Within the healthcare industry, effective organizational culture requires building trust, nurturing collaboration, and positioning leaders to drive strategic and impactful change. In this episode of Value-Based Care Insights, we sit down with Dr. Eric Velazquez, Professor of Medicine at Yale, alongside Doug McKinley, a clinical psychologist and leadership coach. Together, they explore the challenges and opportunities of strengthening the workplace culture in order to improve organizational...

Behavioral health is pivotal for overall patient well-being, yet healthcare providers are just beginning to recognize the significance of lifestyle factors and social determinants in delivering this sort of whole-person patient-centric care. In this episode of Value-Based Care Insights, host Dan Marino sits down with Dr. Matthew Burg, a clinical health psychologist at Yale, to explore how social determinants and behavioral medicine are addressing the clinical needs of patients. Gain insights...

Effective care management is essential for achieving favorable population health outcomes. Yet, the current structure of care management focuses on reacting to health issues and does not adequately anticipate patients' needs. As providers assume risk-based contracts, the abilities to shift to prospective care management allows care managers to more effectively meet the patient’s needs by integrating clinical data, lifestyle criteria and clinical pathways. In this episode of Value-Based...

Improving patient outcomes requires a close look at the latest innovations in healthcare. In this episode of Value-Based Care Insights, we sit down with Dr. Jason Spangler, CEO of the Innovation and Value Initiative, a non-profit organization focusing on advancing the science of determining the merit of various clinical innovations. Dr. Spangler sheds light on health technology assessments (HTAs), their history and how they help leaders decide which new technologies or devices provide...

With the recent push for healthcare reform, state governments started to issue crucial legislation to redesign the Medicaid program. In this episode of Value-Based Care Insights, we explore the new terms and conditions of New York’s 1115 demonstration waivers. With Vanessa Guzman, CEO of SmartRise Health, we share insights into the $6 billion initiative focusing on health equity, workforce investments and the general support of Medicaid programs. Discover how the New York program sets a...

One of the critical bellwethers of a healthcare organization's success in strategic planning is how well the health system leaders work with their boards. In this episode of Value-Based Care Insights, we sit down with Ivan Mitchell and Ann Scott Blouin to identify 2024 healthcare trends, their impact on provider organizations, and how executive leaders can engage with their board of directors. Gain insights on the top trends that are the greatest hurdles for healthcare providers and the...

With post-acute care, providers face various challenges, ranging from reimbursement struggles to meeting the evolving demands of an aging population. Hal Katz, a partner with Husch Blackwell, lends his expertise to shed light on how post-acute providers can navigate these challenges and advance into value-based care. Gain insights on transforming post-acute care models, establishing integrated networks and how providers can flourish in the VBC ecosystem. --- Send in a voice message:...

As 2023 draws to a close, we’d like to revisit episodes that explored relevant issues we’ve seen throughout the past year. Host Daniel J. Marino revisits these profound discussions and how they impact the future trajectory of health systems, hospital and the provider community. Featuring esteemed guests in their respective fields, Dan and his guests look back on important elements affecting strategic growth of hospitals, financial performance of medical groups and successes in risk-based...

Amidst uncertainties surrounding financial returns and the pace of value-based care, providers and executives harbor reservations regarding the privatization of risk. This episode unravels the intricacies of transitioning from fee-for-service to value-based care, shedding light on the challenges and opportunities that accompany this transformation. In this episode of Value-Based Care Insights, Dan sits down with Dr. Will Faber to explore the effects of value-based care on physicians, dissect...

In recent years, the call for health equity has driven healthcare systems, in the communities they serve, to champion better patient care and improve their well-being. However, this aspiration brings with it a series of social and cultural challenges. Join us in the latest episode of Value-Based Care Insights as we sit down with Vanessa Guzman, CEO of SmartRise Health, a healthcare thought leader on the frontline of change. Vanessa highlights the key priorities and challenges encountered by...

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 augmenting EHR systems. Discover the time-saving techniques, the crucial importance of data...

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 nuances of service line trends, structural goals and the distinct approaches for primary care and...

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 strategies for aligning with providers, improving financial performance, and fostering a healthy,...

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 pivotal role of care coordination. Benefits of Capitation Contracts to Providers, Payers, and...

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-centric culture that unites academic, research and clinical operations under one resolute...

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 into the colloquium’s focus on value-based care, health equity and AI’s innovation within...

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 transparent communication in creating a unified voice to advance the culture of the...

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. --- Send in a voice message: https://podcasters.spotify.com/pod/show/lumina-health-partners/message

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 in today’s economy. --- Send in a voice message:...

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. Purvi Shah, whose expertise in ambulatory clinical documentation improvement (CDI) will help...

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, Daniel J. Marino talks with Dr. Hani Salti, a clinical cardiologist and Clinical Assistant Professor...

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 Adjustment Factor (RAF) scores and the impact of Hierarchical Condition Category codes (HCCs).   Tune...

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-based contracts and what has changed over the last few months. --- Send in a voice message:...

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, Cliff Frank.    KEY TAKEAWAYS:    Hospitals and other health care facilities are facing a...