of alignment can be attributed to a disjointed vision, fragmented operations, and misaligned information technology (IT). In this...

Part of CMS’ journey in regulating coordinated care with providers, a value-based exception and safe harbor was enacted in early January 2021 under the Physician Self-Referral “Stark” law and Anti-kickback Statues. The new provision allows value-based enterprises eligible for safe harbor protections under the Stark and Anti-kickback statute. In this episode of Value-Based Care Insights, Daniel J....

The nursing industry has faced many challenges in recent years, including COVID-19, which has resulted in staffing shortages and clinician burnout. As the nursing workforce shifts from baby boomers to millennials, the pressure placed on nurses and clinical staff continues.  Contributing factors to the increased pressure include untimely nursing recruitment in the hospital environment, lack of...

With the advancement of technology in health care organizations are recieving an excessive amount of data. How can organizations manage that data to create actionable insights? In this episode of Value-Based Care Insights, Daniel J. Marino is joined by Rick Howard, Chief Data and Products Officer for an analytics vendor and former Chief Data officer of Ascension Health. The two discuss the managem...

Throughout 2022, primary health care faced many challenges. Staffing shortages, high hospital costs, and the advancement of telemedicine forced health care organizations to rethink their strategic plan heading into 2023. In this episode of Value-Based Care Insights, Daniel J. Marino is joined by Lucy Zielinski, Managing Partner at Lumina Health Partners. Dan and Lucy analyze health care trends in...

Over the past few years, primary care has gone through immense change. Everything from the incorporation of virtual health, to the shortage of primary care physicians to the building of new team-based models of care. In this episode of Value-Based Care Insights, Daniel J. Marino is joined by Dr. Michael Hanak, a board certified family physician working with a large academic medical center in the C...

Each year, one in five Americans visit the emergency department (ED) at least once  – and these costly ED visits are on the rise. Are they a symptom of a larger issue in our health care system? Many of emergency visits are preventable – this may be a symptom for inefficient care management, inadequate patient access, or lack of patient knowledge. As hospitals and payers transition into value-...