Podcasts about quality measures

Your primary care provider is doing their best. But there's something they may not be telling you — not because they're hiding it, but because they simply can't know everything.In this episode of Your Health University, Jamie Preston sits down with Scott Middleton — Founder and Chief Disruption Officer of Your Health — to talk about one of the most underutilized parts of the American healthcare system: specialty care. Scott shares real stories from the field that will make you rethink what you expect from your next appointment, including a patient who had been living in a nursing home for years without ever being offered a weight-loss medication that was available to her, and a lawsuit that turned on a single chest x-ray that no one thought to order.What you'll learn in this episode:Why your primary care provider legally cannot keep up with every new medication, treatment, and specialist recommendation — and what to do about itWhat GLP-1 medications are, who qualifies, and why so many eligible patients are never told they existThe standard of care around lung cancer screening for smokers — and why not knowing this can have life-altering consequencesHow to ask for a specialist referral (and what happens if your provider pushes back)Why behavioral health is one of the most under-accessed specialties in America — and how to change that for yourselfWhat "integrated care" actually looks like when it works — and what you deserve to expect from your healthcare teamYou are the CEO of your own health. This episode gives you tools to act like it. www.YourHealth.Org

Most healthcare organizations know specialty care matters. Almost none of them are actually using it at the level their patients need.In this episode of The Disrupted Podcast, Jamie Preston sits down with Scott Middleton — Founder and Chief Disruption Officer of Your Health — for an unfiltered look at one of the most critical gaps in care delivery: specialty services. Your Health currently routes about 10% of its patient appointments through specialty providers. The national average is 20%. Scott makes the case — with real stories from nursing homes, lawsuits, and the road across South Georgia — that closing that gap isn't just a clinical priority, it's a survival strategy.What you'll hear in this episode:Why a 400-pound patient in a nursing home had never been offered a GLP-1 for weight loss — and what that reveals about how providers think about specialtyThe exact communication chain (DPH → EDCS → Care Manager → Provider) and precisely where it breaks downHow 80% of Your Health patients have behavioral health needs while psych providers sit with open schedules — and how to fix that paradoxWhy texts and emails don't cut it in care coordination — and why voice-to-voice is the only real standardThe lawsuit that should have been prevented with a single chest x-ray, and what it means for provider accountability going forwardWhy Scott banned the word "no" inside Your Health — and the mindset shift that comes with replacing itSpecialty is what separates Your Health from every other provider in the market. If you're a DPH, a care manager, or a provider inside this system — this episode is for you. If you're a healthcare leader watching specialty care fall through the cracks anywhere, it might be for you too. www.YourHealth.Org

Vivek Garg, MD, President and CEO of the National Committee for Quality Assurance (NCQA), joins Josh Israel, MD and Sean Cavanaugh to talk about the future of quality measurement in healthcare. While acknowledging clinician frustration with sometimes fragmented or conflicting quality metrics, Dr. Garg shares NCQA's strategy to harmonize CMS quality measurement frameworks including the new Advanced Primary Care (APC) program. APC leverages interoperable data and outcome-oriented signals to align healthcare stakeholders in value-based care. Ultimately, the goal is to shift to a measurement system that supports primary care clinicians in delivering high-quality, patient-centered care that rewards clinicians for improving patient outcomes.

Most families don't know what skilled nursing actually is until the moment they desperately need it — and by then, the system feels impossible to navigate. Joy Patterson has spent 25 years inside that system. She's here to change what you think you know about it.In this episode, Jamie sits down with Joy Patterson, VP of Skilled Nursing Facilities at Your Health, for a straight-talking conversation about what skilled care really looks like, why it's constantly misunderstood, and what separates facilities that deliver exceptional outcomes from the ones that fall short.Key topics covered:Why "we have great relationships" no longer wins hospital referrals — and what C-suite administrators are actually asking forHow avoidable hospitalizations happen, and the clinical interventions that prevent them before a cough becomes pneumoniaThe staffing crisis hitting skilled nursing hardest, and how embedded partnerships change the equationWhat value-based care actually means at the bedside — and why it has nothing to do with cutting cornersThe questions every skilled nursing administrator should be asking a physician partner (but mostly aren't)Why physical presence inside a facility — not remote support — is the single biggest factor in better outcomes for residents and familiesWhether you're a healthcare professional, a family member navigating a loved one's transition, or a Your Health team member building fluency in the landscape — this episode gives you a clearer picture of what excellent skilled care looks like, and why it matters more right now than it ever has before. www.YourHealth.Org

