Marta Murillo

#DYK 67% of #rural areas don't have enough #dental professionals? And 40% of rural adults haven't had dental care in over a year? https://ow.ly/crVa50RmFiW To tackle this challenge, a program in Washington state has established a dedicated pipeline of providers committed to serving rural and underserved communities. Learn more in Insight Into Diversity: ow.ly/Rz9A30sBLZj

Last week, I had an opportunity to join an Association for Financial Professionals Emeritus FP&A Advisory Council meeting hosted by Bryan Lapidus, FPAC. The meeting theme was 'Cost Optimization' and how it differs from 'Cost Cutting'. Each former advisory council member shared a real-life example of a deployed cost optimization initiative. The example I shared was about establishing a best-practice vendor management process that involved setting up a cross-functional team and together we: 1️⃣ Analyzed, reported, and challenged vendor contracts, 2️⃣ Established a single source of truth with all key vendor information 3️⃣ Identified areas of overlap, 4️⃣ Consolidated vendors for similar services, 5️⃣ Renegotiated better pricing or terms, 6️⃣ Standardized common supplies/equipment to leverage buying power for bulk discounts, 7️⃣ Developed vendor performance and procurement analytics (via dashboards), 8️⃣ Improved vendor risk assessment processes, and more. The best outcome was that we built a "Culture of Exploration and Engagement" as all participants became owners of their projects and were finding "Small Wins" that became "Big Successes". Although both options, optimization and cutting, result in cost reductions, there are a few key differentiating factors (see the comparison in the attached document). Special shout out to the team and thanks for sharing fantastic cost optimization examples. Gaileon Thompson, CTP, FPAC, Mitch Max, Kenneth Fick, Catherine Jirak, Pete Geiler, Jeff Altman, Mariya Guttoh, Eric Ellis, MBA, Raja Ramachandran, Nikita M. Miller, FPAC, Carmen Turner MBA, FPAC, Kristine Karlsen, Tracy Butler, MBA, CTP #FP&A #AdvisoryCouncil #BestPractices #CostOptimizationvsCostCutting #StrategicPlanning

30

1 Comment

More than a third of employers are integrating accountable care into their health benefits, according to a new report from the Milken Institute. This trend reflects a growing recognition of the importance of value-based care models in improving health outcomes and reducing costs. By prioritizing coordinated care and focusing on patient outcomes, accountable care aims to provide more efficient and effective healthcare services. Employers adopting these models are likely to see benefits in both employee health and overall healthcare expenditures. Check out this article from Marissa Plescia for more insight. #Healthcare #AccountableCare #EmployeeBenefits

4

Last week MCRA Strategic Advisor, Andrew F. Biernat, GBDS, CWCA , was featured in Managed Healthcare Executive. In the article, Biernat discusses legislation to eliminate the COBRA Creditable Coverage Penalty in Medicare. Learn why this benefits seniors in the link below 👇 https://loom.ly/-SwofDs #COBRA #StrategicAdvisor #Medicare #CreditableCoverage

7

Have you ever wondered if your trauma center is losing money? Find out with our low-cost finance assessment. You could be losing $5m in unsubmitted charges. https://bit.ly/3UWw3SZ #optimalhealthcareadvisors #trauma #healthcareconsulting

21

In just 3 minutes, get insights into: 1️⃣ Where you are along the Risk Adjustment Maturity Model. 2️⃣ Key action steps to advance you in managing your Risk-Adjusted Population. 3️⃣ Top-line survey results to benchmark against. Don't guess, assess! Take the checkup now: https://hubs.ly/Q02vkKst0 📊 #RiskManagement #Healthcare #DataAnalysis #UASIRiskCheckup #UASISolutions

12

"While staff shortages existed pre-pandemic, we are now experiencing a combination of unprecedented labor pressures, a smaller pipeline of health graduates, complicated care reforms and an aging population—propelling the industry into crisis," says Theodore Chien. Organizations must redefine performance in line with evolving care models and adjust compensation strategies accordingly to attract and retain a stable workforce and deliver best-in-class care. We must embrace technology that supports clinical providers and reduce the administrative burden. Check out the full Forbes article here: https://lnkd.in/gi8FetWu #Transformation #Healthcare #VBC #PatientCare #TechTrends #AI #Innovation

4

It’s crucial for supplemental benefits today to demonstrate clear value for both members and their health plan partners. This is a concept we understand well at Papa, having created and scaled a category-defining model—and we continually invest in research to further validate and inform our approach. Like our latest claims analysis that showed Medicare Advantage members who engaged in at least one #Papa visit were associated with a 9% reduction in medical costs. And the impact doesn’t stop there. 🚀 Members who engaged in more Papa visits saw even greater cost reductions, showing the potentially exponential impact long-term connection can have on an individual’s health, including: • 19% reduction in medical costs for members who average more than two Papa visits per month • 30% reduction in medical costs for members who average more than three Papa visits per month 📈 As plans look to enhance their offerings following the recent #CMS Star Rating recalculations, further investing in companion care is proven to maximize impact for your members. Learn how Papa can reduce healthcare costs and improve outcomes for your plan: https://lnkd.in/ejMf_But

