Chris Riopelle

Second instance this month where clients are hyper-focused on renegotiating compensation amounts and benchmark alignment, trying to drive productivity solely through comp incentives—wasting partnership capital and missing the bigger picture. 🤔 The real question: Are we addressing the levers that drive the compensation pool? 🌊 Maybe it's time to focus on rising the tide to lift all boats. "Here’s the deal": ✔️ Access drives and enables volume ✔️ RCM (Revenue Cycle Management) drives cash turns ✔️ Care delivery models + infrastructure drive efficiency, volume, labor and other larger costs These are just a few key levers within your control that can shift the game. Instead of continuing to argue over compensation and chasing shiny new initiatives, let’s partner on getting the fundamentals right first. 🛠️ Need help nailing the basics and setting the foundation for long-term success? Let TrustWorks guide you. 🤝 #Leadership #HealthcareStrategy #Compensation #TrustWorks

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The latest Avalere report reveals that private equity-affiliated physician practices offer significant cost savings and improved care outcomes for Medicare beneficiaries. On average, patients experienced 13.5% fewer inpatient days and 7.9% fewer emergency visits compared to hospital-affiliated practices. This research sheds light on how private equity-backed models can play a crucial role in reducing healthcare spending, while keeping quality and patient experience at the forefront. A definite step forward for sustainable healthcare models. #Healthcare #Medicare #PrivateEquity

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Mandatory bundles in surgery are a bi-partisan objective, and (in)ability to optimize cost/quality will dramatically impact hospital P&L. Regular insights from granular data , and AI-based decision support are the only way to systemically reduce unwanted variability and be both profitable and high quality.

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Somewhat counter to the narrative that you have heard: that Private Equity investment in physician groups increases costs, etc. This study by Avalere comparing what happens when independent specialists join a private equity backed MSO platform vs. acquired by a hospital/foundation or a large corporate entity (Optum) demonstrates the reality: 1. The study found that Medicare patients of private equity-affiliated private practices had Medicare expenditures in line, and sometimes lower, than patients of unaffiliated private practice physicians or those in hospital or corporate settings.  2. Per-beneficiary Medicare expenditures were an average of $963 lower for beneficiaries whose physicians moved from an unaffiliated model to a private equity affiliation in the 12 months following the transition, compared to an average of $1,140 higher for beneficiaries whose physicians moved from an unaffiliated model to corporate affiliation in the year following the transition. 3. Additionally, patients in hospital and corporate settings had greater numbers of inpatient days and emergency department visits.  4. Medicare expenditures for patients attributed to hospital-affiliated physicians had the highest percentage of expenditures in the facility setting (64% to 69%) compared to other practice affiliation models.  5. The analysis shows that hospitals — rather than practices supported by private equity groups — are more likely driving Medicare spending growth, https://lnkd.in/ghGVwuDi

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Despite the "less conclusive quality and cost findings" shown by Hospital-at-home AHCAH programs for Medicare, participants in the program (both patients and clinicians) give it a thumbs-up. Big proponent of moving appropriate acute/post-acute care into the homes, however, a lot of these programs were not well executed and many were not appropriately resourced. It's not surprising that the overall data on quality and cost is underwhelming. Hopefully, the 2 yr extension (currently legislation due) should allow for this picture to become clearer. #HaH #AHCAH #Hospitalathome #Homehealth

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Still trying to make sense of Walmart pulling back from healthcare delivery? 3 quick thoughts: 🏥 Healthcare delivery is hard, even for companies where it's a primary focus. Navigating reimbursement and competition is extremely challenging. 💸 The patient may be a customer, but they are never the payer. 📊 No matter a company's stature, cooperation and reimbursement from health plans—both nationally and locally—are still critical for building profitable businesses. For a deeper dive, check out our full analysis here: https://lnkd.in/eXTeugKD

