Podcasts about patient access

“There are so many more opportunities today for pharmacists that we haven't even dreamed of. In the future, pharmacists are going to provide more direct patient care, like pharmacogenomics, such as point of care testing for influenza and strep throat, and collaborative practice agreements that allow us, through a physician sign-off or medical practice sign-off, to manage and monitor medications." Steven Simenson, BPharm, FAPhA, FACA, DPNAP is the CEO and Managing Partner of Goodrich Pharmacy, Inc., with five community pharmacies in Minnesota. He is a graduate of the University of Minnesota College of Pharmacy along with his wife, Wendy, also a Pharmacist. Steve was the 2013-2014 President of the American Pharmacist's Association and is on the Board of Directors of Pharmacists Mutual Insurance Companies and the Community Pharmacy Foundation. He is actively advocating for the pursuit of Patient Access to and Coverage for Pharmacist Patient Care Services. Steven is at his best taking care of patients.

Dr Frances O'Hagan from BMA NI and politicians talk to Nolan

This podcast is brought to you by Outcomes Rocket, your exclusive healthcare marketing agency. Learn how to accelerate your growth by going to outcomesrocket.com Reducing patient wait times requires optimizing both patient navigation and health system resource utilization, a dual challenge tackled by platforms like DexCare.  In this episode, Jamie Gier, Chief Marketing Officer at DexCare, shares how their patient access platform, originally spun out of Providence Health, is working to ensure that "nobody waits for care." She explains how DexCare reduces appointment wait times by optimizing patient search and discovery while matching demand with the right clinician, location, or virtual care option, particularly for low-acuity needs. Jamie also discusses the importance of addressing generational expectations, the digital needs of caregivers, and the competitive landscape of B2B health tech marketing, which demands a precise ideal customer profile. Finally, she highlights the balance between AI-driven solutions and relationship marketing, emphasizing that trust remains key in partnering with health systems. Tune in and learn about innovative patient access solutions and insightful B2B healthcare marketing strategies! Resources:  Connect and follow Jamie Gier on LinkedIn. Learn more about DexCare on their LinkedIn and website. Discover more about CMO Huddles on their website and LinkedIn.

In this episode, Crystal Broj, Enterprise Chief Digital Transformation Officer at the Medical University of South Carolina (MUSC), shares how the organization is transforming healthcare through AI-powered voice bots, ambient listening, and digital front door innovations. She discusses the challenges and successes of implementing a new patient check-in system and deploying an automated AI agent in their patient access center. Crystal notes that one of the biggest lessons is the value of starting small—piloting technology, demonstrating ROI and KPIs, and scaling gradually. MUSC's AI voice bot – Emily – handles after-hours calls and appointment rescheduling, generating over $3 million in collections and reducing call handling time. Ambient tools like DAX have helped physicians cut “pajama time” by 37%, speed up chart closure, and improve clinical documentation. She also highlights how digital tools in the patient access center enhance scheduling and virtual care access, creating a seamless digital front door.  Crystal stresses the need for agile implementation, effective change management, and aligning technology with real workflows to drive lasting impact. Take a listen.

AI agents are transforming the front-end of the revenue cycle by capturing documents, verifying data, and launching workflows before staff even log in. In this episode, we explore how these digital teammates increase throughput, reduce rework, and empower your team to focus on high-value tasks.

How One Leader Came Out of Retirement to Transform Home Healthcare Jasper Freeman, Director of National Accounts at SC Pharmaceuticals, didn't just return to medical sales—he came back with a mission to change it. In this episode, Jasper shares how he helped launch Ferosix, a revolutionary heart failure treatment designed to keep patients out of the hospital and improve care at home. But that's just the beginning. We dive into: The untold story of Pharmacy Benefit Managers (PBMs) and their massive influence over drug pricing and access Why the insurance-sales-patient triangle is the key battleground in healthcare innovation What the U.S. can learn from other countries about lowering costs and improving care Bold reform ideas—from slashing med school tuition to rethinking drug distribution This is a rare, behind-the-scenes look at the business of healthcare, guided by someone who's lived it at the highest levels. If you're in medical sales—or trying to break in—this episode is a masterclass on what's next and how to lead the change. Connect with Jasper: LinkedIn Connect with Me: LinkedIn Love the show? Subscribe, rate, review, and share! Here's How » Want to connect with past guests and access exclusive Q&As? Join our EYS Skool Community today!

Seamless integration with EHRs is foundational to scaling patient access automation and optimizing revenue cycle performance. In this episode, Client Implementation Specialist Sahana Gangal explains how Infinx approaches standard and custom integrations, overcomes vendor limitations, and ensures successful data exchange across healthcare systems.

The creation of the not-for-profit CommonWell Health Alliance in 2013 was a turning point for data use and interoperability in the U.S. health care market. Many of the largest EHR vendors, clinicians, and others came together to cooperate on carrying out the mission of the HITECH act and the foundations for value-based care.This video interviews Paul L Wilder, Executive Director, and Liz Lewis, Director of Product, at CommonWell Health Alliance. They talk about the increase in the size of health care documentation, the Alliance's increasing integration of payers, the importance of patient access to records, and more.Learn more about CommonWell Health Alliance: https://www.commonwellalliance.org/Health IT Community: https://www.healthcareittoday.com/

In this episode of the Becker's Healthcare Podcast, Brook and Jocelyne from Verifiable dive into the critical connection between provider network growth, payer collaboration, and the modernization of credentialing systems. They explore how outdated legacy systems hinder patient access and provider onboarding, and share actionable strategies for healthcare leaders to improve compliance, reduce delays, and prepare for upcoming NCQA changes. With real-world examples — including Midi Health's rapid nationwide expansion — this discussion offers a forward-looking roadmap for building more efficient, scalable, and patient-centered networks.This episode is sponsored by Verifiable.

