The Change Healthcare Podcast

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Change Healthcare is a leading independent healthcare technology company, focused on accelerating the transformation of the healthcare system through the power of the Change Healthcare Platform. We provide data and analytics-driven solutions to improve clinical, financial, administrative, and patient engagement outcomes in the U.S. healthcare system. Learn more at changehealthcare.com.

Change Healthcare


    • Mar 15, 2023 LATEST EPISODE
    • infrequent NEW EPISODES
    • 31m AVG DURATION
    • 137 EPISODES


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    Latest episodes from The Change Healthcare Podcast

    Partnering for Change: The Benefits of Value-Based Care Models

    Play Episode Listen Later Mar 15, 2023 23:23


    VP and Head of Solutions at Nuna, Parag Patel, chats about how the Prometheus Episode Grouper from Change Healthcare has helped Nuna better serve all. Learn MoreFollow Serrah Linares, vice president of partnerships at Change HealthcareFollow Parag Patel, VP and Head of Solutions at Nunanuna.comchangehealthcare.com/value-based-care/prometheus-analytics

    Patient Experience: Social Determinants of Health in Cancer Care

    Play Episode Listen Later Jan 10, 2023 31:10


    Thyme Care Co-Founder, President, and CMO, Dr. Bobby Green, joins host Yousuf Zafar, MD, to discuss how his team at Thyme Care are working to provide personalized care guidance to help cancer patients through their journey. Dr. Green also shares the importance of combining a human touch with technology to help improve lives and reduce care costs.Learn More:Follow Dr. Bobby Green, co-founder, president and CMO at Thyme CareFollow Dr. Yousuf Zafar, senior vice president, medical informatics at Change Healthcarethymecare.comchangehealthcare.com/data-analytics

    Partnering for Change: Improving Access to Care Through Transportation

    Play Episode Listen Later Dec 20, 2022 21:55


    Safr Care CEO, Syed Gilani, joins host Serrah Linares to discuss how Safr Care approaches the unique challenges they face, and how Change Healthcare helps Safr Care achieve its mission.Learn More Follow Serrah Linares, vice president of partnerships at Change Healthcare Follow Syed Gilani, President and CEO of Safr Caresafrcare.commarketplace.changehealthcare.com/products/eligibility_and_claims/eligibilitychangehealthcare.com/channel-partners

    Capitol Connection: Getting Healthcare Policy Over the Finish Line

    Play Episode Listen Later Dec 16, 2022 50:06


    Founder and CEO of State of Reform, DJ Wilson, joins host Deanne Kasim to discuss the efforts underway to bring health plans, providers, and regulators together, with an emphasis on innovation.Learn More Follow Deanne Kasim, VP of health policy at Change HealthcareFollow DJ Wilson, founder and CEO at State of Reformchangehealthcare.com/government-affairschangehealthcare.com/government-affairs

    Healthcare Mandates: Creating a Model of Care

    Play Episode Listen Later Nov 1, 2022 28:52


    Quartz Health Solutions director of accreditation and quality insurance, Amy Bachhuber and senior director of Medicare operations, Mark Kirchberg join host Shelley Stevenson to discuss how they implement dual eligible special needs plans.Learn MoreFollow Shelley Stevenson, director government programs practice at Change Healthcare ConsultingFollow Amy Bachhuber, director of accreditation and quality insurance at Quartz Health SolutionsFollow Mark Kirchberg, senior director of Medicare operations at Quartz Health Solutionschangehealthcare.com/healthcare-consulting/government-programs-consulting

    Capitol Connection: Marching to the Midterms

    Play Episode Listen Later Oct 4, 2022 40:14


    Sirona Strategies Partner Kristen Ratcliff McGovern joins host Deanne Kasim to discuss policy and legislative trends leading up to the midterm elections. McGovern shares the key issues Congress needs to focus on before the end of the year, as well as some pre- and post-election considerations.Learn MoreFollow Deanne Kasim, vice president of health policy at Change HealthcareFollow Kristen Ratcliff McGovern, partner at Sirona Strategiessironastrategies.comchangehealthcare.com/government-affairs

    An Evolved Approach to Digital Patient Engagement

    Play Episode Listen Later Jul 26, 2022 32:14


    Luma Health co-founder and CEO Adnan Iqbal joins the Change Healthcare Podcast to discuss how and why his company created a digital patient engagement platform that empowers healthcare providers to differentiate themselves in a competitive market.Follow UsTwitter @Change_HC Facebook @ChangeHealthcareLinkedIn @ChangeHealthcarePresented by Change Healthcarewww.changehealthcare.com

    Partnering to Accelerate Transformation: Wedding Health Technology with Indigenous Wisdom

    Play Episode Listen Later Jun 28, 2022 19:41


    As COVID surged around the world, native Hawaiians were at an increased risk due to socioeconomic factors and comorbidities. To understand the work being done to support vulnerable Hawaiians, we spoke with Kevin Vaccarello to hear how Sustain Hawaii was able to use technology to expand their operation and support their mission of transforming the islands' capacity for self-reliance.Follow UsTwitter @Change_HC Facebook @ChangeHealthcareLinkedIn @ChangeHealthcarePresented by Change Healthcarewww.changehealthcare.com

    Let's Talk Interoperability: Consent and Data Segmentation

    Play Episode Listen Later May 5, 2022 32:49


    With the new CMS and ONC regulations firmly in place, individual access is taking off. But there are still some tricky issues to address around consent and data segmentation. In this episode of the Let's Talk Interop podcast, our panel explores how technology can support consent capture and revocation as well as consent sharing. They also dive into the work our industry is doing to create standardized ways to segment sensitive data so that patients can safely access their own data and caregivers can access data when needed.

    Capitol Connection: Post-Pandemic Healthcare Policy

    Play Episode Listen Later Apr 15, 2022 47:47


    As our public health emergency (hopefully) winds down, federal and state governments are reshaping healthcare policy. To gain clarity we sat down with Ceci Connolly, CEO for the Alliance of Community Health Plans to discuss federal and state healthcare policy trends around Medicaid, mental health, preauthorization and value-based care.

    Let's Talk Interop: Straight Talk on TEFCA

    Play Episode Listen Later Feb 25, 2022 38:10


    Get to know the newly released Trusted Exchange Framework and Common Agreement (TEFCA): what it is, what it does, and how it might impact nationwide interoperability.

