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What if the fastest way to grow your healthcare organization is to slow down? In this episode of The Disrupted Podcast, Scott Middleton returns from Scotland straight into the thick of a merger — and what he's learning is reshaping how he thinks about change itself. Scott takes us inside the integration of TCPA and Providence Care into Your Health, where two very different models are colliding. One organization built 640 billing codes last year; the other built 40. One puts a single nurse practitioner in a building with no support; the other surrounds providers with nurses and community health workers. The opportunity is enormous — but so is the risk of moving too fast and scaring everyone away. What if the fastest way to grow your healthcare organization is to slow down? In this episode of The Disrupted Podcast, Scott Middleton returns from Scotland straight into the thick of a merger — and what he's learning is reshaping how he thinks about change itself. Scott takes us inside the integration of TCPA and Providence Care into Your Health, where two very different models are colliding. One organization built 640 billing codes last year; the other built 40. One puts a single nurse practitioner in a building with no support; the other surrounds providers with nurses and community health workers. The opportunity is enormous — but so is the risk of moving too fast and scaring everyone away. In this conversation, Jamie and Scott explore: Why a nurse practitioner alone is a "single source of failure" — and how staffing changes everything How to enter a building without threatening the provider they already love Why billing isn't bureaucracy — it's how Medicare knows you made a difference The art of giving people what they think they need now, and the rest over time Advanced care planning, DNRs, and why the right message sometimes needs a different voice This is a masterclass in change management disguised as a healthcare conversation. Listen now — and rethink what "disruption" really requires. Why a nurse practitioner alone is a "single source of failure" — and how staffing changes everything How to enter a building without threatening the provider they already love Why billing isn't bureaucracy — it's how Medicare knows you made a difference The art of giving people what they think they need now, and the rest over time Advanced care planning, DNRs, and why the right message sometimes needs a different voice This is a masterclass in change management disguised as a healthcare conversation. Listen now — and rethink what "disruption" really requires. www.YourHealth.Org
This episode of Quality Matters examines the growing role of digital wellness and chronic condition management programs and the challenge of measuring what truly matters. Host Rachel Harrington is joined by Peter Robertson of the Purchasing Business Group on Health and California Quality Collaborative and Kevin Masci of Omada Health to discuss how digital health solutions can help address rising healthcare costs, workforce shortages and fragmented care experiences. Peter and Kevin explain why meaningful engagement goes far beyond app downloads and login counts. Instead, successful programs focus on sustained participation, patient-centered goal setting, integration with primary care and measurable improvements in health outcomes. The conversation explores how employers, health plans and providers are evaluating digital solutions through clinical outcomes, patient-reported outcomes, utilization measures and value-based contracting arrangements. The guests also discuss one of the most important challenges facing digital health: trust. Privacy, transparency, data security and clear communication about how patient data is collected and used all play critical roles in long-term adoption. The episode concludes with a Patient Voice segment featuring Brandee Hicks, who shares her firsthand experiences using digital health tools, highlighting both the convenience they offer and the ongoing challenges around interoperability, digital literacy and maintaining support after programs end. Highlights Beyond Logins and Clicks Meaningful engagement isn't about how often patients open an app. It's about helping people achieve their health goals through sustained participation and measurable outcomes. Measuring What Matters Guests discuss the growing use of clinical outcomes, patient-reported outcomes, utilization data and value-based contracting to assess digital health program performance. Trust Is Essential Digital health solutions must address concerns around privacy, transparency, data security and how patient information is stored and shared. The Patient Perspective Brandee Hicks shares how digital tools can improve organization, access and self-management while also revealing gaps in continuity, support and interoperability. Looking Ahead The future of digital health depends on better integration with primary care, more personalized engagement strategies and stronger measurement frameworks that prioritize patient outcomes. Key Quote: "If we're really serious about improving health outcomes, we have to move beyond measuring clicks and logins. The real question is whether people are achieving meaningful progress toward their health goals—and whether these programs are creating lasting value for patients, providers and purchasers alike." — Kevin Masci Time Stamps: (02:20) Meet Peter Robertson (03:45) Meet Kevin Masci (05:53) Why Digital Solutions Matter (10:01) Care Coordination, Not Care Fragmentation (11:52) Defining Meaningful Patient Engagement (15:07) Why Consistent Measurement Matters (18:32) Measuring Outcomes in Value-Based Contracts (21:12) Data Stratification, Risk Adjustment and Performance Guarantees (27:22) Privacy, Trust and Transparency in Digital Health (30:44) The Future of Digital Wellness and Chronic Care Management (35:08) Patient Voice: Brandee Hicks (40:25) Patient Challenges, Access and Continuity of Care (45:23) Key Takeaways and Closing Thoughts Dive Deeper: Connect with Peter Robertson Connect with Kevin Masci Connect with Brandee Hicks Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