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Just finished reading a major health plan’s value-based care results compared to fee-for-service (FFS), and I have to say, it didn’t shock me to see that aligning incentives leads to better quality outcomes—having worked in full-risk medical groups, that’s pretty much "Value-Based Care 101." What did surprise me, though, was how shockingly poor the FFS outcomes were for blood pressure and blood sugar control. You’d think FFS remote monitoring solutions would have some kind of built-in incentive for providers to jump on the bandwagon and share in the economics of improving these metrics. But apparently, that memo got lost in the fax machine. So, am I missing something here? Imagine if 100 people went to a mechanic to fix their brakes, sat in the waiting room, watched the mechanic work on their brakes, paid for the service, and then half of them happily drove home with faulty brakes that actually increased their chances of a crash. I mean, wouldn’t that shop be out of business faster than you could say “malpractice”? 🚗💥 To all my FFS physician colleagues who vent about meaningful use, quality metric reporting headaches, the friction of utilization management, risk-adjustment-focused coding quirks, or any other population health and managed care imperfections—take a good, long look in the mirror. Then ask yourself: are you just an innocent bystander here, or might you be holding the pen that wrote some of these changes? 🪞🤔 #ValueBasedCare #FFS #HealthcareInnovation #RemoteMonitoring #healthtech Quintuple Aim

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On the latest episode of #HealthTechnologyPodcast with Christine Winoto from the UCSF Rosenman Institute, our Co-Founder and CEO, Graham Gardner, MD, MBA, discusses his transition from cardiology to tech entrepreneurship, the development of the Kyruus Health, and its impact on patient access and provider data management. Link in comments so you can have a listen 🎧

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🎙️ Latest Relentless Health Value Podcast Inbetweenisode: Why Givers and Collaborators Win in Healthcare What’s the secret to transforming healthcare and achieving real value? Collaboration. In this episode, we discuss: 🩺 Why value in healthcare is no longer dictated by providers or middlemen—it’s determined by patients and plan sponsors 🌟 How givers create sustainable, patient-centered collaborations 🤝 Real examples of how boundary-setting givers drive collective success Transforming healthcare isn’t a solo endeavor—it’s a team effort. And it takes leaders who are willing to give and collaborate. 🔗 Tune in to hear how we can work together to make 2025 the Year of the Giver: https://cc-lnk.com/INBW40 👂 After you listen, share your thoughts: What role do you think givers play in reshaping the future of healthcare? Also mentioned in this #healthcarepodcast: Relentless Health Value Podcast; Aventria® Health Group; Scott Tromanhauser, MD, MBA, MHCDS; Marilyn Bartlett; Ann Kempski; Matthew Bunte, MD, MS, FSVM, FSCAI, FACC; Brian Uhlig; William Gailmard; Dr. John Lee; Paula Muto, MD; @Linda Krebs; Adam Grant; Christina Farr; Robert Andrews; Ann M. Richardson, MBA; Laurence Bauer; Rob Marty, DBA, MHA

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PE acquisitions of healthcare providers organizations has slowed this year. I think this is just a pause to take a deep breath before the next plunge. Look for activity to start to spike again later in the year. #healthcare #hospitals #clinics #healthsystems #pe #privateequity #venturecapital #mergers #acquisitions #consolidation

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What does the future hold for retail medicine and virtual care? Walmart is the latest to announce their health center closure. https://lnkd.in/geZpMTkS. This following Optum news, VillageMD closing in Nevada, Teladoc Health problems, etc. What comes next? This is another in a long line of examples that technology and even consumer willingness are not enough when the reimbursement environment does not support particular care models. Are we getting ready to lose all the lessons painfully learned during the pandemic? Or will new virtual care models emerge following this round of closures?

