LUMINA Podcasts

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

• 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.

Episode Overview

• 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.

Episode Overview

Episode Overview

Episode Overview

Episode Overview

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