Join Dr. Olga Kagan, founder of the Food Allergy Nursing Association (FANA), as she shares insights on revolutionizing food allergy care through nursing innovation, technology, and evidence-based practice. Learn how FANA is empowering nurses to lead transformative change in this critical healthcare subspecialty while improving patient outcomes and quality of life.Discover how nursing leadership is revolutionizing food allergy care through evidence-based practiceLearn strategies for implementing innovative, technology-driven care models in specialty nursingUnderstand the impact of nurse-led research and education on patient outcomes in food allergy managementOlga Kagan, PhD, RN, CIMI, FHIMS, Founder, Food Allergy Nursing Association (FANA)Megan Antonelli, Chief Executive Officer, HealthIMPACT Live

In this thought-provoking episode of This Week in Pharmacy, I am joined by three powerhouse leaders from health innovation: Dr. Alex Ding (Humana), Dr. Marc Watkins (Kroger Health), and Brian Urban (Best Buy Health). Together, they explore the next generation of patient access—where healthcare meets lifestyle, nutrition, and digital convenience. Special Guests:  Dr. Alexander Ding, MD, MBA – Medical Director, Humana Dr. Marc R. Watkins, M.D. – Chief Medical Officer, Kroger Health Brian Urban – Head of Innovation, Best Buy Health From food-as-medicine initiatives and retail-driven clinical models to smart tech integration in chronic care, this episode examines how cross-industry collaborations are shaping the future of health. It's not just about treating illness—it's about engineering longevity.

What does patient access really mean, and how can we make it better? Adam Mariano, General Manager of Healthcare at LexisNexis Risk Solutions, tackles this question head-on. In this interview, he discusses why patient access is more than just a DEI issue and shares what healthcare organizations can do to remove barriers to care. Plus, he gives a sneak peek into what LexisNexis Risk Solutions is working on to help hospitals and payers improve access with better data and real-time insights. Learn more about LexisNexis Risk Solutions at https://risk.lexisnexis.com/healthcare Find more healthcare marketing stories at https://swaay.health

In this episode of the NAHAM Connections Podcast, National Director of Experience at Ensemble Health Partners, member of the NAHAM Publications Committee and host Susan Milligan, CHAM, CRCR, is joined by Kobe Crossley, CHAM, CRCR, Patient Access director at Banner Health. Together, they explore the growing influence of ambulatory care and its impact on Patient Access professionals. Kobe, with her extensive experience in ambulatory care, shares valuable insights on the key factors driving the shift toward outpatient procedures, as well as the emerging challenges and best practices for Patient Access teams. She discusses how the rise in ambulatory care is prompting Patient Access professionals to adapt to evolving workflows, insurance requirements and access challenges. Kobe also highlights how automation and digital tools improve efficiency while enhancing the overall patient experience. Susan and Kobe dive into the strategies that Patient Access leaders can use to stay ahead, emphasizing the importance of continuous learning, industry certifications and sharing knowledge with colleagues. Tune in for Kobe's expert perspectives on navigating the evolving ambulatory care landscape and positioning Patient Access teams for future success. || LINKS *Episode* https://www.naham.org/page/ConnectionsConsiderationsforPriceTransparencyinAmbulatoryCare https://www.naham.org/page/ConnectionsPodcastEpisode23 https://www.naham.org/page/PatientAccessInTelehealth https://www.naham.org/page/HowBannerHealthBoostedPointofServiceCollectionsin2024 https://www.naham.org/page/AccessKeys?&hhsearchterms=%22access+and+keys%22 *Social Media* https://www.naham.org/page/NAHAMConnections | https://www.facebook.com/NAHAMDC/ | https://twitter.com/MyNAHAM | https://www.instagram.com/nahamdc/ | https://www.linkedin.com/company/national-association-of-healthcare-access-management-naham-/ *NAHAM Website* https://www.naham.org/ | https://www.naham.org/page/NAHAMConnections

Join Patty Hayward as she reveals how AI-enabled contact centers are revolutionizing healthcare access and patient engagement. Learn how Talkdesk's technology is bridging critical communication gaps between patients and providers, while delivering more personalized care experiences through intelligent automation.Discover how AI-powered contact centers are solving healthcare access challengesLearn practical strategies for implementing automated, yet personalized patient engagementUnderstand the future of healthcare communication and its impact on patient care deliveryPatty Hayward, GM of Healthcare and Life Sciences, TalkdeskMegan Antonelli, CEO, HealthIMPACT Live

Patient access errors like eligibility verification mistakes and missed prior authorizations can quietly drain millions in lost revenue. In this episode of RCMinutes, we explore how AI automation agents help eliminate these front-end issues, reduce denials, and safeguard profitability for healthcare organizations.

In this episode, we sit down with Franziska Jovin, Chief Experience Officer and Senior Vice President of Patient Access at Cooper University Healthcare. Here, she discusses advancements in patient experience and how her background in inpatient care has shaped her approach to ambulatory operations. Jovin also shares insights on creating seamless, patient-centered healthcare experiences.

