Navigant Healthcare Podcast Series

In the 17th episode of the All Things Financial Management podcast, presented by the American Society of Military Comptrollers (ASMC) and Guidehouse, Ms. Christina Freese, Deputy Chief of Staff for Resource Management for the US Army Materiel Command, sat down with host Tom Rhoads to discuss how the use of category management, a structured approach to create categories for common goods and services, has enabled the Army Materiel Command to eliminate redundancies, increase efficiency and effectiveness, achieve cost savings, and enhance the war fighter capabilities.

In Episode 16 of the "All Things Financial Management" podcast, presented by the American Society of Military Comptrollers (ASMC) and Guidehouse, host Tom Rhoads sits down to discuss the transformation of the Defense Health Program and how it funds DOD healthcare with Colonel John Lee, Deputy Chief Financial Officer of the Defense Health Agency.

IT Modernization - State of the Union (featuring Anil Krisnananda & Mark Kneidinger) by Guidehouse

IT Modernization – Cloud Modernization (featuring Raquel Morgan & Tom Santucci) by Guidehouse

IT Modernization – Leveraging Emerging Technologies (featuring Anil Krisnananda & Tanya Arthur) by Guidehouse

In Episode 15 of the "All Things Financial Management" podcast, presented by the American Society of Military Comptrollers (ASMC) and Guidehouse, host Tom Rhoads sits down to discuss military service financial operations with. Mr. Shawn Lennon, the deputy Director J8 and Director of Financial Improvement Audit Remediation for the Defense Logistics Agency.

All Things Financial Management ft Wes Miller by Guidehouse

All Things Financial Management - Dr. Beck and Mr.O'Brien by Guidehouse

All Things Financial Management: Audrey Davis by Guidehouse

All Things Financial Management - Alaleh Jenkins by Guidehouse

All Things Financial Management: Mark Hakun by Guidehouse

All Things Financial Management: Rich Brady by Guidehouse

All Things Financial Management with Steve Herrera by Guidehouse

All Things Financial Management Podcast Episode 1 by Navigant

All Things Financial Management Podcast Episode 3 by Navigant

All Things Financial Management Katherine VanScoy by Navigant

All Things Financial Management Tom Brandt by Navigant

All Things Financial Management Doug Glenn by Navigant

All Things Financial Management Podcast Episode 2 by Navigant

All Things Financial Management Kirstin Riesbeck by Navigant

Welcome to the AMLA Coffee Break, a collaborative podcast series with Guidehouse and Pillsbury Winthrop Shaw Pittman, where we discuss the various topics in the AML Act of 2020. Our first episode is on enhanced whistleblower protections and increased penalties, so settle in and pour yourself a cup of coffee as we kickoff our AMLA Coffee Break Series. Stay tuned for our next edition, which will be on foreign subpoenas.

In this podcast, Dave Valeri and Mike Parrinello from Guidehouse discuss some of the challenges related to investment accounting in the insurance industry. In addition to the uniqueness of the insurance environment, Rick, Mike and Dave touch on COVID-19 and the resiliency of asset managers and software providers during this crisis.

“Encrypting” Crypto with Alma Angotti by Navigant

In episode five of Sustainability Sparks, host Vincent Hoen, associate director at Guidehouse, and guest Suzanne Greene, program manager of the Sustainable Supply Chains Initiative at the MIT Center for Transportation and Logistics, discussed sustainable supply chains and climate topics.

Episode three of Sustainability Sparks is a live recording from Apparel Textile Sourcing Tradeshow. It features host Emily Damon, associate director at Guidehouse, discussing brand sustainability with Jenn Swain, global senior sustainability manager at Burton, a winter apparel and hard goods company.

In episode two of Sustainability Sparks, host Noah Goldstein, director at Guidehouse, and guest Chris Pyke, senior vice president of ArcSkoru, discussed the building greenhouse gas nexus.

A Message from John Saad and Maggie Feldman-Piltch

This is the first podcast audio for Tim Talks.