    Innovation: Strategies for Moving Enterprise Imaging to the Cloud

    Play Episode Listen Later Jan 28, 2022 29:16


    While crossing professional paths over many years, health IT leaders Eric Lacy and Jim Schreiner became good friends—and learned advocates for the transition of enterprise imaging to the cloud. From their perspectives, informed by a radiology practice and a hospital setting respectively, they offer advice and optimism on what lies ahead on the path to the cloud. Tracy Byers, Senior VP and General Manager of the enterprise imaging business for Change Healthcare leads the conversation.

    A New Approach to Alcohol Treatment

    Play Episode Listen Later Jan 11, 2022 28:31


    Mike Russell is the co-founder and CEO of Monument, an online treatment platform for those looking to change their relationship with alcohol. In this episode, Change Healthcare's Anuj Desai talks with Mike about how his own experience drove him to create a new approach to alcohol treatment. Mike tells Anuj how his company was born and how technology has enabled an alternative care mode

    Enterprise Imaging in the Cloud: Adoption and Outlook

    Play Episode Listen Later Jan 4, 2022 51:54


    For healthcare providers, the potential of cloud technology intrigues, yet adoption has proven difficult.   Nowhere is this more evident than in imaging, which has a legacy of aging, on - premise applications that interact with every point of care. Faced with unscalable solutions and limited alternates, many providers' have stalled their initiatives. Today's enterprise cloud imaging solutions offer new hope. Here we discuss what's next for cloud based medical imaging, outlining drivers and barriers to adoption. 

    Payer Government Mandates: And the Survey Says...

    Play Episode Listen Later Dec 17, 2021 56:47


    We recently asked payers across the country about the No Surprises Act. What do they think about it? How are they preparing for it? How do they feel it will affect their business? In this inaugural episode of our government mandates theme — which we plan to record quarterly, or as critical updates become available — our panelists reflect on payers' survey responses.

    Let's Talk Interop: Moving Toward Electronic HEDIS Measures

    Play Episode Listen Later Dec 3, 2021 36:05


    Join our presenters as they discuss the history and future of HEDIS reporting. Listen in to discover how existing pain points, regulatory agencies, and environmental factors are influencing the transition from claims-based to clinical-based measures.   Today's panel includes: Genevieve Morris, senior director, clinical interoperability strategy at Change Healthcare; Robert Connely, vice president, business development, provider networks, clinical networks at Change Healthcare; Eric Whitley, independent health informatics consultant   Here's what they chatted about: Why HEDIS was first established, how it's evolved over the years, and where it's headed How COVID-19 has affected the healthcare data landscape Moving from claims-based to clinical-based measures: Key considerations How market influences will inform the future of HEDIS and healthcare data What career path Genevieve would choose if she could go back 20 years

    SDoH: Advancing Individual-level Data to Drive Better Care

    Play Episode Listen Later Dec 2, 2021 27:36


    As a “free-range” child in the late ‘60s and early ‘70s, Dr. John Halamka rode his bicycle to the dumpsters of defense contractors, pulling out the integrated circuits they had thrown away. By age 14, he had gained an advanced understanding of technology, however his passion lied in biology and life sciences—which led to a “crazy idea”: “What if I made a career that brought together technology and service to patients?” Roughly a half century after his novel notion, Dr. Halamka joins Change Healthcare's Tim Suther to share stories and lessons from the leading edge of incorporating social determinants of health (SDoH) and individual data into healthcare.   On today's show, Dr. John Halamka joins Tim Suther to discuss gaps that exist between what we know about SDoH and individual-level data in healthcare, and how organizations are incorporating individual-level data to drive better care outcomes.   Today's panel: Dr. John Halamka, president, Mayo Clinic Platform; and Tim Suther, senior vice president, data solutions at Change Healthcare.   Here's what they chatted about: Why is the real-world healthcare experience still decidedly mixed despite knowledge that social determinates affect up to 80% of health outcomes? Lessons from the front lines of healthcare, including what works and what doesn't. How we end up with incorrect or ineffective healthcare data, and the need for alternate sources of data. Incorporating social determinants into predictive algorithms, and where these algorithms are most likely to fail. Why “innovation without risk” is an unrealistic goal, and how organizations can approach innovation instead. Why healthcare organizations need to make data security a priority, along with an approach Mayo Clinic uses to protect patient data.

    What Can Research Tell Us About COVID-19 Breakthroughs?

    Play Episode Listen Later Nov 18, 2021 28:00


    In today's episode, Tim Suther is joined by Dr. Mark Cullen, who's been at the forefront of population health for decades—even before it was a recognized field. Listen in as Tim and Dr. Cullen discuss the collaborative effort that has gone into the COVID-19 Research Database, and what the resulting research and analysis can tell us about vaccine effectiveness, breakthrough infections, social determinants of health (SDoH), and booster vaccines. Today's panel includes: Dr. Mark Cullen, consultant in population health and the Founding Director of the Stanford Center for Population Health Sciences; and Tim Suther, senior vice president, data solutions at Change Healthcare. Here's what they chatted about: What data can tell us about COVID-19 vaccine effectiveness and breakthroughs, and what it can't. What's behind vaccine hesitancy and where we go from here. How social determinants of health (SDoH) and pre-existing conditions have affected infection and mortality rates.    

    Infrastructure, Budgets, and other Critical Public Health Policy Issues in the Balance

    Play Episode Listen Later Oct 18, 2021 54:39


    The US Government is poised to make groundbreaking federal and state policy decisions. Special guest Matt Salo, executive director of the National Association of Medical Directors, joins us to discuss the latest congressional action on the infrastructure package, challenges of current budget reconciliations, and Medicaid expansion consideration. We also explore critical state health and health tech topics including the growing data privacy and security policy efforts, state public option models, COVID vaccine hesitancy, how Medicaid programs have addressed public health needs, and what's next for telehealth policy in states.

    Value-Based Care Innovation — Payers, Providers and Tech Collaborate to Drive Outcomes Pt.2

    Play Episode Listen Later Sep 27, 2021 33:03


    Analytics are key to success in value-based care. That's because analytics deliver data-driven insight into exactly what it takes to achieve desired patient outcomes for any given episode of care. With that insight, payers and providers can collaborate to move more smoothly from fee-for-service to fee-for-value, to create logically bundled payment programs, and to  produce insight-driven results. So learning more about VBC analytics will help you reap more of VBC's potential benefits.