Cannabis started as a movement, not just a business. But as legalization expanded, the industry found itself caught between profit and purpose, struggling under massive overregulation and taxation. So how do we get back on track?For over 11 years, Luna Stower has been on the front lines—fighting for safe access, patient rights, and the end of prohibition. While many have lost steam, her relentless passion and advocacy have never wavered. She has worked to bridge the gap between activism and industry, ensuring that cannabis remains accessible, ethical, and true to its roots.This week, we sit down with Luna Stower to discuss:The real challenges of legalization and what's holding progress backWhy patient access must come firstHow small actions can create big change in the industryChapters00:00 Introduction to Luna Stower and Cannabis Roots03:31 Optimism vs. Reality in Cannabis08:43 Activism and Advocacy in Cannabis Legislation12:56 Navigating Cannabis Conversations in Society14:43 The Unique Classification of Cannabis17:57 The Conspiracy Against Cannabis20:14 The Role of Activism in Cannabis Legislation22:29 Cannabis as a Catalyst for Broader Social Change23:24 The Importance of Speaking Up24:24 Descheduling Cannabis: A Call to Action25:33 The Prison Industrial Complex and Cannabis26:57 Economic Impact of Cannabis Legalization28:52 Racism and Cannabis: A Lens on Society29:11 Challenges Facing the Cannabis Industry30:37 Vaping Safety and Regulation32:53 Patient Access and Rights34:08 Long-term Safety of Vaping38:22 Global Cannabis Perspectives42:01 Consumption Lounges: A New Experience43:55 Activism and Community EngagementGuest Links https://www.linkedin.com/in/lunastower/https://www.lunastower.com/https://www.instagram.com/luna_stowerhttps://x.com/lunastowerhttps://www.instagram.com/getispire/Our Links:Bryan Fields on TwitterKellan Finney on TwitterThe Dime on TwitterAt Eighth Revolution (8th Rev), we provide services from capital to cannabinoid and everything in between in the cannabinoid industry.8th Revolution Cannabinoid Playbook is an Industry-leading report covering the entire cannabis supply chain The Dime is a top 5% most shared  global podcastThe Dime has a New Website. Shhhh its not finished.The Dime is a top 50 Cannabis PodcastSign up for our playbook here:

In this episode, June Scarlett, Chief of Patient Access at White Plains Hospital, discusses the hospital's 2025 goals, including expanding specialty care, leveraging AI-driven technology, and addressing workforce challenges. She also shares insights on balancing high-tech solutions with a human touch and her leadership approach in navigating evolving healthcare demands.

In this episode, we sit down with Franziska Jovin, Chief Experience Officer and Senior Vice President of Patient Access at Cooper University Healthcare. Here, she discusses advancements in patient experience and how her background in inpatient care has shaped her approach to ambulatory operations. Jovin also shares insights on creating seamless, patient-centered healthcare experiences.

Discover how to optimize work queues in Patient Access Plus Workforce Management to streamline patient access workflows, enhance team productivity, and leverage AI-driven automation for case management.Brought to you by www.infinx.com

Wildfires have ravaged South California in recent months, forcing health system leaders to navigate patient access disruptions while ensuring continuity of care. Beyond the immediate crisis, these disasters create lasting "access debt"—a backlog of delayed appointments and unmet patient needs that can overwhelm health systems long after the flames have died down. How can access leaders prepare for and recover from such disruptions?This month, Founder and Executive Director Elizabeth Woodcock sits down with Aimee Corke, Director of Emergency Management and Business Continuity at Northwell Health; Connie Lee, MPH, FACHE, Senior Director of Patient Access at UCLA Health; and Leigh Bouskila Turk, MHA, Director of Practice Development and Support Services at Nicklaus Children's.The leaders share firsthand experiences managing patient access during wildfires, hurricanes, and other emergencies—discussing business continuity strategies, recovery planning, and how to maintain access in the face of disruption.

Dr. Phil and Dr. Andrew Hartz, Founder & President of the Open Therapy Institute (OTI) https://www.opentherapyinstitute.org/ delve into the complex intersections of therapy with cultural and political dynamics. They explore the current shift towards a more politicized mental health field, highlighting the challenges and implications of departing from traditional patient-centered care models. Discover how the Open Therapy Institute is at the forefront of reimagining therapy by emphasizing a patient-centered approach that respects and embraces diverse worldviews without bias. Dr. Hartz discusses the importance of openness, curiosity, and engaging with differing perspectives as vital components of the therapeutic process. Also, identify the negative impact of cancel culture on patient access to mental health services and the ethical imperatives that must guide therapy in these turbulent times. Now is the time to return to foundational, unbiased care in the mental health field. Thank you to our sponsors: Beam: Visit https://ShopBeam.com/DrPhil and use code DRPHIL for up to 40% off. Preserve Gold: Visit: https://preservegold.com/ Get a FREE precious metals guide that contains essential information on how to help protect your accounts. Text “DRPHIL” to 50505 to claim this exclusive offer from Preserve Gold today.

In this episode, Lisa Griffin, Lisa Griffin, MBA, CCCM - Chief Consumer Officer, Consumer Experience and Patient Access at University Hospitals, discusses the hospital's commitment to community care, groundbreaking advancements, and strategies for improving patient access and workforce engagement. Lisa shares her leadership insights and the organizational goals shaping 2025, including cultural transformation, digital innovation, and operational efficiency.

In this episode of Revenue Cycle Optimized, Jennifer Glockzin, Senior Manager of Patient Access, demystifies the complex world of medication authorizations. Learn about the two primary types of medication prior authorizations, the role of pharmacy benefit managers (PBMs), and how tools like CoverMyMeds streamline the process.

Access is a key challenge for patients and plan members. Kyruus Health recently launched two new products designed to address the challenge of access to care and care navigation: Reach and Guide. These solutions leverage artificial intelligence to streamline the experience. Healthcare IT Today sat down with Kyruus Health's Chief Product Officer, Peter Beaumont, at their E3 Executive Summit to learn more about their new products. Learn more about Kyruus Health at https://kyruushealth.com/ Find more great health IT content at https://www.healthcareittoday.com/

