Is the COVID-19 pandemic a wake-up call for value-based payment innovation and care delivery, or does it raise serious questions about value-based models’ ability to perform? Host Mark Moticik circles up with David Delaney, Cindy Garvin, and Andrei Gonzalez to explore the immediate and lasting impact of COVID-19 on value-based care, and review the steps payers can take to understand how alternative payment and care models performed throughout the crisis.

Today’s expert panel convened Mark Moticik, vice president of Payer BPaaS Services at Change Healthcare; David Delaney, MD, senior vice president and general manager of Payer Technology Enabled Services at Change Healthcare; Cindy Garvin, senior consulting manager at Change Healthcare; and Andrei Gonzalez, associate vice president, Product Management, Value-Based Payments at Change Healthcare.

Listen in for the panel’s insights on:

• How COVID-19 is influencing momentum around value-based care
• Whether the pandemic can accelerate the case for value-based care
• Potential changes to the relationship between primary care physicians and specialists
• New provider and payer perspectives on risk, capitation, and other alternative payment models
• Which innovations in care, such as telemedicine and drive-thru testing, will persist beyond the COVID-19 crisis
• How these innovations can impact the value equation long term
• Ways to create a more elastic healthcare system in the U.S.
• Why the healthcare industry’s experience fighting COVID-19 could change the definition of value-based care
• Predictions on how COVID-19 will impact the underlying economic model of care delivery
• Whether alternative payment models can co-exist with government-sponsored plans
• Latest lessons learned about social determinants of health (SDoH) beyond testing, treatments, and fatalities
• Steps payers can take to implement and sustain SDoH strategies

Episode Resources

1. David Delaney’s bio
2. Andrei Gonzalez’s bio
3. Cindy Garvin’s bio
4. Mark Moticik’s bio
5. CMS COVID-19 FAQ
6. Medicaid COVID-19 Portal
7. Case Study: Value-Based Care Enablement
8. Best Practices to Engage Providers in Value-Based Models
9. How to Accelerate the Transition to Value through Episode Intelligence
10. Value-Based Payments Resource Center
11. HealthQx Value-Based Payment Analytics
12. Value-Based Care Business Process Management Services
13. Value-Based Care Enablement Solutions
14. Value-Based Care Transformation Services
15. Value-Based Payment Solutions
16. Change Healthcare Industry Insights
17. COVID-19 Updates and Resources
18. COVID-19 Updates Newsletter
19. Change Healthcare Insights Newsletter

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Get the iOS app
• Get the Android app
• Suggest or become a guest
• Contact Change Healthcare

Organizations that don’t have strong revenue integrity leave money on the table and might experience compliance problems

If you ask 10 revenue cycle leaders what the primary focus of their revenue integrity efforts should be, you might get 10 different answers. Revenue integrity is not confined to one part of the revenue cycle, and it is not a stand-alone function. In the truest sense, revenue integrity is an outcome.

By Elaine Dunn and Vindali Vartak

Elaine Dunn is vice president of Revenue Integrity at Change Healthcare. Vindali Vartak is senior director of Advanced Analytics at Change Healthcare.

Episode Resources

1. Elaine Dunn's bio
2. Vindali Vartak's bio
3. Strategies for Fine-Tuning Revenue Integrity
4. Revenue Integrity Solutions
5. Change Healthcare Industry Insights
6. COVID-19 Updates and Resources
7. COVID-19 Updates Newsletter
8. Change Healthcare Insights Newsletter

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Get the iOS app
• Get the Android app
• Suggest or become a guest
• Contact Change Healthcare

The pandemic left payers, providers, and regulators no choice but to fully embrace telehealth--finally. CMS, ONC, and payers expanded coverage. Providers flocked to telehealth to mitigate the risk of in-person visits and ensure care delivery. In the aftermath, the benefits and limitations of “telehealth,” and the promise of a true virtual care model, are now clear—as are the gaps that must be closed, such as enabling labs, e-prescriptions, remote imaging, expanded eligibility, claims management, and more.

On today’s show, G. Shah, VP of Platform and Marketplace, convenes a Change Healthcare expert panel to discuss how COVID-19 upended the telehealth trend, the trajectory of telehealth’s evolution into a true virtual care model, and what’s needed from a business and technology standpoint to get there. On the panel: Ian Ellis, VP and general manager of Clinical Exchange; Cindy Klain, VP of Medical Network; and Greg Jones, director of Product Management.

Here’s the deep dive they took into the present and future of virtual care:

• Expanding the footprint of care
• Patients seeing remote providers: How do they get their labs and prescriptions?
• How payers and providers can get started with telehealth
• Digital health companies and innovation
• Using APIs to build better solutions
• Ensure providers are equally supported in the telehealth model
• From telehealth to true virtual care: the next vista
• The bookends of the financial journey for telehealth providers
• The financial model of providing care
• Virtual labs and prescriptions
• Virtual imaging
• Virtual medical eligibility and claims management
• Using bundled APIs to help telehealth providers create better experiences
• Towards continuous care from an episodic care model
• Eliminating complexity
• APIs only a telehealth provider could love
• This time next year: What does virtual care success look like?

