Robbie Allen

Healthcare has entered a new era, and today’s decisions will reverberate for years. In a new infographic, #ECGMC’s Andy Bachrodt and David Willis identify the key trends that will define the US healthcare provider market over the next decade. #infographic #healthsystemstrategy

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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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Transaction planning is critically important. But even before that, how do you know if a transaction makes sense? My partner Andrew Bachrodt helps unpack what C-Suite leaders need to consider, and WHEN.

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As revenues recover, it's clear that many hospitals are still grappling with rising costs. However, the hospitals that stand out are those embracing technology to drive efficiency and operational improvements, significantly reducing staff burnout. 🌟 Healthcare professionals entered this great profession to care for patients, not to be bogged down with manual tasks. That's why leading hospital systems are implementing comprehensive applications to enhance people, processes, and automation. This approach ensures cost-effective, top-of-license performance, ultimately benefiting both staff and patients. 💼❤️💡🔧 #GetReady #HealthcareInnovation #TechInHealthcare #OperationalExcellence #PatientCare

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Good summary by Noah Tong from Fierce Healthcare on the recent NAACOS spring meeting. At the event, four specific areas of focus were highlighted, including monitoring of DME fraud, a new best practices playbook, an expected pause in legislation passage this year, and SNF partnerships. ACOs are shifting to eCQM, with pilot testing for digital quality measures mentioned. MRO just posted a valuable blog on this topic for ACOs making the change. Check it out! #accountablecare #ACO #MIPS #valuebasedcare #healthcarequalityreporting Noah Tong Fierce Healthcare

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The most recent Kaufman Hall report reveals a concerning trend in the healthcare industry. Over 40% of US hospitals are operating at a financial loss, emphasizing the widening gap between high and low-performing hospitals. The report underscores the urgent need for strategic improvements. Key insights highlight that top-performing hospitals have embraced proactive technologies, leading to enhanced workflows and a larger patient footprint. In contrast, lower-performing hospitals struggle with misalignment among people, processes, and technology, hindering efficiency and overall performance. Recognizing these challenges, ReadySet Surgical focuses on alignment optimization by streamlining processes, leveraging technology, and enhancing teamwork synchronization. These efforts aim to boost hospital performance and enhance patient outcomes. Addressing the gap between people, processes, and technology is vital for a sustainable and efficient healthcare system. Applications like those by ReadySet Surgical are crucial in driving positive change in hospital performance and patient outcomes. #GetReady #Healthcare #HospitalPerformance #AlignmentOptimization #PatientOutcomes

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We have struggled to integrate digital advancements into a seamless patient experience. To optimize the patient journey, virtual visits/tools and in-person offerings must work in an integrated fashion across the full spectrum of patient needs. Learn about the 4 key principles here and add your comments.

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On the latest Vital Signs, Nikhil Krishnan and I sat down with Parth Mehrotra, CEO of Privia Health. Privia is a physician enablement platform and >$2B public company partnering with 4500+ providers on practice improvement and value-based care. We talk about the most important ways to manage risk, building effective physician enablement solutions, the future of value-based care programs & contracts, and more. Some highlights: 🏥 Capabilities practices need to participate in risk-based contracts Parth highlights 3 sets of capabilities:  1. Diversification of risk. This can range from pooling the risk with other providers to hedging risk across multiple programs.  2. Audit, compliance, controls and documentation 3. A tech stack and data that allows the provider to understand their patient population and care for them throughout the entire care workflow (e.g., identifying the patient’s relevant conditions, closing care gaps, caring for the patient after the visit). 🏥 The types of providers partnering with Privia Parth explains that physicians have 4 general settings in which to practice medicine: 1. Being employed by a hospital or a clinic. 2. Starting their own practice or joining another independent practice. 3. An independent practice that partners with another entity to help with business operations. 4. Selling the practice and having the new owner transform it. He notes that practices that join Privia are self-selecting: these physicians want to stay independent but need another player to help throughout the entirety of the practice. 🏥 How physician enablement companies influence practices Parth is a strong believer that physician enablement companies don’t need to buy practices in order to influence outcomes. Rather, companies can achieve better outcomes by giving physicians more autonomy. Improved performance is driven by the combination of 1) giving physicians the tools to manage everything outside of direct patient care and 2) maintaining incentives for physicians to want the practice to succeed. A must-listen for anyone looking to understand the physician enablement landscape and how providers can take on risk. Check out the full episode below: Spotify: https://spoti.fi/3Ulb7FL Apple: https://apple.co/4dQwS7i

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Congratulations Acuity Behavioral Health, clinically validated, peer-reviewed, live and in action, producing real results for real health systems. Scott GoodMichael W. Boyce, Ph.D. Mark Sevilla, DNP, RN, CENP Leigh Evans Jim Szyperski Tom Danner Elaine Forte https://lnkd.in/eQby8t82 The quantity and acuity of U.S. residents experiencing mental health challenges has steadily increased over the past 20 years—accelerating since the COVID-19 pandemic (Goodwin et al., 2022). To exacerbate the issue, inpatient care facilities face dramatic staffing challenges, as many nurses have retired or resigned. A recent study (American Nurses Foundation, 2022) shows that insufficient staffing is the most common reason nurses leave the profession; nine of ten nurses indicate that the hospital where they work is understaffed. In addition, hospital expense growth—of which, labor costs are the biggest contributor—has increased at a rate more than twice the average reimbursement rate (American Hospital Association, 2023). Burgeoning mental health needs combined with critical capacity issues and health system cost structures drive the need to more efficiently deploy direct care staff in the mental health inpatient setting.