If you have zero clue what co-pay maximizers and/or co-pay accumulators are and the financial incentives involved for PBMs (pharmacy benefit managers) and plan sponsors here, after you're done listening to this episode, go back and listen to the show with Joey Dizenhouse (EP423). Also, the episode called “Game Theory Gone Wild” with Dea Belazi, PharmD, MPH (EP293). Both these shows could fill in some blanks. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. Here's the micro mini of the co-pay maximizer/accumulator deal. These are vehicles that are designed by vendors who are also sometimes called maximizers or sometimes they're also PBMs. But these programs are designed to get as much money out of Pharma as possible in the form of co-pay support. So, here's how the maximizers are supposed to maximize plan sponsors getting pharma money. Say, for some drug, the pharma company has, I don't know, $12,000 max in co-pay support available to patients in total per year. Pharma does always cap the dollars that are available for patients. So, in this hypothetical, $12k a year is available. What a forthright or well-run maximizer will do is figure out, you know, if there's $12k max available, then they'll set a co-pay—so there's variable co-pays for patients—so they'll set a patient co-pay of, like, $1000 a month, which adds up to $12k over 12 months of the year. Get it? Every single month, the patient has a $0 co-pay, but the plan maximizes the dollars that the plan gets. Or, you know, maybe they'll charge $1,025 a month so the patient has some small “skin in the game,” and the plan sponsor just banked $12k. Sounds great, right? Well, sure, when it works as promised … and we'll get to this in a moment. Accumulators, on the other hand, have no such “Hey, let's make sure the patient actually gets their meds” guardrails. They hear that the Pharma is offering $12k, and the accumulator vendor and their plan sponsor clients also are like, “Cool, let's get that money as fast as possible.” So, they make the co-pay for that drug, I don't know, like hypothetically $3000. Great, now the patient runs out of that co-pay money in May. And don't forget and/or let me inform you, for both maximizers and accumulators, dollars paid by the Pharma generally don't count to the plan deductible for the patient. So now, the patient walks into the pharmacy, if in an accumulator or in a poorly run maximizer program, they walk into the pharmacy in May and are told that if they want their drug, they're gonna need to pay the $3000 co-pay that was set out of pocket every month until they reach their deductible. With some of these co-pay maximizer/accumulator plans, the plan sponsor may be a little bit out of the loop relative to what is actually going on here. The plan sponsor may think that members are doing fine—you know, they're getting their drug every month—so they may be surprised to learn about this running out of money in May issue. And what is true more often than it's not true, this $3000 or whatever—hundreds or thousands of dollars—payment due co-pay, the patient learns about it at the pharmacy counter or while trying to get chemo. It comes as a complete surprise, the fact that they owe three grand or whatever. What patient just shrugs and pays up in that moment because they happen to have their entire deductible or thousands of dollars lying around and at the ready? What a shock to find this out at the pharmacy counter or at the infusion clinic. Some of these maximizer programs are also starting to veer back into accumulator zones, like they're doing things such as saying that the member must pay their out-of-pocket max or their deductible or 30% of the cost of the drug, right, like some number before the plan will allow the patient to use the co-pay reimbursement program to begin with. So, there's other things that are emerging right now, which, again, cause the patient to have a very, very large out of pocket in order for them to get a drug which they have been prescribed and—ostensibly, at least—need. Allegedly, and sometimes for sure, dollars raked in from Pharma make it across the PBM/maximizer, vendor, middleman trench all the way over to the plan sponsor. For sure, especially for the administrative only maximizer vendors … yeah, you're gonna have the dollars actually making it to the plan sponsor. But sometimes the vendor running these programs is paid spread, right? So, the more expensive the drug and the richer the co-pay card program, the more the vendor will make because they take a percentage of savings. So, the more expensive, the more savings, therefore, the more the vendor is gonna make. In these cases where the vendor is paid a spread, can I take Perverse Incentives for $600, Alex? Right? But in sum, again, there's a lot to this conversation with Bill Sarraille, so please do listen to the whole thing. Bill offers five main pieces of advice, so I'm just gonna cover them right here up front—spoiler alert, I guess, but just to keep them all in one place. 1. Look into what is going on with a maximizer and/or accumulator program. First of all, is the plan sponsor paying spread? And also, how are these programs being marketed to members and how aggressively? Because there are a lot of plan sponsors having way more negative impact than they suspect they are. So, that's point of advice #1: Really look into actually what is happening on the grounds with some of these programs. 2. Eliminate surprise. Any plan sponsor listening, and Brian Reid also says this very crisply in an episode a month or so ago (EP456). If a plan sponsor wants to do stuff like this—like force a patient to pay hundreds or thousands of dollars out of pocket—if at any point during the year they are gonna wind up with thousands of dollars in co-pay or coinsurance to get their Crohn's disease med or cancer med or whatever, be really up front about this at least. It's really important if we really want to make sure that patients are taking maintenance meds and getting the medications that they're prepared for the reality that, at a certain point during the year, they are going to have a really big bill. 3. There is legal risk here. So also, Bill's advice is check into whether accumulators and/or maximizers are unlawful under the ACA (Affordable Care Act) and/or by deceptive practices rules when maximizers or accumulators are teed up as a benefit. And it, again (reference point of advice #2), it's not explained that dollars they get from Pharma will be taken by the plan and not applied to the patient deductible. I was just reading about the crazy aggressive marketing tactics that some of these vendors are using to get members to sign up and … yeah, definitely look into deceptive practice rules. 4. If it's utilization management that we're trying to achieve here, then your utilization manager should be utilization managing. These maximizers are not meant to impact utilization management. Patients really cannot differentiate, as per study after study, it's very difficult for patients to differentiate high-value from low-value care or meds. So, pretty much the impact of having a patient with thousands or hundreds of dollars of out-of-pocket spend to get a med isn't going to be to ensure that the right people are taking the right med. Point is, use the right tool for the right job. So, if we're trying to keep patients away from low-value meds, the tool for that is utilization management. Also be aware, if the PBM says it cannot do utilization management or you'll lose your rebates and/or is pushing into a maximizer accumulator program to do this instead, that's kind of a clue that they cannot do it because they are taking money from Pharma to not have any restrictions on a drug. Read the article in the New York Times (you're welcome) about how PBMs took secret payments for the free flow of opioids, and Chris Crawford also talks about this sort of same-ish thing in an upcoming show relative to GLP-1s. But if you're trying to do utilization management, then do utilization management. 5. Use our understanding of this whole goings-on as a rationale or a way to tamp down perverse incentives. We want to wind up with patients getting charged a percentage of net prices, not a percentage of some wildly inflated list price with this whole accumulator maximizer contributing to, you know, just more wildly inflated list prices so the co-pay programs can be bigger and someone can make even more money off of the percentage of savings. And plan sponsors addicted to rebates now have another bucket of cash. Like, this is just another example of how perverse incentives pervade the system. And we should certainly be aware of that. Bill Sarraille was a healthcare attorney for many years. He retired from his law firm on the first of last year, and now he's doing the things he wanted to do before but couldn't because his billable rate was too high. Bill is teaching at the University of Maryland Law School and doing some regulatory consulting, etc. He's working with a variety of patient groups. Also mentioned in this episode are University of Maryland Francis King Carey School of Law; Joey Dizenhouse; Dea Belazi, PharmD, MPH; Brian Reid; Chris Crawford; Marilyn Bartlett; Scott Haas; Paul Holmes; and Tom Nash. You can learn more at University of Maryland Francis King Carey School of Law and by following Bill on LinkedIn. You can also sign up for his Substack.   Bill Sarraille is a professor of practice at the University of Maryland Francis King Carey School of Law, a regulatory consultant, and a retired senior member of the Healthcare Practice group at Sidley Austin LLP. Bill is a nationally recognized expert in healthcare, life sciences, drugs, medical devices, and patient access to treatments. He is widely known for his expertise in a broad array of healthcare matters, including rare disease treatment access barriers, pharmaceutical pricing, Anti-Kickback Law compliance, the 340B program, and managed care and PBM issues. During his years practicing law, Bill was recognized repeatedly by The Best Lawyers in America in both healthcare law and administrative law. He was also consistently listed as a leader in the field of healthcare law in Chambers USA: America's Leading Lawyers for Business. Bill also serves as the general counsel of the charity the Pharmaceutical Coalition for Patient Access, as an advisor to multiple patient advocacy groups on patient access issues, a compliance advisor to a coinsurance patient assistance foundation, and as the director of a rare disease society and Kalderos, Inc., a health IT firm with a focus on effectuating pharmaceutical discounts and rebates.   09:31 What should plan sponsors be aware of right now? 14:01 What is the justification for maximizers, and why is this at odds with the purpose of insurance? 18:05 Where does the issue of “fairness” land within cost containment? 20:00 Brian Reid's LinkedIn post on insurance company access challenges. 21:30 What are the real legal issues presented by some of these co-pay maximizers and co-pay accumulator programs? 27:06 How are these programs creating perverse incentives? 29:28 EP450 with Marilyn Bartlett, CPA, CGMA, CMA, CFM. 32:16 “If you're covered by the ACA, I think this is unlawful.” 32:57 What advice does Bill have in regard to these programs? 33:49 What potential litigations does Bill see coming in the near future in regard to these co-pay maximizers and co-pay accumulator programs? 38:38 EP365 with Scott Haas. 38:45 EP397 with Paul Holmes.   You can learn more at University of Maryland Francis King Carey School of Law and by following Bill on LinkedIn. You can also sign up for his Substack.   @HCLAWComment discusses #costcontainment on our #healthcarepodcast. #healthcare #podcast #pharma #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Stacey Richter (INBW41), Andreas Mang (Encore! EP419), Dr Komal Bajaj, Cynthia Fisher, Stacey Richter (INBW40), Mark Cuban and Ferrin Williams (Encore! EP418), Rob Andrews (Encore! EP415), Brian Reid, Dr Beau Raymond, Brendan Keeler  

