Raymond Hwang, MD, MEng, MBA

Good summary by Noah Tong from Fierce Healthcare on the recent NAACOS spring meeting. At the event, four specific areas of focus were highlighted, including monitoring of DME fraud, a new best practices playbook, an expected pause in legislation passage this year, and SNF partnerships. ACOs are shifting to eCQM, with pilot testing for digital quality measures mentioned. MRO just posted a valuable blog on this topic for ACOs making the change. Check it out! #accountablecare #ACO #MIPS #valuebasedcare #healthcarequalityreporting Noah Tong Fierce Healthcare

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CMS releases 10M line database of 2022 Part B claims by physician and CPT code. For example, you can see every surgeon who billed Medicare for a prostatectomy, and how many he billed. How many labs billed Medicare for BRCA testing 81162, and how many cases each got paid for. You can sort for a zip code and find how many office visits were billed there, and by which doctors. Quite a resource. Details at blog. #cms #bigdata #partb #utilization https://lnkd.in/gXCju6eB

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The US Physician Workforce will be decimated by the boomer doctor retirement cliff between now and 2030. A disturbing pattern in recent study findings makes this issue much more urgent - and the timeline to impact much shorter - than the government predictions. Let me show you why. The new statistics, the references ... everything The dots will all line up when you watch this short video and I'm happy to have the chance to show them to you. If you are a physician leader, this video is a Must-Watch because the mainstream media is not covering this phenomenon. Employers are only focused on short-term results: the numbers at the end of this second quarter, or the end of 2024.  They don't see this long-term trend. I also strongly recommend you share these videos with your C-suite - especially if your organization does not have a Corporate Wellness Strategy in place at this time. Learn what to watch out for - and what you must start doing now - to implement a Physician Wellness Strategy while there's still time. This trend will play out over the next three or four years. It's inevitable. You can't fight father time and nobody's getting any younger. Every doctor needs to know what is coming. Watch these short outtakes from this week's Wellness Champion Summit Webinar https://lnkd.in/gFYckWS4 **You will learn** 👉 What is the Boomer Doc retirement cliff? 👉🏽 How bad is it? 👉🏿 Recent changes in female physician and medical student behavior make things much worse. 👉 How the answer to this one question to your CMO doubles the projected physician shortage of 2030. 👉 Does AI at the same time make things better or worse? 👉🏿 What your organization must do now to prepare. 👉🏽 Why I'm predicting a brief window of opportunity for a corporate Physician Wellness Strategy - but you must act now!

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A top down approach to tech adoption will never work in healthcare. While this approach may work in other industries where liability lies on the executive team, in healthcare liability more often rests with the clinician. At the end of the day we answer to the medical authorities which regulate our medical license. To be blunt, while painful its okay if I get fired because I do not adopt new technologies adopted by my institution. Its not okay and my entire medical career is in jeopardy if I do not follow the regulations set out by my provincial college of physician and surgeons. Part of which is to maintain the standard of care and follow a patient centric approach to healthcare. Technology adoption in healthcare requires a bottoms up approach to adoption. You need buy-in from clinicians and payors. Both are necessary and neither alone is sufficient. I realize I did not say you need buy-in from patients but I am assuming this is a given. #healthcare #technology #innovation #physician

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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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Technology in its current state is worsening the physician crisis. There seems to be a new referral pathway every month with unlimited check boxes and data for us to input. Each often requiring a new log in and at times two factor authentication. It seems with every new tech in healthcare we spend more time interacting with the tech and less time interacting with our patients. The solution is simple, if the tech in question results in decreased physician-patient time then it shouldn’t be rolled out. The one thing to keep in mind is say you’re rolling out a new patient intake form for referrals for MRIs to better triage patients. It’s important to think about the downstream effects of who will fill out this form and the time needed to do so. As a front line physician every new referral intake pathway increases my admin burden and endpoint burnout. In an ideal world I simple type “MRI lumbar spine” in my EMR and all the data is auto populated. Sadly this almost never happens. #primarycare #healthcare #familyphysician

