Trending Health

Six years after the Medicare Access and CHIP Reauthorization Act (MACRA 2015), Vynamic’s Mindy, Ryan, and Jen discuss where we are today in the transition from Fee-For-Service (FFS) reimbursement to Value-Based Care (VBC). The episode opens with an acknowledgment that VBC is at a crossroads – the transition has been bumpy, VBC models have been “consistently inconsistent” (2:10), and the misalignment of payer and provider compensation models continues to be an ongoing challenge (3:18). The conversation then moves to what is needed for this transition to VBC to be successful; it requires operational overhaul (5:10), robust analytics, appropriate engagement of providers, and health system transparency. Innovation takes time and transitioning to VBC requires a shift in cultural mindset and a detailed strategy for change and adoption (8:10). The episode then explores what VBC means for Life Sciences companies, as the industry starts to reckon with the development of more expensive products with higher intrinsic value (14:50), including curative one-time treatments and gene therapies. From a market access perspective, Life Sciences companies should be creative with contracting and how they approach payers and providers about the products they bring to the market (15:18). Ultimately, these stakeholders will need to reach a middle ground to make products accessible to the right patients (20:04). As an industry, we should strive for “the art of the possible” (21:33) and engage in cross-sector thinking to make VBC models successful. 

Podcast Tags: healthcare, MACRA, fee-for-service, value-based care, reimbursement, innovation, Life Sciences, strategy, market access, value-based payment over time (VBPOT)

Source Links - Below, we've listed links to some of the facts and resources discussed on this show.

- https://revcycleintelligence.com/features/entering-the-next-phase-of-value-based-care-payment-reform

- https://www.fiercehealthcare.com/payer/new-cmmi-director-says-value-based-care-models-at-crossroads?mkt_tok=Mjk0LU1RRi0wNTYAAAF8k4XqnunZZyMo3p_xn3tEs3yH708uXgCNuApAFnJQHSR0EYcv1E2LCt6NlhnrwdH2JyVf-V_pxlSfU24GHKz3P3xDIZMa8jQIoLXYaPdibJyNaBh1Cc4&mrkid=152778267

- https://www.fiercehealthcare.com/payer/verma-says-value-based-care-models-haven-t-made-good-return-investment

- https://www.fiercehealthcare.com/payer/providers-call-for-another-chance-to-sign-up-for-direct-contracting-model?mkt_tok=Mjk0LU1RRi0wNTYAAAF8dKGQQGD5eCW9fP3QjJTt2D336_V8b5iB8tDE7JqOsFLKdsRpvjVAlrQMysKq4T7UamDcOD1mve6rocLCDDeRVC2cdYdiQ8iLjpaC6J0UFZyS_CaD5xk&mrkid=152778267

- https://www.fiercehealthcare.com/practices/medical-groups-urge-cms-to-walk-back-aco-quality-overhaul-citing-potential-negative?mkt_tok=Mjk0LU1RRi0wNTYAAAF824GfFyUI8FL_gS064nifCYSR3Zuk0KLpuNBZaeS1tB3UYGjMu883L-Dr2vtKP2pn19XwOcAZW-KlyrW9Zq1P7IUionDrt-hi739yRxkSO6YfNeiaYl4&mrkid=152778267

- https://revcycleintelligence.com/news/a-new-administration-value-based-payment-to-dictate-2021-success

- https://www.fiercehealthcare.com/practices/industry-voices-3-questions-providers-need-to-prioritize-as-they-look-to-take-more-risk?mkt_tok=eyJpIjoiWW1JeFpESmlPRFEwWkRsaSIsInQiOiJ2dlcwTkRqUUVsUUpUVm94T2h3cTd5UzNYcWp0cUJwZHpKVWUxZUxZVXRFVTFWamx4Ykh1NDJXckptYVIxZitFQzBDM1VvcncrWGRsQ1JNUzdDK2lOTURPOVQ2RVAzQmNib0dsWDVIOUhhMmlqOEpGc01aUGd4dktrU1RXNmVnWHpqaGFSb3RBYWdBZ3hOWXMzZnpzWkE9PSJ9&mrkid=152778267

- https://digitally.cognizant.com/value-based-care-in-life-sciences-whats-it-worth-to-you-third-of-a-multipart-series-codex5396/

- https://www.zs.com/insights/new-era-value-based-contracts

- https://www.bakertilly.com/insights/implications-of-value-based-care-for-the-life-sciences

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC.