In this week's episode, hosts Reed Smith and Chris Boyer share their perceptions and insights on patient access - what it is, what internal and external factors are impacting access and then they dive into a recent study by Experian that implies that both patients and providers are feeling optimistic about access improvements in health systems. Lastly, they share some ways to implement a consumer-centric access strategy.  Mentions from the Show: Experian Health Report: The State of Patient Access – 2024 Consumer-Centric Patient Access: Insights from Top Providers Reed Smith on LinkedIn Chris Boyer on LinkedIn Chris Boyer website Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, National Director of Experience at Ensemble Health Partners, member of the NAHAM Publications Committee and host Susan Milligan, CHAM, CRCR, is joined by NAHAM President, Philip Quick, MPS, CHAM. They discuss the exciting milestones and ongoing progress of NAHAM as the organization celebrates its 50th anniversary. Philip shares his personal journey in Patient Access and reflects on the pivotal moments of NAHAM's evolution. From advocating for Patient Access leadership roles to navigating the challenges of the pandemic, he highlights the organization's adaptability in meeting the needs of healthcare professionals. Susan and Philip also take a deep dive into the future of NAHAM, focusing on the newly introduced tiered membership model, the re-accreditation of key certifications and the anticipated launch of the new Learning Management System (LMS) in 2025. Additionally, they discuss the upcoming release of Access Keys 5.0, which will include updates for both acute and ambulatory access. Tune in for insights on how NAHAM continues to shape the Patient Access field and how its members are contributing to the growth and leadership in healthcare. || LINKS *Episode* https://www.naham.org/page/ConnectionsPodcastEpisode24 https://www.naham.org/page/ConnectionsReunionWeekendACelebrationofNAHAMsLegacyandConnections https://www.naham.org/page/Connections50YearsofNAHAMCelebratingOurLegacyThrough5DecadesWith5Voices https://www.naham.org/page/ConnectionsNAHAM50thAnnualConferenceAdvancingPatientAccess https://www.naham.org/page/ConnectionsASpringboardtoSuccessPerspectivesfromFirst-timeNAHAMAnnualConferenceAttendees https://www.naham.org/page/AccessKeys *Social Media* https://www.naham.org/page/NAHAMConnections | https://www.facebook.com/NAHAMDC/ | https://twitter.com/MyNAHAM | https://www.instagram.com/nahamdc/ | https://www.linkedin.com/company/national-association-of-healthcare-access-management-naham-/ *NAHAM Website* https://www.naham.org/ | https://www.naham.org/page/NAHAMConnections

Partnering for Success in Patient Access Transformation Danelle Newman, Manager of Patient Access at OSS Health, shares her journey in overcoming challenges in patient access management. Learn how strategic partnerships, like the one with Infinx, helped streamline authorization workflows, manage staffing shortages, and ensure exceptional patient care. Danelle provides actionable insights and a firsthand perspective on the value of collaboration in healthcare operations. Brought to you by www.infinx.com. 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/

In this episode of Revenue Cycle Optimized, Danelle Newman, Manager of Patient Access at OSS Health, shares her journey in overcoming challenges in patient access management. Learn how strategic partnerships, like the one with Infinx, helped streamline authorization workflows, manage staffing shortages, and ensure exceptional patient care. Danelle provides actionable insights and a firsthand perspective on the value of collaboration in healthcare operations.