In this episode of The Dish on Health IT, Tony Schueth, CEO of Point-of-Care Partners (POCP), welcomes Angel Ballew, Head of Pharmacy Clinical Programs & Services at Centene Corporation, along with Seth Joseph, Managing Director of Summit Health Advisors, and Jason Reed, Senior Consultant at Point-of-Care Partners, for a discussion about what it will take to scale pharmacist-delivered clinical services. The conversation builds on findings from the NCPDP Foundation-funded white paper, A Business Model Framework to Scale Pharmacy-Delivered Clinical Services, developed with contributions from Point-of-Care Partners and Summit Health Advisors. The research starts from an important premise: there is already significant evidence that pharmacist-delivered clinical services can improve patient outcomes. The harder question is how to make those services operationally and financially sustainable at scale. Tony begins by asking Angel about the role pharmacists can play in closing care gaps, particularly for vulnerable and rural populations. Angel notes that Centene serves approximately 3.5 million people living in rural communities, but emphasizes that access challenges extend beyond geography to transportation, housing, food insecurity, and other social determinants of health. Against that backdrop, pharmacists can be among the most accessible healthcare professionals in a community and may interact with patients more frequently than physicians or other providers. Angel describes opportunities for pharmacists to reinforce medication adherence, identify medication-related concerns, provide immunizations, support test-and-treat services, conduct screenings, and perform other clinical services. As states continue expanding pharmacists' scope of practice and provider recognition, she sees opportunities to further integrate pharmacists into the healthcare team, particularly in communities with limited provider access. Seth and Jason broaden the discussion by sharing what emerged from the stakeholder interviews and industry research behind the white paper. Pharmacist-delivered services are already being piloted or implemented across areas including gaps-in-care counseling, test-and-treat programs, medication counseling and medication therapy management, immunizations and preventive screenings, and chronic disease management. Jason notes that pharmacists can play an important role between physician visits for patients managing conditions such as diabetes and hypertension. The conversation then turns to one of the biggest obstacles to scale: reimbursement and credentialing. Angel describes the tension between generating enough patient volume to make participation worthwhile for pharmacies and demonstrating enough outcomes and value to justify health plan investment. She discusses Centene's work to make credentialing requirements clearer for pharmacy partners, including the internal education required to bring pharmacy into processes traditionally designed around other healthcare providers. Tony asks Seth what the research suggests needs to change. Seth explains that the findings pointed strongly toward health plans and pharmacies working together to lead the development of sustainable models. Pharmacy benefit managers remain important participants with established relationships, networks, technology, and processes, but Seth describes the difficulty an innovative program champion within a PBM can face when they must first secure a client and then assemble participating pharmacies. Health plans may have greater ability to initiate programs and bring the necessary parties together, although their different lines of business and geographic markets add their own complexity. Angel shares how some of this has played out at Centene. The organization has worked directly with pharmacy communities and industry partners, often state by state because of differences in pharmacist scope-of-practice requirements. At the same time, Centene has developed a national program with consistent quality measures and an infrastructure that can support additional pharmacy service opportunities. That experience provides a real-world look at what scaling can require. Angel describes participation approaching 73 percent nationally and nearly 30,000 pharmacies contracted to participate in the program, including growth of more than 10,000 pharmacies over the past several years. She points to consistency as an important part of building participation. Rather than continually replacing programs with something new, Centene has gathered feedback and iterated, helping pharmacy partners gain confidence that the opportunity is stable enough to warrant their investment. The discussion then returns to a central finding of the white paper: the “cold start,” or chicken-and-egg, problem. Pharmacies may hesitate to invest in technology, staffing, workflow redesign, and clinical capabilities until sufficient patient volume exists, while health plans want sufficient pharmacy participation before investing in programs and measuring outcomes. Meanwhile, differences in credentialing, enrollment, reimbursement, contracting, and reporting continue to create practical barriers. Tony introduces the concept of regional Pharmacy Health Alliances for Reimbursable Medical Services, or PHARMS, as one potential approach to addressing the cold-start problem by bringing health plans and pharmacies together within a geographic market. Angel agrees that the concept begins with the right problem. The industry does not lack evidence that pharmacists can improve outcomes or help address gaps created by provider shortages. What remains less aligned is the business model. She cautions, however, that health plan operations vary considerably across lines of business, patient populations, benefit designs, quality priorities, and state Medicaid requirements. A regional model therefore needs enough flexibility to account for those differences. Seth explains that this variation is precisely why the research pointed toward regional collaboration rather than attempting to solve every issue nationally at once. The goal is not necessarily complete standardization, but identifying enough commonality among health plans and lines of business to prioritize a smaller number of services and begin building the infrastructure needed to support them. Angel views those complexities as design considerations rather than reasons not to pursue regional collaboration. She also sees the potential for lessons and common approaches developed regionally to eventually contribute to greater standardization nationally, particularly within individual product lines. Jason brings the discussion back to the pharmacy perspective. Pharmacies need confidence that services will be reimbursed before they can reasonably invest in technology, redesign workflows, train staff, and begin documenting clinical care differently. Regional collaboration among multiple payers could give pharmacies greater confidence that those investments will support sufficient patient volume while creating value for patients, pharmacies, and payers. From there, the conversation moves to another critical requirement for advanced pharmacy practice: data interoperability. Tony points out that pharmacists cannot effectively close care gaps if relevant clinical information remains siloed. Angel agrees that pharmacists need timely, actionable clinical information and enough context beyond the dispensing system to intervene effectively. At the same time, she cautions against overwhelming pharmacists with more information than they can realistically use within their workflows. She also challenges the idea that interoperability must be an all-or-nothing proposition. While the industry continues working toward a more ideal interoperability environment, imperfect data exchange should not prevent health plans and pharmacies from making progress today. Jason expands on the interoperability challenge by discussing the emerging concept of a pharmacy EHR. Pharmacy management systems are highly effective at supporting medication dispensing and claims transactions, but advanced clinical services require additional information. He argues that the answer is not simply to deliver the entire EHR to the pharmacist. Instead, the industry needs to identify the minimum actionable clinical information pharmacists need to make better decisions and perform specific services. Just as importantly, Jason emphasizes that pharmacy interoperability must be bidirectional. Pharmacists increasingly generate clinically valuable information through patient interactions, and that information also needs to reach providers and other members of the care team. Angel notes that Centene already receives some information back from pharmacies, including through programs involving social determinants of health, although the more seamless bidirectional infrastructure envisioned by the group is still developing. Looking ahead five years, Seth describes himself as a “data-driven optimist.” He points to momentum across private-sector organizations, national and independent pharmacies, state governments, and policy initiatives. While significant reimbursement, policy, and infrastructure challenges remain, he believes many of the pieces needed to overcome the cold-start problem are beginning to come together. Angel shares that optimism. Her hope is that pharmacists become a much more integrated and visible part of frontline healthcare delivery. The COVID-19 pandemic demonstrated how accessible and valuable pharmacists can be when the healthcare system needs them, and she sees an opportunity to continue moving the profession beyond its traditional dispensing role. Jason adds that demographic pressures, including an aging population and primary care capacity challenges, will continue creating demand for pharmacists to practice at the top of their licenses. He expects states to continue expanding pharmacist prescribing authority and clinical roles while technology, interoperability, and potentially AI help pharmacies operate more efficiently and support broader clinical services. Tony closes with the question asked of every guest on The Dish on Health IT: what is one habit or perception healthcare stakeholders should change or revisit starting tomorrow? Angel challenges listeners to think about pharmacists as more than medication experts. They are also access experts. In a healthcare system facing provider shortages, increasing complexity, barriers to care, and pressure to improve quality, she encourages healthcare leaders to ask how they can better leverage one of the most accessible healthcare professionals available in nearly every community. Rather than focusing only on what pharmacists dispense, Angel leaves listeners with a broader question: What can pharmacists prevent or help solve? The episode closes, as always, with the reminder that Health IT is a dish best served hot. Prefer video? Catch episodes on the POCP YouTube channel

