Radio Advisory

Last week on Radio Advisory, we broke down what healthcare leaders need to know for 2025 and beyond following the recent elections. But before we move on from 2024 completely, we have to acknowledge that there’s been a lot moving in the policy space this year, and frankly, there have probably been a few important policy areas on your radar that we haven’t discussed.

That’s why this week, host Abby Burns invites Advisory Board experts Gina Lohr, Sarah Roller, and Paul Trigonoplos to dive into three major policy areas of the last year: Medicare drug negotiations, changes to physician employment and payment, and an emerging mandatory bundled payment model called TEAM. The experts unpack how these policies are affecting the industry, how the elections outcomes may impact them, and, critically, how much attention leaders should be paying them going forward. In other words, should leaders consider each policy a big deal, a little deal, or no deal?

Links:

(Correction: An earlier version of this episode misstated that there is a $200 out-of-pocket cap on drug spending going into place. That number is $2,000 and references the Medicare Part D out-of-pocket cap set to begin in 2025. We have removed the number from the audio.)

Get exclusive, early access to Advisory Board’s annual “What CEOs need to know” briefing.

2 ways labs can embrace innovation to drive revenue and accelerate growth

Market Scenario Planner

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

(Note: This episode was recorded on November 7, 2024)

The results of the 2024 elections are in: Donald Trump will be the 47th President of the United States, and we are all but certain to have a Republican trifecta at the federal level. Admittedly, there’s a lot we don’t know about what healthcare will look like under a second Trump administration—a lot will depend on who is appointed to key leadership positions overseeing federal health agencies and Congressional committees. But while we wait for those appointments, what can we anticipate based on President-elect Trump’s first term, campaign, and the Republican platform?

This week, hosts Rachel (Rae) Woods and Abby Burns invite Advisory Board experts Natalie Trebes and Ben Palmer to break down the implications of a second Trump term on the healthcare industry. They unpack how power dynamics have shifted since the first administration, and what we’re likely to see on issues like the ACA, enhanced subsidies, Medicaid, drug pricing, abortion, and more.

Links:

Join 165,000+ healthcare leaders and get the industry’s most important news in your inbox—every day.

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

Conversations around GLP-1s in today’s healthcare market are mixed. Some stakeholders are thrilled with their potential, while others are filled with questions and even anxiety about how these powerful and popular drugs will impact their business. Many in the industry have been asking for months: “What can GLP-1s do?” But maybe this is the wrong question. Leaders should be asking “What CAN’T GLP-1s do?”

To answer that question, live from HLTH 2024, host Rachel (Rae) Wood invites Rob MacNaughton, CEO of lifestyle intervention and obesity management organization Calibrate, Rita Glaze-Rowe, President at life sciences research organization Real Chemistry, and Dr. Spencer Nadolsky, lipid and obesity specialist and founder to break down the cross-industry perspective on GLP-1s and how the healthcare leaders should be thinking about both the potential and limitations of these novel therapies. In a market that is buzzing around the novel medications, these experts suggest a new focus on comprehensive weight management programs.

Links:

Join 165,000+ healthcare leaders and get the industry’s most important news in your inbox—every day.

What the 2024 elections mean for healthcare

[Webinar, 10/24] How the 2024 elections could impact the healthcare industry

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

Remote patient monitoring (RPM) has a surprisingly long history in healthcare. As technology improves, RPM can expand physician capacity, better manage complex patients, and improve total cost of care. Despite RPM’s potential, leaders often struggle to root RPM in a clear business case, or they underinvest in implementation, never fully integrating RPM into existing workflows and systems.

This week, host Rachel (Rae) Woods invites Advisory Board RPM expert Lauren Woodrow and Advisory Board cardiovascular expert Kristin Strubel to break down why RPM technologies aren’t being properly utilized, guide leaders on where to place their strategic bets, and share use cases for how RPM can improve quality and finances across service lines.

Links:

What the 2024 elections mean for healthcare

Mapped: Key healthcare-related ballot measures to watch

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

For years, the best word to describe Medicare Advantage (MA) was “untouchable.” Hugely popular among seniors, profitable for health plans—the hybrid public-private payment model grew to the point that it now covers more seniors than traditional Medicare. But in the past few years, the tide has started to change. And if you’ve been paying attention in recent months, you’ll have seen headlines announcing that payers that are scaling back their MA offerings and providers are exiting MA contracts. The MA market has gone from “untouchable” to “volatile.”

