Podcasts about Providers

In this episode of Syntax, Wes and Scott talk about your options for hosting your app including some of the big players, but also others you may not have heard of. Show Notes 00:11 Welcome 01:06 Explaining basic concepts in hosting providers 07:55 How is hosting priced? 10:09 The big names in hosting Amazon Web Services Google Cloud Microsoft Azure DigitalOcean | The Cloud for Builders Sales Cloud Flightcontrol — AWS Without Pain Supper Club × Next.js on AWS + Serverless with Dax Raad — Syntax Podcast 589 16:29 Render Render 23:50 Vercel Vercel: Develop. Preview. Ship. For the best frontend teams 28:04 Heroku Cloud Application Platform | Heroku 31:58 Digital Ocean 36:10 Linode Create your account - Linode 38:34 Netlify Develop and deploy websites and apps in record time | Netlify The Deno Show — Syntax Podcast 322 Decap CMS | Open-Source Content Management System 46:30 Fly Deploy app servers close to your users · Fly Railway 54:19 Cloudflare Cloudflare - The Web Performance & Security Company | Cloudflare 00:43 Deno deploy Deno Deploy | Deno 03:04 SIIIIICK ××× PIIIICKS ××× ××× SIIIIICK ××× PIIIICKS ××× Scott: Automators - Relay FM Wes: Dropbox.com Shameless Plugs Scott: Sentry Wes: Wes Bos Tutorials Tweet us your tasty treats Scott's Instagram LevelUpTutorials Instagram Wes' Instagram Wes' Twitter Wes' Facebook Scott's Twitter Make sure to include @SyntaxFM in your tweets Wes Bos on Bluesky Scott on Bluesky Syntax on Bluesky

#neurofeedbackpodcast #neurofeedback #holistichealth #mentalhealthpodcast #mentalhealth #biohacking John Mekrut Founder of The Balanced Brain Neurofeedback Training Center, joins Jay Gunkelman the man who has read over 500,000 brains scans, and Dr Mari Swingle The Author of the Best Selling Book iMinds on the Neurofeedback Podcast NeuroNoodle to discuss his experiences with Neurofeedback Practice in his almost 20 years of being in the field In this short clip we discuss how Neurofeedback Providers can empower you on you Mental Health Betterment journey To get the full context please watch the whole show: https://youtu.be/LVaoSVq_C0w @thebalancedbrainneurofeedback https://www.thebalancedbrain.com/https://www.thebalancedbrain.com/our-team/john-mekrut/ --- Send in a voice message: https://podcasters.spotify.com/pod/show/neuronoodle/message Support this podcast: https://podcasters.spotify.com/pod/show/neuronoodle/support

May is Military Appreciation month and we are truly grateful for the sacrifice and service members and their families. Gail Williams is the clinical director of At Ease USA (AEU), a nonprofit committed to providing access to confidential trauma treatment and support for active military, veterans, frontline healthcare workers and their loved ones, regardless of their ability to pay. AEU complements existing services offered by military and veterans organizations, with a focus on the elimination of barriers to treatment for those suffering from the effects of PTSD.   Providers interested in partnering with At Ease, please contact Gail for more information. Military members, retired military, veterans, families and front line healthcare workers who have or wonder if they have PTSD can contact Gail for more information about engaging At Ease for services. Read the show notes here:   https://www.voiceofinfluence.net/272 Give and receive feedback that makes a difference! Register for our 20 minute Deep Impact Method video course here:  www.voiceofinfluence.net/deepimpact

Justin Janoska joins us again to discuss Masculinity, Trauma, and Identity. Key Points:- What is masculinity?- How are you seeing it in patients or individuals?- The connection between masculinity and disease- What is the science on this?- How do you resolve this?FREE Journal Club for Providers, RD2Bes, and Online Coaches: https://www.fitwithdasha.com/Reminders-------------------------------- We've transformed over 500+ lives! ✓ Reduce bloat and lose inflammation ✓ Tackle Gut & Hormones from the CORE ✓ SIBO, IBS, IBD, Amenorrhea, Hypothyroidism, PCOS, Celiac, Chronic Constipation, GERD, Coming off PPIs/Linzess/Metam in ucil, Laxative Abuse, and more! -------------------------------- → FREE 15 min Discovery Call: https://calendly.com/coreperform/coreperform → About Our CorePerform Services: https://coreperform.com/services → Submit your questions for next week here: https://www.facebook.com/groups/359139741759181 -------------------------------- Ready to Join Our Fam and Change Your Life? Click Here→ DOWNLOAD OUR SERVICES https://coreperform.kartra.com/page/menu -------------------------------- FREE Weekly Gut Health Training What protocols, treatments, and solutions do we use to transform the lives of 500+ people? How have we helped hundreds resolve SIBO, IBS, H Pylori, Parasites, and more? Want free recipes to get started? Have a quick question? Tired of feeling alone in your journey? Click Here→ JOIN OUR FACEBOOK GROUP -------------------------------- MEET OUR FAM Dasha - @dashafitness Sarah - @skimfood ---------------- GIVEAWAY! Leave a rating + review on iTunes for a chance to win up to $200 in VIP prizes! Winners are announced monthly on the CP Corner. → Simply leave a review, and send a screenshot to the CorePerform Instagram or Facebook Page

Elon Musk appoints Linda Yaccarino Twitter's new chief. Once a week in the US, there's a lithium-ion incident on an airplane. Why aren't there cellular radios in laptops? What Linux distro should you use for a MacBook laptop? How can I install applications in Linux Mint? Sam Abuelsamid and EV vehicles and the Alfa Romeo. How can I adjust the icon sizes on my iPad? Why am I not getting notifications when I get a text on my phone? The Legend of Zelda: Tears of the Kingdom hands-on. Is it worth switching to an MVNO service? What advantages do you get from having an MVNO provider? Why am I getting frame drops during video playback on my Linux laptop? What are some options to get kids to learn programming? Hosts: Leo Laporte and Mikah Sargent Guests: Sam Abuelsamid and John Ashley Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Show notes and links for this episode are available at: https://twit.tv/shows/ask-the-tech-guys/episodes/1974 Download or subscribe to this show at: https://twit.tv/shows/ask-the-tech-guys Sponsors: canary.tools/twit - use code: TWIT drata.com/twit

Oregon Office of Rural Health and the organization Age+ is teaming up with several other entities on a Forum on Aging in Rural Oregon next week in Seaside (May 15-17). Sarah Andersen, Field Services Director for OORH and Age+ President Stephanie Hooper.

This is your WORT local news for Monday, May 8.Childcare centers across the state close their doors for a day to show what could happen if they don't get more support,It's a tale of two bills as our Democratic Governor and the Republican-led legislature looks for ways to increase local fundingAnd in the second half, this week in city and county government, a rainy Monday could lead to a rainy graduation this weekend, and two new movie reviews.

netnumber Global Data Services' NumeriCheck Solution Offers Solutions With consumers around the world continuing to face an onslaught of fraudulent communications, it's not surprising that stopping illegal text messages has moved to the forefront of regulatory concern. Under the FCC's recent crackdown, a new Report and Order now requires U.S. wireless carriers to implement heightened verification processes for text messaging while STIR/SHAKEN requirements are already pressuring providers to increase anti-fraud voice call measures. At the same time, as security concerns grow across the global communications ecosystem, members of the telecom community must now ensure that they are optimizing their fraud prevention solutions for both messaging and voice origination and termination. In this podcast, Catalin Badea, Senior Director of Product Management at netnumber Global Data Services, outlines an innovative solution that can help providers meet these challenges - NumeriCheck, the company's comprehensive number verification and validation solution. NumeriCheck leverages real-time phone number intelligence data to reliably and accurately validate phone numbers to screen for potential fraud and help providers meet stringent new regulatory policies to mitigate the most sophisticated of fraud schemes. More netnumber news Visit https://netnumber.com/

Yesterday, Third District Judge Andrew Stone halted a ruling that would limit performance of abortions in hospitals. With this delay, four clinics throughout Utah are still allowed to perform abortions. KSL Newsradio legal analyst Greg Skordas sits down to talk about the consequences and implications these delays have on the access to abortion.See omnystudio.com/listener for privacy information.

Thinking of starting a med spa practice or adding med spa services to your existing practice? Join host Ericka Adler and Roetzel attorney Christina Kuta this week as they discuss starting a med spa, the issue providers face during startup and how to avoid them. Ericka and Christina provide tips to be involved with a med spa if you aren't a licensed provider, physician risk involved in owning a med spa, what to look for in management agreements and how to charge for services. They also dive into what providers need to do think about if they are adding med spa services to their existing practice, including licensure issues and services offerings. 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

When a landlord or tenant has an issue, they can apply for a hearing at the Landlord and Tenant Board. But for years now, the waitlist for a hearing has been many months long. Why is there still such a backlog? And what does it means for landlords and tenants seeking justice? For insight, we welcome: Varun Sriskanda, board member for the Small Ownership Landlords of Ontario;Geordie Dent, executive director of Federation of Metro Tenants Associations; Kathy Laird, retired human rights lawyer and adjudicator and a spokesperson for Tribunal Watch Ontario; Gloria Salomon, CEO of Preston Group and vice-chair of the Federation of Rental-housing Providers of Ontario.See omnystudio.com/listener for privacy information.

Ontario's latest housing bill is called the Helping Homebuyers, Protecting Tenants Act. But does it actually do enough to keep tenants in secure housing? The Agenda discusses the changes in the bill, especially to rental replacement bylaws. With guests: Tony Irwin, president and CEO Federation of Rental-housing Providers of Ontario; Carolyn Whitzman, housing researcher and Adjunct Geography Professor at the University of Ottawa.See omnystudio.com/listener for privacy information.

