Value-Based Care Insights

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-...

Rural health care providers often encounter barriers that limit their ability to provide the care they need. Even well before the pandemic, rural health providers faced many challenges. Today, workforce shortages and access to health care services are at an all-time high. On this episode of Value-Based Care Insights, host Daniel J. Marino is joined by the CEO of Great Plains Health, Ivan Mitchell....

Today's health care has created many environmental challenges, which take a toll on physicians and contribute to burnout. Often, especially during the height of the pandemic, health care leaders guide hospitals and team members through difficult times. However, many physicians feel overwhelmed and undervalued without a healthy culture to fall back on. In this episode of Value-Based Care Insights,...

Today, the health care environment is ever-changing and leaders must wisely set the future strategic direction for their organizations. To that end, the strategic planning process needs to define the future goals of and opportunities for the organization – and also must address the leadership and culture requirements for success. In this episode of Value Based Care Insights, Dan is joined by Clini...

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, Clif...

Healthcare industry leaders across the country are all facing the same challenges with their workforce. We are seeing record high turnover rates and record low job satisfaction. Now is the time to prioritize proactively listening to employees and making changes that will stabilize the workforce after a tumultuous couple of years. On this episode of Value-Based Care Insights, host Daniel J. Marino...

Over the past few years, the shift to value-based care has slowed down as organizations struggled with leadership alignment concerning care delivery advancements. However, there are successful organizations that have advanced value-based care – and can provide guidance on how to position for value-based success, including how to build performance based contracts and create strong physician incenti...

When switching to value-based care contracts, alignment with the providers, physicians, payers, employers, and patients must exist through a model that benefits all. Health care providers must be strategic in selecting quality measures to track that identify areas to improve efficiencies and create real value. On this episode of Value-Based Care Insights, host Daniel J. Marino and Dr. Jon Burrough...

Social determinant of health (SDoH) factors have a great influence on the quality and care management of a population’s health. As technology advances to better capture SDoH factors, clinicians can explore new ways to integrate this data into clinical workflows to proactively identify patients at high risk for adverse outcomes – resulting in better quality care. On this episode of Value-Based Care...

Telehealth is poised to see continued growth as the health care industry experiences the benefits of telehealth models, specifically supporting patient care delivery and closing care gaps. On this episode of Value-Based Care Insights, host Daniel J. Marino and Dr. Alan Kumar, Senior Vice President of Medical Affairs and Chief Medical Officer at Community Healthcare System, discuss the key factors...