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Dr. Luis Raez and Michael Reff share the newest update to the medically integrated dispensing pharmacy standards from NCODA and ASCO. They review updates to domain one, on key patient-centered quality standards on health equity and social determinants of health, drug access, patient safety, education, and adherence to maximize treatment outcomes and domain two, on key operational quality standards on logistics, care coordination, and waste prevention. We also cover the impact of these updated standards for clinicians, oncology practices, and people receiving oral anti-cancer medications. Read the complete standards, “Medically Integrated Dispensing Pharmacy: ASCO-NCODA Standards.” Transcript These standards, clinical tools, and resources are available on ASCO.org. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the JCO Oncology Practice. Brittany Harvey: Hello, and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Michael Reff from the Network of Collaborative Oncology Development and Advancement and Dr. Luis Raez from Memorial Cancer Institute and Florida Atlantic University, co-chairs on "Medically Integrated Dispensing Pharmacy: American Society of Clinical Oncology – Network of Collaborative Oncology Development and Advancement Association Standards Update." Thank you for being here, Michael and Dr. Raez. Dr. Luis Raez: Thanks for inviting us. Michael Reff: Thank you for having us. Brittany Harvey: Then, before we discuss these standards, I'd like to note that ASCO takes great care in the development of its standards and ensuring that the ASCO Conflict of Interest policy is followed for each guidance product. The disclosures of potential conflicts of interest for the expert panel, including Michael and Dr. Luis Raez who have joined us here today, are available online with the publication of the standards in JCO Oncology Practice, which is linked in the show notes. So then, to dive into the content here, Michael, I'd like to start with what prompted an update to these ASCO-NCODA standards and what is the scope of this update? Michael Reff: Thank you, Brittany. What led NCODA and ASCO to endeavor in this, and it started back in 2019 as the amount of oral anticancer medications became more and more prevalent in cancer treatment, we saw the need providing a blueprint for excellence in care for patients prescribed oral anticancer medications, specifically in the outpatient setting. And the update was driven by the rapid growth of these oral oncolytics starting back in the mid to late 2015 through 2019 or so, and then continued on into the 2020s where we are today. We saw the increase in the complexity of the management of these patients with these therapies basically outside the traditional clinical settings. And we wanted to make sure that with more cancer treatments that are taken at home than just at the clinic, like in the oral setting, new challenges had emerged around patient safety, access, adherence, and overall treatment success. The updates now address patient-centered and operational interventions designed to improve access, safety, quality, accountability, and outcomes of oral anticancer and other supportive care medications prescribed for the cancer patient. Dr. Luis Raez: As Mike said, these guidelines help improve patient care tremendously, but also help us a lot as an oncologist, you know, community oncologists that- now that we have opportunity to dispense these oral oncolytics, we need help to create our medical integrated pharmacies, and NCODA is providing here a way that, how to do this safely, efficaciously, good quality, you know? So that's why I think we always do everything for the patients, but also this helps a lot to the doctors. And there are a lot of what we call specialty pharmacies or medical integrated pharmacies now nationwide. Michael Reff: I'll build on what Dr. Raez had mentioned. This is the impetus. If you looked at the innovation that was coming from the pharmaceutical companies, many of it coming in the oral form for anticancer medications, and based on that, taking a look at the infrastructure that is in place in these practices, whether it's in the community or the IDN or health system settings, this amount of innovation that was coming needed to be addressed by taking a look at the medically integrated oncology team. And these standards address not just the pharmacy component, but also the whole continuum of care, starting with a medical oncologist or the hematologist, with the pharmacists, nurses, the pharmacy technicians, others that are involved in the care of the patient. And there were no standards involved. And when we approached ASCO back in 2018 to eventually publish the first version of these standards, the need was identified, and we worked collaboratively with ASCO to create the first set and then the revisions as we talked about. One thing to note regarding the revision plus the original standards, we had a cross-section of the care team on the committee, and we did that very purposefully. So, the ASCO-NCODA team curated a committee to help develop these original standards and the revision of these standards with medical oncologists both from community and health systems, pharmacists from both community and health systems, and also nurses. And we also included a patient that currently has and currently receives oral anticancer medication. And so NCODA and ASCO are very proud of the committee that we put together because of the experts in their field, but also extended the invitation to a current patient. And we embedded everybody's expertise in the curation of these standards. Brittany Harvey: Absolutely. I appreciate that background and context and how it's critical to improve patient care. And these standards really help oncologists, and we're looking across the continuum of care to provide optimal care for our patients. So then next, Dr. Raez, I'd like to review the key points of the revised standards for our listeners. So for Domain 1, what are the key patient-centered quality standards on health equity and social determinants of health, drug access, patient safety, education, and adherence to maximize treatment outcomes? Dr. Luis Raez: Yeah, this was a great effort, you know, at the multidisciplinary team. And as you can read in the standard, there were more than 240 publications reviewed; more than 55 of them are quoted here. And the standards are in two groups, as you said. With the group one, I'll briefly mention some of them. For example, SDOH, social determinants of health, is very important because as doctors, we prescribe, and sometimes patients don't get the medication, you know? And we prescribe assuming that 100% of the patients will get the medication. But something simple like the patient doesn't have insurance, the patient is underinsured. I have a patient that we didn't have an address to send the medication because he's homeless. Something that as a doctor you say, "Oh, oh my God, this is outside my realm," but it's not outside reality. So that's why, even if we don't think that this is part of our expertise dealing with social determinants of health, the fact that the patients have food insecurity, they don't have transportation, they don't have insurance, they don't have a caregiver, impact tremendously in the outcomes of the therapy. So that's why, basically, in this standard, we want to call attention that SDOH, social determinants of health, needs to be identified. There are in the literature countless examples of why this is important. For example, in the guidelines, we quote two or three examples of prostate cancer studies that, for example, we quote a study of 27,000 people with prostate cancer that were taking oral oncolytics, and how come the fact that the elderly, seniors, the fact that they have high prescription costs, and how all of this affected the adherence to the medication. And that's why it's important to identify the SDOH. And in other sections of the guidelines, we said how to address them, no? Another important thing in this domain is the cultural, you know, we need to be culturally sensitive and to take care of all of these social factors. For example, here in South Florida, we deal with the Haitian culture, Filipino culture, Latin culture, and American culture, and it's a blend, but it's not easy to go from one to the other. Another one is the fact that we have to include new technologies. A lot of patients, for example, we use EMR, EMR Epic, and now Epic has everything in the phone. The fact that we can have now the patient can see her prescription medication over the phone, the fact that they can use the phone to request from you a refill, and from your phone, you send the refill to the pharmacy, and you notify from your phone to the patient that the refill is sent, and the patient can check in his phone that the refill is ready. These things are amazing because that's why it's important that we incorporate these technologies to the patient care, and in this specific case, of dispensation of oral therapies, no? Another crucial point is education. You cannot be sending a patient a package of 300 pills without education. So that's why in our guidelines, mainly pharmacy, clinical pharmacies, or in some centers like mine, we have advanced practice providers, it's mandatory in our centers to have like a one hour of education before you send the prescription. So the patient is aware about side effects and contraindications, all of these things. They provide them also materials and also consent. You know, in the old times, you don't give chemo without a consent. Now, a lot of people say, "Oh, it's only a pill." There is a lot of benefits or side effects that can come from the pill, so you need to consent everybody, you know? So, another aspect is adherence. I already told about that, but we need to provide patients with a baseline assessment, no? So, you cannot send again the prescription and hope, "Oh, I'll figure it out what happened next month when the patient comes back." I tell you, the patient is homeless, where are you going to send it? If the patient is telling you, "I don't have insurance," what good is it for you to send a prescription? The patient will not get it. So that's why you need to do a baseline assessment of adherence. You need to do a calendar. You need to do electronic support, I mentioned already with the EMR and the phones. For example, my MIP, my specialty pharmacist, sends me a message in the EMR, "Dr. Raez, the insurance is not covering, the patient has a high copayment, we are going to delay the dispensation of the medication." So there needs to be a communication. Or sometimes there is a confusion with the insurance, and I cannot wait for the poor patient to call three, four weeks later, "Oh, I didn't get the medication," to know what happened, no? My MIP is very good. They send the clinical pharmacist a message, "Hey, you know, the insurance doesn't believe that the pill is adequate, or you need to provide more documentation. You need to prove the mutation, the genetic aberration." So if you provide us that, the insurance may approve. So that communication with the doctor is very important to improve adherence. And one important thing that we have in this one that we didn't have in the anterior is the tracking of outside medications. A lot of times you say, "Okay, the insurance