In an interview for Morning Briefing POTUS, Guidehouse’s Jan Vrins, leader of Guidehouse’s global Energy, Sustainability, and Infrastructure segment, discusses how governments and corporations can adapt to the energy transformation.

As healthcare shifts to the outpatient setting, enhancing clinical documentation improvement (CDI) has become more of a focal point for providers. Outpatient CDI is designed to accurately capture the acuity and severity of a patient’s illness in order to maintain complete and accurate medical records, capture chronic medical conditions, and promote higher-quality patient care. In this podcast, Guidehouse Director Rajiv Sheth discusses the main reasons why providers should consider developing an outpatient CDI program, to include: - Better patient outcomes - Decreased risk of hospital readmissions - Specificity of coding and documentation for care provided Additional outpatient CDI program benefits Sheth mentions include producing fewer denials on the back-end, better continuum of care coordination, and improved financial and profile accuracy. Our discussion concludes with Sheth’s opinion on a recent survey suggesting providers are planning to implement CDI technology that leverages artificial intelligence (AI). He agreed that CDI technology is crucial today and predicts that think AI and machine learning will continue to evolve. He also suggests that providers should implement programs that include AI machine learning, as it will only help them be more effective and ultimately provide better care for their patients.

The rise of robotic process automation, or RPA, has impacted industries worldwide. Compared to humans, bots work 24/7, never take sick days, are more accurate, and can often do the work of multiple full-time equivalents. Financial services firms have been at the forefront of RPA, with sector average cost savings ranging from 50% and 75%. While examples of provider RPA success to date is limited, that’s likely to change. According to an HFMA/Navigant survey, 15% of health system executives are targeting RPA to drive future revenue cycle improvements, whereas it wasn’t on the radar of a single executive a year ago. In this podcast episode, Navigant Director Len Mandel discusses how providers can improve efficiencies and reduce costs using RPA. Mandel provides a specific roadmap to success that includes four key segments: strategy, infrastructure, transition and support, and production monitoring and scaling. He also outlines the many areas in the healthcare revenue cycle that can benefit from RPA, including patient access services, such as appointment scheduling and registration notifications; auditing self-pay for existing coverage, insurance eligibility, and verification; patient self-pay administration; and submitting pre-authorizations. Mandel concludes with a summary of the opportunities across healthcare for those looking to integrate RPA.

In this Navigant On Healthcare podcast episode, Navigant Life Sciences Managing Director Ross Meisner and Director Mike Fix address the incredibly complex challenges that medtech companies face when bringing new technologies to market.

Clinical denials due to errors in medical necessity documentation, length of stay, and level of care may be a fact of life for healthcare providers, but there are procedures that can be put in place to reduce the denial of payments by payers. To achieve payment, resolution of clinical denials requires an appeal on the part of the healthcare organization. In this Navigant On Healthcare episode, Navigant Senior Vice President Shela Schemel discusses the benefits of using an integrated and holistic solution for inpatient and outpatient units. Schemel highlights the effectiveness of the appeal process in collaboration with a healthcare provider’s utilization management department, patient access services, revenue integrity, patient financial services, and health information management. She emphasizes that the professional denials team should include nurses who provide clinical education with a focus on case management, utilization management, medical review, coding, and claims processes. Additionally, team members should have payer experience. When everyone on the team understands the payer side of it, healthcare providers can rely on this experienced team to have a superior knowledge of evidence-based clinical guidelines, applicable state and federal agency regulatory mandates, coding guidelines, and of changing policies. Denial management can be accomplished with critical evaluation and decision-making about whether an appeal is warranted.