What are your providers thinking about when you're in labor? When a tiktok went viral about what bugged labor nurses, the labor community went wild -- but in reality what ARE your providers thinking about. I loved having a CNM on the episode to chat about it. Today's guest is Juli Pyle (she/her) a certified nurse midwife who practices at a community hospital in rural Pennsylvania. Juli was a stay at mom for many years to five children before deciding to return to school to pursue a degree in nursing. She graduated from Colorado Mesa University with a bachelors of science in nursing degree in 2016 and then began her nursing career as a labor and delivery nurse. She quickly discovered that this was her true passion (as she had suspected since having her own children) and quickly gained a reputation for professionalism, compassion and expertise among colleagues and patients. She then returned to Frontier Nursing University to complete a Master's degree in Nursing with an emphasis in midwifery. In 2020, she graduated and began as a certified nurse-midwife at a small community hospital in central Pennsylvania where she has been since that time. Her focus as a CNM is to provide evidence-based education to all birthing families, give true autonomy and informed consent throughout their time with her and to share love, understanding, empathy and true shared-decision making. When not immersed in the birthing world, she enjoys spending time refinishing furniture, gardening, raising and breeding different types of chickens, hiking and vacationing with her family. This episode was inspired by Labor Nurse "icks" Big thanks to our sponsor The Online Prenatal Class for Couples -- if you're looking to communicate with your healthcare team, come join me in there! In this episode What we thought about the labor nurse "ick's" Difference between midwives, doctors and nurse's thoughts. Producer: Drew Erickson

On today's show, we are joined by Thomas Majewski, Managing Partner of Eagle Point Credit Management to discuss what a CLO is, differences between a CLO and a CDO, how Eagle Point Credit is able to pay these yields, the 2023 banking crisis, and much more!     Find complete shownotes on our blogs... Ben Carlson's A Wealth of Common Sense Michael Batnick's The Irrelevant Investor Feel free to shoot us an email at animalspiritspod@gmail.com with any feedback, questions, recommendations, or ideas for future topics of conversation.   Check out the latest in financial blogger fashion at The Compound shop: https://www.idontshop.com   Investing involves the risk of loss. This podcast is for informational purposes only and should not be or regarded as personalized investment advice or relied upon for investment decisions. Michael Batnick and Josh Brown are employees of Ritholtz Wealth Management and may maintain positions in the securities discussed in this video. All opinions expressed by them are solely their own opinion and do not reflect the opinion of Ritholtz Wealth Management. Wealthcast Media, an affiliate of Ritholtz Wealth Management, receives payment from various entities for advertisements in affiliated podcasts, blogs and emails. Inclusion of such advertisements does not constitute or imply endorsement, sponsorship or recommendation thereof, or any affiliation therewith, by the Content Creator or by Ritholtz Wealth Management or any of its employees. For additional advertisement disclaimers see here https://ritholtzwealth.com/advertising-disclaimers. Investments in securities involve the risk of loss. Any mention of a particular security and related performance data is not a recommendation to buy or sell that security. The information provided on this website (including any information that may be accessed through this website) is not directed at any investor or category of investors and is provided solely as general information. Obviously nothing on this channel should be considered as personalized financial advice or a solicitation to buy or sell any securities. See our disclosures here: https://ritholtzwealth.com/podcast-youtube-disclosures/

Discussing the top headlines of the week, including protests at the State Capitol and changes to state crime victim assistance programs concerning emergency contraception.

Many lawyers go into pro bono unaware of the vicarious trauma they can experience when helping clients in difficult situations. Hear from a pro bono leader and an expert in learning design about how thoughtfully designed training can help lawyers at all stages of their careers become more effective and resilient advocates.  Related Links: Vicarious Trauma and Service Provider Wellness - Practising Law Institute Working with Domestic Violence Survivors - Practising Law Institute Interviewing Pro Bono Clients - Practising Law Institute Interactive Learning Center (ILC) Homepage - Practising Law Institute PLI is proud to offer programs, Pro Bono Memberships, and scholarships to support the essential public service work of the legal profession. 

In episode 92, Robert Pearl, MD, Forbes healthcare contributor, former CEO of The Permanente Medical Group, and author of two highly acclaimed books, "Mistreated" and "Uncaring," provides our audience with outstanding insight into the current and future state of the healthcare system. This episode delves into Pearl's personal journey to becoming a healthcare leader, the importance of restructuring and repairing inadequacies within our healthcare system, ChatGPT and the innovation of AI in contemporary times, potential trends in the future of healthcare, the importance of prioritizing diversity, equity, and inclusion where Robert Pearl MD claims that “providing great care to everyone” is the ultimate goal, and the purpose of cultivating emotional intelligence in systems of health.

The report from the Society of Family Planning also shows abortions via telemedicine have doubled in the U.S. after Roe v. Wade was overturned. Providers say constantly changing state laws leave patients confused about where they can access reproductive care.

MMOA Podcast - a nonHealthcare providers thoughts on aging. Dr. Samantha Chamberlain brings in her football coaching husband to discuss his past and current thoughts around aging. Let's just say the older adult division had some work to do to get him to stop thinking he was OLD at 30! Want to stay on top of all things geriatrics? Go to https//:MMOA.online to check out our free eBooks, lectures, and the MMOA digest.

It finally happened! CareTalk and Dr. Eric Bricker (AHealthcareZ), two titans of healthcare YouTube, join forces to take on some of the juiciest topics in healthcare finance and more.

Jimmy and March Delatour discuss that status of the turn key market in 2023. As always Turn Key remains the best way for investors to grow wealth passively because of the 4 Pillars. There is always a lever to pull when you can win in four ways

AP correspondent Donna Warder reports on a new abortion law in Kansas.

In this episode, hosts Joe Records, Payal Nanavati, and Jodi Daniel talk to three members of the health information industry regarding the Trusted Exchange Framework and Common Agreement (TEFCA) published by the Office of the National Coordinator for Health Information Technology (ONC). This episode features Jay Nakashima (Executive Director of eHealth Exchange), Nichole Sweeney (General Counsel and Chief Privacy Officer of CRISP Shared Services), and Erica Galvez (CEO of Manifest MedEx), who each share their experiences in the health information exchange industry and their expectations of TEFCA. Payers, Providers, and Patients – Oh My! is Crowell & Moring's health care podcast, discussing legal and regulatory issues that affect health care entities' in-house counsel, executives, and investors.

The U.S. Supreme Court protected access to the widely used abortion pill Mifepristone — for now. We'll hear how all the legal whiplash is affecting Arizona providers. Plus, trains are getting longer and potentially less safe. That and more on The Show.

Advocates for survivors of domestic violence and sexual abuse say that events revolving around alcohol consumption, like the Super Bowl or NFL Draft, can escalate violence against women.

Today's episode is sponsored by my friends at Paleovalley.   Make sure to support this podcast and head over to Paleovalley.com/NwJ and use code NWJ to get 15% off your first order._____Hey guys! I wanted to share some real talk about Chronic Inflammatory Response Syndrome (CIRS) while many of you are navigating or considering this illness.I hope this helps you consider things about the CIRS illness.Our hope is to provide group care over time to help support our Carnivore and CIRS communities.Make sure to download the free resource guide with this episode. https://www.nutritionwithjudy.com/introduction-to-chronic-inflammatory-response-syndrome-cirs I discuss the following:Standard care failuresTruth about CIRS patientsCIRS and non-CIRS providersFinding indoor environmental (IEPs) specialistsThe cost of CIRSNwJ and CIRS careCarnivore and CIRS realizationsShoemaker Step 1: Importance of a clean environmentThe real talk of CIRS_____RESOURCESCIRS Supplementary HandoutNwJ CIRS ArticleNwJ Free CIRS Resource NwJ CIRS Bloodwork  NwJ CIRS Mini BloodworkNwJ MARCoNS TestingVision Contrast Sensitivity TestDr. Shoemaker Certified PractitionersJoin my newsletter Evidence-Based CIRS Research:1. Haas PJ, van Strijp J. Anaphylatoxins: Their role in bacterial infection and inflammation. Immunol Res. 2007; 37(3):161-175. PubMed 178734012. Klos A, Tenner AJ, Johswich KO, Ager RR, Reis ES, Köhl J. The role of the anaphylatoxins in health and disease. Mol Immunol. 2009 Sep; 46(14):2753-2766. PubMed 194775273. Hawlisch H, Wills-Karp M, Karp CL, Köhl J. The anaphylatoxins bridge innate and adaptive immune responses in allergic asthma. Mol Immunol. 2004 Jun; 41(2-3):123-131. PubMed 151590574. Gasque P. Complement: A unique innate immune sensor for danger signals. Mol Immunol. 2004 Nov; 41(11):1089-1098. PubMed 154769205. Peng Q, Li K, Sacks SH, Zhou W. The role of anaphylatoxins C3a and C5a in regulating innate and adaptive immune responses. Inflamm Allergy Drug Targets. 2009 Jul; 8(3):236-246. PubMed 196018846. Wills-Karp M. Complement activation pathways: A bridge between innate and adaptive immune responses in asthma. Proc Am Thorac Soc. 2007 Jul; 4(3):247-251. PubMed 176070077. Richani K, Soto E, Romero R, et al. Normal pregnancy Is characterized by systemic activation of the complement system. J Matern Fetal Neonatal Med. 2005 Apr; 17(4):239-245. PubMed 161478328. Oku K, Atsumi T, Bohgaki M, et al. Complement activation in patients with primary antiphospholipid syndrome. Ann Rheum Dis. 2009 Jun; 68(6):1030-1035. PubMed 186256309. Ingram G, Hakobyan S, Robertson NP, Morgan BP. Elevated plasma C4a levelsHead over to paleovalley.com/nwj and get 15% off your first order. Promo code NWJ