    Value-Based Care Innovation — Payers, Providers and Tech Collaborate to Drive Outcomes

    Play Episode Listen Later Sep 24, 2021 23:43


    Analytics are key to success in value-based care. That's because analytics deliver data-driven insight into exactly what it takes to achieve desired patient outcomes for any given episode of care. With that insight, payers and providers can collaborate to move more smoothly from fee-for-service to fee-for-value, to create logically bundled payment programs, and to  produce insight-driven results. So learning more about VBC analytics will help you reap more of VBC's potential benefits. Presenters: Summerpal Kahlon, MD, VP Value-Based Payment at Change Healthcare Kyle Kroening, Product Manager, NetworX Product Suite at Cognizant Jennifer Mann, Senior Manager, NetworX Product Management Team at Cognizant

    Cost Transparency: Driving Better, More Informed Care Decisions

    Play Episode Listen Later Aug 10, 2021 44:21


    Would you order something online but not expect to know the cost until after the item is delivered? The answer is probably, no! For years, healthcare costs have been a mystery, not revealed until after services were completed. Now, with the shift to cost transparency in healthcare, consumers are acquiring the tools to get advanced pricing on healthcare services. Two important federal regulations are helping to drive this new normal. In this episode, host Ed Domansky talks with Mike Peresie about the opportunities and challenges payers face in implementing price transparency in healthcare. Mike is the senior vice president and general manager of the Medical Network business at Change Healthcare.

    Delivering a Retail-Style Experience Through Healthcare's Digital Front Door

    Play Episode Listen Later Jun 17, 2021 50:52


    Consumers expect digital access to providers to be on par with their online retail experiences. After all, they're footing the bill for healthcare under their high-deductible health plans. And o providers today need a “digital front door” that attracts and retains patients, and ultimately drives revenue. Today's show brings together healthcare leaders from Adobe, Microsoft, and Change Healthcare to discuss this new normal, and what providers need to know to be successful with a digital-front-door strategy. Today's panel features Ivy Portwood, principal marketing manager at Adobe; Tracy Picon, senior director with Microsoft's U.S. Health and Life Sciences group; Tom Swanson, heads of Adobe's Health and Life Sciences strategy and marketing; and Patrick Leonpacher, business development and operations executive with Change Healthcare. Here's what they discussed: Why digital front door matters Patient self-help capabilities Components of a digital front door How to use digital tech to empower patients How to improve healthcare accessibility What healthcare leaders can learn from retail Why personalization aids patient retention How to bring price transparency into the patient experience Keeping the human touch in a digital world Episode Resources Ivy Portwood's bio Tracy Picon's bio Tom Swanson's bio Patrick Leonpacher's bio Unlocking Patient Access Price Transparency Healthcare E-commerce Platform Paradox-of-Choice Report Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Squeezing Paper Costs Out of the Healthcare Ecosystem

    Play Episode Listen Later Jun 16, 2021 31:39


    Paper checks comprise about one-third of all payments from health plans to providers. They're accompanied by printed remittance information, which adds to the costs of printing, mailing and depositing checks. How can healthcare convert more payments from paper to electronic formats? In part one of a two-part series, host Brian Andrews, along with colleagues Dan Pay and Mark Zurline, discuss new technology that simplifies payment processing and posting. Brian Andrews is Change Healthcare's senior vice president of provider network development. He joins Dan Pay, vice president of strategy and management operations; and Mark Zurline, senior director of payments product management, in this compelling discussion about the latest advances in payment processing. They discuss: The financial scale of healthcare's paper-check problem Why paper checks persist in healthcare Takeaways from converting paper claims to electronic Inside the National Payments Connector (NPX) The hidden value of one-time enrollment How to consolidate remittances to a central portal Considerations for system security Episode Resources Brian Andrews' bio Dan Pay's bio Mark Zurline's bio National Payments Connector Phasing Out Paper Checks Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Health IT Innovation Targets HIPAA's Complexity

    Play Episode Listen Later Jun 8, 2021 42:03


    HIPAA sets a floor rather than a ceiling for how patient privacy works state by state. Human factors also add complexity to policy under the law in areas such as clinical trials and substance abuse treatment. Today's guest David Finney is joined by Deanne Kasim and Arien Malec to explore how efficient exchange of personal data, proven in existing technology and innovative networks, offers the promise of information sharing at reduced cost. David Finney is co-founder and partner of Leap Orbit. Deanne Kasim is executive director of health policy at Change Healthcare. Arien Malec is senior vice president of product development at Change Healthcare. Here's what they discussed. Forms of data use authorized by HIPAA HIPAA's patchwork of privacy protections Patient authorization's role in HIPAA Information that requires patient authorization HIPAA's de-identified data standard Technology for documenting patient privacy directives A complicating factor in authorization State approaches to data collection Policy recommendations for data exchange A preemptive national health privacy law Episode Resources David Finney's bio Deanne Kasim's bio Arien Malec's bio Leap Orbit HIPAA resource for professionals California CCPA Change Healthcare Government Affairs Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare Disclaimer: The information provided within this podcast does not, and is not intended to, constitute legal advice. Instead, all information, content, and materials are for general informational purposes only. Listeners should contact their attorney to obtain advice with respect to any particular legal matter.

    Vaccine Credentialing and the Healthcare Experience

    Play Episode Listen Later Jun 4, 2021 32:59


    Today 37% of the U.S. is vaccinated. But how do you verify that? What vaccine was given? How do you schedule follow ups? What about vaccinations for other diseases? Vaccine credentialing is one answer, but healthcare credentials issued by different organizations need to be consistent, interoperable, private, and secure. On today's show, Ramesh Raskar, PhD, and Kris Joshi look at the present and future of healthcare credentialing, the challenges, and the opportunities for population health. Today's panel features Ramesh Raskar, PhD, founder of the PathCheck Foundation; and Kris Joshi, executive vice president and president of Network Solutions at Change Healthcare. Here's what they discussed. U.S. vaccine hesitancy compared to other countries Issuing and using vaccine credentials Integrating credentialing into the public health infrastructure Preparing for outbreaks and booster-shot programs Considerations for interoperability and the consumer experience Lessons to be learned from other countries Crowdsourcing to close public health IT gaps Episode Resources Ramesh Raskar's bio Kris Joshi's bio The PathCheck Foundation Uber-izing the COVID Vaccination Experience CDC COVID Vaccinations U.S. Data Tracker CDC's Child and Adolescent Immunization Schedule CDC's Adult immunization Schedule Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Getting Health Policy Legislation Over the Finish Line