Most nursing home administrators don't realize they're sitting on one of the most underutilized revenue streams in all of Medicare — and until someone shows up and tells them what it's worth, they never will. In this episode, Scott Middleton — founder and Chief Disruption Officer of Your Health — calls in from the road as he travels across rural Georgia on a multi-day facility tour, fresh off completing a major merger with TCPA. What follows is an unfiltered, on-the-ground breakdown of two transformational opportunities Scott is actively building: chronic care management (CCM) reimbursement and ACO cost savings — and the very specific reasons most of the industry is getting both wrong. In this episode, you'll hear: Why Medicare already pays $65/hour for care management performed by nurses, community health workers, and social workers — and how Your Health is now contracting with nursing home facilities to perform it, paying them up to $100 per patient per month The "Fuse" platform — a communication and documentation tool that routes care management notes directly into billing-ready buckets, syncing with point-of-care software so the minutes get captured and billed automatically How ACO risk scores work, why Your Health's scores have grown 30% under their current plan, and what failing to see hospice patients could cost the organization — up to $22 million in a single year The $4,800 per patient per year problem: how one physician in their network was quietly rated one of the worst under the ACO model simply because his patients were going home without any follow-up Scott's announcement that SSAs and TCPs are being restructured to report directly to peer group administrators — and why the confusion about their roles has cost the company If you lead a nursing home, an assisted living facility, a physician group, or any organization inside the long-term care ecosystem, this episode will change how you look at what you're already doing — and what you're leaving behind. www.YourHealth.Org

What if the patient you discharged three years ago is still costing you money today? In this episode of The Disrupted Podcast, Scott Middleton pulls back the curtain on the mechanics of value-based care most providers never see — and the merger bringing it all into focus. With the July 15th closing date approaching, Scott walks through what the merger of Your Health with TCPA and Providence Care actually means on the ground: new contracts, new provider numbers, a reimbursement model built on RAF scores and revenue rather than guesswork, and a technology stack — from the Clini app to QR-coded patient wristbands — designed to capture what was previously left on the table. In this episode: Why patient attribution under value-based contracts follows you for years — and what hospice discharges are really costing the organization How the new bonus structure ties pay to billing, RAF scores, and quality measures (and why you can never be paid to put someone on hospice) The difference between care management, facilitated visits, and what providers have been under-billing all along How skilled nursing facilities became the highest-leverage opportunity in the entire model Why advanced care plans aren't just clinical — they're a 30% income increase hiding in plain sight If you've ever wondered why the "why" behind a process matters more than the process itself, this episode is the answer. Press play. www.YourHealth.Org

What if the people case-managing your care had a financial reason to keep you sicker? That's the uncomfortable question Scott Middleton puts on the table in this episode — recorded live from the American Case Managers Conference in Orlando, where Scott went to learn, and ended up being told Your Health didn't "fit" because they weren't a hospital. Jamie and Scott unpack what the nurse case manager role actually looks like at Your Health — and why moving case management out of hospitals and into patients' homes isn't just better care, it's better economics. Scott shares the research proving the model works: 50% reduction in Medicare spend when patients are seen at the right frequency by the right people. In this episode: Why hospitalists may be "the demise of the American healthcare system" The difference between nurse practitioners (diagnose and treat) and nurse case managers (assess and guide) — and why blurring them costs patients The 16.05-visits-per-risk-point model David Clemens' research validated How coding departments are quietly diagnosing patients with diseases they don't have Why Medicare's 6-year insolvency window may be the disruption we need Head-to-toe assessments, delegation rights, and the real job of an RN in the home If you've ever suspected the system is working exactly as designed — just not for the patient — press play. www.YourHealth.Org

In this episode of The Disrupted Podcast, Jamie and Scott have a  raw, specific, and deeply personal conversation about Care Managers: who they are, what they're actually supposed to do, and why getting this role wrong is costing patients their health and organizations millions of dollars. Scott opens with a story that hits hard: his 91-year-old father's recent hospitalization, the mistakes that nearly happened, and what it cost him — financially and emotionally — to navigate a system that wasn't built for the patient. What you'll hear in this episode: Why care managers are controllers, not schedulers — and what happens when organizations get that wrong The medication reconciliation crisis: how discharge errors are sending patients straight back to the ER How Your Health's new geographic mapping tool is transforming how care teams schedule 30 days of visits in advance The shared bonus model designed to stop care team members from fighting over visits — and start winning together What care managers should never be doing — and the analytical skill set that separates great ones from average ones If you're building care teams, leading a healthcare organization, or just trying to keep a loved one safe in a broken system, this episode will change how you think about the people standing between your patients and the hospital. www.YourHealth.Org