allowed us to provide the medication it's 100% responsible." But then the insurance says, "Oh, no, no, don't worry. CVS will provide the medication." So it says, "Well, it's you know, it's not my responsibility. CVS will provide the medication, they have to take care." But we know that outside our specialty pharmacies or MIPs, the care is not very good. So that's why we are taking our ownership that, "Okay, the insurance said the patient will get the medication from some outside pharmacy." But our clinical pharmacists track that. What happened? Did the patient get it? The patient didn't get it. The copayment is still high. So even if you get the medication from somewhere else, if the copayment is high, we, our clinical pharmacists, help the patient to navigate and get the foundation or the copayment or finally the maker, the industry partner, provides the drug for free, but somebody needs to do the paperwork. And that's why this is very important. We cannot abort our responsibility because, "Oh, the insurance said somebody else will give it." I work for the public healthcare system, so my patients, some of them don't have insurance, they are underinsured. So we see these problems every day. And finally, the standards talk about the importance of safety, documentation, verification, monitoring, refills, you know, you need to keep track of refills. We already mentioned how important is the technology to facilitate the refills, and the quality. Brittany Harvey: Yes, thank you for touching on those highlights for Domain 1. It's important that all patients have access to care and these oral anticancer medications, and not only just access to care, but safe and effective care. It's really important, as you mentioned, Dr. Raez, to meet patients where they're at and incorporate technology. And I also want to note the coordination with external pharmacies that you mentioned in tracking outside medications as well. It's not only important for multidisciplinary care within the oncology practice itself, but also external to the oncology practice. That's why we put together this multidisciplinary panel to develop these standards. So then, expanding on that, Dr. Raez, for Domain 2, what are the key operational quality standards? Those on logistics, care coordination, and waste prevention. Dr. Luis Raez: Yeah, we have a lot of standards here, but maybe we can summarize in five or six points, no? For example, financial toxicity in cost and waste are very important because the patients, yeah, you put them on therapy, but as you can understand, if there is disease progression, the patient don't need the medications. And sometimes you get refills even if the patient has disease progression. If you do a dose reduction, the same problem. Or you discontinue medication and the patient keeps getting the drugs. So, you're talking about drugs that are between 20 and 30 thousand dollars per month. This is a lot of money. There are studies that we're quoting in the standards that the waste could be from 1 to 3 or 4 thousand per patient, no? Another aspect is dispensing. When you dispense the medication, this is not as easy as, "I'll ship to your house a bag of medications." You know, there needs to be a diagram, a decision tree. You need to train the staff to know what we're doing. There needs to be an auditing of the process. They need to be even packaging and shipping, you know? For example, I'm in Florida today and outside in summer it's going to be 95 degrees. So, everybody leaves the package outside your house, and sometimes you go the whole day until when you come at 6:00 p.m. There are medications that cannot be left outside there, you know? I don't know, it sounds like a joke, but I have a patient that the medication used to be stolen because people thought that that was something important, you know? And of course, it's important because it's a $20,000 medication. So, the poor patient, because he lives in an area that is not safe, has to come and pick up in person. All of these things sound very trivial, but that's real life that affects adherence. Another important thing is shortage. This is something that we just suffered two or three years ago, and we have to think about what happens in the next shortage. What happens if there's going to be a shortage? What do we do or how are we going to do that? Now we know it's something that is happening probably very soon again, and something that we have to consider. Another standard is the care coordination. You need to have probably, if it's possible, a coordinator. I know that for small practices it's very hard, but for big cancer centers, you should have a coordinator of this. I already mentioned before, the communication between the physicians and the doctors to coordinate the care, no? You need to write the prescription again, you need to provide more information, or to be notified, "Hey, you know, the patient is throwing up in the first week, you need to see the patient, please," no? So, this type of communication needs to exist so we can serve the patient better. It's also important, you know, we're improving quality and we're improving care. It's important to try to collect patient-reported outcomes. This is something that now we have the opportunity, if we do things well, to do it and show that we're providing a better care. The other thing is that we already mentioned SDOH in the other standard. In this standard, we mention mainly SDOH to partner. For example, we collect in my center SDOH, and I always get frustrated when the patient doesn't have transportation. But I didn't know that there are local institutions that provide free Uber rides, free Lyft rides. So that's why it's important to partner with these institutions. I have a local grocery chain that provides free food for the patients, and I didn't know that. It's important to be aware what the patient needs and what resources do you have to fulfill the SDOH. That's the part that we mention in here. So that's why, in summary, those are the six probably most important points here. I'll ask Mike for some comments. Michael Reff: Thank you, Dr. Raez. Brittany, to answer your question, and as was pointed out on logistics, care coordination, and prevention of waste, certainly that is an aspect that has changed in the revision that we're here to talk about. There's really two components to waste, and it's cost avoidance and then waste prevention. And as Dr. Raez mentioned several times, the importance of the medically integrated team and having the ability for that practice to fill that prescription internally and have robust documentation. Cost avoidance is a critical component that the medically integrated pharmacy, or the MIP, can help the total cost of care. And that is by preventing errant fills or waste that can occur by intervening in the care of the cancer patient, as we do every day. But when the practice has access to the medication and can fill that prescription in-house in the medically integrated pharmacy, that team, that care coordination that takes place, can prevent those errant fills or additional fills when there's dose reductions, there's holidays, there's things that happen in real time. And it's impossible for a mail-order pharmacy that's in another state that has lead times, when a prescription needs to be mailed 7 days or 10 days before the patient will run out of the medication, it's impossible for them to logistically coordinate that care like we can internally within the medically integrated pharmacy. So, we prevent waste and overall cost of care by cost avoidance and having that coordination or that continuity of care that we talk about. And we prevent waste from the mail-order pharmacies by taking that prescription internally and filling it, but also doing it in a way that's more sustainable and cost-effective for all stakeholders in the oncology ecosystem. Brittany Harvey: Absolutely. Thank you both for reviewing those key standards for Domain 2 and touching on the importance of distribution logistics and all the things that a medically integrated pharmacy needs to think through in getting oral anticancer agents to patients. Following that, Michael, we've touched on this a little bit earlier, but how will these updated standards impact clinicians and oncology practices? Michael Reff: Yes, and as Dr. Raez and I have discussed throughout this podcast, these additional standards are there to help support that continuity of care by educating the clinicians that are in the oral anticancer medication space to elevate their provision for these oral therapies. What I mean by that is the practice has to perform at a certain level in order for them to, as I call it, deserve the right to fill that prescription by having the processes and procedures in place. And these standards, these updated or revised standards, are the blueprint for better patient care and to help the practices execute on that journey of continuous improvement. Dr. Luis Raez: Yeah, I only want to add, we have practical examples in the guidelines. We quote a couple of studies that have been successful. And this year, for example, I am a lung cancer doctor, we are presenting in World Lung our standards of adherence to oral oncolytics for EGFR therapy, following the NCODA-ASCO standards. We're around 95% of adherence. We are a healthcare system that is public. We have people with no insurance and a lot of social determinants of health. We are trying to show that it's feasible, even in the most difficult circumstance, when you follow the standards, to be successful. Brittany Harvey: Definitely, these standards can help clinicians and oncology practices succeed in providing these medications. So then beyond that, and to wrap us up, Michael, what do these revised standards mean for patients who are receiving oral anticancer medications? Michael Reff: Yes, great point and question, Brittany, because we have covered the benefits to the clinicians and the practices themselves. But how is this going to support better patient care? And it does it in a whole host of ways. I'll cover just a few of them. What I'm about to share with you relates back to what we call at NCODA the "core claims." Like, what's the core claims of having a medically integrated pharmacy within the practice? And there are seven different core claims that we feel practices that are focused on the continuity of care can deliver better outcomes that are embedded in these standards. And it's talking about abandonment, adherence, access and affordability, speed to therapy or time to fill, as we call it, education, patient satisfaction, and cost avoidance that we covered earlier. So those are the core claims that a practice that follows these revised standards can help elevate. So, faster and more affordable access to the oral cancer medications; individualized support to address barriers like transportation, finance, language, or health literacy, and so on; clear, patient-friendly education; something that is near and dear to all clinicians' hearts, and of course, the patient that was on our panel or on our committee, to empower them to manage side effects and recognize when to seek help; and a stronger partnership with a care team, with regular follow-ups focused on their experience, challenges, and successes; and then, greater overall safety through proactive monitoring for medication errors or complications. So all of these