Episode Resources

1. G. Shah’s bio
2. Ian Ellis’s bio
3. Cindy Klain’s bio
4. Greg Jones’ bio
5. Change Healthcare Launches Suite of Solutions to Support and Accelerate the Adoption of Virtual Care
6. Telehealth Medical Eligibility and Claims Management API Bundle
7. Telehealth Lab Orders, Results, and ePrescribe API Bundle
8. Virtual Care Enablement
9. API & Services Connection™ for Healthcare
10. Change Healthcare Industry Insights
11. COVID-19 Updates and Resources
12. COVID-19 Updates Newsletter
13. Change Healthcare Insights Newsletter

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Get the iOS app
• Get the Android app
• Suggest or become a guest
• Contact Change Healthcare

Interoperability improves patient outcomes, lowers cost, and can serve to meet evolving regulatory standards

Value-based care—and the regulatory push for transparency—expands the need for collaboration. Increasingly, that interoperability will expand from provider-to-provider systems to include patients and payers.

By Faisal Mushtaq

Faisal Mushtaq is SVP and General Manager of Clinical Networks at Change Healthcare.

Episode Resources

1. Faisal Mushtaq's bio
2. Change Healthcare Offers Free Connected Consumer Health™ Interoperability Solution for Health Plans to Meet CMS Deadline
3. Change Healthcare Launches Suite of Solutions to Support and Accelerate the Adoption of Virtual Care
4. Accelerate Healthcare Data Interoperability
5. Interoperability Solutions for Healthcare
6. Advancing the Use of APIs in Healthcare
7. API & Services Connection™ for Healthcare
8. Change Healthcare Industry Insights
9. COVID-19 Updates and Resources
10. COVID-19 Updates Newsletter
11. Change Healthcare Insights Newsletter

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Get the iOS app
• Get the Android app
• Suggest or become a guest
• Contact Change Healthcare

Denver Health Enterprise Chief Information Security Officer Randall Frietzsche joins host John Zuziak to share how Denver Health conducts security assessments, evaluates new vendors, and monitors for vulnerabilities.

Learn More 

• Follow Randall Frietzsche, enterprise chief information security officer at Denver Health
• Follow John Zuziak, former security and IT risk management practice director at Change Healthcare
• denverhealth.org/
• changehealthcare.com/healthcare-consulting

President of the Healthcare Leadership Council, Mary Grealy, joins host Deanne Kasim to discuss how the coalition of chief executives from all disciplines in U.S. healthcare work to develop policies, plans, and programs to achieve a 21st-century system that makes affordable, quality care accessible to all Americans.

Learn More

• Follow Mary Grealy, president at the Healthcare Leadership Council
• Follow Deanne Kasim, VP of health policy at Change Healthcare
• hlc.org/
• changehealthcare.com/government-affairs

Today’s show is an update on policy proposals to help improve the pandemic’s outcomes and reopen the U.S. economy.

Today’s panel is led by Deanne Kasim, executive director of Health Policy at Change Healthcare; and Arien Malec, SVP of product R&D at Change Healthcare, former ONC leader, and current HITAC member.

Here's what they covered:

• Proposals to reopen the economy
• Where we’re at today
• What’s changed since April
• What to consider and focus on
• A roadmap to reopen the recovery and beyond
• Policy, proposals, and infrastructure
• The phenomenon of the wizard’s apprentice
• Contact tracing technologies and implications
• Contact tracing security, privacy, and data rights
• Thoughts on digital immunity passports
• Scaling vaccine production and distribution, treatment cost, and reimbursement
• Playbook for the next pandemic

Episode Resources

1. Arien Malec’s bio
2. Deanne Kasim’s bio
3. Reopening the Economy: How Fast is Too Fast?
4. Change Healthcare Government Affairs
5. COVID-19 Updates and Resources
6. COVID-19 Updates Newsletter

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Suggest or become a guest
• Contact Change Healthcare

How Change Healthcare’s API and Services Connection™ marketplace helps payers, providers, and digital health companies deliver a more efficient, consistent experience

Learn how APIs sourced from a portfolio of integrations, workflow enablers, and intelligent advisors let payers, providers, and digital health companies create innovative ways to engage, care for, and manage patients.

By Gautam M. Shah

G. Shah is Vice President of Platform and Marketplace, Change Healthcare.

Episode Resources

• G. Shah's bio
• Enabling Efficiency in Telehealth
• Advancing the Use of APIs in Healthcare
• API & Services Connection™ for Healthcare
• COVID-19 Updates and Resources
• COVID-19 Updates Newsletter

Show Resources

• SUBSCRIBE to the podcast using any podcatcher or RSS reader
• Suggest or become a guest
• Contact Change Healthcare