What happens when ancient philosophical questions about "the good life" collide with modern healthcare regulations?  In this compelling episode of TCNtalks, host Chris Comeaux welcomes hospice leaders Annette Kiser, Chief Compliance Officer with Teleios, and Judi Lund Person, Principal, Lund Person & Associates LLC,  for a deep dive into the regulatory crossroads facing hospice providers.In this episode,  we discuss the FY 2026 Proposed Rule, which focused on implementing the HOPE initiative, and two RFIs (Requests for Information) that were part of it.  Also, discuss how important it is for us in the hospice field to give CMS feedback via these RFIs.  These will impact the Future Quality Measure Concepts for the Hospice Quality Reporting Program, and CMS is asking for input on three concepts for the  HQRP Hospice Quality Reporting Program:- The Challenges of Interoperability,- The Evolving Quality Measures related to Patient Well-Being - Nutrition, including Safe Eating Habits, Exercise, Nutrition, and Activity  appropriate for end-of-life careLast, they discuss a separate RFI related to the Advanced Digital Quality Measurement (dQM) in the HQRP (Hospice Quality Reporting Program) and the data standards of Health Level Seven® (HL7®) and Fast Healthcare Interoperability Resources® (FHIR®).Annette and Judi have a wealth of experience and knowledge.  This is a great listen for staff, leaders, and Boards of hospice and palliative care organizations to become more educated about the tracks being laid with the proposed 2026 Wage Index.  This show is timely and relevant, so join us.Guest:Annette Kiser, Chief Compliance Officer with Teleios Judi Lund Person, Principal, Lund Person & Associates LLC Host:Chris Comeaux, President / CEO of TELEIOShttps://www.teleioscn.org/tcntalkspodcast/navigating-the-future-hope-wage-index-and-cms-quality-measuresTeleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

In Part 2 of our deep dive into the MDS process, Heart-to-Heart with HealthCap welcomes back MDS expert to unpack the most recent updates to the Minimum Data Set (MDS) as of October 1, 2023. Angie Szumlinski and Robin explore critical coding changes, penalties tied to incomplete assessments, challenges with Section GG, and how interdisciplinary teams can improve accuracy and resident outcomes. From quality measures to schizophrenia audits, this episode is packed with practical insights for senior living professionals navigating today's MDS landscape. Robin has also created a to support your learning!

CASS Care, một tổ chức phi lợi nhuận phục vụ cộng đồng đa văn hoá, có nhiều chương trình hỗ trợ thiết thực dành cho người cao niên, trong đó có cộng đồng người Việt. Một tin vui là mới đây Viện dưỡng lão do CASS điều hành tại Campsie đã đạt xếp hạng 5 sao trên hệ thống đánh giá của My Aged Care, dựa trên các khía cạnh như Tuân thủ quy định (Compliance); Chất lượng dịch vụ (Quality Measures); Trải nghiệm của cư dân (Residents' Experience); Nhân sự (Staffing). Cô Giang Phan đại diện cho tổ chức nầy cho biết về các dịch vụ, cũng như thủ tục để giúp đỡ cho các bác cao niên muốn hưởng dịch vụ.

In this episode of Heart-to-Heart with HealthCap, Angie Szumlinski is joined by MDS expert for Part 1 of our two-part deep dive into the MDS process. Robin shares how the MDS is used across care delivery, compliance, and reimbursement—and why coding accuracy and interdisciplinary collaboration are more critical than ever. Whether you're new to MDS or need a refresher, this episode offers foundational insights you won't want to miss. Robin has also created a f to support your learning!

In this episode, join moderator Brea Burmeister and experts Dr. Scott Weiner and Dr. Arjun Venkatesh as they explore how quality measures can transform opioid use disorder (OUD) care in emergency departments. Discover innovative metrics, quality improvement initiatives, and EHR data integration to optimize patient outcomes. Learn about overcoming barriers like stigma and resource shortages and get key recommendations from recent OUD treatment studies. Perfect for healthcare professionals and anyone interested in advancing OUD care.What You'll Learn:Challenges and opportunities of addressing the opioid epidemic in emergency medicineACEP's work on metrics and the development of quality improvement measuresKey quality initiatives to enhance OUD care and reduce harmThe barriers to adopting these initiatives and strategies to overcome themRecommendations based on recent studies in OUD treatment and medicationMODERATOR: Brea BurmeisterMember, CHIME Opioid Task ForceBio: With 23 years in healthcare, Brea specializes in managing relationships within Integrated Delivery Network (IDN) Health Systems, regional Group Practices, and Specialty Pharmacy accounts. She strengthens value-based care models by developing strategic plans, analyzing performance data, improving care coordination, and implementing process improvements. Brea's work enhances patient outcomes and experiences while reducing costs. Additionally, her volunteer work with the Opioid Task Force reflects her commitment to public health advocacy and community well-being.GUEST: Scott Weiner, MD, MPH, FAAEM, FACEP, FASAMEmergency and Addiction Medicine Physician, Brigham and Women's HospitalAssociate Professor, Harvard Medical SchoolCo-chair, Clinical Advisory subcommittee, CHIME Opioid Task ForceBio: Dr. Weiner is the McGraw Distinguished Chair in the Department of Emergency Medicine at Brigham and Women's Hospital and an Associate Professor of Emergency Medicine at Harvard Medical School. He is board-certified in emergency medicine and addiction medicine. He is an active researcher, working on multiple projects that focus on prevention and treatment of opioid use disorder.GUEST: Arjun Venkatesh, MD, MBA, MHSChair, Department of Emergency Medicine, Yale University School of MedicineChief, Emergency Medicine, Yale New Haven HospitalBio: Dr. Venkatesh is Chair and Chief of Emergency Medicine at the Yale University School of Medicine and Yale New Haven Hospital. He has received over $ 12 million in funding by the NIH, CMS, AHRQ, and CDC to develop measures and interventions that improve acute care outcomes and value. He has supported CMS's development of the Overall Hospital Quality Star Ratings, has led the development of quality measures for the Clinical Emergency Data Registry, and is PI of the Emergency Quality Network (E-QUAL). His work has produced over 200 publications and been implemented in numerous national quality and value programs. He is a graduate of Northwestern University School of Medicine, a proud graduate of the HAEMR Class of 2012 often referred to as the Greatest Class Ever, and completed the RWJF Clinical Scholars Program at Yale.Additional Resources:ACEP E-QUAL opioid initiativeCedr

