Empowered Patient Podcast

Dr. Marcy Carty, President and Chief Medical Officer of myLaurel, emphasizes the need to change the model where hospitals are the safest place for medical care. MyLaurel's acute care services include pre-hospital care to prevent emergency room visits, care-at-home to help patients get discharged earlier, and post-hospitalization care to smooth the transition. They work with primary physicians and other care providers to ensure a coordinated approach and use technology in the home to perform monitoring and diagnostics overseen by medical professionals and responders who can provide in-person and virtual visits.

Marcy explains, "In the past, our health systems have looked at volume. I was a chief medical officer at a hospital, and I remember my CEO saying, "How many heads and beds can we get?" And so the system's really driven towards reducing risk and putting people into hospitals, assuming that it's the best place to be cared for. At myLaurel, we challenge that and work with communities to say, "How can we change that paradigm and bring the care to someone at home where they can sleep in their own bed, where they can hold all the power in their decision-making and ensure their goals of care are really incorporated into the care plan?" We want to change the paradigm that hospitals are the safest place to be and bring that care home, where I would say most people we talk to want to be cared for."

"In general, myLaurel focuses on elderly or frail or people with complex medical conditions. What that means is our average patient is in their eighties, our average patient has about 13 medications, and our average patient has six or more chronic conditions. They generally represent the top 10% of patients for a health plan, accountable care organization, or physician group."

#myLaurel #AcuteCare #InHomeCare #HospitalatHome #ObservationatHome

mylaurelhealth.com

Listen to the podcast here

Dr. Marcy Carty, President and Chief Medical Officer of myLaurel, emphasizes the need to change the model where hospitals are the safest place for medical care. MyLaurel's acute care services include pre-hospital care to prevent emergency room visits, care-at-home to help patients get discharged earlier, and post-hospitalization care to smooth the transition. They work with primary physicians and other care providers to ensure a coordinated approach and use technology in the home to perform monitoring and diagnostics overseen by medical professionals and responders who can provide in-person and virtual visits.

Marcy explains, "In the past, our health systems have looked at volume. I was a chief medical officer at a hospital, and I remember my CEO saying, "How many heads and beds can we get?" And so the system's really driven towards reducing risk and putting people into hospitals, assuming that it's the best place to be cared for. At myLaurel, we challenge that and work with communities to say, "How can we change that paradigm and bring the care to someone at home where they can sleep in their own bed, where they can hold all the power in their decision-making and ensure their goals of care are really incorporated into the care plan?" We want to change the paradigm that hospitals are the safest place to be and bring that care home, where I would say most people we talk to want to be cared for."

"In general, myLaurel focuses on elderly or frail or people with complex medical conditions. What that means is our average patient is in their eighties, our average patient has about 13 medications, and our average patient has six or more chronic conditions. They generally represent the top 10% of patients for a health plan, accountable care organization, or physician group."

#myLaurel #AcuteCare #InHomeCare #HospitalatHome #ObservationatHome

mylaurelhealth.com

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Dr. Waqaas Al-Siddiq, the CEO and Founder of Biotricity, focuses on remote patient monitoring for heart health with HeartSecure, the three-channel wearable device that collects continuous ECG data. This device provides a more comprehensive view of the electrical activity of the heart compared to other wearables like smartwatches and can help identify potential cardiac issues, especially those that are intermittent and asymptomatic. Used by cardiologists and now available as a home-based diagnostic, this technology is a tool to screen those with risk factors such as high blood pressure, diabetes, sleep apnea, and obesity.

Waqaas explains, "When we talk about wearables, we have to understand what those wearables are collecting. A typical watch, like an Apple Watch or Samsung Watch or these kinds of devices, collects data through a PPG, which is really looking at light refraction and basically looking at your pulse rate. Based on skin tone, it will have varying results. Based on how tight you are wearing the band, it will have varying results."

"The second problem and why the cardiac issue is the number one killer and why it's the silent killer is most of these issues are intermittent, and most patients are asymptomatic. So if you don't feel the symptoms, you could take that 30-second ECG all the time, and you may never catch it because many times, these issues happen while we're sleeping. They're happening early in the morning."

"The reason people are passing away is because many of these patients are screened is because when they are put on a monitor, sometimes you'll collect data on a patient for 24 hours a day for seven days. You'll not find the issue, and suddenly, you extend the monitor to day ten, and you'll find it on day nine. So how can you hold a device or a watch continuously for 24 hours, let alone continuously for nine days? And that's your challenge. That is why wearables are great awareness drivers. They're great tools if you've already been diagnosed and you're trying to manage your condition, but incredibly, incredibly blunt instruments when it comes to figuring out what your issue is."

#Biotricity #HeartSecure #HeartHealth #Preventative #HeartDisease #HealthyHeart #SelfCare #HealthyLifeStyle #HealthTestatHome

biotricity.com

Listen to the podcast here

Dr. Waqaas Al-Siddiq, the CEO and Founder of Biotricity, focuses on remote patient monitoring for heart health with HeartSecure, the three-channel wearable device that collects continuous ECG data. This device provides a more comprehensive view of the electrical activity of the heart compared to other wearables like smartwatches and can help identify potential cardiac issues, especially those that are intermittent and asymptomatic. Used by cardiologists and now available as a home-based diagnostic, this technology is a tool to screen those with risk factors such as high blood pressure, diabetes, sleep apnea, and obesity.

