Michelle Shiffman

I'm so proud to lead leaders like Eric Nguyen here at Carbon Health. While he's early on his leadership path, he's quickly mastered many of the basics: 1. Exceptionally capable, yet humble. Eric delivers results, yet is more eager to praise others than to take credit for himself. He doesn't hide problems, and never brings one without presenting two possible solutions. He then tosses his earned laurels aside to tackle whatever's next. 2. Expert tight-rope walker at fostering relationships in the workplace. He truly cares about his people and the company simultaneously. He builds camaraderie and culture without needlessly pandering to individual whims or sacrificing accountability. That strong dyad partnership is no accident! 3. Master of processes and procedures, and isn't afraid to "teach up." Eric taught me (a physician with very nearly 20 years of experience) much of what it takes to get through my clinic days at Carbon Health with ease. This isn't just by chance! He's continuously honed those processes through repeated trial and error. His clinician onboarding process is now spreading across the organization, and we're better for it. Which of these skills resonate most for those of you who lead early career leaders? Which made the biggest difference at the beginning of your own leadership journey?

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As policymakers push for more home and community based services as preferable to residential long term care, it is critical to remember that appropriate, accessible housing, transportation and socialization are the underpinning to hcbs being a successful strategy.

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This is an important study. And what’s happened here is not limited to Massachusetts—it’s happening in many other places as well. Nearly half of all pediatric emergency departments where the child was kept overnight in the emergency department for 3+days while awaiting inpatient psychiatric care did NOT result in admission to inpatient psychiatric care. Transgender and non-binary youth were less likely to be admitted than cisgender counterparts but were boarded in emergency departments longer. Black youth were also less likely to be admitted. Is it possible not all of these kids needed inpatient care? Sure. But I think those of us that work in mental health know there are other things at play here. ——Emergency department boarding is the default ——disparities in care and lack of equitable treatment ——lack of psych providers ——lack of appropriate inpatient care beds for young people, which is more true for specialized care-such as that for eating disorders. It may shock the world to know that emergency departments are not equipped to provide mental health care beyond basic triage and safety. This is important when the person cannot be kept safe in any other way, but let’s not assume that mental health treatment is occuring in emergency departments. Because it’s not. We as a society must do better in psych care delivery for our kids. Perhaps we start by addressing inequities in care, expanding access to psych care (including expanding Medicaid coverage) and fully implementing mental health parity. #mentalhealth #eatingdisorders #suicideprevention

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This flew under the radar a bit but is noteworthy on several fronts: 1.State medicaid programs like Medi-Cal are notorious for running in the red - and reimbursing providers poorly. Prima facie, the intentions are good; but so are most of the roads to hell. 2.These funds came from a tax on health plans, and has been accumulating for some time. The state is also able to raise matching federal funds doubling the moneys available. They apparently have license to use as they see fit. 3. I am astounded that it's legal to use this money as a slush fund to offset the state budget deficit; but I've seen stranger things. 4.The CA state budget for Medi-Cal is over $150B and accounts for around 20% of the state's General Fund spending. (For comparison, the entire projected General Fund was $90B barely 20 years ago.). The state keeps expanding the parameter of services and constituents eligible for Medi-Cal; but the money is just not there. 5. Levying a tax on health plans in the name of addressing health equity disparities, only to divert the money to offset state budget deficits seems like a bad bait and switch. Ge Bai Marty Makary M.D., M.P.H. Anthony DiGiorgio, DO, MHA Adam J. Bruggeman, MD, MHA, FAAOS, FAOA

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In reflecting on PX Week 2024 and in my role supporting the patient experience, finding new education and little nuggets of learning is always important. The Beryl Institute has a great podcast called "To Care is Human". This one is a good one if you have 30 mins to give it a listen. My takeaway nugget: when discussing what patients really need from their healthcare experience, they discussed that all feedback could be divided into 3 buckets; connect with me, listen to me, partner with me. Connect, Listen, Partner....this whole patient experience thing might not be rocket science after all :) https://lnkd.in/gPw2zijw

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H@H is here to stay - here are the top 8 programs nationally: This model of care will only be catalyzed with #AI & #RPM and has been proven to lower costs, while improving care and actually lowering burnout....(until the EMR showed up...common sticking point)

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I had the pleasure of joining Rob Schenk on his podcast to discuss my research on providing more person-centered care to older adults with cognitive disorders. Check out the podcast to learn about non-drug interventions for dementia and how we can "break the cycle" of reflexive psychotropic use and over-medication. #personcenteredcare #aging #dementia #nonpharmacologicalinterventions

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Loving these two examples of how Sanford Health and Perinatal Associates of NM are leveraging technology to reach high-risk pregnant patients who may live hours away from their closest obstetric provider: 🌟 Beautifully told CNN feature video (4 min) of how Sanford Health of Northern Minnesota upscaled doctor's offices with telemedicine equipment and got patients their own blood pressure cuff and heart rate monitor so they could do virtual prenatal visits from home: https://lnkd.in/db8w8W4A 🌟 A new article from Healthcare Innovation profiling how Dr. Michael Ruma uses teleultrasound to care for patients all across New Mexico. Without teleultrasound, those same patients might have to drive four hours to see a maternal-fetal medicine specialist. The sooner patients can be seen, the sooner preventive measures can be taken and preparations made for a safe delivery. https://lnkd.in/d7YmhkwK

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Grief and loss are a personal and sometimes confusing experience. Most people are familiar with the 5-stages of grief as described by Elizabeth Kübler-Ross, but did you know this has since evolved to 7-stages? The 7-stage model is widely accepted as more inclusive and accurate to what people experience. Physicians devote their careers to improving and preserving their patients’ health and longevity. But along with the success and fulfillment physicians often derive from practicing medicine, grief and loss permeate the profession as well. In the traditional culture of medicine, the latter emotions are not just undiscussed, but also poorly understood. Join us for this webinar where we analyze how grief may affect physicians both mentally and physically and identify resources and coping strategies to utilize while processing grief.

