Taylor Curtis

The Association of Healthcare Value Analysis Professionals (AHVAP) is excited to invite dynamic and insightful speakers to share their expertise at the 2025 AHVAP Annual Conference and Industry Partner Expo, which will be hosted next October in beautiful Grapevine, Texas at the Gaylord Texan Resort. This premier event, dedicated to advancing the field of healthcare value analysis, will bring together professionals, thought leaders, and industry innovators to explore the latest trends, challenges, and best practices in value analysis. With an expected attendance of 500+ professionals from across North America, this is the industry's premier professional gathering for the healthcare value analysis specialty. We are excited to officially open our call for speakers, which will close at midnight ET on December 31, 2024.    We are seeking speakers who are passionate about transforming healthcare through value-driven strategies, improving patient outcomes, and fostering cross-functional collaboration. Whether you are a seasoned value analysis professional, clinician, supply chain expert, or industry partner, this is your opportunity to contribute to the conversation and inspire a community of like-minded professionals.   The 2025 conference theme, focuses on Catalysts for a Resilient Future: Driving Healthcare Value Through Strategic Innovation, and we welcome proposals that align with this vision. This theme focuses on the pivotal role of value analysis professionals, healthcare professionals, and industry partners in shaping the strategic and resilient future of healthcare through leading practices and enterprise initiatives. It showcases how proactive decision-making, industry partnerships, and innovative solutions contribute to optimized patient outcomes, continuous quality improvement, and effective fiscal responsibility in a dynamic healthcare environment. Join us in shaping the future of healthcare value analysis by sharing your unique insights, case studies, and innovative solutions with an engaged audience of professionals dedicated to creating impactful change.   Please note that all submissions are limited to two (2) speakers. Selected speakers will receive complimentary full conference registration, but are responsible for other costs for conference attendance. Sessions may be selected for thirty (30) or sixty (60) minute blocks based on scheduling needs for the event.    To submit your presentation for consideration: https://lnkd.in/e7tTjzed. #AHVAP2025 #AHVAP #valuebasedcare #valueanalysis #professionaldevelopment #valueanalysis

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I recently returned from HLTH USA annual conference hearing the excitement of potential more action (not talk) by investors, hospitals and emerging start ups as we head into 2025. The nearly frozen venture and IPO markets are thawing and with the election soon behind us should bring more comfort to a stable outlook. Healthcare revenue cycle remains a very attractive investment to private equity however limited deals in the lower middle market are resulting in any quality business assets selling at high valuations. We are busy helping business owners on financing while their sale is delayed until next year. Let’s discuss strategic options on debt or equity with you today. #healthcareinnovation #dealmaking #HCIT #revenuecycle #RCM

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Check out the press release to learn more.

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Here’s your recap of last week’s health IT news 🗞️ 👇 🖊️ AI Ambient Scribes • CHRISTUS Health + Abridge: The 15,000 provider Texas health system adopted the ambient scribe enterprise-wide.    • Tampa General Hospital + Nuance Communications DAX Copilot: Over 500 providers at the health system will begin utilizing the AI ambient scribe.    • Texas Oncology + DeepScribe: The statewide oncology practice adopted the AI ambient medical scribe. (ed. note: scribes continue to be hot!) ☎️ AI Contact Center • Clearstep: The AI conversational chat vendor launched a new feature allowing patients to self-schedule specialist visits. 📊 Data & Analytics • InterSystems + CLEAR: The cloud-based patient data service is integrating the identity technology to expedite access to patient records.    • WakeMed + Bamboo Health: The health system is adopting the data interoperability and encounter notification service. 🥼 Clinical Decision Support • University Hospitals + Aidoc: The Cleveland-based health system is implementing the AI clinical decision support platform across 13 of its hospitals and additional outpatient locations. 🧑‍💻 Virtual and At-Home Care • University of South Carolina School of Medicine + Rimidi: The hospital group and an affiliated multispecialty clinic are adopting the remote patient monitoring platform to reduce complications from postpartum hypertension.    • Mount Sinai Health System + HealthSnap: The medical center announced a new remote patient monitoring and chronic care management program in partnership with the virtual care management platform.    • Wheel: The telehealth company released a new AI-driven virtual care platform designed to enhance the patient experience and offer resources to help partners scale their virtual care services. 💬 Patient Engagement • CipherHealth: The patient engagement solution focused on patient rounding released a new AI summary tool.    • DexCare: The care orchestration platform completed a $75M series C funding round 🩼 Durable Medical Equipment • Better Health: The medical device and peer support network completed a $14M funding round. 🧠 Food for Thought: • Silicon Valley Bank released an interesting report on the state of investment in AI in healthcare, including stats on AI usage at healthcare organizations and the impact of leveraging AI on startup valuation. https://lnkd.in/em7AfivT    • The journal Critical Care Medicine published an editorial on an “in clinico” evaluation of a machine learning-based early warning system to predict in-hospital deterioration. We found it to be an interesting look at the actual impact of a model’s deployment on care processes and patient outcomes in a critical care setting. https://lnkd.in/eQhZbVKu

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According to recent research Harris Williams conducted in partnership with Sage Growth Partners, healthcare leaders say that workforce shortages, an overall decline in the financial climate, and operational process challenges are all contributing to the worsening of revenue cycles. This latest article discusses key findings from the study, including the current state of revenue cycle management, factors negatively impacting hospital and health system revenue cycles, where organizations are planning to invest to improve their revenue cycles, and what M&A investors should consider as they seek opportunities in the space.

