Heather Hart Bechtold, MBA

ICYMI: I spoke on Becker's Healthcare Podcast last month to discuss some of the ways Kaiser Permanente is harnessing innovation to improve care. I highlight COVID-19 learnings around telehealth and accessibility, the influence of ambient AI in the clinician setting, and more. Check out the episode: https://bit.ly/49Ha8EK #HealthCare #Becker’sHealthPodcast #HealthOutcomes

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In a move to streamline care, LA Care Health Plan which managed Medi-Cal and several other plans for low-income Californians is cutting back 24% of its prior authorization requirements. "This change aims to reduce administrative burdens and speed up patient access to necessary treatments," the article explains. This is good to see. Could significantly benefit patient care by removing unnecessary delays in treatment approvals. Devil is in the details but still good progress, particularly for the most vulnerable. Check out the article by Nona Tepper in Modern Healthcare at https://lnkd.in/evVP3eqP

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MLK, JR. COMMUNITY HOSPITAL in Los Angeles is on the brink of closure due to overwhelming patient volumes exceeding its capacity. During a June 7 press conference, community representatives, state lawmakers, and hospital staff voiced concerns about the hospital's critical status. California Assemblymember Mike Gipson highlighted that MLKCH is one of the last facilities providing essential services in the area but is struggling to remain open. Last November, hospital leaders warned that they might run out of funds by early 2024. The hospital also faces a severe shortage of maternity care services in South Los Angeles, with MLKCH being one of the few to maintain a maternity ward. Despite state funding at its opening in 2015, the hospital's emergency department saw 120,000 annual visits in 2023, far exceeding the projected 30,000. With 76% of visits from Medi-Cal, which underpays for care, the hospital loses money on each visit. Without increased state funding, it could run out of operational revenue by early 2025. This situation highlights the critical need for sustainable funding and capacity management in safety net hospitals. To avoid similar issues, our team ensures financial stability through diversified funding sources, enhances operational efficiency, and advocates for fair reimbursement policies to maintain essential healthcare services for underserved communities. We are the One! #revenuecycle #revenuecyclemanagement #priorauthorization #medicalbilling #medicalcoding #healthcare #healthcaretechnology #accountsreceivables #denialmanagement #consulting #management #implementationpartner Becker's Healthcare

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These are some good takeaways and observations from Fall Forum! Thanks Muhammad S. for sharing.

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Are Hidden Practices Driving Up Healthcare Costs Nationwide? A recent study from USC suggests that Sutter Health’s alleged anticompetitive practices may have driven hospital prices 30% higher than those of their competitors since the early 2000s. Sutter reportedly used “all or nothing” contracts to force insurers to include all its hospitals or none, effectively eliminating competitive pricing (Sutter denies these allegations and claims the study is flawed). The situation in Northern California, where healthcare costs are already significantly higher than in Southern California, may not be an isolated incident. The increasing consolidation of the healthcare sector often leads to higher costs for consumers, a trend well-documented across the nation. Could other hospital systems be engaging in similar practices, hidden behind legal battles and confidential documents? And how many other communities are unknowingly paying the price?

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A 2021 report by the The National Academies of Sciences, Engineering, and Medicine found that while more than 35% of health care visits in the U.S. are to primary care physicians, only about 5% of health spending is on primary care. That’s compared with about 13% for some other developed nations. #primarycare #prevention #publichealth #california https://lnkd.in/g37iugjS

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September is National Suicide Prevention Month. Thank you Katrina Domingo, PsyD for nominating subject matter expert, Terra Morais, Psy.D., provide insightful tips for suicide prevention. Dr. Morais has worked for Kaiser Permanente for 9 years, and has been manager of its Psychiatric Consultation Service for 2 years. She has specialized training in the treatment of psychiatric emergencies in children and teenagers. We all have times when we feel sad or overwhelmed. For some people, these feelings can become so strong that they have thoughts of ending their life. Suicide is a leading cause of death in the United States and has been on the rise across all groups for years, but we can take steps to help prevent it.   SELF If you are having serious thoughts that you or your loved ones would be better off if you were dead, the most important action you can take is getting immediate help. You can call or text 988 to talk to someone who knows how to keep you safe. If you notice yourself having these thoughts occasionally, or find yourself feeling hopeless, here are some steps to help prevent those thoughts from getting worse: 1. Tell someone you trust how you are feeling. This can be scary, but it the people who care about us want to help us feel better and can be devastated by the thought that they could have helped if only they had known how their loved one was feeling. 2. Prioritize your sleep and reducing stress in any way you can. Lack of sleep contributes to problems with mood, thinking, and emotional regulation. 3. Make a plan to do something enjoyable with a loved one and ask them to help you stick to it. Research has shown that social connections and responsibilities are highly protective factors in preventing suicide deaths. OTHERS Here are some warning signs that someone may be having thoughts of suicide: https://lnkd.in/dyz2BZsd If you notice worrying changes in someone you know, here are a few ways to help: 1. Ask them if they have been feeling like hurting or killing themselves. Sometimes people worry that asking will “put the idea in someone’s head,” but in fact people struggling with thoughts of suicide are usually relieved that they can talk about it. 2. When someone tells you about their thoughts of suicide, listen without judgment or argument and ask if they want assistance reaching out for help. You can call or text 988 with them or make sure they have the number.   RESOURCES The National Suicide Prevention Lifeline (24/7 toll-free suicide prevention service): Dial 988, https://988lifeline.org/   Suicide Prevention Hotline in Spanish: 1-888-628-9454, https://988lifeline.org/   LGBT Youth Suicide Hotline: 1-866-488-7386, or text START to 678-678, https://lnkd.in/d656hGQy   The Crisis Text Line: Text "HOME" to 741741 for free, 24/7 crisis support #suicideprevention #suicidepreventionawarenessmonth #TPMG #DSA #health #wellness #leadership #tips #support