It was 3 o'clock in the morning when Scott Middleton finally signed the papers. The merger was official. And within days, he was already on the road — visiting facilities, riding along with providers, and spotting the same gap everywhere he went: brilliant clinicians doing real work that was completely invisible to the system. In this episode of The Disrupted Podcast, Jamie sits down with Scott Middleton, calling in from Boston, to unpack what he's discovering on the ground in the newly merged Your Health organization — and why tracking your time isn't about paperwork. It's about protection, proof, and getting paid for every minute of care you're already delivering. What you'll hear in this episode: The Dr. Jeeve story: a high-producing doc who managed a nursing home crisis by phone, saved a patient from an unnecessary ER visit — and never billed for it, leaving Medicare with no record of his intervention Why not documenting a visit before a hospitalization doesn't just cost you revenue — it makes you look like a bad provider, even when you did everything right How insurance companies like United Healthcare boldly take 15% off the top of every healthcare dollar — and why that math means providers can't afford to give their time away for free The TCPA pattern Scott keeps seeing: 15,000–18,000 visits a month, almost entirely in nursing homes, with zero follow-up once patients go home The new post-discharge standard: every patient leaving a nursing home gets a telehealth visit within 48 hours, then weekly follow-up for four weeks — no one gets left in the gap This episode is a masterclass in understanding that documentation isn't bureaucracy — it's how you tell your story, protect your reputation, and keep the care you've already given from disappearing. www.YourHealth.Org
What does it actually cost when a doctor writes a verbal order over the phone instead of seeing the patient? Scott Middleton has the receipts — and the answer is going to make you rethink everything about how American healthcare spends its money. In this episode of The Disrupted Podcast, Scott announces a landmark three-way merger bringing Your Health together with Transitional Care Professionals of America (TCPA) out of Georgia and Providence Care, a hospice organization in South Carolina. The combined organization will serve approximately 55,000 active patients — not patients on a list, but people being seen regularly — and Scott lays out exactly how he's going to run it. What you'll hear in this episode: Why Scott's family owning 80% of the merged company changes everything about how decisions get made — and who they get made for The difference between fee-for-service and value-based care, and why the ACO model means every unnecessary hospitalization literally comes out of Your Health's pocket How Your Health's risk-adjustment-based visit model (16 visits per year per risk point) was independently validated by a new government study — and why it works The three things Scott is asking every new employee to do in the first weeks: align with a nurse practitioner, track every minute of care management, and recruit like their livelihood depends on it — because it does Why Scott's new management philosophy is six words: "Keep them out of the hospital and see your damn patients" This isn't a corporate announcement. It's a playbook for how healthcare can actually work when operators run the company, providers see their patients, and every minute of care gets counted. www.YourHealth.Org
Most healthcare organizations wait until they're drowning to add administrative support. Your Health is doing the opposite — and it's changing the math on what a primary care practice can actually deliver. In Part 1 of this two-part conversation, Scott Middleton — owner of Your Health, founder, and Chief Disruption Officer — sits down with Jamie Preston to unpack why a dedicated administrator is now sitting beside the executive director of clinical services at every care group. With hospice added to the model, a single care group can now be responsible for more than 80 staff members across four care teams — bigger than most medical organizations in the country. Asking a nurse to run that alone was breaking people and burying clinical judgment under scheduling concerns. In this episode: Why the care group exploded overnight — and what hospice changed about staffing ratios What the administrator does on Monday morning before the clinical team even looks at the dashboard The Bridget story: how a "we're not allowed to do one-on-ones" response nearly cost a dementia patient her home Why "what could we have done today" is the wrong question — and what to ask instead How fee-for-service quietly incentivizes the wrong decisions at the hospital level The team structure every administrator now sits inside: nurse, HR, marketing, engagement If you've ever wondered what's actually supposed to stand between a great clinician and burnout, this is it. www.YourHealth.Org
What if the people case-managing your care had a financial reason to keep you sicker? That's the uncomfortable question Scott Middleton puts on the table in this episode — recorded live from the American Case Managers Conference in Orlando, where Scott went to learn, and ended up being told Your Health didn't "fit" because they weren't a hospital. Jamie and Scott unpack what the nurse case manager role actually looks like at Your Health — and why moving case management out of hospitals and into patients' homes isn't just better care, it's better economics. Scott shares the research proving the model works: 50% reduction in Medicare spend when patients are seen at the right frequency by the right people. In this episode: Why hospitalists may be "the demise of the American healthcare system" The difference between nurse practitioners (diagnose and treat) and nurse case managers (assess and guide) — and why blurring them costs patients The 16.05-visits-per-risk-point model David Clemens' research validated How coding departments are quietly diagnosing patients with diseases they don't have Why Medicare's 6-year insolvency window may be the disruption we need Head-to-toe assessments, delegation rights, and the real job of an RN in the home If you've ever suspected the system is working exactly as designed — just not for the patient — press play. www.YourHealth.Org
What if the reason healthcare teams burn out isn't the workload — it's the org chart? On this episode of The Disrupted Podcast, Jamie and Scott, break down the evolution of The Care Group Model — and why the instinct to build a "separate hospice team" is exactly the wrong move. Scott walks through what a true care team looks like when nurse practitioners, nurses, community health workers, social workers, chaplains, and triage nurses are orchestrated around the patient — not siloed around a diagnosis. Inside the episode: Why adding hospice to existing care groups beats building a parallel hospice division The new non-clinical "administrator" role Your Health is rolling out — and why every nurse needs one at their side Using DISC assessments to build teams that actually function (and why nurses aren't the same personality type) How mutual accountability and group-based bonuses fix the "don't bill too much CCM" problem Why matching a chaplain to a patient's faith tradition matters more than checking the box The $110 million Medicare savings story the industry still doesn't understand If you lead a clinical team, run an operation, or care about what healthcare could look like when it's built around people instead of paperwork — press play. www.YourHealth.Org
