LUMINA Podcasts

Each year, one in five Americans visit the emergency department (ED) at least once  – and these costly ED visits are on the rise. Are they a symptom of a larger issue in our health care system? Many of emergency visits are preventable – this may be a symptom for inefficient care management, inadequate patient access, or lack of patient knowledge. As hospitals and payers transition into value-based care, interpreting ED visits may be a symptom of a larger problem. 
 
In this episode of Value-Based Care Insights, Daniel J. Marino is joined by Dr. Nicholas Dodaro, Chief Medical Officer and co-founder of Medical Life Holdings, a portfolio of companies and practices founded in 2006 to improve the value of health care delivery. The two discuss common issues with emergency room visits, why they’re so costly, and what to do about them.

Key points include:

• “Unmanaged” or “unengaged” patients seem to be a big contributor to unnecessary ED visits.
• Understanding the financial impacts of ED visits on the performance of value-based contracts.
• Reviewing ED visits can be insightful to future improvements with care delivery.

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 

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.

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.
  

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.

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.

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.

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.

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.

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.