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Union nurses at Kaiser Permanente SAN FRANCISCO MEDICAL CENTER protested against the use of untested and unregulated artificial intelligence (AI) tools in healthcare. Michelle Gutierrez-Vo, president of the California Nurses Association (CNA), criticized hospitals and the tech industry for not proving the efficacy of these tools in improving patient care. Kaiser Permanente's investment in AI technologies raised concerns among nurses, prompting over 200 to rally. Gutierrez-Vo emphasized the need for thorough testing and validation of AI systems before implementation to ensure patient safety. While AI offers benefits like reducing burnout, Douglas B. Johnson, a medical AI researcher, stressed the importance of balancing these benefits with patient safety and stakeholder buy-in. The nurses' concerns extended to AI systems within electronic health records, particularly Kaiser Permanente's use of Epic, which may not adequately account for patients' changing conditions. Despite contractual agreements for notification of new technologies, compliance issues persist, with nurses calling for immediate action if technology adversely affects staffing or patient care. The protest against untested AI tools in healthcare sheds light on concerns surrounding patient safety and emphasizes the imperative for rigorous testing. It emphasizes the irreplaceable value of human expertise in telehealth, highlighting our team's superiority over AI in providing personalized care based on years of clinical experience and nuanced understanding of individual patient needs. We are the One! #revenuecycle #revenuecyclemanagement #priorauthorization #medicalbilling #medicalcoding #healthcare #healthcaretechnology #accountsreceivables #denialmanagement #consulting #management #implementationpartner MedPage Today

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Stanislaus Surgical Hospital (SSH) in Modesto, Calif., will indefinitely suspend operations on September 14 and lay off all 160 employees, including nurses, midlevel providers, and support staff. The decision follows Centers for Medicare & Medicaid Services's termination of the hospital's provider agreement for failing to comply with Medicare and Medi-Cal participation conditions in three areas: basis and scope, pharmaceutical services, and infection control. SSH leadership disputes the decision and is considering an appeal. Despite months of efforts to address CMS concerns, the hospital could not maintain its Medicare certification. SSH has served the community for over 20 years, earning a five-star patient satisfaction rating. CMS previously postponed the termination in April, allowing time for corrective actions, but ultimately decided after a July onsite survey that the hospital had not made sufficient progress. The closure impacts both patients and employees, as the hospital was highly regarded for its quality care. Our RCM team and consulting professionals help healthcare entities avoid situations like Stanislaus Surgical Hospital’s by ensuring compliance with Medicare and Medicaid requirements, improving internal processes, and enhancing infection control practices. We focus on regulatory adherence, operational efficiency, and corrective action plans to prevent provider agreement terminations and financial disruption. We are the One! #revenuecycle #revenuecyclemanagement #priorauthorization #medicalbilling #medicalcoding #healthcare #healthcaretechnology #accountsreceivables #denialmanagement #consulting #management #implementationpartner Becker's Healthcare

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A few weeks ago, I had the privilege of meeting hospital leaders at the Nevada Healthcare Forum in Las Vegas. I am grateful for the thoughts and experiences that were shared by so many leaders including Maria Sexton from the University Medical Center of Southern Nevada (UMC), Linn Billingsley from ScionHealth, Karla Perez from UHS, Jeffrey Murawsky, MD from HCA Healthcare, and Brian Kleven from Dignity Health. The use of AI is top of mind for many Hospital Leaders to mostly solve challenges or improve business models. THINGS TO CONSIDER: 1. Don't have an AI strategy, but leverage AI in your organization's strategy. 2. Governance, training, and rules for AI can be challenging. 3. Create a multidisciplinary steering committee to help guide the process and uncover risk. 4. If you need guidance, contact me. Baker Tilly is a Top 10 CPA firm and advisory firm with a practice focused on healthcare. We will share our expertise and experience and help guide you to effectively leverage AI within your organization. #ai #healthcare #strategy #governance