    Play Episode Listen Later May 27, 2021 50:07


    Can states build models of health policy innovation supported by federal investment? Early efforts are under way to bring health plans, providers, and regulators together, with an emphasis on innovation. State of Reform’s DJ Wilson joins Deanne Kasim and panelists Angela Evatt, Steve Brennan, and Matt Keppler to discuss the components driving this approach among emerging federal and state legislation. Today’s special guest is DJ Wilson, founder and CEO of State of Reform. DJ joins Change Healthcare’s Deanne Kasim, executive director of health policy; Angela Evatt, director of state health policy; Steve Brennan, Wester Region senior manager of state health policy; and Matt Keppler, Central Region senior manager of state health policy. They discussed: Policy takeaways from Biden administration’s first 100 days Public health investment opportunities in upcoming infrastructure legislation The post-pandemic outlook for value-based care Where states are working with federal partners Status of state data privacy bills Progress on health information exchange legislation Public option efforts to control healthcare costs Legislative activity on vaccination credentialing Employers requiring proof of vaccination Episode Resources DJ Wilson’s bio Deanne Kasim’s bio Angela Evatt’s bio Steve Brennan’s bio Matt Keppler’s bio Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    The Evolution of Clinical Interoperability

    Play Episode Listen Later Apr 12, 2021 38:56


    After years of slow to no progress, clinical interoperability is being propelled forward by consumer and competitive market pressures, and an array of federal mandates. On today’s show, host Charles Pelton talks with Genevieve Morris about the evolution of clinical interoperability, where it started, where we are today, and where the industry is headed. Genevieve Morris is Sr. Director of Clinical Interoperability Strategy at Change Healthcare. She previously worked as a healthcare IT and policy consultant and advisor, and worked on the development of regulations at the U.S. Office of the National Coordinator for Health Information Technology. Charles Pelton is an independent industry analyst and event host. They review: The impact of “information blocking” rules Policy or technical challenges: which is the inhibitor? Standardizing core healthcare data What data remains to be standardized How the federal standards-setting process works When real-time healthcare data access is important (and when it isn’t) How and when data interoperability makes a clinical difference Building trust between healthcare organizations A role for AI Episode Notes Genevieve Morris’s bio Charles Pelton’s bio Why Clinical Interoperability Between Providers and Payers Is so Important Clinical Interoperability Is Happening: How Will You Respond? Everything You Dare to Ask About Healthcare Interoperability CommonWell Health Alliance Clinical Document Collector API Change Healthcare Developer’s Marketplace Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    The Capitol Connection: The National Interoperability Policy Agenda

    Play Episode Listen Later Apr 8, 2021 49:24


    An ONC brief finds healthcare made significant progress on data sharing. But that connectivity is largely between EHRs. Today’s panel draws a distinction between simple EHR data sharing and truly interoperable healthcare services that are usable and extensible via FHIR across myriad vendor, payer, and provider solutions. Lisa Bari, interim CEO at the Strategic Health Information Exchange Collaborative, joins our Change Healthcare panel to look at progress across the national interoperability policy agenda. Our panel: Lisa Bari, interim chief executive officer at the Strategic Health Information Exchange Collaborative joins Change Healthcare executives Deanne Kasim, executive director of Healthcare Policy; Arien Malec, senior vice president of Product Development; and Genevieve Morris, senior director of Clinical Interoperability Strategy. They talk about: The latest on interoperable health data and health information exchanges (HEI) Use cases for public health data and access Study finds business cases to promote interoperability lacking Why interoperability incentives and penalties are failing Ways to accelerate interoperability nationally How to level the HIE playing field Technology, policy, and trust issues that must be solved A public utility model for HIEs Implications of the 21st Century Cures Act on interoperability Episode Resources Lisa Bari’s bio Deanne Kasim’s bio Arien Malec’s bio Genevieve Morris’ bio Change Healthcare Government Affairs Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Taking Clinical Decision Support Beyond PAMA’s Mandate

    Play Episode Listen Later Apr 6, 2021 47:16


    The Protecting Access to Medicare Act (PAMA) ties imaging reimbursement to using clinical decision support (CDS) to help ensure medical necessity. But why stop there? On today’s show, Dr. Ryan Lee with the Einstein Healthcare Network in Philadelphia shares how Einstein has gone beyond compliance to embrace a broad and collaborative use of CDS. Dr. Ryan Lee is an Associate Professor of Radiology at Thomas Jefferson University and leads radiology, quality, and safety programs at the Einstein Healthcare Network in Philadelphia. Greg Mogel is the Chief Medical Officer for CareSelect at Change Healthcare. They discuss: CDS's impact on compliance, cost, and quality Substituting medical evidence for anecdotal judgment Going beyond radiology Lessons learned (the hard way) about the keys to CDS success Determining the best study, the wrong study, or no study Streamlining preauthorization for commercial insurers and Medicare Applying CDS to pediatric cases Reducing unnecessary imaging, costs, and exposure to radiation Episode Resources Ryan Lee’s bio Greg Mogel’s bio CareSelectTM Imaging Bringing Clinical Decision Support to Imaging to Assure PAMA Compliance Audiobook: Aligning the Lab with the Hospital’s Strategic Priorities Your PAMA Questions Answered Audiobook: The New PAMA Math Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    The Capitol Connection: Healthcare Policy Shifts

    Play Episode Listen Later Feb 22, 2021 39:14


    Today Jen Covich Bordenick, CEO of the eHealth Initiative, helps us assess the Biden administration’s ambitious 100-day agenda for combating COVID-19. She joins Change Healthcare’s Deanne Kasim, Angela Evatt, and Steve Brennan to discuss how COVID-19 is now central to everything happening with healthcare policy legislation and executive orders at the federal and state government levels. Our panel: Deanne Kasim is executive director of Healthcare Policy, and Angela Evatt and Steve Brennan are senior managers of State Health Policy at Change Healthcare. They’re joined by Jen Covich Bordenick, the CEO of the eHealth Initiative. Topics discussed on today’s show: Progress on vaccine distribution and related public health issues Vaccination appointments and the healthcare digital divide Legislation to address disparities in access to care Momentum for permanent waivers expanding telehealth access and payment The potential for “asynchronous” remote care coverage Privacy issues with COVID-19 tracking data and apps Public health infrastructure weaknesses exposed State healthcare bills and policy focus State budget challenges and federal funding uncertainty Episode Resources Jen Covich Bordenick’s bio Deanne Kasim’s bio Angela Evatt’s bio Steve Brennan’s bio eHealth Initiative CDT and eHI Release Proposed Consumer Privacy Framework for Unprotected Health Data Change Healthcare Government Affairs Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    How to Emerge From the Pandemic Stronger Than Before