Most organizations put "Collaboration" on a wall. Few actually live it — and in healthcare, the cost of not living it isn't a missed deadline. It's a missed patient. In the first episode of Your Health University's brand-new Most organizations put "collaboration" on a wall. Few actually live it — and in healthcare, the cost of not living it isn't a missed deadline. It's a missed patient. In the first episode of Your Health University's brand-new Our Values Series, host Jamie Preston gathers four members of Your Health's patient experience team — Rebecca Dillard (VP of Organizational Experience), Jennifer Kessler (Division President of Product), Whitney Myers (Senior Solutions Advisor), and Carlos Hayward (Business Office Manager) — for an unfiltered conversation about what genuine collaboration looks like inside a fast-moving, mission-driven healthcare organization. No theory. No platitudes. Just the real, messy, mundane, and occasionally remarkable daily practice of people choosing to work together when it would be easier to go it alone. What you'll hear in this episode: Why real collaboration means recognizing what the person next to you brings that you simply cannot replicate — and building toward that, not around it The true story of a patient found living in an RV without his medication — and how cross-team collaboration made the difference between crisis and care Where collaboration most commonly breaks down in healthcare settings, and the small documentation and communication habits that prevent it The one question — "How can I do my job differently to make yours better?" — that builds trust across departments faster than almost anything else The daily habits these four healthcare professionals actually practice to keep collaboration alive, from weekly team check-ins to learning someone's preferred communication style before you assume Collaboration isn't a value you perform. It's a choice you make — one conversation, one phone call, one honest mistake admitted at a time. Values Series, host Jamie Preston gathers four members of Your Health's patient experience team — Rebecca Dillard (VP of Organizational Experience), Jennifer Kessler (Division President of Product), Whitney Myers (Senior Solutions Advisor), and Carlos Hayward (Business Office Manager) — for an unfiltered conversation about what genuine collaboration looks like inside a fast-moving, mission-driven healthcare organization. No theory. No platitudes. Just the real, messy, mundane, and occasionally remarkable daily practice of people choosing to work together when it would be easier to go it alone. What you'll hear in this episode: Why real collaboration means recognizing what the person next to you brings that you simply cannot replicate — and building toward that, not around it The true story of a patient found living in an RV without his medication — and how cross-team collaboration made the difference between crisis and care Where collaboration most commonly breaks down in healthcare settings, and the small documentation and communication habits that prevent it The one question — "How can I do my job differently to make yours better?" — that builds trust across departments faster than almost anything else The daily habits these four healthcare professionals actually practice to keep collaboration alive, from weekly team check-ins to learning someone's preferred communication style before you assume Collaboration isn't a value you perform. It's a choice you make — one conversation, one phone call, one honest mistake admitted at a time. www.YourHealth.Org
A man is dying — literally in his last hour, the death rattle audible — and the hospital team arrives to take him for a radiation treatment. His family had no idea. No one had told them. No one had started the conversation. This is not a rare exception. This is what happens when social services is treated as an afterthought. In this episode of The Disrupted Podcast, host Jamie Preston and Scott Middleton, Owner and Chief Disruption Officer of Your Health, go deep on one of the most overlooked levers in healthcare — social services. From the social determinants that drive healthcare costs more than healthcare itself, to the care team structures Your Health is building to close the gap, this is a candid, unfiltered look at what's broken, what's possible, and what it actually costs when we don't act. What you'll hear in this episode: Why social determinants of health — food access, medication literacy, housing instability, social isolation — are the real drivers of healthcare spending, and why most systems still ignore them The truth about advanced care planning: why it's quietly dropping, why every patient within two to three years of death needs that conversation, and the story of Janet Denino's cousin that makes the cost of silence impossible to ignore How the mental health stigma is shifting generationally — and how telehealth, AI-assisted tools, and a smarter therapy cadence are changing who actually gets support The billing math behind 280,000 possible care management hours that were built down to 110 — and why that gap isn't just a business problem, it's a human one What it actually takes to build a social services program that works: the right roles, the right ratios, and why getting out to see patients is non-negotiable The system won't fix itself. But the people in it can. This episode shows you how. www.YourHealth.Org
In this episode of The Disrupted Podcast, Jamie and Scott have a raw, specific, and deeply personal conversation about Care Managers: who they are, what they're actually supposed to do, and why getting this role wrong is costing patients their health and organizations millions of dollars. Scott opens with a story that hits hard: his 91-year-old father's recent hospitalization, the mistakes that nearly happened, and what it cost him — financially and emotionally — to navigate a system that wasn't built for the patient. What you'll hear in this episode: Why care managers are controllers, not schedulers — and what happens when organizations get that wrong The medication reconciliation crisis: how discharge errors are sending patients straight back to the ER How Your Health's new geographic mapping tool is transforming how care teams schedule 30 days of visits in advance The shared bonus model designed to stop care team members from fighting over visits — and start winning together What care managers should never be doing — and the analytical skill set that separates great ones from average ones If you're building care teams, leading a healthcare organization, or just trying to keep a loved one safe in a broken system, this episode will change how you think about the people standing between your patients and the hospital. www.YourHealth.Org