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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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Stay Strong UF Health and Others Refusing to Cave on Unreasonable Payer Terms... Please Don't Listen to Their Nonsense, Which Would Result in Contributing to Their Shareholder Value at the Expense of Patients So it goes n8 #healthinsurance #hosptials #physicians #valuebasedcare https://lnkd.in/gUP_AS8P

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Healthcare's siloed and often useless data comes from leaders failing to focus on what's measured ACROSS services and partners, including how data will be used to compare services and attribute both clinical and financial outcomes. Nerd alert! 🤓 This issue is oddly rarely discussed as per Andy's post, given those of us who understand how data is collected, analyzed, monitored, and used see this gap all the time. It's true for public health systems too (maybe more so). Lack of clarity around measuring collective impact is one of the main gaps Just Whole Care fills for clients, many of whom have no choice but to ask these questions because of limited funding and being treated as fringe CBO's (they're the 'partner' or 'grantee' health systems want, though not as a their measured driver of impact, no. That's to be saved for the health system's value-based contracting credit.). This issue also keeps the State of California and its Medi-Cal managed care plans from true population health management, which we know we're pumping hundreds of millions into through CalAIM. Today the term "data governance" largely focuses on policies and procedures for WHO CAN ACCESS data, HOW and WHEN, as well as how data will be managed technologically.  The WHY and WHO ELSE are barely discussions, short of what payers and funders demand (see California's field-leading Data Exchange Framework: https://dxf.chhs.ca.gov/). Reasons being, the main goal of today's data governance is to ensure the 'right' people get the 'right' data at the 'right' time for the 'right' reasons. It's basically about a single clinician's use to not screw up + CYA for HIPAA and other laws. Not about patients or collaboration. Reactivity and greed over planning and sharing...BORING! As noted by Effie Andrikopoulou, MD MBA FACC FASE, investments in digital health solutions are failing for this very lack of data governance that addresses WHO IS RESPONSIBLE AND ACCOUNTABLE for selecting metrics, and monitoring them across service lines for the quality of collection (accuracy, volume, and impartiality of information), as well as their impact...not just the impact of each service, but also the impact of the measurement process on patient and workforce wellbeing (often more negative than executives accept). There's clearly no one responsible and accountable to address Graham Walker, MD's concern that digital health vendors may be piling the burden of proving their value proposition onto clinical staff -- a big no no. A lot seems pretty in labs and VC meetings, but in the real world, if staff feel put upon by greed and a lack of evidence, they'll silently revolt. In the end, it's all another version of healthcare's myopic, binary thinking: it's either my measure or yours, it can't be both. Digital's just good until proven bad. Either no one's accountable or everyone is...huh? Health drivers aren't binary. Let's stop acting like our data should be. #digitaltransformation #datascience

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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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A great publication by the American Hospital Association on the “cost of caring”, looking at the cost pressures and macro drivers in healthcare. In 2023, data shows that hospitals and health systems faced substantial challenges due to higher labor, drugs, and supplies costs. At the same time, reimbursements from Medicare and Medicaid did not keep pace with these mounting costs, and hospitals and health systems increasingly encountered challenges navigating the disastrous business practices of commercial insurer who are increasingly denying payments and delaying access to patient care. Here are a few highlights from the report: 💰 Since the start of 2022, the number of days cash on hand for hospitals and health systems has declined by 28.3% 🏥 In 2022, the most recent year for which data are available, hospitals admitted nearly 137 million patients in emergency departments and delivered over 3.5 million babies. 📈 Medicare and Medicaid underpayments totaled nearly $130 billion in 2022, and Medicare paid just 82 cents for every dollar hospitals spent caring for patients, resulting in a shortfall of almost $100 billion. 🙅‍♂️ Additionally, a 2023 study by Premier found that hospitals spend just under $20 billion annually appealing denials. ✍ Resignations per month among healthcare workers grew 50% between 2020 and 2023, according to data from McKinsey. 😮 Due to Medicaid determinations, more than 19 million enrollees have been disenrolled. Though partially offset by record Marketplace enrollment and possible enrollment in employer-sponsored coverage, this has still resulted in a steady increase in uncompensated care costs throughout 2023 and will likely continue into 2024 – particularly for states that have not expanded Medicaid. While recent data suggest that some hospital and health system finances have modestly stabilized from historic lows in '22, the hospital field is still far from where it needs to be to meet the demand for care. Link in comments and credit to American Hospital Association.

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We are receiving a lot of great feedback on the new "Pediatrics by PRG" module in the Pinson & Tang CDI Pocket Guide, which is the preeminent resource in the CDI space. If you haven't checked it out yet, take a look at the detailed review of over 40 topics that provide guidance to CDI specialists, coders, & clinicians on pediatric and neonatal conditions. This partnership is a key element of how Pediatric Resource Group (PRG) can help hospitals understand the CDI opportunity in the peds/neonatal space and tackle it confidently. If there are other topics you'd like to see, let us know, we can develop and publish those quickly. #CDI #pediatrics #Clinicaldocumentation

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Looking for a quick recap of the healthcare trends from Q3 2024? Check out our Q3 2024 Healthcare Quarter in Review! Once a quarter we deliver healthcare trends, risks, opportunities, and regulatory updates directly to your inbox. Sign up if you haven’t already: https://lnkd.in/g6xNtMwC

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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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Our latest newsletter shares insights from our joint report with the New York Stock Exchange and dives into healthcare's cyberattack fallout, boosting modern marketing, and more. #NYSE #healthcare #marketing

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