No Surprise Act 2022: Ensuring Compliance

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
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Emotional Intelligence: A Predictor for Leadership Performance

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.
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The Health Care Workforce Challenge: Three Solutions that Work!

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
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2022: Tackling Critical Health Care Challenges

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 
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Embracing Operational Effectiveness to Drive Performance

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.
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Medical Practice Operations: Enhancing Care Delivery Post-COVID

Episode Overview:

In this episode of Value-Based Care Insights, Daniel J. Marino speaks with Phil Hasse to discuss the real-life implications of COVID on medical practices. Hasse shares his insights on how operations have changed drastically since COVID and how hospitals are managing now. They also explore the impact of physicians, revenue, patients, and the business practice of medicine as health care navigates through COVID.

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CFO Insights for COVID Financial Recovery

Episode Overview:

As health care leaders continue to navigate COVID and its impact on organizations, many still face unprecedented challenges. Numerous studies reveal the financial performance of hospitals is still below where it was pre-COVID.

As the industry moves forward, it’s important to ask, “What do CFOs need to think about going forward?” and “What does the future look like?” In this podcast, Daniel J. Marino and Steven Berger discuss the role of CFOs and how their handle on operating margins contributes to the success of health care organizations.

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The Emerging Role of the Independent Provider

Episode Overview:

Employment has become a viable option and a trend, and more physicians have become employed over the past decade or two. However, we’re starting to see another trend with specialists who are deciding against employment, and starting their own practice or joining groups or large systems. Many see this an opportunity to stand out in the market and want to embrace the entrepreneurial spirit to have more control of their business and their work-life balance. Definitely having a strong business acumen has contributed to their success.

In this episode of Value-Based Care Insights, Daniel J. Marino speaks with Dr. Carlos Torre, founder of Sleep, Snoring & Sinus Center of Florida and triple board-certified sleep specialist, to discuss becoming independent and growing his practice.

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Best Practices to Operationalize Provider-Sponsored Health Plans

Episode Overview:

Around the country, providers are frustrated by the challenges that accompany working through the negotiations and financial reimbursement that come from work with payers. As a result, many providers are considering alternative arrangements such as provider sponsored health plans and direct-to-employer contracts. But developing and moving forward with a new payer strategy requires a long-term commitment and a solid plan — and that’s where provider-sponsored health plan strategies come in.

Today’s provider-sponsored health plan strategies are much different from those in the early 2000s. Now, we’re seeing hospitals working with successful networks that as focused on quality performance outcomes, reducing costs, connect with patients and employers, and decreasing e employer premiums through coordinated health system and employer collaborative efforts. In this episode, host Daniel J. Marino and Clifford Frank, a national expert in managed care contracting and payer strategy, discuss the challenges and opportunities surrounding provider-sponsored health plans.

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Building a Results-Based Collaborative Leadership Model

Episode Overview:

As organizations transition through this next iteration of the pandemic and think about how to position themselves for 2022, physician and executive leadership continues to be a top priority.

The next generation of executive leadership must think differently and have the ability to evolve with anticipated crises and changes in the industry. It is imperative to understand what will be expected of those leaders, the requirements they must satisfy, and how they should position themselves and their organizations for success.

In this episode of Value-Based Care Insights, Daniel J. Marino speaks to Dr. Cheri Olson of IPMA and Doug McKinley of the Lumina Leadership Institute to discuss the need for a collaborative leadership model.

This is the second episode in a two-part series supporting the collaborative IPMA and Lumina Leadership Institute CME Conference, taking place October 14, 2021.

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