Chip Neuman

Join the conversation! Our team is facilitating the strategy task force of a hospital client in Washington State this week. We're analyzing surveys, focus groups, market, and organizational data to develop a strategic plan framework for the next three years. What are your favorite and least favorite strategic working session activities? Do you hate ice breakers? Love SWOT analysis? Share your thoughts! #strategicplanning #healthcare #hospital #WashingtonStateHospitals #taskforce #dataanalysis

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Over the past five years, Blue Shield has developed new payment models in collaboration with provider and hospital partners to bring better value into the health care market and bend the cost of health care trend. With 56% of our healthcare spend now in a pay-for-value model, we're empowering health through value, not volume. This shift is crucial as we continue to address the unsustainable rise in healthcare costs.    Our innovative payment models, such as Primary Care Reimagined and the Accountable Care Alliance, are designed to support providers in delivering quality care at lower costs while improving both member and provider experiences. This year alone, we've seen a 7.4% reduction in overall healthcare costs from our prevention-focused model.    Read more about our journey and the impact we're making. #ValueBasedCare #WellAhead

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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.

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Cue Health, a venture-backed diagnostic company based in San Diego, CA, previously valued at $2.3 billion, has announced another round of layoffs, affecting approximately half of its remaining workforce. This news comes on the heals of the founding CEO’s recent departure. Despite its earlier success supplying COVID-19 tests to major organizations, Cue has struggled to maintain profitability, reporting significant losses in recent years. Click here to read more: https://bit.ly/3Wv3777 #layoffs #venturecapital #privateequity #ASCO24 #deerbornedifference

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I'm excited to share what one of my clients (UCI Health) is doing to enhance patient experience by boosting communication between doctors and nurses. NRC Health's new article covers their journey and key takeaways. Plus, catch the full webcast on-demand for more details. Read and watch at the link below! #HumanUnderstading #PatientExperience

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In this blog post written for Health Tech Idaho by Jason Hudson, Rourke Yeakley, MD and I break down in simple, easy to understand principles of why we need to switch away from historical #feeforservice healthcare billing and care delivery. Enjoy!

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Steal this idea: Sharp CEO on improving your health system's culture: Where staffing levels and morale are low and burnout remains high at certain hospitals and health systems in the post-pandemic world, San Diego-based Sharp HealthCare is working to strengthen personal care for employees by improving upon a more than 20-year-old philosophy at the health system, The Sharp Experience. http://dlvr.it/T9TFvy

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This is what Tegria does and this is how we can help partner to achieve your goals. #clinicaldecisionsupport

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Excited that Becker's Healthcare will air its “CEO + CFO Virtual Forum tomorrow and our panel’s discussion titled, “Hospital Financial Strategy Reboot: How to Proceed as Healthcare Exits the Hospital.” As I noted, UC Davis Health is optimizing the most effective and wise ways to balance care for inpatient, outpatient and at-home contexts, while always putting our patients at the center of everything we do.   https://lnkd.in/ebbkH4Ws

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I recently attended the Driving Health Equity Seminar in Burbank hosted by California Association of Health Plans. It was enlightening to hear health plans, providers, and vendors from across California share insights on different strategies to address health equity throughout the state – a topic that is at the forefront of healthcare. Here are a few interesting threads that came out of the seminar: Data standards to measure health equity - Beginning in 2024, the Department of Managed Health Care (DMHC) has required health plans to report on health equity and quality measures. It was interesting to hear about some of the challenges associated with data collection and standardization, many of which centered on the quality of reported data and self-attestation information. One strategy proposed to combat this is to have trusted providers in the community collect the information versus a health plan representative who does not have a relationship with the patient. Transgender, Gender Diverse, or Intersex (TGI) Working Group - The DMHC established the TGI Working Group to create quality standards for patient experiences and measure cultural competency for the TGI community. This involves developing a trans-inclusive training curriculum for healthcare plan staff who directly serve TGI members. DMHC highlights barriers to receiving gender-affirming care, such as the "transgender broken arm syndrome," where providers may lack formal hormone therapy training and hastily refer patients to endocrinologists due to uncertainty. Additionally, the TGI Working Group is setting standards for collecting Sexual Orientation, Gender Identity, Gender Expression, and Sexual Characteristics (SOGIESC) data. Maternal Health Outcomes - Medi-Cal managed care plans are combating maternal health disparities among women of color by employing strategies like expanding the workforce to include community health workers and doulas, as well as fostering community partnerships. For instance, in LA County, a successful pilot program offering free doula services for Medicaid members has become a permanent benefit. However, the current fee schedule poses sustainability challenges for many doulas. To address this, there's a proposal to establish Hubs for administrative oversight, ensuring doulas receive fair reimbursement for their services. Chief Health Equity Officers (CHEO) - An insightful panel featured CHEOs from various Health Plans and Health Systems. One highlight was the discussion led by a panelist from Kern Health System, who outlined strategies for addressing health disparities in rural communities. Kern Health System's approach includes establishing Regional Access Committees (RACs) with member engagement representatives from different regions, fostering trust and enabling better connection of members to services. The session also underscored the significance of partnering with Community-Based Organizations (CBOs) that have established trust within their communities.

