David Audley, MA, FAMF

Risant Health investing $1B+ into Cone Health after acquiring it is pretty dang cool. Kudos to Kaiser Permanente's leadership. This is how M&A in healthcare should be done. #healthcare #hospitals #clinics #healthsystems #mergers #acquisitions #privateequity #leadership #strategy https://lnkd.in/gJtjtXpZ.

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With our Denials Navigator, you can tackle denial challenges with unparalleled efficiency and precision. This revolutionary tool monitors your denial inflow and alerts your staff early to payer behavior changes. Contact our team today to request a demo and get ahead of payer tactics. Click here: https://lnkd.in/gdA3Jrs3 #healthcare #revenuecycle #denials #claimsmanagement

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Medicare reimbursement for cutting-edge digital health tools remains inconsistent at best. This is stifling innovation and hindering patient access to potentially life-changing technologies. CMS has an opportunity to address this issue head-on with two key payment rule proposals coming out next month. We need decisive action to establish clear reimbursement pathways. Prescription digital therapeutics are software-based interventions that deserve a place in the 2025 physician payment rule. What specific reimbursement models would encourage wider adoption of these tools? #MedTech #DigitalHealth #CMS https://lnkd.in/gNnuWwBU

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We try to leverage technology in ways that superpower our people and help with the scalability of care. This is great advice from Froedtert Health’s Bradley Crotty MD MPH during Reuters #Digitalhealth24 conference. Here’s to superpowering teams and scaling care.

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700,000+ appointments every month. 5,000+ providers. One powerful solution. 👇 Healee is transforming patient access by streamlining scheduling, telehealth, and communications. All in one platform. Whether it’s mental health or primary care, Healee’s tech handles high-volume traffic across multiple teams, facilities, and time zones, making care more accessible and efficient. I spoke with Plamen Petrov, CEO of Healee, who said: "We founded Healee to simplify healthcare by streamlining scheduling and patient management. Our platform is designed to handle high-volume appointments, freeing up providers to focus on delivering quality care instead of administrative tasks." So, what makes Healee stand out? → Personalized scheduling: Patients get a fully customized experience, and providers get smart booking optimization that matches the right patient to the right provider. → Multi-team magic: Manage complex, high-volume appointments across different locations, time zones, and licensure requirements. → Seamless integration: Healee fits perfectly into your current tech stack with EHR API integration, HIPAA-compliant data storage, and branded web/mobile apps. Healee simplifies operations, boosts efficiency, and helps healthcare organizations attract, engage, and retain more patients while growing profitability. 💡 How is your healthcare organization handling patient access and scheduling challenges? ___ ✨ Follow me, Hetali Mehta, MPH for more on how health tech is reshaping patient care!

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By automatically capturing patient care summaries directly to the EHR, Dragon Medical One is the speech recognition solution that fits your needs without fighting your workflow. Learn more at https://lnkd.in/e86xfcb7

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Wellness Wednesday – Data Exchange RheoMed MSO is proud to be one of greater than 100 health care entities participating in the California Data Exchange Framework through LANES in Los Angeles County. We join medical groups, hospitals, clinics, health plans, MSO’s, health departments, mental health facilities, post-acute facilities, and social service organizations that want to coordinate and improve care by exchanging data for patient care in real time. However, not all health care entities participate in data exchange. Sometimes this is due to relatively challenging situations such as cost, personnel, expertise, priorities, etc. The state of CA has provided financial and technical support to help overcome some of these barriers. In other cases, companies, while publicly supportive of data exchange, choose not to participate due to reasons such as competitive advantage, “proprietary information”, or simply control. This behavior is inexcusable, if not scandalous, because it interferes with optimal patient care. Let’s commit as a medical community to work together to improve patient care. Let’s all “do well by doing good”. RheoMed MSO, Inc. #wellnesswednesday #valuebasedcare #renalcare

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Over the past five years, Blue Shield has developed new payment models in collaboration with provider and hospital partners to bring better value into the health care market and bend the cost of health care trend. With 56% of our healthcare spend now in a pay-for-value model, we're empowering health through value, not volume. This shift is crucial as we continue to address the unsustainable rise in healthcare costs.    Our innovative payment models, such as Primary Care Reimagined and the Accountable Care Alliance, are designed to support providers in delivering quality care at lower costs while improving both member and provider experiences. This year alone, we've seen a 7.4% reduction in overall healthcare costs from our prevention-focused model.    Read more about our journey and the impact we're making. #ValueBasedCare #WellAhead

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Gain insight into your patients' pain points! 🤔

