Dena Bravata M.D., M.S.

The Great Reckoning in Medicare Advantage: Collaboration or Division? The landscape of Medicare Advantage is facing its biggest shift in two decades, according to McKinsey, which is presenting new challenges for payers and providers alike. As pressures mount, the vital question emerges: “How can health systems avoid getting the smallest slice of the remaining pie?” In a recent panel of payer and health system executives hosted by Strategy Catalyst, executives from both sectors discussed the future. The consensus? Those positioned to thrive in the impending Medicare Advantage "great reckoning" will be the innovators who foster collaborative efforts to optimize each other's cost structures. What might this entail? • Payers could seek to reduce their own cost-regulating denials and prior authorizations by trying to work collaboratively, focusing on efficient data sharing and solution-driven dialogues with providers. • Providers could streamline contracts to only work with those seeking mutual value, guided by well-defined principles for selecting partners and governing contract performance. Potential collaborative areas: • Jointly deciding on supplemental benefits that will be high impact of the population and promoting their utilization through the health system's medical group. • Establishing joint quality measures that would allow movement to prospective payment systems. • Exploring evidence-based care guidelines that could be agreed upon jointly to reduce administrative burdens, like unnecessary prior authorizations. Join the conversation and let us know your thoughts. For more detailed insights, ask for our two-pager on the future of Medicare Advantage.

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Come join Right Triangle’s Director of Healthcare Analytics & Integration, Cindy Lou Vogel at the 𝐑𝐞𝐠𝐢𝐨𝐧𝐚𝐥 𝐈𝐧𝐧𝐨𝐯𝐚𝐭𝐢𝐨𝐧 𝐅𝐨𝐫𝐮𝐦: 𝐀𝐫𝐭𝐢𝐟𝐢𝐜𝐢𝐚𝐥 𝐈𝐧𝐭𝐞𝐥𝐥𝐢𝐠𝐞𝐧𝐜𝐞 𝐚𝐧𝐝 𝐇𝐞𝐚𝐥𝐭𝐡 𝐚𝐧𝐝 𝐇𝐞𝐚𝐥𝐭𝐡 𝐂𝐚𝐫𝐞 - a panel discussion on the intersection of AI and health care with an eye toward public health. Event Overview: The use of artificial intelligence (AI) has increased dramatically over the past few years, through standalone tools like ChatGPT and built-in AI assistants in all of our familiar platforms like Zoom and Microsoft 365. There are significant opportunities and challenges with using AI in our work in public health and health care. Panelists will share knowledge, ideas, examples and ethical considerations when thinking about AI in the context of public health and health care with areas of expertise including ethical use of AI, training community health workers, managing a federally qualified health center (FQHC) and health care analytics and integration. This is not a roadmap to the implementation of AI in your health department or healthcare facility but instead an exploration of the use of AI for non-technical members of the health and health care world with a public sector consideration. Panelists include: - Lindsey Jarrett, PhD, Vice President, Ethical AI Services, Center for Practical Bioethics - Hannayd Ruiz, Community Health Project Manager, Mid-America Regional Council - Patrick Sallee, President and CEO, Vibrant Health - Cindy Lou Vogel, Director, Healthcare Analytics and Integration, Right Triangle Consulting Free Registration: https://lnkd.in/g3gvigWd #DataGovernance #AIGovernance #Healthcare

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Interesting read 📖 Head of US Commercial Operations, McCall Letterle, M.Ed. addresses the recent rulings in Georgia and the critical need for solutions like Telehealth and evidence-based technology to reduce barriers to ADHD care. 👉 https://ow.ly/1qro50Rr90p #Telehealth #virtualADHDcare #GeorgiaRuling

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Navigating healthcare is overwhelming. Providers with different kinds of expertise practice across multiple care settings. Insurance coverages offer varied benefits but opaque costs. Consumer preferences and context are too often ignored. Technologies designed to connect it all instead lack integration and alignment. Each represents puzzle pieces that must come together to complete even a single healthcare journey. How those pieces come together (or don’t) profoundly impacts patients. World-class surgery is wasted without access. Benefit designs are irrelevant if patients don’t understand them, can’t afford them and don’t use them. Stand-alone applications add complexity and confusion—isolating data in silos and fracturing what should be an informed and transparent care experience. Without a coordinating platform, we cannot fully contribute our expertise. Many of us have devoted our lives to improving the healthcare system—whether as clinicians, investors, administrators or technologists. Perhaps understandably, much of our focus is on the contours of our own puzzle piece instead of the overall picture. At times, we even compete with each other, denying access to data or workflows as a mechanism to grow our individual pieces. https://lnkd.in/gpxFG5Rf #healthcareaccess #healthcare #healthcareinnovations #healthcaretechnology #healthandwellness #healthandwellbeing #technology #innovation #healthcaretrends #patientcare #patientcentric #patients #hospitals #healthcareproviders #healthcareprofessionals #healthcaresystems