Send us a textEver tried to schedule a doctor's appointment, only to be stuck on hold for what feels like forever?You're not alone. A lot of Americans feel the same frustration.Could there be a better way to take control of scheduling?In this episode of HealthBiz Briefs, Relatient CEO Jeff Gartland explains why self-scheduling is still a novel concept in medicine and how its implementation can improve patient access while increasing appointment volumes for providers.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.

Administrative staffing shortages are straining healthcare providers, especially in critical tasks like insurance verification and prior authorizations. In this episode, we explore how AI-driven solutions from Infinx are helping providers streamline workflows, maintain efficiency, and focus on delivering exceptional patient care despite limited resources.

In this episode, Patrick Kokoruda, MHA, CCSL, Vice President of Clinical Access Management, and George Ruiz, MD, a board-certified cardiologist and chair of Cardiology, both from Geisinger, discuss the transformative power of collaboration in improving patient access. They delve into the art and science of structuring clinicians' time, leveraging technology, and standardizing processes to connect patients with the right care at the right time. Hear their innovative approaches to optimizing capacity, addressing clinician shortages, and creating scalable, patient-centered solutions that redefine  access to care. 

On this episode of Managed Care Cast, we're talking with Josie Cooper, BA, executive director of the Alliance for Patient Access. Her study, "Utilization Management and Physician Burnout," involved a survey that assessed physician experiences with utilization management and burnout, investigating the potential link between the 2.

We love to hear from our listeners. Send us a message.Rita Johnson-Greene, COO at Alliance for Regenerative Medicine (ARM) joined Cell & Gene: The Podcast Host, Erin Harris, on site during 2024 Meeting on the Mesa to record their discussion. Johnson-Greene shared information about the Joint Clinical Assessment (JCA) in Europe and its potential impact on cell and gene therapies, how globalization impacts patient access, an update on ARM's Grow Internship Program, as well as a few key takeaways from the event that sector professionals can anticipate impacting the CGTs in the next 12 months and beyond.Subscribe to the podcast!Apple | Spotify | YouTube

In this episode, host Shikha Jain, MD, speaks with Amita Patnaik, MD, FRCPC, about providing patient access to breakthrough drug developments, bringing early phase cancer trials to physicians and more. •    Welcome to another exciting episode of Oncology Overdrive 0:14 •    About Patnaik 0:21 •    The interview 1:23 •    How did you decide to become an oncologist, and how did you end up co-founding the START Center for Cancer Research?  1:32 •    Can you tell me about START's overarching purpose and where you see its need being most fulfilled? […] What do you hope START will accomplish in the next five to ten years?  11:33 •    How successful has START been at including underrepresented patient populations in clinical data? 17:52 •    What are some challenges you've found as you have navigated through founding a company and executing its mission? 21:48 •    What is next for you?  25:21 •    If someone else wanted to create a company like START, what are some tips you would give them?  27:23 •    If someone could only listen to the last few minutes of this episode, what would you want them to take away? 32:03 •    How to contact Patnaik 34:44 •    Thanks for listening 35:27 Amita Patnaik, MD, FRCPC, is an internationally recognized medical oncologist and the co-founder of the START Center for Cancer Research. We'd love to hear from you! Send your comments/questions to Dr. Jain at oncologyoverdrive@healio.com. Follow Healio on X and LinkedIn: @HemOncToday and https://www.linkedin.com/company/hemonctoday/. Follow Dr. Jain on X: @ShikhaJainMD. Patnaik can be reached via email amita.patnaik@startresearch.com or via the START website.

Our special guest of Pulse is known online as e-Patient Dave. Dave Debronkart is a leading light of determined patient advocacy for individual access to their own health information. Dave joins us in the PulsePod studio to explore a new movement he is championing - #PatientsUseAIOpenAI's Transformation and AI TransparencyOpenAI's shift from a non-profit to a for-profit corporation raises concerns about AI transparency, accountability, and the concentration of power in tech. How does this impact healthcare?ChatGPT Use in HealthcareA recent UK study reveals that 20% of surveyed GPs use generative AI tools in clinical practice, highlighting the need for education on both benefits and risks.Patient Data Sharing ControversyAustralia's largest medical imaging lab, i-Med, faces scrutiny for sharing patient scans with AI startup Harrison AI. Is this all a bit overblown?AI Consultation in AustraliaThe Department of Health and Aged Care is running a public consultation on Safe and Responsible AI, with healthcare as a priority area for reform. Listeners are encouraged to participate in the consultation and attend the upcoming webinar hosted by the Australian Alliance for Artificial Intelligence in Healthcare (AAAiH).Epic vs Particle: Interoperability & Patient Access to RecordsA lawsuit between EMR provider Epic and data integration company Particle Health highlights the ongoing debate about patient access to health information and interoperability. The outcome of this case could significantly impact the future of health data sharing and the balance between data protection and patient empowerment.Real World Testing of AI-enabled General PracticeHunter, New England and Central Coast Primary Health Network has launched a new project to test and trial AI tools in 10 of its practices and act as a showcase for these tools.Resources: Follow ePatientDave on LinkedIn | X | SubstackGovt AI consultation: Submissions link & Webinar linkVisit Pulse+IT.news to learn more, engage in this rapidly growing sector, and subscribe to breaking digital news, weekly newsletters and a rich treasure trove of archival material. People in the know, get their news from Pulse+IT – Your leading voice in digital health news.Follow us on LinkedIn Louise | George | Pulse+ITFollow us on X Louise | George | Pulse+ITSend us your questions pulsepod@pulseit.newsProduction by Octopod Productions | Ivan Juric