Gain insight into your patients' pain points! 🤔

Ok, everyone in #healthcare has seen the South Park clip. So, I wanted to share the Byzantine math of #Medicare #JCode Drug billing in that spirit. Here below is an explanation of benefits (EOB) of a recent denosumab (Prolia) injection under a Medicare supplement. It's from one of the big 3 health plan insurers. Prolia is a drug you can't pick up at the pharmacy - you have to go somewhere to get it injected. First, J code or injectable drugs at your doctor's office are not #PartD drugs, they are billed under #MedicarePartB. I was curious to compare the EOB vs. the CMS Average Sales Price (ASP) Quarterly drug pricing file - so I checked the math below. The math vs. the January ASP file actually checks out - although I do think you need a PharmD to calculate it! (The mandated limits in charging for J code or Part B drugs under Medicare BTW is called "Sequestration.") But I still have questions, like: 1. Why are the rest of us paying potentially 6.5-7 times more for the same drug than #Medicare patients? 2. Is it right that the Medicare patient is paying 100% of the cost of the injection after the negotiated injection rate? 3. Why are the billed rates so much higher than the mandated, open-source published rates within the CMS ASP files? 4. And, could we maybe get the tradename on these EOBs so patients know what the drug is in the first place that they are being billed for? 5. Ditto on the dose. The ASP payment limit is for 1 mg, but the dose of denosumab (Prolia) in this instance was 60 mg. Discuss. #pharmacy

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Our new guide on modular content provides a solution to the problem of the overwhelming influx of medical data. Learn how creating reusable, adaptable modules ensures consistent and optimized communication across channels. Find out how this strategy boosts physician engagement, speeds up time-to-market, and reduces content creation costs. Download now and learn how to revolutionize your medcomm strategy: https://lnkd.in/djvXdpMF #Medcomm #Medaffairs #Strategy #Modularcontent

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California becomes the latest state to attempt the fool’s errand of telling #healthcare interested parties to restrain their margins (#hospitals, #physicians, #pharma, #homehealth, device makers, etc) in the interest of the #TripleAim or else! Wish state legislators the best of luck as policymakers attempt to tame the state’s half Trillion dollar healthcare economy. Never forget Uwe’s Cosmic Rule of Healthcare: “every dollar of healthcare spending = someone else’s dollar of healthcare revenue”. The effort “will require a sustained wrestling match with a sprawling, often dysfunctional health system and powerful industry players who have lots of experience fighting one another and the state.” I’ll say! Heard predicted at a healthcare conference many years ago by Senator Ron Wyden of Oregon “True meaningful #healthcarereform will never happen at the state level”. Add California to the growing list of states to prove him correct. #healthcarecosts #healthcarevalue #valuebasedhealthcare #patientcenteredcare #PrimaryCare #HealthEquity

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Is Medicare having a mid-life crisis? Today's great symposium on the Future of Medicare felt a little like a group of caring friends staging an evidence-based intervention to help a dearly loved 40-year-old get back on track. The day started with the premise that forty years ago, Medicare was introduced to reduce healthcare costs and simplify the healthcare system. Along with Pradeep Philip, Prof Jane Hall and Richard Holden on the first panel, we asked: 'Is Medicare doing this now?' I'm keen to know - what do you think? There was a lot of talk about the universality of Medicare. What does universality mean to Australians? Is it about everyone paying their share to fund Medicare? Or is it about everyone getting fair access? Maybe it's about healthcare being free for all? This is a question we must answer together. What do you think Caroline Edwards, Stephen Duckett, Anthony Scott? There's more to Medicare than simply defining universality. Baked into Medicare are assumptions about risk versus benefit – it's a debate at the heart of healthcare. Should we use data about patient risk to determine access to care? Or should the likely benefit from treatment be more important? This question is more than academic. There were lots of conversations today about how we allocate taxpayers dollars to ensure the best outcomes for all Australians. Prioritising risk helps us address the most urgent needs first. But focusing on treatment benefits can lead to long-term health improvements. Striking the right balance is critical. I'd love your thoughts. Denzil G Fiebig James Downie Emily Lancsar Health equity was an recurring theme running through the sessions today. Tailored approaches to address inequities, like targeted bulk billing incentives or MyMedicare, can be problematic. These proliferating programs aim to help but in practice can make the system more difficult to navigate and so more inequitable for health consumers. Sam Shipley Dr Liz Develin The role of administrative data in evaluating and researching Medicare’s effectiveness cannot be overstated. Often it is all we've got. Yet administrative data is not usually collected for research or evaluation purposes. Colleagues today presented important insights using this not always fit-for-purpose data. It's crucial to bring academic views, such as those of health economists, evaluation experts, and others, into the conversation alongside public servants, citizens, industry, and clinicians. Phillip Gould Teresa Dickinson PSM Kees Van Gool Just like friends staging an intervention, there was honesty, support, hope, dare I say love, in the room today. Public conversations about Medicare where everything is open for conversation, even the more sensitive issues, are essential. By bringing all voices to the table, we can move forward together and ensure our healthcare system meets the needs of all Australians. Academy of the Social Sciences in Australia #Medicare #HealthFunding #HealthEconomics

