As America shifts to value-based care, it becomes ever more important to get reimbursement claims accurate from the get-go.

by Dave Cardelle and Amy Larsson

Dave Cardelle is VP of Payment Integrity Solution Management at Change Healthcare. Amy Larsson is VP of Clinical Claims Management Solutions at Change Healthcare.

Episode Resources

1. Download the Ebook
2. Contact Change Healthcare

Show Resources 

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Download the audio and listen offline
• Get the iOS app
• Get the Android app
• Suggest or become a guest

Payment Accuracy is essential to reducing administrative costs, optimizing fee for service, and enabling the transition to value-based care.

by Amy Larsson, VP Clinical Claims Management Solutions, Change Healthcare.

This is part one of a two-part series, focused on trends and best practices in the payment accuracy industry. Part one focuses on How Payment Accuracy Enables the Transition to Value-Based Care. Part two focuses on How Pre-Submission Improves the Provider-Payer Relationship.

Episode Resources

1. Download the Ebook
2. Contact Change Healthcare

Show Resources 

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Download the audio and listen offline
• Get the iOS app
• Get the Android app
• Suggest or become a guest

Pre-submission of medical claims reduces friction and promotes collaboration between providers and payers.

By Dave Cardelle, VP of Payment Integrity Solution Management, Change Healthcare.

This is part two of a two-part series, focused on trends and best practices in the payment accuracy industry. Part one focuses on How Payment Accuracy Enables the Transition to Value-Based Care. Part two focuses on How Pre-Submission Improves the Provider-Payer Relationship.

Episode Resources

1. Download the Ebook
2. Contact Change Healthcare

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Download the audio and listen offline
• Get the iOS app
• Get the Android app
• Suggest or become a guest

Former Senate Majority Leader Bill Frist joins host Deanne Kasim to discuss healthcare innovation, policy, technology, leadership, medicine and, of course, the senator's new podcast.

Learn More

• Follow Deanne Kasim, VP of health policy at Change Healthcare
• Follow former Senate Majority Leader Bill Frist
• asecondopinionpodcast.com/
• changehealthcare.com/about/government-affairs
• changehealthcare.com/press-room/press-releases/detail/commonwell-health-alliance-awards-change-healthcare-with-six-year-contract
• changehealthcare.com/press-room/press-releases/detail/change-healthcare-to-provide-free-healthcare-data-interoperability-services-for-all-americans-on-amazon-web-services

The Centers for Medicare and Medicaid Services recently launched a new innovation model known as the Comprehensive Primary Cares Initiative (CPCI). The goal of this voluntary multi-payer model is to strengthen the use of and reliance on primary care for all patients, while pushing forward in the progression from fee-for-service to a value-based healthcare system.

The CPCI comprises a new set of payment models designed to transform primary care to deliver higher value for patients throughout the U.S. healthcare system. CMS says the CPCI builds on lessons learned from previous models, and will reduce administrative burdens and empower primary care providers to spend more time caring for patients while reducing healthcare costs.

To help understand this complex but important new CMS program, we invited Dr. Andrei Gonzales, Change Healthcare’s AVP of Product Management for Value Based Payments, to talk about the initiative’s potentially transformative effect on payment and clinical models. In addition to helping improve care quality and reducing cost for CMS members, Dr. Gonzales says this new model can also help improve quality scores and expand opportunities for shared savings.

Covered on today's show:

• What is the CMS Comprehensive Primary Cares Initiative (7:22)
• The timeline for the effect on primary care physicians (17:18)
• What health plans can do now to prepare for the future (20:33)
• Providers’ reactions to the new initiative (22:35)

Episode Resources

1. Contact Patrick McGuigan
2. Dr. Andrei Gonzales's bio
3. CMS Comprehensive Primary Care Initiative
4. Research: Value-Based Care State-by-State
5. Seminar: How Anthem is Scaling Value-Based Payment
6. Value-Based Payment Resource Hub

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Download the audio and listen offline
• Get the iOS app
• Get the Android app
• Suggest or become a guest

There’s no denying that reducing bad debt is at the top of revenue cycle leaders’ agendas. Patient liability has skyrocketed in recent years due to the rise in high-deductible health plans and erosion in coverage.

And many, if not most providers are being tripped up by these changes. The reason: Existing revenue cycle management practices are out of step with their patients’ new reality. They were never designed to accommodate sudden and dramatically higher patient liability.

The result is bad debt is rising, and the work required to collect it is damaging relationships with patients. But it doesn’t have to be this way. New thinking is emerging around contemporary patient liability management that pairs improvements to the patient experience with reducing denials and bad debt.

We invited two experts on the topic of advanced liability management to join us today on the Change Healthcare podcast: Raghu Bukkapatnam, Chief Strategist for Technology Enabled Services at Change Healthcare; and Bill Krause, VP of Digital Experience and Consumer Engagement at Change Healthcare. On today's show, we cover:

• The consumerization of revenue cycle management (02:59)
• Providers struggling to meet consumer expectations, bad debt rising (6:44)
• The nexus of patient liability, consumer engagement, digital experiences, and collections (10:31)
• Gaps providers can close to reduce bad debt and improve patient relationships (17:29)
• Where the industry falls on the patient liability management continuum (24:55)
• Advice for providers facing resistance to change (28:37)
• Risk and ROI measurement for advanced patient liability management (36:16)
• Time to change: The patient liability management countdown (41:17)
• Examples of successful patient financial experience transformation (46:52)

Episode Resources

1. Bio: Raghu Bukkapatnam
2. Bio: Bill Krause
3. Infographic: How Patient Liability Management Helps Improve the Patient Financial Journey
4. Improving the Patient Financial Experience and Maximizing Patient Collections
5. Change Healthcare Introduces the First Patient Liability Solution to Help Improve the Entire Patient Journey
6. Contact us

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Download the audio and listen offline
• Get the iOS app
• Get the Android app
• Suggest or become a guest

Johns Hopkins University School of Medicine’s director for The Center of Transformative Geriatric Research, Dr. Bruce Leff, and UC San Diego Department of Emergency Medicine associate medical director, Dr. Allyson Kreshak, join host Laura Coughlin to discuss the opportunities, benefits, and challenges of Hospital in the Home programs.

Learn More

• Follow Laura Coughlin, vice president of clinical innovation and development at Change Healthcare
• Follow Dr. Leff, Director for the Center of Transformative Geriatric Research at John Hopkins University School of Medicine
• Follow Dr. Allyson Kreshak, associate medical director for UC San Diego Emergency Department of Emergency Medicine
• changehealthcare.com/clinical-decision-support/interqual