Mindy McGrath, Healthcare Industry Learning Lead

[email protected]

Ryan Hummel, Executive

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

In this minisode, Mindy, Ryan, and Jen discuss a few recent newsworthy items including: the potential waiving of international patent protections for COVID-19 vaccines (00:35), Walmart’s acquisition of telehealth company MeMD right as AmazonCare signs its first customer (05:20), and movement in the hospital-at-home space with Mayo Clinic and Kaiser Permanente’s investment into acute care company, Medically Home (08:53).

Podcast Tags: healthcare, healthcare news, telehealth, healthcare investment, COVID-19

Source Links - Below, we've listed links to some of the stories and resources discussed on this show.

· https://www.npr.org/sections/coronavirus-live-updates/2021/05/05/993998745/biden-backs-waiving-international-patent-protections-for-covid-19-vaccines

· https://www.bloomberg.com/news/articles/2021-05-08/eu-tells-biden-to-export-vaccines-now-and-worry-about-ip-later?mkt_tok=ODUwLVRBQS01MTEAAAF89Tk5m7ShsEm0KIkMwOZK39Dv8cr78LRG7Zgbx9L0rVPl7tdE1HirKtLrMu-etXgRb0GIFGXyrR8-bQ-4tRneOXc_zVB3C8kiIao0YiDN6Hyt

· https://www.fiercepharma.com/pharma/don-t-expect-lifting-covid-19-vaccine-patents-to-happen-quickly-if-at-all-analysts?mkt_tok=Mjk0LU1RRi0wNTYAAAF89hxn0kk_FRFBZ_3Iwevy1qT4RcJk2wCs46oWxbD8fmpyepvvK6RmMfySqLByOxW0hynnfzL9howEQAeszvDQSJTP4wfhqej51xQfU3KY7f16B8NdKg&mrkid=65631392

· https://www.reuters.com/business/healthcare-pharmaceuticals/wto-chief-says-hopes-covid-patent-issue-settled-by-december-2021-05-10/

· ttps://www.fiercehealthcare.com/tech/walmart-to-acquire-telehealth-company-memd-as-amazon-care-signs-first-customer?mkt_tok=Mjk0LU1RRi0wNTYAAAF89okEjqsNtLXuuD1iCcPyOubkq1L__X2wSAnpPvwgaltLmvcQFjYiGEvYgGEP2GK6f_SBsnPvy20xpbb90EGf1QZbzVHBsxDW-o1hw26fmGu8Fc8sOA&mrkid=65631392

· https://www.statnews.com/2021/05/12/telehealth-companies-are-fueling-a-lobbying-frenzy-to-protect-their-covid-boom/

· https://www.businessinsider.com/amazon-diagnostics-new-brand-home-medical-tests-covid-sti-genomics-2021-5#

· https://www.fiercehealthcare.com/tech/mayo-clinic-kaiser-permanente-to-scale-up-hospital-at-home-efforts-100m-investment-into-tech?mkt_tok=Mjk0LU1RRi0wNTYAAAF9DwRCUxxqoJ70XBEBsX0AFOPs6sbfyoNGgqhYxxoyKvSsMG7hMDITEzeITH-NTeupzCjSG7ChTbOZ7D41LhujDt_KqUUp8S4vIoYJi91Yhe1kPordfA&mrkid=65631392

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC.

Mindy McGrath, Healthcare Industry Learning Lead

[email protected]

Ryan Hummel, Executive

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

Mental Health Awareness is a national focus in both the US and the UK during the month of May. Now, more than ever before, mental and behavioral health are at the forefront of healthcare discussions, as individuals across the globe grapple with the COVID-19 pandemic and the accompanying recession. In this special bonus episode, Vynamic’s Kevin Fletcher discusses the importance of mental and behavioral healthcare, and what challenges and opportunities industry leaders should be considering.

Podcast Tags: healthcare, mental health, behavioral health, telehealth, digital health

Source Links - Below, we've listed links to the resources referenced in the episode

· https://www.nami.org/Get-Involved/Awareness-Events/Mental-Health-Awareness-Month

· https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC.

Kevin Fletcher, Director

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

Social, non-medical factors (including economic factors, neighborhoods, employment, and physical safety) play a major role in individual and population health – Jen, Mindy, and Ryan discuss how partnerships and technology solutions are addressing key social determinants of health, and what leaders should be thinking about as the system evolves its focus and investment in “whole person care.” The episode opens with a discussion of healthcare partnerships and innovations addressing food insecurity (01:44), housing instability (04:52), financial strain (07:40), and transportation (09:45). Complexity and fragmentation in both the healthcare and social services systems are driving a wave of innovations linking patients to social services at the point of care (12:40). As the industry continues to move toward whole person care, healthcare leaders should be considering how they harness data to determine ROI (16:50) and if their goals are best achieved through partnerships with local organizations (20:49).

