Herman McKenzie

🌟 Upcoming Live Webinar: Enhancing Dialysis Facility Preparedness 🌟 🗓️ Date: June 25 ⏰ Time: 2 PM ET Join me, Kristi Wells, RN from Greenfield Health System, for an essential webinar explicitly designed for nurse leaders in the dialysis industry. Here's why you should attend: 🔍 Insightful Learnings: Gain firsthand insights into state surveyors' crucial findings and perspectives. Understand what they look for during evaluations and how this impacts facility operations. 📈 Improve Facility Readiness: Learn about the latest trends and focus areas identified by surveyors. This knowledge will help enhance your facility's preparedness and compliance, ensuring you meet and exceed regulatory standards. 💡 Actionable Strategies: I'll share key strategies and best practices to prepare your facility for upcoming surveys, helping you avoid common pitfalls and enhance patient care. 🎓 Earn CE Credits: Earn 1.00 Continuing Education credit by attending this webinar and completing the required post-test and evaluation. This webinar is not just a learning opportunity—it's a chance to improve your facility's operations and patient outcomes directly. Stay ahead of the curve by understanding the latest surveyor expectations and industry standards! Register Here: https://lnkd.in/eBpmNXbw ✨ Don't miss out on this chance to elevate your professional practice and facility standards! ✨ #DialysisCare #NurseLeaders #HealthcareWebinar #DialysisPreparedness #StateSurveyors #ContinuingEducation #NursingEducation #DialysisNursing #HealthSystem #PatientCareExcellence

1

Are you inundating your patients with messages❓ Are they receiving the right information at the right time❓ Download "Your Guide to Governance," a comprehensive resource designed to help you effectively manage your patient communications strategy enterprise-wide. 𝐓𝐡𝐢𝐬 𝐠𝐮𝐢𝐝𝐞 𝐢𝐧𝐜𝐥𝐮𝐝𝐞𝐬 𝟓 𝐛𝐞𝐬𝐭 𝐩𝐫𝐚𝐜𝐭𝐢𝐜𝐞𝐬 𝐭𝐨 𝐡𝐞𝐥𝐩 𝐲𝐨𝐮: ✅ Understand the risks of over-messaging and digital fatigue ✅ Break down silos and establish a governance committee ✅ Measure, iterate, and improve your enterprise-wide communication strategy ➡️ Download the full governance guide and workbook here » https://lnkd.in/gGHjjExa #healthcare #patientexperience #digitalhealth #medtech #healthtech

15

🔍 **Retention Strategies in Healthcare: Addressing Workforce Shortages Post-COVID** 🏥 Retention remains a top priority for healthcare executives as they navigate workforce shortages and complex challenges. Solving this issue is no easy task. We are dedicated to supporting our clients' retention efforts and partnering with them to tackle these workforce challenges head-on. Our commitment is unwavering as we continue to provide innovative solutions tailored to the unique needs of the post-COVID era. By focusing on strategic retention, we help our clients maintain a stable and engaged workforce, ensuring the delivery of quality care. It takes us all working together to create resilient healthcare teams. See blog in comments. #Healthcare #Retention #WorkforceSolutions #Prolink #PostCOVID #HealthcareLeadership #EmployeeEngagement

24

2 Comments

Keep our rurals open but if you really want to help get the foreign equity owned GPO that sets the pricing for our hospitals BANNED from our state. Economies of scale are used by Vizient against Oklahoma rural hospitals. If you have 13 tiers, hidden tiers, and tier maxes…that’s not a contract, that a free for all nightmare of a scam we all fell for. Their awful written tiered agreements force our rurals to pay more for the exact same items that our large hospitals pay less for. Example box of gloves a large hospital system in the state will pay 6-8 bucks for a box of 250 exam gloves. That same box for a rural EMT? 24 bucks. There is no price transparency and you are forcing patients who live in rural areas to pay more because of the lack of infrastructure by the corporations serving them to effectively and economically get goods and services to these hospitals. And distributors who whine about the cost of delivering to rural hospitals all while posting BILLIONS in profit every quarter are the first on my 💩 list. Let’s keep our rurals open but let’s make them more profitable so that they can continue to add much needed services and gainfully employ more community members.

6

1 Comment

When hospital leadership is unstable, Interim Leadership has time and time again been a useful solution. In this KBA blog, we're sharing three real-life challenges and three real solutions for how Interim Leadership can support your organization.

