Daniel J. Marino

Daniel J. Marino
Daniel specializes in shaping strategic initiatives for health care organizations and senior health care leaders in key areas that include population health management, clinical integration, physician alignment, and health information technology.

Recent Posts:

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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Importance of Revenue Cycle Management in Value-Based Care

Episode Overview

Revenue cycle performance is a hot topic across the country as organizations work to rebound from the difficult past couple of years caused by COVID. There are many things that impact and contribute to the complexity of the revenue cycle, but they boil down to three categories: people, process, and technology.

On this episode of Value-Based Care insights, host Daniel J. Marino discusses ways to identify areas of opportunity and increase the revenue cycle performance with revenue cycle leaders, Cecilia Gonzalez and Rachel Greenspan.

 
Key takeaways:
  • When aiming to increase revenue and create efficiencies, leaders must educate and properly train front-end staff so that they understand the entire revenue cycle and how to avoid costly denials.

  • Key performance indicators support operational effectiveness as they drive outcomes and improve the overall financial performance of the group.

  • Centralized pre-certification processes can reduce inefficiencies as staff members become subject matter experts who are focused on the requirements of the payers to ensure timely and proper payment for services.

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Operational Effectiveness in Surgical Services

Episode Overview

Many challenges can arise when trying to implement standardized processes in complex surgical settings. Reviewing the data and performing prioritization exercises will help leaders identify inefficiencies and assist them with understanding where to begin to operate effectively. By utilizing data and engaging surgical staff, hospitals and ASCs will see tangible benefits to the financial bottom line and to staff and patients.

On this episode of Value-Based Care insights, host Daniel J. Marino has an informative discussion with Kate Geick on the benefits of implementing operational effectiveness tools in surgical services. 

 
Key takeaways:
  • One of the biggest mistakes that hospitals make is collecting data without taking the next step to understand and interpret it. After gaining analytic insights into the problems you are facing, you can move forward with an exercise like value stream mapping and identify opportunities for improvement right away.
  • It's really important to not only measure certain KPIs on a regular basis, but also share the analytic insights with the right people on a regular basis. If you aren’t informing the staff who are affected by the inefficiencies and are instrumental in enacting the changes needed, then it will be very difficult to make improvements in processes.

  • Making changes to processes that surgeons and staff have become accustomed to for years can be stressful. Necessary changes may involve more paperwork or more steps and this can create frustration. Bringing the focus back to the purpose and why you’re doing it will help maintain the level of commitment needed to implement meaningful changes for improved operational effectiveness.
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Value-Based Contracts: The Real Risk to Hospitals and Specialists

Episode Overview

Health care providers are in one of the most challenging times with payer contract negotiations. There are new economic pressures, changes in reimbursement structures due to shifts in site-of-care, and payers wanting providers to assume more risk. On this episode of Value-Based Care Insights, host Daniel J. Marino and Cliff Frank, a national expert in managed care contracting, discuss how health care providers must move forward and successfully perform under risk-based contracts.  
 
Key takeaways:
  • The COVID-19 pandemic created a large shift in the site-of-care from the inpatient to the outpatient setting. This caused payers to make changes to their reimbursement structure.

  • Reimbursement pressures are tremendous right now, with payers making frequent adjustments to policies and denying claims that previously would have been approved. This creates additional friction costs for providers, who are working hard to keep up with the shifting landscape.

  • Payers want providers to assume more risk, and in order for a provider to do so, they need to be able to contain and even reduce costs. If providers are going to enter into risk-based contracts, they have to reduce their cost structure internally and reduce friction costs with payers.

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Turning Conflict Into Collaboration – Successful Strategies for Finance and Clinical Leaders

Episode Overview

To be a high performing health care organization, finance and clinical leaders must work together to improve patient care. Many different factors play a part in the often fragile relationship between the two. But by aligning incentives and increasing communication, the dynamic can improve. On this episode of Value-Based Care insights, host Daniel J. Marino has a great discussion with Dr. George Mayzell and Steven Berger on the evolving relationships between hospitals and physicians.
 
Key takeaways:
  • Evolving incentives and changing financial dynamics can create misalignments between hospitals and physicians.
  • The ability to work together is really predicated on transparency, good communication, and some level of mutual governance.
  • In order to provide good quality care, hospitals and physicians need one another and need better financial alignment, whether that is entering something like a co-management agreement, integrated physician network, or a joint venture. Solutions are not one-size fits all, and the most critical piece still comes back to improving communication between hospital and physician.
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Direct-to-Employer Contracts: Benefits to Your Health System

Episode Overview

Given the increasing health care expenditures and the pressures of the recent pandemic, a direct-to-employer (DTE) contracting strategy is an opportunity for employers to reduce administrative friction costs and preserve revenue. These arrangements can allow you to foster a better relationship between the employees and the provider.
 
On this episode of Value-Based Care insights, host Daniel J. Marino has a discussion on the benefits of DTE arrangements with Bradley Olson, VP of Managed Care, and Britney Bart, Business Development, at a large Midwest Clinically Integrated Network.
 
Key points:
  • There is great opportunity to reduce costs by developing a focused DTE relationship.  Starting a relationship doesn't have to be a large, complicated arrangement.
  • Through a strong DTE relationship, you can create value congruence. As the health care network reduces costs, you can be assured that cost is translated back to the employer and to the community.
  • Structuring wellness programs play a big part in fostering relationships between the employee and the provider.  Additionally, opportunities are created to meet the needs of employers and their employees.
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Leadership Insights: Reflecting on the Past and Shaping the Future

Episode Overview

In this very exciting 50th episode of our  podcast, we discuss what we have learned over the past 49 episodes and revisit some of our most memorable moments. We reflect on the key insights we gained from speaking with so many industry experts and look forward to hearing more stories as we continue to glean insights and learn together. 
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