Podcast Tags: healthcare, whole person care, social determinants, population health, public health

Source Links - Below, we've listed links to some of the stories and resources discussed on this show.

· https://www.fiercehealthcare.com/payer/blue-cross-nc-takes-aim-at-food-insecurity-slew-new-pilot-programs

· https://www.prnewswire.com/news-releases/cvs-health-invests-114-million-in-affordable-housing-across-the-country-in-2020-301232866.html

· https://www.fastcompany.com/90291860/this-healthcare-giant-invests-millions-in-affordable-housing-to-keep-people-healthy

· https://news.ibx.com/independence-gradfin-reduce-student-loans/

· https://www.fiercehealthcare.com/digital-health/lyft-pass-for-healthcare-lets-patients-book-their-own-rides-to-doctor?mkt_tok=Mjk0LU1RRi0wNTYAAAF8ebWO55uo0uCPrvrnKsgvNRT-zpwscBBoxU3JD2Mb5IzuV-O9OXgNrfI4vWQElqoSaSVZCY_z2WKFYLmYaf-v_Ku2EvuycMO0j6iu_XxX7HfwPv8a6Fk&mrkid=152778267

· https://www.roundtriphealth.com/

· https://www.nowpow.com/

· https://www.fiercehealthcare.com/tech/health-tech-startup-building-social-care-networks-and-it-just-reached-unicorn-status

· https://www.bluezones.com/blue-zones-results-albert-lea-mn/#section-2

· https://www.healthleadersmedia.com/welcome-ad?toURL=/clinical-care/social-determinants-health-lead-or-partner-0

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC.

Mindy McGrath, Healthcare Industry Learning Lead

[email protected]

Ryan Hummel, Head of Provider Sector

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

In this minisode, Mindy, Ryan, and Jen discuss a few recent newsworthy items including: President Biden’s plans for healthcare in the budget, infrastructure, and American Families Plans (00:43), the recent CMMI announcements regarding payment models (09:05), and a flurry of activity in the EHR space (15:32).

Podcast Tags: healthcare, healthcare news, CMS, direct contracting, EHR

Source Links - Below, we've listed links to some of the stories and resources discussed on this show.

· https://www.fiercehealthcare.com/payer/3-major-health-items-included-president-biden-s-budget-request?utm_medium=nl&utm_source=internal&mrkid=65631392&mkt_tok=Mjk0LU1RRi0wNTYAAAF8ZSpp0j-jtHWMAfGixLTfQeFoKl4m3TuzlhioeaeHGZQWuZ__w72lH5jg5GabFoTKeNp1T8VcFLSAoJL4o5YlZIBEC0QfhToXANutUyti93CVcTdCxQ

· https://www.npr.org/sections/health-shots/2021/04/09/985567929/whats-in-bidens-400-billion-plan-to-support-families-long-term-health-needs

· https://www.vox.com/2021/4/15/22383587/biden-american-jobs-plan-long-term-care

· https://www.washingtonpost.com/us-policy/2021/04/12/sanders-pelosi-biden-obamacare-medicare/?mkt_tok=ODUwLVRBQS01MTEAAAF8ZRDWoJHYKl66dg0Si4uXfkKCBWh9R5lK3RU7l7egshsgkHIvcqYxh3qQ2ehZMHuvB9xjrvRJuQn-O3FXCIFxHUKDXRJje0yTim4IXzLoqNmA

· https://www.fiercehealthcare.com/payer/providers-call-for-another-chance-to-sign-up-for-direct-contracting-model?mkt_tok=Mjk0LU1RRi0wNTYAAAF8dKBFwN78GcSsM-2atfK7uToG4V8zncrqNmbDJHag3XUOgeB5M9wNobnIVJsIt7EzDGd9j8x2EHs0B5dk64ftHmDC6FD6-swFo7SIliLNdLZ5kkaczw&mrkid=65631392

· https://www.fiercehealthcare.com/payer/here-are-payment-models-cms-has-either-pulled-for-review-or-delayed

· https://www.healthcareitnews.com/news/confusion-remains-about-onc-information-blocking-rules-even-after-start-date

