Norman Volsky🎙️

🤔 What do you know about healthcare administration? 🤔 #claimsadjudication #thirdpartyadministration #specialtyinsurance... :) Andrew Munroe, Senior Vice President of Operations, Pharma, and Payor Partners at NexgenRx Inc. joined us on the latest episode of the Health Tech Horizons Podcast to share industry insights, and the latest trends shaping the future of healthcare administration. Join us as we explore the intersection of insurance related technology, innovation, and healthcare with NexgenRx Inc. and Andrew Munroe. ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ 📲 CHECK OUT the VIDEO 📺 ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡ ⚡

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I'm thrilled that today, we announced a significant milestone for Clover Health: the launch of Counterpart Health. Our innovative Clover Assistant (CA) platform is now available to all Medicare Advantage payors and providers under the new brand name Counterpart Assistant. Why am I so excited about this? This move is a strategic leap forward in our mission to improve healthcare for everyone. With Counterpart Assistant, we're not just expanding our reach—we're leveraging cutting-edge AI and machine learning capabilities that have already proven to make a real difference in patient care. The healthcare landscape is evolving rapidly, and the need for advanced, data-driven tools has never been greater. Medicare Advantage plans, in particular, are under pressure to improve patient outcomes while managing costs. That’s where Counterpart Assistant comes in. By bringing our technology to more providers, we're empowering clinicians with the tools they need to deliver high-quality, personalized care. What makes Counterpart Assistant special? First, we’re broadening our impact by allowing providers outside of Clover Health's Medicare Advantage plan to benefit from our technology. Our hybrid SaaS and shared-savings model aligns financial incentives with health outcomes, ensuring flexibility and scalability. CA’s AI-driven insights enhance clinical decision-making, and are associated with earlier diagnosis and better management of chronic diseases. Plus, we've built a robust support system to ensure seamless integration and ongoing assistance for all users. Clinicians using CA have seen significant improvements in Medical Cost Ratios and patient outcomes. The timing couldn't be better. The healthcare industry is ripe for transformation, and our technology is poised to lead the way. By expanding the use of Counterpart Assistant, we’re not just keeping up with the changes—we’re driving them. Join us on this exciting journey. Visit our website for more details. Thank you for your continued support as we strive to bring high-quality healthcare to everyone on Medicare. #HealthcareInnovation #AI #MedicareAdvantage #ValueBasedCare #CloverHealth

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Walmart Exits Healthcare Market: RPM Steps Up to Fill the Gap... Walmart's departure from the healthcare market, including its virtual health care services, will leave a void in care services for underserved communities. While hospitals and primary care providers (PCPs) remain the backbone of our healthcare ecosystem, their resilience is rooted in the trust relationships they've built with patients. This trust is a cornerstone of effective care, and RPM can help hospitals and PCPs extend their reach. RPM uses digital technologies to monitor patients' vital signs, health data, and other relevant information remotely, enabling healthcare providers to deliver timely interventions and preventive care. By leveraging RPM, we can: - Increase access to care for underserved communities - Detect health issues early, preventing complications - Deliver personalized care plans - Reduce healthcare costs - Empower patients to take a more active role in their healthcare As we move forward, RPM can help address the disparities in healthcare access and ensure that everyone has access to quality care, regardless of their zip code or background. Let's harness the power of RPM to create a more equitable and accessible healthcare ecosystem! #RemotePatientMonitoring #Telehealth #DigitalHealth #HealthcareAccess https://lnkd.in/eD7CcaEm

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🔓 Unlock the power of Hospice Dynamix's Predictive Length of Stay (PLOS) for your referral network! 🔎 With this innovative tool, you can quickly and easily identify the depth of your referral network, monitor the impact of each referral source category on your census development and sustainability, and proactively assess the quality of admissions from each referral source type, all in real-time. 🚀 Don't wait - take control of your referral network and optimize your patient population today with Hospice Dynamix! Schedule a demo here 👉 https://lnkd.in/gHtuvXcq Check out this brief video to learn more📽

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Transcarent Secures $126M to Expand Employer-Sponsored Healthcare - HIT Consultant #TranscarentSecuresFunding Healthcare technology company Transcarent has secured $126 million in funding to expand its employer-sponsored healthcare services. #WhatIsTranscarent Transcarent is a healthcare platform that aims to provide better, more transparent healthcare options for employees of large companies. #HowDoesTranscarentWork Transcarent works by partnering with employers to offer personalized healthcare solutions, including virtual care, navigation services, and access to top doctors and hospitals. #BenefitsOfTranscarent The benefits of Transcarent's services include improved access to care, cost savings, and better health outcomes for employees. #FutureExpansion With this new funding, Transcarent plans to expand its services ai.mediformatica.com #transcarent #health #platform #acce #funding #healthcare #employers #7wireventures #mentalhealth #network #pharmacy #fundinground #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/4aXQl5f)