Waqaas explains, "When we talk about wearables, we have to understand what those wearables are collecting. A typical watch, like an Apple Watch or Samsung Watch or these kinds of devices, collects data through a PPG, which is really looking at light refraction and basically looking at your pulse rate. Based on skin tone, it will have varying results. Based on how tight you are wearing the band, it will have varying results."

"The second problem and why the cardiac issue is the number one killer and why it's the silent killer is most of these issues are intermittent, and most patients are asymptomatic. So if you don't feel the symptoms, you could take that 30-second ECG all the time, and you may never catch it because many times, these issues happen while we're sleeping. They're happening early in the morning."

"The reason people are passing away is because many of these patients are screened is because when they are put on a monitor, sometimes you'll collect data on a patient for 24 hours a day for seven days. You'll not find the issue, and suddenly, you extend the monitor to day ten, and you'll find it on day nine. So how can you hold a device or a watch continuously for 24 hours, let alone continuously for nine days? And that's your challenge. That is why wearables are great awareness drivers. They're great tools if you've already been diagnosed and you're trying to manage your condition, but incredibly, incredibly blunt instruments when it comes to figuring out what your issue is."

#Biotricity #HeartSecure #HeartHealth #Preventative #HeartDisease #HealthyHeart #SelfCare #HealthyLifeStyle #HealthTestatHome

biotricity.com

Download the transcript here

Bill Padula, PhD, Assistant Professor of Pharmaceutical and Health Economics, and Dr. David Armstrong, professor of surgery and Neurological surgery, are both at the University of Southern California and are concerned about wound care and the impact of potential changes in Medicare reimbursement of skin substitutes. They discuss the importance of skin substitutes in chronic wound care and their effectiveness in reducing amputations and hospital readmissions. With current advancements in wound care, there is an emphasis on the need for education and advocacy to ensure that Medicare understands the value of skin substitutes and their potential for improving patient outcomes.

David explains, "The skin substitutes we are talking about have been really helpful over the past, maybe at least the last decade, maybe even the last two decades, and especially over the last few years. We've seen now in some studies from our group and others that we can not only reduce amputation, but we can also reduce hospital admission and emergency department admission for these patients. So it's a really exciting time. And so that's on the positive end. On the not so positive end is that there have been some changes, and I'm sure Dr. Padula can talk about this. That may limit our access to it as clinicians, which is concerning certainly for the patients that I'm having right across the hallway."

Bill elaborates, "Up until recently, Medicare hasn't put a lot of governance on reimbursement for skin substitutes, and physicians have been using them autonomously with the patient to treat non-healing chronic wounds. We see from the data that these skin substitutes work best when applied on a patient every one to seven days in a wound clinic, like what David Armstrong runs here at the University of Southern California. Medicare wants to change the reimbursement pattern and reduce reimbursement so that it would be impossible to get reimbursed for more than ten applications of a skin substitute in twelve weeks. So, that reimbursement system makes it impossible for providers and patients to follow parameters for use and improve the likelihood of healing a chronic wound."

#SkinSubstitute #Medicare #CMS #ChronicWounds

Keck School of Medicine at USC

Listen to the podcast here

Bill Padula, PhD, Assistant Professor of Pharmaceutical and Health Economics, and Dr. David Armstrong, professor of surgery and Neurological surgery, are both at the University of Southern California and are concerned about wound care and the impact of potential changes in Medicare reimbursement of skin substitutes. They discuss the importance of skin substitutes in chronic wound care and their effectiveness in reducing amputations and hospital readmissions. With current advancements in wound care, there is an emphasis on the need for education and advocacy to ensure that Medicare understands the value of skin substitutes and their potential for improving patient outcomes.

David explains, "The skin substitutes we are talking about have been really helpful over the past, maybe at least the last decade, maybe even the last two decades, and especially over the last few years. We've seen now in some studies from our group and others that we can not only reduce amputation, but we can also reduce hospital admission and emergency department admission for these patients. So it's a really exciting time. And so that's on the positive end. On the not so positive end is that there have been some changes, and I'm sure Dr. Padula can talk about this. That may limit our access to it as clinicians, which is concerning certainly for the patients that I'm having right across the hallway."

Bill elaborates, "Up until recently, Medicare hasn't put a lot of governance on reimbursement for skin substitutes, and physicians have been using them autonomously with the patient to treat non-healing chronic wounds. We see from the data that these skin substitutes work best when applied on a patient every one to seven days in a wound clinic, like what David Armstrong runs here at the University of Southern California. Medicare wants to change the reimbursement pattern and reduce reimbursement so that it would be impossible to get reimbursed for more than ten applications of a skin substitute in twelve weeks. So, that reimbursement system makes it impossible for providers and patients to follow parameters for use and improve the likelihood of healing a chronic wound."