· https://www.healthcareitnews.com/news/google-has-another-go-patient-health-record-software

· https://www.bloomberg.com/news/articles/2021-04-12/microsoft-makes-big-bet-on-health-care-ai-technology-with-nuance?mkt_tok=ODUwLVRBQS01MTEAAAF8ZRDWn1VlEJ1RYylQefJ0RpmQECdFaqNI4TZ9qJvQ2j8pF_MHB3fS1bLfCVFrQ3At2soUsZP16JiOg2p0py8bLh52Sae8paqPvi5oirHqtn1P

· https://www.fiercehealthcare.com/tech/ehr-startup-canvas-medical-lands-17m-series-a-and-new-partnership-anthem?utm_medium=nl&utm_source=internal&mrkid=65631392&mkt_tok=Mjk0LU1RRi0wNTYAAAF8ZSpp0q5yv3DZt_vJ5JkvKRItiHnaMsfE5k96OfGrrWKi8qpl-OO-28BW1yRkbHdRaNTetZ7mNasg7kBIvJDxv_Z-oTyXBDOd1RYyC4GREaax76Om5Q

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC.

Mindy McGrath, Healthcare Industry Learning Lead

[email protected]

Ryan Hummel, Executive

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

The episode opens with a discussion of what’s spurring these changes (00:50), including the importance of the establishment of the Center for Medicare and Medicaid Innovation (05:11) and the Quadruple Aim (06:45). Over the last decade, ACO models have been a huge source of savings and learnings for CMS (07:13), and even commercial markets (10:05). Reimbursement truly sets the tone and shape for care model innovation (13:17), whether we’re talking about Next Generation ACOs, Direct Contracting (14:28), or even Direct-to-Employer Contracting (18:00). As care model innovation continues, healthcare leaders should be thinking beyond the technical aspects (20:48), not overlooking the importance of change management, capability building, and culture development.

Podcast Tags: healthcare, care models, innovation, ACO, direct contracting, quadruple aim

Source Links - Below, we've listed links to some of the stories and resources discussed on this show.

· https://innovation.cms.gov/innovation-models#views=models

· https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs#:~:text=The%20Medicare%20Access%20and%20CHIP,the%20Quality%20Payment%20Program%20that%3A&text=Streamlines%20multiple%20quality%20programs%20under,Based%20Incentive%20Payments%20System%20(MIPS)

· https://robertpearlmd.com/lessons-macra/

· https://www.fiercehealthcare.com/payer/naacos-calls-for-becerra-to-stem-losses-aco-participation-calls-for-increase-to-aco-savings?mkt_tok=Mjk0LU1RRi0wNTYAAAF7_ioIe6hTHSK2F64EV9LUrhxTPE2HHobV27D-br6GMS2McZnhTwnbCbARn-XYqXeQZKR0hxDk7zwo3jCO_HGwDI9r6-bt8PjKqfYW_ahOZHX3S5Iu_eA&mrkid=152778267

· https://innovation.cms.gov/innovation-models/gpdc-model

· https://www.fiercehealthcare.com/payer/industry-voices-direct-contracting-providers-opportunity-for-forward-thinking-employers?mkt_tok=Mjk0LU1RRi0wNTYAAAF8HRFPlmGwEzapC2b0t14Ks8pYOt74YCWHjBNyzp6ltMGGTkhsg1WzuO7GYD5Jfufw6ninujRfZX6Px4mZyy4tXYxDnoIQ54Zl-ViUHmz8XNLJPnb9xYY&mrkid=152778267

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC.

Mindy McGrath, Healthcare Industry Learning Lead

[email protected]

Ryan Hummel, Head of Provider Sector

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

In this minisode, Mindy, Ryan, and Jen discuss a few recent newsworthy items including: the 11th anniversary of the Affordable Care Act (00:46), the confirmation of Xavier Becerra (06:29), and recent announcements from Transcarent and Amazon Care (11:05).

Source Links - Below, we've listed links to some of the stories and resources discussed on this show.

