The CMS’s Interoperability and Patient Access rule, finalized in March, requires payers give members easy access to, and control over, their claims data. As payers face this looming deadline, they have a choice: comply with the basic requirement, or use the mandate as catalyst to modernize member engagement and improve their market advantage. On today’s show, Deanne Kasim, Bob Hoover, Ed Hafner, and German Scipioni discuss the CMS mandate and opportunities for payers to capitalize on it.

The Change Healthcare podcast panel:
Deanne Kasim, Executive Director of Health Policy
Bob Hoover, VP of Consulting
Ed Hafner, AVP of Payer Strategy Medical Network
German Scipioni, VP of Product Consumer Services

Here’s the path they took for today’s discussion:

• Quick recap: Intent and requirements of the Rule
• Assessing technical capabilities
• Data governance requirements
• What APIs must give payers and members
• A strategy for achieving a new level of member engagement
• Preparing for responses from informed patients
• How to execute your strategy to meet the deadline
• Models for interoperable member-facing solutions

Episode Resources

1. Bob Hoover's bio
2. Deanne Kasim's bio
3. Ed Hafner's bio
4. German Scipioni's bio
5. CMS Interoperability and Patient Access Final Rule
6. CMS Interoperability and Patient Access Fact Sheet
7. Change Healthcare Offers Free Connected Consumer Health™ Interoperability Solution for Health Plans to Meet CMS Deadline
8. Change Healthcare Consulting Services Resource Hub
9. Change Healthcare Consulting Services
10. COVID-19 Updates and Resources
11. COVID-19 Updates Newsletter

Show Resources

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

HFMA President and CEO Joseph Fifer joins host Thomas Laur for a C-suite discussion on the unprecedented challenges revenue cycle professionals now face, how providers are coping, and what can be done to help foster a faster recovery.

Learn More 

• Follow Joseph Fifer, president and CEO of HFMA
• Follow Thomas Laur, EVP and president of technology enabled services at Change Healthcare
• changehealthcare.com/key-patient-access-strategies-in-a-crisis
• changehealthcare.com/solutions/revenue-cycle-management
• changehealthcare.com/covid-19

Patient Collection Strategies in an Economic Downturn

Today many healthcare organizations are facing new levels of uncertainty as a result of the COVID-19 pandemic. While each organization is focused on caring for patients and keeping team members safe and healthy, providers cannot help but also be concerned about the impact this will have on other areas. This rapidly evolving pandemic has put pressure on all facets of healthcare, including clinical care, the revenue cycle, and personnel management.

With that said, it is imperative for providers to evaluate their communications and outreach programs to help ensure that all print, digital, and voice communications have a compassionate, empathetic, and respectful tone that acknowledges the patient’s new and often stressful situation. There are several steps providers can take now, and over the coming months, to help increase patient-collection outcomes and lower overall revenue risk.

By David Figueredo

David Figueredo is National Vice President of Sales, Technology Enabled Sales at Change Healthcare.

Episode Resources

• David Figueredo's bio
• Technology-Enabled Services
• 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

Tougher requirements are coming for D-SNP, the dual-eligible special needs program for Medicare and Medicaid. On today’s show, Shelley Stevenson and Phillip Cardona discuss upcoming regulatory changes, what payers need to know to ensure compliance, and opportunities that arise for payers and members.

Shelley Stevenson leads the government programs practice at Change Healthcare Consulting. Phillip Cardona is a strategy executive with Change Healthcare’s Payer Growth Program. Here’s what they chatted about.

• D-SNP and eligibility
• States starting to require D-SNP plans
• Tougher requirements coming in 2021
• Timeline and roadmap for preparing for 2021 regulations
• How the new regulations impact providers
• What payers need to do to keep providers informed
• Mobilizing a clinical team
• Siloed Medicare and Medicaid patients and the shift to integrated plans
• The impact on long-term support services
• How to analyze where members will need support
• Moving to holistic care

Episode Resources

1. Shelley Stevenson’s bio
2. Phillip Cardona’s bio
3. How to Modernize Dual Enrollment with AI and Behavioral Science
4. COVID-19 Updates and Resources
5. COVID-19 Updates Newsletter

Show Resources

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

Vice president of editorial at Becker’s Healthcare, Molly Gamble, joins host Kelley Blair to discuss what she has seen, experienced and reported for Becker's Healthcare readers over the past six weeks of the pandemic.