In this episode, we dive into the fascinating intersection of artificial intelligence and pediatric neurology. Our guest shares how they became interested in AI's role in healthcare and discusses how AI is being utilized to enhance diagnostic accuracy, especially in neurodevelopmental pediatrics. We explore how these advancements are improving access to care in resource-limited settings and the impact of early diagnosis on long-term outcomes for conditions like autism. Join us as we uncover the latest technological innovations transforming pediatric healthcare, the potential of AI to personalize treatment plans for children, and the concerns surrounding the widespread use of AI in medicine. Dr. Sharief Taraman, is dual board-certified in Neurology with special qualifications in Child Neurology from the American Board of Psychiatry and Neurology and Clinical Informatics from the American Board of Preventive Medicine. Dr. Taraman was the former Division Chief of Pediatric Neurology at Children's Health of Orange County and University of California-Irvine. He remains an active member of the medical staff and the Sharon Disney Lund Medical Intelligence, Information, Investigation, & Innovation Institute at CHOC. He is a Health Sciences Associate Clinical Professor at UC Irvine School of Medicine in the Department of Pediatrics and Affiliate Professor at Chapman University, Dale E. and Sarah Ann Fowler School of Engineering. Dr. Taraman is active in the community as the past president of the American Academy of Pediatrics (AAP) Orange County Chapter, board member of AAP-California, and committee member for the development of the AAP National CHILD health registry. He also serves on the Irvine Unified School District Medical Advisory Board, volunteers for the Capistrano Unified School District and with Girl Scouts of Orange County. Recognized globally as an innovator and specifically an advocate in the field of pediatrics, Dr. Taraman has been involved with the development of three FDA designated breakthrough devices, awardee of the prestigious National Capital Consortium for Pediatric Device Innovation grant, and is an advisor to Board of Directors for the International Society for Pediatric Innovation. He is the Chief Executive Officer at Cognoa and formerly served as the Chief Medical Officer leading the clinical trials that led to the FDA authorization of Cognoa's lead product, Canvas Dx, the first and only FDA authorized diagnostic device for autism for children 18-72 months old with concern for developmental delay. Dr. Taraman graduated Magna Cum Laude from the University of Michigan having majored in Biochemistry. He completed his medical education at Wayne State University School of Medicine and went on to complete residency and fellowship training in Pediatrics and Pediatric Neurology at the Detroit Medical Center and Children's Hospital of Michigan. He continued professional development through the University of California, Irvine - The Paul Merage School of Business with certifications in Leadership for Healthcare Transformation & Physician Leadership. https://cognoa.com/ _________________________________________________ Sponsor the JOWMA Podcast! Email digitalcontent@jowma.org Become a JOWMA Member! www.jowma.org Follow us on Instagram! www.instagram.com/JOWMA_org Follow us on Twitter!www.twitter.com/JOWMA_med Follow us on Facebook! https://www.facebook.com/JOWMAorg Stay up-to-date with JOWMA news! Sign up for the JOWMA newsletter! https://jowma.us6.list-manage.com/subscribe?u=9b4e9beb287874f9dc7f80289&id=ea3ef44644&mc_cid=dfb442d2a7&mc_eid=e9eee6e41e

The "All-Access Pass to Access" podcast, hosted by Elizabeth Woodcock and brought to you by the Patient Access Collaborative, explores the application of behavioral science in patient access. In this episode, Senior Director of Patient Access at UMass Memorial Healthcare, Clara Doan, shares insights from her work on referral processes – and reflects on the application of behavioral science to access. Joined by the Patient Access Collaborative's Senior Director of Research, Chris Profeta, the discussion highlights key behavioral science concepts, such as the recency bias, active commitment, deterrence hypothesis, framing effect, and pique technique, offering valuable strategies for improving patient access. Tune in to learn how these theories can improve our ability, as healthcare leaders, to improve access.

In this episode, we're diving into the key takeaways from the NAHAM 50th Annual Conference, with a spotlight on artificial intelligence (AI) and its impact on Patient Access. As AI continues to generate buzz in healthcare settings, it's crucial to distinguish between genuine advancements and marketing hype. Host Susan Milligan, CHAM, CRCR, is joined by D.J. Plavsic, MBA, CRCR, who shared his expertise on AI at the recent conference. Together, they explore the critical distinctions between basic process automation and true AI, discuss the latest AI applications in Patient Access and provide valuable insights on navigating the evolving AI landscape in our industry. If you're curious about how AI is changing Patient Access or want to learn how to separate genuine AI solutions from the noise, this episode is for you. Tune in to discover what's hype, what's reality and what the future may hold for AI in healthcare. || LINKS *Episode* https://www.naham.org/page/ConnectionsPodcastEpisode21 https://www.naham.org/page/ConnectionsPodcastEpisode19 https://www.naham.org/page/ConnectionsNAHAM50thAnnualConferenceAdvancingPatientAccess https://www.naham.org/page/ConnectionsASpringboardtoSuccessPerspectivesfromFirst-timeNAHAMAnnualConferenceAttendees https://www.naham.org/page/ConnectionsStreamlinedPatientCarePriorAuthorizationEssentials https://www.naham.org/page/Connections6WaystoEnhancePriorAuthorizationWorkflows *Social Media* https://www.naham.org/page/NAHAMConnections | https://www.facebook.com/NAHAMDC/ | https://twitter.com/MyNAHAM | https://www.instagram.com/nahamdc/ | https://www.linkedin.com/company/national-association-of-healthcare-access-management-naham-/ *NAHAM Website* https://www.naham.org/ | https://www.naham.org/page/NAHAMConnections

This episode of the Becker's Healthcare Podcast dives into the future of in-home care with Joseph Buchanan, SVP of Clinical Network at Matrix Medical Network, about how they prioritize high-quality care delivery in patients' homes. They discuss the importance of a clinician-led approach to in-home assessments and how it improves access, patient experience, and health equity for payers.This episode is sponsored by Matrix Medical Network.