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, senior curriculum development specialist with AAPACN, discuss ways nurse assessment coordinators can advance their Quality Measures knowledge. Additional Resources:Quality Measure IQ Series: Pressure Ulcer Measures – ArticleQuality Measure IQ Series: Antipsychotic Medication Measures – ArticleQuality Measure IQ Series: All the Vaccine Measures – ArticleQuality Measure IQ Series: Discharge Function Score Measure – ArticleQuality Measure IQ Series: Long-Stay Falls Measures – ArticleQuality Measures: Fundamentals of Exclusions – PodcastJanuary 2025 Five-Star Unfreeze: What to Expect – PodcastMDS 3.0 Quality Measures: Start with the Basic Ingredients – May 2, 2024 – On-Demand WebinarAt-a-Glance QM, QRP, and VBP Tool – ToolWhen MDS 3.0 Quality Measure Triggers Start and Stop – ToolFive-Star and Care Compare MDS 3.0 Quality Measure Data Periods – ToolQuality Measures Survival Guide – ProductQuality Measures Rescue Guide – Product

In this episode:Meet Vlad KoganLearn about quality measures that isolate school effects from out-of-school effects.Understand some of the factors that impede school board accountability.Hear a bit about Vlad's forthcoming book

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, curriculum development specialist for AAPACN, discuss Quality Measures and some fundamentals about exclusions. Additional Resources: QM Survival Guide

The Mohua Show is a weekly podcast about everything from business, technology to art and lifestyle, But done and spoken ईमानदारी सेConnect with UsMohua Chinappa: https://www.linkedin.com/in/mohua-chinappa/The Mohua Show: https://www.themohuashow.com/Connect with the GuestMahipal Singh: https://www.linkedin.com/in/mahipalsinghmehta/Follow UsYouTube: https://www.youtube.com/@TheMohuaShowInstagram: https://www.instagram.com/themohuashow/LinkedIn: https://www.linkedin.com/company/themohuashow/For any other queries EMAILhello@themohuashow.comEpisode Summary: Join the latest episode with Mahipal Singh, a visionary social entrepreneur and the founder of Revaa, a pioneering brand dedicated to menstrual health and hygiene. Mahipal's journey into this vital advocacy began during the COVID pandemic when he managed his daughter's first period and recognized the stark lack of access to hygienic menstrual products. His perspective is clear: menstrual health is not solely a women's issue but a societal one, necessitating open conversations and the dismantling of societal barriers surrounding menstruation. Mahipal invites everyone to become pad ambassadors, partaking in awareness drives to combat stigma and fostering a positive mindset to enhance overall well-being and confidence during menstruation.Chapters:00:00 - Introduction03:08 - Inspiration Behind Revaa05:48 - Unique Products by Revaa09:23 - Success Stories of Revaa14:20 - Challenging the Societal Myths21:10 - Lifestyle Changes Contributing to Healthier Menstrual Cycle25:38 - Safety & Quality Measures by Revaa29:30 - Team at Revaa Driving the Mission31:40 - Closing RemarksDisclaimerThe views expressed by our guests are their own. We do not endorse and are not responsible for any views expressed by our guests on our podcast and its associated platforms.TheMohuaShow #Podcast #PodcastEpisode#Revaa #RevaaMenstrualHealth #WikiPeriod #PeriodPositivity #MenstrualStigma #ReusableProducts #MenstrualHealthAwareness #PeriodEducation #EcoFriendlyPeriod #MenstrualHygiene #PeriodMyths #SustainableBrands #MahipalSingh Thanks for Listening!

At The Heart of Pediatric Care: A Conversation with Dr. Stephen Hirsch. M.D., FAAPIn this episode, the hosts interview Dr. Stephen Hirsch, a pediatrician with an independent practice Hirsch Pediatrics in Rockville, Maryland. The discussion covers the intricacies of running and maintaining a pediatric practice, the importance of attention to detail, the advantages of independent practice, and the significance of having a well-designed office environment. Dr. Hirsch shares his journey, vision, and passion for pediatric care, emphasizing the emphasis on patient experience, the role of telemedicine, the integration of mental health services, and the financial aspects of running a successful practice.00:00 Introduction and Guest Welcome00:53 Dr. Hirsch's Journey to Pediatrics01:35 Designing the Perfect Pediatric Office03:12 Recruiting and Retaining Staff06:12 Independent Practice vs. Hospital Systems08:42 Challenges in Practice Management09:37 Training and Mentoring New Physicians15:31 Importance of Patient Relationships20:54 Quality Measures and Vaccination Rates27:11 Impact of Sick Visits on Practice Revenue27:39 Balancing Sick Visits and Well Visits29:03 Patient Portal and Triage Strategies30:29 Embedding Mental Health Services33:18 Challenges of Mental Health Integration34:26 Running a Pediatric Practice: Analogies and Insights36:59 Managing Work-Life Balance in a Small Practice40:37 Telemedicine and Office Management45:50 Financial Realities and Pediatric Practice51:32 Concluding Thoughts and Future OutlookSupport the Show.

Welcome back to the Pear Healthcare Playbook! Every week, we'll be getting to know trailblazing healthcare leaders and diving into building a digital health business from 0 to 1. Today, we're thrilled to introduce Ron Vianu, the CEO and visionary behind Covera Health. Covera Health is a pioneering AI-enabled diagnostic technology company, specializing in radiology performance measurement and its consequential impact on healthcare. With a career spanning over three decades, Ron has been a driving force at the intersection of healthcare, technology, and insurance. Ron's entrepreneurial journey began over 30 years ago, founding his first health tech company while a senior at NYU.    His first deep exposure to the field of Radiology was with Spreemo, a company he founded with his co-founder, an orthopedic surgeon, in 2010.  Spreemo was a referral management platform in the occupational medicine space. Spreemo grew to over 200 employees across offices in New York City and Dallas and received significant investment from venture and PE investors.  In this episode, we talk about Ron's work with Spreemo, how he started Covera Health, the partnership with Walmart, his thoughts on the future of AI in radiology, and advice he has for founders. 

Dr. Lisa Vinci joins the Clinical Excellence Podcast to discuss the nuances of quality measures in primary care. Delve into the complexities of healthcare metrics and their impact on patient care, with insights on navigating between standardized measures and personalized medicine.