What if the most powerful person on your care team isn't a nurse, a doctor, or a specialist — but someone showing up at 8:00 AM to check blood pressure, eat lunch with residents, and play vital signs bingo? In this episode, we go deep on the Community Health Worker role: what it is, what it isn't, and why most organizations are dramatically underusing it. Scott pulls no punches on the disconnect between what CHWs are doing and what they should be doing — and why the difference is costing patients their health and workers their bonuses. What you'll hear in this episode: Why the #1 complaint about CHW visits ("you're seeing our patients too much") is actually a communication failure, not a frequency problem — and how to fix it The specific visit types every community health worker should be scheduling: vital signs, medication reconciliation, lab draws, wound care, advanced care plans, and more How Mary White, a CHW in Gainesville, Georgia, goes in with 5 patients on her list and leaves having seen 15 — and what her approach reveals about what this role is really for Why buildings that aren't growing have either the wrong person or not enough people — and how to think through both The full compensation breakdown: base salary, guaranteed bonus, and how the right CHW can earn close to $80,000 a year If you hire, manage, or are a community health worker, this episode will reshape how you think about the role. Hit play. www.YourHealth.Org
Chronic conditions don't collapse all at once — they erode slowly, in the silence between appointments. Understanding how CCM and RPM interrupt that process might be the most important thing a provider reads this year.Learn more: https://ccmrpmhelp.com/contact CCM RPM Help City: Herriman Address: 12953 Penywain Lane Website: https://ccmrpmhelp.com/ Phone: +1 866 574 7075 Email: brad@ccmrpmhelp.com
In this episode, Jamie and Scott discuss a simple leadership posture that changes outcomes: default to “yes” when it protects patients—then solve the obstacles. Scott shares real examples from winter-storm outreach, hospice and palliative care misconceptions, and operational “rules” that block care (often driven by language, software, or habit—not true limitations). They dig into how patient-centered thinking, clearer communication (ditch the acronyms), and smarter systems—like a new mapping tool—can drive more visits, better coordination, and better results. www.YourHealth.Org
Most senior care facilities choose between Remote Patient Monitoring and Chronic Care Management, but the real breakthrough happens when you use both together. The data tells one story while human coordination tells another—residents need both to truly thrive.Learn more: https://ccmrpmhelp.com/contact CCM RPM Help City: Herriman Address: 12953 Penywain Lane Website: https://ccmrpmhelp.com/ Phone: +1 866 574 7075 Email: brad@ccmrpmhelp.com
Healthcare leaders are discovering how Remote Patient Monitoring transforms chronic care management by eliminating workflow chaos, cutting hospital readmissions, and letting clinical teams actually focus on patient care instead of endless administrative tasks that drain time and resources.Learn more: https://ccmrpmhelp.com/contact CCM RPM Help City: Herriman Address: 12953 Penywain Lane Website: https://ccmrpmhelp.com/ Phone: +1 866 574 7075 Email: brad@ccmrpmhelp.com
In this episode of The Disrupted Podcast, Scott Middleton returns from the JP Morgan healthcare conference with a blunt takeaway: the future of care is not a magic pill, another telehealth platform, or a clever financial structure — it's showing up. Scott breaks down why healthcare has become unnecessarily complicated, how fee-for-service incentives distort decision-making, and why “easy-entry” models won't hold up long-term.He makes the case that Your Health's home-based care model is hard to replicate because it requires operational excellence—routing, scheduling, team coordination, and intentional touchpoints. Scott also challenges internal culture issues: finger-pointing, poor communication, inefficient scheduling, and employees misunderstanding the mission. The solution is both simple and demanding: build systems that make weekly in-person encounters possible for high-risk patients and hold the line on execution. www.YourHealth.Org
In this first Disrupted Podcast episode of 2026, Jamie and Scott unpack the reality of a new “High Needs ACO” and what it demands from frontline care teams. Scott explains why spending more in primary care reduces total cost, how care management codes are expanding, and why the real win is keeping patients out of the hospital through proactive, consistent engagement.The centerpiece is a clear operational playbook for facilitated visits: facilitators gather the full story in the home or facility, loop in the provider through audio/video when possible, document in the system, and never delete encounters—because billing isn't just revenue, it's the data trail that proves prevention works. The conversation closes with the bigger picture: this isn't a workflow tweak—it's a way to reduce hospital dependency, protect families, and help stabilize the healthcare economy. www.YourHealth.Org
Key TakeawaysEveryone can be an investigator: Observing subtle changes in behavior, sleep, decision-making, or life management can reveal early signs of behavioral health needs.Integration matters: Combining behavioral and physical health care improves outcomes, prevents avoidable hospital visits, and reduces overall healthcare costs.Impact beyond the patient: Supporting behavioral health has ripple effects on families, caregivers, and communities, improving overall system well-being.Life transitions are critical points: Changes in living situations, cognitive decline, or significant life events are opportunities for early intervention.Collaboration is key: Cognitive behavioral specialists, nurses, primary care providers, and facility staff must work together to ensure timely and effective care.Innovation brings hope: Emerging research, new care models, and broader conversations about mental health as part of overall wellness are reshaping healthcare for the better. www.YourHealth.Org
Discover why thousands of dollars slip through your practice every month while you're already doing the work. The consent process, documentation traps, and billing codes that separate successful CCM programs from failed attempts are simpler than you think.Learn more: https://ccmrpmhelp.com/contact CCM RPM Help City: Herriman Address: 12953 Penywain Lane Website: https://ccmrpmhelp.com/ Phone: +1 866 574 7075 Email: brad@ccmrpmhelp.com
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 15 features a Newsworthy update on the OIG Work Plan for November 2025.Sonal's Trusty Tip and compliance recommendations focus on chronic care management documentation.Spark inspires us all to reflect on resilience based on the inspirational words of Edmund Hillary.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
