For many healthcare startups and established vendors, partnering with payers is a crucial part of their business plan. And as we know, selling in healthcare is hard. It’s even harder when you don’t understand how these large corporations work. What do they want? How do they set priorities? How do they make purchasing decisions? How long does that process take? The list goes on, and if you’re strategizing without this knowledge you’re going to struggle. That’s where this episode comes in. Today w...
Nov 17, 2020•1 hr 1 min•Ep. 148
There’s a lot of talk about addressing physician burnout, but little practical advice about what to do. The path to action lies first in understanding the many sources of burnout, and then separating them into those that we can impact, and those we cannot. There’s a class of burnout factors that are intrinsic to being a physician. Simply put, it’s a hard job, and it's demanding in both a physical and mental sense. But this is part of what they signed up for, and due to their passion and sense of...
Nov 10, 2020•39 min•Ep. 147
Many private organizations have stepped up to provide support as we deal with the pandemic. Surescripts, for their part, repurposed clinical direct messaging infrastructure to help health systems communicate critical information from the frontlines to federal agencies. It’s a great story of a private organization rapidly transitioning to fill a need. What we’d like to explore, and what we think you will most benefit from hearing, is why Surescripts was in a position to do this in the first place...
Oct 29, 2020•55 min•Ep. 146
It may seem cliché to say payers need to be more like Amazon, but the analogy provides fundamental, and surprisingly actionable insights for the health insurance industry. Think about your experience with Amazon (or Google or Zappos, or any other organization that provides a phenomenal customer experience). Whether they're helping you find the right product, or streamlining the purchase, or dealing with a delivery problem, or a return, these organizations have made the transactions feel easy... ...
Oct 16, 2020•55 min•Ep. 145
On this episode, we discuss the HealthIMPACT Fall Forum coming up September 30th – October 2nd, 2020. Shahid Shah, our co-host and the HealthIMPACT Forum Chair, tells us it’s a “No BS and No PowerPoint” event that’s intended to be more of a conversation than a series of presentations. The goal is to get healthcare leaders together and facilitate a conversation amongst peers about the work they’re doing in the real world. We also talk about what it’s like to host a conference virtually and the te...
Sep 24, 2020•26 min•Ep. 144
On this episode we talk with Dr. Vivian Lee about her new book, The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone . Dr. Lee offers a fresh perspective that will strengthen your understanding of the issues facing America’s healthcare system. And while she acknowledges that our government must play a substantial role in driving systemic change, she points out how each of us as individuals, clinicians, payers, and employers all have a role to play. The book’s...
Sep 11, 2020•46 min•Ep. 143
Patient Centricity is a buzzword that’s easy to throw around, but difficult to realize. The notion itself is straightforward… build your product or service around the patient who it is intended to help. Talk with them. Incorporate their input. Understand their needs, desires, and goals. It’s so straight-forward that today’s guest tells us this is no “ah-ha” moment for healthcare, but more of an “ah-duh”. Why do other industries do this organically, while healthcare talks about it as some enlight...
Sep 02, 2020•50 min•Ep. 142
Payers already face a formidable challenge when it comes to internal data management. After years of consolidation in the industry, many payers have a collection of legacy systems cobbled together to run their operations. This makes data management difficult for things like claims, provider directories , and member demographics. And those are just “the basics”. Now, as quality measurement evolves and payers experiment in value-based payment , there’s an acute need for the integration of real-tim...
Aug 14, 2020•1 hr 1 min•Ep. 141
In a growing crowd of national health information networks, eHealth Exchange is one of the oldest and most connected in the U.S.. Notably, they are the primary way healthcare organizations connect with federal agencies such as the Social Security Administration (SSA), Department of Defense (DOD), and the Department of Veterans Affairs (VA). In addition, they're connected with 75% of all U.S. hospitals, more than 60 regional and state HIEs, more than 5,000 dialysis centers, and more. Today we tak...
Jul 30, 2020•45 min•Ep. 140
Everything you’re trying to accomplish comes down to one thing… getting people to do stuff. Behavioral economics, in its simplest terms, is the study of how and why people decide to do what they do (or don’t do). Whether you’re trying to sell, get users to adopt a new system or workflow, or make your staff feel comfortable coming back to work during a pandemic, understanding behavioral economics will greatly increase your chances of success. Today we’re talking with Karen Horgan , CEO at VAL Hea...