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💥 Interesting insights Andy Mychkovsky...on August 16th, Colorado Healthcare Strategy & Management (CHSM) is going to tackle another angle of the Mergers and Acquisitions topic called 'Balancing Efficiency, Costs and Access: 3 Sides of the M&A Coin' to discuss local and national trends and how patient care continuity is the ultimate goal. Register here for this #freewebinar: https://lnkd.in/gyegHUMX

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#MedicareAdvantage plans need a #healthequity strategy. Sleepwalking into the new 2027 Stars measures isn’t a winning plan. Data from measurement year 2024 and 2025 will impact Star ratings in 2027. The new Health Equity Index is designed to reward MA plans that meet two criteria. First, having a high percentage of MA enrollees with social risk factors (SRF), defined as those enrolled in the income-based programs #Medicaid, #Medicare Savings Program (MSP), or the Extra Help / Low Income Subsidy (#LIS) program, as well as those who qualify for Medicare due to #disability. Second, delivering strong relative Stars measure performance on this population. The new HEI is part of a broader effort by the federal government to use payment as a mechanism for spurring action on closing the health equity gap. I want to raise up my friends at Uno Health and their incredible founder, Anna De Paula Hanika. They’re on the front lines of enrolling MA members into low-income assistance programs and nobody does it better. “On average, members save $4,500 a year by enrolling in Medicaid or LIS and other income-based assistance programs like SNAP, utility assistance and phoneline assistance. For many, that’s more than the difference between having to choose to pay for groceries or the medications,” Anna told Oliver Wyman in the attached article. “From a plan perspective, we’ve also seen the positive impact on Star ratings that having more members enrolled in these programs can drive. And it’s a strong member retention tool: a comprehensive program enrollment can reduce churn rates among Dual Special Needs Plan populations by as much as 10%, further enhancing the value of these programs.”

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Vendors with at-risk fee models. I sat down this past weekend with a friend and CEO of a VC-backed early-stage healthcare vendor in the value-based care outcomes space. Her name will remain anonymous but she is enormously talented and well-respected. She asked for my input on what their fee model should be, selling into health plans and employers. She is considering going fully at-risk. Here’s what I mentioned to her: Full risk value-based care has actually been around for many years. It’s not new but has recently captured more thought and attention in healthcare. The idea is to bring down medical costs through prevention which is also in the best interest of the patient. Vendors, health plans and providers are financially rewarded for performance. There are shared savings, partial risk, full risk and hybrid models that many vendors have chosen. Sword Health and many other larger vendors have recently chosen to offer full risk fees based on defined outcomes. For startups, this is a challenging model to adopt. They need steady revenue, investors may want to see early captured revenue traction and product/service validation, the product/service is often not fully baked or tested and is often missing key functional features, and because companies at this stage often don’t have material deal and client volume yet, which allows the company to absorb some losses if they don’t deliver the outcomes expected, it remains a challenging model for early companies. For growth stage companies that are app-based, service-based or platform-based, they are often more financially secure and often start to implement and test partial at-risk fee models. Critical to at risk models is ensuring the clients (health plan, provider, employer) are able to do their part. This includes data-sharing in a timely manner, proper integration and communication with care teams, and having and sharing with the vendor defined metrics (financial, outcomes, data quality and meaning, care improvement) they are seeking to achieve. Lastly, I shared with her that outcomes based vendors often have multiple fee models based upon the client. PEPM, PMPM, hybrids, at-risk, flat fees, large implementation fees and more modest licensing or recurring fees and vice versa, adjusting fee amounts annually, etc. The very best model is to listen to each and every client, understand what fee model works for them and within specified parameters, determine if that works for you at any given time, ensure your fees are tracked and easily managed, and adapt with your clients one by one along the way continually capturing feedback while sharing insights with them. That helps create a stickier client and you are riding the wave together. When done well, accurate financial forecasting becomes much easier, retention is there, revenue spikes short and long-term, and your competition never knows what’s coming next around what fee model you use.

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Understanding the distinct perspectives and strategies of providers and payers is crucial for effective negotiation and risk management. These insights can help providers and payers avoid common pitfalls, as well as highlight the importance of alignment between them. Looking forward to more insights from you and your team Joseph Rafferty. Teaming up with Michael McCabe is a smart move.

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