In this episode, Genoplex Founder and CEO, Chris Leidli, and CTO, Shoukri Kattan, take a dive deep into their shared passion for health, wellness, and longevity, and explore how technology is revolutionizing patient access to advanced therapies. Chris and Shoukri discuss the groundbreaking work happening at Genoplex, including how the company's Advanced Therapy Connect digital platform is transforming the way patients connect with life-changing treatments.

This episode of the Becker's Healthcare Podcast dives into the future of in-home care with Joseph Buchanan, SVP of Clinical Network at Matrix Medical Network, about how they prioritize high-quality care delivery in patients' homes. They discuss the importance of a clinician-led approach to in-home assessments and how it improves access, patient experience, and health equity for payers.This episode is sponsored by Matrix Medical Network.

Navigating the Pitfalls of 'Stat' Authorizations Discover how to classify and submit prior authorization requests to avoid unnecessary delays and ensure timely patient care with Senior Manager for Patient Access, Jennifer Glockzin. Master the strategies for effective communication with insurers and learn to leverage AI tools to enhance the efficiency of your authorization processes. Brought to you by www.infinx.com. 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/

In this week's episode, hosts Reed Smith and Chris Boyer share their perceptions and insights on patient access - what it is, what internal and external factors are impacting access and then they dive into a recent study by Experian that implies that both patients and providers are feeling optimistic about access improvements in health systems. Lastly, they share some ways to implement a consumer-centric access strategy.  Mentions from the Show: Experian Health Report: The State of Patient Access – 2024 Consumer-Centric Patient Access: Insights from Top Providers Reed Smith on LinkedIn Chris Boyer on LinkedIn Chris Boyer website Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Greg Peters, co-founder and CEO at BetterHealthcare, and Dr. Heidi Jannenga, DPT, co-founder and chief clinical officer at WebPT, discuss what is at the heart of patient access in healthcare. Together, they explore Greg's passion for standardizing access to care and the inspiration that led to the creation of BetterHealthcare. Tune in for this engaging conversation as the two discuss why care differs so dramatically depending on where you go and Greg's mission to create a more uniform experience for patients.   Learn more:  https://www.betterhealthcare.co/  https://www.webpt.com/podcast  

Specialty medications are costly and complex to obtain and make up over 50% of the drug spend in the US. In this episode, Julia Regan, co-founder and CEO of RxLightning, explains why she created a digital platform that helps patients access high-cost, complex drugs faster and more efficiently. RxLightning's platform supports over 1600 medications, working seamlessly with provider platforms and EHR systems to reduce prescription wait times from weeks to days, ensuring top-quality patient care through a more cohesive experience. Throughout this interview with Saul Marquez, Julia underscores how the company has grown to include 1200 organizations that use its services, leveraging white-labeling to increase adoption. She also emphasizes how, despite financial constraints and the need to balance revenue with value, RxLightning has made significant strides in digitizing prescription processes, ensuring data protection, and improving patient outcomes.  Tune in and learn how RxLightning is transforming the specialty medication landscape and making prescriptions at lightning speed! Resources:  Watch the entire interview here. Connect and follow Julia Regan on LinkedIn. Learn more about RxLighting on their LinkedIn and website.

For too many people in the U.S., health care is unaffordable and not accessible. Even patients who have health insurance coverage can be confronted with barriers that keep them from accessing the health care that they need. And research shows health disparities are rampant, with health care access — and outcomes — worse for people of color and other marginalized groups. The new State of Patient Access report from the PAN Foundation breaks down these disparities and highlights next steps for creating more equitable access to care.  “Our goal with the project was really to understand the challenges that adults living with chronic conditions every single day face accessing the care they need,” says Amy Niles, the PAN Foundation's health policy expert and Chief Mission Officer. “More importantly, our goal was to understand what disparities exist, and there were some significant disparities between various groups and communities.” To learn more about the report, and what can be done to help overcome barriers to care for underserved communities, Health Disparities podcast host Dr. Ramon Jimenez spoke with  Niles, along with Adrianna Nava, president of the National Association of Hispanic Nurses.

The future of healthcare lies in personalized, proactive care models driven by innovative solutions that prioritize patient needs and preferences. In this episode, Haley Bolton discusses patients' struggles with navigating healthcare systems, emphasizing the importance of patient-centered approaches and leveraging technology for self-service options while maintaining personal connections. She also discusses how AI helps streamline processes like sorting patient symptoms and setting appointments, showing Emory Healthcare's commitment to improving health fairness and investing in data and analytics for better decision-making and personalized care. Tune in and learn how innovative solutions are transforming healthcare delivery to better serve patients' needs! Resources: Connect and follow Haley Bolton on LinkedIn. Follow Emory Healthcare on LinkedIn. Discover the Emory Healthcare Website! About Memora Health: Memora Health, the leading intelligent care enablement platform, helps clinicians focus on top-of-license practice while proactively engaging patients along complex care journeys. Memora partners with leading health systems, health plans, and digital health companies to transform the care delivery process for care teams and patients. The company's platform digitizes and automates high-touch clinical workflows, supercharging care teams by intelligently triaging patient-reported concerns and data to appropriate care team members and providing patients with proactive, two-way communication and support.

Join me and Dr. David Charles, Chief Medical Officer of the Alliance for Patient Access and a distinguished neurologist, for a dynamic discussion. In this episode, Dr. Charles sheds light on step therapy, fail-first protocols, and care pathways, revealing their impact on patient care. Explore how the Alliance champions patient education and advocates for healthcare policy improvements. Tune in to delve into the intersection of patient advocacy and healthcare reform with Dr. Charles and the Alliance. Thank you to Amgen, Merck and Daiichi Sankyo for making this episode possible!