aspects, or tenets, as I'll call them, are baked into these quality standards that are totally aligned with NCODA's core claims document that, again, talks about abandonment, adherence, access and affordability, speed to therapy, education, satisfaction for the patients, and also cost avoidance. Dr. Luis Raez: I only want to add and invite the community to adhere to these standards, to practice the standards. You will be providing the best patient care that we can nowadays. Brittany Harvey: Definitely. I think these standards are very important. And Michael, I thank you for touching on those key claims from NCODA. I think those, along with these updated standards, will improve outcomes for patients everywhere. So I want to thank you both so much for your work to update these standards and all the time you put into it. And thank you for your time today too, Michael and Dr. Raez. Michael Reff: I'd like to thank not only the committee, my esteemed committee that helped support the standards and the revision. Many of the original healthcare providers and patient that were on the first go of the standards were part of the second standards. We revised it, of course, and we got additional support from the new committee. And certainly ASCO and their partnership and collaboration with NCODA has been tremendous. And we look forward to the oncology community at large adopting these standards, again, to work together, we do become stronger, and it will improve cancer care for patients receiving oral anticancer medications. So thank you, Brittany. Dr. Luis Raez: I only want to say the same thing. Actually, there is probably more people in NCODA that is not in the publication that has helped. Same in ASCO. Also, we want to give thanks to Dr. Stephen Grubbs, our leader in quality. He's retiring. We're going to miss him, but he has been a key collaborator with Mike organizing these standards for the last five or six years. So, looking forward to these standards in practice. Brittany Harvey: Absolutely. A big thank you to the entire panel and everyone who contributed to this, and NCODA as well. And then finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the complete standards, go to www.asco.org/standards. I also encourage you to check out the companion episode on these standards on the PQI podcast by NCODA, which you can find on Apple Podcasts and Spotify. You can also find many of our standards and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
UnitedHealth Group (UHG) stock is plummeting following the abrupt resignation of its CEO Andrew Witty. His sudden departure, coming on Tuesday, May 13, came amid multiple lawsuits and threatened actions by private, state, and federal agencies across the country, and amid massive criticism for the company's tendency to deny beneficiaries coverage for services at elevated rates.Witty's exit from the giant payer – a long-time dominant force related to revenue cycle, provider staffing, utilization, and managed and commercial health insurance plans – seems to have rattled many in America's sprawling health delivery system. So, how could these recent events affect other hospitals and health systems?During the next live edition of the popular Talk Ten Tuesdays, the Internet broadcast produced by ICD10monitor, Dr. Juliet Ugarte Hopkins will share what she thinks of what might lie ahead. Dr. Ugarte Hopkins is the medical director for Phoenix Medical Management, Inc. and the Immediate Past President of the American College of Physician Advisors.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH;• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates;• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news;• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk; and• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Radiology reports are rich in clinical detail, yet ICD-10 codes often fail to fully capture the complexity and specificity of imaging findings.That is why the producers of Talk Ten Tuesdays and ICD10monitor have invited Laura Manser to explore the most common disconnects between radiology documentation and ICD-10 coding – especially in areas like incidental findings, laterality, and linking imaging results to medical necessity.During the next edition of the weekly broadcast, Manser is also expected to highlight common errors, such as coding suggestive findings as definitive diagnoses, and provide practical guidance on bridging the gap between documentation and compliance.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.
Hosts Gregg Masters and Fred Goldstein meet veteran health policy thought leader and managed care activist John Gorman, Founder & Executive Chairman at Nightingale Partners LLC. John is a prominent figure in U.S. health policy, renowned for his extensive experience in Medicare and Medicaid programs. He founded Gorman Health Group, a leading consultancy in government health programs, and later established Nightingale Partners LLC, the first Opportunity Zone fund focused on SDOH investments. John is a vocal advocate for addressing poverty and racism as core health issues and is recognized for his candid insights into the challenges and reforms needed in the healthcare system. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
The revenue cycle can be thought of as a machine that keeps churning nonstop, making everything work, financially speaking, for your hospital.But even the most well-oiled machinery can get clogged, meaning it doesn't perform at its peak. And that is why the producers of ICD10monitor and Talk Ten Tuesdays have invited Jessica Miller-Dobbs to join the popular Internet broadcast as its special guest for some shop talk.Jessica is the Director of Health Information Management (HIM) and Revenue Cycle for Datavant. She is scheduled to appear during the next live edition of Talk Ten Tuesdays, 10 a.m. Eastern on May 6, for a refreshingly new approach in learning how to get your revenue cycle humming.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Payer edits and denials are pervasive in healthcare reimbursement.These problems typically arise from coding inaccuracies, insufficient documentation, or non-compliance with payer-specific guidelines. These challenges can lead to revenue loss, increased administrative burden, and frustration among healthcare providers.A skilled coding staff plays a vital role in mitigating these issues. Proactive identification of potential red flags at the time of coding can decrease the number of edits and denials being returned from the payer.Join our special guest Lorie Mills, director of health information services for Primeau Consulting Group, during the next live edition of Talk Ten Tuesday, April 29, 10 Eastern for a refreshingly new approach to understanding how and what smart coding can do to avoid these expensive and frustrating issues.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Substituting for Christine Geiger will be Amy Jo Combs, Senior Coding Compliance Consultant for First Class Solutions. She will discuss the significant difference between “History of” and “in remission” when reporting leukemia.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Hosts Gregg Masters and Fred Goldstein meet Pravin Pant, MSHI, VP, Advanced Analytics at ZeOmega. They discuss the role and application of AI to Social Determinants of Health (SDoH), including how AI impacts care management and the patient experience. Pravin leads ZeOmega's advanced analytics team in working on new and existing AI solutions and social determinants of health (SDOH) solutions. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
Custodial and social hospitalizations have long been a hospital challenge.From inadequate patient support and services to medically unwarranted occupancy of inpatient beds, plus lack of payment for provision of care, prevention and management of these cases continues to be an issue.While much has been discussed about how to proceed, many hospitals fail.And that is why the producers of ICD10monitor and Talk Ten Tuesday have invited Dr. Juliet B. Ugarte Hopkins to be the special guest during the next live edition of Talk Ten Tuesday.Dr. Ugarte Hopkins is the medical director for Phoenix Medical Management, Inc. and immediate past president of the American College of Physician Advisors. Dr. Ugarte Hopkins will report on this developing crisisAlso part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
In today's healthcare environment, America's hospitals are experiencing increases in payer denials as a result of incorrect application of drug HCPCS units and a drug HCPCS modifier (JW/JZ).These denials have increased costs for providers, because the existing staff is either being redirected to spend more time on the issue or additional staff are being hired to resolve the drug charge denials. Healthcare industry professionals need an easy-to-use and cost-effective resource to submit their claims correctly the first time.During the next live edition of Talk Ten Tuesdays, senior healthcare consultant Tiffani Bouchard will review the current environment in which coders work while explaining how new technology tools and solutions have the potential Drew Updike to expedite the drug lookup process.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Steve Heard, Chief Innovation Officer at J2 Interactive, presents a strategy in this interview for dealing with new forms of data known as Social Determinants of Health (SDoH) and how traditional HIEs can evolve to help organizations exploit this data.Heard points out that SDoH has the strongest impacts on people who are poor, isolated, or otherwise marginalized, but that those populations have impacts on the health of everybody else. He therefore urges policy-makers not to "abandon" these people or ignore the needs indicated by the data.Learn more about J2 Interactive: https://www.j2interactive.com/Health IT Community: https://www.healthcareittoday.com/
Effective communication is a critical skill in navigating clinical and non-clinical interactions to avoid disaster striking a facility's bottom line.In fact, poor communication directly impacts the bottom line. Today, amid a cacophony of competing and complex issues spanning generations and a range of viewpoints, there is an overarching need to foster collaboration.During the next live edition of Talk Ten Tuesday, Lorie Mills, director of health services for Primeau Consulting Group, will report on the importance of identifying both effective and ineffective communication practices, and their impact on organizational success.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• Point of View: Dr. James S. Kennedy, founder of CDI MD, will serve as the guest cohost, and will report on a topic that has caught his attention.
In this episode, Kari Curry, Medicaid Care Coordination Hub Supervisor at CHESS Health Solutions, shares how CHESS delivers high-touch, high-impact care management within a Medicaid Clinically Integrated Network (CIN).Kari walks us through a patient journey that highlights how CHESS uses real-time data from NCHIE, comprehensive social determinants of health (SDOH) screening, and structured care planning to reduce ED utilization and improve health equity. She also covers CHESS's success with AMH Tier 3 audit readiness and payer collaboration—proving that value-based care in the Medicaid space is not only possible, but measurable.