Episode 136: Street Med 2.      Future Dr. Bedi presents the history and purpose of street medicine and shares why she became interested in this topic. Dr. Saito tells his personal experience and shares the particular challenges of unhoused patients.Written by Indudeep Bedi, OMS III, MSIII, Western University of Health Sciences. Comments by Steven Saito, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Indu: I want to talk about street medicine in some general terms, as well as Tracy Kidder's article published in the NYT this year, called "You have to learn to listen," which is based on Kidder's book Rough Sleepers, on Dr. Jim O'Connell's work with the Boston homeless community.  Dr. Saito: Let's start by talking about street medicine in general. What exactly is street medicine? Street medicine was a term coined by Dr. Jim Withers, from Pittsburgh, who has been practicing the art since the 90s. He founded the Street Medicine Institute (SMI) in 2009, which strives to connect providers worldwide to address homelessness. Providers practice healthcare, of course, but first and foremost, it is about building relationships and demonstrating you are one of them instead of the power differential that usually exists in our system. It requires a paradigm shift, and it's a shift in thinking. Dr. Jim Withers himself, for example, began to wear ragged clothes and put dirt in his hair to show these vulnerable individuals that he was accepting of who they were and respected them for it. In return, they respected him. Dr. Saito: Do you know of other programs which exist? There are a bunch of programs now that have spurred up, such as Doctors without Walls, San Francisco's community health center, of course, are very own CSV, and the Boston Pine Street shelter, which I will talk about more. The SMI publishes an annual report, and there are about 50 independent street medicine programs nationwide. Many global programs have sprung up, too. An international street medicine symposium was founded in 2005. In general, this is an excellent community of providers who can share best practices regarding this unique population. Even a student coalition at the SMI helps get student-run programs off the ground. Dr. Saito: What is one of the homeless community's biggest problems? That is a tricky question because of the complexity surrounding this issue. I will tackle this by answering that housing is one of the most considerable problems. The housing may be either transitional or permanent. Transitional operates to get the individual immediately off the street. In contrast, permanent housing takes longer to find, but many charities have bought real estate to create permanent housing. Permanent housing also includes the individual being vetted, in a lot of cases, to make sure that they will do okay if they have a place of their own. Are they able to be independent? Can they pay rent? Do they have a job? In 2009, however, a new program was implemented known as Housing First. This social program provided "a no-strings-attached" housing to the homeless population with substance use and mental health problems. What was great about this program is it was found that the relapse rate was much lower in this population when compared with other programs. In 2018, however, due to gentrification and rent increases, there was a very steep rise in homelessness in cities on the west coast, such as Seattle, San Francisco, and Los Angeles. To combat this, many state-wide programs were established that work with healthcare providers to provide these individuals with the help they need. Dr. Saito: What is the article "You have to learn to listen" about?I would first like to read a short excerpt from the article: "In American cities, visions of the miseries that accompany homelessness confront us every day — bodies lying in doorways, women standing on corners with their imploring cardboard signs dissolving in the rain. And yet, through a curious sleight of mind, we step over the bodies, drive past the mendicants, return to our own problems. O'Connell had spent decades returning, over and over, to the places that the rest of us rush by." Dr. O'Connell completed his IM residency at Mass General in Boston and was about to move on to an oncology fellowship when he was approached by some colleagues with a request to take a position as a physician for one year in a grant-funded program from the city of Boston to address homelessness in the 1980s. The program operated outside of Pine Street Inn homeless shelter. One of the initial experiences that Kidder describes Dr. O'Connell having was his first day of being there, being surrounded by stern-faced nurses who obviously knew more than he did about this niche population. He really had to prove himself to them and the individuals who were homeless. Soon after he joined, Dr. O'Connell met a nurse by the name of Barbara McInnis, who told him, "I really think we want doctors, but you've been trained all wrong. If you come in with your doctor questions, you won't learn anything. You have to learn to listen to these patients." Nurse McInnis also taught Dr. O'Connell a common practice at their shelter, which was to soak patients' feet by filling a tub and pouring in betadine, as a lot of the population did not have footwear. This reflection of "placing the doctor at the feet of the people he was trying to serve" is beautiful. That is precisely what street medicine is about. Dr. O'Connell has been managing the street medicine program at Pine Street since then, and that oncology fellowship remains forgotten. The program he is a part of now has 19 other shelters in order to tackle Boston's growing homelessness problem. However, it was apparent to Dr. O'Connell a few years in that these shelters were not really making a difference in terms of curbing the amount of homelessness. That problem was still continuing to grow. In addition, many other systemic issues were leading to the rise in homelessness, such as the AIDS epidemic around the time, lack of welfare programs, gentrifications, etc. But the difference was being made in the sense that these individuals who had been pushed to the margins, who were overlooked, and who were in essence burned by the healthcare system in one way or another and highly suspicious of providers for that reason, were now able to be coaxed into receiving and accepting the help they needed. This was done by, as said previously, placing the physician at the feet of the people he was trying to serve.Over the years, the program continues to grow and even created a new clinic with beds, offering housing vouchers, but it also faces other problems, such as funding and efficiency. A significant focus for the homeless community is housing options. And most people will do really well after being housed, while for others, finding housing brings more troubles with it when they need to be continuously moved from home to home to avoid eviction. I think a lot of it has to do with the lack of resources that come with housing. Homelessness is so complex that finding a home is simply not enough, and these individuals can again fall through the cracks if those other issues are not addressed. While street medicine does a lot of good, it is a harsh reality that individuals have a low life expectancy and will die of this homelessness because of the other issues that remain a constant in their lives, such as substance use, HIV, AIDS, and mental health issues. Dr. Saito: How did you come to be interested in this topic?I have been interested in street medicine for a while now. I volunteered in some projects that exposed me to the perils facing the population, especially for addiction. For example, I had an excellent opportunity to work with an organization that would put up tents to test the communities for HIV and connect them with resources if needed. We would specifically go to the areas where people who were homeless or of low SES tended to congregate. I really started to think about it more recently when I encountered a patient on the Infectious Disease service who was incredibly complex in an immunocompromised state due to AIDS, with multiple hospitalizations and pretty much every infection under the sun. He was what we commonly refer to as non-compliant because of substance use, and whenever we found placement for him upon discharge, he would run away from that home. I think, as providers, we are very quick to judge and label patients as non-compliant without pausing to understand the nuances of their condition. He would later continually return to the hospital in an acute exacerbation of his illness. With each hospitalization, his baseline continues to worsen. And I was deeply saddened to come across such a patient and also recognized within myself this frustration with the system in which we operate. I am a bit despondent about his outlook, and the work of the CSV team is critical to these rough sleepers. ____________________Conclusion: Now we conclude episode number 136, “Street Med 2.” Future Dr. Bide recounted the experience of Dr. O' Connell and some of the challenges faced by our unhoused patients. Dr. Saito added his personal experience and reminded us that compliance with medications may be difficult in unhoused patients. Here in Clinica Sierra Vista, we are proud of our street medicine program, and we hope many more volunteers would join us in our mission to bring “health for all.”This week we thank Indudeep Bedi, Steven Saito, and Hector Arreaza. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Meyers, T. (2022) Understanding the practice of Street Medicine, Direct Relief. Direct Relief. Available at: https://www.directrelief.org/2022/02/understanding-the-practice-of-street-medicine/.Balasuriya, L. and Dixon, L.B. (2021) Homelessness and mental health: Part 2. The impact of housing interventions. Psychiatry Online. Available at: https://ps.psychiatryonline.org/doi/10.1176/appi.ps.72504.Atherton, I. and Nicholls, C.M.N. (2012) Housing first as a means of addressing multiple needs and homelessness. European Journal of Homelessness. European Observatory on Homelessness. Available at: https://dspace.stir.ac.uk/handle/1893/9035#.ZCRWKBXMKdY.Kidder, T. (2023) You have to learn to listen: How a doctor cares for Boston's homeless. The New York Times. Available at: https://www.nytimes.com/2023/01/05/magazine/boston-homeless-dr-jim-oconnell.html.Street Medicine Institute Annual Report (2021). Street Medicine Institute. Available at: https://stmi.memberclicks.net/assets/AnnualReport/Street%20Medicine%20Institute%202021%20Annual%20Report.pdf.Royalty-free music used for this episode: “Gushito - Burn Flow." Downloaded on October 13, 2022, from https://www.videvo.net/

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Tomasz Tunguz is the Founder and General Partner @ Theory Ventures, just announced last week, Theory is a $230M fund that invests $1-25m in early-stage companies that leverage technology discontinuities into go-to-market advantages. Prior to founding Theory, Tom spent 14 years at Redpoint as a General Partner where he made investments in the likes of Looker, Expensify, Monte Carlo, Dune Analytics, and Kustomer to name a few. Tom also writes one of the best blogs and newsletters in the business which can be found here. In Today's Episode with Tomasz Tunguz We Discuss: Founding a Firm: The Start of Theory: Why did Tom decide to leave Redpoint after 14 years to found Theory? What are 1-2 of his biggest lessons from Redpoint that he has taken with him to his building of Theory? What does Tom know now that he wishes he had known when he started investing? 2. From 150 LP Meetings to Closing $230M: Raising a Fund I How would Tom describe the fundraising process? How many meetings with LPs did he have? How many did he know previously? What documents did he share with LPs? Did he have a dataroom? How did he use it? How did Tom create a sense of urgency to compel LPs to come into the fund? How does Tom feel about the debate between one close and multiple closes? What was the #1 reason LPs said no to investing? What worked and Tom would do again for the next raise? What did not work and he would change for the next raise? 3. Where Will Value Accrue in the Next Decade of AI: Startup vs Incumbent: Will incumbents embrace AI before startups are able to acquire distribution? Infrastructure vs Application Layer: Where will the majority of value accrue in the next decade; infrastructure or application layer? Bundled or Unbundled: Will bundled services be the dominant consumer and enterprise choice or will unbundled specialized solutions win? 4. AI and The World Around It: How does Tom believe AI could save the US economy? Why does Tom believe Google are the losers in the AI race? Which incumbents have responded best to AI? Why does Tom believe we will be in a worse macro place at the end of the year than we are now?

In this episode, we explore the critical role that third-party logistics (3PL) providers can play in helping companies achieve their sustainability goals. We sit down with Alex Schwarm from Arrive Logistics to discuss the various ways in which 3PL providers can contribute to sustainable logistics, including green transportation, waste reduction, sustainable warehousing, collaboration, reporting, and transparency. For more information subscribe to Check Call the newsletter or the podcast.Follow the Check Call PodcastOther FreightWaves Shows

How will the post-pandemic recovery and recuperation be impacted by rising costs, workforce flux, burnout, and shortfalls? What about the compounding crises that are depleting resources and impacting supply chains? How will coverage and payor mix shifts affect the industry, and what about the changing competitive landscape with new entrants? How will rising consumer expectations and the expanding impact of digital technologies, along with consumer-driven shifts in care delivery preference and modeling, play a role? Will the demand for improvements in health equity be met, and what about the negative EBITDA trends? How will legacy industry leaders and employees push back against the transformational paradigm shift?These are the question I asked my next guests, Robert Jehling and Matt Falkner of Silverline Robert is the Healthcare Provider Practice Leader d Healthcare GTM Leader at Silverline.  He has over 23 years of experience in the areas of Consumer Lifecycle Management, Contact Center  Design and Management, Marketing, Business Development, Supply Chain Logistics, and consumer/patient experience in Fortune 50 Consumer Service Companies and National Healthcare entities. He is an industry expert in areas of Healthcare Consumerism, Digital Transformation, Omni-Channel Engagement modeling,Robert has held Healthcare Executive Leadership Roles  including having been a Chief System Experience Officer and Chief System Access Officer for a top 25 Integrated Healthcare System, Consultant and Solution Design SME to health systems, providers, and payers nationally. He has also been an Executive Digital, Operations, Marketing, Consumer Lifecycle Management, and Strategy leader for Fortune 500 organizations.  He has held executive leadership positions with AT&T, ShareCare, Belo Media, Chaners/PrimeMedia, and Energy Future Holdings. Robert's role at Silverline as the Healthcare Provider Practice Leader and Healthcare GTM Leader is focused on identifying industry trends and needs analysis around SF Platform use cases, platform solution sets, strategic road mapping and solution design to build and execute the strategy for delivering market penetration of SF Licensure and Silverline SI and Advisory Services. He is also responsible for leveraging his industry expertise to create healthcare provider industry brand awareness, preference, and advocacy for both Silverline and SF within the industry sector, client base, and new client marketplace.Matt Falkner is the  Sales Director at Silverline with 10 years of experience in the healthcare vertical, primarily focusing on Providers, Payers and Patients.  Of those ten years, he has ~4 years working directly for a Provider organization focused on Behavioral Health as a Patient Access Director, Patient Access Coordinator and Post Care outreach Director. Matt has worked closely with Salesforce Account Executives and RVPs over the years to promote the flexibility and interoperability of the Health Cloud platform. He has led hundreds of Provider and Payer pursuits and speaks to the platform's value from his real-world experience as a user and director of similar provider organizations. Let Us Welcome Robert and Matt to the Follow The Brand Podcast Where We are Building a 5 STAR Brand That You Can Follow!