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🚀 Harnessing Technology to Transform Mental Health Care 🚀 Technology is revolutionizing the way we approach mental health care delivery. Let's explore the exciting intersection of technology and behavioral health: 1. Empowering Accessible Care: Technology breaks down barriers to accessing mental health care by providing virtual platforms for therapy sessions, support groups, and self-help resources. Teletherapy services enable individuals to connect with licensed professionals from the comfort of their own homes, overcoming geographical limitations and reducing stigma associated with seeking help. 2. AI-Powered Therapy Tools: Artificial intelligence (AI) is driving advancements in personalized mental health care through virtual therapists and chatbots. These AI-powered tools offer round-the-clock support, delivering evidence-based interventions, psychoeducation, and coping strategies tailored to individual needs. By leveraging natural language processing and machine learning algorithms, these tools can provide real-time feedback and emotional support, complementing traditional therapy approaches. 3. Mental Health Apps: Mobile apps have become invaluable tools for promoting mental wellness and self-management. From mood tracking and meditation to cognitive behavioral therapy (CBT) exercises and stress reduction techniques, mental health apps offer a wide range of resources to support users in managing their mental health effectively. With user-friendly interfaces and customizable features, these apps empower individuals to take control of their well-being anytime, anywhere. 4. Data-Driven Insights: Technology enables the collection and analysis of vast amounts of data, providing valuable insights into mental health trends, treatment outcomes, and user engagement. By leveraging data analytics and predictive modeling, mental health providers can identify patterns, predict risk factors, and personalize interventions to optimize care delivery and improve patient outcomes. 5. Ethical Considerations: As we embrace the potential of technology in mental health care, it's crucial to prioritize ethical considerations, including data privacy, confidentiality, and informed consent. Mental health professionals must uphold ethical standards and ensure that technology-enhanced interventions adhere to established guidelines and best practices. The integration of technology into behavioral health represents a transformative opportunity to expand access, improve outcomes, and promote mental wellness on a global scale. By embracing innovation and collaboration, we can harness the power of technology to create a brighter future for mental health care. 🌐💡 #TechnologyInBehavioralHealth #MentalHealthInnovation #DigitalMentalHealth

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In our experience, the issue is not what the digital health companies are doing but rather what they don't know they need to do - digital health is not a shortcut for health systems. In other words, there is usually not anyone on the health system side acting as a product owner with the necessary resources committed to doing the hard work of change management, technical system integration, upskilling the teams, etc. We recommend health systems implement digital health solutions like they do EMR implementations. 10-20% of the cost is the software. 4-8x that amount should be spent on the client side to ensure successful integration and implementation.

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As part of our #M3P solution in JUDI®, the report dashboard gives Medicare Part D #plansponsors insights into payment activity. With all this data at your fingertips, available to slice and dice as you see fit, you can easily visualize and keep track of payment trends. Want to see Ryan Kelly (Chief Technology Officer) run through a live demo of our M3P solution? Check out the replay of our webinar here: https://okt.to/9ZTsSW

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This episode from my colleague Asher Perzigian's podcast is key for anyone passionate about healthcare and entrepreneurship. Tune in to gain valuable insights from Lawrence Leisure of Chicago Pacific Founders 🚀 #podcast #healthcareinnovation #leadership

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Mandatory bundles in surgery are a bi-partisan objective, and (in)ability to optimize cost/quality will dramatically impact hospital P&L. Regular insights from granular data , and AI-based decision support are the only way to systemically reduce unwanted variability and be both profitable and high quality.

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the word is out and our acuity index is catching on. if you are struggling with measuring acuity and operations in behavioral health, please reach out.

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The benefits of DROPPING BlueCross BlueShield as a payer.... One of our clinics at StrataPT was seeing 3,000 BCBS visits. Here's the result if they dropped them right now - Save $300,000 - Drop 1.2 full-time employees - Downsize clinic size - Pay less rent - Profit margin goes from 9-12% to 20-25% Now if they successfully negotiate their BCBS contract up even $10 it's a totally different story. The point is you MUST evaluate the pros and cons of dropping a payer...even if it's a big one like BCBS. Agree or disagree? #physicaltherapy #healthcare #healthcaretechnology #occupationaltherapy

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Thanks to Adam Burns of WittKieffer and on-demand leader Patrick McDermott for sharing your insights with Newsweek. On-demand leadership is not about replacing executives, but extending capacity and skills to propel missions forward. Patrick nailed it when he said: "I wasn't filling an executive vacancy...I was basically the sidekick to the CFO and the revenue cycle vice president. I wasn't replacing them, but I was complementing them, supplementing them." Whether in transition, transformation or crisis, the need for supplemental expert leadership and capability confronts every organization. #ondemandleadership #impactfulleadership

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Choosing the right TA technology can be daunting, especially in the healthcare sector where the stakes are high and the needs are specific. Tony Lioi, Director of TA Technology at BAYADA Home Health Care, shares invaluable insights, emphasizing the importance of building strong partnerships with internal IT teams. Tony's journey from a niche staffing firm to leading tech initiatives at BAYADA highlights a strategic approach to integrating diverse tools into cohesive systems. Click the link below to hear the full episode. #Talent #Recruiters #Recruiting #HRTech