Social Determinants of Health, or SDOH, are a buzzword these days—but often little more. We acknowledge their importance, but actual progress on capture (and subsequent patient support) has been slow. To be fair real barriers including technological limitations and limited financial incentives stand in the way. But my current guest understands better than most the major role SDOH play in patient health. He and his organization have developed a digital tool to facilitate capture and improve the lives of patients in their community. They're making a difference. Dr. Pablo Buitron de la Vega is Assistant Professor of Medicine, Medical Director, Preventive Medicine Residency, and Clinician Lead for the THRIVE Social Determinants of Health Program at Boston Medical Center / Boston University School of Medicine. A native of Ecuador, he's made SDOH his mission. On this show we cover: Dr. de la Vega's long journey from Ecuador to U.S. physician, the obstacles he overcame, and how the experience shaped his mission as a provider Defining SDOH and common examples in his line of work as a Boston physician Basics of capture in ICD-10 and what makes SDOH difficult to collect Boston Medical Center's SDOH capture tool, THRIVE: What it does, tangible benefits, and how your organization can get access Low-tech strategies for SDOH capture you can implement today Dr. de la Vega's National Institutes of Health (NIH) grant to develop a triage tool to help address patients' unmet social needs
Implementing SDOH/Health-Related Social Needs Screening and Management in Ambulatory Care. Our speaker for the session is Kevin Fiori, MD, MPH, MS, FAAP, from Montefiore Einstein, a premier academic health system known as a pioneer in the space and one of the largest value-based providers for health-related social needs assessment and value-based whole-person care.Panelist:Corey Karlin-Zysman, MD, Chief of the Physician EnterpriseBarbara J. Martin, PhD, ACNP-BC, MPH, System Senior Vice President, Advanced PracticeLearning Objectives:- Summarize current evidence, guidance and rationale for health-related social needs (HRSN) screening in clinical practice.- Describe lessons learned from Montefiore Health System's experience implementing and scaling HRSN screening and navigation support.- Identify future directions for integrating HRSN screening and support in health care delivery.
World Health Day, which will be officially observed on Monday, April 7, will mark what organizers claim will be a year-long celebration. Here at ICD10monitor and Talk Ten Tuesdays, we will celebrate a bit early, during the next edition of the Talk Ten Tuesdays live Internet broadcast.Headlining the broadcast will be Lorraine Fernandes, immediate past president and communications chair of the International Health Information Management Association.This year's World Health Day theme focuses on efforts to end preventable maternal and newborn deaths, and “to prioritize women's longer-term health and well-being.”The World Health Organization (WHO) cites published estimates that nearly 300,000 women lose their lives due to pregnancy or childbirth annually. The WHO also states that more than 2 million babies die during their first month of life, and that 2 million more are stillborn.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, a veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Send us a textTaylor Justice is the Co-Founder & President of Unite Us ( https://uniteus.com/team/taylor-justice/ ), a technology company with a mission is to improve the health and well-being of individuals and communities by integrating all the social determinants of health. The Unite Us goal is to unlock the potential of every community by strategically partnering with government agencies, health systems, insurers, and community organizations, through their best-in-class technology, expansive network of resources and care options, and qualified team of experts.With Unite Us, providers across sectors can send and receive secure referrals, track every person's total health journey, and report on tangible outcomes across a full range of services in a centralized, cohesive, and collaborative ecosystem. Taylor is a social entrepreneur, who previously co-founded HigherEchelon, Inc., a government consulting company. Taylor is passionate about solving significant problems in the health and human service sectors, and with an MBA from Columbia Business School and a B.S. from West Point leads a team of innovators at Unite Us who create accountable coordinated care networks that interconnect clinical and non-clinical social service providers and track the outcomes across the full range of services. #TaylorJustice #UniteUs #SocialDeterminantsOfHealth #SocialCare #SDOH #ClosedLoopReferralPlatform #Veterans #Eldercare #HomeHealth #Medicaid #CostSavings #CommunityOrganizations #PredictiveAnalytics #ReEntry #JusticeInvolvedPopulations #Recidivism #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #Podcasting #ViralPodcast #STEM #Innovation #Science #Technology #ResearchSupport the show
National Doctors' Day is Sunday, March 30. Even though the national one-day observance is only a few days away, the ICD10monitor producers of Talk Ten Tuesdays want to ensure that everyone is aware of the significant contributions made daily by America's doctors. Hence, our recognition of the occasion will continue during the next live edition of the popular weekly Internet broadcast.As part of the celebration, physician and attorney Dr. John K. Hall has been invited to be the special guest on Talk Ten Tuesdays. Dr. Hall, a popular panelist on Monitor Mondays, has distinguished himself as an astute reporter of healthcare news: he introduced the audience to the concept of Chevron Deference at the time when little information was available on an unprecedented development.Dr. Hall will report on two virus outbreaks in particular that have captured the attention of Americans.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, a veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
There is an increasing awareness of the importance of screening for social drivers of health (SDOH) for patients with cancer. Social drivers like income level and stable housing can impact a patient's access to quality cancer care. To help multidisciplinary teams in oncology care screen for SDOH, ACCC has developed a screening tool to help identify potential SDOH factors that may hinder access to cancer treatment and clinical trial participation. In this episode, CANCER BUZZ speaks with Richard Martin III, MD, MPH, medical director of Health Equity and Community Engagement at Tennessee Oncology and Dana McDaniel, DNP, FNP-C, AOCNP, director of Oncology and Clinical Research at Mosaic Life Care about their experiences using the screening tool as part of ACCC's pilot program. “Everybody's role with SDOH is different, but really, everyone has a role with SDOH assessment—taking the time to sit down with the patient, ask the questions, listen to them, and then connect them to the appropriate services so that we can tailor their care and ultimately improve quality.” - Dana McDaniel, DNP, FNP-C, AOCNP “Being able to capture data around patients' interest [in clinical trials], their awareness and their barriers, and being able to cross reference those 3 things to better focus strategies around [trial] enrollment…that's just going to be gold as far as information to help you know where to go…and when that patient's ready, to help get them onto a trial.” – Richard Martin III, MD, MPH Richard Martin III, MD, MPH Medical Director, Health Equity and Community Engagement Tennessee Oncology Nashville, Tennessee Dana McDaniel, DNP, FNP-C, AOCNP Director of Oncology and Clinical Research Mosaic Life Care St. Joseph, Missouri Additional Resources: ACCC SDOH Screening Tool (English) (https://bit.ly/4ikNPdb) ACCC SDOH Screening Tool (Spanish) (https://bit.ly/4ixsixA) ACCC SDOH Resource Library (https://bit.ly/4bJtDz6) Improving Equitable Access to Care: Unpacking Medicare's New Documentation, Coding, and Billing Requirements (https://bit.ly/4bKlMRU)
What if your health plan's biggest opportunity to improve outcomes wasn't in a hospital or clinic—but in a home, a grocery store, or a child's support system? Mark Rakowski, President of Chorus Community Health Plans (CCHP) and Senior Vice President of Children's Wisconsin, joins Eric to explore the plan's innovative approach to social determinants of health. From its Housing Navigator Program and Foodsmart initiative to its groundbreaking mental health strategy, CCHP is driving better health, lowering costs, and achieving remarkable results—including a 70% treatment adherence rate among Medicaid members. If you're a healthcare leader looking for scalable, high-impact strategies to address social determinants of health and improve member outcomes, this episode is a must-listen! About CCHP Chorus Community Health Plans, which is owned by Children's Wisconsin – the state's only health care system dedicated 100% to children and teens, is focused on improving the health and well-being of its members by providing access to a broad network of health services and providers, as well as prevention programs. CCHP is the second-largest Medicaid health plan in the state. The plan serves 150,000 Medicaid members in 28 counties in eastern Wisconsin. In 2017, CCHP began offering individual and family plans in the Marketplace in southeastern Wisconsin, and the plan has now expanded to 15 counties in eastern Wisconsin, covering 15,000 members in 2022. About Mark Mark is responsible for the health plan's overall operation. He directs the development of strategies and budgets, negotiates contracts and ensures compliance. In addition to these roles, Mark oversees the contractual relationship with the Wisconsin Department of Health Services and monitors and influences state and local healthcare policy. Mark is also actively involved in the Children's Wisconsin strategic plan to improve children's health in Wisconsin. The plan focuses on increasing access to preventive services, addressing social drivers of health, and partnering with providers to improve care coordination. Mark joined Children's Wisconsin and the CCHP team in 1999 as director of managed care. Before that, he had 11 years of experience in healthcare-managed care roles. Mark earned a bachelor's degree in finance from the University of Wisconsin–Whitewater and a master's in accounting from the University of Wisconsin – Milwaukee.