In this podcast, Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, curriculum development specialist for AAPACN, discuss a few outstanding questions that members asked during the recent AAPACN webinar, Keep Quality Measures Hot During the Five-Star Freeze.

This week's episode of the #BuzzPodcast is all about the newly revised Quality Measure User's Manual. Clinicians, administrators, and operators, are you ready to navigate these crucial updates?Stay informed and tune in!

On today's episode, Madison sits down with Aparna Gupta, NHPCO's VP of Quality, and Sarah Simmons, NHPCO's Director of Quality, to discuss the future of quality measures to ensure the hospice and palliative care community is as equitable and accessible as possible.  Have a question that you'd like to hear discussed on an upcoming episode? Email Madison at podcast@nhpco.org 

In this episode we hear the second half of the conversation between CHESS' own Melissa Pollock and Advocate Health's Vice President of Population Health Midwest Megan Reyna as they discuss navigating the data and quality measures for success in Value-based care.So Megan thank you so much for coming back to the Move to Value podcast. I'm really excited to talk to you a little bit more about population health at Advocate and curious - we did talk last time about ACO REACH. I was just curious a little bit about provider buy-in. How did you message ACO REACH and the model to providers? What did that look like? How were you able to get providers on board with this new innovative model?Thanks for having me back, Melissa, happy to be here. Yes so everything that we do within population health in the Midwest really goes through a strong physician governance model and it is a true partnership with our physicians to participate in in in our value based care contracts. So ACO REACH as well, we really educated the practices who we thought would be good participants based on the data that we talked about last time to participate in ACO REACH would benefit from this program and we had conversations with them, really educated them on this program and the why and what the wraparound services would look like and then we continue to have conversations with them around what where we need to innovate within this model. The Medical Group as well because our Medical Group does participate in both Wisconsin and Illinois again in the areas of Milwaukee and then the South side of Chicago around what their needs are and really um what the practices, that entire care team, is needing umm in order to help patients manage their chronic diseases. And that's a conversation that we have with our practices and we continue to look at our data to say what are we seeing within the data to provide different services as we move forward. It will be a care model that continues to iterate um as we move along within this program to make sure that we're successful and patients are getting the needed care that they need.Did you find it difficult to get providers on board with downside risk or, I know you mentioned in the last podcast that you guys have been doing capitation for a long time, but I didn't know was there any pushback that you felt or any kind of hurdles you had to jump over in those conversations with some of the providers maybe some of the independent ones?So our aligned practices that are participating we did have um intentional conversations around capitation for this population. This is a population we were very intentional with what population we were participating in and this is a tough population that often is not going in to see the primary care provider. And so you know I think COVID also um brought a unique opportunity for our physician practices to think differently about capitation and what are benefits of capitation and so really looking at this population and providing an upfront payment to those practices, we are in total care um capitation for ACO REACH, um really provided them an opportunity to think differently. And I think our strong history with value-based care contracts and success that they've been able to see they were able to view it as a true partnership. And it wasn't a one and done we meet with these practices on a monthly basis and we are continuing to look at the finances and make sure that our model makes sense and that they're successful because if they're not successful within the model then the model isn't successful for us and so they really need to be able to provide the needed services and say something's working or not working um for the success of our entire project participation.So, you guys are really providing data to those providers on a monthly basis of performance I would guess and metrics, is that right?...

At the intersection of ICD-10-CM social determinants of health (SDoH) codes and the Centers for Medicare & Medicaid Services (CMS) Star Rating Quality Measures, one will find a wide array of socio-economic factors and competing issues, all of which carry the potential to profoundly affect healthcare outcomes and ratings.During the next live edition of Talk Ten Tuesdays, listeners will enjoy the benefits of learning new strategies to leverage these codes for enhanced quality scores and health equity – that's when former American Health Information Management Association (AHIMA) leader Angela Comfort will return to the weekly broadcast. During her presentation as our special guest, you'll come to realize the pivotal role these codes play in the CMS pursuit of ensuring balanced, patient-focused care. This essential episode will enlighten healthcare practitioners, policymakers, and administrators alike on utilizing data-centric methods for improved patient services.Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report the latest coding news.SDoH Report: Juliet Ugarte Hopkins, MD, president of the American College of Physician Advisors, will substitute for Tiffany Ferguson, and will report on the news that's happening at the intersection of coding and the SDoH.News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

In this Bell Works Talks, Pam Marcus will discuss the importance of assessing Adverse Childhood Experiences (ACEs) when predicting the risk for suicide. Ms. Marcus is an Advanced Practice Nurse Psychotherapist in Private Practice in Upper Marlboro, Maryland. She provides psychotherapy to individuals and families experiencing a variety of diagnoses, such as Anxiety Disorders, PTSD, Personality Disorders, Gender Dysphoria, Substance Use Disorder and Affect Disorders. Her area of interest is to prevent feelings or thoughts of suicidal by addressing the hopelessness and powerlessness often experienced by these individuals. Ms. Marcus is currently a Professor of Nursing at Prince George's Community College. She was the former Clinical Director for the Crisis Response System where she provided direct patient care as well as clinical supervision for the mobile crisis dispatch team; urgent care clinic; Intensive Family in Home Team; and telephone triage for crisis intervention. Ms. Marcus lectures and consults extensively on psychiatric nursing. She has authored many chapters in several Psychiatric Mental Health nursing textbooks. She has authored two Psychiatric/Mental Health nursing skills, Mosby/Elsevier Nursing Skills Online and is a content expert. Ms. Marcus presently serves on the Peer Review Committee for the periodical Journal of Addictions Nursing: A Journal for the Prevention and Management of Addictions. She has provided peer review on continuing education programs for American Psychiatric Nursing Association. Ms. Marcus provides content expert evaluations for InterQual by McKesson, Clinical Practice Guidelines. Ms. Marcus is currently participating in the American Psychiatric Association's initiative Quality Measures. Ms. Marcus was awarded the national honor of Excellence in Practice – Advanced Practice by American Psychiatric Nurses Association, November 2012. Resources: https://www.cdc.gov/violenceprevention/aces/index.html https://www.cdc.gov/brfss/ https://harvardcenter.wpenginepowered.com/wp-content/uploads/2018/08/ACEsInfographic_080218.pdf (ACEs graphic) National Center for Injury Prevention and Control, Division of Violence Prevention