KEY TAKEAWAYSThe new ACO model increases funding for high-risk Medicare patients but requires disciplined execution.Visits — frequent, short, meaningful ones — are the #1 driver of reduced hospitalizations and better outcomes.The target is four visits per patient per month for those with a 2.4–2.8 risk score.Current numbers show only 2.5 visits per patient per month — leaving savings and outcomes on the table.Facilitators are essential: their job is to start conversations, gather information, and initiate telehealth visits.Notes, Mobius recordings, and consistent communication make providers more effective over time.Small, weekly touchpoints outperform long, infrequent visits in both outcomes and cost savings.Every team member plays a role in preventing hospitalizations and improving patient stability. www.YourHealth.Org
Pharmacists spend hours counseling patients on medications and chronic conditions without earning a dime for this clinical work. Remote Patient Monitoring and Chronic Care Management partnerships with physicians transform these unpaid daily activities into steady monthly revenue streams.Learn more: https://ccmrpmhelp.com/contact CCM RPM Help City: Herriman Address: 12953 Penywain Lane Website: https://ccmrpmhelp.com/ Phone: +1 866 574 7075 Email: brad@ccmrpmhelp.com
Key Takeaways (for on-air recap & social)Presence prevents: Being in the building daily beats any remote administrative stack.Rituals > heroics: Small, repeatable actions (exercise + vitals + lunch checks) compound.Caregivers stabilize: A modest weekly schedule creates 40 hours of reliable on-site support.Therapy cadence matters: Spread the care; keep people moving longer to reduce falls.Document to decide: Specific behavioral notes → faster NP decisions → fewer crises.Mission creates growth: Aligning to “no hospitalizations” reduces noise and increases referrals. www.YourHealth.Org
Key Topics:How sudden insurance and policy changes disrupt patients and providersThe importance of prevention and primary care in lowering long-term costsWhat fully staffed care teams look like and why they matterBalancing productivity and patient-centered careWhy disruption is necessary for a healthier futureTakeaway: Healthcare continues to be shaped more by profit and red tape than by prevention and patient outcomes. But with innovative care models and a relentless focus on what patients truly need, leaders can shift the system toward better health and lower costs. www.YourHealth.Org
Episode NotesWhat Health Connectors are and why they matter.The danger of a provider-centered workflow—and how to avoid it.Real examples of how proactive home visits catch problems early.Why vital signs can be the key to preventing 50% of heart attacks.The culture shift needed: salaried roles with responsibility, not clock-in/clock-out mindsets.Scott's challenge to all healthcare workers: “Go see your damn patients.” www.YourHealth.Org
Welcome back to Ditch the Lab Coat! In this episode, host Dr. Mark Bonta sits down with Dr. William Cherniak, an emergency physician, global health leader, and CEO of Rocket Doctor—a Canadian tech company on a mission to shake up how we access healthcare. As the world continues to grapple with the lessons learned from COVID-19, Dr. Cherniak and Dr. Bonta dive deep into the evolution of virtual care and its role in both episodic and chronic healthcare.Together, they challenge the misconceptions around virtual medicine, exploring how digital innovation is not just a convenient alternative but often a superior solution for patients who need fast, efficient, and ongoing medical attention. From navigating Canada's complex healthcare policies to leveraging AI and Bluetooth-enabled devices, Dr. Cherniak shares his journey as a physician-entrepreneur working to make healthcare more accessible—whether you're managing blood pressure from your living room or urgently treating poison ivy without a trip across town.Tune in as we unravel the myths of hands-on-only healthcare, the future possibilities of remote diagnostics and procedures, and what it will take for medicine to truly enter the 21st century. If you're curious about how virtual care is changing the patient-doctor relationship, cutting through red tape, and building a compassionate, tech-savvy future, this is an episode you can't miss.(https://www.linkedin.com)(http://rocketdoctor.io/)Episode Lessons 1 – Virtual Care Is Effective – Virtual healthcare can match or even surpass in-person care for many conditions, especially when accessibility is an issue.2 – Breaking Down Healthcare Barriers – Virtual care improves access for patients struggling with long waits or limited transportation to clinics.3 – Episodic vs. Chronic Care Needs – Healthcare isn't just for chronic patients; episodic care can be efficiently managed through modern virtual models.4 – Innovation Born From Necessity – Rocket Doctor's creation was driven by gaps in primary care, especially for those without family doctors.5 – Team-Based Medical Support – Virtual platforms enable teams of physicians to support each other, ensuring continuity even when one doctor is away.6 – Navigating Bureaucracy and Policy – Different provinces and health systems determine how virtual care can be provided and reimbursed, affecting implementation.7 – Seeing Beyond Clinic Walls – Virtual visits provide unique insights into patients' home and social environments, revealing valuable context for care.8 – Tech Empowers Doctors and Patients – Electronic records, AI tools, and Bluetooth devices streamline tasks, allowing more focus on patient care and faster follow-up.9 – Busting Medical Tradition Myths – Not every visit needs physical examination; much required care can be accurately delivered without in-person touch.10 – Envisioning Healthcare's Future – Real integration of AI, seamless records sharing, and patient-driven portals will further revolutionize how care is delivered virtually.Want me to bold all the lesson titles for consistency, or keep only the last one bold as the highlight?Episode Timestamps00:00 – Medical Podcast Disclaimer 05:28 – Reimagining Virtual Care in Canada 08:04 – Canadian Tech-Driven Medical Practice 11:54 – Bureaucratic Challenges in Healthcare 13:39 – Embracing Virtual Healthcare 19:53 – Virtual Care: Beneficial vs. In-Person 20:54 – Canada's Acute vs. Preventative Care 26:14 – Virtual Care Evolution 2019 30:08 – Healthcare Innovation and Streamlining 32:59 – Home Ultrasound Study for Pneumonia 35:40 – Virtual Care: Medicine's Evolution 37:42 – Science Skepticism Podcast Promo DISCLAMER >>>>>> The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions. >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests. Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.