This is the All Local Afternoon update 4/14/23

I hope you listened to episode 399, which was Part 1 of this two-part exploration of my manifesto, meaning my aims and my path or framework to achieve those aims. Regarding the first part of my manifesto, episode 399 from two weeks ago, here's the tl;dl (too long, didn't listen) version; but please go back and listen to that show (Part 1) because it's about you—and it's a compliment and a thank you, and you deserve both. Just to quickly recap, Part 1 of my manifesto is that I started this show because I want to, and wanted to, provide information to those in the healthcare industry trying to do the right thing by patients, to get you the insights that you might need to pull that off, to create a Coalition of the Willing, as I've heard it called. When we get reviews like the one from Megan Aldridge, a self-proclaimed Relentless Health Value binge listener, I feel very gratified because it makes me feel like I'm chipping away at this mission and in a non-boring way. Thank you, Megan. Along these lines, there was also a recent review from Mallory Sonagere, who says she listens to learn new things and to be a little sharper at how she approaches her day job. And just one more I'll mention: I loved the review from Mark Nixon calling Relentless Health Value the best healthcare podcast out there. Every review like this I take as validation that maybe I can count some measure of success toward achieving the mission to empower others on their journeys to make it better for patients or to transform the healthcare industry. But this whole endeavor to create a manifesto is also borne out of me struggling personally to figure out what “having personal integrity” in this business actually means when it comes to deciding what to do and what not to do, when it comes to deciding who or what to try to help or support or who or what to step away from either passively or actively. I mean, how this podcast gets funded is my business partner and I pay for it with money from our consulting business and from some tech products that we have on offer. Who do we choose to take on as clients, and what are we willing to do for them or help them with? These are questions that literally keep me up at night. And this is what this episode, Part 2, is all about. It's about my struggle and how I attempt to navigate my own path forward. And holy shnikeys, it's tough to find a path, especially when you have the sort of perspective that I've wound up with over these past however many years. It can feel like no matter what I do, there's negatives as it relates to the Quadruple Aim. You raise one of the quadrants, and something else for somebody else certainly has the potential to be negatively impacted. We cannot forget here in the short term, but, for sure, often in the longer term as well, it's a zero-sum game. Every dollar someone takes in profit under the banner of improving health or even saving money is a dollar that someone else paid for. Is the amount of profit fair? Where'd that money come from? Is there COI (conflict of interest), and if so, what's the impact? I think hard about things like this. An inescapable fact is that there has been a financialization of the healthcare industry, and that includes everybody who also gets sucked into the healthcare industry whether they want to be or not (ie, patients/members and plan sponsors and, oftentimes, physicians and other clinicians, too). But the financialization of healthcare means that most everybody at the healthcare industry party has a self-interest to either make money or save money. And sometimes the saving money means saving money for themselves, not necessarily anything that is ever gonna accrue to patients or members. Now let's say I'm trying to determine if I want to take on a new client or decide if I personally want to promote or do something or other. This self-interest that abounds all around matters here because it means it is often very tough to find some kind of “pure” initiative to hitch your wagon to. The crushing reality that we all face is you gotta earn a living. The other reality is that often the person that benefits from the thing you want to do (ie, the patient) is not gonna pay for it. And frequently, physician organizations won't either. If everybody was lining up to pay to get something fixed, the problem would not be a problem, after all. But the only way your moral compass is the only moral compass in play is if you're doing whatever you're doing for free, really, or by yourself—and thus you are not encumbered by anybody else or any self-interest beyond your own … and your own motives are the only motives that you can control. I hear all the time initiatives and coalitions and advocacy organizations and even research funded by grants … these things also get bashed as suspect because who'd that money come from and whose “side” are the funders on. Nikhil Krishnan wrote on LinkedIn the other day (and I'm gonna do a little bit of editing, but yeah). He wrote: “Patients have low trust in healthcare because they think every stakeholder is incentivized not in their best interest. Many patients think the hospitals want to keep them sick, the [carriers and plan sponsors] don't want to pay their claims, the drug companies want to keep them on their meds, etc. And we can't pretend like that … isn't true.” Every party, every stakeholder has some measure of self-interest. They have to; otherwise, they'd be out of business. It's all a matter of degrees. No big group, no entire category gets to stand on the high ground here when you think like a patient. There's great hospitals and great people who work at hospitals, and then there's people doing things that cause a strikingly large percentage of patients to fear going to the hospital for clinical and/or financial reasons. Pick any other stakeholder and I'd tell you the same thing. Any other stakeholder. It's basically up to us as individuals to do the right thing. In every sector of the healthcare industry, there's good eggs and there's bad eggs and there's eggs in the middle just doing their day jobs as instructed. Personally, I want to be a good egg, and that's what my manifesto is all about. Let me dig into this a bit further for just a sec and then I'll continue with my personal manifesto for how I find my own path of integrity through all of this confusion. Here's another anecdote. Stuff like this I make myself crazy thinking about: I was listening to a podcast, and one of the guests said, “I wanted to get my MPH [Master of Public Health] because I felt a personal calling to be altruistic.” Then, 120 seconds later, he says something like, “So then, when it came time to pick my internship, I hunted around to find the one that paid the most money—and that's how I wound up working for an HMO in the '90s.” Consider how that strikes you. How do you feel about that guy right now, who, by the way, has gone on to support some very interesting and probably impactful initiatives? There's this commonly used phrase, “Let's do well by doing good.” So, back to that HMO intern. Let's just say we all agree that these HMOs were not unconflicted organizations. We all know they had a reputation for putting profits over members, and a reason they went out of business was because they denied care. They refused to pay claims for patients who had AIDS. And it turns out that the friends and families of people with AIDS are incredibly well organized and sued the crap out of the HMOs, which may have expedited their demise. You know what the intern was doing at the HMO? He was helping them with data analytics, and his personal goal was to use that data to improve patient outcomes. So, okay … here's the thought experiment: Do we want this HMO taking money that they're gonna take anyway and then not adding the value that they potentially could add with their data because they don't have any smart, dedicated, highly compensated interns working there to keep the ship pointed in a decent direction? I mean, I guess if I know I'm gonna spend a dollar as a member of that plan, I'd prefer to get as much as possible for my dollar that is already being spent. Maybe from that perspective, this guy is doing well by doing good. You see how this gets messy when you take a theoretical statement and then apply everyone's real-world prejudices and predilections to it. Here's a last point to ponder, and this is another thought experiment … so, just heads up and then I'll get to the point here: Say you are asked to help with a program run by a Medicare Advantage (MA) plan to provide those in need of transportation a ride to their annual wellness exam. Do you help? Those who listen to this show will fully understand there's a lot of self-interest involved in getting patients to the annual wellness exam because … risk adjustment. Also, star ratings. Listen to the show with Betsy Seals (EP375 and EP387) if you need the full story here. Short version is, MA plans can't upcode, either fairly or aggressively (if they are so inclined), if the patients don't show up for their annual physical. So, there's a lot of money for them at stake. But, then again, are physicals important for patients? Do they improve patient care and health? If we think yes, then again, is this doing well by doing good to help patients get to their appointments? After literally years of asking myself questions like this—and most of them were not thought experiments—I came up with my manifesto. And there are three parts to it, and I will go through each of them. But here's my manifesto in full: If the thing results in a net positive for patients, then I will do it. The timeframe is short-term or medium-term. And the assumption is that it will take a village and I am not alone in my efforts to transform healthcare or do right by patients. Here's how I think about the first part of my manifesto: If the thing results in a net positive for patients, then I'll do it. And keep in mind, I could talk about this for seven hours; so everything I'm saying is oversimplified to some degree and has as many nuances as there are stars in the sky. So, to calculate the net-positive impact, I think through what good the thing could do and weigh that against the negatives. And there are always negatives because, most of the time, the work that I do anyway has to get paid for by somebody and that somebody has some self-interest. Self-interest means that they are attaining something that furthers their business goals. Let me list two major upside/downside contemplations: 1. How much good does the thing actually do for patients? I think about this. What's the value here? Is it a little? Is it a lot? Will this thing be a distraction for clinicians, because time is often the most precious currency? If we're talking about some kind of navigation or utilization management, what's the reason someone wants to do this? Is the reason clinically and, for reals, evidence driven? Or are we predominantly doing this to enrich shareholders or save plan sponsors money in ways that are not a win-win for patients in the clinic right now trying to get cancer treatments for their kid? I try to think like a patient and be as impartial as possible. 2. Money. Where's the money for this thing coming from, and who wins in this particular initiative (ie, is it a win-win and patients win something worthwhile)? Now, the company doing the funding has got to win, too; otherwise, they wouldn't fund the thing. That's where it gets subjective, and, as aforementioned, do I care if the company in question wins if the patient wins, too? Or is this company so damn evil at its core that I am willing to sacrifice the opportunity to do a good thing for patients in order to not have anything to do with said possible funding entity. Or am I cutting off my nose to spite my face because this is a really important thing for patients and this particular company is the only one that's gonna fund it? Because tragedy of the commons or whatever else. Again, this gets dicey really fast. Let me poorly paraphrase a little exchange I saw on LinkedIn the other day that had me completely preoccupied during my work-from-home midday walk around the block for at least three days. Somebody wrote (maybe that Master of Public Health intern), “Given how intractable it feels to me to try to reduce healthcare spend, I think I'm going to try to help patients get more value out of the dollars that are currently being spent by them or on their behalf.” Do you think that's a worthy goal? Well, not everyone does. Somebody in T-minus 8 seconds responded, “That's a toxic way of thinking. Everyone who is not actively working to reduce healthcare spend by putting patients in cash-pay models is part of the problem.” This is a good segue into the second part of my manifesto. The first part is: If the thing results in a net positive for patients, then I'll do it. Here's the second part: The timeframe is short-term or medium-term. And here's what I mean by that. My main focus is helping patients right now. This is what this has to do with the aforementioned exchange on LinkedIn wherein someone was trying to figure out how to get more out of the dollars we're currently spending and someone else said that's toxic, because we should rip it all down and build a better model. There's incremental change, and then there's disruptive change. These two things are not mutually exclusive. Apparently, Mr. This Is Toxic doesn't agree with me, but as I said in the last episode, there's that Buckminster Fuller quote: “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” And sure, I like to aspire to that as much as the next person. But does aspiring to a big hairy goal mean completely forgoing any incremental ways that patients can be helped immediately, like right now? If you ask me—and you're listening to this, so you de facto asked me—incremental change will probably actually support and beget disruptive change. So, incremental versus disruption is not a battle royale. These things are not diametrically opposed. They're probably actually aligned. I could go on a tangent here to explain why, but I'm not going to … except to say tipping points. But forget about that for a sec. Here's the more basic question: If all parties are interested in transforming healthcare, legit, how does someone trying to do it incrementally, or improve value for patients right now, in any way negatively impact someone trying to be disruptive and/or trying to change financial models? Keep all this in mind and now let me get back to my manifesto. I'm worried about patients, and I'm worried about them largely right now, short term to medium term. So, if I have the opportunity to help a patient—and I think about my two grandmothers (God rest their souls) here, but both of them would have died in the healthcare system multiple times in avoidable ways had my family not been there advocating for them—if I have the opportunity to help a patient, I will do so as long as I believe that the impact is a net positive in the shorter term. Disruption is a longer-term operation. Some have said it's a generational change. When I see stuff like Toxicity Guy wrote on LinkedIn, I really try to understand what his point is, as I always try to understand what people's points are. Could he be arguing that no one should work to improve care right now or try to maximize what we get for the bucks that we've already been shelling out? And, if so, for what reason … so that what happens? So that resentment about poor-quality care builds up to a boiling point such that everybody shuns the status quo and moves to a new care model and financial models faster? Is that the aim of Toxicity Guy? To force a let-them-eat-cake moment for the purposes of triggering a faster revolution? I've probably thought about this guy's motives and his potential impact harder than he has. In my manifesto, in my worldview, I don't let grandmas suffer right now so that someone else has a better narrative, even if I am in full support of what that person is trying to do and the mission that they are on, which, by the way, is a longer-term one. This gets me to the third part of my manifesto: The assumption is that transforming the healthcare industry will take a village and I am not alone. When I state this outright, it's gonna seem self-evident; but sometimes it's hard to not push blame here like Toxicity Guy, so I say this sort of in his defense. Here's the point of contemplation: There's maybe four big parts of the healthcare industry at a minimum. We have those trying to fix SDoH (social determinants [or drivers] of health). We have those trying to fix medical morbidity (ie, are patients on evidence-based pathways and taking meds appropriately, limiting polypharmacy side effects/cascades). Once a patient is in the healthcare system, what happens then? Then we have those working hard to improve behavioral/mental health. And lastly, everything going on with what I'm gonna call FDoH (financial determinants of health)—patients making decisions or having decisions made for them due to financial implications for them or for somebody else. Lots of stuff rolls up under these categories, but even just listing out these four things, we got a hell of a lot of work to do to improve the lot of patients and taxpayers and make it easier to do business in this country. I always try to keep in mind that it will take a village. Just because someone is working on getting patients housing or eating better does not imply that they don't care about employers struggling to curb claims billing waste, fraud, and abuse—and vice versa. It's just not everybody can do everything. For me personally, I tend to focus my attention on helping as many patients as possible get on what would be for them the optimal treatment plan or best care pathway. That does not mean I'm anti-someone working on getting more competition in the payer space. Nor does it mean I'm against trying to curb the price of overpriced (as per ICER [Institute for Clinical and Economic Review]) pharmaceutical products or legislate to rein in hospitals doing stuff that, in my book, they should not be doing. I am all for getting all of these things done. I just do not have the bandwidth or the depth of expertise to do everything myself. I would suspect that no one does. As my grandma used to say (and anyone who attended a slumber party seance in eighth grade might know), many hands make light work. You get 15 girls each holding out but two fingers, and you can lift up your friend, no problem. When I keep in mind that it takes a village, it helps me curtail the tendency to become paralyzed in my quest to help patients because I can see a potential problem it might create somewhere else in the industry or somewhere else down the line. I have to trust that one of my fellow villagers is holding down that end of the fort. Here's a quote from J. Michael Connors, MD, that he wrote in his newsletter: “When you point one finger, three are pointing back at you … It's like everything you learned in kindergarten seems to be so applicable to our approach to healthcare. Sadly, the game of finger pointing and pushing blame on others is killing real innovation in healthcare.” This is so real, which is why inherent in my manifesto here is my efforts to remember we are all on the same team (all the good eggs, anyway). That it takes a village, that there will be some things that some people are doing that I maybe don't fully agree with. There might be groups who don't accomplish much. There are certain people doing well (ie, doing self-interested things) but, at the same time, creating a better place for patients. As long as, in general, we are all following the same North Star, we'll achieve much more spending our time focused on our own missions and not worrying about what other people are doing. And when I say “not worrying about what other people are doing,” I mean people in the “good egg” village. I do not mean I intend to stop calling out conflicted and net-negative self-interested behavior, because this is what some people in the village should hopefully have their eyes on and get busy working against. The village here, it's a Venn diagram. At the point where other people's circles intersect with my mission or what I think would be better for patients, these are the people I can work with and collaborate with. These are the people that I'd take their business or I'd try to help them if I can. My manifesto is to determine when something is a positive for patients and then to find others who will win as a result of that thing happening. Then I can study why this is a win for those others, which is always going to be some self-interested why. And then I can think through what the negatives are if their self-interest comes to fruition. Is it still a net positive? If yes, proceed. Look, this making it better for patients, this transforming healthcare, it is hard, dispiriting work. It's a long slog. I'd like to suggest we encourage each other. Can we be the wind beneath each other's wings when we find a kindred spirit? Can we focus on the points of intersection and spend our energy deepening what's going on there? So again, here's my manifesto: If the thing results in a net positive for patients, then I'll do it. The timeframe I'm concerned about … short-term, medium-term. The assumption is that it will take a village to transform healthcare and I am not alone. I feel kind of exhausted having finished that. But let me ask you this: What is your manifesto? If you have one or if you have thoughts on this, go to our Web site and click on the orange button to leave a voice message. My hope is to do an upcoming show sharing what you think.   For more information, go to aventriahealth.com.   Each week on Relentless Health Value, Stacey uses her voice and thought leadership to provide insights for healthcare industry decision makers trying to do the right thing. Each show features expert guests who break down the twists and tricks in the medical field to help improve outcomes and lower costs across the care continuum. Relentless Health Value is a top 100 podcast on iTunes in the medicine category and reaches tens of thousands of engaged listeners across the healthcare industry. In addition to hosting Relentless Health Value, Stacey is co-president of QC-Health, a benefit corporation finding cost-effective ways to improve the health of Americans. She is also co-president of Aventria Health Group, a consultancy working with clients who endeavor to form collaborations with payers, providers, Pharma, employer organizations, or patient advocacy groups.   03:16 “It's a zero-sum game.” 03:26 Is the amount of profit fair? 03:37 What is an inescapable fact of the healthcare industry? 03:54 What does the financialization of healthcare mean? 04:19 Why does the self-interest in healthcare matter? 06:18 “It's basically up to us as individuals to do the right thing.” 10:03 What is the first part of Stacey's manifesto? 10:18 How does Stacey calculate the net positive of an impact? 10:41 What are two major upsides/downsides that Stacey contemplates? 13:31 Why are incremental change and disruptive change not mutually exclusive? 17:40 “I always try to keep in mind that it will take a village.” 19:19 Why finger pointing is killing innovation in healthcare.   For more information, go to aventriahealth.com.   Our host, Stacey Richter, discusses our #healthcarepodcast and where she sees the path moving forward. #healthcare #podcast   Recent past interviews: Click a guest's name for their latest RHV episode! Dawn Cornelis (Encore! EP285), Stacey Richter (EP399), Dr Jacob Asher, Paul Holmes, Anna Hyde, Dea Belazi (Encore! EP293), Brennan Bilberry, Dr Vikas Saini and Judith Garber, David Muhlestein, Nikhil Krishnan (Encore! EP355)  