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Check out our quick illustrated video to see how we're revolutionizing healthcare with personalized recommendations and actionable insights for your patients. Elevate your care strategy with MyGoodLife.

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🔧 61% of healthcare leaders say enabling self-service through data analytics platforms is critical to their teams' productivity.  Arcadia’s CEO Michael Meucci discusses how AI is becoming the new form of self-service, empowering clinicians and staff. See the full study we conducted with HIMSS Market Insights: https://bit.ly/3TQfcS8 #AIinHealthcare #generativeai #dataanalytics

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Facing the challenges of flu season? Yoh is your trusted partner for all your needs—vaccinations, screenings, scheduling, and more. See how we filled 761+ positions for a Northern California healthcare system in just three months. Read the case study: https://hubs.ly/Q02zxN9D0 #Healthcare #FluSeason #VaccineSupport #PatientCare

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Navigating Challenges in Orthopedics: Key Insights and Solutions Recent developments shed light on the hurdles facing orthopedics today. From declining reimbursements to cybersecurity threats and product recalls, these challenges demand attention and strategic responses. Key Takeaways: Reimbursement Decline: With reimbursement rates for orthopedic procedures decreasing annually, maintaining financial viability becomes increasingly challenging. Cybersecurity Risks: Orthopedic practices are not immune to cybersecurity incidents, which can compromise patient data and disrupt operations. Product Recalls: Recent recalls of orthopedic devices highlight the importance of quality assurance and timely communication to ensure patient safety. Implications: Access to Care: Declining reimbursements threaten Medicare beneficiaries' access to quality care, highlighting the need for sustainable reimbursement models. Patient Confidentiality: Cybersecurity breaches can jeopardize patient confidentiality and erode trust, underscoring the importance of robust cybersecurity measures. Patient Safety: Product recalls raise concerns about patient safety and emphasize the importance of rigorous quality assurance protocols. Potential Solutions: Advocate for Fair Reimbursement: Orthopedic practices can negotiate with payers and streamline operations to mitigate the impact of declining reimbursements. Strengthen Cybersecurity Measures: Investing in advanced cybersecurity infrastructure and providing staff training can help safeguard patient data from cyber threats. Enhance Quality Assurance: Implementing rigorous quality assurance protocols and maintaining open communication with regulatory agencies can prevent product defects and ensure patient safety. Let's address these challenges collaboratively to uphold the highest standards of care in orthopedics. #Orthopedics #Healthcare #HealthcareChallenges #HealthcareSecurity #PatientSafety https://lnkd.in/exSGMCqP

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🌟 Streamline Your Practice with QHSLab’s Integrated Service Program (ISP)! 🌟 Healthcare providers, does this sound familiar? Multiple tabs open, hunting for patient data, juggling billing codes, writing reports—all while striving to give patients your best. 🏥 This admin overload is all too common, but QHSLab is here to change that! Why ISP? 🔹 Automated Pre-Visit Assessments: Our platform identifies upcoming appointments and sends automated patient assessments 48 hours before their visit, giving you insights in advance. 🔹 Customized Patient Data Collection: Gather vital health data tailored to your practice—covering allergies, sleep patterns, mental health, and more. 🔹 Immediate Clinical Reports: Instant reports provide educational insights for patients and detailed data for your informed decision-making. 🔹 Accurate Billing Support: We ensure your billing codes are precise and align with your services, minimizing errors and maximizing your reimbursement. Outcome? Less time on admin tasks, more time with patients, and a boost in both care quality and your practice’s efficiency. Simplify processes, avoid coding errors, and focus on what matters most—your patients. 🚀 Ready to enhance patient care and optimize your practice? Learn how QHSLab’s ISP can be your next game-changer. Contact us today or visit our blog for more details! #HealthcareInnovation #PatientCare #EfficiencyInPractice https://lnkd.in/eKMbW6nW

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