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A thoughtful review from Fierce Healthcare on the shutdown of telehealth by both Wal-Mart and Optum. My two takeaways: 1. A commodity service will inevitably receive a commodity price. 2. Patients desire a complete solution for their healthcare journey, meeting them with the desired care at the desired time (and in a payment method that they desire). Digital health should continue to be a core delivery method for care, bridging patients between physical appointments and solving for less acute needs (and delivering at a much more cost effective price). https://lnkd.in/gzhMZhXt

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Drex DeFord Advises Simplifying Healthcare for Vendor Risk Reduction: https://lnkd.in/dDvhYsDF First Health Strategic Advisory Board Member & Healthcare Strategist Drex DeFord dives into pressing concerns around the increasingly complex, difficult to manage, and frequently targeted healthcare environment. Drex’s conversations with This Week Health fuel meaningful conversations to spur the change necessary for improving health sector resilience. We’re proud to have such a dedicated member of the healthcare cybersecurity space advising our leaders and ensuring First Health is at the forefront of digital health security innovation. For more insight into First Health’s leadership and board members, visit https://lnkd.in/gQUx5BzD or contact First Health at [email protected]. #CISO #CIO #CTO #CDO #Compliance #HIPAA #HealthcareIT #HealthcareSecurity #CyberRisk #ThirdPartyRisk #RiskAssessment #Cybersecurity #HTM #DigitalHealth #PatientSafety

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Surescripts finally found a buyer! TPG (formerly Texas Pacific Group) is a (big) PE firm - ranked third in the PEI 300 ranking of the largest private equity firms in the world. As noted in the press release, the transaction is subject to customary regulatory approvals. There are a lot of reasons to potentially block acquisitions: reduced competition (not a problem here given we're at n=1 of e-prescribing networks), concentration in market power (i.e. they own other similar products), national security concerns (i.e. foreign ownership),and many more. I don't expect any pushback here, but some possible parallels: - DOJ did try unsuccessfully to block the acquisition of Change Healthcare in 2022 with worries of reduced competition in health insurance markets and access to sensitive data. Doesn't have the same flavor here - TPG arguably increases competition by distancing Surescripts from current owners CVS Health and Express Scripts by Evernorth. - Visa attempted to acquire Plaid, but was blocked by the DOJ citing stifling of payments innovation. I'd be curious to see what any lawsuit has to say about Surescripts' innovation that would be further stifled by this. -  TPG was blocked by Oregon's public regulator from buying Portland General Electric (woo Portland) from Enron (lol) in 2003. Slightly political in nature and PGE is a utility whereas Surescripts isn't yet viewed in that light. My guess is that any pushback would be akin to the FCC block the PE acquisition of television networks in Standard General - TEGNA. While attributed to market consolidation and labor market disruption, "resistance to M&A" and "PE/hedge fund bad" vibes contributed to the submarining of this deal. Could fuel something here too - people really don't like PE. A PE firm is the best possible path for Surescripts to avoid regulatory scrutiny as opposed to a payer. I am not sure it will change a lot in terms of Surescripts' day-to-day operations or culture, which by all reports is heavily corporate already. Sometimes you see a short term innovation and product innovation "bets" in the first 2-5 years after an investment, which would be cool, but usually you see a squeeze on headcount and other operational efficiencies. Curious for others' thoughts. PE market is newer to me and I don't know TPG's full portfolio quite yet. https://lnkd.in/geVJaqU8

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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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💡For those who like fresh perspectives... Lyric's Mike Spellman put together a terrific white paper, "Fostering a Future of Value: The Next Era of Successful Payment Integrity." In this engaging piece, Mike delves into the profound transformation underway in payment integrity. Traditionally anchored to increased medical savings, the lens is shifting in PI—from savings to unlocking more value for stakeholders and patients. New Perspectives: Savings (traditional) = The dollars not spent through reduction in medical cost utilizing pre-pay and recovered through Post Pay services and solutions to identify claims that should not be paid in full or should be paid a percentage of what was billed. Value (fresh & new) = The dollars not spent by improving the outcomes through members decisions for care and providers efficient delivery of care. Reduction in unnecessary services, stronger provider engagement to correct bad billing behaviors, and better pre-care coordination reducing higher downstream costs. This paper shines fresh light on traditional PI. Well worth reading for #healthplans and claim/payment integrity professionals. 🔗Read here: https://lnkd.in/gVfCXWb9

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Let's keep hospice focused first and foremost on the PATIENT. After all, we only get one chance to do it right... "There are six primary trends that are influencing consolidation and professional practices: regulatory complexity. technology and integration, private equity ownership. demographics, economies of scale and consumer expectations,” Henderson said. “So many of these things that we see that are influencing health care consolidation need to be pointing toward the patient." #patientsfirst #hospicecare #youonlygetoneshot https://lnkd.in/gbbgV-YF

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Healthcare Location Science at its finest! Pivotal Analytics delivers national and local market data for the healthcare sector, trusted by premier healthcare providers and partners across the US. Our insights, derived from over 65 data sources, go beyond spreadsheets, offering unparalleled market insights not readily available to healthcare planners. Whether you're a healthcare provider, payor, investor, consultant, real estate broker, or developer, Pivotal enables you to rapidly analyze any market, site, or portfolio, uncovering investment opportunities and supporting communities nationwide. Our SaaS subscription and reporting offerings streamline strategic business decisions, saving time and reducing risk in a competitive market. In the dynamic healthcare landscape, access to reliable and actionable insights is paramount. Pivotal Analytics leads the way, providing unbiased, comprehensive market insights empowering professionals at every level. Our commitment to in-depth analysis ensures informed decision-making for strategic planning, investments, and community initiatives, guiding you through the complexities of the healthcare market. Transform your market analysis approach with Pivotal Analytics and navigate the future of healthcare confidently. For a product demo or detailed information, reach out to Brian Michels, MBA. #HealthcareData #MarketInsights #StrategicPlanning #InvestmentOpportunities

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Walmart's decision to exit the challenging primary care arena by closing all its healthcare clinics marks a significant shift in the landscape of healthcare provision. This move underscores the complexities and difficulties of providing healthcare services within the retail sector. One key impact is the potential disruption in access to primary care for communities Walmart clinics serve. For many individuals, especially in underserved areas, these clinics represented a convenient and affordable option for basic healthcare services. The closure may leave a gap in healthcare accessibility, particularly for those without easy access to traditional medical facilities. This decision highlights the formidable challenges of integrating healthcare services into retail environments. While the concept held promise in terms of convenience and cost-effectiveness, the reality may have proven more challenging to sustain. The intricate web of regulatory hurdles, staffing issues, and the complex nature of healthcare delivery likely played a significant role in Walmart's decision, illustrating the uphill battle faced by retailers in this sector. It also raises questions about the role of large corporations in healthcare provision. While retailers like Walmart have the scale and resources to potentially revolutionize healthcare delivery, their success in doing so remains uncertain and requires careful consideration. The closure of Walmart's clinics may prompt other retailers to reassess their own healthcare strategies and approaches, underlining the need for a well-thought-out and sustainable healthcare model.

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If you are going to HFMA and want to understand more about Payer MRFs including what your competitors know about your rates, reach out to Pete Titas.

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The decision to outsource a function requires thought and due diligence. Listen to how we supported Core Clinical Partners in that journey and provided value beyond the day to day.

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Recent updates to Medicare Advantage Star Ratings highlight the growing importance of call center performance in shaping patient experiences and influencing reimbursement outcomes. This Healthcare Dive article dives into the implications of these changes, offering valuable insights for healthcare leaders striving to adapt to evolving standards.

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McKinsey & Company Report: The healthcare industry is anticipated to undergo significant shifts, with government segments expected to outgrow commercial segments by 65% by 2027. This shift, driven by rising Medicare Advantage penetration and growth in duals segments, will impact payer profit pools. Health systems are facing substantial pressure due to inflation and labor shortages, but transformation efforts and cost containment, particularly in labor, are expected to help EBITDA margins recover. Healthcare technology is also predicted to experience rapid growth, with an estimated 12% compound annual growth rate (CAGR) from 2022 to 2027. https://lnkd.in/g4MfPH99

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New Expectations The cost of healthcare collections continues to rise despite significant technological investments by providers and payers alike. Healthcare is the only industry where the payer and the provider have little understanding of how a transaction is priced as well as how rules are used to determine the price of an episode of care. A recent implementation of CALIBRATE demonstrated that over 16% of claims were mispriced from the provider's contract. Imagine any industry with a 16% error rate! Should we have new expectations of this decades old problem? We believe that we should reimagine the cost of collection between payers and providers with new metrics and expectations that truly define the life of a claim. - 99% of medical claims are priced according to the provider's contract terms. - Pricing variances are identified within three days of the payment posting process and resolved by the payer within ten days from payment receipt. - Pricing variances are resolved PRIOR to traditional claim appeals processes. - Payer Administrative guidelines are identified, codified, and priced into the provider contract. - Claim denials are resolved through specific provider workflows. - Claim appeals are reduced by 50%. By unlocking the historical "payer's black box", CALIBRATE creates new expectations for managed care and revenue cycle leadership to reach new levels of perfection for providers and payers alike.

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