The White House will ask the Supreme Court to intervene in the legal battle surrounding the abortion medication mifepristone. A federal appeals court ruled in favor of continuing access to the drug, but also limited its distribution through the mail and said it can only be used through the seventh week of pregnancy. Geoff Bennett discussed the ruling with Dr. Jamila Perritt. PBS NewsHour is supported by - https://www.pbs.org/newshour/about/funders

Providers in the St. Louis region are having trouble finding enough workers. Low pay is taking a toll on child care centers and parents.

The White House will ask the Supreme Court to intervene in the legal battle surrounding the abortion medication mifepristone. A federal appeals court ruled in favor of continuing access to the drug, but also limited its distribution through the mail and said it can only be used through the seventh week of pregnancy. Geoff Bennett discussed the ruling with Dr. Jamila Perritt. PBS NewsHour is supported by - https://www.pbs.org/newshour/about/funders

Resolving care gaps requires more than simply introducing technological platforms and helping patients get familiar with digital processes. Despite the rise of video visits to help patients expand their access to numerous services, health centers are finding that a robust virtual care team experience may not necessarily be what all patients are looking for. This learning has helped Petaluma Health Center to focus more resources on patient navigation support as well as accommodations for in-person visits. The goal is not that every patient has a video visit, but that every patient gets the kind of visit that's most appropriate for them.Learn more about the people, places, and ideas in this episode: Jessicca Moore, FNP, and Director of Innovation at Petaluma Health CenterTechnology Hub, a CCI program that helps organizations vet, pilot, evaluate, and spread innovative digital health solutions targeting Medicaid markets and historically underinvested communities

We continue our discussion with Dr. Rachel Goode. Dr. Rachel is an Assistant Professor at the School of Social Work, University of North Carolina at Chapel Hill (UNC-Chapel Hill) and a licensed clinical social worker. She received her PhD, MPH, and MSW from the University of Pittsburgh. Her research interests include developing, implementing, and evaluating interventions to address racial/ethnic and socioeconomic disparities in obesity and eating disorders. HER Health Collective has four key initiatives after narrowing down the myriad of topics affecting mothers. These include, Equity of maternal care, Rejecting Diet Culture, Perinatal Mood & Anxiety Disorders and Expectations of Motherhood. Dr. Rachel's work targets several of these same areas. We discuss how our work coincides and the importance of sharing our personal experiences with food insecurity. Dr. Rachel shares ways to make peace with food, and so much more! Today's episode includes a discussion of the following topics: The difficulty of the public and medical system to recognize when something is disordered. The importance of sharing your story. How to heal your relationship with food and how to eat again. Building a healthy relationship with food at any weight. Why it's more important to feel good in your body. How to make peace with food. The importance of self-determining your desires. The vision of her research going into the medical system. The changes needed in how the medical community is trained to approach and treat marginalized patients. Episode Resources: NCEED - https://www.nceedus.org/ SBIRT screening tool - https://eatingdisorderscreener.org/ Living FREE Lab - https://livingfreelab.org/ Dr. Rachel featured in The Daily Tar Heel - https://www.dailytarheel.com/article/2023/01/university-rachel-goode-feature Intuitive Eating Resources: https://www.intuitiveeating.org/ Counselor Directory: https://www.intuitiveeating.org/certified-counselors/ https://christyharrison.com/haes-anti-diet-intuitive-eating-providers-eating-disorder-recovery HER Health Collective, Directory of Providers: https://herhealthcollective.com/her-experts/ Thank you to our Podcast Sponsor, Camp Gladiator! Get a free week of classes -  campgladiator.com/trainer/tammyyalch Support Mama Needs a Moment! Become a patron through our Mama Needs a Moment Patreon. https://www.patreon.com/HERHealthCollective --- Support this podcast: https://podcasters.spotify.com/pod/show/herhealthcollective/support