12

3 Comments

Managing prior authorizations across all lines of business is easier when you have a single source of truth. PA Checkpoint becomes that source of truth for our clients - listen to BCBS of Minnesota share their experience: #PriorAuthorization #AIinHealthcare #ItilitiHealth

5

Understanding Common Sentinel Events When it comes to receiving healthcare, your safety should always be the top priority. Hospitals strive to provide the best possible care, but occasionally, unforeseen events called "sentinel events" can occur. Understanding these events and learning how to advocate for yourself can empower you to stay safe during your hospital stay. In this blog, we will explore the most common sentinel events and provide valuable tips on advocating for your well-being. Sentinel events are defined as unexpected occurrences involving death or serious physical or psychological injury to a patient. These events are often preventable and can result from errors in medical care, communication breakdowns, or system failures. While sentinel events are rare, it is crucial to be aware of them and take proactive measures to minimize their occurrence. Medication errors can happen due to various factors, such as incorrect dosage, wrong medication, or administration errors. To prevent medication errors, be proactive in your healthcare by asking questions about your medications, understanding their purpose and potential side effects, and double-checking with your healthcare providers. While rare, surgical errors can have severe consequences. Examples include wrong-site surgeries, incorrect procedures, or foreign objects left inside the body. To mitigate the risk, confirm your identity and the planned procedure with your healthcare team before surgery. Hospital-acquired infections can be a significant threat, particularly for patients with compromised immune systems. To prevent infections, ensure that healthcare providers clean their hands before touching you, follow proper hygiene practices, and maintain a clean environment. Don't be afraid to remind healthcare professionals about hand hygiene if necessary. Clear and open communication is key to your safety. Ask questions, express concerns, and actively participate in decision-making regarding your care. Make sure you understand your diagnosis, treatment options, and potential risks. If something doesn't seem right, voice your concerns to your healthcare team. Learn about your medical condition, treatment plan, and potential risks. Empower yourself with knowledge so that you can actively participate in your care. Having a trusted advocate, such as a family member or friend, by your side can provide an extra set of eyes and ears. They can help ask questions, take notes, and ensure that your concerns are addressed. Being an informed and proactive healthcare consumer is crucial to ensuring your safety in the hospital. Your well-being matters, and by taking these proactive measures, you can help create a safer healthcare experience for yourself and others.     #SentinelEvents #PatientSafety #HealthcareSafety #MedicalErrors #HospitalSafety #QualityCare #PatientRights #PatientAdvocacy https://lnkd.in/gAqwJebx

10

5 Comments

No Surprises - The majority of the NSA-eligible claims were resolved through an initial payment—5.2 million based on the survey and 8.0 million based on national estimates. Less than a quarter of the claims entered the 30-day open negotiation process, most of which (73 percent) were resolved without initiating the IDR process. CMS estimated the number of 17,000 claims would enter the IDR process each year. 334,828 disputes were initiated between April 15, 2022, and March 31, 2023, a figure almost fourteen times greater than the agency’s estimate. After proposing new regulations related to the IDR process in October 2023, the government predicted 420,000 initiated disputes for the next year. However, AHIP and BCBSA estimated that nearly 670,000 claims were submitted to the IDR process between January 1 and September 30, 2023, and this figure is not likely to have peaked yet. Use of IDR process is anticipated to grow. How is the air ambulance industry fairing under no surprises? If you are an Air Ambulance provider who’s interested in learning more about pathways to in-network participation and improving your cash flow contact me. #nosurprisesact #airambulance #ambulance

8

I totally agree with you Tom Parker on many fronts. A one-size fits all staffing model unfairly ties a facility's proverbial hands behind their backs given the need to take into account resident's diverse requirements, geographic/demographic differences, facility size and core competencies within a building. All of that has to be dealt with before any consideration can be given to team member preferences to promote retention. Flexibility and adaptability are essential for long term care providers to survive. They need the ability to be agile and pivot based upon their needs NOT another barrier. #skillednursingfacilities #ltcstaffing #ahca #ahcancal

13

1 Comment

It can't be overstated how this SCOTUS debate on #EMTALA has repercussions for all acute and emergency care. There are a few parts to it but the one that is relevant is that we 'provide necessary stabilizing treatment for emergency medical conditions and labor within the hospital’s capability and capacity'. In this debate, stabilizing treatment would not include abortion care in ID - the clinician would have to wait until there was 'medical certainty the mother would die. That means waiting until the patient is in critical condition (ie dying) before intervening. If they create this standard definition, this will not be relevant to the case of abortion alone - it could redefine what we *can do in all acute and emergent scenarios. Waiting on conditions to become critical. *For the record, I believe all emergency department staff will continue taking care of patients whatever happens here - no one will be sitting around 'waiting'. This is not how emergency care works. Our goal is to intervene before patients get to the point of being critical. Yes, patients do show up critical but the ED has many other patients that we evaluate for impending emergency conditions. And we treat them accordingly. The longer we wait, the chances of morbidity and mortality increase. This is not a viable option. This is condemning patients to die. The argument that not all patients who show up to an ED are emergent: yes, but patients do not necessarily know that. Also the emergency department is sometimes the only option for care someone has. The system has created this purpose. Sure this needs reworking but blaming patients for it is not the way. This is what happens when clinical medicine does not mesh with what the law wants to do. There is no effective way to separate one type of healthcare (ob/abortion care) with all other types of emergency care. The law can try to intervene like this. But Medicine does not work that way. Basically, this is a big deal. This will also affect getting specialist consults and follow-ups. That is an entire other discussion. #howdidwegethere #medicine #scotus #healthcare

6

1 Comment

CMS has officially issued its fiscal year 2025 IPPS Proposed Rule, which ushers in a variety of proposed updates. Wondering what they are and how they might impact your hospital? Follow the link below to read our latest blog post and learn all you need to know.

