Listening In (With Permission): Conversations About Today's Pressing Health Care Topics

Ryan calls Chris Chan, Chief Value Officer of finHealth, to discuss the pitfalls many self-insured employers face related to their claims review as they try to meet their fiduciary responsibilities.

"We're seeing increased scrutiny and requests from employers to say, “Hey, we, we know we have this cycle in the past that we worked where we just automatically approve these things, but we need to be better stewards of our plan and really understand on a weekly basis whether the charges are appropriate or not.""

In this episode of Listening In (With Permission) Dr. Matthew Resnick, Chief Medical Officer at Embold Health, discusses with Ryan the evolution of quality measurement and improvement in healthcare, emphasizing the importance of aligning care with evidence-based guidelines.

He highlights the need for integrating quality and cost considerations to drive progress in the healthcare system and addresses the disparities in access to high-quality care, particularly in rural areas, and suggests short-term and long-term solutions to address these challenges.

The episode underscores the significance of purchaser engagement in prioritizing healthcare quality alongside cost considerations to drive meaningful improvements in patient outcomes and reduce unnecessary care.

In this podcast episode Dayne and Tim Huke, Chief Growth Officer for Cedar Gate Technologies, explore firsthand the core of CPR's latest case study, Unlocking Value: Diabetes Care Management Vendors' Impact on Quality and Clinical Outcomes for Self-Funded Employers. What are the challenges faced by employers as they navigate the expansive ocean of point solution vendors, seeking answers to the ever-growing health care cost dilemma? Find out in this podcast episode!

On our latest podcast episode the tagline is, "Value-Based Contracting: It's Not Magic, It's Math." 🏥 Andréa Caballero calls the co-founding team at Syntax Health, Rachael Jones, Chief Executive Officer, and Emily Walker, Chief Analytics Officer, to demystify the complexities of value-based contracting, and encourage employers to stop treating it as a sideshow, and instead to make it the main event.

Rachael and Emily break down the math behind value-based contracting and share anecdotes from the trenches of healthcare negotiations. Tune in for an enlightening discussion on how math, trust, and transparency intersect in the healthcare industry.

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In our latest episode of Listening In (With Permission), Guy calls Rob Andrews, founding CEO of the Health Transformation Alliance (HTA) and former U.S. Congressperson.

Listen in as Rob and Guy discuss the challenges and triumphs in healthcare, and how the HTA is bridging the gap between providers and patients, bringing about a new era of convenience and trust in primary care.

Listen to how HTA, through their advanced primary care program, is knitting together a network of primary care doctors across the nation so that their plan members are never more than five miles from one of these providers. With virtual care options as support, this approach will ideally lead to more problems solved at the primary care level without referrals, and when referrals are made those referrals are based upon data, sending the patient to the highest-value doctor.

"If I had one wish for American health care, I think it would be that we figure out a way to dramatically increase the salaries of primary care physicians, increase their compensation and reduce their student debt. If you did that, I think we would get more really able people going into that profession and you get better care outcomes for consumers."

Listen In today, and don't forget to subscribe on your favorite podcast platform. #LIWP

Part two of our three-part data series.

In this insightful podcast episode, we dive deep into the evolving role of Chief Financial Officers (CFOs) in healthcare purchasing. Join Ryan Olmstead, CPR's Director of Member Services and Jeffrey Hogan, President of Upside Health Advisors, as they discuss the significant changes brought about by the Consolidated Appropriations Act of 2021 (CAA).

The conversation delves into how, under the CAA, CFOs are now named fiduciaries, personally liable for procurement decisions, which marks a significant shift in their responsibilities.

This episode explores the future of data ownership, access, and usage in healthcare. Jeffrey predicts a growing trend of value-based solutions, advanced primary care organizations, and bundled payments, offering predictability and accountability in healthcare costs.

Listen In (With Permission) today to stay up to date on all things health care and subscribe on your favorite podcast platform! #LIWP

Part Three of our three-part Data Podcast Series.

In this episode of Listening In (With Permission), CPR's Director of Member Services, Ryan Olmstead engages in a captivating conversation with Julie Selesnick, Senior Counsel at Berger Montague, with two decades of experience in healthcare law. Together, they delve into the complex world of healthcare data transparency, legal challenges, and the evolving policy landscape.

Julie shares her impressive background, having transitioned from a defense attorney to a plaintiff-side attorney specializing in Employee Retirement Income Security Act (ERISA) and employee benefits law.

The episode spotlights a pivotal case where two Taft-Hartley clients filed a class-action lawsuit against a healthcare provider, Anthem, over restricted access to claims data. Ryan and Julie discuss the challenges faced by purchasers, including delayed data access, incomplete information, wrongful payments, and misconduct.

Listen In (With Permission) today and subscribe on your favorite podcast platform. #LIWP

"So when I say it's a gift, anytime a consumer gets enough information to make an informed decision, it's a gift."

Listen In (With Permission) to Hugh O'Toole, CEO of Innovu, about the transformation happening in employer-sponsored healthcare.

Hugh explains how data transparency is the key to making informed decisions and achieving significant cost savings, and how the new CAA regulation will help free up the data necessary to simplify an overly-complex system.

This is part one of a three part series on Health Care Data, where we will explore the new fiduciary responsibility of the CFO in managing health care benefits from a variety of perspectives. Hope you enjoy, and subscribe today!

Suzanne calls up Candace Shaffer, Senior Director, Benefits at Purdue University to discuss the benefits purchasing strategies that she and her team have implemented and some of the tremendous savings as a result of those strategies.

They also discuss what goes into thorough strategic decision making; utilizing your data, understanding your business, and seeking regular input from plan members are all steps Candace and her team take to plan strategically, and based on the results, very effectively.

Andréa call Allison Sesso, President and CEO of RIP Medical Debt (RIP) to discuss the crisis of Medical Debt and RIP's unique mitigation strategy. They also discuss innovative policy on the state and federal level to help relieve consumers of medicals debt and make health care more affordable.

"While we love our solution and we think it's really important to help resolve the issue for individuals right now...we very clearly understand and appreciate that we are not the answer, which is why we do need to focus on the systemic solutions and contribute to that proactively."