Time is money. And nowhere is that adage more relevant than in today's American hospitals.For example, consider the patient who is medically ready for discharge, but still waiting for a skilled nursing facility (SNF) bed to open up. Or the case in which a patient might medically require a cardiac catheterization before being safely cleared to discharge to home, but there's a delay until the procedure can be performed on Monday.So, when is it okay to delay?Answering that question as well as reporting on the nuances of such delays will be Juliet Ugarte Hopkins, MD, the special guest during the next edition of the long-running and popular Talk Ten Tuesdays broadcast produced by ICD10monitor.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of CDI for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Overwhelmed by nutrition advice?You're not alone.From sketchy influencer “secrets” to Big Food's algorithm-driven traps, a myriad of pitfalls means making healthy choices has never been harder.Questions abound: should you go all-in on the potato diet? Or embrace the all-meat life? (Spoiler: probably not.)This week, during the long-running and popular Talk Ten Tuesdays Internet broadcast produced by ICD10monitor, Dr. Nick van Terheyden will cut through the noise – breaking down diet fads, industry tricks, and practical ways to eat better, without the overwhelm.Because good nutrition shouldn't be this complicated.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
In this episode of Healthcare on the Rocks: Employee Benefits with a Twist, hosts Brittany Hardaway and Rachael Baumgartner sit down with Dr. Janet Young, Clinical Analytics Advisor at Springbuk, to unpack a growing challenge for employers: the rising costs of diabetes care. Dr. Young shares that diabetes-related spending has surged by 38% over the past three years—far outpacing other chronic conditions. A major driver? The skyrocketing use of GLP-1 agonists, medications originally developed for diabetes but now widely used for weight loss. "More than 40% of members with type 2 diabetes filled a prescription for GLP-1s last year—double the rate from four years ago," she notes. While these medications offer powerful benefits, including improved glucose control and cardiovascular protection, their costs continue to climb, creating tough decisions for employer-sponsored health plans.As employers strategize for the future, Dr. Young emphasizes three key priorities: tracking diabetes trends, proactively addressing prediabetes, and ensuring equitable access to care.The conversation also explores the expanding role of continuous glucose monitors (CGMs) beyond type 1 diabetes patients. These devices, which eliminate the need for fingersticks, are gaining traction among insulin-dependent type 2 diabetics and could have broader applications—potentially even helping prediabetic individuals prevent disease progression. Dr. Young also highlights the stark disparities in diabetes treatment based on social determinants of health (SDOH), with more vulnerable populations less likely to access newer medications and monitoring tools. Key TakeawaysDiabetes costs are rising fast – Diabetes spending jumped 38% over three years, driven largely by the rising use of GLP-1 agonists.GLP-1 medications are in high demand – More effective than older treatments and linked to weight loss, GLP-1s are now used by over 40% of type 2 diabetics.CGMs are expanding beyond insulin users – Real-time glucose tracking is gaining popularity and could play a role in prediabetes prevention.Social determinants of health matter – Diabetes rates double in high-vulnerability populations, yet these groups have less access to newer treatments.Employers should focus on three things – Monitor diabetes trends, tackle prediabetes early, and reduce treatment disparities.Stay in Touch!Connect with Janet Young on LinkedInGet the complete 2025 Employee Health Trends report and other related resourcesConnect with our co-hosts Brittany Hardaway and Rachael BaumgartnerHave feedback, questions, or suggestions for show ideas? Send them to us at podcast@springbuk.com. Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening! Theme music: "Overboard" by Stay Outside
Overwhelmed by nutrition advice?You're not alone.From sketchy influencer “secrets” to Big Food's algorithm-driven traps, a myriad of pitfalls means making healthy choices has never been harder.Questions abound: should you go all-in on the potato diet? Or embrace the all-meat life? (Spoiler: probably not.)This week, during the long-running and popular Talk Ten Tuesdays Internet broadcast produced by ICD10monitor, Dr. Nick van Terheyden will cut through the noise – breaking down diet fads, industry tricks, and practical ways to eat better, without the overwhelm.Because good nutrition shouldn't be this complicated.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
On this final episode of our Emotional Onboarding Series for The Healthcare Plus Podcast, Dan Collard is joined by Bart Kaericher, President, CEO, and Chief Cultural Officer of Aramark Healthcare+. Highlighting his commitment to Aramark's 25,000+ teammates and the hospitals and patients they serve, Bart shares the importance of a human-centric approach to employee engagement and collaboration to enhance patient experiences. Along Aramark's journey to becoming a Modern Healthcare Best Place to Work (which they achieved for the first time in 2024), Bart shares several key learnings and adjustments his team made, including:Implementing Early Connect, a program aimed at supporting new employees, and Team Member Connect, a new system of rounding that encourages coworker connections.Offering a daily pay system to support the team's financial flexibility and address social determinants of health (SDOH).Reducing early turnover by connecting with new hires before they step onsite and regularly through the first 120 days. Advocating for a focus on purpose, culture, and effective communication.Missed an episode in our Emotional Onboarding series? Listen back now with Dr. Katherine Meese, Patti Frank, Natasha Lee, and Abby Spence. About Bart KaericherBart Kaericher is the President & CEO of Aramark Healthcare+. Since his arrival to Aramark he's been focused on building an organization that is delivering a vision of having engaged employees, positive patient experiences, operational excellence, caregiver support, and being problem-solvers within the healthcare arena. Having a unified Culture of Caring has become a strong differentiator for Aramark Healthcare+. Before joining Aramark in May 2021, Bart served as Chief Growth Officer & Senior Vice President of Compass One Healthcare. While at Compass Group, he played an instrumental role in building revenues, profits, and valuable strategic partnerships. Prior to his tenure with Compass One Healthcare, Bart worked for more than a decade in the medical device industry at American Hospital Supply, now B. Braun Medical. Bart holds an MBA in Healthcare Marketing from Saint Joseph University in Philadelphia, PA, and a BS in Business from Miami University, Oxford, Ohio. He has also completed Cornell University's Executive Healthcare Leadership program.
Host: Dr. Leyla Warsame, ACMIO, M Health Fairview Guest: Jays'on Davidson, PhD Candidate, UCSF Description: Listen in to this episode with PhD Candidate Jays'on Davidson on his educational path to informatics and his work with data and social determinants of health.