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🚨 40% of Hospitals Are Losing Money! (Source: Kaufman Hall) 🚨 https://lnkd.in/eEenrkWG While many will shrug and say it is not a big deal because it is the smaller hospitals that are unprofitable, but the reality is much more significant. These hospitals often serve as the largest employers in their communities. When a rural hospital closes, it doesn't just impact healthcare; it devastates local businesses, the broader economy, and the health of that community. Moreover, the presence of a nearby hospital is a critical factor for businesses scouting new locations. Companies know they can't attract top talent if the nearest hospital is in the next county or town. Unfortunately, these hospitals are frequently overlooked by vendors, making it harder for them to thrive. At VantageHealth.ai (and our sister company CompliantHealth.com), we are committed to addressing these challenges. Our value-added solutions aim to move hospitals from red to black through improved revenue streams, reduced costs, increased compliance, and enhanced patient engagement. Let's work together to support these vital institutions and ensure they continue to serve their communities effectively. #Healthcare #RuralHealth #HospitalManagement #CommunityImpact #HealthcareInnovation

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Great to be on Morning Joe today talking about American Medical Association priorities to improve healthcare access, reduce physician burnout, improve sustainability of the Medicare program, deal with cyberattacks in healthcare, and navigate the promise of AI. As I arrive in the final weeks of my AMA presidency – a year on the road, a year meeting with physicians, a year of seeing and hearing about the challenges facing our health system – I see a system in crisis. The Change Healthcare cyberattack and ensuing reimbursement challenges could not have come at a worse time.   But we are years – and a confluence of preventable events – into what’s made it the worst possible time.   Physicians have known for some time that our Medicare payment system that reimburses physicians for the care we provide was failing – and this was creating severe financial stress for physicians in private practice, which are the backbone of our health care safety net, particularly in rural and underserved communities.   When you adjust for inflation, the payment rate to physicians who care for Medicare patients has dropped 29% since my first year of medical school in 2001!   Then there’s burnout, driven by onerous burdens like prior authorization. Consider that roughly two in three doctors admitted to experiencing burnout during the pandemic, according to a survey from the AMA, the Mayo Clinic and Stanford University School of Medicine. That’s the highest level of burnout ever recorded by the AMA! Consider that 1 in 5 physicians surveyed during the pandemic said they planned to leave medicine within the next 2 years, while 1 in 3 said they’d cut back on their hours. Consider that nearly half of all practicing physicians in the U.S. today are over age 55. Consider that foreign-trained physicians, called International Medical Graduates or IMGs, face enormous obstacles—such as immigration and green-card delays—to practice medicine in the U.S.   Consider that the average young doctor now leaves medical school more than $250,000 in debt, and that this heavy debt load has huge implications for our health system, often forcing aspiring physicians to bypass primary care and less populated, rural areas in favor of more lucrative specialties in or near large cities.   This is not sustainable. And I worry that health outcomes across the country will continue to decline unless we take the necessary steps today to bolster our physician workforce, reform our broken Medicare payment system, and create a sustainable model for health care that ensures access to care for all who need it – urban and rural alike.   So we must continue our quest to: ·       Maintain payment for digital health tools that work ·       Fix prior authorization to reduce delays for pts ·       Reduce physician burnout ·       Address the stigma around mental health ·       Reform Medicare payment to support seniors It’s time to rebuild, and the AMA is ready.

