Rural Health Care: What Works?

Episode Overview

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. The two discuss modern-day challenges that exist in today's rural health care environment.

Key points include:

  • How to address rural health care challenges and deliver the right level of care while remaining economically stable
  • Strategies to provide access to primary and specialty care in rural areas 
  • The need for alignment between health care providers and insurance carriers within rural communities 
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Transforming Physician Burnout into Physician Wellness

Episode Overview

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, Daniel J. Marino is joined by Lumina Managing Principal, Dr. George Mayzell, as they discuss the factors that contribute to physician burnout and tactics health care leaders can build to create a culture around physician wellness.

Key points include:

  • As organizations move to value-based care, leaders need to consider factors that enhance physician wellness.
  • Leaders must address staffing issues and administrative burdens to enhance direct patient care.
  • Health care leaders must develop a wellness-driven culture that aligns physicians with their core mission.
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Culture and Leadership: The Foundation for Successful Strategic Planning

Episode Overview

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 Clinical Psychologist and owner of DLM Pathways, Dr. Doug McKinley. The two discuss the essential ingredients to align the strategic planning with leadership development while incorporating four critical steps for strategic initiatives combined with the five key behaviors of a cohesive team.

Key points include:

  • Building a culture is not easy, especially when challenges arise. Before having to solve a cultural issue, implementing the five key behaviors in your organization can prevent and guide cultural issues.

  • Why do organizational strategies fail? Often it comes down to leadership. From a cultural perspective, leaders need to have self-accountability, while being honest and transparent with their team members. Leaders shouldn’t be afraid to be vulnerable.

  • A successful strategy is built on healthy adaptive leadership. Trust is the overarching factor in building and maintaining an agile organization.

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Navigating Value-Based Contracting Products

Episode Overview

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 points include:

  • Hospitals and other health care facilities are facing a number of challenges, and inflation is a key component to internal issues. It’s essential that providers have an understanding on how to navigate an ever-changing infrastructure.

  • Risk contracting has been a common issue for hospitals as payers are making money on empty hospitals and slower ORs. This obviously increases the need for better contracts between payers and providers.

  • The ACO module has changed drastically, impacting how care is coordinated for Medicare patients.

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Solutions to Workforce Challenges

Episode Overview

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 discusses how to create positive change while facing the current healthcare workforce challenges with Lumina Principal, John Malone and national expert and industry leader in workforce management, Kristi Roe.

Key points include:

  • COVID was an accelerant to an already existing problem with employee experience in our healthcare workforce. The idea of organizational listening at scale, and really deeply understanding the experience of caregivers, has been amiss. COVID lifted this issue up and we're all talking about it. 

  • Healthcare providers have gone through a lot of change in the past two years. When going through significant changes, thoughtful communication and listening are necessary components to successfully managing change. Stakeholders must be engaged, and everyone needs to understand their role in implementing good quality change management.

  • Organizational leaders need to organize around improving the employee experience in a more deliberate way. A “retention” goal should be on strategic scorecards and a priority for leaders.

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Advancing into a High-Performing Value-Based Network

Episode Overview

Over the past few years, the shift to value-based care has slowed down as organizations struggle with leadership alignment around care delivery advancements. However, lessons can be learned from organizations that have successfully advanced value-based care – including how to position the organization for value-based success, how to build performance based contracts, and how to create strong physician incentives.

On this episode of Value-Based Care Insights, host Daniel J. Marino and Dr. Christopher Crow, CEO and Co-Founder of Catalyst Health Group, discuss how to make changes in an organization’s culture, finances, and operations to successfully transition to value-based care.

Key points include:

  • Building a solid culture on trust is critical; it is all about physician alignment, performance outcomes, and transparency. A good trusting relationship makes it easier to align incentives over time.
  • Understanding the infrastructure requirements to support value-based contracts allows for timely recruitment and effective operational change management. Focus must be on team development, operational and clinical workflows, and technology to achieve high-performance and desired outcomes.
  • The cornerstone should be the physician-patient relationship - and these relationships take time and compound over time.
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Creating Financial Value Out of Quality

Episode Overview

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 Burroughs, President and CEO of Burroughs Healthcare Consulting Network, discuss where to start on tracking quality outcomes and how to align a provider organization around value.

Key points include:

  • There are preliminary steps that are required; first, the organization must create alignment across its leadership team so that everyone is excited about the direction.
  • Measure selection is key. Finding the right measures will carry the greatest weight, for example, they will lead to lower expenditures and increased revenue. 
  • To support the strategy, the financial impact must be quantitated  to understand earnings. Additionally, resources necessary to reach the goals must be considered.
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Integrating Social Determinants of Health in Care Management

Episode Overview

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 Insights, host Daniel J. Marino and Amy Valley, Vice President of Clinical Strategy and Technology Solutions at Cardinal Health, discuss the importance of incorporating social determinants into care management.


Key Takeaways:

  • There are five main categories of SDoH: medical, environmental, physical, behavioral and social. These factors create a proliferation of data that can be difficult for clinicians to manage, however, new technology aims to identify the signals of a potentially high-risk situation for a patient.
  • SDoH provide a perspective into health conditions - and incorporating these factors into clinical workflows help to proactively identify patients at risk for adverse outcomes.
  • The recent staffing shortages are forcing organizations to re-evaluate their approach to navigating care. Analytic platforms are a necessity to support care delivery. These tools have been proven to increase efficiencies and improve clinical outcomes.
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The Evolving Role of Telehealth

Episode Overview

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 for a successful rollout and how to increase adoption during the ongoing evolution of telehealth.

 
Key takeaways:
  • COVID forced health care organizations to adopt telehealth, and adopt it quickly. In the post-lockdown world, organizations are now looking at how they can continue to evolve telehealth. It is expected that the various telehealth platforms and EMR (electronic medical records) will continue to integrate the technology.  In the next five years, we will see the marketplace evolve to greatly improve operational efficiency.
  • The shift to telehealth has provided primary care providers the ability to identify care gaps that they can close during the telehealth visit; alerts pop up on the screen to help providers in real-time, which leads to better outcomes for the patient.
  • Large IT initiatives are expensive, complicated, and require buy-in. Adopters must be methodical, diligent, and patient with the approach. Converting to new telehealth models will take time and effort.

 

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Decoding Legalese of Value-Based Contracts

Episode Overview

As the health care industry shifts from fee-for-service to value-based arrangements, providers are facing a lot of challenges. A provider's relationship with payers is often strained by the new business model, and a provider's ability to collaborate with payers has never been more important.

On this episode of Value-Based Care Insights, host Daniel J. Marino and Hal Katz, an industry leader in health care law, discuss how providers can successfully navigate value-based contracting with payers in a mutually beneficial way.

 
Key takeaways:
  • Previously there has been a lack of relationship between providers and payers; and with the shift towards value-based care, it is vital for those relationships to improve  
  • Risk sharing requires the provider to agree to be responsible for a specific set of services and the costs associated with such services, which can include hitting certain performance measures. The elements need to be entered into the agreement otherwise there’s no obligation for the payer to honor those terms.
  • With all risk-based contracts, it key for providers to include protections.  Such as, for example, that the financial arrangement doesn't kick in until a minimum number of members assigned to the provider has been reached.  Also, if there is a change in that threshold for two consecutive months, the payment bumps back down to the traditional fee-for-service rate.
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