As revenue degradation continues to challenge profit margins, understanding and optimizing reimbursement rates is a key component to a healthcare provider’s success. In this Navigant On Healthcare podcast episode, Navigant Director Robert Roig discusses the pressure that is on managed care leaders today to succeed by negotiating with strategic intent, clear goals, and precise data to support their requests from payers. These leaders also need to provide analytics for contract modeling and accountability to ensure payers are maintaining proper reimbursement that aligns with the negotiated contracts. Roig encourages providers to ask themselves: • Are we able to ensure proper reimbursement is paid? • Are we able to effectively model future payer rate changes? In addition to contract modeling, Roig recommends that each organization reviews zero balance accounts that may have been have overlooked. Examples include when insurance payers apply money to accounts, but the total account value isn’t where it should be. Roig states that when you have a team and the technology that can investigate what’s happening with specific accounts: why they were denied, the opportunities for appeal, the contract language, and how it was applied to the account, you can see if there are payments that still should be made to the hospital provider.

With medicines becoming more specialized and costs rising, the delivery of specialty products has increased in its complexity. Patients need more education and assistance in finding ways to access, pay for and learn about new products and therapies. Manufacturer-sponsored patient service programs are designed to respond to these concerns. In this Navigant On Healthcare podcast episode, Navigant’s Dana Edwards and Casey Horton review how pharmaceutical manufacturers have been developing programs and patient hubs to assist both patients and the healthcare professionals who prescribe the products in addressing these challenges. Manufacturer-sponsored patient service programs typically provide a range of services that support patient access to therapy. Those services may include reimbursement support to help the patients navigate their insurance coverage, fast start programs to help patients gain access to products while working through insurance barriers, financial assistance to help patients pay for out of pocket expenses, patient assistance in the form of free products for uninsured patients, and educational programs to help patients initiate and stay on therapy. Edwards and Horton also spend time in this episode addressing how these programs have recently faced some government scrutiny. They also discuss the specific elements a pharmaceutical company should consider when setting up a program.

In this Navigant On Healthcare podcast episode, Navigant Managing Director Bill Hannah and Director Jeff Leibach share their expertise on why it’s essential for hospitals and health systems to rebalance their revenue portfolios, and how they can do so. With the acceleration away from fee-for-service payment models, health systems are experiencing more complexity in their revenue streams than ever before. As a result, health system leaders can no longer rely on historical revenue projection methodologies and anecdotal explanations when they miss revenue projections or embark on new strategic initiatives. Bill and Jeff discuss how today’s leaders must proactively manage their revenue like a portfolio to be periodically examined, compare it to existing strategic and clinical initiatives, and rebalance it according to performance. Such a portfolio approach can create a single source of truth and allow leaders to fully understand current performance while accurately projecting future scenarios. Specific topics covered on the podcast include: - The business case for a portfolio mindset regarding health system revenue management, to include the types of questions providers need to answer to achieve this type of outlook. - Why it’s essential for health systems to rebalance their revenue portfolios. - The role data analytics can play in helping identify the root causes of a health system’s revenue changes across such areas as collections, volume, and unit reimbursement.

This episode of Navigant On Healthcare is taken from an on-demand webinar co-sponsored by Navigant and the Health Plan Alliance. In this episode, Navigant Managing Director Dennis Butts interviews Blake Allison, chief executive officer of Southeastern Health Partners, about his organization’s experiences with Medicare value-based models. Southeastern Health Partners is a joint venture between AnMed Health, Bon Secours St. Francis, and Spartanburg Regional Healthcare System.

In this podcast episode, Navigant directors Stephanie Lewko and Brian Segobiano discuss data privacy as it relates to global med tech and pharmaceutical organizations, including the great risk from the substantial obligations and fines stemming from global privacy regulations.

Joseph Campbell WTOP - Part 2 by Navigant

Affluent parents and celebrities have recently been accused and connected with conspiring with William Singer, a California businessman so that their children can get into some of the most prestigious schools in the U.S. Joseph Campbell, director at Navigant Global Investigations and Compliance practice and former FBI assistant director shares how the FBI was able to unravel this national conspiracy and work quickly with multiple jurisdictions and cooperating witnesses.