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Amazon's effect on physician consolidation Becker's Physician Leadership Review published this in early April- As physicians migrate to employed models and the healthcare industry consolidates, retail giant Amazon continues to double down on its focus on primary care and other physician specialties.  Amazon has 221 primary care offices in more than 20 markets. In February 2023, it finalized a $3.9 billion acquisition of virtual and in-person primary care company One Medical, which added more than 200 brick-and-mortar physicians offices and roughly 815,000 One Medical members. The One Medical deal has already "changed the landscape" of healthcare and altered the way hospitals do business, health system leaders told Becker's. "The acquisition of One Medical by Amazon should remove any lingering doubt that Amazon is serious about making a real and substantive move into healthcare as well as cementing the notion that any viable healthcare strategy must have at its foundation a robust primary care offering," Richard Zane, MD, chief innovation officer for Aurora, Colo.-based UCHealth, told Becker's.  Amazon has since launched One Medical for Prime, offering Amazon Prime members unlimited virtual visits for $9 a month. In January, Amazon Pharmacy integrated with One Medical to give patients and providers increased access to medication consultations. One Medical provides concierge primary care, with longer appointments and no wait times, as well as 24/7 virtual care for a yearly membership of $199 and has formed collaborations with 19 hospitals. The hybrid primary care company has specialty care referral agreements in the health systems' local markets.  The deals allow specialists from health systems to deliver care to Amazon's primary care patients.  Some of those health systems told Becker's in September the partnership improves access to primary care in their markets.  "This partnership with One Medical is a prime example of Mass General Brigham's commitment to working with world-class partners that complement our strengths," said Lynn Stofer, president of Mass General Brigham Community Physicians, part of the Somerville, Mass.-based health system. "One Medical offers a broad primary care network with tight connections to our entire team of Mass General Brigham specialists, providing outstanding services for our patients and increasing access to care at a time when demand continues to outpace supply." #healthcare #insurance #physicianleadership #disruptor #physicianshortage #ama

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Great new insight from our Pivotal Analytics team. We spend a lot of time preaching about the value of localized data and this infographic is great way to see that in action - demand for Cardiology varies a LOT on a market-to-market basis. Utilizing claims data as an input allows us to tailor insight to a local population, something we see far too few people doing on a regular basis - I continue to be surprised how many strategy leaders rely on demand intel driven by national benchmarks.

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Pssst, it’s not fee for service (ffs) that’s devastated American Healthcare access, outcomes or costs. The Bismarck Healthcare Modelused in several democratic capitalistic nations such as Germany, Japan, Switzerland and others enables private insured and private ffs manufactured medical care for all citizens at a fraction of the cost and with better outcomes and access than in America. Bismarck systems have more private hospitals and health insurers COMPETING per capita than in America. This is achieved simply by making health insurers profit-neutralized utilities instead of luxuries. Read about Bismarck: https://lnkd.in/ecUwsHWP

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Arlen Meyers, MD, MBA insights on #physician #innovation and #entrepreneurship are among the clearest and most impactful I’ve encountered. He lays out a sober assessment of the current state of physicians’ role in improving heathcare, challenges we encounter to leading transformation, as well as providing solution frameworks and education on these topics. Follow his LinkedIn posts here, dive deeper in his Substack, join the Society of Physician Entrepreneurs (SoPE), and check out his book, Digital Health Entrepreneurship. https://lnkd.in/geeAYKDq

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The Optimal Work Comp Solutions Panel of Physician Specialists.  The best of the best at your service!  Print out our sheet to refer to at your convenience. Venakata Bodavula, MD Jasen Gilley, MD Patricia Hurford, MD, MS Chris Kostman, MD #owcsplus #orthopedics #orthopedicsurgery #workcomp #workerscompensation #stlouis #shouldersurgery #kneesurgery #performanceorthopedics"          #handsurgery #hipor #painmanagement #physicalmedicine #functionalmedicine #injections

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Addressing the Nuances of Healthcare Models The shift from fee-for-service to value-based care models in orthopedic surgery is a topic of considerable discussion. While acknowledging the merits of value-based care, it's essential to confront the challenges inherent in this transition. Many hospitals maintain fee-for-service contracts with insurers, where physicians are compensated based on service volume. This setup, often tied to metrics like 'relative value units' (RVUs), can potentially influence decision-making, possibly leading to unnecessary procedures. However, the transition to value-based care is not simple. Practices may find themselves navigating a landscape where they must balance value-based initiatives with revenue generation from fee-for-service arrangements. Yet, it's critical to approach this shift with caution. While advocating for value-based care, we must recognize the complexity of each patient's case, avoiding oversimplification. Every individual presents a unique set of circumstances, challenging us to determine the most appropriate course of action. In summary, the journey towards value-based care requires a nuanced approach, one that acknowledges the realities of fee-for-service while embracing the principles of quality-driven healthcare. As we navigate this terrain, let's remain steadfast in our commitment to patient well-being and the pursuit of excellence. #OrthopedicSurgery #HealthcareModels #ValueBasedCare #MedicalInsights