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Privia Health had a solid start to 2024 with continued growth and execution. One notable trend is Privia's pullback on capitation. Privia wants to be thoughtful about taking full risk - in markets and scenarios where it makes sense (and it's profitable of course). Flexibility is built into Privia's operating model, and you can see the levers being pulled in Q1 and in 2024 given significant MA headwinds. You can see the pullback in value-based care revenue in Q1 2024 in a chart below. By the way - what do you guys think of the new one-pager format?? If you like these, you'll love my newsletter. Subscribe here! https://lnkd.in/gniNmHvz

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I'm thrilled to share our latest work, "Operationalising Personalisation in a Healthcare System," published in Journal of Healthcare Management, co-authored with Tom Jackiewicz, President of University of Chicago Health Systems. 📘💡 Our research reveals that the future of healthcare hinges on recognizing employees and patients not just as part of the system but as vital consumers whose needs are paramount. Despite this shift, many healthcare leaders remain untrained in personalization, failing to see the deep connection between individualized care and improved health outcomes. This oversight can no longer be overlooked as we aim to transform healthcare systems to truly serve and succeed. In this publication, we explore: • The imperative shift from outdated standardization to dynamic personalization in healthcare. • Strategies to dismantle systemic barriers, enabling a truly individual-centric approach. • The significant benefits of personalization for both providers and patients, illustrated by initiatives led by Tom at UChicago. As we prepare for the 2024 Healthcare in the Age of Personalization Summit, we invite you to join us in redefining healthcare leadership to fully embrace the personalization necessary in our rapidly evolving landscape. 📖 Dive into the full article for a comprehensive understanding of our findings and actionable insights: Operationalising Personalisation in a Healthcare System: VISIT: https://lnkd.in/dnUSfGem to read the full article! Register now to be part of the transformative journey at the Summit: https://lnkd.in/e8AVyJk4 Together, let's champion a healthcare system where every individual’s needs are not just met but anticipated, making each person feel truly seen, heard, and cared for. 🌍🏥 #HealthcareInnovation #PersonalizationInHealthcare #Leadership

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Here’s your recap of last week’s health IT news 🗞️ 👇 💼 Administrative • Pager + League: The care orchestration solution will be embedded into the patient engagement platform for maternity care.    • Veradigm®: The ambulatory care solutions vendor has announced that it is exploring a merger, sale, or other transaction.    • Kyruus Health: The provider search and scheduling solution said it would add MEDITECH to its list of EHR partners which already includes Epic , Oracle (Cerner), athenahealth , and others.   🥼 Clinical • Clover Health: The physician enablement technology company launched its previously internal-facing clinical decision support tool via its subsidiary Counterpart Health as a standalone solution for external Medicare-focused payers and providers.    • Children's Minnesota + ShiftMed: The pediatric health system is partnering with the on-demand workforce tech platform. 🤝 VBC • Innovaccer: The VBC data & analytics company launched its quality management and reporting platform for health plans. 🤖 AI • Plenful: The AI workflow automation company focused on streamlining pharmacy operations announced a $17M Series A.    • SamaCare: The AI prior auth platform announced a $17M Series B. 💡 Things We Found Interesting • In our view, there’s not enough discussion about why technology pilots in health systems fail. So we appreciated this perspective from Justin R. Brueck at Endeavor Health, on three of the most common reasons he sees things go awry. https://lnkd.in/eKBZ_g2N    • We’re continuing to see stories illustrating both the promise and perils of leveraging generative AI in the practice of clinical medicine. Given the pace of progress, it seems clear that AI will play a significant role in clinical care sooner than later. Lots of thorny questions to work through in a short amount of time. (Here are a couple examples from Yudara Kularathne MD, FAMS(EM) and Graham Walker, MD we appreciated: https://lnkd.in/ePUr2SgE, https://lnkd.in/ej9UpfYg)    • On that note, we’re always interested to read the latest research on how AI solutions are performing in the field. One recent study published in JAMA found that AI scribes significantly reduced time spent in the EHR. Researchers of another, however, cautioned that providers must remain vigilant when using GenAI, based on the fact that Chat-GPT produced different outputs when asked to simplify radiology reports for patients of different races. https://lnkd.in/emNi-_Ai, https://lnkd.in/ejH4KHsq  

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Walmart's exit from Healthcare: A lesson in passion and core business LinkedIn is buzzing with news about Walmart closing its Health Centers and Virtual Care operations. While the parent company boasts impressive revenue and profit figures, it seems those weren't enough to sustain its foray into the healthcare space. This decision highlights a crucial aspect - succeeding in healthcare requires more than just capital; it demands a deep understanding of the industry and unwavering commitment. Walmart is a not alone Walgreens and Amazon have had the same fate. Amazon has swindled down its healthcare manpower within one year of acquiring OneHealth. The healthcare industry is complex and ever-evolving. While Walmart's intentions were noble, their departure serves as a reminder that financial muscle alone can't guarantee success in every sector. Passion, expertise, and a laser focus on the core business are essential for long-term sustainability. #walmart #healthcare #business #pivot #healthcareinnovation https://lnkd.in/dnAHrKck

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