    Play Episode Listen Later Feb 16, 2021 21:13


    Just 14% of organizations emerge from an economic downturn in better shape than they were before the slump, according to a recent study by the Harvard Business Review. But the study also found that companies that adopted a “progressive focus” will outperform rivals during and after a downturn. On today’s podcast, Kevin Brooks and Jeanette Flom consider the role of digital transformation as a strategy to help organizations emerge from the downturn stronger and better prepared for the future of healthcare. Today's panel: Kevin Brooks is senior vice president of marketing at Change Healthcare. Jeanette Flom is senior vice president of client engagement at AVIA. Kevin and Jeanette cover: Digital transformation and the COVID-19 pandemic Unlocking digital strength in an economic downturn Three strategic pillars to improving digital patient experiences Increasing back-office efficiency with digital innovation The differences between digital projects and a digital organization Setting priorities for digital transformation efforts The role of digital in the changing nature of healthcare Episode Resources Jeanette Flom’s bio Kevin Brooks’ bio AVIA Health AVIA Connect 4 Ways to harness Digital Solutions A Playbook to “Being Digital” in Healthcare Roaring Out of Recession Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    The Policy Connection: Healthcare Policy and the Road Ahead for States

    Play Episode Listen Later Jan 25, 2021 35:31


    While a new administration addresses federal policy for the pandemic, vaccines, and more, the policy implementation remains largely with the states. Today’s guest is Hemi Tewarson, visiting fellow leading state health policy research at the Margolis Center for Health Policy at Duke University and former director of the National Governors Association Center for Best Practices Health Division. She discusses what changes to expect for healthcare policy, and how the states and industry can prepare. Today’s panel features Deanne Kasim, executive director of Healthcare Policy at Change Healthcare; Arien Malec, SVP of Research and Development at Change Healthcare; and Hemi Tewarson, senior policy fellow at the Margolis Center for Health Policy at Duke University. Here's what they discussed. The policy burden on states and how the federal government can help Policy issues put on hold during the pandemic that remain to be addressed The collision between surging demands and depleted state budgets The impact of predictable federal funding on health policy How to solve logistical challenges of vaccine distribution Overcoming public resistance to vaccination What’s next for telehealth policy How to institutionalize lessons learned from the pandemic Episode Resources Hemi Tewarson’s bio Deanne Kasim’s bio Arien Malec’s bio Margolis Center for Health Policy at Duke University Supporting an Equitable Distribution of COVID-19 Vaccines: Key Themes, Strategies, and Challenges Across State and Territorial COVID-19 Vaccination Plans Change Healthcare Government Affairs Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    The Capitol Connection: A Post-Election Discussion with Gov. Howard Dean

    Play Episode Listen Later Dec 21, 2020 28:40


    With the 2020 election in the rear-view mirror, what’s next for healthcare policy? Divided government at the federal and many state levels, and ballooning deficits, complicate the pandemic response even as a national vaccination program rolls out. Deanne Kasim invited Gov. Howard Dean, MD, former chairman of the Democratic National Committee, to join her in a panel discussion and share his views on what might come next for health policy. Disclaimer: The views and opinions expressed by Governor Dean in this podcast are those of his own and do not purport to reflect the opinions, views, or official policies or positions of Dentons or Change Healthcare. Today’s panel features Deanne Kasim, executive director, Health Policy; Angela Evatt, senior manager, Health Policy; and Steve Brennan, Senior Manager State Health Policy, for Change Healthcare. They were joined by Gov. Howard Dean, Senior Advisor, Public Policy, to the global law firm Dentons. Here's what they talked about: Election analysis and implications for healthcare policy Obstacles to bipartisan policy action Pandemic relief prognosis Executive actions vs. legislation The challenging logistics of vaccine distribution State ballot initiatives related to healthcare policy Investment in public health infrastructure COVID-19 contact tracing Budget pressure on states Episode Resources Gov. Howard Dean's bio Deanne Kasim's bio Angela Evatt's bio Steve Brennan’s bio Change Healthcare Government Affairs Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Making Member Communications Meet Today’s Consumer Expectations

    Play Episode Listen Later Dec 18, 2020 23:03


    The way health plans communicate with members today is strikingly similar to how they communicated 10, 20, even 30 years ago: mostly on paper via U.S. mail. Why are member communications largely stuck in the past while most other industries have aggressively shifted to digital engagement? A recent Harris Poll study of healthcare consumers found 71% of consumers now want their health plan to connect with them digitally, and that number will only grow as a result of the pandemic. On today’s show, Phillip Cardona and Sally Love Connally discuss what payers need to do to bring member communications into the digital age, while meeting regulatory compliance and other business challenges unique to healthcare. Phillip Cardona is strategy executive on the Payer Growth Program team at Change Healthcare. Sally Love Connally is senior vice president and general manager of Member Communications at Change Healthcare. Here’s what they chatted about: How health plans are falling short of rising consumer expectations Shortcomings exposed by the pandemic Risks and rewards of digital member communication Old school vs. new school: Giving members choice Why health plans find omnichannel communication strategies challenging Regulatory restrictions and barriers, and how to overcome them Getting the basics right How to keep pace with a rapidly evolving member communications landscape Episode Resources Phillip Cardona’s bio Sally Love Connally’s bio Change Healthcare Payer Growth Program Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Getting Healthcare Claims Paid Right, With Less Waste

    Play Episode Listen Later Dec 17, 2020 21:20


    A source of inefficiency in U.S. healthcare is the process for detecting and correcting inaccurate insurance claims payments. Traditional approaches, based on claims auditing, use a “pay and chase” process to recover improper payments. On today’s program, Change Healthcare’s Phillip Cardona and Mike Spellman discuss alternatives to pay-and-chase, including an innovative approach that helps payers and providers work together to catch errors early, reduce administrative overhead, and improve payment accuracy. Phillip Cardona is strategy executive for Change Healthcare’s Payer Growth Program. Mike Spellman is a senior director for Payment Accuracy Solutions at Change Healthcare. Phil and Mike discuss: Contrasting traditional payment integrity and proactive payment accuracy programs How primary and pre-submission claims editing work with retrospective payment integrity reviews Efficiencies gained from identifying claims coding and payment errors earlier Why provider collaboration and transparency is essential The phases of payment accuracy maturity The role of technology in improving payment accuracy Leadership challenges for payers and providers Episode Resources Phillip Cardona’s bio Mike Spellman’s bio Change Healthcare Payer Growth Program Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Trends in Electronic Payments and the Impact on Provider Revenue