Comprehensive medication management (CMM) provided by a clinical pharmacist can improve the quality of care and reduce health care costs through the optimization of medication use and a significant reduction in medication-related problems. Dr. Curtis Haas discusses the limitations of the current evidence and recommends structure, process, and outcome measures to ensure that the key elements of CMM that drive the observed benefits are implemented with fidelity to address the goals of the quadruple aim. Read the full text article at: https://accpjournals.onlinelibrary.wiley.com/doi/10.1002/jac5.1767.

Josh and Brian are joined by Lee Fleisher, MD, Chief Medical Officer at the Centers for Medicare & Medicaid Services (CMS) and Director of the Center for Clinical Standards and Quality. They discuss a recent publication, “Aligning Quality Measures at CMS” in the New England Journal of Medicine which Dr. Fleisher co-authored, and the art and science behind the selection of health care quality measures.

Josh and Brian are joined by Doug Jacobs, MD, MPH, Chief Transformation Officer in the Center for Medicare at the Centers for Medicare & Medicaid Services (CMS), and Michelle Schreiber, Deputy Director for the Centers for Clinical Standards and Quality at CMS, and Director of the Quality Measurement & Value-Based Incentives Group at CMS. In the first part of this quality-focused series, they discuss the work they are doing to align quality measures across CMS and improve the system to benefit both clinicians and patients. 

Tune in for today's industry updates.

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Join Health Affairs Insider.There are currently an estimated 37.3 Americans living with diabetes, more than a 40 percent increase from a decade ago. Thus, it isn't surprising that efforts to measure and improve the quality of health care focuses a significant amount of attention on diabetes.Major health care quality datasets all include a number of measures related to the quality of diabetes care. Given the continuing growth in the burden of diabetes, it's appropriate to ask the question: What are we actually getting from measuring the quality of diabetes care as we do it today?Rozalina McCoy from Mayo Clinic joins A Health Podyssey today to discuss just that very topic.McCoy and coauthors published a paper in the July 2022 issue of Health Affairs examining diabetes quality measures in the US since the mid-1990s. They recommend some pretty significant changes in how we measure and report on the quality of diabetes care.McCoy's research was part of a six-paper cluster of research on type 2 diabetes, all of which were published in the July 2022 issue of Health Affairs.Order the July 2022 issue of Health Affairs for research on type 2 diabetes and more.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts

Last week, roughly 5,000 liver community stakeholders gathered in London for the 2022 International Liver Congress (#ILC2022,) the first major hepatology Congress to be held in person since the start of the pandemic (smaller, but very valuable, meetings like NASH-TAG, LiverCONNECT and Paris NASH have taken place with an in-person component, but the International Liver Congress and The Liver Meeting have not). The first three days of the program focused on a range of issues, with specific emphasis on non-invasive tests (NITs) and their role at different stages in diagnosis and treatment. This conversation touches on two issues: the use of AI to better understand the meaning of liver volume and elements of morphology and, relatedly, how much more sophisticated a view we take of NAFLD and NASH than we did even five years ago.The issues around AI and liver morphology arise from Jörn Schattenberg's comment that consistent with Stephen Harrison's "KISS" (Keep It Simple, Stupid!) principle, researchers are starting to explore the meaning of changes in liver volume. Ultimately, Jörn notes, pairing these kinds of measures with AI-supported histopathology can yield tremendous benefits. Roger comments on a breakfast he attended that morning that suggested that AI and NITs each provide different, important information on individual liver health: NITs can address collagen burden but not structure, while AI can identify changes in structure but not link them to the impact on the patient. Zobair ends this part of the conversation by noting that companies are starting to use AI in these ways.The second part of this conversation stems from Roger's observation that we know far more about the disease than we did 3-4 years ago. He goes on to describe how the environment is more collaborative and open-minded than it might have been if, in fact, we saw drug approvals at that time. Zobair takes this observation to a different plane, noting that 5-10 years ago, "some very important experts" believed that we all understood the etiology of Fatty Liver disease, so why spend more time? He goes on, "we could not have been more wrong," observing that what we have learned about progression and regression in placebo arms suggests a far more complex disease than something that progresses linearly, or even constantly in one direction. He goes on to add that the multiple drug trial failures is that targeting drugs to a single solution based on animal models is likely to fail because this is a multiple mode of action disease. His third point: the "source" of the disease is visceral obesity and insulin resistance, which all viable solutions must address. This identifies two targets for treatment, while simultaneously demonstrating that therapy will be chronic, lifelong and with behavioral elements. The rest of the conversation addresses the challenges with shaping this kind of lifelong, multitarget therapy in the US today.