Jul 10, 2020•39 min•Ep. 139
Public health vs. the economy is a dangerously false dichotomy. We can protect our people AND get back to work if we accept reality and embrace science. You already know you should wear a mask, wash your hands , and practice social distancing. As we begin to go back to work and spend time with our extended families and friends, Remote Patient Monitoring (RPM) tools present an additional layer of protection that could allow us to do so more responsibly, safely, and productively. Remote Patient Mo...
Jul 01, 2020•36 min•Ep. 138
Michael Ackerman, director of the Master in Healthcare Innovation Program at The Ohio State University, believes that every innovation program must do three things in tandem: Innovation – filling gaps where no solution currently exists, in a way that adds value Renovation – quality improvement and process improvement Exnovation – removing functions that no longer add value; also known as de-implementation When practiced together, and ideally led by different teams within the organization, the 3 ...
Jun 24, 2020•58 min•Ep. 137
The COVID-19 crisis has presented marketers with quite a challenge. Customers don't want to be sold to and no one wants to spend money. In fact, traditional marketing has been paused for fear of coming off as insensitive and out of touch. But that doesn't mean you stop. You just do it differently. The pandemic is driving marketers back to the fundamentals of relationship building and value creation. This is how you stay relevant during the crisis, and as we reopen the economy. On this episode, w...
Jun 17, 2020•57 min•Ep. 136
The COVID-19 crisis and the resulting lock-downs across the world forced many organizations to go virtual in an instant. Some of them had sound Business Continuity (BC) and Disaster Recovery (DR) plans in place. And while they were still interrupted, they were able to move quickly and keep their people working. Others were caught off-guard and are now scrambling to make it all work. In an industry like healthcare with reams of sensitive data and the regulations that go with it, this breakneck pa...
Jun 10, 2020•36 min•Ep. 135
We’ve talked a lot about the importance of addressing social determinants of health (SDOH) in healthcare, and why it may be the most critical factor when it comes to lowering costs and improving outcomes… especially for vulnerable communities. For me, there is zero doubt that this is what needs to happen. However, we’ve seen very few programs that have been successful, sustainable, and scalable. That’s a big problem, and when this happens, you risk losing the attention of key decision-makers tha...
Jun 03, 2020•52 min•Ep. 134
Health Systems are being asked to make changes in 2 months that would have otherwise taken years. As some business lines come screeching to a halt, others have sped to a breakneck pace. Prioritizing problems to solve and finding novel solutions have never been more essential. Here today to teach us how innovation is done at Geisinger Health is Karen Murphy. Enjoy! Highlights from the Episode We define innovation at Geisinger as a fundamentally different approach to solving a problem that has qua...
May 27, 2020•38 min•Ep. 133
In our ongoing series around the COVID-19 crisis, we plan each episode with the specific aim of delivering you, the listener, actionable items you can do right now. To ensure that during this crisis you can solidify and strengthen your business while continuing to serve your patients at the highest level, we're bringing you two of our favorite people in healthcare. Joining us today is David Goldhill, CEO of Sesame and Dr. Allison Edwards who runs a direct primary care facility, to talk about how...
May 20, 2020•50 min•Ep. 132
Many doctor’s offices have been closed for weeks and those that haven’t have seen massive cancellations. This episode is for healthcare providers and people working inside health offices. Today we’re going to share what we're seeing across the country in terms of closures, cancellations, and plans going forward. Joining us to help you formulate a plan, is Tashfeen Ekram, MD co-founder and chief medical officer of Luma Health . Highlights from Serving Patients and Doing Business in Spite of COVID...
May 14, 2020•59 min•Ep. 131
Surescripts is at the center of almost all prescriptions for medications in the US. In this era, when almost no other kind of prescriptions are being allowed, how is Surescripts thinking about digital prescriptions? How has Surescripts adapted to the new needs of patients and providers at the point of care with their real-time prescription benefit ? Dr. Andrew Mellin, Chief Medical Information Officer at Surescripts joins us today to show us how the right technology changes physician prescribing...
May 06, 2020•38 min•Ep. 130
A year after Draft 2 of TEFCA , what has happened and where are we now? The ONC awarded a cooperative agreement to The Sequoia Project to serve as the Recognized Coordinating Entity (RCE) to develop, update, implement, and maintain the Common Agreement and the QTF. On today's episode, Shahid Shah joins your host, Don Lee to talk with the CEO of The Sequoia Project, Mariann Yeager. If you are an HIE and you want to become a QHIN (or sell to one), this episode is for you. Highlights from What you ...