Overwhelmed by nutrition advice?You're not alone.From sketchy influencer “secrets” to Big Food's algorithm-driven traps, a myriad of pitfalls means making healthy choices has never been harder.Questions abound: should you go all-in on the potato diet? Or embrace the all-meat life? (Spoiler: probably not.)This week, during the long-running and popular Talk Ten Tuesdays Internet broadcast produced by ICD10monitor, Dr. Nick van Terheyden will cut through the noise – breaking down diet fads, industry tricks, and practical ways to eat better, without the overwhelm.Because good nutrition shouldn't be this complicated.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
In this episode, I cover:What is cholesterolWhat is HDL, what is LDL, why is one often considered good and one badHow much does dietary cholesterol impct blood cholesterol levelsWhat are the components that contribute to cholesterol levelsWeight neutral, non-diet approaches to managingcholesterolIs your cholesterol your fault?Resources mentioned:SDOH blog post: https://leahkernrd.com/the-social-determinants-of-health-and-intuitive-eating/egg study: https://pubmed.ncbi.nlm.nih.gov/26864369/The Rosetto Effect: https://www.pbs.org/video/italian-americans-introduction/5 reasons why weight doesnt determine health: https://leahkernrd.com/
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Discharge orders have evolved. Today, they indicate the end of hospital billing for an encounter.However, when the discharge order is placed on a day other than the day a patient actually leaves the hospital, it can often lead to under-reporting the patient's length of stay (LOS) and other issues. And when some clinicians are told to place such an order when patients are medically ready to leave – even if there is no safe discharge plan – this forces the team to make the tough decision: to discharge or not to discharge. Thus, potential patient safety issues arise, as Dr. Juliet Ugarte Hopkins will report as the special guest during the next live edition of Talk Ten Tuesdays.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Addressing social determinants of health (SDOH) requires a multifaceted approach involving various sectors and stakeholders. There are population groups and underlying medical conditions that can increase the risk of mild to moderate COVID-19 infection, progressing to a severe outcome. The speakers will discuss these aspects and provide strategies for change. CE and ABIM MOC credits available: https://bit.ly/4k0q2jY
Every Gen X'er listening to this is gonna be singing that Clash song in your head for the rest of the day. So, let's turn our attention to Medicare Advantage policy. And on the show today, I grill the one and only Betsy Seals to find out which policies she thinks are going to stay and which are going to go. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. Obviously, this is very much in the context of a new administration and also just other things that are going on. But today we talk about the following four “stay or go” policy areas. Here's the first policy area we talk about: changes and activities within the Stars program. How will the Medicare Advantage Stars program change or not? Not only with this new administration, but also there are lawsuits and how they will impact the goings-on moving forward. Second policy, will it stay or will it go, that we talk about is risk adjustment and all of the activity in government oversight and focus on recoupment of improper payments as kind of the overarching bucket and what will be the incoming administration's method around risk adjustment. This is certainly on many people's minds. The third “will it stay or will it go” policy that we discuss is the use of AI (artificial intelligence) by Medicare Advantage plans. What does the appropriate oversight of the use in AI look like? Lots of talk about those prior auth AI algorithms and the high levels of denied care. A big topic of everybody's collective mind is looking at how to ensure that oversight is appropriate and that we're using AI for good and that it's not having any adverse impact. So that's the third will it stay or will it go. Fourth, and lastly, the whole agent broker realm—additional CMS and government oversight over misleading or inaccurate information coming from the marketing or the agent broker marketing world. How will that look in 2025 and moving forward? This last one, I'm kind of all over the nuance there after reading posts and comments by Samantha George, and I would recommend following her on LinkedIn would be my suggestion. I am reflecting back on the Ann Kempski episode (EP444), where we talk about the whole, really consider the downstream impact when making any policy changes, because there can be unintended consequences. Now, in a show about carriers—in this case, Medicare Advantage carriers—I'd be pretty tone deaf not to mention the nation's ire at carriers at this exact moment in time, some of it extremely well earned and some of it reflective of an extremely dysfunctional healthcare system. I'd also be tone deaf not to mention the MedPAC (Medicare Payment Advisory Commission) report, which states that Medicare Advantage plans receive payments from CMS that are 122% of spending for similar beneficiaries in traditional Medicare. This translates to an estimated $83 billion in higher spending in 2024. And I would lastly be remiss not to mention how Medicare Advantage plans are most carriers' most profitable service lines, with average earnings of around $1800 per enrollee. All of what I said is not some kind of grand revelation, of course, to most listeners of this show. And it's also not the topic of the conversation today, although some of this did get asked and answered in the earlier shows (EP387, EP375, EP291) with Betsy Seals. One thing I will remind everyone about is that there are regional carriers that are not the big five who may or may not be doing big five types of things. And also, it is actually really difficult to run a Medicare Advantage plan successfully. They call it risk for a reason. One thing I really appreciated about the conversation with Betsy Seals that follows is her advice to contemplate value to the patient and make sure that anybody working on the carrier side, you have enough of a bead on what's actually happening to be able to identify when things are going off the rails, which does not seem to be the case in some instances. This also, by the way, having a bead on what's actually happening on the ground, helps to ensure compliance and that's piece of advice two. Last piece of advice is to learn how to be proactive and not reactive. And this is eminently more possible vis-à-vis data that's available and learning how to use it well. Betsy Seals, my guest today, has had a very busy last couple of years since she was on Relentless Health Value the last time. Betsy is CEO and co-founder of Rebellis Group, a managed care consulting firm focused specifically in Medicare Advantage. Rebellis was actually acquired in February of 2024 and joined as a family of a couple of other consulting firms that now Betsy heads up. So, in short, she's really busy. Also mentioned in this episode are Samantha George; Ann Kempski; Rebellis Group; and Vivian Ho, PhD. You can learn more at rebellisgroup.com and alerionadvisors.com and by following Betsy on LinkedIn. Betsy Seals is the CEO of Alerion Advisors, a family of companies dedicated to delivering unparalleled consulting services across the healthcare spectrum. As a parent organization, Alerion Advisors unites three specialized firms—Rebellis Group, Advent Advisory, and Toney Healthcare—to provide health plans and their partners with comprehensive, innovative, and results-driven solutions. With over 25 years of experience in the managed care industry, Betsy is a nationally recognized leader known for her regulatory expertise and strategic insights. Betsy brings to the table a solid mix of leadership and business acumen, as well as regulatory and strategic knowledge within the managed care landscape. Betsy's expertise is focused in the areas of mergers and acquisitions, compliance, sales and marketing, strategy, supplemental benefit landscape, innovative benefit design that address social determinants of health (SDoH), and health plan operations. 05:09 Will the Star Ratings program stay in this new administration? 08:08 How will the lawsuits against CMS policies play out with this new administration? 10:24 Why is it hard for Medicare Advantage plans to survive, let alone thrive? 16:22 How does AI directly impact beneficiary lives? 21:38 What's going on now with the override payments? 27:08 How is non-collaboration going to impact Medicare beneficiaries moving forward? 31:45 Why is it important to become more technologically savvy in compliance? You can learn more at rebellisgroup.com and alerionadvisors.com and by following Betsy on LinkedIn. @betsyseals discusses #medicareadvantage policies on our #healthcarepodcast. #healthcare #podcast #changemanagement #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Wendell Potter (Encore! EP384), Dr Scott Conard, Stacey Richter (INBW42), Chris Crawford, Dr Rushika Fernandopulle, Bill Sarraille, Stacey Richter (INBW41), Andreas Mang (Encore! EP419), Dr Komal Bajaj, Cynthia Fisher
Could generative artificial intelligence (AI) revolutionize healthcare, or is it just a risky trend?During the next must-see live broadcast of Talk Ten Tuesdays, Dr. Christopher Boyle will walk you through the potential and pitfalls of generative AI. His journey will take you on an exploration of three promising uses of AI that focus on safety, documentation, and coding accuracy. You'll learn how you can balance the benefits of AI while ensuring compliance. Dr. Boyle will also report on how AI is addressing the social determinants of health (SDoH).Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
When a law enforcement officer comes to your facility, what do you need to know? And what should you do?While until recently, this topic was seldom on the top of lists ofhealthcare issues, a recent move by the Trump Administration (Executive Order) appears to have revoked a longstanding policy that prevented federal law enforcement agents (U.S. Immigration and Custom Enforcement) from going to certain areas long considered safe – think hospitals and schools – to conduct enforcement activities.So, what should you do – and what can you do, legally?Register now to attend the next live edition of Talk Ten Tuesdays, coming up at 10 a.m. EST on Feb. 4, when healthcare attorney David Glaser will weigh in on the topic as the broadcast's special guest.Listen and learn as Glaser will tell you what you and your team can and should do when faced with these unusual and unwelcomed visits.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will have the latest CDI updates.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
It could be the shot heard ‘round the world: the announcement recently of Stargate, a multi-billion-dollar artificial intelligence (AI) project now underway in the U.S. and backed by huge corporations, including Oracle, Open AI, and SoftBank, among others. But what will be the impact on healthcare, and notably, health information management (HIM) professionals?Reporting on this huge healthcare issue during the next edition of Talk Ten Tuesdays will be the legendary Rose Dunn.Dunn, who served as past president and former interim CEO of the American Health Information Management Association (AHIMA), will do double duty next Tuesday. She will also handle reporting duties for the Talk Ten Tuesdays Coding Report, substituting for Christine Geiger. In that capacity, Dunn is expected to report on the 60-Day Refund Rule, part of the 2025 Physician Fee Schedule.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of Clinical Documentation Integrity (CDI) for the vaunted Brundage Group, will report the latest documentation quandaries your team is likely to encounter this year.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.
Looking to unravel healthcare's complex issues? Looking to streamline your operations and improve decision-making?Join us this coming Tuesday, Jan. 14 at 10 a.m. EST, when the long-running Talk Ten Tuesdays kicks off its 2025 broadcast season with special guest Frank Cohen, senior director of analytics for VMG Health. Cohen will share his insight on Hanlon's Razor, a principle that can be summarized as “never attribute to malice that which can be adequately explained by incompetence.”This principle isn't about blame-sharing, but rather about how to foster empathy and clarity while also helping to develop constructive problem-solving.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• CDI Report: Cheryl Ericson, Director of clinical documentation integrity (CDI) for the vaunted Brundage Group, will make her debut appearance as the broadcast's CDI correspondent.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject expert, will begin the 2025 Talk Ten Tuesdays broadcast season as the co-host for the long-running and popular weekly Internet broadcast. Comfort, assistant vice president of revenue integrity for Montefiore Health, assumes the broadcast job following the expected departure of Erica Remer, MD.