Dr. Tamara Huff, MD, MBA sits down with Dr. Alisahah Jackson for a discussion about enhancing the health of every community, and they explore the challenges of building healthier communities against a backdrop of declining health infrastructure, particularly in rural communities. They also discuss the reality of the elephant in the room, that racism exists both in terms of attitudes and bias, and in various structural forms, and how building trust is vital to the displacement of bias.  Dr. Jackson is a proven leader in empowering women to improve their health and the health of their families and communities. She was named the first Chief Community Impact Officer at Atrium Health, where she established strategies for Health Equity and Social Determinants of Health. More recently, she became the System Vice President, Population Health Innovation and Policy, at CommonSpirit Health, and is also CEO of Why Health Matters. Dr. Tamara Huff is a member of Movement is Life Steering Committee & Founder & CEO, Vigeo Orthopedics, LLC. Excerpts:  “There are decisions that are being made for us that actually drive health outcomes. Economic, policy and investment decisions. People may live in a food dessert. Or a maternity dessert. We have to start acknowledging that these decisions are happening outside of our own decisions about our health behaviors.”  “Providers will often label patients as “non-compliant,” and that is a term I encourage everyone to take out of their vocabularies. I simply don't believe that people wake up in the morning and decide that they want to be unhealthy. Our responsibility as care providers is to identify what the barriers are that people have to achieving great health, and help patients mitigate or eliminate them.”   “I was a young African American female physician coming into a community that had only seen one other Black female physician, and I really had to build trust. I'm not going to sugar coat it, there were definitely patients who did not want to see me.” “One of the things I love about Movement is Life is that you are providing resources to help with behavior change. And thank you, Movement is Life, for being an accelerator of these much needed conversations.”  “What the data tells us, what the research tells us, is that people who have providers who look like them, who can connect with them, tend to have better health outcomes. Movement is Life has been culturally humble enough to say that things like food are very cultural, it's one of the things that makes a group uniquely different, so their needs are different. Changes in Hispanic culture are going to look different to changes in African American culture, and different from the dominant culture.”   

On this episode of Provider's Perspective, we speak with Doc Lounge Podcast, Dr. Susan Badidi. Dr. Badidi walks us through her experience of becoming a Family Medicine physician. Dr. Badidi shares advice with upcoming physicians about how to navigate finding the right specialty. She also speaks to the importance of finding the right position to fit your lifestyle and achieve the right level of work-life balance. 

Is there any way to successfully communicate my child's needs to a medical professional that helps me get results? Big question!  Navigating our children's special needs on a daily basis is hard. But what makes the journey even harder is feeling unheard and unseen in a medical or therapeutic provider's office. We've all had that figurative (or maybe literal) door slammed in our face. We've felt dismissed, disregarded, and just plain stupid.  What if we told you there was an effective, and practical, way to successufully communicate your child's needs to providers that got results?  There is. That's why we're excited to welcome Maureen Peterson to The Honestly Adoption Podcast. She's a medical professional but also the parent of a child with chronic illness. She knows the ins and outs of communication from both the professional and parental side of things. And she's here today to share her expertise with us! A Little More About Maureen... In her own words... "As a general pediatrician and allergist/immunologist, I have spent my career caring for patients with a variety of acute and chronic health problems. I am a military veteran and mother of three amazing children. I have first-hand experience with being a parent of a child with long-term health issues. Through my own journey, I have learned that to enjoy the life that I was given even if it wasn't the life I had planned. I became a certified life coach to teach parents how to build self-confidence and decrease overwhelming emotions creating a calm, meaningful life." How To Connect With Maureen... Get her Quick-Start Advocacy Checklist here Follow her on Instagram Connect with her on Facebook Also On The Show... Insight Virtual Conference is coming soon! We're less than 2 weeks away from this exciting conference kicking off featuring over 15 hours of training content, PLUS access to world-renowned thought leaders and trainers. Click Here to learn more! Thanks for stopping by this week ;-) 

Two things to know today Hiring freezes and layoffs impede upskilling efforts for tech workers, Pluralsight report finds AND Bloomberg announces large-scale AI model trained on financial data while deep fake video promotes transparency standard for digitally created content   Advertisers: QuoteWerks: https://quotewerks.com/mspradio/ TimeZest: https://timezest.com/MSPRadio     Do you want the show on your podcast app or the written versions of the stories? Subscribe to the Business of Tech: https://www.businessof.tech/subscribe/   Support the show on Patreon:  https://patreon.com/mspradio/   Want our stuff?  Cool Merch?  Wear “Why Do We Care?” - Visit https://mspradio.myspreadshop.com   Follow us on: Facebook: https://www.facebook.com/mspradionews/ Twitter: https://twitter.com/mspradionews/ Instagram: https://www.instagram.com/mspradio/ LinkedIn: https://www.linkedin.com/company/28908079/      

For rural health care providers, 2022 ended on an up note, when AHA was able to secure some important policy wins in the final omnibus appropriations package to fund the government. This year brings a new set of challenges, goals and opportunities. In this episode, three AHA rural health care policy experts discuss the 2023 rural advocacy agenda for Congress and the Administration.

Well, this episode became extremely relevant again after that Cigna case bubbled up in the news. Here's the “too long, didn't read” version: Attorneys filed a class action lawsuit against Cigna, alleging that the carrier is overcharging for lab services or did overcharge for lab services. The plaintiff is an individual member of a Cigna plan. The complaint tells a pretty wild story. On the Explanation of Benefits (EOB) that this member received for lab services, the amount billed was over $17,000. My understanding is, this member went to Labcorp to get those lab services. Cigna claimed it had negotiated a discount of over $14,000 for those lab services, meaning the remaining balance was something like $2700. OK … good news, I guess. Instead of the lab services costing $17,000, they cost $2700 to the plan and member. Except Cigna said to this member that they were only gonna pay $471 on the member's behalf. This left the member with the responsibility to fork out over $2000 in deductible and coinsurance payments. I'm rounding the numbers here for brevity. So, in sum, member's told she owes $2000+ out of pocket for charges that were allegedly originally over $17,000. Now, a couple things: The cash price for an uninsured customer at Labcorp for the same services was $449, according to the complaint. Also, weirdly, on the Explanation of Benefits, Cigna allegedly said that the lab services provider was not Labcorp. It was “Health Diagnostic Lab” (or everything I just said in all caps with some letters missing) instead of the actual provider Labcorp. Then the plot thickens … The lawsuit alleges that this “HLTH DIAG LAB” is a pseudonym for Cigna Healthcare of Arizona and that this Cigna affiliate used their pseudonym to create a fake invoice. This is also a quote from the complaint. Bottom line, and this is the real point I wanna make here, the actual out of pocket to the payer was something less than $500, $600, you would think. But it appears that the plan was hoping to get almost 5x that out of the plan member. And had this plan member met her deductible that year, I would speculate that this 5x would have come out of the pocket of the plan sponsor. Either way, 5x margin? That's some pretty sweet returns. Look, the point I'm making here isn't about this particular case. It's about the totality of the thing. This case just got a whole bunch of attention because, as Julie Selesnick put it on LinkedIn recently, “This case … hits all the high notes—overcharging, keeping the spread, fraudulent billing.” But think about this for a second. You think this was an isolated incident? That someone in Arizona had a brainstorm to juice their quarterly earnings and set up a whole company to jack up one person's lab payments? I don't know. What do you think? As Lee Lewis mentioned on LinkedIn, while this case has a lot going on, a member getting charged $2500 for what should cost $450 or whatever … he wrote, “I've seen worse.” I say all this to say: Plan sponsors? Hi there. Are you getting your claims data, and are you having it audited for stuff like this? And by whom are you having your claims data audited for stuff like this? And that's not a rhetorical question. I mean, here we have a well-respected payer opening up (allegedly) a reseller of lab services sending allegedly fake invoices. That's one way to vertically integrate, I guess. Here's another way you can vertically integrate that maybe we all should be aware of: companies that provide audit services that many plan sponsors use to check if claims have been paid properly. Those same auditing companies, these same companies oftentimes have another book of business besides their auditing claims for plan sponsors work. They also work with provider organizations doing revenue optimization. Right. They help providers maximize their revenue, revenue that is coming from … claims they send plan sponsors. Sometimes when I talk about this stuff, I feel like I'm in a cartoon—like that meme with all the Spider-Men pointing at each other and nobody knows who is actually Spider-Man because everybody is dressed up in the same costume pointing and saying the other guy is the one causing the problems here. As Dawn Cornelis says in this episode today, approximately 30% of healthcare spending (ie, healthcare payments) are some combination of fraud, waste, and/or abuse. It's a $1-billion-a-day problem. In this episode, we dig into the three main issues that Dawn tends to find when looking at the claims that were going to hit the checkbook of a plan sponsor as per their payer or TPA (third-party administrator): 1. Claims that were not paid correctly: Turns out, 5% to 10% of claims just aren't paid right. There's a whole motley crew of errors that can transpire, but bottom line, the bill was for $10 and somehow the plan sponsor was gonna pay $15. Or they double paid. 2. Things that, if we knew about them, we could do better in the interest of the member: Jeff Hogan put this really well on LinkedIn the other day. He wrote, “Today's purchaser fiduciary needs great analytics to prioritize the needs of their members … including wasteful and abusive vendors, site of care, cost/quality variation in health systems.” Do labs that the plan is being charged $2500 instead of $450 go here or in the next problematic category? I'm not sure. 3. Claims that are just wrong: They should never have been sent in the first place. We also talk about kind of a different issue entirely: the hidden fees that are buried in some of these payer contracts, which felt like a reprise, frankly, of the conversation I had with Paul Holmes a few weeks ago in episode 397 talking about PBM (pharmacy benefit manager) contracts and all the hidden fees and, ultimately, probably costly provisions buried in them that plan sponsors are on the hook for—a lot of times very unknowingly.   You can learn more at claiminformatics.com or by emailing Dawn at d.cornelis@claiminformatics.com.     Dawn Cornelis is a professional in healthcare cost containment with 30+ years of dedication to combatting improper payments, fraud, waste, and abuse. She has led the industry in developing healthcare transparency technology platforms and services. As a result of her efforts, hundreds of millions of dollars of improper payments were delivered through pre- and post-payment technology programs. She is an expert in the field of healthcare claims data, with an emphasis in audit and recovery, and has navigated the payment systems of all of the national healthcare carriers. Furthermore, she approaches each project with integrity and attention to detail while cultivating long-term client relationships. In 1993, Dawn cofounded the first audit and recovery firm and served for 17 years as the chief operating officer of Claim Recovery Services while representing some of the best Fortune 100 companies. In 2017, Dawn cofounded ClaimInformatics, a healthcare technology company that offers a SaaS-based solution product to support health plans in the marketplace that addresses the new transparency regulations. She developed and trademarked multiple technologies and has a United States Patent Pending named CONTINUITY OF CARE (Publication #20150127370). Dawn currently serves as a member of the Self-Insurance Institute of America's price transparency committee, which focuses on legislation and education for self-funded entities. Over the course of her career, Dawn's efforts have supported national and local organizations spanning financial, healthcare, union, and government sectors. With her years of healthcare knowledge, Dawn is a proven expert, consistently delivering excellence.   06:57 The story in the data. 07:33 Who's submitting these claims? 08:04 The three problems with the data. 10:54 The varying factor between carrier systems to stop fraud, waste, and abuse. 11:32 Why carriers don't push for better systems to stop inappropriate dollars. 13:28 The difference between fraud, waste, and abuse. 14:46 “When it becomes the norm, that's what's very bothering.” 15:10 The barriers or hurdles in the marketplace. 17:38 What we don't know about but could do better at when looking at the data. 19:10 “It's not so much the health system and what they are charging. It's about … what the contracted rate is agreed to. That's what drives our costs.” 20:04 “Data's fixed for itself.” 22:49 Identifying and eliminating fraud. 22:54 The lack of enforcement behind preventing illegal billing. 26:01 How providers ensure they aren't inadvertently harming employers and patients through billing.   You can learn more at claiminformatics.com or by emailing Dawn at d.cornelis@claiminformatics.com.   Check out our encore #healthcarepodcast with Dawn Cornelis of @claiminformati1 as she discusses saving billions through healthcare billing. #healthcare #podcast #digitalhealth #healthtech #healthcarebilling   Recent past interviews: Click a guest's name for their latest RHV episode! Stacey Richter (EP399), Dr Jacob Asher, Paul Holmes, Anna Hyde, Dea Belazi (Encore! EP293), Brennan Bilberry, Dr Vikas Saini and Judith Garber, David Muhlestein, Nikhil Krishnan (Encore! EP355), Emily Kagan Trenchard