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10 years ago, I had the honor of being a part of a small team charged with reimagining how a community hospital could be resurrected to serve the South LA population long known to be under-served and under-resourced with respect to its healthcare needs Since then, much progress has been made. And in many ways due to its success, much is still left undone. Primary care access, while underfunded and inaccessible in many communities like South LA, specialty care is equally unpredictable, inaccessible and under-resourced- if not moreso. What results? As a urologist who staffs two of the busiest hospital EDs in the country, we routinely see patients whose presentation is merely to "see a specialist." 60% of patients referred to a specialist never see one! The implications: we have grown so untrustworthy as a healthcare system when servicing medicaid populations that patients and clinicians alike resign to leveraging the ED for routine primary and almost all of their specialty care needs. This has to change. The elderly man with newly diagnosed prostate cancer, the recently discharged young women with a painful, untreated kidney stone, or construction worker who required an emergent bladder repair of a complication of surgery all of who could not "find a urologist" or whose primary care doctor resorts to "sending them to the ED" for tests they struggle to obtain through the patient's medicaid plan are clearly not being served well by our current system. Hence is why we started over 5 years ago HubMD (hubmd.org) and Afya (afyaglobal.com) to begin creating a better way- a responsive and intentional approach to caring for the least among us through ambulatory triage with eConsults, expanding access with virtual visits and coordinating patients care through transitions be it from clinic, hospital, ED, urgent care, psychiatric or correctional facility. We now conduct >6,000 eConsults per month and coordinate care for a growing number of patients specialty care needs. 10 years from now, I hope to not have the type of ED consults I see today. It will take persistent, collective, and strategic effort to create the change we need.

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"Our expenses, including supplies and labor costs, continue to outpace increases in revenue," Don’t get pushed in a position where you have to let good people go because your suppliers are over charging your orginization. Impensa® can help your supply chain team manage your supplier relationships, contracts, and identify revenue leakage. https://lnkd.in/ghA3Yqmg

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Not fair and balanced Advertorial for Private Equity A total conflict of interest Immoral to destroy healthcare for opportunity to work for companies that profit on ultimately destroying USA 🇺🇸 healthcare as we knew it. People that worked for CMS should be banned from working in industries that profited from the decisions and have connections for future decisions to destroy the healthcare fabric No discussion of the negatives only the positives Consolidation leads to fewer choices for patients The cons for patients outweigh the pros for the investors. Profits over care ultimately leads to rationing of the care that is not profitable Management of PE selects doctors to interface that benefit from a hard line approach over providers that see quality issues and patient safety as important Cheerleaders 📣 for the profiteers