I encourage everyone to attend conferences when you can. I meet the most interesting experts in the field of the nonprofit world. From scientists, to pharma, to other nonprofit execs like me. I was thrilled to meet Jenifer Waldrop. She joined the Black Women's Health Imperative as the Executive Director of the Rare Disease Diversity Coalition (RDDC) in October 2022. The organization address challenges faced by rare disease patients of color. They bring together rare disease experts, health and diversity experts.Their Vision: a world without health disparities in rare disease patients' communities.Mission: to address the extraordinary challenges face by historically underrepresented rare disease patients as encompassed by social determinants of health (SDOH). Jenifer volunteers as the Professional Development Director of the National Association of Asian American Professionals (NAAAP) of Colorado.Find more here: Rarediseasediversity.org Please like, subscribe, and comment on our podcasts!Please consider making a donation: https://thebonnellfoundation.org/donate/The Bonnell Foundation website:https://thebonnellfoundation.orgEmail us at: thebonnellfoundation@gmail.com Thanks to our sponsors:Vertex: https://www.vrtx.comViatris: https://www.viatris.com/en
Drs. Tomeka Dowling and Crystal Toll discuss the need to integrate concepts of diversity, equity, and inclusion (DEI) and social determinants of health (SDOH) into nursing curricula. RN to BSN students were surveyed to assess their perceptions of DEI-SDOH curricular threads and impact on nursing practice. Students indicated that DEI-SDOH curricula promoted self-examination, critical analysis of health care systems, and development of DEI-SDOH competence. You can learn more about their curriculum development process and assessment in their article.
Chime In, Send Us a Text Message!In this episode, we explore the critical role of social determinants of health (SDOH) in stroke prevention and recovery with an incredible panel of experts from the Bugher Collaborative. Our guests include:Dr. Nirupama Yechoor, Principal Investigator at Mass General Hospital and leader of the Bugher Collaborative.Dr. Devanshi Choksi, neurologist and colleague of Dr. Yechoor at Mass General.Rachel Kitagawa and Sofia Constantinescu, neurology postgraduates from Yale University.We dive into:The Bugher Collaborative: Its mission, the partnership between Mass General, Yale, and UCSF, and how it addresses equity in stroke care.Research Highlights: Insights into how socioeconomic status, access to care, and community support affect stroke outcomes.Yale's Findings: Key demographic differences uncovered through their research and what they reveal about health equity.The Road Ahead: Next steps for the collaborative and their vision for improving stroke care.Magic Wand Wishes: What each guest would change to improve stroke prevention and recovery if they had unlimited resources.This conversation builds on our discussion of the 2024 ASA Stroke Prevention Guidelines, offering a deeper dive into the intersection of health equity and stroke care.Resources and Links:Learn more about the Bugher CollaborativeDr. Nirupama Yechoor's BioDr. Devanshi Choksi's BioRachel Kitagawa's BioSofia Constantinescu's BioSupport Our Show! Thank you for helping us to continue to make great content. We appreciate your generosity! Support the showShow credits:Music intro credit to Jake Dansereau. Our intro welcome is the voice of Caroline Goggin, a stroke survivor and our first podcast guest! Please listen to her inspiring story on Episode 2 of the podcast.Connect with Us and Share our Show on Social:Website | Linkedin | Twitter | YouTube | FacebookKnow Stroke Podcast Disclaimer: Our podcast and media advertising services are for informational purposes only and do not constitute the practice of medical advice, diagnosis or treatment.
Is This Normal?: A Podcast of the Michigan State University College of Nursing
SEND US FAN MAILIn this episode, we talk with Dr. Veronica Bernacchi, a health disparity scientist and nurse researcher, about how social determinants of health (SDOH) impact cancer outcomes. Bernacchi explains SDOH—factors like income, access to healthcare, and living conditions—and how they contribute to cancer disparities, especially in rural and underserved communities.We explore how telehealth can improve access to care, its challenges, and how nurses can play a key role in bridging gaps by building trust and supporting patients. Bernacchi also highlights the importance of understanding community strengths and using culturally sensitive approaches to promote health equity.This conversation illuminates the systemic barriers to cancer care and the steps we can take to create more equitable outcomes for all patients.To find your breaking news and latest updates within the College of Nursing, please refer to our website at nursing.msu.edu. You can also find us on all social media platforms @MICHSTNursingIf you have a question for our hosts or a prospective guest, please message us at: MCOM.nursing@msu.edu
Estás escuchando #JUNTOSRadio: ¿Qué es la resiliencia?, ¿Qué impacto tiene la resiliencia en la salud mental?, ¿Qué podemos hacer para seguir desarrollando nuestra resiliencia?, Celia Ruiz Coordinador del proyecto de determinantes sociales de la salud (SDOH) en United Health care, nos responde estas y otras preguntas. Celia nació y creció en el East Side de Kansas City de padres que emigraron de El Derramadero, Guanajuato, México. Celia es Instructora bilingüe de primeros auxilios en salud mental, miembro de la junta de arte como mentor, y comisionada de la comisión LGBTQ y de la Comisión Municipal de Arte de Kansas City, Missouri. Celia es hablante nativo de español, intérprete y defensora de la comunidad. Recursos informativos en español: American Psychological Association https://www.apa.org/topics/resilience/camino Mayo Clinic https://www.mayoclinic.org/es/tests-procedures/resilience-training/in-depth/resilience/art-20046311 Facebook: @juntosKS Instagram: juntos_ks YouTube: Juntos KS Twitter: @juntosKS Página web: http://juntosks.org Suscríbete en cualquiera de nuestras plataformas de Podcast: Podbean, Spotify, Amazon Music y Apple Podcast - Juntos Radio Centro JUNTOS Para Mejorar La Salud Latina 4125 Rainbow Blvd. M.S. 1076, Kansas City, KS 66160 Este programa está realizado para fines educativos, para diagnósticos y tratamientos consulte su Médico. No tenemos los derechos de autor de la música que aparece en este video. Todos los derechos de la música pertenecen a sus respectivos creadores.
The Centers for Medicare and Medicaid Services (CMS) measures and, in some cases, penalizes facilities whose inpatient mortality or readmission (up to 3 per cent of their traditional Medicare revenue) rates for pneumonia, heart failure, acute myocardial infarction, and other conditions exceed their established benchmarks. Since these measures are based solely on ICD-10-CM/PCS-based administrative data applied to algorithms developed by Yale University, inaccurate documentation and coding can unwittingly misrepresent a facility's excellent performance resulting in underserved underpayments. During the next live edition of the long-running Internet broadcast, Talk Ten Tuesday, Dr. James S. Kennedy, president of CDIMD in Nashville, Tenn., will present five relatively simple CDI strategies involving the CMS mortality and readmission measures that, if implemented, will more accurately reflect your facility's excellent performance and lower or eliminate undeserved penalties. Be sure to take notes and invite your colleagues from quality to listen as well.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Join us to learn more about how Highmark Health is improving community health by tackling food insecurity with Nebeyou Abebe. Nebeyou Abebe is the Senior Vice President of Social Determinants of Health (SDoH) at Highmark Health, a $27 billion national health organization. With nearly 20 years of experience in SDoH, population health, and employee wellness, he leads initiatives to address non-clinical factors impacting health, such as housing, food insecurity, and transportation. Highmark Health, based in Pittsburgh, serves millions through its affiliated businesses and focuses on improving health outcomes by tackling both medical and non-medical drivers of poor health. Previously, Abebe was the Global Vice President of Health and Well-being at Sodexo Group, where he led efforts impacting over 100 million consumers and 425,000 employees. He also worked on public health initiatives with the Louisiana Public Health Institute and directed national campaigns for the CDC to reduce HIV/AIDS stigma. Abebe holds a bachelor's in economics from the University of Massachusetts-Amherst, a Master's in social and public policy from Georgetown University, Sponsor: The podcast is made possible by FoodNiche-ED, a gamified platform that enhances the knowledge of food and health. Learn more on foodniche-ed.com Twitter: https://twitter.com/foodniche_ed Instagram: https://www.instagram.com/foodniche_ed/ Facebook: https://www.facebook.com/FoodNicheEd/ LinkedIn:https://www.linkedin.com/company/foodniche-education About Dr. Olayanju: Dr. Julia Olayanju is a scientist and educator who advocates for enhanced nutrition education in schools and communities. She is the founder of FoodNiche-ED and FoodNiche where she and her team are driving a healthier future through programming, resources and technology.