Seeking abortion care in Idaho is about to get even harder.New legislation in Idaho makes it a crime to assist a minor with abortion care in another state without parental consent.And that has legal implications for providers in Washington.Legal Voice Washington Policy Counsel Alizeh Bhojani is here to explain.We can only make Seattle Now because listeners support us. Make the show happen by making a gift to KUOW: https://www.kuow.org/donate/seattlenowAnd we want to hear from you! Follow us on Instagram at SeattleNowPod, or leave us feedback online: https://www.kuow.org/feedback

In this episode of BackTable, Dr. Bagrodia interviews Dr. William Flanary, a physician-comedian popularly known as Dr. Glaucomflecken, about lessons he has learned as a two-time testicular cancer survivor and the importance of humor in medicine. --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/VJvXZx --- SHOW NOTES First, Dr. Glaucomflecken shares about his first diagnosis of testicular cancer. During his third year of medical school he felt a lump in his testicle, which led to a quick workup, diagnosis, and a full orchiectomy. The diagnosis was emotionally difficult, as he was in his mid-twenties and healthy. He returned to comedy, a skill he had developed in high school and college, to cope with his diagnosis. This time, however, he started to practice medical-based comedy with his new experiences as a medical student. He recounts other discussions he had about his cancer, such as fertility, the possibility of chemotherapy, and active surveillance. Four years after his first orchiectomy, he received his second diagnosis of testicular cancer during his last year of residency. He recounts feeling distraught and overwhelmed, as questions about fertility, hormone replacement, medical expenses, and postponing residency became more serious. He decided to have a full orchiectomy and testosterone replacement therapy, which solved his issues with fatigue and irritability. Additionally, his wife got him involved in testicular cancer support groups and foundations, including one called First Descents, an organization that encourages young adults with cancer to explore the outdoors. He notes that young patients are often overlooked in cancer support groups and encourages cancer patients to find their support networks outside of friends and family as well. Then, Dr. Flanary discusses his experience with suffering from cardiac arrest in 2020, which led to his wife doing ten minutes of chest compressions to keep him alive. He reflects on this event and concludes that it taught him how to be a better physician to his patients by making sure he involves patients' families and encouraging him to address medical insurance issues directly. Finally, Dr. Flanary discusses how he uses humor to advocate and educate patients on social media. He notes that comedy can stimulate conversation and debate and encourages physicians to have social media presence. --- RESOURCES Knock Knock Hi Podcast https://podcasts.apple.com/us/podcast/knock-knock-hi-with-the-glaucomfleckens/id1659572053 First Descents https://firstdescents.org/

In this episode of BackTable, Dr. Bagrodia interviews Dr. William Flanary, a physician-comedian popularly known as Dr. Glaucomflecken, about lessons he has learned as a two-time testicular cancer survivor and the importance of humor in medicine. --- CHECK OUT OUR SPONSOR Veracyte https://www.veracyte.com/decipher --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/VJvXZx --- SHOW NOTES First, Dr. Glaucomflecken shares about his first diagnosis of testicular cancer. During his third year of medical school he felt a lump in his testicle, which led to a quick workup, diagnosis, and a full orchiectomy. The diagnosis was emotionally difficult, as he was in his mid-twenties and healthy. He returned to comedy, a skill he had developed in high school and college, to cope with his diagnosis. This time, however, he started to practice medical-based comedy with his new experiences as a medical student. He recounts other discussions he had about his cancer, such as fertility, the possibility of chemotherapy, and active surveillance. Four years after his first orchiectomy, he received his second diagnosis of testicular cancer during his last year of residency. He recounts feeling distraught and overwhelmed, as questions about fertility, hormone replacement, medical expenses, and postponing residency became more serious. He decided to have a full orchiectomy and testosterone replacement therapy, which solved his issues with fatigue and irritability. Additionally, his wife got him involved in testicular cancer support groups and foundations, including one called First Descents, an organization that encourages young adults with cancer to explore the outdoors. He notes that young patients are often overlooked in cancer support groups and encourages cancer patients to find their support networks outside of friends and family as well. Then, Dr. Flanary discusses his experience with suffering from cardiac arrest in 2020, which led to his wife doing ten minutes of chest compressions to keep him alive. He reflects on this event and concludes that it taught him how to be a better physician to his patients by making sure he involves patients' families and encouraging him to address medical insurance issues directly. Finally, Dr. Flanary discusses how he uses humor to advocate and educate patients on social media. He notes that comedy can stimulate conversation and debate and encourages physicians to have social media presence. --- RESOURCES Knock Knock Hi Podcast https://podcasts.apple.com/us/podcast/knock-knock-hi-with-the-glaucomfleckens/id1659572053 First Descents https://firstdescents.org/

In this episode of BackTable, Dr. Bagrodia interviews Dr. William Flanary, a physician-comedian popularly known as Dr. Glaucomflecken, about lessons he has learned as a two-time testicular cancer survivor and the importance of humor in medicine. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/VJvXZx --- SHOW NOTES First, Dr. Glaucomflecken shares about his first diagnosis of testicular cancer. During his third year of medical school he felt a lump in his testicle, which led to a quick workup, diagnosis, and a full orchiectomy. The diagnosis was emotionally difficult, as he was in his mid-twenties and healthy. He returned to comedy, a skill he had developed in high school and college, to cope with his diagnosis. This time, however, he started to practice medical-based comedy with his new experiences as a medical student. He recounts other discussions he had about his cancer, such as fertility, the possibility of chemotherapy, and active surveillance. Four years after his first orchiectomy, he received his second diagnosis of testicular cancer during his last year of residency. He recounts feeling distraught and overwhelmed, as questions about fertility, hormone replacement, medical expenses, and postponing residency became more serious. He decided to have a full orchiectomy and testosterone replacement therapy, which solved his issues with fatigue and irritability. Additionally, his wife got him involved in testicular cancer support groups and foundations, including one called First Descents, an organization that encourages young adults with cancer to explore the outdoors. He notes that young patients are often overlooked in cancer support groups and encourages cancer patients to find their support networks outside of friends and family as well. Then, Dr. Flanary discusses his experience with suffering from cardiac arrest in 2020, which led to his wife doing ten minutes of chest compressions to keep him alive. He reflects on this event and concludes that it taught him how to be a better physician to his patients by making sure he involves patients' families and encouraging him to address medical insurance issues directly. Finally, Dr. Flanary discusses how he uses humor to advocate and educate patients on social media. He notes that comedy can stimulate conversation and debate and encourages physicians to have social media presence. --- RESOURCES Knock Knock Hi Podcast https://podcasts.apple.com/us/podcast/knock-knock-hi-with-the-glaucomfleckens/id1659572053 First Descents https://firstdescents.org/

This episode's Community Champion Sponsor is Catalyst. To virtually tour Catalyst and claim your space on campus, or host an upcoming event: CLICK HERE---Episode Overview: During this episode, we're joined by Melissa Kozak, co-founder of Citus Health, a digital health transformation leader that enables real-time, secure collaboration between patients, care teams, care partners, physicians, and family members to optimize the patient experience and positively impact the financial outcome of the care provider. While together, Melissa shares her personal experiences as a post-acute nurse and the communication and care coordination challenges she faced while connecting frontline clinical teams with patients and partners in home-based care. Melissa also provides valuable advice for aspiring entrepreneurs looking to start a company in the home-based care space. Join us to learn about Citus Health's mission, the impact of the pandemic on the shift of care to the home setting, and the need for collaborative efforts to solve the clinical shortage problem. Let's go!Episode Highlights:Melissa's experience as a post-acute nurseCommunication and care coordination challenges faced by frontline clinical teams with patientsMelissa's advice for aspiring entrepreneurs in the post-acute spaceWhy Melissa is so passionate about Citus Health's missionThe pandemic's impact on the shift of care in the home settingMelissa's concern about the clinical shortage in nursingThe need for collaborative efforts within the community to solve the clinical shortage problemAbout our Guest: As a post-acute nurse, Melissa saw first-hand the communication and care coordination challenges connecting front line clinical teams with patients, field staff and partners in home-based care. She also recognized that providers were relying on manual processes to communicate and deliver care, causing inefficiencies and decreasing quality of care. Melissa teamed up with a leading healthcare technologist and founded CitusHealth in 2016 to tackle these challenges head on by providing real-time, secure solutions that ensure a high level of care team coordination and family engagement.Links Supporting This Episode:Citus Health website: CLICK HEREMelissa Kozak LinkedIn page: CLICK HERECitus Health Twitter page: CLICK HEREMike Biselli LinkedIn page: CLICK HEREMike Biselli Twitter page: CLICK HEREVisit our website: CLICK HERESubscribe to newsletter: CLICK HEREGuest nomination form: CLICK HERE

