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Maximizing Medicare Advantage, STARs Ratings, and AI Innovations with Rex Wallace
Summary:
In this episode, Dr. Liz Kwo sits down with Rex Wallace, Founder and CEO of RWC, a consultancy dedicated to enhancing healthcare through quality, operational excellence, and stakeholder engagement. Rex shares insights on the complexities of the payer ecosystem, focusing on the STARS Rating program which serves as a universal scorecard for Medicare Advantage plans. He discusses the importance of access to care, the integration of AI and telemedicine, and the potential for startups to influence healthcare positively. Additionally, Rex delves into the significance of health equity in Medicare and how various healthcare sectors can leverage technology to improve patient outcomes.
Key Takeaways:
STARS Rating Program: An essential tool for Medicare beneficiaries to choose healthcare plans based on quality rather than cost.
Access and Trust: Crucial factors in enhancing healthcare delivery and improving patient satisfaction.
Innovative Opportunities: AI and telemedicine are pivotal in increasing healthcare access and enhancing patient management.
Startup Challenges: Startups need to connect their solutions deeply with healthcare pain points to be effective.
Health Equity: Increasingly vital in Medicare, focusing on reducing disparities and enhancing care for all patients.
👉Order my book Digital MD: Revolutionizing the Future of Healthcare
Order Here: http://www.digitalmd.co/
Timestamps:
00:00 - START
00:54 - Overview of the STARS Rating Program
02:26 - Discussing the importance of access to care and trust in healthcare
04:34 - Exploring innovation with AI and telemedicine
06:00 - Challenges faced by startups in the healthcare sector
08:21 - Evaluating different healthcare sectors for technology application
10:26 - How to find and engage with healthcare experts and influencers
12:52 - Strategies for approaching different healthcare markets: Commercial, Medicare, and Medicaid
16:00 - The growing importance of health equity in healthcare settings
21:18 - Rex’s advice on leadership and navigating business challenges in healthcare
26:02 - Conclusion and final thoughts
🔗 Connect with Rex Wallace:
Linkedin: https://www.linkedin.com/in/rexwallace/
Email: [email protected]
🔗 Connect with Dr. Liz Kwo:
LinkedIn: https://www.linkedin.com/in/lizkwo/
Email: [email protected]
Website: http://www.digitalmd.co/.
📚 Resources Mentioned:
Medicare STARS Rating Program: https://www.cms.gov/newsroom/fact-sheets/2024-medicare-advantage-and-part-d-star-ratings#:~:text=The%20Star%20Ratings%20system%20helps,health%20care%20decisions%20for%20them.
CMS Website: https://www.cms.gov
RISE Star Ratings Masterclass: https://stars.risehealth.org
SSN Stars and Quality Conferences: https://www.starratingssummit.com
Sponsor:
Everly Health Solutions is the leader in at-home lab testing for health plans. Their convenient, member-centric approach has helped plans achieve industry-leading results. In just one year, Everly Health Solutions helped a multi-state Medicare group improve 15 of their plans by at least one star! That's a win for members, providers, and the plans themselves.
Learn how Everly Health Solutions can elevate your health plan at EverlyHealthSolutions.com
View all episodes
By Dr. Liz KwoSummary:
In this episode, Dr. Liz Kwo sits down with Rex Wallace, Founder and CEO of RWC, a consultancy dedicated to enhancing healthcare through quality, operational excellence, and stakeholder engagement. Rex shares insights on the complexities of the payer ecosystem, focusing on the STARS Rating program which serves as a universal scorecard for Medicare Advantage plans. He discusses the importance of access to care, the integration of AI and telemedicine, and the potential for startups to influence healthcare positively. Additionally, Rex delves into the significance of health equity in Medicare and how various healthcare sectors can leverage technology to improve patient outcomes.
Key Takeaways:
STARS Rating Program: An essential tool for Medicare beneficiaries to choose healthcare plans based on quality rather than cost.
Access and Trust: Crucial factors in enhancing healthcare delivery and improving patient satisfaction.
Innovative Opportunities: AI and telemedicine are pivotal in increasing healthcare access and enhancing patient management.
Startup Challenges: Startups need to connect their solutions deeply with healthcare pain points to be effective.
Health Equity: Increasingly vital in Medicare, focusing on reducing disparities and enhancing care for all patients.
👉Order my book Digital MD: Revolutionizing the Future of Healthcare
Order Here: http://www.digitalmd.co/
Timestamps:
00:00 - START
00:54 - Overview of the STARS Rating Program
02:26 - Discussing the importance of access to care and trust in healthcare
04:34 - Exploring innovation with AI and telemedicine
06:00 - Challenges faced by startups in the healthcare sector
08:21 - Evaluating different healthcare sectors for technology application
10:26 - How to find and engage with healthcare experts and influencers
12:52 - Strategies for approaching different healthcare markets: Commercial, Medicare, and Medicaid
16:00 - The growing importance of health equity in healthcare settings
21:18 - Rex’s advice on leadership and navigating business challenges in healthcare
26:02 - Conclusion and final thoughts
🔗 Connect with Rex Wallace:
Linkedin: https://www.linkedin.com/in/rexwallace/
Email: [email protected]
🔗 Connect with Dr. Liz Kwo:
LinkedIn: https://www.linkedin.com/in/lizkwo/
Email: [email protected]
Website: http://www.digitalmd.co/.
📚 Resources Mentioned:
Medicare STARS Rating Program: https://www.cms.gov/newsroom/fact-sheets/2024-medicare-advantage-and-part-d-star-ratings#:~:text=The%20Star%20Ratings%20system%20helps,health%20care%20decisions%20for%20them.
CMS Website: https://www.cms.gov
RISE Star Ratings Masterclass: https://stars.risehealth.org
SSN Stars and Quality Conferences: https://www.starratingssummit.com
Sponsor:
Everly Health Solutions is the leader in at-home lab testing for health plans. Their convenient, member-centric approach has helped plans achieve industry-leading results. In just one year, Everly Health Solutions helped a multi-state Medicare group improve 15 of their plans by at least one star! That's a win for members, providers, and the plans themselves.
Learn how Everly Health Solutions can elevate your health plan at EverlyHealthSolutions.com