    Play Episode Listen Later Dec 17, 2020 30:15


    Research indicates the more methods a provider offers patients for remittance, the more likely the provider will be paid quickly. Why, then, have providers proven reluctant to embrace one of the newest and innovative methods of payment: virtual cards? On today’s show, Phillip Cardona and Bill Barbato reveal what virtual cards are, how they help providers get immediate payment of approved claims, why providers have been reluctant to embrace them, and why that reluctance might be fading. Phillip Cardona is strategy executive for the Payer Growth Program at Change Healthcare. Bill Barbato is general manager and vice president of Payment Solutions at Change Healthcare. Here's what they dug into: Payment options defined, pros and cons The link between payment options and bad debt How electronic payment speeds payer reimbursement Virtual cards defined How virtual cards work Where virtual cards fit in the array of provider payment options Why virtual cards have caught on elsewhere but not in healthcare Advantages of virtual cards for payers What’s next for healthcare fintech Episode Resources Phillip Cardona’s bio Bill Barbato’s bio Change Healthcare Payer Growth Program Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Audiobook: How to Improve Denial Management Throughout the Patient Journey

    Play Episode Listen Later Dec 14, 2020 14:55


    Denials can be triggered by mistakes that occur before, during, or after a patient’s visit. Improvements before patient encounters can result in preventing the bulk of denials before they ever reach payers. Episode Resources How to Improve Denial Management Throughout the Patient Journey (print version) Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Bridging the Consumer Experience Divide

    Play Episode Listen Later Dec 14, 2020 62:52


    A special edition of the Change Healthcare Podcast Today we're bringing you a live forum with the CEOs of HFMA, the Healthcare Financial Management Association, and AHIP, America's Health Insurance Plans. Today's live forum is about Bridging the Consumer Experience Divide, where Matt Eyles, the CEO of AHIP, and Joe Fifer, the CEO of HFMA, join Change Healthcare’s Bill Krause to discuss how "consumer-first collaboration" can benefit all healthcare stakeholders. People often focus on the competing business interests of health insurers and providers, but both are striving to achieve the same goals: to make healthcare accessible, affordable, and high quality. And today, payers and providers increasingly agree that these goals can't be achieved without it making it easier for consumers to digitally engage with the healthcare system and gain a more informed and active role in their healthcare decisions. We brought these industry leaders together for a live forum to discuss how health insurers and providers can work together to improve the consumer experience, and how that can help healthcare consumers and the industry reduce costs, improve outcomes, and accelerate payment. The panel: Bill Krause is vice president and general manager of Digital Experience and Consumer Engagement at Change Healthcare. Matt Eyles is president and CEO of America's Health Insurance Plans (AHIP). Joe Fifer is president and CEO of the Healthcare Financial Management Association (HFMA). Here’s what the panel discussed and debated during the live forum: What consumers want from their digital healthcare experience How current digital tools fall short of consumer expectations Why health systems and insurers should work together to build better consumer experiences How providing consumers with information in advance helps reduce billing confusion after treatment Why telehealth is a good digital front door for providers Insights and ideas for empowering healthcare consumers to help drive healthcare transformation Episode Resources Matt Eyles’ bio Joe Fifer’s bio Bill Krause’s bio AHIP website HFMA website Harris Poll 2020 Consumer Experience Index Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Audiobook: Humanizing AI

    Play Episode Listen Later Dec 7, 2020 8:25


    How to Close the Trust Gap in Healthcare To promote trust in artificial intelligence in healthcare, AI products and services must come from a deep understanding of user and patient needs and promote user and patient engagement. By Keith Roberts Keith Roberts is vice president of Engagement as a Service at Change Healthcare Episode Resources Keith Roberts' bio Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    AI Poised to Transform Payer-Provider Relationships

    Play Episode Listen Later Dec 7, 2020 27:37


    Digital technology is making claims processing more efficient and cost effective—and that is changing how payers and providers collaborate, as well as their relationships. Today Phillip Cardona and Mike Peresie discuss how payers and providers are starting to use AI to analyze electronic medical record (EMR) data, increase claims processing automation, and streamline workflows, all with the potential to fundamentally transform the payer-provider relationship. They also cover the latest AI capabilities, what’s coming next, and how to prepare for the fundamental business shifts that AI can spark. Phillip Cardona is strategy executive for Change Healthcare’s Payer Growth Program. Mike Peresie is senior vice president and GM of Medical Network at Change Healthcare. Phil and Mike discuss: How AI's impact on claims processing can change payer-provider relationships Using AI to analyze EMR data to find revenue opportunities and cost savings “Intelligent transactions” and how they can improve efficiency The secret to eliminating paper shuffling, faxing, and snail-mailings in claims processing Why fixing front-end procedures helps speed back-end processes Enabling the remote workforce for today's new business environment Where AI and automation can help improve cash flow for both payers and providers Episode Resources Phillip Cardona’s bio Mike Peresie’s bio Change Healthcare Payer Growth Program Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Audiobook: How Groupers Differ and Why That Can Impact Your Value-Based Care Strategy

    Play Episode Listen Later Nov 30, 2020 11:00


    Groupers are key to developing alternative payment models, but not all groupers are alike By Andrei Gonzales, M.D., assistant vice president, Value-Based Care Strategy, Change Healthcare Dr. Gonzales is responsible for product management of HealthQx®, Change Healthcare’s value-based payments analytics platform. Episode Resources Andrei Gonzales, M.D., bio Groupers Comparison Grid Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    It’s Time to Rethink Coordination of Benefits