Episode NotesScott shares a story about meeting a compliance pharmacist who unexpectedly became the solution to a major organizational challenge.The importance of pharmacy compliance and direct-to-manufacturer drug purchasing.Why God's timing plays a role in healthcare growth and leadership decisions.The danger of miscommunication across facilities and how to “season” a team for long-term effectiveness.How leaders can emerge from any position — from providers to CNAs to medical assistants.Why job descriptions must be clear, but leadership requires flexibility. www.YourHealth.Org
Sometimes, patients need help with the simpler things, like scheduling appointments with their medical professionals. Other times, they may need assistance with something that is more involved - like accessing home health or medical equipment.In this episode of Oaklawn Health Matters, Oaklawn Medical Group Executive Director Zach Chapman discusses how the CareHarmony partnership helps Oaklawn chronic care patients proactively tend to their health care needs.Episode ResourcesOaklawn Care ManagementAbout OaklawnOaklawn was founded in 1925 as a 12-bed hospital in a residential home, funded by a group of visionary philanthropists. Now, almost ten decades later, we've evolved into a highly regarded regional health care organization, licensed for 77 acute care beds and a 17-bed inpatient psychiatric unit. We've continued to be an independently owned not-for-profit hospital, with our main campus residing on the same site as the original hospital, providing facilities, equipment and technology that are usually only found at larger health systems. We enjoy a reputation for advancing medicine and providing compassionate, personal care. Our service area includes Calhoun County and parts of Branch and Eaton counties with a medical staff of more than 300 providers representing over 55 specialties. For information, visit www.oaklawnhospital.org.Oaklawn Health Matters is produced by Livemic Communications.
On this episode Justin invites Matt Ethington, CEO of ChronicCareIQ, a company that provides a care management platform designed to improve patient outcomes, optimize reimbursement, and strengthen patient-physician relationships. Justin and Matt discussed the evolution and opportunities in chronic care management, highlighting its growing adoption, financial potential, and role in transitioning to value-based care. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
Chronic care management and remote patient monitoring are essential tools for addressing physician shortages, improving patient access, and enabling value-based care. In this episode, Mark Whittington, Managing Director at HealthXL, discusses how his organization is driving change in healthcare by focusing on chronic care management and remote patient monitoring (RPM). He emphasizes that these programs can help patients stay healthy longer, improve their quality of life, and reduce the burden on primary care physicians. Mark also highlights the importance of patient engagement, accountability, and a collaborative partnership between practices and their chronic care management/RPM provider for successful implementation. Finally, he touches on the emerging role of AI in gleaning insights from patient data to predict and prevent health issues. Tune in and learn how HealthXL is leveraging chronic care management and RPM to revolutionize healthcare! Resources: Connect with and follow Mark Whittington on LinkedIn. Learn more about HealthXL on their LinkedIn and website. Email Mark directly here.
In this episode of AFSPA Talks, we continue our conversation from Annual Meeting about weight loss, cardiovascular health, and diabetes management. Today's focus is on Chronic Care Management Programs. To tell us more about those programs, we have Grace Silverio from Teladoc Health. For more information about the Chronic Care Management Programs available to Foreign Service Benefit Plan members at NO COST, click here.If you have questions about these programs, join AFSPA Live, our live Q&A session, on Thursday, April 24, 2025, at 11 AM ET. If you would like to submit a question in advance, fill out this form.
This week their guests are Mike Hoxter, Chief Technology Officer, and Briana Rodriguez, RN, BSN, the Director of Clinical Programs at Lightbeam Health Solutions, specializing in Chronic Care Management, Transitional Care Management, Remote Patient Monitoring and Annual Wellness Visits. The company builds customized operational solutions to align ancillary care teams as seamless members of their partners' value-based care goals. They discuss: empowering ACOs, predictive analytics in population health, closing care gaps, reducing healthcare costs, and the future of value-based care. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
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About Mark Whittington:Mark Whittington is the Managing Director at HealthXL, a company focused on improving healthcare outcomes for patients with chronic conditions through chronic care management and remote patient monitoring. Mark is passionate about helping people stay healthy longer and improving their quality of life, especially those in vulnerable stages of their health journey.Things You'll Learn:Chronic care management and RPM can alleviate the burden on primary care physicians, allowing them to focus on patients who need face-to-face care while managing routine cases remotely.Devices used for remote patient monitoring (blood pressure cuffs, pulse oximeters, etc.) should be simple and familiar. Accountability and consistent use are the most critical factors for success.Transparency and communication with patients through various channels (devices, texting, apps) will improve patient engagement and access to care.AI has the potential to glean insights from patient data, predict health issues, and enable earlier interventions, ultimately improving patient outcomes.Chronic care management and RPM are key components of value-based care. They enable providers to proactively manage patient health and prevent costly complications.Resources:Connect with and follow Mark Whittington on LinkedIn.Learn more about HealthXL on their LinkedIn and website.Email Mark directly here.