Apr 15, 2020•54 min•Ep. 129
There is an urgency to utilize social determinants in healthcare decision making, especially to meet the needs of underserved populations. Jvion launched its new COVID-19 Community Vulnerability Map , a free, publicly available tool that identifies populations — down to the census block level — that are likely to experience severe outcomes requiring hospitalization when they contract the virus. The map integrates the findings of the data analysis project that Jvion conducted last week, which ana...
Apr 09, 2020•59 min•Ep. 128
An #HCBiz Brief: Given the shortage of Personal Protective Equipment (PPE) in our hospitals due to COVID-19 and the elevated risks our medical professionals are facing every day, I wanted to share a tool I came across at an infection control conference last year that might help. This is a short PSA about an engineered control that prevents infective aerosols, sprays, and splash-back generated by suctioning. I hope you find it helpful. https://prodaptivemedical.com/stal-shield/ And here's an inte...
Mar 31, 2020•13 min•Ep. 127
The Opportunity Zones incentive is a new community investment tool to encourage long-term investments in low-income urban and rural communities nationwide. Nightingale is accelerating the health care industry’s ability to deploy underfunded SDOH benefits by leveraging the innovative financing mechanisms of Opportunity Zones, to catalyze a new marketplace of social service providers. Joining us today is the Founder of Nightingale Partners, John Gorman , to talk about one solution that is good for...
Mar 27, 2020•57 min•Ep. 126
Today’s episode is about how the Rural Risk-Free Solution helps rural hospitals and health systems take on risk faster to achieve value-based care. The methodology is a community / population health approach. By providing analytics on care metrics, nurse-led and team based care, and population health programs, you can improve outcomes for both communities and the hospitals. Today we have Lynn Barr here from Caravan Health to explain how it works. Highlights from A Rural Risk-Free Solution The ru...
Mar 19, 2020•58 min•Ep. 125
Drugs are way too expensive. It has got to be from someone in the middle taking up all the money. Blame the pharmacy benefits managers! Right? Not so fast. If you're like me and have gotten derailed by complicated flow charts trying to understand PBMs in the past, this is the episode for you. AJ Loiacono , CEO of Capital Rx , is a new PBM injecting some much-needed trust back into the system. By starting fresh and denouncing business as usual, AJ is giving control back to self-insured entities w...
Feb 05, 2020•56 min•Ep. 124
The interoperability promise of a shared, longitudinal medical record has so far focused on connecting health systems to each other. With the growing investment and constant new entrants of SDOH solution vendors, a new wave of interoperability challenges are becoming apparent. How does your health app connect to an EHR? Will new anti-data blocking legislation help or hurt SDOH startups? In this wide-ranging conversation, Don Lee and Shahid Shah talk with Niko Skievaski, President and Co-Founder ...
Jan 15, 2020•56 min•Ep. 123
Health systems have been working hard to lay the foundation for taking on a larger case mix of value-based contracts. 75% of health systems surveyed said they are ready to accept downside risk in the next two years, up from 42% in 2015. As health systems are discovering, value-based care reimbursement is more complicated and requires a new level of specificity in documentation. The question is, are health systems really ready to take on downside risk while continuing to manage FFS contracts? Tod...
Jan 09, 2020•1 hr•Ep. 122
The quantification of how social determinants effect health has finally put enough pressure on healthcare organizations to force action. Finally discovering what social workers have known for years, the health sector is on the verge of providing a permanent revenue stream for Social Care Organizations who previously relied on grants and charitable donations. For your organization to develop health partnerships, Juliette Price from Helgerson Solutions Group says you need to answer three questions...
Dec 18, 2019•1 hr 8 min•Ep. 121
For long time listeners of this show, you know we’re in the business of helping entrepreneurs understand how to create use case alignment, how to get over the hump of defeating good marketers with a not so good solution, and how to get the right tools in the hands of people who need them. The hurdles involved with getting permission and building consensus around which new tech to bring in slows down diffusion and implementation of needed solutions. Well today we’re looking at a new platform that...
Dec 04, 2019•1 hr•Ep. 120
The design solutions from the consumer wearable market are making this next generation of remote patient monitoring devices ready for mass adoption. With the solutions you’ll hear about today and CMS finally finding a method to pay for them , hospitals and patients will soon agree that remote monitoring could be the key to a more holistic healthcare solution. With successful physician adoption strategies like the one we heard from Henry Ford Health System , more developers will be utilizing remo...
Nov 27, 2019•40 min•Ep. 119