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This AEP is expected to be extremely disruptive to all Medicare patients. The Inflation Reduction Act and new CMS Final Rules have caused shockwaves across insurers. MAPD and PDPs are predicted to radically change benefits, premium, patient cost sharing, network participation, and some insurers will pull out of markets or specific counties. It is critical for every senior to assess their existing insurance this AEP and determine the impact on their cost, coverage, and access. You’ll help yourself and staff by referring patients to MedicareOnDemand before and during the AEP for an insurance assessment to ensure a smooth 2025 transition.

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Social determinants of health data can be immensely powerful, connecting payers and providers to the information they need to close gaps in care and improve health outcomes throughout communities. Without the right strategies and tools, however, SDOH can look like a lot of potential and no realized purpose. In this short, demo-style video, Chief Product Officer David Bartley walks through various dashboards and drilldowns that healthcare organizations are using to drive value-based care forward and enhance care for the most at-risk populations. Watch it now: https://lnkd.in/gTESNxhF

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📢 **Transforming Healthcare with Orb Health: The Power of Chronic Care Management (CCM) in Closing Care Gaps and Boosting Quality Scores** 📢   In the evolving landscape of healthcare, Orb Health stands out as a pivotal partner in chronic care management (CCM), bridging care gaps and elevating quality scores. As healthcare professionals, we recognize the critical need to provide continuous, coordinated care for patients with chronic conditions. Here’s how Orb Health’s CCM solutions are making a significant impact:   🔹 **Closing Care Gaps:** Orb Health’s CCM programs ensure that patients receive regular check-ins, follow-ups, and personalized care plans. This proactive approach helps in early detection and management of potential health issues, reducing emergency room visits and hospital readmissions. By addressing these care gaps, we can significantly improve patient outcomes and overall health.   🔹 **Enhancing Quality Scores:** Quality scores are essential indicators of a healthcare system’s performance. Orb Health’s CCM contributes to higher quality scores by improving patient adherence to treatment plans, ensuring timely medical interventions, and promoting proactive care. As a result, healthcare providers can achieve better ratings in quality metrics, which are crucial for accreditation and reimbursement processes.   🔹 **Patient-Centered Care:** At the heart of Orb Health’s CCM is a patient-centered approach. By focusing on the unique needs of each patient, we foster stronger patient-provider relationships and enhance patient satisfaction. This holistic care model not only improves health outcomes but also builds trust and engagement among patients.   🔹 **Leveraging Technology:** The integration of technology in Orb Health’s CCM allows for better data management and real-time monitoring of patient health. Digital health tools enable seamless communication between patients and care teams, ensuring that no detail is overlooked. This technological support is vital in maintaining comprehensive and efficient chronic care management.   By partnering with Orb Health, healthcare systems can not only close existing care gaps but also pave the way for higher quality care and improved patient experiences. Let’s continue to innovate and collaborate, ensuring that every patient receives the best possible care. 🌟   #HealthcareInnovation #ChronicCareManagement #PatientCare #QualityImprovement #HealthcareExcellence #OrbHealth #CareGapClosure #PatientCenteredCare #HealthTech #ContinuousCare

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We are thrilled to share our latest blog post on the innovative Tuesday Health Clinical Care Model, which is transforming the landscape of supportive care for patients with serious illnesses. At Tuesday Health, we believe in a patient-centered approach that goes beyond traditional healthcare. Our Clinical Care Model integrates the latest advancements in telehealth, home-based care, and multidisciplinary collaboration to provide holistic, continuous, and personalized care. Here's how we're making a difference: 🔍 Proactive Patient Identification: Using advanced predictive models to identify individuals who will benefit most from our care. 🤝 Holistic Approach: Addressing social determinants of health such as food insecurity, transportation, and caregiver support. 💼 Multidisciplinary Team: Nurses, social workers, physicians, and specialists working together to provide comprehensive care. 📱 Technological Integration: Leveraging telehealth and digital platforms to enhance care delivery and accessibility. 📊 Continuous Improvement: Regular evaluations and data-driven refinements to ensure high-quality care. Our mission is simple yet profound: to enhance the quality of life for our members and their caregivers while reducing unproductive medical spending. By focusing on the individuality of each patient's journey, we strive to set new standards in supportive care. 👉 Dive into our blog to learn more about how we're revolutionizing healthcare: https://hubs.la/Q02DByyb0 Join us in our mission to transform serious illness care. Together, we can make a meaningful impact! #TuesdayHealth #SupportiveCare #HealthcareInnovation #PatientCenteredCare #PalliativeCare #HomeBasedCare #MultidisciplinaryCare