2

In case you missed it: Community Health Systems (CHS), one of the largest hospital chains in the U.S., has filed a lawsuit against cost management firm MultiPlan, accusing them of colluding with health insurers to underpay providers. This is the third such lawsuit against MultiPlan in less than a year. Filed in a New York district court on May 8, 2024, the lawsuit alleges that MultiPlan uses repricing algorithms to significantly reduce reimbursement rates, costing CHS hundreds of millions and health systems billions annually. MultiPlan denies these allegations. MultiPlan serves as an intermediary between insurers and providers, using repricing tools to determine out-of-network claim reimbursements. CHS claims that MultiPlan colludes with major insurers like UnitedHealth, CVS, Cigna, Elevance, Humana, Centene, and Health Care Service Corporation to force providers into accepting lower payments. The complaint states that MultiPlan's repricing algorithm manipulates insurers’ claims data to recommend lower payment rates, leveraging its extensive preferred provider organization to enforce these rates. By 2020, this practice reportedly underpaid 370,000 out-of-network claims daily, resulting in $19 billion in annual underpayments. CHS argues that this system leaves providers unable to effectively negotiate or resolve disputes over individual claims, leading to significant financial strain. In addition to out-of-network claims, MultiPlan allegedly seeks to extend its payment model to in-network reimbursements. The lawsuit claims that MultiPlan retains a portion of the savings from reduced reimbursements, incentivizing underpayment. A recent New York Times investigation highlighted this issue, revealing that insurers benefit from this scheme, sometimes leaving patients to cover the balance. The American Hospital Association and Sen. Amy Klobuchar have called for an antitrust investigation into MultiPlan following these revelations. Despite the lawsuits, MultiPlan maintains that the allegations are baseless and states that their business strategy remains unaffected. For more details, read the full article here: [Link to Article] #Healthcare #RevenueCycleManagement #HealthcareNews #MedicalBilling #MultiPlan #CommunityHealthSystems https://lnkd.in/eTtzbS6V

18

The value is in attending, interacting, and formulating next steps to more talent...Topics Include: Leveraging Community College Partnerships: Understanding credentialing and career connections. Local Labor Boards and Training: Career opportunities and funding sources. Grant Applications and Apprenticeships: Pursuing federal funding and lessons from HAEP. Real-World Retention: 25 ways to reduce turnover.

5

Very interesting article. It compares hospital and health plan consolidation in specific markets. Indiana is a market that is deemed a high cost market (7th highest in nation for hospital costs) because of hospital consolidation per studies, yet when you look at the market, plans have more leverage as the top 3 represent 91% of the large group market. A few thoughts: 1) you can look at number of hospitals, but it would be better to compare commercial spend for these systems as I would imagine a lot higher than the counts indicate. Some hospitals may have a higher proportion of governmental business and that needs to be considered. 2) Based on plan leverage, one would think plans would say no to continued commercial price increases. It's important though that employers support plans in these discussions. I have seen many times over the years that employers want access above everything else, which means the plan has little leverage with the hospital to take hard line stands or risk losing large national employers who will just switch to another plan creating a vicious cycle of continued cost increases. 3) Under this environment, there is little incentive to move to VBC like arrangements vs. fee for service. 7. For example, in Indiana, the systems with the largest share of total hospitals are St. Louis-based Ascension (13.9%), Indianapolis-based IU Health (11.3%), Mishawaka-based Franciscan Health (8.7%) and Franklin, Tenn.-based Community Health Systems (8.7%). These four systems own 42.6% of all the hospitals in Indiana combined 8. On the other hand, the three largest payers in Indiana — Elevance Health (68.9%), UnitedHealth Group (17.1%) and Physicians Health Plan of Northern Indiana (5.3%) — represent 91.2% of all privately insured patients with insurance from the large-group market.  

36

7 Comments

Excited to share this article by Rick Parrish in the The Journal Of Healthcare Contracting highlighting how Regard's innovative integrated kitting solutions are tackling one of healthcare's most urgent challenges: labor shortages. Take a read and see how we're making a difference! #HealthcareInnovation #LaborSolutions

24