• https://www.washingtonpost.com/health/becerra-squeaks-through-confirmation-vote-to-become-hhs-secretary/2021/03/18/cd11bac4-8750-11eb-8a8b-5cf82c3dffe4_story.html?mkt_tok=ODUwLVRBQS01MTEAAAF79SJML2Iwo2rw8_Ud2DXU7lNrBRfFv8DvZiNcbRBjYUwb2VoIJbmfCxidf0cLphTwFpoSRcKk4D-Dfe7lqBYeawTzN6irdWbugSzXFoZlbzO-

• https://www.fiercehealthcare.com/tech/game-competition-healthcare-space-heats-up-as-amazon-care-expands-analysts-say

• https://www.forbes.com/sites/katiejennings/2021/03/18/concierge-medicine-on-steroids-startup-raised-40-million-to-disrupt-primary-care/?sh=22466aa55650

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at

1-888-VYNAMIC.

Mindy McGrath, Healthcare Industry Learning Lead

[email protected]

Ryan Hummel, Executive

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

The journey into motherhood comes with its own unique risks and outcomes that are determined by one’s country of birth, socioeconomic status, education, and even race. In this bonus episode of Trending Health, Vynamic’s Diversity & Inclusion Council presents excerpts from a recent panel on the Disparities in Maternal Health in honor of International Women’s Day. The panel discussion was led by Vynamic Director Tilewa Otunba Nwaeze and featured Kassandra Margetis, LCSW-R, former Manager of Mental Health & Strategic Partnerships at the NYC Bureau of Maternal, Infant & Reproductive Health and Kendra Mitchell, an MFA candidate in the Peter Stark Producing Program at USC and currently working as Associate Producer on Maternity, an upcoming short film highlighting the black maternal mortality crisis.

The episode opens with a discussion of what is driving this change (00:47), specifically the acceleration due to COVID-19 – from rapid stand up due to necessity, to increased comfort as more patients experienced virtual care, to the removal of regulatory and reimbursement barriers. While “telehealth” may be the first thing that comes to mind when talking about virtualization in healthcare, there is so much more (06:05) – including remote patient monitoring to manage chronic disease (06:20), the incorporation of patient-generated health data into care management (08:22), decentralized clinical trials (09:40), and digital HCP engagement in life sciences (10:40). As virtualization continues to mature, healthcare leaders should be thinking about (12:35) operationalization, information security and data privacy (13:03), data mapping and management (13:45), and capabilities development (14:05). Virtualization in healthcare provides an opportunity for increased access and reach across geographies (15:25), demographics (16:21), and mental health services (17:00). Payment parity and favorable policy decisions will be critical in maintaining momentum in virtualization (18:02).

Podcast Tags: healthcare, virtualization, telehealth, remote patient monitoring, e-detailing,

Source Links - Below, we've listed links to some of the stories and resources discussed on this show.

· https://www.jmir.org/2020/9/e20786/

· https://www.kff.org/womens-health-policy/issue-brief/opportunities-and-barriers-for-telemedicine-in-the-u-s-during-the-covid-19-emergency-and-beyond/

· https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448894/

· https://news.careinnovations.com/blog/rpm-growing-in-popularity-for-chronic-disease-management

· https://mdgroup.com/blog/why-decentralisation-is-the-future-of-clinical-trials/

· https://www.accenture.com/us-en/insights/life-sciences/coronavirus-changing-pharma-hcp-engagement

· https://www.fiercehealthcare.com/hospitals/money-behind-mental-health?utm_medium=nl&utm_source=internal&mrkid=152778267&mkt_tok=eyJpIjoiT0RVek1EVTRZelZoTlRrMiIsInQiOiJsWWNQNVJVTnNDMXl0V3NMWEJkZU1YV3dRVCtJK1lyQm9Zd1E5bEViUnhNdXJVR3Z0eHlsMU9vOGlkWDFQQ3JrMXRPRFlQWFdQZU0waWlNck1LMFF2T1JcL1F4QUxOUENndGlCZTJwR1k5N3lLOGRLRWFrOWZuUHhwNUhnTE1MWVhPeWNrVk1PNkpGcFZrWlBOVzNzVm13PT0ifQ%3D%3D

· https://www.fiercehealthcare.com/tech/house-health-leader-calls-for-permanent-medicare-telehealth-expansions-but-concerns-about?mkt_tok=Mjk0LU1RRi0wNTYAAAF7nIf

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at

1-888-VYNAMIC.

Mindy McGrath, Healthcare Industry Learning Lead

[email protected]

Ryan Hummel, Executive

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

In this minisode, Mindy, Ryan, and Jen discuss a few recent newsworthy items including: the latest in vaccine development from Pfizer, Moderna, J&J, and AZ (00:29), the review of 340B in the courts (06:48), Aetna’s re-entry into the ACA exchanges (13:38), and the announcement of the new health data start-up, Truveta (16:33)