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Robin Goldsmith thanks so much for having Sameer Berry, MD, MBA on your show to talk about Oshi Health and our innovative care for #digestivehealth conditions. Such a great conversation around the challenges in #gastroenterology and how new care models like ours address them in ways that are a win for all stakeholders. #valuebasedcare #accountablecare #wholepersoncare

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I’ve seen a lot of buzz about how AI will change the nature of patient-provider relationships — and is this a good thing or a bad thing? Here’s the thing. AI should EMPOWER the patient-provider relationship — and support the development of trust between patients and providers. Example 👇 At the bedside, clinicians can partner with their patients face-to-face. But even then, various factors present significant challenges to cultivating trust. For instance, one survey conducted by PatientPoint found that half of Americans are afraid to ask their healthcare providers questions about conditions and symptoms. So how do healthcare professionals extend these relationships beyond the hospital? Chatbots can seem sterile in their automated responses, but the right AI-backed technology can use natural language processing (NLP) to communicate with patients at a human level. AI can help interpret and respond to patient questions and concerns, and flag the right care team member when more assistance is needed. AI should empower a trusting patient-provider relationship. Not replace it.

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“The cross-setting Discharge Function Score (DC Function) measure determines how successful each HHA is at achieving or exceeding an expected level of functional ability for its patients at discharge.” -CMS Attention Home Health Agencies, NOW is the time to train/ re-train your clinicians! 2024 performance impacts your 2026 payment. The DFS will be public on Care Compare come January 2025 and replaces the Total Normalized Composite measure for Value Based Purchasing. If you haven’t reviewed it yet, take a glance at the DFS (Discharge Function Score) in your IQIES. Discharge Function Score (also known as the GG questions) will carry 20% weight of risk adjustment. Again, now is the time to train/ re-train your clinicians! It’s never too late! Takeaways: 💫M questions will remain at least throughout 2025 💫GG DC goals set at SOC/ROC (column 2) will be removed (yay!) 💫A DC Function Score will have a risk adjustment model that will predict an expected DFS, this is then going to be used to compare against the actual result of care at time of DC. 💫Questions answered with “dash”, “skip” or “Not Assessed” will be assigned a statistical imputation value! 🤯 This makes it that much more important to answer every question, think back to your ACT days. It’s best for the clinician to assess and add a relevant value than allow CMS to dictate that value for you. How confident are your clinicians with M/ GG questions? Can they spot the difference between two similar questions? It starts at the beginning, if your clinician answers incorrectly at SOC/ROC, that TCS (true clinical significance) of improvement is not accounted for. 💰 and ⭐️ are left on table. Do you have questions regarding DFS or need training, send me a message! Teaching and educating is our passion. We want every clinician on your team to have confidence in their assessments and see your agency achieve AND exceed an expected level of functional ability for your patients at discharge.

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How can we build the right infrastructure to support remote patient monitoring (RPM) for all kinds of patients in all kinds of settings? Check out this new paper in NEJM Catalyst by recent medical school graduate, Nina Singh, MD on why and how to create the core capabilities within a health system , taking a different, more scalable approach -- "the focus is on building tools and workflows for practices that are interested in using RPM rather than on building centralized RPM programs for specific high-need populations." Practical tips include a #playbook for RPM and much more: "Exploratory features include a playbook detailing best practices for RPM use across NYULH, a device loaner program, direct Bluetooth pairing (as opposed to Bluetooth syncing and transmission of data through data aggregator pathways), systematic offboarding workflows for inactive or stable patients, and small centralized programs being developed among groups of practices with similar patient populations and needs (e.g., primary care faculty group practices managing hypertension). Super proud of Dr Singh's work during her year off with Nader Mherabi and others in informatics at NYULANGONEMEDICALCENTER. She's heading to University of California, San Francisco Department of Medicine to start her internship--what a star! Talmadge E. King, Jr. MD Robert Wachter Atul Butte https://lnkd.in/e-VpGie7

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