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Key Strategic Insights = A Successful OP CDI Program The challenge of value-based care starts with a collaborative approach, when launching an Outpatient Clinical Documentation Integrity (OP CDI) program. Here are some key strategic insights to success: 1. Engage with Population Health Understand Pain Points: Begin by understanding the specific challenges faced. This fosters collaboration. Tailored Questions: Use customized questions to facilitate productive discussions and ensure alignment with needs. 2. Effective Software Implementation Manage Patient (Pt.) Volumes: Implement software solutions to efficiently handle pt. volumes. OP CDI Calculator: Utilize a calculator to determine Full-Time Equivalent (FTE) needs. Data Analytics and Reporting: Emphasize the importance of continuous improvement via data analytics. 3. Workflow Creation Establish Robust Workflows: Create strong workflows before integrating reviewers. 4. Collaboration & Communication Promote Strong Collaboration: Encourage robust communication between key stakeholders. Leverage Software: Use technology to reduce physician burnout & streamline communication. 5. Patient-Centered Approach Address social determinants of health (SDOH) & ensure accurate documentation of conditions and care plans. Patient Outcomes: Keep patient care at the center of all doc. & workflow processes. 6. Regulatory Compliance Adhere to Guidelines: Follow regulatory requirements such as CMS guidelines on Hierarchical Condition Categories (HCC) coding to avoid penalties and enhance credibility. 7. Measurable Outcomes Set Clear Goals: Aim for measurable outcomes like improved HCC recapture rates, enhanced RAF scores, better HEDIS measures, and addressing SDOH needs. 8. Stakeholder Engagement Involve All Stakeholders: Ensure that executives, clinicians, and other relevant parties are involved in planning and implementation process. Success Stories Recently, I helped several CDI directors validate their cases for OP CDI programs within Accountable Care Organizations (ACOs). By engaging with population health leadership, we identified key issues such as RAF gaps and HEDIS measures, and tailored processes to address them. For instance, a CDI director I guided successfully identified HCC and HEDIS recapture as their biggest pain points. With strategic solutions in place, they are now ready to implement the project for the 2025 budget yr., aiming to improve their HCC recapture rate by 20%, leveraging data analytics for outcomes and improvement needs. Benefits of Implementing These Strategies Align Risk Stratification: Properly align risk stratification with chronic conditions and healthcare needs. Quality Measures: Improve quality measures and address SDOH. Collaborative Team: Ensure success with a collaborative team supported by technology. Overall, these strategic actions will enhance patient care and operational efficiency. #Healthcare #Leadership #CDI #PatientCare #ValueBasedCare #HealthcareInnovation

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In a move to streamline care, LA Care Health Plan which managed Medi-Cal and several other plans for low-income Californians is cutting back 24% of its prior authorization requirements. "This change aims to reduce administrative burdens and speed up patient access to necessary treatments," the article explains. This is good to see. Could significantly benefit patient care by removing unnecessary delays in treatment approvals. Devil is in the details but still good progress, particularly for the most vulnerable. Check out the article by Nona Tepper in Modern Healthcare at https://lnkd.in/evVP3eqP

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Advantus Health Partners strategic partnerships surpass other national GPOs. Teaming up with Alliant Purchasing introduces an unprecedented solution to the market, revolutionizing healthcare supply chain solutions. Our partnership with Alliant highlights critical contracts in the surgical implant portfolio, offering unique advantages for GPO members and vendors. Additionally, we provide comprehensive purchased service agreements for activation, delivering programmatic value to hospitals, health systems, and vendor partners. Since our collaboration, member hospitals have enjoyed savings ranging from seven to 21%, a significant achievement amid ongoing financial pressures in healthcare. At Advantus, we strategically manage the supply chain, focusing on sustained value in surgical implants, cost reductions, and reliability. Like the Costco model, we prioritize reputable brands to drive standardization, enhance clinical care, and reduce expenses. #HealthCareInnovation #AdvantusAlliantPartnership #SupplyChainTransformation Learn more: https://lnkd.in/eMs9REYw

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📢 Excited to share insights from the California Association of Health Plans seminar; CalAIM: What's Next for Enhanced Care Management & Community Supports 🌟 Attending this seminar series has been a game-changer, providing a deep dive into the innovative strategies driving enhanced care management and community support in California. Key takeaways include: 1. **Integration of Care**: Emphasizing a holistic approach to patient care, bridging healthcare and social services. 2. **Community-Centric Solutions**: Leveraging local resources to meet the unique needs of diverse populations. 3. **Data-Driven Decisions**: Utilizing advanced analytics to improve outcomes and streamline services. 4. **Collaborative Efforts**: Strengthening partnerships among healthcare providers, community organizations, and policy makers. Feeling inspired and equipped with new knowledge to drive positive change in healthcare! 💡 Looking forward to integrating these insights into our new HXI focused initiatives at #mPulse and contributing to healthier, more supportive communities in CA. #CalAIM #HealthcareInnovation #CommunitySupport #EnhancedCareManagement #CaliforniaHealth

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👀 👀 👀 L.A. Care Health Plan, the largest public health plan in the nation, serving nearly 3 million people in Los Angeles County, made a major move today... nixing nearly a quarter of its prior authorization requirements. CEO John Baackes said the change is aimed at reducing administrative burdens for providers, shortening discharge times and avoiding care delays. Read more about it here in reporting out today from Hayley DeSilva for Modern Healthcare. #Medicaid #Medicare #priorauthorization #PriorAuth #managedcare

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