Last week, roughly 5,000 liver community stakeholders gathered in London for the 2022 International Liver Congress (#ILC2022,) the first major hepatology Congress to be held in person since the start of the pandemic (smaller, but very valuable, meetings like NASH-TAG, LiverCONNECT and Paris NASH have taken place with an in-person component, but the International Liver Congress and The Liver Meeting have not). The first three days of the program focused on a range of issues, with specific emphasis on non-invasive tests (NITs) and their role at different stages in diagnosis and treatment. This conversation touches on the impact that NAFLD has on patient quality-of-life and the importance of integrating quality-of-life issues and metrics into everything from clinical trials to treatment protocols.This conversation starts with an observation from Jörn Schattenberg about the importance of looking more carefully at quality-of-life metrics, both in terms of patient treatment and clinical trial outcomes. MIchelle Long, making a closing comment, notes how much more collaborative researchers in the meeting are compared to years past. She then makes an announcement about a major, exciting change in her career, and then exits the conversation.Zobair Younossi identifies "fatigue" as the patient-reported outcome from NAFLD that links most closely to quality-of-life issues He points out that fatigued Fatty Liver patients produce lower quality-of-life scores and also exhibit higher levels of mortality. He goes on to note that fatigue is also linked to unemployment and underemployment, which means that it has clear economic costs. Roger Green asks whether payers will accept economic analysis on this and, as a result, pay for therapy. Zobair suggests that this will depend on whether advocates can make this issue part of the policy, which will drive individual payers' behavior in the US and shape government policy elsewhere. In response to a question from Roger, Louise Campbell comments that the policy environment in the UK is not very different from the US despite differences in how care is actually paid for. She goes on to identify one challenge in this issue, which is that quality-of-life scores decline as soon as a patient becomes aware of their disease, which has the potential to complicate employee analyses when the employee is not yet a patient. She also agrees with Zobair's earlier statement that he would prescribe a slightly more expensive medication if it improves quality-of-life. Zobair closes this conversation by returning to discuss the importance of fatigue and describing himself as "heartened" that fatigue is now measured in most (if not all) clinical trials.

Last week, roughly 5,000 liver community stakeholders gathered in London for the 2022 International Liver Congress (#ILC2022,) the first major hepatology Congress to be held in person since the start of the pandemic (smaller, but very valuable, meetings like NASH-TAG, LiverCONNECT and Paris NASH have taken place with an in-person component, but the International Liver Congress and The Liver Meeting have not). The first three days of the program focused on a range of issues, with specific emphasis on non-invasive tests (NITs) and their role at different stages in diagnosis and treatment. This conversation touches on two issues: how proper use and explanation of NITs can increase patient motivation and why adding NITs to quality measures can have such an effect on educating providers and increasing treatment.This conversation starts with Michelle Long and Louise Campbell discussing studies that demonstrated that patients receiving a FibroScan changed behaviors in ways that lasted at least six months, whether or not they learned they had liver fat. From here, Zobair Younossi discusses the importance of front-line, primary care screening with FIB-4 for all patients with diabetes. Zobair suggests that we consider making use of FIB-4 as a test for co-morbidities in diabetes a formal quality measure, in the same way that providers are required to check creatinine to assess possible kidney damage. Michelle and Roger Green added to Zobair's comment to discuss the specific benefits of adding an electronic health record-generated FIB-4 test as a standard assessment for diabetic patients. Zobair goes back to the point that we need primary care to serve as a front line for diabetes testing. In this context, he suggests the importance of FIB-4 and gives reasons he believes FibroScan will never become widely used in primary care. Louise Campbell disagreed, saying that having FibroScan in primary care would educate patients and drive better care. Jörn Schattenberg discusses some sessions where the consensus supported early FIB-4 use. Roger Green wraps up this conversation by talking about the importance of having formal quality measures around FIB-4 use in the US by telling a story from his own medical history.

ResourcesLearn more about the Value Toolkit at diabeteseducator.org/valueRead the Value Toolkit Paper: https://doi.org/10.2337/cd21-0089

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Dr. Michael Weinstein of Capital Digestive Care talks to Dr. Costas Kefalas from Akron Digestive Disease Consultants about his work as the president of the GI Quality Improvement Consortium (GIQuIc), a benchmarking registry that tracks quality measures such as cecal intubation rates, withdrawal times and adenoma detection rates. Hear about the path Dr. Kefalas took to independent GI, his role in co-founding the Ohio Gastroenterology Society, and how drumming in an acoustic Greek band called Aegean Odyssey is his way to release stress. Join Dr. Weinstein and Dr. Kefalas as they discuss the importance of advocacy and coming together as independent GI practices to promote important issues to policymakers at the state and federal level. Produced by Andrew Sousa and Hayden Margolis for Steadfast Collaborative, LLC Original score by Hayden Margolis Gastro Broadcast, Episode 31

In this episode of the Patient Partner Innovation Community podcast, Desiree Bradley is joined by Jayanti Bandyopadhyay, Christine Holland, and Emma Bickel from Mathematica to discuss the importance of using patient lived experience in measures development.

In this episode of the Patient Partner Innovation Community podcast, Desiree Bradley is joined by Jayanti Bandyopadhyay, Christine Holland, and Emma Bickel from Mathematica to discuss the importance of using patient lived experience in measures development.

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MT, AAPACN vice president of education and certification strategy talks about quality measures for skilled nursing facilities (SNFs) with Pat Newberry. Specifically, they address the differences between the SNF QRP and Five Star measures, and clarifications around claims-based quality measures. 

Anne Pedersen, Director of Nursing at UPMC Hamot and Joanne Sorensen discuss how to engage patients in solutions.

Dr. Stephen Flack joins Roxanna to discuss six value-based competencies needed to generate value and improve health. 

Dr. Michael Seim joins Roxanna to discuss how to not only meet but exceed consumer expectations through reliability. 

Which quality measures will improve EMS? by EMS1 Podcasts

Welcome to the Patient Partner Innovation Community Podcast. This podcast was created to inform patients, families and caregivers about important health transformation topics. On this week's episode, we speak with Lindsey Wisham again about The Person and Family Engagement Network(PFEN) and learning how to include your voice in quality measures development work. Contacting PFEN: PFEN Website https://031d022.netsolhost.com/pfe/ Victoria Danner PFE Coordinator Email: victoria.danner@rainmakerssolutions.com Phone: (706) 401-7932 ------------------------------------------------------------------ Recorded May 2020/Released May 2020.

Dr. Anthony Aquilina joins Roxanna to discuss how WellSpan plans on leading their region with value. 

On this, the 100th episode of the NP Dude podcast I try to give some background the new Merit-based Incentive Payment system and my predictions as to what this will mean down the line.  Have a listen, share the show and don’t forget to keep giving ratings on Facebook and iTunes!  As always, you can […] The post Episode 100 – What the Heck is MIPS and Why You Should Care! first appeared on The NP Dude.