The question is: why is this happening, and what does it mean for payers, providers, and seniors moving forward? In this episode, hosts Rachel (Rae) Woods and Abby Burns invite health plan experts Max Hakanson and Chelsea Needham to dissect what is going on in MA and how plans and providers are—or should be—navigating the changing tide.

Links:

[Webinar, 10/24] How the 2024 elections could impact the healthcare industry

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

As care delivery becomes more complex and new disruptors join the scene, one thing has become clear: operational excellence is now table stakes in ensuring your organization’s financial sustainability and winning patients.

In this episode, recorded live from Advisory Board’s 2024 Strategy Summit, guest host and Managing Director of Physician and Medical Group Research at Advisory Board, Sarah Roller, invites Dr. Mary Jo Cagle, CEO of Cone Health and Dr. Cynthia Horner, Chief Medical Officer of Amwell and President of Amwell Medical Group, to unpack what it takes to achieve operational excellence, why adaptive leadership is essential to success, and why true operational excellence does not have to be as daunting as it seems.

Links:

Pivots for a Sustainable Future Virtual Summit

Join 165,000+ healthcare leaders and get the industry’s most important news in your inbox—every day.

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

For years, health systems have been holding their breath to see if patient volumes would finally return to pre-pandemic levels. Because—per conventional wisdom--if volumes return, then so will operating margins. Right? Not so fast.

In this episode, host Abby Burns invites Advisory Board experts Sebastian Beckmann and Elizabeth Orr to explore why with the positive volume forecast we see in our projections won’t automatically translate to a healthy financial outlook. Later, Optum Advisory expert Alex Kist joins the group to share what it’s looked like to help one health system put their local data into action to achieve the kind of differentiated growth our experts have been touting.

Links:

If you are looking for hands-on support, email us at [email protected] or learn more about how Advisory Board can help.

Join 165,000+ healthcare leaders and get the industry’s most important news in your inbox—every day.

Strategic Planner's survey 2024

Survey insights: 6 priorities for health system strategists in 2024

Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent.

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

Two weeks ago on Radio Advisory, we told our listeners that the number one area of focus for health system growth is operational excellence, and a major part of that is capturing all of the revenue on the table from your medical group. Healthcare organizations have spent the last decade buying up medical groups and physicians, in part because of the “promise” of downstream referrals. It is a long-held belief that physician employment leads to higher referral integrity. But according to an Advisory Board data analysis, that doesn’t hold true - just 55% of total referral revenue attributed to employed PCPs is realized in-network.

This week, host Rachel (Rae) Woods invites Advisory Board physician experts Eliza Dailey and Colleen Wagner to unpack where referral leakage actually happens and share the real (and relatively easy) steps organizations can take to reduce referral leakage.

Links:

Strategic Planner's survey 2024

Survey insights: 6 priorities for health system strategists in 2024

Digital surgery: A way for orthopaedic programs to set themselves apart

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

In the midst of the COVID-19 pandemic, The Centers for Medicare & Medicaid services released the Acute Hospital Care at Home payment waiver. The action was expected to usher in a new era of home-based care. But while it’s certainly grown in recent years, frankly, that massive shift hasn’t happened. The question is, why?

This week, host Abby Burns invites Dr. Matthew Richards, Senior Medical Director of home-care enablement company Medically Home, to explore the role that home-base care could play in the future of healthcare, and to unpack the misconceptions that prevent home-based care from playing a larger role in the healthcare ecosystem today.

Links:

Strategic Planner's survey 2024

Survey insights: 6 priorities for health system strategists in 2024

A transcript of this episode as well as more information and resources can be found on www.advisory.com/RadioAdvisory.

(This episode originally aired on September 26, 2023.)

Value-based care has been dominating industry conversations in recent years. Here on Radio Advisory, we talk a lot about best practices, how to make the right investments, and how to best prepare leaders for the future of value-based care. But given all this momentum, we want to spend time asking the question: what are the misconceptions or misaligned expectations that leaders have around value-based care?

In this episode, host Rachel (Rae) Woods invites Advisory Board value-based care expert Daniel Kuzmanovich and Optum Advisory Service's SVP of value-based care, Erik Johnson, to discuss the mindset shifts they think leaders should be making when pursuing a sustainable value-based care strategy. Throughout the conversation they discuss what leaders are currently getting wrong, how myths about value-based care are impacting the industry, and more.

Links:

3 strategies for a successful sleep apnea therapy program: Lessons from ENTTX's ASC partnership

Strategic Planner's survey 2024

Survey insights: 6 priorities for health system strategists in 2024

Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent.