Martha Lawrence’s Post

The 2025 proposed CMS rule has some exciting news for #digitaltherapeutic devices. The proposed rule represents a significant advancement in expanding access to behavioral health services and DANA Brain Vital stands ready to play a pivotal role in this new era by providing objective outcome measurements on the efficacy of therapeutic interventions on cognitive function. Our advanced capabilities ensure that digital therapeutic companies can confidently demonstrate the impact of their products, thus meeting CMS requirements and optimizing patient care. DANA seamlessly integrates into existing application platforms, eliminating the need for it to be used as a separate application. This streamlined integration simplifies the process for digital therapeutic companies and enhances the overall user experience.  Moreover, DANA offers additional revenue opportunities for digital therapeutic clients by enabling them to leverage existing billing codes for therapeutic monitoring. https://lnkd.in/g2WT-22e

Across the five specialties examined, only 6% of physicians were in private equity-affiliated private practices in 2022, per new AIMPA and Avalere study. That's compared to 37% who were affiliated with corporate entities, and 45% affiliated with hospitals. Read the report here: https://lnkd.in/ewFweH52

Discover the key clinical factors that impact PDGM success in a recent Axxess blog post. From patient comorbidities to therapy utilization, we break down the essential considerations for thriving under PDGM. Check it out now for valuable insights and tips for operational success: https://lnkd.in/gDmqedp4 #homehealthcare #PDGM

Physicians in unaffiliated private practice are increasingly switching to hospital or corporate affiliation. That's associated with considerably higher #Medicare expenditures, according to new AIMPA and Avalere report. Across five specialties, researchers found that Medicare expenditures for beneficiaries in private physician practices affiliated with private equity were on average 9.8% lower than for similar patients in hospital-affiliated practices in 2022. Get the facts here: https://lnkd.in/ewFweH52

Value-based care (VBC) differs significantly from fee-for-service (FFS) in terms of compensation. In VBC, providers' compensation is directly tied to performance outcomes, instead of the consistent FFS model. Given the unpredictable nature of medical outcomes, adapting VBC as a viable model for more chronic treatment specialties such as oncology and pain medicine is still a work in progress. Currently, only a small number of payers are involved in VBC, but growing interest is attracting the attention of major payers like Medicare. While primary care shows more interest in VBC, specialties with standardized and time-bound interventions such as orthopedics and nephrology have gained traction. Although VBC offers numerous benefits and cost savings to patients, transitioning to VBC is concerning due to the high associated risks. Currently, the lack of proper administrative infrastructure to switch to VBC poses the biggest obstacle, rather than a lack of buy-in from primary care providers. In summary, VBC models continue to attract interest due to the large amount of capital spent on healthcare annually. While VBC models have gained traction in primary care, they have yet to significantly impact specialty practices. It is crucial to find a way to transition to VBC without compromising providers' compensation pathways. This challenge cannot be underestimated! #healthcare #medicine #patientcare Bain & Company: "Value-Based Care: Opportunities Expanded" 📸 by: ETKHO

Early intervention not only saves lives but also reduces the cost of care. Explore how predictive tools are reshaping individualized care for CKD and ESRD patients. Read the full article here. #dialysis #dialysisclinic #aihealthcare #valuebasedcare

The patient journey in renal care is not a linear path; it's a complex experience shaped by medical, emotional, social, and existential factors. Renal patients often navigate a series of life-altering milestones: diagnosis, adaptation to treatment like dialysis or transplantation, and frequent reassessment of life quality and end-of-life care. At each point, patients must confront the multifaceted nature of their illness, often facing fears around mortality, dependency, lifestyle limitations, and self-identity. This journey often raises profound existential questions: What does this disease mean for my life? How will this affect my relationships, purpose, and autonomy? These questions reach beyond clinical care and point to the critical role of existential advocacy in renal care—a role that ensures patients are not passive recipients of care but active participants in shaping their experience, values, and priorities. The frameworks discussed here, combined with practical integration strategies at both corporate and clinical levels, are essential for providing holistic, meaningful support throughout the patient's experience. Frameworks for Supporting Patients: Applying Existential Advocacy to Practice To effectively support patients in their journey through renal care, healthcare professionals and advocates can utilize frameworks that guide the core tenets of existential advocacy. These frameworks provide actionable steps for fostering patient empowerment, enhancing emotional support, and ensuring ethical care that respects each individual's unique journey. Below are several frameworks designed to bring existential advocacy to life: SPEAK Framework for Patient Engagement S – Share Information Transparently P – Promote Active Participation E – Encourage Emotional Expression A – Acknowledge Diverse Experiences K – Keep Consistent Communication The SPEAK framework emphasizes patient engagement throughout the continuum of renal care, recognizing that are more patients than their diagnoses; they are individuals with their own values, goals, and lived experiences. Sharing information transparently allows patients to understand their health status, treatment options, and potential outcomes, which is vital in renal care where decisions often have significant lifestyle implications. Continue to follow the MOSAIC Exsitential Advocacy Program for trainng that is not superficial like the NKF or NxStage, We deepe than surface level advocacy. These organizations take the easy way out. #MosicAdvocacyTraininig #VoiceoftheVoiceless. #ESRD #Dialysis

In my latest blog publication with Katie O'Neill and John Golembesky, we explored explore how Value-based care can promote physician satisfaction and physician wellness by streamlining clinical pathways to simplify physician decision-making, improving chronic disease management programs by enhancing patient communications and employing non-physician providers to support proactive patient care strategies; and transition appropriate clinical and care management responsibilities from physicians to other members of the healthcare team, such as clinical pharmacists and case managers. Let us know your thoughts! Sheppard Mullin Richter & Hampton LLP

“It is not just about the numbers. Whether opening a facility or adding a service, we pay strict attention to ensuring we deliver quality, evidence-based care in a safe environment with expertly trained staff.” Read more from Stephanie Eken, Chief Medical Officer, and Navdeep Kang, PsyD, Chief Quality Officer, Inpatient Services, about the clinical priorities that are in place that will allow Acadia Healthcare to continue to set the standard for patient care. #QualityCare #Healthcare #Commitment.

RISE WEST Colorado Spring Are you a healthcare provider—PCP, specialist, practice manager, ACO, or part of an HMO—and think that risk adjustment coding doesn’t impact you? It’s time to reconsider. What are HCCs or Risk-Adjusting Conditions? They include chronic, lifelong conditions, along with acute and sub-acute conditions that require higher resource utilization. Seasoned risk adjustment coders are experts in documentation. 𝐂𝐨𝐧𝐬𝐢𝐝𝐞𝐫 𝐭𝐡𝐞𝐬𝐞 𝐞𝐱𝐚𝐦𝐩𝐥𝐞𝐬: #1 A breast cancer diagnosis in the assessment without much supporting documentation of ongoing management and mastectomy in surgical history. #2 A hip fracture initial visit code in a post-discharge outpatient record without proper follow-up care documentation. #3 A diabetes with peripheral neuropathy code in claims, but no documented management of neuropathy. Whether you’re in an ACO aiming for shared savings or an HMO where star ratings depend on chronic disease management, documentation supporting Quality Measures is essential. Be it fee-for-service, Value-Based Care or MIPS incentives, accurate coding with strong supporting documentation is crucial. At Annova, we deliver value where it matters most—during healthcare delivery. Our Concurrent coding experts: 1. Identify Missed coding opportunities 2. Maximize ICD Specificity 3. Highlight high-risk coding practices 4. Suggest corrective actions pre-claims or improvements in future visits 𝐉𝐨𝐢𝐧 𝐮𝐬 𝐚𝐭 𝐁𝐨𝐨𝐭𝐡 𝟏𝟐𝟕 at the RISE WEST conference to learn how we can help optimize your organization’s coding accuracy and documentation quality. #Healthcare #RiskAdjustment #HCCCoding #ACOs #ValueBasedCare #AnnovaSolutions #MedicareAdvantage #ACA #ConcurrentCoding #CDI