    Play Episode Listen Later Nov 30, 2020 23:40


    Up to 1 in 5 insured are covered by more than one healthcare plan. It’s no secret that one plan will often pay more claims than it’s obligated to while another never gets the bill. Health plans typically solve for this problem through provider audits and other post-payment activities, when better coordination of benefits (COB) up-front can prevent the improper payment altogether. But what does “better coordination” mean? Today Phillip Cardona and David Bachert reveal the secrets and impact of better COB. Phillip Cardona is strategy executive for Change Healthcare’s Payer Growth Program. David Bachert is director of Payment Accuracy for Change Healthcare. Here's what they covered: Why health plans pay should direct their attention to COB How coordination of benefits (COB) differ from third-party liability (TPL) Nuances of COB by state and plan type How plans can monitor for other primary coverage The trouble with “pay and chase” and payment recovery How to initiate a coordination of benefits program How to use available data to improve payment accuracy Episode Resources Phillip Cardona’s bio David Bachert’s bio Change Healthcare Payer Growth Program Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Audiobook: Pandemic-Driven Medicaid and ACA Expansion

    Play Episode Listen Later Nov 23, 2020 16:14


    Pandemic-Driven Medicaid and ACA Expansion Impacts and Considerations for Payers By Jimmy Liu and Dan O’Brien Jimmy Liu is vice president of Risk Analytics at Change Healthcare. Dan O’Brien is director for Risk Adjustment Strategy at Change Healthcare. Understanding the full impact of the COVID-19 pandemic on the healthcare industry is not yet possible, but a few outcomes are evident. Medicaid and Affordable Care Act (ACA) enrollment rates are surging alongside the unemployment rate. In addition, postponed procedures and delayed routine services—as well as pent-up demand for elective procedures—will soon drive increased utilization. This report details expected changes in the composition of national Medicaid and ACA member populations, and explores the potential financial consequences of the pandemic on payers. We address the timing of the Medicaid/ACA expansion and provide five immediate, actionable strategies to help payers mitigate challenges caused by the pandemic. Episode Resources Jimmy Liu's bio Dan O’Brien's bio Pandemic-Driven Medicaid and ACA Expansion Risk Adjustment Analytics Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Strategies to Defend Against Ransomware Attacks

    Play Episode Listen Later Nov 23, 2020 26:47


    Ransomware attacks against hospitals are proliferating, in part because the attackers understand the consequences of compromising healthcare finances, patient privacy, and patient safety. With well over 60 known ransomware attacks against hospitals and health systems this year, healthcare leaders need to be thinking about what they can do to protect themselves better. On today’s show, Bob Hoover speaks with John Zuziak about the latest healthcare IT strategies that can help mitigate ransomware attack risk. Today’s show panel features Bob Hoover, VP of Change Healthcare Consulting, and John Zuziak, practice director, IT Risk Management at Change Healthcare. Here’s what they discussed: Why ransomware attacks targeting hospitals are increasing Reasons why hospitals are vulnerable to attack Hospitals and health systems that were attacked this year How ransomware compares with other cybersecurity threats How risk assessment differs for hospitals vs. other businesses How to quantify risk for executive leaders and board members The connection to COVID-19, remote work, and phishing attacks Strategies for preventing and mitigating against ransomware attacks When defenses fail: How to limit ransomware’s impact and recover quickly Episode Resources Bob Hoover’s bio John Zuziak’s bio Change Healthcare Consulting Podcast: Cybersecurity During and After a Pandemic Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Digital Transformation of Healthcare in a COVID-19 World

    Play Episode Listen Later Nov 16, 2020 36:40


    Healthcare's digital experience has lagged other industries. Then came the pandemic. Overnight, digital engagement became a safer way for consumers to find, access, and pay for medical care. Today’s panel looks at how better access to telehealth, and other recent advancements, convinced stakeholders how effective virtual healthcare delivery can be, and how that experience might foreshadow permanent market changes. Today's panel features Change Healthcare's Natalie Lawrence, director of Business Development, and Zayan Khadri, product manager on the Digital Consumer Experience team. Here are the issues they discussed: How the COVID-19 crisis pushed healthcare organizations to prioritize digital transformation The role of telehealth in the future of healthcare Why “touchless” experiences for processes such as patient check-in are now crucial Whether pandemic-induced virtual healthcare delivery will become permanent How healthcare organizations can make routine healthcare experiences resemble the best e-commerce experiences Sources of consumer dissatisfaction and how to address them The impact of the CMS price transparency mandate How to use the mandate as a competitive advantage What tomorrow's healthcare experience should look like Episode Resources Natalie Lawrence’s bio Zayan Khadri’s bio Harris Poll 2020 Consumer Healthcare Experience Index Insights from the Harris Poll 2020 Consumer Healthcare Experience Research Shop Book and Pay Virtual Front Desk Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    CommonWell’s Paul Wilder on Interoperability, Healthcare Policy, and the Pandemic

    Play Episode Listen Later Nov 9, 2020 45:19


    Healthcare interoperability gained increased urgency as a result of the pandemic. The need for public health measures, such as virtual care and contact tracing, showcased progress but also revealed gaps that must be closed. On today’s show, Arien Malec and Deanne Kasim speak with Paul Wilder, executive director of CommonWell Health Alliance, about how interoperability can drive innovation to close these gaps, mitigate compliance risks, and improve capabilities for stakeholders and the consumer experience. Today's panel: Change Healthcare’s Arien Malec, SVP of R&D; Deanne Kasim, executive director, Health Policy; and Paul L. Wilder, executive director of CommonWell Health Alliance. Here's what they explored: The nationwide imperative for universal access to health data for patients, providers, and payers Data interoperability and access gaps that emerged during the pandemic How CommonWell's partnership with Carequality facilitates health data interoperability and portability How a federated system for record retrieval can operate without a central database Where gaps in the healthcare system persist The prospect of increased government regulation Anticipating regulatory requirements Where further regulation might be required to enable broad interoperability Episode Resources Paul Wilder’s bio Arien Malec’s bio Deanne Kasim’s bio CommonWell Health Alliance Carequality Connectivity Change Healthcare Interoperability Solutions Change Healthcare Government Affairs Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Rebuilding Consumer Confidence, with special guest David Betts of Deloitte Consulting