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Reports indicate that Innovaccer, a prominent healthtech unicorn, is in talks with Kaiser Permanente, a major US health insurance and healthcare provider, regarding a potential funding round. The investment amount under discussion ranges between $200 million to $250 million. This funding, if finalized, will comprise both primary and secondary components. While specific details are yet to be disclosed, it's known that Kaiser Permanente is an existing customer of Innovaccer and has been in discussions with the company for some time. However, reports from TechCrunch suggest that this funding round might result in a downround for Innovaccer, potentially leading to a valuation decrease. If the funding goes through, Innovaccer's valuation could drop to somewhere between $2.5 billion and $3 billion, indicating a potential decline from its valuation of $3.2 billion during its Series E round in December 2021. TechCrunch also hints at a possible secondary transaction valuation as low as $2 billion. Innovaccer has yet to comment on these funding discussions. This news of potential funding comes shortly after Kaiser Permanente announced a collaborative effort with Innovaccer to enhance its value-based care services, showcasing the potential synergy between the two entities. Established in 2014 by Abhinav Shashank, Kanav Hasija, and Sandeep (Sandy) Gupta, Innovaccer leverages healthcare data analytics to provide actionable insights for various stakeholders in the healthcare ecosystem, including healthcare providers, hospitals, insurance companies, and other relevant entities. Headquartered in Bengaluru, India, and San Francisco, USA, Innovaccer has raised approximately $390 million in funding to date. The company boasts an impressive investor lineup, including Tiger Global Management, B Capital Group, Microsoft's M12 fund, and OMERS Growth Equity. Earlier this year, Innovaccer acquired Cured, a digital marketing and customer relationship management startup. The ongoing funding discussions at Innovaccer align with a growing trend of secondary transactions in the Indian startup scene. Recent examples include Capillary Technologies, on the verge of an IPO, raising $95 million in secondary transactions as part of a $140 million Series D round. Moreover, reports suggest that early-stage investor Chiratae Ventures sold a portion of its stakes in Lenskart, Bizongo, and Rentomojo to private equity firm Madison India Capital for $70 million. The potential funding from Kaiser Permanente and Innovaccer's strategic partnership hold considerable promise for the company's future. With its dedication to data-driven healthcare solutions and a burgeoning list of high-profile collaborators, Innovaccer is poised to sustain its growth momentum and leave a lasting imprint on the healthcare landscape. #innovaccer #funding #discussion #healthcare #healthtech #kaiserpermanente #strategicpartnership #bengaluru #data #analytics #allboutcorps

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On multiple occasions during the past several years, #CMS has solicited input on how it might reimburse for digital health products that present an awkward fit within the Medicare system. Now, developers say it’s time to act. Ultimately, many stakeholders agree that the #Medicare system wasn’t crafted to address software used as a primary healthcare tool. Thus, long-term solutions will almost certainly require legislation. That is not going to happen right now, though, and industry stakeholders say CMS’ annual rules offer at least some potential opportunities to push the system forward: https://bit.ly/4d3KZq3

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"Watershed’s SaaS platform gives providers real-time information, including health status, social determinants of health, location and involved care team members." #care #healthcare #healthtechnology #digitalhealth #saas #postacute

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At Medium, public health isn’t just another vertical. It is something all of us are really passionate about. And we think of an engagement in public health as an opportunity to address some of the extremely difficult, but crucial, challenges in healthcare across the world. We are driven by a deep desire to make an impact at scale to help create healthier families, more efficient healthcare eco-systems, and communities empowered to manage their own health. That’s the future we strive to build with our clients: be it foundations, donor agencies, impact funds, governments or CSR initiatives of large business houses. We have proven capabilities in Identification of Impact Opportunities, Public Health Data & Analytics, Research & Insights, Programme Design, Impact Assessment, Strategic Planning, Health Communication, Digital Health Innovation and Emerging Technologies. Here is a glimpse of some of our most exciting work in public health: >>  Helped a global not-for-profit organization focusing on innovation in diagnostics with insights to develop diagnostic solutions aimed at febrile illness. We conducted in-depth interviews with a diverse range of stakeholders across the country to arrive at some rare and high-impact insights >>  Conducted a comprehensive assessment of digital initiatives addressing maternal malnutrition aimed at lower-income households and applied strategic framework to help our clients identify the ones with high scaling potential >>  Helped develop public health information strategy for a group of countries by leveraging international benchmarks for disease surveillance and data management and conducting comprehensive assessment of current policies and capabilities. >>  Based on available data and insights from on-ground research, we conceptualised a service delivery model to improve healthcare outcome at community level in two specific regions in Eastern and North India for the CSR initiative for a large corporate house >>  Backed with insights and our core expertise in healthcare delivery, we conceptualized a chain of primary care clinics specifically focused on the urban poor as a hybrid model leveraging brick-and-mortar physical outlets and AI-backed technology. Interested in learning more about how we can support your public health initiatives? Contact us today! Bill & Melinda Gates Foundation PATH FIND World Health Organization UNICEF IFC - International Finance Corporation Clinton Foundation USAID Jhpiego Public Health Foundation of India (PHFI) NITI Aayog Official Sight and Life AVPN India Health Action Trust AVPN Tata Trusts Piramal Swasthya Cipla Foundation Acumen Omidyar Network Villgro Aavishkaar Capital #PublicHealth #HealthcareConsulting #PopulationHealth #SocialImpact