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An important report from California Health Care Foundation that sheds light on pressing health disparities within #Asian communities. 🔎 Key insights include overall access barriers and how that contributes to reduced access to quality care. Varying health needs and preferences require tailored approaches to care and support for this diverse community. 💡 So why does this matter? Addressing these disparities is crucial for achieving overall #healthequity and improving outcomes for ALL populations, but also highlights the importance of developing #healthcare solutions that are culturally sensitive AND accessible. 🙌 I encourage you to read the report: A Closer Look: Health Disparities Among California's Asian Communities (chcf.org) #HealthEquity #AsianCommunityHealth #CulturalCompetency #HealthcareAccess #PublicHealth #HealthDisparities #Advocacy #InclusiveHealthcare

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Case Study Summary: Phoenix Children’s Partners with Healthgrades for Patient Acquisition Solution Phoenix Children’s, a leading pediatric healthcare system in Maricopa County, Arizona, faced increasing demand due to the region's rapid population growth. The hospital needed an effective patient acquisition strategy beyond traditional Google searches to maintain its leadership and support expansion. Phoenix Children’s partnered with Healthgrades to enhance its online presence and reach a broader audience of commercially-insured consumers. Key Challenges: 1. Expand digital marketing initiatives. 2. Increase patient volumes, particularly among new residents seeking pediatric care. 3. Promote general practitioners and specialists in a region with diverse healthcare needs. 4. Engage caregivers (parents, grandparents, guardians) making healthcare decisions for children. Solution: 1. Phoenix Children’s collaborated with Healthgrades to highlight nearly 200 doctors accepting new patients. 2. Healthgrades’ platform prominently featured Phoenix Children’s physicians, even on competitor profiles. 3. The strategy targeted primary care, orthopedic, and cardiovascular pediatric care. Results in 12 Months: -Physicians featured over 135,000 times to consumers on Healthgrades. -Generated over 4,500 phone calls from prospective patients. -This partnership allowed Phoenix Children’s to extend its reach, effectively engage with decision-makers, and generate significant new patient inquiries, supporting its growth and rebranding efforts.

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What is the #familysystems approach? Why do we in #familymedicine train to think systemically in addition to algorithmically? What is the history of family systems training here at UCSF? Learn all the answers in this compelling podcast with Drs. George Saba and Cory Johnson https://bit.ly/4elIakT

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October is Breast Cancer Awareness Month, and we want to emphasize the importance of early detection. A mammogram is a simple procedure that can help identify breast cancer in its early stages, when treatment is often most effective. Did you know that: Early detection can significantly improve survival rates. Mammograms are recommended for women ages 40 and older. Many insurance plans cover mammograms. In the interest of your health, don’t delay. Scheduling your mammogram is easy online with MyChart. Together, we can make a difference in the fight against breast cancer. https://lnkd.in/g8umVfXz

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Check out Children's Hospital Los Angeles (CHLA)’s newest blog focusing on the Inspire Nurse Leaders leadership development plan. Learn more about the impact it has on these nurse leaders!!

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Honored to share the results of Joslin Insight's work creating a positive work environment at Los Angeles General Medical Center with Nancy Blake, Daryl Joslin, and Ria Sangalang. Thank you to the entire team and LA General's wonderful directors of nursing and nurse managers. Our recent #NurseLeader article, “Enhancing Nurse Satisfaction and Retention Through Real-Time Feedback: A Case Study at Los Angeles General Medical Center,” highlights how real-time, anonymous feedback can drive cultural change and improve nurse engagement. The print version will appear in the October edition of Nurse Leader. Our IRB-approved study reveals that LA General saw a 9% reduction in nurse turnover and improved clinical outcomes. I want to commend Nancy Blake for the work she is doing. While multiple factors contributed to this success, I’m humbled that a key factor was the Joslin Insight App, which provided leadership with the feedback needed for informed decision-making. Changing culture isn’t easy, especially in health systems, where the focus can often shift toward compliance rather than genuine engagement. However, our national studies show that truly listening to nurses and addressing their needs is not only a simple and vital solution but also a fundamentally human one. The ANA Workplace Survey, which we helped conduct, revealed that 11,442 nurses ranked this among the top three for improving work satisfaction, alongside increasing pay and staffing. If you’re a leader looking to create a healthier work environment, this article offers tips on how real-time communication tools like the Joslin Insight App can make a difference. In your experience, how has a genuine engagement approach led to meaningful change and benefited patient care? https://lnkd.in/eAHhAU2R #nurseleadership #nurseengagement #nursesatisfaction #workplaceculture #healthcareleadership

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Sharing below on the last day of #SuicidePreventionAwarenessMonth

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