LUMINA Podcasts

Episode Overview

Episode Overview

Episode Overview

• 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.

Episode Overview

• 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.

Episode Overview

Episode Overview:

The No Surprise Act went into effect on January 1, 2022. It protects patients from out-of-network surprise bills. Health care organizations must comply with these regulations for emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.

In this episode of Value-Based Care Insights, Daniel J. Marino speaks to Shawn Stack of HFMA to share how health care systems can navigate the No Surprise Act.

• Price transparency initiatives originally rolled out from a perspective of providers being transparent on their actual charges
• One of the biggest drivers of higher costs is the structure of the Medicare fee schedule and reimbursement
• As the No Surprise Act and Price Transparency Act is implemented, it will be important to give feedback to legislators and CMS on policies

Episode Overview:

Highly effective leaders have a high Emotional Intelligence or Quotient (EQ), understand when to manage and when to lead, and know how to handle complex situations. Through two role plays, a good example and a bad example of EQ are presented in a medical practice between the medical director and a primary care provider.

In this episode of Value-Based Care Insights, Daniel J. Marino speaks to Lucy Zielinski of Lumina Health Partners and Dr. Cheri Olson of IPMA to share techniques to increase EQ and grow in leadership skills. Here are some key takeaways:

• When delivering messages, it is important to practice active listening and ask for feedback.
• Advance your EQ by taking self-assessments and getting a coach. 
• EQ skills are not only inherent - they can be learned, practiced, and improved.

Episode Overview

The health care industry has long been challenged with workforce issues: high turnover, recruitment and retention, escalating wage growth, and low morale.  Health care executives and human resource leaders could not imagine these challenges getting much worse, then along came COVID-19. Now surveys across the industry are indicating workforce issues are the number one challenge facing many provider organizations.

In this podcast episode of Value-Based Care Insights, Daniel J. Marino speaks with John Malone to highlight the extent of the COVID-19 impact and example solutions that work to address workforce challenges. Key points include: 

• The importance of empowering frontline supervisors and managers to decrease burnout, and improve retention and turnover with a sense of ownership and decision-making authority 
• The standardization of workflows to move work processes down to the appropriate resources to address staff burnout and dissatisfaction
• Tailored retention strategies based on key workforce metrics that are accurate and understood by management
• The conscious awareness of a positive culture leading to a high-performing organization

Episode Overview:

The way health care providers connect with patients has changed significantly since the onset of COVID. With new challenges, having care models that are consumer-focused and convenience-based is critical more than ever before. The need for a strategic focus is paramount for organizations to successfully bounce back from COVID. 

In this episode of Value-Based Care Insights, Daniel J. Marino speaks with Bill Bodnar to discuss several challenges health care organizations are facing as they transition out of COVID. Bodnar shares his insights on new challenges, including workforce dynamics, non-traditional health care models, and the pursuit of value. Key points include: 

• The competition among primary care providers and specialists with non-traditional providers, shifting to consumer-focused and convenience-based models 
• The use of automation and other innovative solutions to address workforce burnout and employee retention
• The advancement of population health management and value-based contracts to improve patient care and financial outcomes 

Episode Overview:

During the past 18 months, hospitals and health systems have focused on reducing expense mostly through FTE attrition. Many health systems and hospitals are at a point where reducing costs cannot come from reducing FTEs but must occur from other places.

High-performing healthcare organizations have focused not only on reducing costs through minimizing inefficiencies but maximizing revenues as well. Developing a culture of continuous improvement allows the organization to not only meet its clinical and financial goals but exceed them. High-performing organizations accomplish this by implementing Lean methodologies to eliminate waste, operate more efficiently and increase clinical outcomes with patients.

In this episode of Value-Based Care Insights, Daniel J. Marino speaks to Kate Geick of Lumina Health Partners to discuss how operational effectiveness through staff engagement and commitment can yield improved operational and financial performance. Here are some key takeaways:

• You can have the best technology and technical solution, but without the role of people, you may not meet the outcomes you need. It is important to gain people's commitment and buy-in and have a positive culture and attitude in order to make any type of change. And not only that but to sustain them.
• When people think of return on investment (ROI), they often think of just financial. But it is equally important to think about the satisfaction of the clinical, non-clinical staff as well as the patients.
• Operational effectiveness may seem overwhelming – and leaders don’t know where to start. Starting with one small pilot may produce great value and result in process improvement, team engagement and positive financial performance.
• With operational effectiveness, it is important to stay patient. Changes don’t just happen overnight. Be clear with what you are measuring and be consistent with how often you review them and be able to pivot when you need to.