This week and in episode 400 of Relentless Health Value, at the encouragement of the Relentless Health Value team, I'm gonna do two shows entitled “My Manifesto,” Part 1 and Part 2. In other words, why did I start Relentless Health Value and what's the goal around here? I started contemplating this mission to define the mission thinking about how healthcare will ultimately be transformed and my role (if any) in all of this—or, more accurately, your role as a listener of this show and, often enough, someone who has the ability to take action. You there, listening right now, you are the alchemist who will transform the words that you hear here into something tangible. And that is how this show makes a difference. It is through the Relentless Health Value Tribe, and you, whether you realize it or not, are a very special person. But before I continue along this complimentary vein, let me back up for just one sec and talk about how I realized how special you are to begin with. It's a funny thing because I get asked all the time who listens to this show, sometimes with a “Who listens to this show?” vibe. I mean, we talk about complicated topics; and when I say we talk about complicated topics, I mean we hurl ourselves right in the middle of them. Acronyms and 400-level perplexities abound. I used to say who listens to this show when asked—and this is absolutely true—I used to say that more than 40% of you are senior-level executives with decision-making authority, which might mean you are a doctor or a nurse or other clinician and a leader of some kind, either formally or informally. You could work at a provider organization, a payer, a digital health company (big or small). Maybe you make policy, you're a researcher, private equity … You're an EBC (employee benefit consultant) or work in benefits at an employer. Maybe you do something in the population health space. You could be a legislator looking for insight. A journalist. Right? We get around. But while the audience of this programme is big (very big by some standards), I run across healthcare industry peeps often enough in decision-making roles who listened to half a show one time and decided it wasn't for them. It took me a long time to put my finger on who listens and who does not, and this was also the moment that I started thinking about our listeners as a tribe. The people who listen 99% of the time are listening to figure out how to do the right thing for patients or members. They want to know how what they do fits into the larger picture, this larger healthcare ecosystem. And they want to know this for actionable reasons. I mean, frankly, this is a lot of the reason why I started this show to begin with: because I found myself in a similar situation (still am, truth be told). I started to understand that doing something in healthcare is like a game of pachinko. The action, which might feel like it logically should result in X good thing for patients, bounces around in this black box that is the healthcare ecosystem and may pop out the other side in ways that are the opposite of what was originally intended. I want to have positive impact, right? All of us do, or you wouldn't be listening right now. And that is the common thread that holds us all together—besides, of course, being smart, capable, curious, and incredibly charming individuals. And I say all this with evidence: Every single person I have met who listens to this show on the regular meets all of these criteria. You are great people, and it is a distinct honor and a privilege to spend time with you every week. I am proud, really proud of what this group of individuals has accomplished. We have moved needles, and we have pushed agendas. Now, I know you people. You are going to be doing one of two things right now. Twenty percent of you are gonna be smiling and thinking about the program you started or the work that you did and the accolades that followed. Or maybe you're just simply aware of what you've done because you have data, or patients or members or family members thanked you and you saw that look in their eyes and you knew how much what you did meant for them. Or you work for a company that is laser focused on some kind of disruption, and it's small enough that you can clearly see your impact. But there's a lot of you (the majority of you, frankly) I get on the phone with, and you're less sure if you've actually had any impact. You are frustrated—and a little depressed maybe—because you see all this madness and ways patients are harmed all around you. You see maybe decisions that you realize have a deleterious (ie, bad) impact on patients or members. You are now eyes on, and now you feel largely powerless. I will tell you the same thing that I tell every member of the Relentless Health Value Tribe who says this. I don't doubt it might be more difficult to see the impact you are having if you work for a larger company or if you work for one of these incumbents, especially when you have a recognition that there might be other departments or other individuals doing things that you may not be fully aligned with. But do not doubt that you have impact and that that impact is meaningful. I was talking to Larry Bauer, and he told me with a lot of conviction (and he's one that would know) that you, Relentless Health Value listeners, you are the innovators. You are the ones who spot problems, and you tinker around with available resources and you figure out how to make it just even a little bit better for patients or members. Think about it this way and just hang with me through this: CEOs do not actually drive what happens in their organizations. The big bosses set up the incentive structures and are the tip of the spear (or whatever that metaphor is) for sure. But an organization's behavior is decided by 10,000 probably tiny little decisions each and every day … 100,000 decisions by the employees of that organization. It's the sum of all those micro choices, those micro moments, that determine the impact that that organization has on those it serves. I saw a meme the other day: “When people travel to the past, they worry about radically changing the present by doing something small. Few people think that they can radically change the future by doing something small in the present.”     Who your boss is doesn't matter is my point. If you are touching things in the middle of that pachinko game, you have power. Right? We are all decision makers here, and we are not synonymous with the companies that we work for. We are not the Borg. Would it be nicer and faster if there wasn't an ongoing financialization of the healthcare industry? If boards of hospitals and private equity and C-suites all would put their “mission before margin” hats on for a change? Yeah, that would be ideal. Would it be nice if the disrupters among us had more market penetration? Sure … the good ones, absolutely. And probably the best path forward is to get ourselves over to a company that's building a new model to make the current one obsolete, to quote Buckminster Fuller. But it's not like it's an either/or. In addition to having a long-term vision, maybe we can do something in the meantime here. I'd rather that some patients and members get treated some amount of better right now as well as envisioning a new model to make the current one obsolete. We each might be pressing forward, I don't know, 0.01% at a time; but let's just consider that 0.01% in this country is 35,000 people plus their families and ~$300 million when it comes to healthcare in the US. Multiply that impact by everybody listening right now—there are thousands of you. So please do not dismiss the impact that you have, no matter who you work for: thinking critically, considering the larger picture, recognizing the impact that your organization has in big ways and in small ways and then making big and small choices and decisions that are aligned with your values and your integrity. Sometimes people will talk to me about what they want their legacy to be, and this is kinda it. So, how to deepen that possible impact that any of us might have? It is always the highlight of my day when I hear that one of you has found somebody else in the RHV Tribe and the two of you (or three of you or four of you) have struck a deal to do something. You've collaborated in some way. The larger organizations everybody might work for … maybe they're on board or half on board, but again, we are not our companies. I love it when I hear that a physician organization hooked up with somebody at a payer and figured out how to do a pilot or collaborate on something, not going through the official Contact Us forms or whatever but by finding somebody on the same mission in that other organization and then everybody working up the chain in their own organizations from the inside. So many different individuals who work for so many different parts of the healthcare ecosystem listen, and there are lots of synergies to explore, especially if we stop thinking at the organizational level and start thinking about what we individually want to achieve. It's possible to help each other, to find the overlapping bit of the Venn diagram where interests align and something can get done. And I'll talk about that more in Part 2. Here's from Malcolm Gladwell's The Tipping Point. He wrote: “If you want to bring a fundamental change … you need to create a community … where … new beliefs can be practiced and expressed and nurtured.” This, maybe in sum, is the ultimate goal of Relentless Health Value: to provide that loose-knit community so that those in the Relentless Health Value Tribe who want to can find like-minded people across the industry to work with, the ones who are also just as well informed and understand how this ecosystem knits together—meaning you can more easily work with them to find points of mutual interest that are net positive for patients. There was a point in my podcast career where I thought having a really broad audience of listeners from all across the industry was kind of a problem because it makes it really hard to answer the question, “Who listens to your show?” But now I realize it's a huge accelerant to our potential impact. As I was recording this, I realized I probably should do one thing here; and that is at some juncture, I will probably make an RHV Tribe directory or something. So, go over to our Web site and sign up for the weekly email, which you can do on the Web site, because whenever I get around to doing that, I will start with everybody on the mailing list (because I have your email address). I'll send out a notice or something and ask if you'd like to be part of that directory. This is Part 1 of my manifesto. Next week (hopefully, if I can get my act together) or, if not, the week after that, I will bring you Part 2. In the meantime, thank you from the bottom of my heart for being who you are and doing what you do. It is going to be Relentless Health Value listeners who turn this oil tanker of a healthcare industry around. I guarantee it.   For more information, go to aventriahealth.com.     Each week on Relentless Health Value, Stacey uses her voice and thought leadership to provide insights for healthcare industry decision makers trying to do the right thing. Each show features expert guests who break down the twists and tricks in the medical field to help improve outcomes and lower costs across the care continuum. Relentless Health Value is a top 100 podcast on iTunes in the medicine category and reaches tens of thousands of engaged listeners across the healthcare industry. In addition to hosting Relentless Health Value, Stacey is co-president of QC-Health, a benefit corporation finding cost-effective ways to improve the health of Americans. She is also co-president of Aventria Health Group, a consultancy working with clients who endeavor to form collaborations with payers, providers, Pharma, employer organizations, or patient advocacy groups.   00:47 What is your role as the listener of this show? 01:27 How did Stacey realize how special our listeners are? 01:56 Who are our listeners? 03:15 Why did Stacey start the Relentless Health Value podcast? 04:10 What have the listeners of the Relentless Health Value podcast and its guests accomplished? 05:13 What is Stacey's advice to listeners that feel powerless? 06:22 “It's the sum of all those micro choices … that determine the impact that that organization has on those it serves.” 09:22 “There are lots of synergies to explore.” 10:51 Sign up for our weekly email here.   For more information, go to aventriahealth.com.   Our host, Stacey Richter, discusses why she started our #healthcarepodcast. #healthcare #podcast   Recent past interviews: Click a guest's name for their latest RHV episode! Dr Jacob Asher, Paul Holmes, Anna Hyde, Dea Belazi (Encore! EP293), Brennan Bilberry, Dr Vikas Saini and Judith Garber, David Muhlestein, Nikhil Krishnan (Encore! EP355), Emily Kagan Trenchard, Dr Scott Conard