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In this episode, BerryDunn experts Robyn Hoffmann, Natalie Laaman, and Olga Gross-Balzano discuss Chronic Care Management (CCM) services in Medicare and what your organization needs to be audit-ready. You'll hear a quick overview of Medicare practice requirements with detail on who can provide Chronic Care Management, how to oversee contractor's deliverables, whether CCMs can be provided by a contractor who is outside of the United States, how to handle new patients (or those not seen in a year or more,) and how to prepare and respond to a post-payment audit.
In this exciting kickoff to 2025, Jamie sits down with Your Health CEO Matt Staub to discuss the organization's latest groundbreaking initiatives. From the expansion of the Community Health Integration (CHI) program to the launch of a new Durable Medical Equipment (DME) division and a return to hospice care, Your Health is reshaping the way healthcare is delivered. They also dive into the organization's expansion into Florida, how healthcare is moving beyond the four walls of a hospital, and why integrated care teams are the future. Tune in for an insightful conversation about the future of patient-centered care and how Your Health is leading the charge!
So as you are well aware, at CHESS we often refer to the seven pillars of value-based care. What are these pillars and how does each impact fee-for-value? So, we've tended to use these pillars, if you will, to think about the process. Really, it follows our implementation process in many ways. So, I would start with practice transformation. So, that involves ensuring that physicians, advanced practice providers, office staff from CMA to nurses to even front desk staff, has some awareness of value-based care, understand why it is important, and then are engaged in the process of transforming that practice to a infrastructure that supports the delivery of the value-based care models and success in those models, both clinically, which is ultimately what this is really all about, and financially.From there, you can begin to layer on other services or pillars if you will. These don't necessarily have to happen in this order, but we often start with thinking about quality. Most organizations today have some quality efforts already in place just due to primarily to the fact that CMS and other payors are pushing those. And most people have at least some pay-for-performance type of arrangements, where they're paid for closing quality care gaps. But quality goes beyond just thinking about closing quality care gaps. For our quality team, we're thinking about optimizing the annual wellness visit so that the template within the EMR is just capturing data points and discrete fields. That makes reporting easier back to CMS as well as to the private insurance companies, Medicare Advantage, as well as commercial.We think about Care Coordination and as we define care coordination, that includes, for our teams, nurses and CMAs. They work together to assist also in quality. So, the CMAs help close quality care gaps throughout the year. They schedule annual wellness visits, that's a big emphasis in the first half of the year. If you can already tell, that annual wellness visit is a key component of value-based care because it touches on so many different elements of value. The other role for Care Coordination would be moving with that patient, tracking that patient, outreaching the patient between transitions of care. So, patient is admitted to the hospital, discharged to the skilled nursing facility, then discharged home. Our Care Coordination teams are monitoring that patient as they transition through those different sites of service and ensuring that each transition is as safe as possible. We all know that medication errors, in particular, are a massive problem through transitions of care. So, ensuring that patients know what medications they're taking, or supposed to be taking, and that they can afford those medications. If they can't, then connecting them with the resources to be able to provide those medicines for them.They also perform Chronic Care Management. So, that's identifying. So, we can go back to population health, identifying a group of patients who are either at high risk or rising risk of a complication or with a certain disease state. Identifying those patients, and then on a regular basis, setting up telephonic or even telehealth outreach to those patients, so that between those four office visits a year, that a chronic patient might have with a provider in the office, someone is touching base with them throughout the year. As a clinician, I always think that way. That for an average chronic care patient, I might have an hour or two hours a year of face time with a chronic care patient. Whether that's diabetes, hypertension, the combination of the two. That's really not very much time over the course of the year. And so, when you think about the Care Coordination team being able to touch those patients in between those visits, you really are improving the patient's experience of care. You're extending the provider's reach and ability to impact the patient in between those...
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In this episode of Finding Certainty, Finding Certainty host, Patrick Laing, sits down with Jim Bland, Founder and CEO of Seniors Home Services, to explore how his innovative remote senior care and management solutions are transforming healthcare for seniors and providers alike. Discover how SHS offers a seamless, turn-key approach to Remote Patient Monitoring, Chronic Care Management, and Remote Therapeutic Management, enabling practices to improve patient outcomes and experience, reduce staff workload, and generate substantial new revenue—all with zero out of pocket expense to them. Jim shares his vision for a future where healthcare is more efficient, affordable, accessible, and patient-centered, and explains how SHS is helping practices nationwide embrace this change. For more information on Finding Certainty, Certainty Management, or Certainty Global LLC, visit certaintyteam.com or call (888) 684-3122. To learn more about Seniors Home Services' free health and wellness coaching, go to https://www.remotecaretoday.com/introduction/1292. To learn about the revolutionary brain health program they offer, CereSkills (an app that can help improve memory, balance, and cognition in seniors and is paid for by Medicare), go to https://www.remotecaretoday.com/brainhealth/1292. Thank you for tuning in, and we look forward to sharing this important conversation with you today.