Learn More

• Follow Molly Gamble, vice president of editorial at Becker's Healthcare
• Follow Kelley Blair, former SVP and general manager of health system revenue cycle at Change Healthcare
• changehealthcare.com/revenue-cycle-management
• beckershospitalreview.com/
• beckershospitalreview.com/latest-covid-19-coverage.html
• changehealthcare.com/covid-19

COVID-19 lockdowns and the social isolation they can cause can have an outsized impact on the health of senior citizens and other vulnerable populations. Indeed, several studies associate social isolation and loneliness with increased mortality that's comparable to smoking 15 cigarettes a day.

Today's show features a conversation with Jeff Barkin, MD, associate medical director; Victoria Pham, DO, medical director, Clinical Development, Strategy, and Client Experience; Monique Yohanan, MD, MPH, senior medical director, Level of Care team, and director for Content Development; and Kelly Cavin, VP of Social Determinants of Health, all with Change Healthcare.

Our expert panel discusses what providers and health plans are doing now, and what more they can do, to mitigate the health effects of social isolation and improve other social determinants of health arising from the pandemic.

Here's what they talked about:

• The impact of social isolation on older adults
• How providers are increasing outreach to older patients
• How payers are connecting members with support services
• The rapidly expanding role of telemedicine
• A direct approach to addressing social determinants
• Mental health disorders post-pandemic: a forecast

Episode Resources

1. Jeff Barkin's bio
2. Victoria Pham's bio
3. Monique Yohanan's bio
4. Kelly Cavin's bio
5. Address Social Determinants of Health with Community Advocacy
6. Eligibility & Enrollment with Member Engagement Support
7. My Advocate Eligibility and Enrollment Solutions
8. COVID-19 Updates and Resources
9. COVID-19 Updates Newsletter

Show Resources

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

Independent Health CIO Eric Decker, CISO Peter Jabrucki, and Business Continuity and Disaster Recovery Manager LeMar Ward join host John Zuziak to discuss cybersecurity in the new normal.

Learn More 

• Follow John Zuziak, former security and IT risk management practice director at Change Healthcare
• Follow Eric Decker, CIO at Independent Health
• Follow Peter Jabrucki, CISO at Independent Health
• Follow LeMar Ward, business continuity and disaster recovery manager at Independent Health[RL1]
• independenthealth.com/
• changehealthcare.com/healthcare-consulting
• changehealthcare.com/covid-19

The COVID-19 pandemic is putting unprecedented strain on the healthcare system. And while the challenges facing the front-line healthcare providers are most obvious and concerning, payers are not immune. They're facing hurdles driven by new codes, regulatory changes, and a surge in telehealth that challenges the ability to accurately process timely payments–a critical issue for providers.

On today’s episode, Dr. Frank Dubeck, chief medical officer for Payment Accuracy at Change Healthcare, joins Mike Boykin, value consultant; Tracy Mullen, manager of Clinical Development; and Kathleen Reid, product management leader for Clinical Claims Management to discuss claims code editing considerations during the global health emergency.

Here are the high points of their conversation:

• New codes developed to deal with COVID-19
• Editing to address the influx of telemedicine claims
• Demystifying CMS and CPC telemedicine coding conflicts
• COVID-19 diagnostic coding
• Reviewing rules configuration in ClaimsXten to reduce denials
• Frequency rules editing
• How bundling rules are impacted

Episode Resources

1. Amy Larsson's bio
2. Dr. Frank Dubeck's bio
3. Mike Boykin's bio
4. Tracy Mullen's bio
5. Kathleen Reid's bio
6. Webinar: Claims Management and Payment Accuracy in a Pandemic
7. ClaimsXten
8. Coding Advisor Pre-Submission Claims Adjustment
9. COVID-19 Updates & Resources
10. COVID-19 Updates 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