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Really great read on maternity care closures. Discusses the influence of the RUC in determining reimbursement rates--something I think isn't talked about enough when thinking of ways to improve maternal health equity. https://lnkd.in/gTqqD4yC

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The STOP Obesity Alliance analyzed the state Medicaid coverage data for plan year 2023, with both the Medicaid Fee for Service and top Medicaid Managed Care plans for each state were analyzed. The review included the categories of comprehensive obesity care: nutrition counseling, intensive behavioral therapy, obesity medications, and metabolic and bariatric surgery. Overall, obesity treatment coverage was not covered in fourteen states, twenty-nine states had restrictive coverage, eight states had limited coverage, and no single state covered obesity care. In more detail, twenty-two states did not provide coverage for nutritional counseling, one state failed to provide any coverage for intensive behavioral therapy, obesity medications were not covered in thirty-two states, and only two states did not provide coverage for metabolic and bariatric surgery. Across all evidence-based obesity treatments, no state provided coverage for comprehensive obesity care, with all states applying various levels of exclusions, limitations, or restrictions for the coverage of obesity treatments. https://lnkd.in/eMwjSUMV

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I’m pleased to share @Elevance Health’s Advancing Health Together Report, an annual summary highlighting how we partner to improve whole health for the people and communities we are privileged to serve. Highlighted in this report are areas where we are focused in improving musculoskeletal (MSK) conditions and whole health outcomes, including: 1️⃣ Partnerships with providers and strengthened provider networks to help improve whole health for patients with MSK conditions. 2️⃣ Prioritizing wellness and early education to prevent disease, in part by providing coordinated care through optimal navigation tools, evidence-based programs, and a suite of pain management, rehabilitative offerings through Carelon’s Back & Joint Pain Program if more intensive treatment is required. Read more and share: https://lnkd.in/eDT-ycWq

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For seriously ill patients, palliative care before hospice can make huge improvements in quality of life. The issue: fewer than half of eligible patients receive palliative care referrals. In our new study, my co-authors and I found that using hospice to provide upstream palliative care can increase access, improve outcomes, and ease the transition to hospice. Read the study in the Journal of Palliative Medicine (linked in the comments below). #HealthcareonLinkedIn #palliativecare #hospice #endoflifecare Tamar Klaiman, Ravi B. Parikh, Caleb Hearn, MPH, PMP, Amaya Diana, William Ferrell, Amol S Navathe 

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TIDBIT TUESDAY! PROACTIVE VS REACTIVE By Shelene Giles, FIG Education, Inc. CEO Author, Teacher Excerpt Goals of Life Care Plan Let’s recall that goal of a Life Care Plan is designed to restore the client and family as closely as possible to a level of functioning before the accident. We must address the quality of life, restore independent functioning and lifestyle. Prevention is important in the management of secondary diagnoses and complications. A Life Care Plan's goal is to promote and maintain good health, safety, wellbeing, and quality of life while minimizing complications. A Life Care Plan should be proactive rather than reactive. Being proactive includes providing quality care, reducing overlap, anticipating gaps in care, and planning for age-related changes and needs. Proactively planning includes the prevention of complications by anticipating and providing for evaluations and necessary equipment. Being proactive provides a much better quality of life for an individual compared to reacting once a complication has occurred. A Proactive approach to Life Care Planning provides appropriate recommendations that may reduce hospitalizations, reduce the need for additional home care, and reduce further disability. The Life Care Planner must understand the points made in the records, the assessment and the medical evaluations, and how they correspond with the Life Care Plan's recommendations. The Life Care Planner should assume the interventions outlined and the quality of care that is expected will result in a successful or good outcome. #nurses #ot #pt #crc #doctors #casemanagement #legalnurseconsultant

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Have you ever wondered about the power of in-home health visits, like the ones that clinicians from Signify Health conduct everyday? Take a look at the numbers to see just how we're driving better health outcomes for our members. 👇 ⏲️ In-home health evaluation can last up to an hour — providing our clinicians with dedicated time to answer questions that plan members may have been too shy to ask at the doctor's office. 🖌️ Clinicians collect up to 300 data points per visit, helping to paint a fuller picture of patient health and create a stronger care ecosystem for them. ☎️ 77% of our members answer the phone after meeting with a Signify clinician, strengthening member engagement for ongoing care needs. ➡️ Clinicians made 260,000 health plan care management referrals in 2023, further strengthening the #PersonalizedCare connections that help improve health outcomes. #TeamCVS

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You’re invited! Join us if you want to hear an incredible line up of speakers talk about: The Price of Power. Did you know that the 32BJ Health Fund, which administers health benefits to 32BJ building services union members and their families, pays one-third of our total healthcare spend to just 5 NYC hospitals? The data is clear: the reason for high healthcare spend is excessively high and rising hospital prices, especially in consolidated markets. These prices threaten healthcare affordability for union members and all of us. Please join us at our 3rd annual conference to learn how policymakers and purchasers are taking control of their benefit costs in a market where hospitals have outsized power and influence. Register here: bit.ly/ThePriceofPower. This event is free and open to the public.

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https://lnkd.in/gEAnPgvc Our USC Street Medicine program helped lead the charge for a new CMS Point of Service code 27- acknowledging the street as a legitimate place to receive care. This allows us to flip our usual model of care and “go to the people.” Learn more below and help us get the word out about POS Code 27!

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