Host Justin Barnes records live at GAHIMSS in Atlanta. Stay tuned for the next few weeks to hear all his guests. This week Justin talks to Greg Fulton, Chronic Care Management & Value-based Care Lead at GLF Strategies, and Mike Mosquito, Comms Chair, GAHIMSS Board & lead Emerging Technology and Innovation at NE GA Health System. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
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Our expert guest on this episode is Brian Esterly, who was appointed CEO of TimeDoc Health in August 2023. Brian brings more than 25 years of healthcare leadership experience to ...
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In this inspiring episode of Leaders in Medical Billing, Chanie Gluck sits down with Josh Fertel, owner of J3RCM, to discuss his remarkable journey into the medical billing industry. Pivoting from 30-years in the car business to founding his own medical billing company at the age of 57, Josh shares how personal challenges and a passion for learning led him to his career change. This episode explores the importance of networking, the role of communication in business success, and the entrepreneurial mindset that drives Josh's success. Tune in to hear his story and gain valuable insights for your business! Timestamps 00:00:00 - Introduction and Host's Background 00:00:32 - Guest Introduction: Josh Fertel 00:00:47 - Josh's Career Transition to Medical Billing 00:01:42 - Overcoming Health Challenges 00:02:23 - Learning Medical Billing During Recovery 00:03:02 - Starting J3RCM and Early Success 00:03:32 - Challenges and Unique Perspective in Medical Billing 00:04:20 - Networking and Client Acquisition 00:05:16 - Building a Knowledgeable Team 00:05:49 - First Major Project: Chronic Care Management 00:06:46 - Launching the Angry Biller Podcast 00:07:01 - Frustrations with Physicians' Business Knowledge 00:08:48 - Enjoyment and Purpose of Podcasting 00:09:47 - Communication as a Key Business Focus 00:11:09 - Managing a Remote Team 00:12:45 - Networking and Learning from Industry Leaders 00:13:05 - Host's Business Journey and Offshoring 00:16:01 - Growth and Networking Strategies 00:17:05 - Client Referrals and Specialties 00:18:22 - Software Preferences and Challenges 00:19:13 - Future Goals and Success Metrics 00:20:04 - Planning for the Future 00:20:20 - Contact Information and Closing Remarks
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICDCM. Thanks to all of you for making this a Top 15 Podcast for 3 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ Sonal's 12th Season starts up and Episode 18 features her Newsworthy updates on the month's fraud, waste, and abuse cases. Trusty Tip features Sonal's compliance recommendations on new HCPCS G-codes for chronic care management. Spark inspires us all to reflect on collaboration based on the inspirational words of Margaret Mead. Thanks to Advanced Coding Services: Website: https://advancedcodingservices.com/ Paint The Medical Picture Podcast now on: Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3X Apple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177 Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcast Find Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7A Find Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/ And checkout the website: https://paintthemedicalpicturepodcast.com/ If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com --- Support this podcast: https://podcasters.spotify.com/pod/show/sonal-patel5/support
In this episode, Dr. Shannon Fox Levine shares her unique path to becoming a pediatrician, starting from a criminology major to her final realization during her third-year clinical rotation. She discusses her practice in Palm Beach, which has a strong focus on mental health and chronic care management. Dr. Levine highlights the collaborative efforts with a local nonprofit for mental health care and the challenges faced, especially regarding payment structures and care coordination codes like G2211. The conversation covers the need for fair payment, advocacy for primary care, and the evolving landscape of pediatric care with an emphasis on chronic disease management.00:00 Introduction and Guest Welcome01:13 Dr. Foxx's Journey to Pediatrics04:24 Residency and Early Career05:34 Building a Comprehensive Pediatric Practice07:29 Mental Health Integration in Pediatrics11:33 Challenges and Innovations in Pediatric Care19:19 Patient Experience and Practice Management28:26 The Future of Pediatrics36:28 The Demands of Pediatric Practice36:45 Challenges in Pediatric Infectious Disease37:25 Shift to Chronic Disease Management39:01 Mental Health Crisis in Pediatrics39:25 Insurance and Access to Care Issues40:55 Obesity and Metabolic Syndrome43:22 Vaccination and Disease Prevention44:44 Advocacy for Fair Payment49:18 National Pediatric Advocacy Efforts52:10 Value-Based Care and Chronic Disease01:07:34 Future of Pediatric CareSupport the Show.
Remembering that healthcare is a privilege and approaching it with a heart makes our community healthier. In this episode, Dr. Arti Masturzo, the Chief Medical Officer at CCS, shares insights into her journey in healthcare, the innovative work being done at CCS, and the impact of value-based care transformation. She discusses the unique services offered by CCS, emphasizing the company's approach to healthcare provider support, personalized patient education, and addressing social determinants of health. Arti also delves into the company's evolution and the importance of continuously adding value to the healthcare ecosystem. Moreover, she reflects on the impact of AI and the privilege of contributing to better healthcare outcomes. Tune in to gain insightful perspectives on healthcare innovation from Dr. Arti's wealth of experience in the industry. Resources: Watch the entire interview here. Connect with and follow Arti on LinkedIn. Follow CCS on LinkedIn and visit their website.
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