    Play Episode Listen Later Nov 2, 2020 50:43


    Consumer expectations for a seamless digital health experience, coupled with healthcare's response to the COVID-19 pandemic, are accelerating the pace of the industry's digital transformation. On today's show, experts from Change Healthcare and Deloitte Consulting review the results of Deloitte research on COVID-19's impact on the healthcare consumer, along with Harris Poll research that reveals what today's consumer wants in a digital healthcare experience. On today's show, Rick Preston moderates a discussion with panelists David Betts, principal for Life Sciences and Healthcare at Deloitte Consulting, and Bill Krause, vice president and general manager of Digital and Consumer Experience for Change Healthcare. This show was produced as part of the Change Healthcare/Deloitte webinar series, The New Healthcare Essentials: Consumer Engagement, Interoperability, Virtual Care, and the Remote Workforce, which explores the four factors every healthcare organization must address to sustain and grow their business in the post-pandemic era. The panel dives into: Key findings from Deloitte’s survey Research findings, surprises, and expected results The increase in consumer agency Stages of the healthcare journey where consumers are acting with greater agency How well the health system empowered consumers during COVID-19 Healthcare decisions consumers feel confident in making When consumers feel they lack information to make good decisions Types of information missing from consumers’ decision making The healthcare experience consumers really want How healthcare measures up Important opportunities to improve the consumer experience Strategies to ease consumer access to healthcare What prevents change in consumer health behavior How payers can support members by providing a meaningful healthcare experience Viability of a concierge-like experience Role of the CMS price transparency rule in creating a better consumer experience Episode Resources David Betts’ bio Bill Krause’s bio Deloitte Life Sciences & Healthcare Deloitte 2020 Survey of US Healthcare Consumers Change Healthcare - Harris Poll 2020 Consumer Experience Index Rebuilding Healthcare Consumer Confidence webinar replay Digital Patient Experience Communications and Payment Solutions for Payers Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    The Capitol Connection: 2020 Year-End Outlook

    Play Episode Listen Later Oct 26, 2020 28:35


    The election, the COVID-19 crisis, and a Supreme Court case challenging the Affordable Care Act have healthcare leaders on alert. What comes next? On today’s show, Change Healthcare’s Deanne Kasim and Angela Evatt take a look at the current policy landscape through the end of the year, and catch us up on what’s pending in Congress, with Washington regulators, and in the states; and how some of these issues might play out. Today’s panel features Deanne Kasim, executive director, Health Policy, and Angela Evatt, senior manager, Health Policy, for Change Healthcare. They run down: The stalled rescue package—and whether there will there be action in the lame duck session Legislation to enable greater flexibility for data exchange Whether temporary waivers allowing expanded use of telehealth will become permanent New regulations pending with OMB Status of the final CMS Price Transparency Rule for Payers Medicare Advantage developments and the possibility of new prior authorization rules Amy Coney Barrett’s Supreme Court nomination and the ACA What’s next for Congress State reopening and vaccine distribution plans State budgets and possible Medicaid budget cuts State data privacy and telehealth initiatives Elections and key races to watch Episode Resources Deanne Kasim's bio Angela Evatt's bio State Actions to Close Budget Shortfalls in Response to COVID-19 Telehealth Legislation & Regulation Change Healthcare Government Affairs Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    The Outlook on Electronic Prior Authorization, with special guest April Todd of CAQH

    Play Episode Listen Later Oct 19, 2020 33:18


    It’s no secret that achieving fully electronic prior authorization is a challenge, but the potential upside is tremendous—to the tune of $454 million in savings, according to the 2019 CAQH Index Report. On today’s show, Andrew Johnson meets with our special guest from CAQH, April Todd, to shed light on areas around prior authorization that remain the most challenging, the benefits of transitioning to an automated workflow, and efforts underway to speed adoption of electronic prior auth. Today’s panelists are Andrew Johnson, vice president of Electronic Prior Authorization Solutions for Change Healthcare, and April Todd, senior vice president for the CAQH, a non-profit alliance creating shared initiatives to streamline the business of healthcare. They unpack: The purpose and role of the CAQH CORE (Committee on Operating Rules for Information Exchange) Why prior authorization is a challenge for payers and providers Update on alignment between industry standards bodies, including CAQH, WEDI, and HL7 Da Vinci Which areas of healthcare are furthest along in adopting electronic prior authorization CAQH’s latest research on the cost of manual versus automated transactions How electronic prior authorization drives better patient care and reduces costs Building blocks of an ideal prior authorization workflow Steps Change Healthcare and CAQH are taking to advance electronic prior authorization How COVID-19 is affecting adoption Timeline for shifting prior authorization into a fully automated process How listeners can support electronic prior authorization advancement Episode Resources April Todd’s bio Andrew Johnson’s bio CAQH website CAQH Index CAQH Core The "Intelligent" 278: Creating a Standard for Shared Decision Support InterQual Connect How InterQual Connect works Automation and Appropriate Care Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

    Bringing Clinical Decision Support to Imaging to Assure PAMA Compliance

    Play Episode Listen Later Oct 12, 2020 37:55


    The Protecting Access to Medicare Act (PAMA) requires providers to consult a clinical decision support mechanism when ordering advanced imaging tests. While the CMS has extended the PAMA compliance deadline to Jan. 1, 2022, some providers–such as St. Charles Health System–are wasting no time to ensure compliance. Samantha Waldrop and Elizabeth Zobel join Nick Geyer to share how St. Charles implemented imaging clinical decision support (CDS), including their goals, challenges encountered, their approach, and the results. Nick Geyer, product marketing manager at Change Healthcare, leads a discussion with Samantha Waldrop, applications analyst at St. Charles Health System, and Elizabeth Zobel, senior customer success strategist at Change Healthcare. Here what they talked about: Overview of PAMA Requirements around imaging Clinical Decision Support (CDS) Impact of PAMA on St. Charles How St. Charles evaluated imaging CDS options Why St. Charles decided to work with Change Healthcare How St. Charles defined implementation goals, plan, and timeline Team members involved How the rollout went Challenges encountered during the rollout and how St. Charles addressed them Impact of the new imaging CDS on providers and workflows Methods to drive CDS training and adoption Issues around providers using free text vs. structured indications Radiologists’ reaction to the new system CDS usage levels at St. Charles Next steps for St. Charles’ CDS roadmap Implementation lessons learned Advice for other healthcare providers on complying with PAMA and implementing imaging CDS Benefits of imaging CDS, beyond PAMA compliance Episode Resources Samantha Waldrop’s bio Elizabeth Zobel’s bio Nick Geyer’s bio Your PAMA Questions Answered The New PAMA Math Laboratory Data Key to Overcoming Medicare Cuts Aligning the Lab with the Hospital’s Strategic Priorities Predicted Indications (AI) in CareSelect Imaging CareSelectTM Imaging CareSelectTM Imaging – AI Indication Selection Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

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