#SkinSubstitute #Medicare #CMS #ChronicWounds

Keck School of Medicine at USC

Download the transcript here

Gretchen Case, Managing Partner at The Wilshire Group a boutique healthcare revenue cycle consulting company that helps healthcare clients streamline workflows and processes. They work with hospitals, physician groups, and other providers to optimize their investment in technology and improve patient outcomes. Gretchen points out the various aspects of revenue cycle management, which include insurance benefit verification, explanation of costs, and identification of financial support. The middle revenue cycle includes the codification of clinical data and coordination with insurance companies and electronic health records. The third phase is the billing and payment.

Gretchen elaborates, "Some of the automation I've seen over the last several years has been designed to query the documentation and come up with suggested codes, called computer-assisted coding. And there is a lot of that in play. I think it expedites things and it makes things more efficient. I don't know of anybody who's just flipped that button and left it behind and not continued to monitor and manage it."

"There's also movement right now around what we call a single path. That's just one way of saying it, but it's about coding the professional and the technical at the same time. What does that mean? The physician's procedure charge and the technical is what the hospital is going for that technical component of the services. And a lot of times, we share codes. So, if you're going to be coding the physicians and getting her bill out the door correctly, you might as well be coding the hospital one at the same time. So there are definitely developments there, but I haven't seen anything. Just completely automate it and step away."

#TheWilshireGroup #RevenueCycleManagment #RCM #Hospitals

thewilshiregroup.net

Listen to the podcast here

Gretchen Case, Managing Partner at The Wilshire Group a boutique healthcare revenue cycle consulting company that helps healthcare clients streamline workflows and processes. They work with hospitals, physician groups, and other providers to optimize their investment in technology and improve patient outcomes. Gretchen points out the various aspects of revenue cycle management, which include insurance benefit verification, explanation of costs, and identification of financial support. The middle revenue cycle includes the codification of clinical data and coordination with insurance companies and electronic health records. The third phase is the billing and payment.

Gretchen elaborates, "Some of the automation I've seen over the last several years has been designed to query the documentation and come up with suggested codes, called computer-assisted coding. And there is a lot of that in play. I think it expedites things and it makes things more efficient. I don't know of anybody who's just flipped that button and left it behind and not continued to monitor and manage it."

"There's also movement right now around what we call a single path. That's just one way of saying it, but it's about coding the professional and the technical at the same time. What does that mean? The physician's procedure charge and the technical is what the hospital is going for that technical component of the services. And a lot of times, we share codes. So, if you're going to be coding the physicians and getting her bill out the door correctly, you might as well be coding the hospital one at the same time. So there are definitely developments there, but I haven't seen anything. Just completely automate it and step away."

#TheWilshireGroup #RevenueCycleManagment #RCM #Hospitals

thewilshiregroup.net

Download the transcript here

Lynn Carroll, the Chief Operating Officer at HSBlox, focuses on payer-provider collaboration to mitigate risks related to the transition from a fee-for-service model to value-based care. Care coordination is critical to this model to reduce duplicative and unnecessary services and low-value providers by effectively sharing patient data. They are seeing an emphasis on high-cost categories, diagnostics, and disease management to rein in costs and improve patient outcomes.

Lynn explains, "At HSBlox, we have built a platform for payer and provider collaboration around these types of arrangements, particularly for onboarding different types of alternative payment model contracts, bringing together the care continuum to align primary care with specialty care because primary care can't go alone in achieving success under value-based programs. A significant amount of spend, particularly under the total cost of care programs, is driven by specialty utilization."

"We have built a platform that allows for multi-participant programs that enable the sharing of data and the movement of funds across these different alternative payment models. The purpose of the platform was to provide the infrastructure that would allow these programs to flourish and accelerate the pace of the end game for value-based administration."

#alternativepaymentmodels #carecoordination #contractmodeling #healthoutcomes #patientengagement #permissioneddataexchange #populationhealth #referralmanagement #reinbursementmodels #riskbearingproviders #ValuebasedCare #VBC

HSBlox.com

Listen to the podcast here

Lynn Carroll, the Chief Operating Officer at HSBlox, focuses on payer-provider collaboration to mitigate risks related to the transition from a fee-for-service model to value-based care. Care coordination is critical to this model to reduce duplicative and unnecessary services and low-value providers by effectively sharing patient data. They are seeing an emphasis on high-cost categories, diagnostics, and disease management to rein in costs and improve patient outcomes.

Lynn explains, "At HSBlox, we have built a platform for payer and provider collaboration around these types of arrangements, particularly for onboarding different types of alternative payment model contracts, bringing together the care continuum to align primary care with specialty care because primary care can't go alone in achieving success under value-based programs. A significant amount of spend, particularly under the total cost of care programs, is driven by specialty utilization."

"We have built a platform that allows for multi-participant programs that enable the sharing of data and the movement of funds across these different alternative payment models. The purpose of the platform was to provide the infrastructure that would allow these programs to flourish and accelerate the pace of the end game for value-based administration."

#alternativepaymentmodels #carecoordination #contractmodeling #healthoutcomes #patientengagement #permissioneddataexchange #populationhealth #referralmanagement #reinbursementmodels #riskbearingproviders #ValuebasedCare #VBC

HSBlox.com

Download the transcript here