48

3 Comments

Compare your healthcare salary increases to the latest data. Participate by June 28 in Gallagher’s 2024 Healthcare Salary Increase Pulse Survey. See how your peers are responding to changing market conditions. https://rb.gy/l4ow1o #CareerWellbeing #GallagherConsulting #HealthcareCompensation

9

Estimates are a great starting place, but it’d be a big mistake to hold $351,000 as THE number for every 65-year-old retiring couple. Learn why in my latest article for Rethinking65: #RetirementPlanning #HealthcarePlanning

11

#RISE Best experts at the 2024 Risk Adjustment Conference always helping to innovative strategies and best practices for optimizing healthcare outcomes, risk adjustment success and regulatory compliance. RISE

10

Cigna, eviCore, and Excellus Blue Cross Blue Shield plans have announced coverage for closed-loop #spinalcordstimulation. IPSIS, as part of the Multisociety Pain Workgroup, provided medical directors with substantial evidence of the efficacy of #SCS therapy. https://lnkd.in/ewDH_JVm #IPSISAdvocacy #neuromodulation #InterventionalPainMedicine #PainMedicine #InterventionalPainManagement #PainManagement

5

Will you be attending the Risk Adjustment Forum 2024? Would you like me to introduce you to Tina so you can learn more about Rebellis Group and Toney Healthcare? Let me know!

1

Explained: The Benefits and Challenges of Risk Adjustment Accurately predicting patients’ future health care costs is critical in capitated payment models, which give providers a lump sum to cover each patient’s full treatment costs. Risk adjustment is a key tool that plans use to ensure providers have enough resources for patients requiring more intensive and costly care. If it’s not designed thoughtfully, however, providers could face financial risks and patients could suffer. In a new explainer, The Commonwealth Fund’s Celli Horstman, MPP and Corinne Lewis, MSW explain the basics of risk adjustment, including:   ➗ the information that goes into risk adjustment calculations 📈 why payers are considering expanding which factors are taken into account  ⛔️ potential drawbacks to risk adjustment, and more.

25

Adjusting to risk: Seizing opportunities in risk adjustment coding Wednesday, May 1, 1-2 p.m. EST Speakers: Crystal May, Risk Adjustment Consultant, Norwood; Brian Murphy, Branding Director, Norwood and host of Off the Record; Register here: https://lnkd.in/gPDewtDY It’s often been said that the only constant in life is change. And the mid-revenue cycle is no exception. As new regulations emerge and new technologies develop, professions get radically transformed—or even erased altogether. The antidote is a commitment to lifelong learning, and embracing the discomfort that accompanies growth. Join Crystal May, CCS, CPC, CDEO, CPMA, CRC, Approved Instructor, Risk Adjustment Consultant for Norwood, and Brian Murphy, host of the Off the Record podcast, for this free one-hour live webinar. Crystal and Brian will discuss Crystal’s healthcare journey that eventually led to risk adjustment. They’ll also review some of the common findings and coding errors she’s seeing while conducting in chart reviews. This is not a technical .ppt-driven presentation, but a conversation about Crystal’s journey that may provide fuel for your own career in risk adjustment. Note: No CEUs will be provided for this program. Register here: https://lnkd.in/gPDewtDY

31

5 Comments

Adjusting to risk: Seizing opportunities in risk adjustment coding Wednesday, May 1, 1-2 p.m. EST Speakers: Crystal May, Risk Adjustment Consultant, Norwood; Brian Murphy, Branding Director, Norwood and host of Off the Record; Register here: https://lnkd.in/gPDewtDY It’s often been said that the only constant in life is change. And the mid-revenue cycle is no exception. As new regulations emerge and new technologies develop, professions get radically transformed—or even erased altogether. The antidote is a commitment to lifelong learning, and embracing the discomfort that accompanies growth. Join Crystal May, CCS, CPC, CDEO, CPMA, CRC, Approved Instructor, Risk Adjustment Consultant for Norwood, and Brian Murphy, host of the Off the Record podcast, for this free one-hour live webinar. Crystal and Brian will discuss Crystal’s healthcare journey that eventually led to risk adjustment. They’ll also review some of the common findings and coding errors she’s seeing while conducting in chart reviews. This is not a technical .ppt-driven presentation, but a conversation about Crystal’s journey that may provide fuel for your own career in risk adjustment. Note: No CEUs will be provided for this program. Register here: https://lnkd.in/gPDewtDY

22

4 Comments