In this episode, Navigant revenue cycle experts Andrew Hancock, managing director, and Amanda Vallozzi, associate director, share insights on how the revenue integrity process can help hospitals and health systems reduce the risk of revenue loss and payment denials. Hancock and Vallozzi discuss how a revenue integrity program is vital to a provider’s success and how adherence to policies and procedures - especially in the middle of a hospital’s revenue cycle - can make a difference in preventing gross revenue leakage and ensuring accurate reimbursement. The conversation also highlights the key components of a revenue integrity department, including gross revenue capture and net improvement focus areas; important success factors such as organizational commitment and how to best coordinate with operations, finance, and other areas; an appropriate implementation approach, timeline, reporting, and key performance areas; and provider case study examples. As Hancock suggests, high-performing organizations have implemented revenue integrity functions and departments, allowing them to “maximize the effectiveness and efficiency of the revenue cycle directly” and “coordinate those activities with interdependent areas, such as clinical departments, contracting, and physician offices. We know that some of those outlying areas can have significant impact on the revenue cycle’s ability to collect and optimize cash collections.”

In this episode, AdventHealth’s Vice President of Care Integration and Quality, Jill Piazza, discusses lessons learned from AdventHealth’s Population Health Services Organization on ways payers and providers can more effectively collaborate to develop highly-targeted, high-impact approaches to care management, or health management.

In this episode, Rulon Stacey, a managing director and leader of Navigant’s healthcare strategy business unit, discusses the trends that will significantly impact healthcare in 2019 and beyond, as well as the steps providers and payers should take to prepare for their futures. The healthcare trends that are shared in this podcast are based, in part, on Navigant’s recently released 2019 Healthcare Outlook and insights from hospital and health system C-suite executives, who attended Navigant’s 2018 CEO Forum at Texas Health Resources in Arlington, Texas. Key topics addressed in this forum include whether economies of scale exist through hospital consolidation, the benefits and challenges of electronic health record platforms, and the influx of private equity. At the conclusion of this podcast episode, Stacey shares his perspective on the idea that investors have spent years trying to benefit from physician practices, although managing physician practices has been inefficient. He recommends discipline in the New Year, stating that other organizations, private equities specifically, can bring the discipline needed to effectively manage physician practices. He suggests that finding ways to bring that discipline where the industry hasn’t had it in the past can take the industry to places we’ve never expected it to go.

Today’s healthcare environment requires providers to find new ways to improve quality while decreasing costs. One proven approach unites healthcare providers to increase value across the care continuum through clinical integration (CI). But the challenge remains for health systems striving to drive successful CI while operating in both fee-for-service and value-based care environments.

A 2018 Navigant/HFMA analysis suggests continued clinician shortages may be challenging hospital leadership to reduce labor costs. According to the survey of more than 100 CFOs and operations execs: • Current nurse and physician shortages represent areas of both the largest increases and reductions compared to a year ago, but mental health provider shortages may represent the direst situation. • 78% of execs predict an increase in labor budgets over the next year, with almost 1-in-5 projecting surges of 5%+; Just 14% predict decreases, none more than 5%. In this podcast episode, Navigant Managing Director Danielle Dyer and Director Vamshi Gunukula discuss these survey results, including how the shortage of these specialized positions is likely causing hospitals to project higher labor budgets in the coming year. They also suggest how predictive analytics, proactively matching staffing to patient care demand, and more efficient workflows can help providers address these challenges.

In this episode, Christopher Stanley, M.D. discusses a study he recently co-authored on academic medical center quality, cost, and value-based program performance compared to non-AMCs, and its implications for both.

Navigant discusses end-of-life care delivery as it relates to the provider, as well as the relationship between provider and consumer.

What the General Data Protection Regulation (GDPR), a privacy regulation governing the processing of individuals’ personal data in the European Union, means to healthcare and life science organizations abroad and in the U.S.

Navigant speaks to Ken Petronis, a founder and former CEO of Bon Secours Health System's Good Help, one of the nation’s earliest and most successful ACOs, on what it takes to develop an ACO and attributes vital to their success.

Navigant looks at how healthcare providers are responding to evolving customer expectations, and the need to increase patient satisfaction, with customer contact centers as the epicenter of a provider’s identity.

Navigant discusses how, with providers focusing on offering easy access and value, micro-hospitals are coming to forefront as viable solutions.