Even savvy dentists tend to find a challenge in boosting their reimbursements by correctly coding procedures as medical claims instead of dental ones.During the next live edition of Talk Ten Tuesdays, Jeff Holt will report on the benefits of this strategy, including common pitfalls that make dentists want to pull their hair out. You'll discover that the benefits of having top-notch coders and cutting-edge tech is like finding the Holy Grail.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.Tune in to Talk Ten Tuesdays live on LinkedIn, or sign up below to join our email list for exclusive access to our live streaming platform.
Welcome to the latest episode of RISE Radio, our podcast series that focuses on issues that impact policies, regulations, and challenges faced by health care professionals responsible for quality and revenue, Medicare member acquisition and experience, and/or social determinants of health.Special thanks to DUOS for sponsoring this episode, which features Ana Handshuh, principal of CAT5 Strategies, and Jenn Kerfoot, chief strategy and growth officer, DUOS, discussing the impact of the election on Medicare Advantage and the potential changes ahead under President-elect Donald Trump's nominees: Robert F. Kennedy Jr. as HHS secretary and Dr. Mehmet Oz as CMS administrator.During this 55-minute podcast, they discuss the overall outlook for Medicare Advantage, as well as regulations that address marketing practices, prior authorization, Star ratings, health equity, and social determinants of health. About Ana HandshuhAna Handshuh, principal at CAT5 Strategies, is a government programs executive with expertise in creating and implementing corporate programs for the health care industry. Her background includes quality, core measures, care management, benefit design and bid submission, accreditation, regulatory compliance, revenue management, communications, community-based care management programs and technology integration. She is a sought-after speaker on the national health care circuit in the areas of quality, Star ratings, care management, member and provider engagement, and revenue management.About Jenn KerfootJenn Kerfoot, chief strategy & Growth officer, DUOS, is a visionary health care leader with deep expertise in Medicare Advantage and value-based care. Kerfoot leverages her extensive background in health care policy, regulation, and business development to drive strategic growth and innovation at DUOS, developing tailored solutions that meet the evolving needs of Medicare Advantage plans. A seasoned podcast host, Kerfoot regularly explores critical issues like the looming threat of Medicare insolvency, the challenges of financing care for an aging population, the impact of rising health care costs, and disparities in care access. With previous leadership roles at FarmboxRx, Excelera Health, and NationsBenefits, Kerfoot has a proven track record of navigating complex health care regulations and aligning strategies with market demands. Beyond her executive role, she is a recognized thought leader and advocate for progressive health care practices, advising venture capital and private equity firms on investments in transformative health care solutions. Kerfoot's pragmatic optimism and relentless problem-solving approach are key to her success in fostering collaboration and pushing the boundaries of what's possible in health care. About DUOSDUOS is a health care technology company building solutions to improve plan performance and enhance the continuum of care. Our AI-powered digital experiences match social determinants of health (SDoH) and care navigation needs with more than 100,000 Medicare benefits, community resources and government programs to improve health outcomes and beneficiary satisfaction and close gaps in care.
In can be confusing and even demoralizing for a medical student or resident to understand what's expected of them when caring for patients with social needs. They already feel overwhelmed. Are they supposed to now also screen for housing insecurity? Is it their job to intervene to address social needs? And if someone else is doing the screening, what's their role? And are they also supposed to be advocating for changes to social policies? Finally, what's special about social needs as opposed to all the other reasons that, for instance, a patient can't control their diabetes? A patient may not be able to store their insulin because they are poor. Or they may not be able to administer it because they can't read the bottle or their fingers are arthritic. Our guest, Emily Murphy MD, an academic hospitalist, provides her perspective on teaching medical students and residents about SDOH. Co-host Saul Weiner, expresses concern that messages to trainees about their roles are confusing, that the SDOH movement is just the latest buzzword in medicine, like “patient-centered care,”, and that while getting a huge amount of attention the movement could ultimately have little impact on patient wellbeing. He, Dr. Murphy, and co-host Stefan Kertesz discuss these questions and concerns and consider what needs to change.
He was enthralling as he explained his revolutionary technology that empowers healthcare professionals to make crucial decisions in real time that improve patient care. Dr. Gerasimos Petratos, founder and CEO for HITEKS, had successfully automated the tenuous physician query process.In our continuing series of technical reporting, “Healthcare Technology,” the producers of ICD10monitor and Talk Ten Tuesdays have invited Dr. Petratos to be the special guest during the next live edition of the weekly Internet radio broadcast.Beyond outlining the automated query process, Dr. Petratos is expected to provide an update on other proprietary products in his company's arsenal.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.
Feeling parched?Well, you're not alone. Hospitals across the country are dealing with a saline shortage.Thanks to Hurricane Helene's unwelcome visit to the Baxter International facility in North Carolina, your IV bags may be running low. Imagine a busy highway suddenly reduced to a single lane: that's what this IV shortage feels like for impacted healthcare providers.During the next live edition of the long-running and popular live Internet radio program Talk Ten Tuesday, Dr. Nick van Terheyden will report on just about everything related to this topic, from switching to oral meds (because who needs a needle when you can swallow?) to challenging those pesky “keep the veins open” (KVO) orders (seriously, do you really need to keep those veins open all the time?)Join Talk Ten Tuesdays and leave feeling hydrated and empowered!Also part of the broadcast, these instantly recognizable panelists will report more news during their segments:• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will continue with the final installment in her three-part series on the significant changes in the newly released ICD-10 codes.• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.Cozen O'Connor Public Strategies - The Beltway BriefingListen for of-the-moment insider insights, framed by the rapidly changing social and...Listen on: Apple Podcasts Spotify
Send us a textBen and Daphna sit down with Monica Jones, Senior Family Consultant at the Children's Hospital of Philadelphia and NICU parent, to discuss the critical role of family voices in neonatal care. Monica shares insights from her work with CHNC, including a universal tool to address health disparities and support NICU families. She emphasizes the importance of personalized resources, Medicaid advocacy, and the unique challenges NICU families face. Tune in to hear Monica's impactful journey from NICU parent to advocate, working to improve care and financial support for all families.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
The panic was widespread. Rumors were flying. Cellphone alarms were sounding.From large hospital conference rooms to upholstered cubicles, everyone seemed to have the same sense of disbelief and mounting frustration: Acentra Health (previously Kepro) had announced a new appeal process for Medicare patients – specifically, those whose status changed from inpatient to observation.Among those who maintained a sense of composure was healthcare regulatory guru Ronald Hirsch, MD.Dr. Hirsch, a popular presenter on Monitor Mondays, produced by RACmonitor, carefully read the documents and concluded that while no one in healthcare wanted to be burdened with another Medicare form, the news was much less dire than it had first seemed.That is why the ICD10monitor producers of the popular Talk Ten Tuesdays Internet radio program invited Dr. Hirsch to report on his analysis of the new Medicare appeal process.Also as part of the broadcast, these instantly recognizable panelists will report more news during their segments:• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will continue with the final installment in her three-part series on the significant changes in the newly released ICD-10 codes.• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.Tune in to Talk Ten Tuesdays live on LinkedIn, or sign up below to join our email list for exclusive access to our live streaming platform.Cozen O'Connor Public Strategies - The Beltway BriefingListen for of-the-moment insider insights, framed by the rapidly changing social and...Listen on: Apple Podcasts Spotify
The Rules of Engagement for medical coding and clinical documentation integrity (CDI) are based on four authoritative sources: the ICD-10-CM/PCS Official Coding Guidelines, the American Hospital Association (AHA) Coding Clinic Advice, the American Health Information Management Association (AHIMA) Standards of Ethical Coding, and practice briefs. These are, in the words of senior healthcare consultant Gloryanne Bryant, “the Big Essentials.”Bryant, past president of the California Health Information Association (CHIA), will report on each of these essential publications during the next live edition of the ever-popular Talk Ten Tuesdays live Internet broadcast.Also during the broadcast, these instantly recognizable panelists will report more news during their segments:• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will continue with the final installment in her three-part series on the significant changes in the newly released ICD-10 codes.• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, 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.Cozen O'Connor Public Strategies - The Beltway BriefingListen for of-the-moment insider insights, framed by the rapidly changing social and...Listen on: Apple Podcasts Spotify