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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 info@firsthealthadvisory.com. #CISO #CIO #CTO #CDO #Compliance #HIPAA #HealthcareIT #HealthcareSecurity #CyberRisk #ThirdPartyRisk #RiskAssessment #Cybersecurity #HTM #DigitalHealth #PatientSafety

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The ATA Nexus 2024 conference focused on "The Next Chapter in Virtual Care," discussing access to quality care through telehealth and remote monitoring, with themes including AI, collaboration, and regulatory challenges. Attendees emphasized thoughtful telemedicine delivery and clinician involvement in transforming care models. Read the full breakdown: https://brnw.ch/21wKGX5

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As we all know, the pandemic prompted the rapid adoption of telehealth technology across most health systems in the United States. But there is one significant consideration that many providers didn’t consider at the time: adopting high-quality security measures. The Pandemic and Virtual Care Coverage The pandemic led to increased coverage for telehealth with fewer restrictions, prompting more patients to utilize digital services instead of in-person services. The hopes of this decision were that fewer patients would be entering high-risk facilities and opt for stay-at-home care instead through the duration of the pandemic. Telehealth Cybersecurity Attacks Telehealth vendors that existed for some time before the pandemic already had quality security measures in place – it’s primarily the telehealth solutions that started popping up across the market throughout the pandemic that some providers are encountering issues with. Top virtual care software vendors saw a 30% increase in cybersecurity attacks in the first month of the pandemic. Unsurprisingly, hackers are trying to take advantage of the mass adoption of this technology with malware activity shifting from organization-focused attacks to vendor-focused attacks. Poor security leaves your practice and patients vulnerable to dangerous cybersecurity attacks. This means that your practice data and your patient’s information are at higher risk of getting into the wrong hands, in turn leaving your practice vulnerable to violating compliance and security regulations. So, how do you find the right telehealth vendor? 1. Increased Security The right telehealth vendor has quality security in place. They have years of experience fighting off cybersecurity attacks and know how to keep patients and providers safe. They have a seamless integration process that enables your team to understand how to safely use the software and lower your risk of cyber-attacks or vulnerability. 2. Customer Support Customer support is vital through any transition. If your practice is considering implementing a new telehealth solution, then it would be wise to partner with a vendor that offers quality customer support. This is important for the moments when your team has questions or concerns regarding the technology, enabling your team to run at its most effective pace. 3. Accessible Solution The virtual care solution your practice chooses to implement should also be accessible while offering top security. This means it should be user-friendly, but also HIPAA compliant. With more of your team working from home and on-the-go, an accessible solution can make all the difference. Find a vendor that wants to help your team utilize all that telehealth has to offer without putting you and your practice at risk. Learn more about our quality telehealth solution here: https://ow.ly/eZP350RILoc

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Rimidi Partners with USC to Improve Postpartum Care for High-Risk Mothers - HIT Consultant #Partnership: Rimidi collaborates with USC to enhance postpartum care for high-risk mothers. #RemoteMonitoring: Utilizing digital health tools to monitor high-risk mothers postpartum. #DataAnalysis: Analyzing data to identify trends and improve outcomes for high-risk mothers. #PatientEngagement: Engaging high-risk mothers in their postpartum care through technology. #Telehealth: Providing virtual postpartum care to high-risk mothers for better accessibility. #Research: Conducting research to enhance postpartum care for high-risk mothers. #Innovation: Leveraging technology to revolutionize postpartum care for high-risk mothers. #Impact: Improving outcomes and reducing complications for high-risk mothers through innovative care approaches. ai.mediformatica.com #health #postpartum #rimidi #monitoring #outcomes #partners #partnership #patientmonitoring #postpartumcare #remotepatientmonitoring #this #better #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/3VDOxJy)

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